{"version":"1.0.0","segments":[{"startTime":1.295,"endTime":4.195,"body":"Today we talk about embryoth"},{"startTime":4.975,"endTime":7.895,"body":"why having abnormal embryos doesn't mean you're at"},{"startTime":7.935,"endTime":10.751,"body":"high risk of having a baby with a chromosomal"},{"startTime":10.783,"endTime":13.591,"body":"disorder. I'm Dr. Mark"},{"startTime":13.623,"endTime":16.527,"body":"Amols and this is"},{"startTime":16.591,"endTime":18.995,"body":"Taco about Fertility Tuesday."},{"startTime":30.835,"endTime":33.515,"body":"Today we talk about the difference between having"},{"startTime":33.635,"endTime":36.563,"body":"abnormal embryos from PGT and the"},{"startTime":36.619,"endTime":39.211,"body":"actual risk of having a child with a chromosomal"},{"startTime":39.243,"endTime":42.011,"body":"disorder. Just because you see a lot of"},{"startTime":42.043,"endTime":44.851,"body":"abnormal results doesn't mean the odds of having"},{"startTime":44.963,"endTime":47.947,"body":"an affected baby are high. In fact,"},{"startTime":48.131,"endTime":50.707,"body":"most anapoidia embryos won't even make it to"},{"startTime":50.731,"endTime":53.299,"body":"implantation. Let's break down the real"},{"startTime":53.347,"endTime":56.027,"body":"numbers and what they mean for your chances"},{"startTime":56.171,"endTime":59.171,"body":"of success. So what am I talking about?"},{"startTime":59.323,"endTime":61.803,"body":"Well, sometimes when you go through"},{"startTime":61.819,"endTime":64.363,"body":"IVF and you get your PGT results"},{"startTime":64.419,"endTime":67.115,"body":"back, you end up having a lot of"},{"startTime":67.155,"endTime":68.815,"body":"abnormal embryos."},{"startTime":69.675,"endTime":72.131,"body":"And the thing that you start thinking is,"},{"startTime":72.323,"endTime":75.043,"body":"if all these embryos are abnormal,"},{"startTime":75.139,"endTime":77.827,"body":"does this mean I've been dodging bullets my whole life"},{"startTime":78.011,"endTime":80.827,"body":"and I've had a chance of potentially having a baby with"},{"startTime":80.851,"endTime":83.289,"body":"down syndrome or some type of other chromosomal"},{"startTime":83.427,"endTime":85.861,"body":"abnormality? And the answer is"},{"startTime":86.013,"endTime":88.813,"body":"no. And this is because most"},{"startTime":88.909,"endTime":91.909,"body":"of the embryos that are abnormal m are never even going"},{"startTime":91.917,"endTime":94.621,"body":"to make the implantation. And if they do,"},{"startTime":94.773,"endTime":97.545,"body":"they likely are going to end in the miscarriage."},{"startTime":98.205,"endTime":100.465,"body":"Let's talk about a specific sample."},{"startTime":101.005,"endTime":103.837,"body":"Let's say you are 41 to 42"},{"startTime":103.861,"endTime":106.685,"body":"years of age. Your aneemloidy rate"},{"startTime":106.805,"endTime":109.505,"body":"would be around 85%, meaning"},{"startTime":109.955,"endTime":112.691,"body":"85% of the"},{"startTime":112.763,"endTime":115.215,"body":"eggs are going to be genetically abnormal."},{"startTime":116.155,"endTime":119.003,"body":"Now what's interesting is though, if you look at"},{"startTime":119.139,"endTime":121.835,"body":"the chances of having a baby with down"},{"startTime":121.875,"endTime":124.579,"body":"syndrome, Even at age 42, your"},{"startTime":124.627,"endTime":127.491,"body":"chances are only 1 in 50 that you will have a"},{"startTime":127.523,"endTime":130.515,"body":"child with down syndrome. And this is true for"},{"startTime":130.595,"endTime":132.987,"body":"pretty much all age groups. For"},{"startTime":133.011,"endTime":135.717,"body":"example, if you're under 30 years