Good quality day 3 didn't make it to blast on day 5
5 Replies
rpatel010 - October 12

Hello Dr. Jacobs,

I am a regular reader of this forum. Just wanted your expert advice on my case. Here are the details.
I had two IVF cycles so far because of unexplained infertility. My husband's sperm analysis look normal. My both IVF cycles failed. In first cycle, only 5 eggs were retrieved. All fertilized, transferred 3 of them since doctor thought they were not of good quality embryo on day 1, transferred 3 on day 2.

2nd cycle: Was good cycle as far as stimulation goes. Retrieved 16 eggs. 13 fertilized. Looked good on day 1, so doctor said he will wait until day 5 and transfer only one blastocyst. We were happy. Out of 13, 10 embryos were A quality on day 3 with 6-12 cells each. When we were at the clinic on day 5 morning, doctor said he didn't have any blastocysts, not even morulas. All but only 2 embryos were arrested. The two were at the pre-morula stage. and were hatched and then transferred. We knew that chances were zero.

What could have gone wrong? If 10 A grade embryos were available on day 3, why no blastocysts on day 5? Doctor himself was surprised and said never seen that in his lifetime. I just need your expert advice on this. What should we do in our next cycle? Do you think all of our next cycle embryos will also get arrested before making it to the blastocysts?

Thanks for your time. Anyone having similar situation, please post your opinion.

Raj

 

B. Jacobs, M. D. - October 12

Just because an embryo looks good, does not mean it will be successful. We cannt determine anything about the genetics or chromosomes of the embryos by looking at them in the embryo lab.
Good luck.

 

rpatel010 - October 12

Thanks Mr. Jacobs. Now, my question is...

Does it mean that if we do another IVF cycle and we will get the same results (no blastocyst on day 5). What would you suggest? Our doctor said that we might have lost some viable embryos by waiting until day 5. They might have implanted if transferred earlier.

Thanks.

 

B. Jacobs, M. D. - October 13

I cannot speak to the quality control in the lab or the quality of the embryos. There are a great many variables. Our lab routinely grows blastocysts. Not all labs can. If an embryo will not grow to blastocyst in the lab we use, it may not row to blastocyst, at all. If other embryos in your lab are growing to blastocyst, it may well be an egg or spem issue. That will vary from one sperm or egg cell to the next. Most sperm and eggs are not capable of producing a successful pregnancy.
Good luck.

 

rpatel010 - October 13

Thanks for the reply.

I forgot to mention. I am 26 yrs old and my husband is 31 yrs old.

Since quality of egg and sperm varies, it is possible that in our next cycle we may be able to get one of the better quality sperm and egg combination, which will result in blastocyst, is it right?

In our previous cycle, on day 5 2 embryos were at the compacting morula stage, they already started compacting. Doc said they were about a day and half late in development.

Is there any test we could do to figure out sperm or egg issue?

Thanks.

 

B. Jacobs, M. D. - October 13

I have no ay of knowing if your experience has been an embryo issue or a lab issue. Human embryos are amazingly fastidious. The slightest thing can interfere with their growth and survival. Also, only about 1/3 of the eggs any woman makes are capable of producing a successful pregnancy. We know less about sperm, but most of them are not normal, either.
Good luck.

 

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