Your Thoughts
6 Replies
heidikisin - October 2

Just wanted your thoughts regarding how my cycle has progresses.

10 eggs retreived
2 were degenerated
after the four hour wait
2 were immature
6 were fertilitized with ICSI
1 fertilitized abnormally (didnt split from the polor body)
1 didnt divide (i think)
4 were growing after ICSI
2 arrested at 4 cells
1 arrested at 8 cells

1 was transferred on day 5 at "early blastocyst" stage
are Your Thoughts regarding how my cycle progressed?
Would you say the picture reflects an "early blastocyst"?
What are the dents around the outside edge?

btw i was one day shy of 38 when ER was done and I only have one ovary. My E2 after HCG was 2400.

Thanking you in advance for your thoughts


Dr Smith - October 3

I know it seems like you had a high attrition, but that's not unsually for someone 38. You had one developmentally competent embryo in the bunch and that's about right. I would have expected one of two.

Yes, the picture is of an early blastocyst. The cells that form the periphery of the circle have a "lace curtain" appearance and they are the cells that will form the fetal side of the placenta. They are also the cells that produce hCG, the pregnancy hormone. The cells in the center of the circle are the stem cells. In the early blastocyst stage, the stem cells have not yet aggregated into an "inner cell mass", but in your case, the stem cells are visible as a dispersed group of cells in the center of the embryo. It looks fine.


heidikisin - October 3

Thank you so much for your response and sharing you knowledge. You are a blessing


heidikisin - October 6

Dr. Smith,

When would you expect a blastocyst to start producing hcg?
I thought as soon as implantion occurs hcg is produced and goes up quickly since this tissue is fast replicating.

Please explain

Thanks again


Dr Smith - October 10

The trophectoderm (peripheral cells) of the blastocyst stage embryo is already producing hCG prior to transfer. As the embryo implants and invades the endometrium, the trophectoderm makes contact with the maternal blood vessels and secretes hCG into the materal bloodstream. However, this is a tiny weeny, itsy bitsy embryo and it takes many days for there to be enough hCG in the maternal blood (think of how diluted that little bit of hCG is in the volume a maternal blood) to be detected.


heidikisin - October 19

Dr. Smith,

Thank you for all your replies.

Our cycle didn't work. Not even a positive pregnancy test.

With the attrition of my eggs. Would you suggest attempting IVF again?

My husband and I have been pregnant naturally (1st chromosome 13 terminal deletion, 2nd Trisomy 16). We both have normal karyotypes. I only have the one ovary.

My doctor has offered me a high dose stimulation cycle with IUI or we could try donor embryo. She didn't mention another IVF but she knows our finances wouldn't cover it until 6 months.

What would you recommend? Also, does using gonal F 150/menopur 150 bid affect egg quality negatively?

thank you again



Dr Smith - November 7

If your tubes are open and there is no contributing sperm problem, IUI is an option. When it all boils down, it a numbers game. All you're really trying to do is get a good egg and for the resulting embryo to devlop normally. If you think about, IVF v. IUI is moot at this point. I'd give IUI a try, at least in the interim.

No, the 150/150 will not have a detrimental effect on the eggs as long as the stimulation falls between 9 and 12 days. Outside of this range the eggs could be compromised.

Best of luck.



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