of"},{"startTime":135.741,"endTime":138.405,"body":"age, you know that the unemployed risk"},{"startTime":138.525,"endTime":141.237,"body":"is going to be very low. It could even be as low as"},{"startTime":141.341,"endTime":144.237,"body":"20, 25%. But that would scare me"},{"startTime":144.301,"endTime":146.781,"body":"if I thought I had a 25%"},{"startTime":146.853,"endTime":149.821,"body":"chance of having a child with down syndrome or"},{"startTime":149.853,"endTime":152.597,"body":"some chromosomal problem. However, in"},{"startTime":152.621,"endTime":154.917,"body":"reality I only have a 1 in"},{"startTime":154.981,"endTime":157.957,"body":"1,000 chance of having a child with"},{"startTime":157.981,"endTime":160.405,"body":"down syndrome. And if I look at all"},{"startTime":160.445,"endTime":163.099,"body":"cromosomal disorders, not even down syndrome,"},{"startTime":163.277,"endTime":166.183,"body":"it'only 1 in 200. Now, just in"},{"startTime":166.199,"endTime":168.951,"body":"case you're curious, for the different age groups, the risk of down"},{"startTime":168.983,"endTime":171.543,"body":"syndrome is about 1 in 1,000. For"},{"startTime":171.639,"endTime":174.199,"body":"people under 30, about 1 in"},{"startTime":174.247,"endTime":177.247,"body":"700. Between about 30 and 35, about 1"},{"startTime":177.271,"endTime":179.727,"body":"in 250. Once you hit about 35 to"},{"startTime":179.751,"endTime":182.647,"body":"37 by 38 to 40 it's about"},{"startTime":182.671,"endTime":185.647,"body":"1 in 141 to 42, about 1"},{"startTime":185.671,"endTime":188.439,"body":"in 50. And when you get to 43 in above,"},{"startTime":188.487,"endTime":191.003,"body":"it's about 1 in 25. Matter of fact,"},{"startTime":191.139,"endTime":193.455,"body":"even at age 45,"},{"startTime":193.835,"endTime":196.691,"body":"about 1 in 10 will have a risk of"},{"startTime":196.723,"endTime":199.555,"body":"down syndrome. That means you still have a 90% chance"},{"startTime":199.595,"endTime":202.427,"body":"of having a healthy pregnancy. The"},{"startTime":202.451,"endTime":205.051,"body":"point is you dont have to be scared"},{"startTime":205.203,"endTime":207.963,"body":"about having kids naturally. I run into this all the"},{"startTime":207.979,"endTime":210.652,"body":"time. Ill patients be so shocked"},{"startTime":210.828,"endTime":213.796,"body":"by having abnormal embryos that they willl say"},{"startTime":213.82,"endTime":216.792,"body":"to me is it even safe for us to keep trying on our own? And I"},{"startTime":216.808,"endTime":219.084,"body":"have to remind them absolutely."},{"startTime":219.864,"endTime":222.608,"body":"Let's say for example we took 100"},{"startTime":222.656,"endTime":225.464,"body":"embryos that had down syrome. So these are"},{"startTime":225.504,"endTime":228.304,"body":"PGT tested embryos. We know they have down"},{"startTime":228.344,"endTime":231.304,"body":"syndrome and then we put them into patients."},{"startTime":231.464,"endTime":234.2,"body":"The question is how many of them"},{"startTime":234.272,"endTime":236.632,"body":"would actually lead to a live"},{"startTime":236.688,"endTime":239.584,"body":"birth? Well, surprisingly only"},{"startTime":239.624,"endTime":242.516,"body":"about two of them. So as"},{"startTime":242.54,"endTime":245.38,"body":"you can see, the chances are very few"},{"startTime":245.412,"endTime":248.244,"body":"will make it there. Even though that sounds very scary putting back those"},{"startTime":248.284,"endTime":250.916,"body":"embryos, most will not make it"},{"startTime":250.94,"endTime":253.724,"body":"there. There was even a study where they actually"},{"startTime":253.764,"endTime":256.544,"body":"went