failed blastocyst
0 Replies
postblast - February 26

Dear Doctor,

I recently underwent an unsuccessful blastocyst transfer. I am 40, produced 12 eggs, 7 of which fertilized via ICSI. Lining on day of egg retrieval looked good. Day 3 embryos ranged from "A" grade to "B". On day 5, there were 2 early blastocysts transferred, grade B. Sounds to me like embryos started to slow down growth-wise on day 4 (age-related I suspect).

There is so much confusing and conflicting information out there re: ART that my head is starting to get dizzy. Re: blastocyst, some embryologists have noted they believe [i][/i]some[i][/i] embryos do better in the uterus. (anonymous forums). According to this site, this is absolutely false except if the lab is inadequate. (At least, I think that's what I read...) so I'm not sure what to think.

My clinic notes that 50-70 percent of embryos generally make it to blast stage. I am now wondering what to do if we try again and happen to get enough embryos to be considered for blastocyst transfer. Decision is up to the RE and lab doctors, but until this site, I had thought maybe a 3-day transfer might help.

From a read of other replies, it sounds like you would normally recommend a blast transfer when possible (as long as lab is good).

I guess my questions are: is there ever a situation where you recommend 3-day over 5-day?

Is there anything I can do besides healthy diet, etc. to encourage better results outside of donor eggs?

Is it true that embryo "development failure" past the 3 day mark can be attributed to sperm quality rather than egg quality? (embryologist opinion...) I'm now thinking this might be hard to determine.

Is there ever an issue with the embryos not adapting well to the uterus environment (i.e. they're switching from nice lab diet to utero "diet" which might be quite different and so have problem adjusting)

I have around a 25-day cycle... would this influence the latest that an embryo should be transferred? (i.e. if wait too long after retrieval, will body start to think there's nothing going on and so lining start to shed...?) If relevant, I started spotting 6 days after the transfer and started period 5 days before preg test was scheduled. Was on progesterone suppositories to support lining. Clinic doesn't check lining on day of transfer (checks on day of retrieval).

Sorry for the lengthy email. I'm sure ART continues to be a work in progress but am boggled. Thank you for any help you can provide.

 

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