3day or 5day transfer
6 Replies
anna1979 - November 9

Hi Dr Smith

I am 27 and have had 3 ICSI's. First time I had zero fertilisation! Apparently something to do with the sperm? Second and 3rd times text book (with new partner, ex husband from 1st cycle couldnt keep his pants zipped!) all the way through, great eggs, great embies transferred at 4 cell and plenty for the freezer. Negative pregnancy test.

I have had some immune testing which is all fine and dandy.

I am about to start stimming for my 4th go and I wondered what your opinion was on 3day vs 5 day. I already know you love your blastocysts! But my clinic is a very small clinic and not a great deal of experience with Blasts. I wondered would it be safer to go with what they know rather than risk some human error in taking my embies to blast?

I am also having viagra this cycle...do you think it helps with implantation?

Best wishes to you from good old England!

Anna :O)


Dr Smith - November 15

Cheers. Sorry for the delay luv - I've been sick.

Tough call. You can't tell anything about the developmental potential of 4-cell embryos, which is a major limitation if you can only transfer 2. On the other hand, if the lab has limited experience with blastocyst culture, I would not suggest being a guinea pig for their learning curve. Gowing blastocysts is not rocket science, but the lab conditions have to be kicked up a notch from culturing embryos to Day 2. Go with what they know and hope for the best.

However, I think there is something really wierd going on here. At 27 with good fert and good embryos (and a new partner), I'm suspicious of implantation issues. Did your immune testing include Natural Killer Cell (accompanied by the "dum, dum" music from "Jaws") levels and activation? These test are important to determine if your immune system is being a little over zealous in patrolling your uterine cavity. I'd recommend it if it hasn't been done.


anna1979 - November 15

Hi Dr Smith

Hope you are feeling better now.

The NK stuff did cross my mind. I have not had the full 'chicago' tests as yet. After spending £12000 on our previous treatments we suddenly got funding for another 2 IVF's at our local clinic. We didnt want to throw our 'free' cycles away so wanted to have one more go and then move onto the NK tests.

I am also having cabergoline this time too as have high prolactin levels. I think if this is a BFN then we will defo be moving to a clinic that does the NK stuff.

Thanks for your reply :O)


Dr Smith - November 16

Best of luck.


anna1979 - November 19

Hi Dr Smith

Sorry to be such a pain but I had my stims scan on Friday. Everything is growing well but the sonographer made a comment about there being a little fluid either in my tube or beneath my womb. She said this is perfectly ok?!

I am aware that fluid can be toxic and can kill embies. I just wondered what your view is on this? I am back for another scan on Monday and am going to raise it then as have been worried sick. I have heard that fluid can be drained during EC so may ask about that too.

I very much value your opinion so any comments would be greatly appreciated.

Anna :O)


Dr Smith - November 20

This is more of a medical question, but I'll give it a shot. Fluid accumulation in the pelvic cavity can be removed at the time of the egg collection. You have not mentioned endometriosis in your previous posts, so I think this a nothing to worry about. If it is an accumulation of fluid from endometriotic lesions in the pelvis, this fluid is embryo toxic and may be picked up by the tubes and brough int the uterine cavity. That would be bad.


anna1979 - November 20

Thanks Dr.

I had another scan today. There is defo fluid there underneath the womb. Nothing has ever been mentioned before about endometriosis.

I think I am just going to close my eyes and hold on tight for this ride!

Thanks again for your reply.

Take care




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