and they had people go through PGT testing"},{"startTime":256.884,"endTime":259.812,"body":"and they put back the embryos into everyone. They didn't tell them what"},{"startTime":259.828,"endTime":262.588,"body":"the results were. And then after the"},{"startTime":262.636,"endTime":265.62,"body":"fact they went back and they unblinded it to find"},{"startTime":265.652,"endTime":268.53,"body":"out who ended up getting pregnant,"},{"startTime":268.652,"endTime":271.534,"body":"who didn't and what was the quality of those"},{"startTime":271.574,"endTime":273.958,"body":"embryos when it comes to anaploy"},{"startTime":274.006,"endTime":276.674,"body":"status. And what they found is"},{"startTime":277.174,"endTime":280.062,"body":"no one had a live birth with"},{"startTime":280.078,"endTime":282.934,"body":"an embryo that came from an employy"},{"startTime":282.974,"endTime":285.846,"body":"status from the PGT results. So"},{"startTime":285.87,"endTime":288.79,"body":"this should make you feel pretty good that even if you're"},{"startTime":288.822,"endTime":291.35,"body":"not doing testing, you don't have to worry so"},{"startTime":291.382,"endTime":293.814,"body":"much about having a child with a chromosomal"},{"startTime":293.854,"endTime":296.524,"body":"problem. Yes, by testing them you do"},{"startTime":296.564,"endTime":299.436,"body":"reduce that risk. But the point is even when"},{"startTime":299.46,"endTime":302.436,"body":"they are abnormal, they usually will not make it to"},{"startTime":302.46,"endTime":305.26,"body":"a live birth. So let's talk about that a little bit"},{"startTime":305.292,"endTime":307.612,"body":"more. There are several reasons"},{"startTime":307.708,"endTime":310.38,"body":"why anemlanted embryos do not lead to a live"},{"startTime":310.412,"endTime":313.332,"body":"birth. There are basically biological"},{"startTime":313.388,"endTime":316.38,"body":"barriers that prevent them from developing successfully."},{"startTime":316.572,"endTime":318.852,"body":"One of the first ones is can be failure to"},{"startTime":318.868,"endTime":321.776,"body":"implant due to"},{"startTime":321.8,"endTime":324.68,"body":"the genetic imbalances that disrupt the normal"},{"startTime":324.712,"endTime":327.324,"body":"cell division in early embry development."},{"startTime":327.744,"endTime":330.032,"body":"And thelated embryos have a much lower chance of"},{"startTime":330.048,"endTime":332.912,"body":"implanting. Many of them will not progress past the"},{"startTime":332.928,"endTime":335.744,"body":"point ofB Blastocys stage and will not keep"},{"startTime":335.784,"endTime":338.752,"body":"growing. So for many patients they won't even get"},{"startTime":338.768,"endTime":341.432,"body":"a positive pregnancy test. Now clearly,"},{"startTime":341.608,"endTime":344.488,"body":"having abnormal chromosomes doesn't make the"},{"startTime":344.496,"endTime":347.358,"body":"embrya just stop growing all the time, because if they made it"},{"startTime":347.366,"endTime":350.27,"body":"a blastocyst, clearly they can be abnormal and still keep"},{"startTime":350.302,"endTime":353.246,"body":"going a little bit of a distance. And that depends"},{"startTime":353.31,"endTime":356.046,"body":"where the chromosomal problem is. If the"},{"startTime":356.07,"endTime":358.942,"body":"chromosomal problem, let's say, is in the beginning"},{"startTime":359.118,"endTime":361.526,"body":"of the DNA, when a lot of the cells are"},{"startTime":361.55,"endTime":363.894,"body":"dividing, then it's going to stall"},{"startTime":364.014,"endTime":366.99,"body":"early and it's not going to implant. But"},{"startTime":367.022,"endTime":369.926,"body":"what if the DNA