Aa
New to the forum
Hey ladies, I am new to the forum. I am an embryologist, and often come across people who don't really understand the embryo side of IVF, so I joined to help in whatever way I can...and of course pray for all you ladies hoping for a BFP!
Hi Lvn, and welcome to the forum! I'm sure your expertise will be a big help to many of the women on here :-)
I actually have a question for you already. Do you know if IVF has a lower risk of miscarriage than a normal conception, since only the strongest blastocysts are transferred back? I've had two miscarriages (both conceived without help), and my RE now wants me to move on to IVF, which we would have to pay out of pocket...but I'm mostly just worried about having another miscarriage. Any thoughts?
I actually have a question for you already. Do you know if IVF has a lower risk of miscarriage than a normal conception, since only the strongest blastocysts are transferred back? I've had two miscarriages (both conceived without help), and my RE now wants me to move on to IVF, which we would have to pay out of pocket...but I'm mostly just worried about having another miscarriage. Any thoughts?
Thanks for joining the forum and for your good wishes! I am about to start my first ivf and would really appreciate your informed opinion and advice.
I was supposed to start ivf meds weeks ago but because of a damn cyst that refuses to go away I have to wait. My doc ordered an estradiol test today to see whether the cyst is active. I am guessing that if it's not active I may proceed with the meds. I would really like to proceed with ivf but afraid that the cyst can affect the quantity of my embryos. We are paying out of pocket and quantity is not a small issue for us since I am not sure we can pay for another fresh cycle. Will the cyst affect the quantity and/or quality of my follicles/embryos? I will really appreciate your advice.
I was supposed to start ivf meds weeks ago but because of a damn cyst that refuses to go away I have to wait. My doc ordered an estradiol test today to see whether the cyst is active. I am guessing that if it's not active I may proceed with the meds. I would really like to proceed with ivf but afraid that the cyst can affect the quantity of my embryos. We are paying out of pocket and quantity is not a small issue for us since I am not sure we can pay for another fresh cycle. Will the cyst affect the quantity and/or quality of my follicles/embryos? I will really appreciate your advice.
Thank you so much for the kind words! I do believe that there is a lower risk of miscarriage in IVF because the embryos transferred are always such high quality. A good embryologist/RE will only transfer high quality embryos. And if the embryos are grown out to blastocyts you can tell a lot about the health of the embryo if they are questionable on day 3 (another option for transfer).
However, since most miscarrages occur between 10 and 12 weeks it is basically out of the hands of the RE if the miscarriages continue to occur. Have you consulted with an RE who specialized in recurrent pregnancy loss? This might be of high value to you. There are some immunological tests that can be done which may help to diagnose the reason for the miscarriages, and sometimes there are treatments which can be given to reduce the risk of miscarriage.
Another advantage of IVF is they can do pre-implantation genetic diagnoses to guarantee that the embryos which are transferred back are genetically normal, as genetic abnormalities can also cause miscarriage.
Did you have a D&C with either of your miscarriages? In the future this can also be valuable because they can do genetic testing on the products of conception and try and narrow down the reason for the miscarriages.
A lot to swallow I know. Good luck to you though, its so hard when our patients miscarry but it is also a very positive notion because getting pregnant is half the battle. And unfortunately about 1/4 of pregnancies end in miscarriage, horrible odds. We always say its a wonder anyone gets pregnant at all with so many factors working against us.
Let me know if there's anything else I can help you with and thanks for the warm welcome!
However, since most miscarrages occur between 10 and 12 weeks it is basically out of the hands of the RE if the miscarriages continue to occur. Have you consulted with an RE who specialized in recurrent pregnancy loss? This might be of high value to you. There are some immunological tests that can be done which may help to diagnose the reason for the miscarriages, and sometimes there are treatments which can be given to reduce the risk of miscarriage.
Another advantage of IVF is they can do pre-implantation genetic diagnoses to guarantee that the embryos which are transferred back are genetically normal, as genetic abnormalities can also cause miscarriage.
Did you have a D&C with either of your miscarriages? In the future this can also be valuable because they can do genetic testing on the products of conception and try and narrow down the reason for the miscarriages.
