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I know it seems like you had a high attrition, but that's not unsually for someone 38. You had one developmentally competent embryo in the bunch and that's about right. I would have expected one of two.

Yes, the picture is of an early blastocyst. The cells that form the periphery of the circle have a "lace curtain" appearance and they are the cells that will form the fetal side of the placenta. They are also the cells that produce hCG, the pregnancy hormone. The cells in the center of the circle are the stem cells. In the early blastocyst stage, the stem cells have not yet aggregated into an "inner cell mass", but in your case, the stem cells are visible as a dispersed group of cells in the center of the embryo. It looks fine.

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Thank you so much for your response and sharing you knowledge. You are a blessing

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Dr. Smith,

When would you expect a blastocyst to start producing hcg?
I thought as soon as implantion occurs hcg is produced and goes up quickly since this tissue is fast replicating.

Please explain

Thanks again

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The trophectoderm (peripheral cells) of the blastocyst stage embryo is already producing hCG prior to transfer. As the embryo implants and invades the endometrium, the trophectoderm makes contact with the maternal blood vessels and secretes hCG into the materal bloodstream. However, this is a tiny weeny, itsy bitsy embryo and it takes many days for there to be enough hCG in the maternal blood (think of how diluted that little bit of hCG is in the volume a maternal blood) to be detected.

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Dr. Smith,

Thank you for all your replies.

Our cycle didn't work. Not even a positive pregnancy test.

With the attrition of my eggs. Would you suggest attempting IVF again?

My husband and I have been pregnant naturally (1st chromosome 13 terminal deletion, 2nd Trisomy 16). We both have normal karyotypes. I only have the one ovary.

My doctor has offered me a high dose stimulation cycle with IUI or we could try donor embryo. She didn't mention another IVF but she knows our finances wouldn't cover it until 6 months.

What would you recommend? Also, does using gonal F 150/menopur 150 bid affect egg quality negatively?

thank you again

heidi

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If your tubes are open and there is no contributing sperm problem, IUI is an option. When it all boils down, it a numbers game. All you're really trying to do is get a good egg and for the resulting embryo to devlop normally. If you think about, IVF v. IUI is moot at this point. I'd give IUI a try, at least in the interim.

No, the 150/150 will not have a detrimental effect on the eggs as long as the stimulation falls between 9 and 12 days. Outside of this range the eggs could be compromised.

Best of luck.

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