was abnormal later in"},{"startTime":369.95,"endTime":372.646,"body":"the DNA, maybe past the point of this"},{"startTime":372.67,"endTime":375.074,"body":"division, when you start getting into things like"},{"startTime":375.234,"endTime":378.218,"body":"developing organs? Well, then in that"},{"startTime":378.266,"endTime":381.17,"body":"situation, it may implant, but it may lead"},{"startTime":381.202,"endTime":384.014,"body":"to an early pregnancy loss, such as a miscarriage,"},{"startTime":384.314,"endTime":386.97,"body":"because the body is going to recognize that the chromosomal"},{"startTime":387.002,"endTime":389.962,"body":"abnormalies are going to lead to"},{"startTime":390.058,"endTime":393.026,"body":"defects in the embryo. And those defects are either going to cause"},{"startTime":393.05,"endTime":396.042,"body":"the embryo to succumb to that, or the body will,"},{"startTime":396.178,"endTime":399.17,"body":"at that point, stop the pregnancy. So"},{"startTime":399.202,"endTime":402.064,"body":"in the situation where, let's say there are"},{"startTime":402.224,"endTime":404.936,"body":"minor problems in the chromosomes and the embryo"},{"startTime":404.96,"endTime":407.736,"body":"implts but it then stalls,"},{"startTime":407.88,"endTime":410.88,"body":"the body will realize that the embryo is not growing anymore"},{"startTime":411.032,"endTime":412.804,"body":"and will then pass the embryo"},{"startTime":413.504,"endTime":416.464,"body":"through a miscarriage. Now,"},{"startTime":416.544,"endTime":419.112,"body":"even further along, there could be some type of developmental"},{"startTime":419.168,"endTime":421.896,"body":"arrest. For example, let's say when the heart is being"},{"startTime":421.96,"endTime":424.216,"body":"developed and maybe the chromosomal"},{"startTime":424.36,"endTime":426.36,"body":"abnormalies are causing the heart to develop"},{"startTime":426.432,"endTime":429.424,"body":"abnormal, that can then lead the baby to"},{"startTime":429.464,"endTime":432.016,"body":"pass, because the heart cannot support the"},{"startTime":432.04,"endTime":434.464,"body":"embryo at that point, you can get a later"},{"startTime":434.504,"endTime":437.232,"body":"miscarriage. Some of these chromosomal"},{"startTime":437.288,"endTime":439.896,"body":"abnormalies can disrupt the formation of things like the"},{"startTime":439.92,"endTime":442.736,"body":"placenta, not just the heart. And that"},{"startTime":442.8,"endTime":445.616,"body":"can then lead to problems that"},{"startTime":445.64,"endTime":448.464,"body":"affect the developing embryo. And then the last"},{"startTime":448.504,"endTime":451.368,"body":"thing is going to be things like lethal genetic disorders."},{"startTime":451.496,"endTime":454.326,"body":"So these are going to be things that prevent a pregnancy from"},{"startTime":454.35,"endTime":456.926,"body":"being viable. These are the things like"},{"startTime":457.11,"endTime":459.691,"body":"any chromosome disorder, other than like 13,"},{"startTime":459.819,"endTime":462.606,"body":"18, 21 and Turner's syndrome."},{"startTime":462.71,"endTime":465.63,"body":"And that's because most of these chromosomal disorders are not compatible"},{"startTime":465.662,"endTime":468.294,"body":"with life. And so again, they won't make it"},{"startTime":468.454,"endTime":471.35,"body":"to a live birth. Now, what's interesting is"},{"startTime":471.542,"endTime":474.31,"body":"some types of chromosomal disorders have a"},{"startTime":474.342,"endTime":477.142,"body":"better chance at a live birth than others. For"},{"startTime":477.158,"endTime":479.874,"body":"example, Klinefelter syndrome,"},{"startTime":480.194,"endTime":482.482,"body":"most