A lot to swallow I know. Good luck to you though, its so hard when our patients miscarry but it is also a very positive notion because getting pregnant is half the battle. And unfortunately about 1/4 of pregnancies end in miscarriage, horrible odds. We always say its a wonder anyone gets pregnant at all with so many factors working against us.
Let me know if there's anything else I can help you with and thanks for the warm welcome!
Thank you again for the welcome!
It is believed that cysts decrease follicular recruitment and embryo quality however in healthy tranfers there does not appear to be a decrease in implantation or pregnancy rates.
So the long and short of it, is that it is harder to get good quality embryos, however, if you do, your chance of pregnancy is just as high as without having a cyst.
I would try and be patient which I know is seemingly impossible, but once the cyst goes away (frustrating and stubborn cyst) your outcome on an IVF cycle will be much better. If you have a higher follocular recruitment, which will give you more mature follicles, you may have the option to freeze embryos which although costly would be cheaper than undergoing a new cycle. Good luck to you, and boo to those stubborn cysts.
It is believed that cysts decrease follicular recruitment and embryo quality however in healthy tranfers there does not appear to be a decrease in implantation or pregnancy rates.
So the long and short of it, is that it is harder to get good quality embryos, however, if you do, your chance of pregnancy is just as high as without having a cyst.
I would try and be patient which I know is seemingly impossible, but once the cyst goes away (frustrating and stubborn cyst) your outcome on an IVF cycle will be much better. If you have a higher follocular recruitment, which will give you more mature follicles, you may have the option to freeze embryos which although costly would be cheaper than undergoing a new cycle. Good luck to you, and boo to those stubborn cysts.
Welcome! I am so glad you are here! We have alot of ladies going into IVF soon so I know you will be asked lots and lots of questions. Thank you for lending a helping hand! HUGS!
Thank you so much for your kind words!!! I am so happy to be asked lots and lots of questions. It gives me such job to talk about embryology as I have such a passion for it. I truly love what I do. I am a helping hand for anyone who needs it!
Thank you so much for your response!!! There are so many ladies going through ivf on this forum that I am sure you'll be getting LOTS of questions.
Thanks for being here!!!!
Thanks for being here!!!!
Thank you so much for your help. I'll be seeing another RE for a second opinion on April 15th, so maybe he will be more open to more tests before I move on to IVF. So far, I've had all the hormone tests done (normal), HSG (normal) and my husband has had a SA (normal). I do have Factor V, though, which I already knew about before TTC. It puts me at higher risk for blood clots, but it's not suppose to be an issue until later on in pregnancy (will need heparin), and both my miscarriages were early on (8 weeks missed abortion [D&C] and 6.5 weeks spontaneous miscarriage). I'll ask him about the immunological tests you mentioned.
Thanks again for being here for all of us :-)
Thanks again for being here for all of us :-)
It sounds like you sure have been through the ringer. I think its important to try and understand why you are miscarrying in order to fully know how to work with it. I think a second opinion is always a wise decision, especially when you consider the financial factors and the emotional ones too!
I'm so glad to have you here. I just failed my first IVF with 3days transfer. I know something is out of Re control such implantation and so....
I just want to do my best to increase the change of pregnancy.....My RE doesnt provide such 5 days transfer because to him there is no difference. He ask me to trust my body rather than the lab which means let embryos inside me........I understand planty of people get pregnancy with only 3days transfer. I do some research and there is pro and cons for each method....In your opnion, which one is better?
Thanks
I just want to do my best to increase the change of pregnancy.....My RE doesnt provide such 5 days transfer because to him there is no difference. He ask me to trust my body rather than the lab which means let embryos inside me........I understand planty of people get pregnancy with only 3days transfer. I do some research and there is pro and cons for each method....In your opnion, which one is better?
Thanks
Thanks so much for joining the forum. I'm 32 yrs old and have tried ivf 3 times now without success. I have severe endometriosis and each time my embryo quality has been extremely poor. I was wondering if you see alot of this with women who have endometriosis. My RE has no explanation for the poor quality embryos but I feel like it could be related to the endo. Any thoughts?
So sorry to hear you have had so much trouble. It seems so hard that so many people want children and can't have them and then people who get them don't want them.
