Embryo Grading with ICSI
2 Replies
Paloma - November 18

Hi there,

My husband and I have just discovered this website, it's a wonderful form of reference.

I have a question:-

I do not ovulate naturally and have mild PCOS, and my husband has 96% abnormal sperm (acrozyme? - apparently quantity and mobility were fine). I am 28, my husband 30.

We are having ICSI and had egg transfer 2 days ago and egg collection 2 days before that.

They collected 11 eggs, 8 were mature, 6 fertilized. Out of the six they have transferred two, one was 3 cells, and one 4 cells. When I asked them the grade of the embryos they said 3.5 out of 10, and 4 out of 10. The other four weren't suitable for freezing as they had two neucleus so were destroyed.

Our question is, this grading seems so low, realistically what chance do we have? is this as bad as it seems?

We would be very grateful for some advise.

Many thanks


Dr Smith - November 20

You are right to be concerned. The grading appears to be low. Although you exhibit PCOS-like symptoms, it does not appear that you went over the top in your stimulation and that may have improved your chances. However, for reasons we currently do not understand, the developmental capacity of eggs retrieved from PCOS patients are diminished. This may explain why the grading was so low so early in development. The impact of the low sperm morphology score does not manifest until after the 8-cell stage, so if there was a preoblem from the sperm, it did not cause the low grades of the two embryos they transferred. That was strictly from the eggs.

There are slight differences in the "quality" of eggs from cycle to cycle (that's why one cycle works while another does not), but generally speaking, patients egg quality is pretty consistent from cycle to cycle. If this doesn't work, I would suggest trying again. But if that doesn't work, I suggest you look at other options. If you respond to Metformin and develop regular periods, you may be able to concieve on your own or through stimulated of natural IUI's. If this cycle is unsuccessful, speak with your doctor about your other options.


Dr Smith - November 20

P.S. I didn't dodgeyour question about what are your chances. Its just that is absolutely impossible to predict outcome from Day 2 transfers.



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