upcoming FET
1 Replies
RKS - October 3

I've learned that I have 2 "straws" of embryos, each containing 2 embryos
They are:
1) 8 cell, grade 2
8 cell, grade 2
2) 14 cell, grade 2
6 cell, grade 2
My first fresh cycle failed with 2 8 cell grade 1 embryos (NOT hatched); I am 36 with secondary, male factor infertility.
My RE's protocol is for transfer 0f 2-3 frozen embryos this time, with assisted hatching. Everything sounds completely reasonable to me until we get to the decision about thawing. Because they are frozen in pairs, the decision is to thaw the first straw and transfer those 2. The 2nd straw will only be thawed if one of the first 2 embryos doesn't survive (the embryologist expects that they will given their experience). I have limited expectations given their success rate from frozen cycles in my age group is only about 20%. And this whole thing has thrown me a bit because I have paid a flat rate for 3 fresh cycles, but have to use all frozen embryos before I move on to the next fresh cycle. So I would potentially end up doing 2 frozen cycles, the second one with grade 2 embryos (6 cell & 14 cell). Am I correct in anticipating that an embryo with fewer cells is less likely to make it? In which case I may only have one embryo for FET. I am in the process of negotiating this with them. Would it not be reasonable to thaw all 4 and transfer 3? It seems unlikely that all would survive anyway.
Thanks in advance for your help. I am a pathologist & there are so many details I would like to understand more about but have difficulty obtaining the info from my clinic. Any standard textbook in RE or embryology I should check out of the library?


Dr Smith - October 5

I agree with you that thawing all 4 and transferring the best three is the most logical choice. After thawing, it will be clear which embryos are the best. I don't hold out much hope for the 6-cell. Transferring 3 frozen-thawed embryos is standard practice at most clinics in the U.S.

The textbook for Reproductive Endocrinology is:

Clinical Gynecologic Endocrinology and Infertility by Leon Speroff and Mark Fritz.

As with all textbooks, its not 100% accurate and does contain some outdated information. However, it is a good start to understand the field.

Best of luck.



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