Opinion Re Concept of Embryo Crowding
1 Replies
oldgal - October 8

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I
just finished my 1st v cycle. I am 44 and had 11 eggs retrieved, 8 fertilized. 6 of the 8 were excellent grade- 8 cell /or 8+ cell (2 early compacting) on Day 3 with little or no frag. One was a grade 1 - but 4 cell with no frag, and 1 was a 5 cell grade 3 - with 50% frag. RE transferred 5 embies on day 3. 3 others lost arrested between day 4 & day 5.

I tested postive - on 9dp3dt - beta 5; 2nd beta 12 dp3pt - 31; 3rd beta - 16p3pt- 24. Classified as chemical pregnancy.

The good news in my opinion was that I stimmed well, fert rate was goot and embie quality was good. Bad of course, it that our utlimate goal is to seek out and find that "one or two" good eggs that are euploid.

Question:

Can you give me any opinion on the concept of Embryo Crowding? I have found differing trains of thought as it relates to this concept. The idea is that transfer of more than 5 embryos does not result in increaed pregnancy rates, due to the potential competition for implantation that can occur between normal vs abnormal embryos. With that said, the thought is that good embryos could compete with abnormal ones, which could throw off "free radicals" and adversely affect the implantation of good embryos?

Have you every hear of this> Can you tell me how this works as an embryologist?

P.S.- I know so many doctors would recommend 5- day blast a one of the best methods of identifying and selecting the "best embryos" for transfer. But,I respectfully am not inclined to follow this protocal. I prefer 3 day transfers, and if at all possible, would like to consider transferring higher multiples of embryos on day 3 to offset the high %s of anueploidy, knowing that appearance, alignment, blast culture, or other morphological indicators cannot clearly predict which embryo will or wont be euploid.

Thank you so much in advance for for your thoughts or experiencce on the embryo crowding concept

 

B. Jacobs, M. D. - October 9

I have seen nothing in the professional literature regarding "embryo crowding". We almost exclusvely transfer 2 blasrocysts. That process provides the best pregnancy rates without risk of multiple pregnancy. Multiple pregnancies do not go to term. Premature babies have problems.
Good luck.

 

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