of the embryos will end in the"},{"startTime":482.498,"endTime":485.298,"body":"miscarriage, but it will have the highest chances"},{"startTime":485.386,"endTime":488.294,"body":"of a live birth if you put back embryos,"},{"startTime":488.714,"endTime":491.362,"body":"just like down syndrome has a very"},{"startTime":491.418,"endTime":494.106,"body":"high liveirth rate compared to other"},{"startTime":494.13,"endTime":496.49,"body":"chromosome disorders. So, for"},{"startTime":496.522,"endTime":499.234,"body":"example, if you put back a"},{"startTime":499.354,"endTime":502.174,"body":"hundred embryos with klelinefters,"},{"startTime":502.554,"endTime":505.546,"body":"unlike down syndrome, which would have two live"},{"startTime":505.57,"endTime":508.548,"body":"BIR per 100 embryos, you would actually get closer to"},{"startTime":508.596,"endTime":511.42,"body":"six. And thats because it has a"},{"startTime":511.452,"endTime":513.704,"body":"higher chance of resulting in a live birth."},{"startTime":514.324,"endTime":517.14,"body":"But other chromosomal disorders, such as"},{"startTime":517.252,"endTime":520.052,"body":"Turner syndrome, you would not even"},{"startTime":520.108,"endTime":522.42,"body":"expect one live birth per 100"},{"startTime":522.452,"endTime":524.844,"body":"embryos. It would take about"},{"startTime":524.924,"endTime":527.796,"body":"500 embryos with Turner syndrome"},{"startTime":527.9,"endTime":530.812,"body":"to get one live birth. If"},{"startTime":530.828,"endTime":533.784,"body":"you put back embryos with trisomy 13,"},{"startTime":534.754,"endTime":537.746,"body":"you would take 400"},{"startTime":537.93,"endTime":540.386,"body":"embryos to get one live"},{"startTime":540.45,"endTime":542.938,"body":"birth. And if you put back"},{"startTime":542.986,"endTime":545.97,"body":"trisomy 13, it would take about three"},{"startTime":546.002,"endTime":548.538,"body":"to 400 embryos to get one live"},{"startTime":548.586,"endTime":551.494,"body":"birth. The point is,"},{"startTime":552.474,"endTime":555.218,"body":"even when the chromosomes are abnormal, the"},{"startTime":555.266,"endTime":558.034,"body":"likelihood of ling to a live birth is"},{"startTime":558.074,"endTime":560.842,"body":"very low. So when people say things like,"},{"startTime":560.898,"endTime":563.866,"body":"well, I would be okay with having a child with downstrome, why can't I"},{"startTime":563.89,"endTime":566.77,"body":"put that embryo back? The reason is because the"},{"startTime":566.802,"endTime":569.474,"body":"chances of actually coming away with the light birth is"},{"startTime":569.514,"endTime":572.41,"body":"still very, very low. Same thing when it comes"},{"startTime":572.442,"endTime":575.146,"body":"to things like Turner'syndrome Overall,"},{"startTime":575.25,"endTime":578.058,"body":"the point of this podcast was to help those"},{"startTime":578.226,"endTime":581.146,"body":"who are worried about the idea that they have"},{"startTime":581.17,"endTime":584.042,"body":"a high risk of having a child with a"},{"startTime":584.098,"endTime":586.874,"body":"chromosomal disorder, because their PGT"},{"startTime":586.954,"endTime":589.906,"body":"results showed that they make lots of abnorl embryos. And"},{"startTime":589.93,"endTime":592.81,"body":"so in their mind, if they're 45"},{"startTime":592.962,"endTime":595.574,"body":"and have a 95% chance of having"},{"startTime":595.954,"endTime":598.338,"body":"anaplo the embryos, then it's not"},{"startTime":598.386,"endTime":601.074,"body":"unreasonable to think that you also have a high"},{"startTime":601.114,"endTime":603.802,"body":"risk getting pretnaturally of having a"},{"startTime":603.818,"endTime":606.474,"body":"baby with a chromosomal problem. But"},{"startTime":606.514,"endTime":609.298,"body":"clearly the chances are actually quite low."