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Hi
We just completed a donor egg cycle and the RE did not discuss any particulars of the case with us during her stimulation protocol part of the process.
Before the transfer, the embryologist came in and said they believe it was an egg issue. 18 embryos were retrieved and 4 were lost due to being immature or post mature, not sure which. We lost 4 bc of fertilization.
We used husband frozen sperm and icsi the embryos.
When can a patient know if there was an egg issue? Is it only when the eggs are retrieved and before fertilization?
Our donor was 29 and the 6 embryos were 8 cell but b- rating. Our clinic rates embryos as a, b+, b, b-, and from what I understand most c are not viable.
Also what factors determine if an embryo can make it to the blastocyst stages during the fresh cycle?
What are the possibilities the embryos that are frozen which are 2 8 cell b, and the rest 6 cell b-, will unthaw and make it to blastocysts?
Can we lose embryo quality rating such as the b, and b- during the unthaw process or do can we lose cell count too?
thanks for your insight
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Sorry for the delay. I've been swamped with regulatory compliance issues associated with the new FDA rules regarding screening of egg donors.
Q1. The egg problem shows up after they are retrieved, but if the stimulation phase of the donor's cycle is not optimal, an egg problem can be predicted before retieval.
Q2. The eggs must have had adequate time in the follicles to undergo nuclear and cytoplasmic maturation prior to retrieval (again, we are back to correctly managing the stimulation of the donor's ovaries). Mismanagement of the donor's stimulation can result in inadequate cytoplasmic maturation of the egg and that, in turn, can result in embryo fragmentation (i.e. a "b-" grade). Assuming that there was no problem in the stimulation, the genetics of the embryo is the most important factor in dertermining its developmental potential. When using donated eggs, the assumption is that the genetics of the eggs will be O.K.
Q3. Embryos with significant fragmentation (i.e. a "b-" grade) rarely make it through the freeze/thaw process. Those that do survive are unlikely to continue to the blastocyst stage. It is not unsual to loose one or more cells of the embryo when freezing at the 6-8 cell stage.
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