Our post failed Consult with RE
1 Replies
Brenda - June 2

Hi
I wanted to post the results of our consult with our RE. It was amazing.
Our RE showed us the sheet for the donor and said that our donor did hyperstimulate at the end of the cycle. The estrodail readings never reached 200pg/iui per follicle. Do you know which day the estradoil reading should max out and then do you stay at that level during the rest of the stimulation protocol?

Our Re stated that we had a fill in embryologist and the fill in embryologist graded the embryos harder than the other embryologist and that was the reason for our b- and also b.
Our RE had used this embryologist before in past cycles and said this embryologist never graded any other couples embryos as an a grade.

Our RE stated also that the cells of the embryos was much more a predictor of success of a cycle versus the quality of the embryos.

I was shocked. It was amazing then the RE started attacking me as a paitent when I was asking her some questions that contradicted what she had said in the past. And that I was being unreasonable and she would waive her fees to transport our embryos to which ever clinic we wanted.

Lots of issues, but anyway, can embryologist vary that much in grading embryos and I thought it had to do with how fast the embryos divided.

She also said to unthaw all the remaining (8)6&8 cell embryos and take them to blastocysts, and I told her why then did we not take them to blastocysts to begin with. It was our understanding our clinic does not have a good success rate with freezing blastocysts and that is what the embryologist stated, so what do I believe and we are meeting again with this RE, what other questions should I pose to her.

And why did we not take the 10 embryos to blasts to begin with?

 

Brenda - June 5

Dr. Smith
My truest desire is one day to properly express my gratitude to your wonderful, informative and very educational replies. OUr struggles prior to this RE have been indescribable and bordering on criminal. Yes harsh words, but it borders on criminal. But we will not focus on that.

Our donors estradoil readings were whited out on her stimulation protocol sheet, from day 3----all the way till day 11. Interesting.

I understand your point about the embryologist and the grading of the embryos. I think you are exactly right, about the normal embryologist being there bc in a prior cycle our embryos were a b+, with the lenient embryologist.

Have you heard of doing assisted hatching on donor egg embryos. There was definitely a zona pellucida problem, it was clear on the picture of the embryos. You could see the thick outer shell. Would poor response to stims be a reason for thicker outer shell or is it something that you can not predict or know about in advance only when the embryos are made. Would the eggs look a certain way in culture that could indicate that the embryos would have a thicker outer shell from the embryos.

Would it be correct of me to ask what the success rates for assisted hatching is in this clinic and base it on the embryologist experience.

The 8 cyrofrozen embryos (2) are b grade(which could be b+ with the non standin embryologist), and 6 of the embryos are b- 6 and 8 cell embryos. They froze a 9 cell c embryos.
Would you ever freeze a c cell embryo and perhaps it was bc the embryo was 9 cell.

Also it was noted at this clinic that an additional fees were collected if there were 10 or more embryos to freeze versus 9 and less, and that is the reason we feel they froze the c embryo.

There were 10 embryos that were viable, and what factors determine when embryos are taken to blastocysts? Cleve time in the 2 days, fragmentation rates, not sure exactly the factors to look for here.

Actually our clinic has a storage capacity, and after a year of storage is making couples send their embryos out to another facility, which of course reduces the costs involved in the laboratory. This clinic must have experienced an in crease in clients for this storage capacity.
If there is a storage issue, from a business standpoint, would it be prudent to take all embryos to blastocysts.

What would be the reasons other than economics for not taking the embryos to blastocysts?

One theory is if they take the embryos to blastocysts and they do not make then the couples are more apt to blame the doctor if there is nothing to transfer.

I have learned some reading your board, and especially the 3 day versuses the 5 day.
This RE said she does not like to do 5 day bc some of them will not make, and that was my point back to her, is why endure all those drugs if we do not have a chance.

I just want to thank you so much, I wish I could express my gratitude in a better way. You have been a much needed blessing in our struggles, I want to know that and I just so appreciate it and can not stop thank you :) :)


 

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