},{"startTime":609.426,"endTime":612.234,"body":"What most people don't realize is younger"},{"startTime":612.274,"endTime":615.098,"body":"people end up having more babies with down syndrome"},{"startTime":615.186,"endTime":617.71,"body":"than women who are more mature. Now,"},{"startTime":617.782,"endTime":620.774,"body":"statistically it's lower, but because younger people have"},{"startTime":620.814,"endTime":623.67,"body":"more kids, they actually have more babies with down"},{"startTime":623.702,"endTime":626.326,"body":"syndrome. And the reason why we like to use down syndrome as an"},{"startTime":626.35,"endTime":629.158,"body":"example of chromosomal abnormalies is because it's the"},{"startTime":629.206,"endTime":631.754,"body":"highest one of having a child with"},{"startTime":632.134,"endTime":635.046,"body":"that most people are concerned of. Although klelinefeltder has"},{"startTime":635.07,"endTime":637.878,"body":"a higher chance of being born, the"},{"startTime":638.046,"endTime":640.67,"body":"medical implications are much minor."},{"startTime":640.862,"endTime":643.802,"body":"The second goal I would want from this podcast"},{"startTime":643.998,"endTime":646.946,"body":"is for people who are concerned about what"},{"startTime":646.97,"endTime":649.938,"body":"if I get an embryo that has down syndrome"},{"startTime":650.106,"endTime":653.026,"body":"and that I'm okay with that embryo being put back"},{"startTime":653.13,"endTime":655.81,"body":"just like an embryo with Turner'syndrome and"},{"startTime":655.842,"endTime":658.722,"body":"so, although most clinics and"},{"startTime":658.818,"endTime":661.534,"body":"very few will allow you to put that embryo back,"},{"startTime":661.994,"endTime":664.234,"body":"it's important to understand that statistically"},{"startTime":664.314,"endTime":666.778,"body":"speaking, it probably would have never worked"},{"startTime":666.826,"endTime":669.706,"body":"anyways. And that as we talked about, it would"},{"startTime":669.73,"endTime":672.626,"body":"take at least 50 embryos to put back until"},{"startTime":672.69,"endTime":675.562,"body":"one took. And that's even they have a"},{"startTime":675.578,"endTime":678.081,"body":"live birth with a child with downstroam. that's not even talking"},{"startTime":678.137,"endTime":681.081,"body":"about what the risk to the baby would be. I"},{"startTime":681.097,"endTime":683.457,"body":"do think it's important for people to realize that"},{"startTime":683.585,"endTime":686.305,"body":"although many patients are worried about having a"},{"startTime":686.329,"endTime":688.433,"body":"child with a chromosome problem like"},{"startTime":688.473,"endTime":690.937,"body":"downsttrom, many of us also"},{"startTime":691.105,"endTime":693.653,"body":"wouldn't be the end of the world"},{"startTime":693.953,"endTime":696.841,"body":"because it's still a baby that's going to love us. And"},{"startTime":696.857,"endTime":699.745,"body":"I know many people feel that way. And so I don't want anyone to take"},{"startTime":699.769,"endTime":702.489,"body":"from this that it's bad to have a child a chromosomal"},{"startTime":702.521,"endTime":705.451,"body":"problem. It's just that some people, maybe"},{"startTime":705.467,"endTime":708.179,"body":"they're later in life having kids may not have the"},{"startTime":708.211,"endTime":711.083,"body":"stamina to be able to work with a child in that"},{"startTime":711.123,"endTime":713.699,"body":"situation. And so for them, they want to help