So it depends a lot on your RE whether or not to do a blastocyst (day 5) transfer. Here is what goes into our decision. If you have had a day 3 transfer with high quality embryos and did not get pregnant we usually try a day 5 transfer next. Also, if you have a number of good embryos on day 3 we wait until day 5 because only about 50% of embryos in a natural pregnancy will make it to the blastocyst stage. There is a lot of cell changes from day 3 to day 5 so we will wait until day 5 and risk cancelling the transfer. We'd rather NOT do a transfer than do a transfer just for the sake of trying when we are not confident they are good embryos.
Theoretically the implantation rates and the pregnancy rates do not show any different. You can just be more selective on day 5 and narrow the number down. For instance if you have 5 good day 3 embryos on day 5 you will probably only have 2 or 3, so lets wait and see whats there on day 5 and only transfer the two best.
I think it is somewhat naive not to try a day 5 transfer. By culturing the embryos until day 5 you can see if they do not progress past day 3 and that can tell us more about your egg quality. But the RE knows best *snicker*. Plus in IVF now, we use sequential media, that means on day 3 the embryos are transfered from cleavage media to blastocyst media. Media has improved a lot in the past 5 years, and most embryos grow as well in the lab as in the uterus.
Have you thought about maybe changing to another clinic which would give you more diagnostic options such as day 5 transfers? Maybe even a day 6 transfer? Good luck to you. Let me know if you have any other questions.
So it depends a lot on your RE whether or not to do a blastocyst (day 5) transfer. Here is what goes into our decision. If you have had a day 3 transfer with high quality embryos and did not get pregnant we usually try a day 5 transfer next. Also, if you have a number of good embryos on day 3 we wait until day 5 because only about 50% of embryos in a natural pregnancy will make it to the blastocyst stage. There is a lot of cell changes from day 3 to day 5 so we will wait until day 5 and risk cancelling the transfer. We'd rather NOT do a transfer than do a transfer just for the sake of trying when we are not confident they are good embryos.
Theoretically the implantation rates and the pregnancy rates do not show any different. You can just be more selective on day 5 and narrow the number down. For instance if you have 5 good day 3 embryos on day 5 you will probably only have 2 or 3, so lets wait and see whats there on day 5 and only transfer the two best.
I think it is somewhat naive not to try a day 5 transfer. By culturing the embryos until day 5 you can see if they do not progress past day 3 and that can tell us more about your egg quality. But the RE knows best *snicker*. Plus in IVF now, we use sequential media, that means on day 3 the embryos are transfered from cleavage media to blastocyst media. Media has improved a lot in the past 5 years, and most embryos grow as well in the lab as in the uterus.
Have you thought about maybe changing to another clinic which would give you more diagnostic options such as day 5 transfers? Maybe even a day 6 transfer? Good luck to you. Let me know if you have any other questions.
So sorry to hear about the endometriosis. What a horrible disease. Very painful and probably very frustrating as well.
There have been numerous studies which have looked at the effect of endometriosis on embryo quality, and I think the verdict is still out. However a number of labs have reported a decreased embryo quality in patients with endometriosis.
For example, there are thoughts that endometriosis causes alterations in the follicle which results in lower quality oocytes. The verdict is still out because I don't think anyone really knows why.
There are also reports that suggest that this negative environment hormonally can cause a decrease in further embryo development. In this same case, the patient with endometriosis was implanted with a donor embryo and successfully carried a child to term, which suggests the issue was not with the uterus, but rather with the embryo.
I wish I had a more complete answer for you, hopefully continued research will unlock the clue. Unfortunately, there is not a lot that fertility treatments can do when there is an egg issue. Good luck to you, and continued hope of success in your effort at TTC.
These observations indicate that infertility in patients with endometriosis may be related to alterations within the follicle which, in turn, result in oocytes and embryos of lower quality, as demonstrated in the IVF programme. In addition, these embryos have a reduced ability to implant, as observed in the oocyte donation model. These alterations may be induced by functional changes in the process of folliculogenesis that affect steroid synthesis, as well as by cytokine release by ovarian and blood cells.
There have been numerous studies which have looked at the effect of endometriosis on embryo quality, and I think the verdict is still out. However a number of labs have reported a decreased embryo quality in patients with endometriosis.
For example, there are thoughts that endometriosis causes alterations in the follicle which results in lower quality oocytes. The verdict is still out because I don't think anyone really knows why.
