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Welcome back Dr. Smith. Glad to know you have a life outside of here! I just had an embryo transfer yesterday. I am ecstatic that I responded reasonably well to my cycle this time although concerned about the eggs/quality and number fertilized. Of 11 retrieved only 6 mature and 3 fertilized. Outcome - two 6-cell and one 4-cell (all transferred day 3). My question is about the shape of one of the embryo's - it is not perfectly round like all the others I've had but rather slightly oblong. Does that mean anything?
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It has been my experience that oblong embryos rarely develop to the blastocyst stage. I have no idea why. Just an observation. So, you concern is justified.
6 out 11 mature? Hmm. Were there a lot of smallish (i.e. around 16 mm) follicles at the of hCG? Sounds like there may have been two batches of follicles on this stim - a group of large, mature follicles and a group of small immature follicles. Although eggs were retieved from the smallish follicles, they were immature. The ultrasound images looked good on paper, but the reality in the dish was different. The "mature" that didn't fertilize may have been borderline mature - nuclear maturity (i.e. halploid) but cytoplasmically immature (i.e. unable to fertilized in the presence of good sperm and/or unable to respond to a sperm that got inside).
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Yes there were 4 follicles that were between 15 and 17mm. They told me to take one more dose of the morning before hCG to try to help the 15's along. I wondered if I had stimmed a day longer if it would have made a difference. (of course a day late a dollar short!)
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Its always a tough call in situations like this. Stimming to long can compromise the larger follicles. Hindsight is always 20/20. I don't think they did anything wrong, it was just how the cycle turned out.
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