A "great" cycle but not pregnant
3 Replies
RKS - October 7

I'm in the frustrating position of failure of my first IVF cycle despite everyone's optimism when two 8-cell, grade 1 embryos were transferred. I am 36 with secondary, male factor infertility. I met with the RE yesterday & he said it was a really good cycle: good stimulation, good quality embryos. The only thing he & the embryologist suggested was a little unusual was my estradiol of ~3400 on day of HCG; 15 mature eggs were retrieved. I did have short-lived mild-moderate symptoms of hyperstimulation. They suggested that if estradiol is too high, the endometrium may not be ideal for implantation. Is this true?
Right now we have two straws of embryos frozen:
1) 8-cell, grade 2; 8-cell, grade 2
2) 6-cell, grade 2; 14-cell, grade 2
My FET protocol calls for transfer of 2-3 embryos with assisted hatching (was not done on my fresh cycle).
But due to the embryos being frozen in pairs, we've been having lengthy discussions about how many to thaw up front. They want to thaw the first straw, and if they both survive, transfer only those 2. The embryologist expects they will survive given embryo quality & their lab's experiences. I am wondering if this is adequate given the inherently lower success rate of frozen cycles, and my own recent failure. What would you do in your practice? I'm feeling pessimistic at this point, so perhaps am leaning toward thawing 4 and transferring 3. But they are more guarded given recent success of FET's at their clinic (~50%), and increased rate of twins. BTW, my clinic is Reproductive Medicine Center, affiliated with U of Minnesota & I do feel they are pretty solid.


Barry Jacobs, M. D. - October 7

Wetypically transfer and/or freeze embryos on day 5, at the blastocyst stage. The genes from the sperm do not play a role in embryo growth and developement until after day 3. By day 5, the embryos from sperm with abnormal genetic make up are no longer growing and are not transferred or frozen.
Good luck.


RKS - October 11

What about the issue of high estradiol (3400) and endometrial receptivity to implantation?


Barry Jacobs, M. D. - October 12

There are certainly hypothetical issues regarding high estrogen levels and implantation rates. Any data supporting the hypothesis are inconclusive.



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