There are also reports that suggest that this negative environment hormonally can cause a decrease in further embryo development. In this same case, the patient with endometriosis was implanted with a donor embryo and successfully carried a child to term, which suggests the issue was not with the uterus, but rather with the embryo.
I wish I had a more complete answer for you, hopefully continued research will unlock the clue. Unfortunately, there is not a lot that fertility treatments can do when there is an egg issue. Good luck to you, and continued hope of success in your effort at TTC.
These observations indicate that infertility in patients with endometriosis may be related to alterations within the follicle which, in turn, result in oocytes and embryos of lower quality, as demonstrated in the IVF programme. In addition, these embryos have a reduced ability to implant, as observed in the oocyte donation model. These alterations may be induced by functional changes in the process of folliculogenesis that affect steroid synthesis, as well as by cytokine release by ovarian and blood cells.
Hi there,
Warm welcome to the forum and thanks a lot.
Could you please tell me what difference does it make to transfer an embryo or a blastocyst. Can a frozen embryo be grown upto blastocyst level. I had an unsuccessful first PICSI cycle and am planning for the second one. Any sort of advice is more than welcome. Thanks.
Warm welcome to the forum and thanks a lot.
Could you please tell me what difference does it make to transfer an embryo or a blastocyst. Can a frozen embryo be grown upto blastocyst level. I had an unsuccessful first PICSI cycle and am planning for the second one. Any sort of advice is more than welcome. Thanks.
Thanks so much for the warm welcome! I think you are some of the most wonderful women I have ever come across, so educated about what they are going through, so eager to learn and understand mroe.
So a frozen embryo can definitely be grown to a blastocyst, and most of the time we do this in normal cycles. Donor cycles tend to be grown to d3 simply because the eggs are so young and healthy. When the embryos are thawed they are cultured to whatever day just as in a fresh cycle. Depending on when they are frozen (what day) will depend how long they are cultured before transfer.
Ok so the great debate, d3 or d5 transfer. There is no difference in the pregnancy rates or implantation rates between a day 3 and day 5 transfer. We often choose a day 3 transfer in a patient who does not have a lot of embryos to work with, or has extremely high grade embryos on day 3 (8c g4, where grade 5 is the highest, but we really dont give out 5's because there's no "perfect" embryo in our eyes, we are our own worst critics).
In a patient who has a number of decent looking embryos on day 3, we will decide on a blastocyst transfer because we can be more selective on day 5 because metabolically the embryo is showing us a lot more about its health on day 5 than day 3. For example, on day 3 the embryo has cleaved from originally being one cell, to be 8 cells. By the blastocyst stage the embryo has started to expand and is intaking and expelling fluid in and out of the cell (expanding and collapsing) which will eventually be the force that causes the zona pellucida to rupture, and the embryo to hatch. If I have lost you along the way, let me know, its a lot to take in.
So by day 5, usually about 1/2 of the original embryos will have stalled, and the embryos which have survived and developed into blasts have a better chance of implanting and resulting in a normal pregnancy. However, nothing we as embryologists do makes the day 5 transfers more successful than day 3. It is simply the fact that we can be more selective, and say 6 embryos which all looked the same on day 3 will have become by day 5, two expanding blastocysts, and 4 icky looking things (yes a technical term).
I hope this answered your question. Good luck on your future cycles. If you have any more questions, please do not hesitate to contact me!
Could you please tell me what difference does it make to transfer an embryo or a blastocyst.
So a frozen embryo can definitely be grown to a blastocyst, and most of the time we do this in normal cycles. Donor cycles tend to be grown to d3 simply because the eggs are so young and healthy. When the embryos are thawed they are cultured to whatever day just as in a fresh cycle. Depending on when they are frozen (what day) will depend how long they are cultured before transfer.
Ok so the great debate, d3 or d5 transfer. There is no difference in the pregnancy rates or implantation rates between a day 3 and day 5 transfer. We often choose a day 3 transfer in a patient who does not have a lot of embryos to work with, or has extremely high grade embryos on day 3 (8c g4, where grade 5 is the highest, but we really dont give out 5's because there's no "perfect" embryo in our eyes, we are our own worst critics).