prevent"},{"startTime":713.731,"endTime":716.475,"body":"it. But I do think it's important to know that"},{"startTime":716.619,"endTime":719.555,"body":"there are many, many children born with"},{"startTime":719.579,"endTime":722.531,"body":"chromosome abnormalities that bring a lot"},{"startTime":722.547,"endTime":725.091,"body":"of happiness to everyone's life as well as their"},{"startTime":725.107,"endTime":727.971,"body":"own. This podcast was just provided to give you an"},{"startTime":727.987,"endTime":730.881,"body":"idea of the statistics and the chances and"},{"startTime":730.897,"endTime":733.801,"body":"that for you to know that what comes out of"},{"startTime":733.817,"endTime":736.545,"body":"the PGT testing is not what we see in"},{"startTime":736.569,"endTime":739.361,"body":"reality. And that's because the point"},{"startTime":739.417,"endTime":742.213,"body":"of chromosomes leading to a live birth"},{"startTime":742.593,"endTime":745.129,"body":"is not directly correlated since most of the"},{"startTime":745.161,"endTime":747.945,"body":"embryos will not make it to live birth. Well,"},{"startTime":747.969,"endTime":750.577,"body":"hopefully someone found this podcast helpful."},{"startTime":750.705,"endTime":753.577,"body":"Maybe you didn't know the statistics for each one of these things, or"},{"startTime":753.665,"endTime":756.033,"body":"maybe you didn't understand this. Maybe you're one of those"},{"startTime":756.073,"endTime":758.863,"body":"people who got a lot of anaploid"},{"startTime":758.903,"endTime":761.335,"body":"embryos in your PGT results and are"},{"startTime":761.359,"endTime":764.023,"body":"thinking I'm afraid to have a kid naturally."},{"startTime":764.183,"endTime":767.159,"body":"And now you can feel comfortable that the chances still"},{"startTime":767.231,"endTime":770.163,"body":"are quite safe and you don't have to worry about that."},{"startTime":770.903,"endTime":773.751,"body":"If you are someone who does have anaploed embryos"},{"startTime":773.927,"endTime":776.775,"body":"and you do want to transfer them, there are"},{"startTime":776.839,"endTime":779.695,"body":"some clinics out there that will transfer abnormal embryos"},{"startTime":779.799,"endTime":782.715,"body":"even once it down synd them, but they are far and"},{"startTime":782.739,"endTime":785.499,"body":"few. What I would tell someone is if that's something"},{"startTime":785.531,"endTime":788.411,"body":"that's going to bother you and you don't feel comfortable"},{"startTime":788.467,"endTime":791.259,"body":"not using those embryos, you probably shouldn't do"},{"startTime":791.291,"endTime":794.019,"body":"PGT testing and just leave things to"},{"startTime":794.051,"endTime":796.443,"body":"natural chances as I always"},{"startTime":796.483,"endTime":799.275,"body":"mentioned. I appreciate everyone who supports"},{"startTime":799.299,"endTime":802.171,"body":"this podcast. Please tell people about it so we"},{"startTime":802.187,"endTime":804.571,"body":"can make this one of the top podcasts around and"},{"startTime":804.627,"endTime":807.267,"body":"educate our fertility family so they can"},{"startTime":807.315,"endTime":810.305,"body":"become strong advocates for themselves. If you"},{"startTime":810.329,"endTime":813.089,"body":"love us, tell your friends about us. Give us a"},{"startTime":813.121,"endTime":816.105,"body":"five star review on your favorite medium. But as"},{"startTime":816.129,"endTime":819.097,"body":"I keep saying, the most important thing is to keep coming"},{"startTime":819.145,"endTime":821.929,"body":"back. I look forward to talking again next week"},{"startTime":821.961,"endTime":824.273,"body":"on Talk about Fertility Tuesday."}]}