Question about my embryos
61 Replies
Dr Smith - May 11

It is not unusual for the post thaw motility of donor sperm to be on the low side. Admittedly, 12% is lower than usual (around 30% is average). In this situation, ICSI was your best bet for fertilization. When eggs fail to activate following ICSI, it most likely a result of poor egg quality rather than "faulty" sperm. The "dark and grainy" kiss of death is also consistent with your age. It might have been observed in the other clinic, but not recorded on the embryology lab sheets because it is so common in cases of advanced maternal age.

It is dificult to say much about 4-cell embryos since they have a long way to go to reach the blastocyst stage and become capable of attachment and implantation. At 40, approximately 80% of your eggs are anueploid (abnormal chromosome number). Anueploid embryos rarely make it to the blastocyst stage. With two embryos transferred and an 80% chance that each one won't even develop to the point where they are capable of implantation, your chances are pretty slim (but not exactly zero). From a purely practical point of view, using donated eggs and donated sperm would give you the best chance of a term pregnancy (assuming there is no contributing uterine factors). Not what you wanted to hear, but thats what I would advise.

 

Bev - May 23

Hi am a very new member please bare with me!
ok so heres what i know
5 eggs fertilized
3 had not divided enough
after 72 hours a 4 cell and a 5 cell were replaced
is this normal.
any advise would be great
thankyou
hopefull

 

Dr Smith - May 24

What is "normal" for embryo development depends on many patient-specific factors. Under ideal conditions, the embryos should have reached the 8-cell stage by 72 hours post insemination. Having a 4 and 5-cell is not a good sign, but a pregnancy is still possible - particularly if your are under 30.

 

kSpell - May 24

Hello...I am 34 and in my 5th IVF cycle and scheduled for retrieval tomorrow (5/25). I have not had any successes in the past and of the retrieved eggs very small amounts fertilize and we have always done a day 3 transfer. This cycle I have had MANY cycts on my ovary (only working with one) and measured about 25 yesterday. I am hoping to have better luck with fertilization and embryo growth this cycle and get to the blastocycyt stage and do a day 5 transfer. Last cycle I had "good quality" embryos with "good" cell division and when I wanted them to put 4 in on day three they gave me a VERY hard time. Do you have a certain number of embryos that you standardly transfer on day 3 and on day 5? I would still like to do 4 embryos. Thanks.

 

Dr Smith - May 24

The recommended number of embryos for patients under 35 is 2-3 Day 3 embryos. However, in cases of repeated IVF failures, it is not unusual to increase the number of Day 3 embryos to 4. In the case of blastocyst transfer, the number of embryos transferred would be increased from 2 to 3.

 

kSpell - May 24

Follow up...I just read your "converstaion" with user Lauren regarding the benefits of Day 5 transfers and how your center does not do any Day 3 transfers. Do you think that if I get to blastocycst stage I should ask the Embryologist to do assisted hatching as you have had so much success with this method?

 

Dr Smith - May 25

In our center, assisted hatching of blastocyst stage embryos increased the implantation rate by 8% per embryo transferred. Others have had similar results. I recommend routine assisted hatching of blastocysts.

When travelling down the Fallopian tube and after entering the uterus, the protein coat that surrounds the developing embryo is exposed to very low levels of protein-digesting enzymes. These act to thin the protein coat from the outside in. These enzymes are not present in the laboratory culture medium. Accordingly, the protein coat is a little bit thicker and a little bit more dificult to break when the embryo reaches the blastocyst stage. The blastocyst stage embryo must physically break and "hatch" out of the protein coat in order to make direct, cell-to-cell contact with the endometrial lining in order to initiate implantation. Assisted Hatching gives the blastocyst stage embryo a helping hand at this "break out" process. In this way, it makes it easier for the embryo to attach to the endometrium.

 

JaneX - June 3

On my first ET from ICSI 18 months ago I had very good embryo quality but all slow growers - we transfered 3 on day 3 - [email protected] cells and [email protected] cells. We got a positive result and had a baby. We have just done our second round of ICSI and we had the same problem - good embryo quality but all slow growers - at ET we transfered 4 on day 3 - [email protected] cells nad [email protected] cells. My question is did we just get lucky the first time around or are these not as bad as they seem?

jane

 

Dr Smith - June 5

Embryos are expected to be between 4 and 8 cells on Day 3. These embryos were within the expected biological variation observed during IVF. In other words, they weren't really slow (2-cell embryos on Day 3 are really slow). Although you were lucky, as is anyone who becomes pregnant from IVF, you were not especially lucky because of slow growing embryos. Best of luck on the FET.