In a patient who has a number of decent looking embryos on day 3, we will decide on a blastocyst transfer because we can be more selective on day 5 because metabolically the embryo is showing us a lot more about its health on day 5 than day 3. For example, on day 3 the embryo has cleaved from originally being one cell, to be 8 cells. By the blastocyst stage the embryo has started to expand and is intaking and expelling fluid in and out of the cell (expanding and collapsing) which will eventually be the force that causes the zona pellucida to rupture, and the embryo to hatch. If I have lost you along the way, let me know, its a lot to take in.
So by day 5, usually about 1/2 of the original embryos will have stalled, and the embryos which have survived and developed into blasts have a better chance of implanting and resulting in a normal pregnancy. However, nothing we as embryologists do makes the day 5 transfers more successful than day 3. It is simply the fact that we can be more selective, and say 6 embryos which all looked the same on day 3 will have become by day 5, two expanding blastocysts, and 4 icky looking things (yes a technical term).
I hope this answered your question. Good luck on your future cycles. If you have any more questions, please do not hesitate to contact me!
Could you please tell me what difference does it make to transfer an embryo or a blastocyst.
Thank you so much for your answere.
Yes, I was thinking to change to another the clinic when I just first start my IVF cycle because my IVF cycle protocol is about similar to prior IUI. I did not feel right since I need more eggs in IVF. At 37 year old, he said people need to take at least 3-4 repronex+bravell, but he only give me 2. He is too concern about over stimulation and turn out I only have 6 small follicles after 4 days of shots, so I must double the med., and have shot up to day 12 try to recue the eggs. I ask him to cancel since there is not many eggs and he said I meet the min eggs which is 5. Finally, he retrieves 5 mature eggs and 3 fertilized so I do day 3 transfer since there is not enough to go futher anyway. I'm so confused now, since he knows my body for over 1 year, if I switch to other, would it be benefit for me? I'll have a follow up next monday. I ask him couple times about if there are many eggs, would he offers me day 5 transfer?
his answere is always no, since he does not believe any difference and he wont allow to have many follicles either since it'll decrease the egg quality. His goal is 5-10 follicles is the most......This really bother me since I have no insurance cover at all.....I could not keep try IVF on and on........
Yes, I was thinking to change to another the clinic when I just first start my IVF cycle because my IVF cycle protocol is about similar to prior IUI. I did not feel right since I need more eggs in IVF. At 37 year old, he said people need to take at least 3-4 repronex+bravell, but he only give me 2. He is too concern about over stimulation and turn out I only have 6 small follicles after 4 days of shots, so I must double the med., and have shot up to day 12 try to recue the eggs. I ask him to cancel since there is not many eggs and he said I meet the min eggs which is 5. Finally, he retrieves 5 mature eggs and 3 fertilized so I do day 3 transfer since there is not enough to go futher anyway. I'm so confused now, since he knows my body for over 1 year, if I switch to other, would it be benefit for me? I'll have a follow up next monday. I ask him couple times about if there are many eggs, would he offers me day 5 transfer?
his answere is always no, since he does not believe any difference and he wont allow to have many follicles either since it'll decrease the egg quality. His goal is 5-10 follicles is the most......This really bother me since I have no insurance cover at all.....I could not keep try IVF on and on........
You are so welcome.
The main problem with your cycle is that if you start your drugs too low, then just upping them mid stimulation can produce a lot of immature eggs and poor quality eggs because they weren't all stimulated starting at the same time.
I think switching to another doctor is a hard decision that only you can make. You can always have your records sent and the new RE will use your past IVF's as a diagnostic tool for your future cycles.
More follicles does not always mean less quality if there are a number of well developed follicles. Our belief is that if we do not think your embryos will make it to day 5, to wait anyways and cancel the transfer. We'd rather do NO transfer at all then put you through all of that knowing you will probably not get pregnant.
I would wait to see how the follow up goes and discuss more stimulation and a better plan. There is no difference in pregnancy rates between day 3 and 5 transfers but it can allow us to not do a transfer at all instead of putting you through the stress.
Good luck to you.
The main problem with your cycle is that if you start your drugs too low, then just upping them mid stimulation can produce a lot of immature eggs and poor quality eggs because they weren't all stimulated starting at the same time.
