blastocyst: freezing vs transfer
5 Replies
mira - April 25

Dear Dr. Smith,
I am currenly starting my 2nd IVF transfer at clinic that has a protical to do day 3 ET but only freeze blastocyst embryo's. I have convinced 1 out of 3 main doctors at the IVF center to do a blastocyst ET. My question is:

Is there much difference in the proticals before transfering or freezing blastocysts that may decrease my chances sence the IVF center is not used to transfering blasocyst stage embryo's(I hope that made sence?)?

Anything else I can say? I have allready stated I would not blame them if there was nothing to transfer (I am 41).

thank you , laura


Dr Smith - April 27

They will culture the embryos exactly the same way for transfer or freezing at the blastocyst stage, so the protocol is the same. As long as you are aware of the possibility that none of the embryos may reach the blastocyst stage, then I say go for it. Better to cancel the transfer than to wait two weeks on pins and needles for a negative pregnancy test.

Best of luck.


laura - April 27

Dear Dr. Smith,
I hear form the IVF center and they are willing to do a blast transfer (day 5)!! Two additional questions:

They recomend PGD befor transfer. What do you think of this? I told them I did not wont PGD

They will transfer day 5 even if the haven't reached the blast stage. Is this a problem?

Thank you so much,


Dr Smith - April 28

PGD has only been shown to be effective (increased term pregnancies) for patients with recurrent pregnancy loss. If that is not your problem, then PGD is unlikely to improve your chances of a term pregnancy.

In our program, if the embryos have not yet reached the blastocyst stage on Day 5 (but look promising) we wait until the morning of Day 6 to make sure they are capable of reaching the blastocyst stage. [i]We will transfer no embryo before its time.[/i] :) Transferring pre-blastocyst stage embryos on Day 5 defeats the purpose of blastocyst culture and transfer. Ask them to wait until the morning of Day 6 if the embryos have not yet reached the blastocyst stage on Day 5.


laura - May 3

Draer Dr. Smith,
I am trying to have a blastocyst transfer with a IVF lab that normally dose day 3 transfer but only freezes blastocycs. They said they would but they strongly recomended PGD. I declined this. Now today they have called and told me they will only consider a blastocyst tranfer if I have three 8 cell embrye's on day 3. What do you think is going on hear? Are they:
1. Concerned about there stats?
2. Concerned that I wont try again if there aren't any blasts to tranfer?
3. Concerned that I will blame there lab?
I told the IVF nurse that I wonted a blast transfer. The IVF nurse said that thay use a diiferent media for blasts and they are not used to tranfering them. I am supposed to have a Doctor confrence 5/4. What do you think I can say to them to reassure them that I will not blame them I I don't make it to transfer



Dr Smith - May 3

Many programs have the policy to mandate a Day 3 transfer when there are fewer than three 8-cell embryos on Day 3. This is because they are worried about not having any embryos for transfer and that you will blame the lab (as you surmised).

It is correct that different culture media is used for extending embryo culture to Day 5. However, they must have some of this media around because they culture extra embryos to the blastocyst stage for freezing.

I'm not sure what their problem is with transferring blastocyst stage embryos, since PGD cases require embryo transfer on Day 4 or 5. Its not that different from a Day 3 transfer. Sounds a little lame.

From what you are saying, it would appear that they are not very concerned about evaluating the developmental potential of your embryos before transfer (i.e. do they reach the blastocyst stage?). Their strategy seems to be to continue to do Day 3 transfers until you are pregnant or financially bankrupt. Unfortunately, this is more common than I care to admit.



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