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Topic: Blastocyst Implantation (Read 13006 times) |
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Dr Smith
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Congratulations!
During a natural cycle, the cells that make the inner lining of the follicle (mural granulosa cells) make progesterone. You need progesterone supplementation after an IVF cycle because many of the mural granulosa cells are removed when the follicle is aspirated to obtain the egg. How much progresterone is enough progesterone is a very good question. No one has an answer, so we tend to maximize the dose to be sure there's enough on board to sustain the pregnancy though the early implantation phase.
Best of luck.
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DianaEvans2
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Thanks for the follow up info, Dr. Smith. Now that explanation makes a ton of sense !! Totally get it and I can in turn share with my husband and girlfriends why they keep stabbing me in the tush. I don't mind the stabbings so much, but my support team dislikes poking me.
When does the early implantation phase end ? (in other words, when does the stabbing stop) Is that also a mixed bag of variables....I heard 4 to 6 weeks since implant? Thank you in advance. Diana
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Dr Smith
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In our program, the stabbing stops after two weeks. Replaced with ooey-gooey progesterone suppositories - hey, you have to look forward to something, right?
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DianaEvans2
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Thanks for insight, Dr. Smith.
I had the supporsitories during my first IVF attempt back in July (different clinc's program), but my current clinic is continuing me on the shots until the fetal heartbeat sono which is in 2 weeks. The sono yesterday showed everything to be in the right place and it is a singleton!
Given that this will be my only child at my age(keeping the positive outlook), I'll put up with 2 more weeks of stabbing and allowing my support team to the proverbially "pain in the a**". Hahaha....I am sure there is much more painful stuff to come...well, it is all a great, interesting experience!
PS:the reason I have a support team is because my husband is on air force reserve duty for 2 weeks
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hopefully trying
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For some reason I can't start a new topic.
Dr. Smith, I had ER on Friday. The embryologist just called to say out of 8 fertilized eggs I have 3 4cell grade B, 1 4cell grade B with a cell that has a multi-nuclei, 2 2cell grade B, 1 2cell grade B with a multi-nuclei, and 1 2cell grade C. She said they very rarely give a grade A so B is good quality. Can you tell me more about this multi-nuclei and what this means? She said that sometimes it can self correct but usually means something is wrong with the embryo. She is predicting that the 3 4 cells will make it to blast. we're also doing PGD and aiming for day 5 transfer.
FYI- this is 1st IVF on lupron, follistem. I am 40, DH is 49. 3 unsuccessful IUI (2 on clomid, 1 on follistem), DX unexplained infertility. I tested postive for sperm anti-bodies. HX of hypothroidism and other horomonal variances at times. Also hx of very light periods (on bcp for 13 years).
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40 yrs old, DH is 50. Hx of hypothyroidism and other homornal abnormalities. Recent abn sperm antibody test. 3 failed IUIs. IVF #1 with ICSI and PGD failed. No male factors.
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Dr Smith
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Multinucleation of one or more embryonic cells (blastomeres) occurs when DNA replication is not followed cell division or when cell division is uneven, resulting in a small blastomere having no nucleus and a large blastomere having two nuclei. These abnormal cell division processes are called "chaotic division" and signify that the embryo is very likely to be genetically abnormal. This will be reflected in the PGD results.
Multinucleation can be self-correcting if only one cell in the developing embryo is affected. However, self-correction only occurs about one third of the time. The rest of the time embryos exhibiting multinucleation fail to reach the blastocyst stage.
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hopefully trying
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Thank you for your help. When multinucleation occurs does this tend to be an older egg issue? Does multinucleation tend to correlate with a specific genetic disease?
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40 yrs old, DH is 50. Hx of hypothyroidism and other homornal abnormalities. Recent abn sperm antibody test. 3 failed IUIs. IVF #1 with ICSI and PGD failed. No male factors.
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Dr Smith
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Multinucleation is more common in women over 35. It is not linked to any specific genetic disease.
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hopefully trying
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Thanks you so much for your time and efforts to help deal with all our anxiety. You and Dr. Jacobs are really engaged in a ministry!! You are offering such a needed thing.
