So, things went so well at the appointment with the doc that I'm thinknig about cancelling the other appointment. I mean, what are hey going to tell me that the first doc didn't already tell me?
I like this doc's more aggresive style. AND, my biggest concern about this doc was that because he was a smaller outfit that their embryologist wouldn't be able to do the day 5 blastoderm biopsy that I would want to do for the PGS. (There's a whole school of thought on what day to take out a cell to run the testing on it. Here: http://www.genesisgenetics.org/pgs.html if you want to read all the studies. Personally, I found them fascinating, but I'm wierd like that.)
What it comes down to is that there's a certain amount of mosaicism that naturally occurs in splitting embryos. Mosaicism is when the egg has one cell that split incorrectly, but all the others are normal. The egg does a pretty good job of pushing the bad splitter to the side and continuing to develop the baby from the good splitters. From the outside, you can't tell which eggs have split chromosonally well and which haven't. So, the embryologist will take out one cell from a 3 day embryo (there are only 8 cells at this point, so the embryo can only afford one) and 2-3 cells from a 5 day blastocyst (which has over 100 cells at this point). And, the embryologist can take the cells from the trophectoderm which is the part of the cell that will become the placenta.
So, then the lab can look at those 2-3 cells and decide if there is mosaicism present and we can make a judgement call at that point. Also, if they happen to take the day 3 cell that has the "bad" mosaicism, the whole embryo will be graded as bad. Whereas if you wait, the embryo may have stopped dividing that cell and all the other cells are normal and you'll only get normal cells at day 5.
BTW, studies show that about 1/3 of embryos have some mosaicism.
But, the point of all this is, is I asked the doc how he felt about the ability of his embryologist to do a blastomere biopsy and he stated, "Frankly, we'd have the lab come out and do the biopsy. They're more experienced and there the ones taking responsibility for the cells. They like it that way." And, so do I! I'm always super impressed with someone who can see their own limitations and find a way around it. So, right now I see no reason why we wouldn't go with this doc.