Blastocyst Grading what are the odds?
3 Replies
Betty65 - June 1

Dr. Smith,

I am 41 using DE from a 21 yr old anon donor, all of her tests came out great etc. Of 18 eggs, we got 13 embryos using ICSI. On day 5 we transfered two Grade A blasts and got a chem pregnancy. For the FET we opted to go for 3 of the 7 that were frozen on day 6. They were 4BC, 4CB and 4CC. I got PG but had to have a D&C at 8weeks, we lost the heartbeat. I'll know within 2 weeks if it was a chrom issue or not. My RE thinks because the placenta was grade C if that was the one that took, then there could be a placenta issue. The 4 frozen are all graded BC. If it was a placenta issue I know you are not a mind reader, but do you think we still have a chance with the remaining 4, they will put all 4 back in on the next FET. I do not have any immune issues. We are now looking for another donor as a back up plan. Thank you for your time.


Dr Smith - June 3

Well... The "C" grading for the trophectoderm (embryonic placenta) may be an issue, but I think the the "B" and "C" grading of the stem cell population (the first letter of the grading system refers to the grading of the stems cells) may be more of a problem. If the embryo has an inadequate number of stems cells (e.g. Grade C), the chances of a "chemical" pregnancy or an early miscarriage (due no fetal heartbeat or one that drops out) are increased. I would discuss this with your docotor since different labs vary a little in their grading systems - some may be more strict than others. At my program, we do not freeze "C" grade embryos for the reasons outlined above. However, as I said, a "C" in one lab may be a "B" in another.


Betty65 - June 3

Thank you Dr. Smith,

I just want to clarify that the remaining 4 embryos are all BC so I think the B (the part that makes up the baby) is OK, it's the second letter of the C (the part that is the placenta) that concerns me. Have you seen this combination go on to make for a healthy PG?

Thank you.


Dr Smith - June 5

I my lab, embryos having a "C" grade in either the stem cells or trophectoderm layer are neither transferred or frozen, because it is unlikely that they would result in a term pregnancy. However, the grading system is different in different labs, so it would be better to ask the Lab Director at your program about what a "C" grade trophectoderm means in their grading system.



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