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40 yrs old, DH is 50. Hx of hypothyroidism and other homornal abnormalities. Recent abn sperm antibody test. 3 failed IUIs. IVF #1 with ICSI and PGD failed. No male factors.
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DianaEvans2
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Re:Blastocyst Implantation/Failed Pregnancy
« Reply #24 on: 03/18/06, 18:37 » |
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Hello Dr. Smith: so sorry to share this bit of news....my pregnancy is now non-viable. The above details described my protocol for IVF#2 cycle. After 7 weeks since implant on Feb 1, the fetus stopped growing and now no heartbeat. Last week's sono showed a heartbeat of 83bpm which I understand was too slow. Fetus only made it to 5.1 mm. This week zilch progress. Yolk and extended sac were all appropriate shapes and sizes for the 7 week progress-they were larger in three successive sonograms.
So waiting for a natural miscarriage (stopped progestrone) or will be scheduled for a D&C on 3/22.
I'm very sad as is hubby and my support team is unhappy too that the journey stopped. I will have genetic plus whatever else analysis done on the miscarriage tissues/discharges. So my question is the following...embryos were ok as 1 of the 5 (8,8,7,7,4 cells) made it to implant and then confirmed pregnancy.
So was it just the last bit of DNA instructions that caused the mis-execution of fetal development? Or something else??
I listened to my doc, did no sports, ate my vitamins and healthy foods, got sleep, reduced work-load. I have felt well overall in the last 7 weeks except for the stretching pains(not sure how to describe it) in the lower stomach and the stabbing spots in the tush given the progestrone shots. Psychologically, I was happy and keeping a optimistic outlook despite the miscarriage at 39 (natural conception with no efforts of IUI, IVF, etc). That miscarriage was attributed to "blighted ovum" which could be anything I suppose and I didn't get much care other than the basics by my ob-gyn since we were happily surprised at that point of pregnancy.
Thank you kindly in advance for any insights, comments. Wishing you a super start to Spring! As they say....hope springs eternal.....Diana
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trishg
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Dr. Smith. I'm 36 (37 in May) . I've had 3 failed Clomid/IUI cycles and now we're doing IVF. I have uterine didelphys and only the left cervix and uterus can be accessed.
Since I have didelphys and can't carry twins my RE has suggested transferring just one, day 5 blast. If I was your patient would you recommend the same? I feel like if my odds of twins with transferring two blasts is only 20% that I should increase my odds of one taking and transfer two.
After reading your other postings I'll definitely ask them to do assisted hatching. You mentioned that you could email the embryologist the protocol - what email address can I give them?
Where do you practice? I'm in Baltimore and am a patient at the Fertility Center of Maryland.
Thank you so much for your time - it's appreciated beyond words.
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Dr Smith
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First, let me clarify that I am an Embryolgist (Ph.D.), not a Reproductive Endocrinologist (M.D.), so I don't "practice" per se. Our program is in Englewood Cliffs, NJ (across the Hudson River from Manhattan).
I'm not an M.D., so I cannot advise you medically, but as an embryologist I would recommend single embryo transfer in your case. We have had patients with similar anatomy and they were successful with single blastocyst stage embryo transfer. Ask about your program's success with blastocyst FET. This will be important since the remaining blastocyst stage embryos will be frozen for later use.
The embryologist at your program can contact me at the e-mail address in the link below my name (look left) or call me at 201-871-1999.
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I dd day 5 transfer 2 dys ago i have some cramps ne n a while.... i am worrie , is it nrmal sign?
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Dr Smith
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There's nothing to worry about. If you start bleeding, call your doctor. Good Luck!
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S
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Hello Dr.Smith,
I just had 2 embryos transferred in an FET. They were 3AA & 3BB blasts which were frozen at day 3. They reached the blast stage when thawed. What are my chances of achieving a pregnancy. I have had one fresh transfer - BFN and a frozen transfer resulting in a chemical pregnancy. I'm 30 years old.
Thanks,
S
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