Dr. Smith, Yesterday we had our embryo transfer. We transferred two and both were in blastocyst stage already. One being a 4 AB and the other being a 3 BB. Our embryologist said the top quality embryo would be a 4 AA. My questions are:
1. Can you tell me, based on your experience what is the likelihood that my embryos will implant given the grades? 2. One of the embryo was already hatching when my doctor did the transfer (I don't know which one). We could see it clearly that it was hatching. Is that ok? Or will there be a problem (be it implantation problem or other problem) when an embryo is already hatching when it is still outside the womb? 3. I have another three embryos that have survived until day 5. Yesterday, one was in the early blastocyst (that it is hard to assign grade) and the other two were still in morulla/morella (?) stage. Do you think they will have any chance to complete their development to a full blastocyst?
Like always, looking forward to your reply. Thank you so much. Dian
1. Although 4AA grade embryos are deemed to have the best developmental potential, 4AB grade embryos have almost as high a developmental potential as 4AA. The 3BB is O.K. (just O.K.), but we have seen pregnancies from 3BB grade embryos. I'd say your chances are roughly 40% with those two embryos.
2. Hatching is a good sign, and it was the 4AB that was hatching (3BB has not yet expanded enough for hatching). If the embryo is hatching at the time of transfer, it means there is already a surface of the embryo available for attachment to the endometrium. No worries.
3. It is not unusual to have extra embryos at the early blastocyst stage or the morula stage on Day 5. These usually develop into fully expanded blastocysts (i.e. 4AA or 4AB grade) by the morning of Day 6. In my program, we also freeze blastocysts on Day 6. Although the resulting pregnancy rate from blastocysts cryopreserved on Day 6 is slightly lower than Day 5 blastocysts, its still worth freezing them.
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