A question for the esteemed Doctor
3 Replies
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Dear Dr. Smith,
My husband and I have 11 frozen embryos that were frozen at the 2PN stage. They are 28 year old embryos and have been stored for 8 years. The time has come to proceed with our dreams of creating a family, and we have an experiences surro, 38 years old who has twice given birth as a surro, and has 3 children of her own.
I am concerned because from what I can determine with my limited knowledge, it appears that embryos frozen at 3 or 5 days is preferable? I asked the nurse at the University of Pennsylvania Hospital if the 2PN stage is less desirable than the others, she said they prefer the 2PN stage for freezing. I was told that the embryos are all very high quality although I dont know the grade assigned them. I just wanted some feedback, and also would our chances be much better with a GS who is younger than 38 (turned 38 in August). She has delivered all of her children by cesarian, and I also know that vaginal births are preferred. Thank you for taking the time to give me any thoughts on my concerns.
Effe
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Esteemed? Who me? I don't think so. But thanks for the compliment anyway.
Freezing embryos at the 2PN stage (embryologist shorthand for a fertilized egg or zygote) is very successful. 2PN embryos survive the freezing and thawing process very well. No worries there. However, there's no way to determine their developmental competence at the 2PN stage. They need to be cultured for an additional period of time to assess their developmental ability. Of course, I would recommend culturing the embryos to the blastocyst stage, but that is problematic. How many do you thaw to get two blastocysts? Hmm. That's a tough call. Most programs thaw around 3-4 and culture them for an additional 2 days (Day 3 of embryonic development). By this point, embryos with good developmental potential should have reached the 8-cell stage. Then transfer the 2-3 best ones.
The uterus does not age the same way the ovaries/eggs do. At 38, there should be no problem with multiparus gestational surrogate. As far as the cesarian section issue, I would defer to an OB/Gyn. They'd have a better handle on that question.
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Dear Dr. Smith,
Thank you for your response to my question. Your response is extremely comforting. You are so kind and generous to spend what must amount to hours upon hours of your time, helping others. You are obviously a very special person and yes, an esteemed doctor!
Thanks a bunch :-*
Oh, 1 more question does come to mind. What are the latest stats on success given our embryos (created when we were both 28), frozen at the 2pn stage, and our 2 time proven carrier age 38? If you tell me that you think that we are safe to be optomistic about a baby entering our lives in the near future I may shoot through the roof with excitement. We realize there are no guarantees, we just want some good odds, we are gamblers after all (ya know, lil poker here and there). I have researched data from 2002, but I would hope the stats have increased since then.
Very Appreciatively Yours,
Effe
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I think you have every reason to be optimistic. Embryos created when you were 28 should have excellent developmental potential and it is very likely that the vast majority of the embryos will survive the thawing process. The fact that they've been frozen for 8 years does not enter into the equation. Frozen embryos do age while frozen and do not experience "freezer burn". A word of caution: don't overdo it and transfer too many embryos and put the surrogate at risk. My advice - as many kids as you like, one at a time. I'd say you should consider a maximum of two 8-cell embryos the first time.
I would [i]GUESS[/i], based on current ART stats, you could expect around a 40% chance of a term pregnancy on this first attempt. Maybe a little higher...
Best of luck.
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