 

goldys - June 6

I hope you'll be candid with me.
I had one day three compacted morula transferred on Sunday. Should I be concerned with the fact that the embryo is progressing so quickly...or be delighted? What are the odds of my becoming pregnant with only one embryo transferred? This is my second round of IVF.
Thanks!!

 

Dr Smith - June 6

The short version is:

Delighted and

It only takes one (good one). Many programs in Europe are opting for single embryo transfer and the data they are publishing indicates only a slight (and I mean slight) reduction in pregnancy rate compared to a two embryo transfer. Hang in there. Best of luck.

 

sonia - June 7

I am 36 years old and went for my first transfer June 2nd. On day three they transferred 2 out of 8 embryos that all were between 6-8 cells. They told me that they might do a double transfer however they wanted to see how the embryos progressed before doing the transfer. On day 5 they called and told me that one had reached morula stage and they said they wanted to wait an extra day. They told me that this was normal. Today being day 6 they told me that 2 embryos reached blast but began to deteriorate and the other 4 did not make it. I was disappointed and a little worried concerning the ones that were transferred. My Embryologist says that not all embryos like to grow in the dish and I should be positive.
I have unexplained infertility, DH A++ (37yrs)on his side and have been trying to get pregnant for 12 years. I got pregnant naturally in 07/04. Unfortunately lost her at 31 weeks.
Can I please get your opinion?

Thanking you in advance

 

Dr Smith - June 7

The following is my opinion (and its just that, my opinion).

I'm afraid I do not agree with the concept of "double" transfers. The second transfer could adversly affect the embryos from the first transfer by disrupting their implantation process.

Deterioration of blastocyst stage embryos on Day 6 is not uncommon, but I have found that changing to fresh culture media on Day 5 prevents blastocyst deterioration to some degree. I also don't agree with transferring deteriorating embryos on Day 6 (or any other day for that matter). However, the worse case senario is that they don't implant. The second worse senario is that one or both of the deteriorating blastocysts initiates the implantation process and generates a "chemical" pregnancy or an empty sac visible on ultrasound. I think your best chance is with the Day 3 embryos (if the second transfer did not disrupt their implantation).

I also disagree with the statement that "not all embryos like to grow in the dish" as an explanation for embryonic arrest. The logic doesn't hold. It does not explain why embryos that are side by side in a the same droplet of medium, in the same dish, in the same incubator, will develop or not develop under identical conditions. How could a developmentally compent embryo just "decide" that it didn't want to grow in the dish while its developmentally competent neighbor "decides" the conditions are fine. This is a fallacy. Its a simple fact that, in humans, not all the embryos generated by IVF are developmentally competent. The reason some embryos fail to develop is because they are genetically abnormal. Placing a genetically abnormal embryo into the uterus won't make it genetically normal. In my opinion, the embryologist was telling you what you needed to hear in order to remain positive and hopeful and to deflect any potential critism of the lab. I don't believe their statement was based on logic or fact.

Thats my opinion for what its worth.

Best of luck.

 

sonia - June 7

Dr.,
Thank you for writing back. I just wanted to clear up one point, I did not have the second transfer. So hopefully at least one of the two that were transferred day 3 will take.

Regards,
Sonia

 

goldys - June 8

Thank you for your response!
I have two questions...which may have no answer. :-)
Do you know whether most day three (or day 5 for that matter) embryo's survive the transfer? Meaining...while we're sitting around hoping to become pregnant...do most of us have viable embryo's hoping to attach, or have many of them not survived the transfer?

My second question is that I have been feeling extremely full for the past couple of days. I had my transfer of a day three morula on Sunday. It doesn't seem possible...but could this be a result of pregnancy...or of the progesterone & estrogen?
Thanks for any info. More importantly, thanks for this wonderful website. The 2ww is horrible...and this helps.
warmly,
Jill

 

Dr Smith - June 13

Sorry for the delay. I must have missed your post. Anyway, better late than never.

The transfer itself (if performed correctly) is not traumatic to the embryos, so their post-transfer viability is not directly related to the transfer. If the embryos are transferred on Day 3, approximately half will die off before reaching the developmental stage where they can implant (blastocyst stage). The implantation rate (implantation per embryo transferred) for Day 3 embryos is about 25%. If the embryos are transferred at the blastocyst stage, they are capable of implantation immediately. However, not all blastocyst stage embryos attach to the endometrium and implant. The implantation rate for blastocyst stage embryos is about 50% (because fewer die off after transfer).

As far as your physical symptoms, I'm not really qualified to interpret them (I'm not a physician). However, I will say this. Because you are taking a variety of horomones and other medications, you can't trust any of you body's sensations. They could mean anything.

 

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