I think switching to another doctor is a hard decision that only you can make. You can always have your records sent and the new RE will use your past IVF's as a diagnostic tool for your future cycles.
More follicles does not always mean less quality if there are a number of well developed follicles. Our belief is that if we do not think your embryos will make it to day 5, to wait anyways and cancel the transfer. We'd rather do NO transfer at all then put you through all of that knowing you will probably not get pregnant.
I would wait to see how the follow up goes and discuss more stimulation and a better plan. There is no difference in pregnancy rates between day 3 and 5 transfers but it can allow us to not do a transfer at all instead of putting you through the stress.
Good luck to you.
Thank you so much for your advice. I'll follow up with him this coming monday and also get the second opinon from other clinic as well in the next couple weeks.
Welcome to the group! I think it's wonderful you are offering your expert advice to our group. These are wonderful women who are some of the most deserving. I have recently had 2 miscarriage. The last one just happened a week ago today. I had perfectly rising hCG levels but and when the ultrasound was done it showed a perfect gestational sac and a yolk sac, it measured me at 5 weeks 4 days pregnant. Then when my hCG levels were checked again they had fallen, 2 days later I miscarried. Everything was expelled. Is there a reason for this? The ultrasound even showed thicken endometrial lining indicative of a healthy progessing pregnancy.
I seen your blog and I too had factorV and lost seven pregnancies between 6-18 weeks, before I found out about the factorV. My Dr. started me on the heparin at 5 weeks and that made a difference. How are your progesterone levels? Mine were always lower in the beginning. Have you tried MACA? I am a firm believer in it. It helps prevent against miscarriages that are due to low hormone levels, and helps with fertility. It is also safe to take throughout pregnancy. I have 4 beautiful children and I thank MACA.
Welcome! What a nice thing you are doing, in joining this group and offering us your expertise and experience. Thank you so much.
Is there an age factor in your practice for the 3day vs 5day? For patients over a certain age, is it best to not wait for the 5 day, because the embryo will have a better chance in the uterus than in the lab?
I'm 43 and got pregnant naturally 7 months ago, but miscarried at 8 weeks. I recently had my first IVf. I only produced 2 follicles, and at retrieval we learned one follicle was empty. My FSH levels are extrememly high, but my RE believes that high FSH levels alone is not the end all of determining factors. He believes it's more indicative of age, and that it might or might not play a role in fertility. The egg looked good, it fertilzied and the embryo was very high quality, so we were happy. For patients over 35, they do not wait for blast, as they believe the embryo has a better chance to go to blast in the uterus. In other words, if it didn't go to blast in the lab, it might have in the uterus. Sadly, I did not get pregnant and we are now considering donor eggs. In retrospect, and after taking a randam FSH level (20.9), he feels that it probably is indicative of low quality/qty of eggs which is why we are considering donor eggs at this point. It's a hard decision of course, as it's hard letting go of the dream.
You mentioned you often choose a 3 day transfer for patients with few eggs, or high quality 3 day embies. So in these cases then, you don't risk waiting for the 5 days and canceling the cycle if they don't go to blast? I'm curious what you would have done with a patient my age - transfered at day 3? Of course I'm hoping that's the case, as it's too late for me now and I'd hate to think that we should have waited and just cancelled the transfer if it didn't go to blast... but I would like to continue to educate myself in all opinions, in case we do another IVF with my eggs (highly unlikely though... we pay for this out of pocket, and doing a second cycle will put us in debt - so might as well go with the best odds).
Lastly, even a great embryo on day 5, once transferred, can still end up NOT developing/dividing correctly, and therefore not acheiving a pregnancy, right? In other words, there is still so much more that needs to happen once in the uterus, that the best of the best still might not be "good enough" for a pregnancy? Otherwise, women would be having multiple births every time! It's just hard, when high quality embryos go in, and it still doesn't work...
Again, thanks so much for your participation in this forum. The women are incredible and as you already see are grateful to have you here. :o)
Is there an age factor in your practice for the 3day vs 5day? For patients over a certain age, is it best to not wait for the 5 day, because the embryo will have a better chance in the uterus than in the lab?
I'm 43 and got pregnant naturally 7 months ago, but miscarried at 8 weeks. I recently had my first IVf. I only produced 2 follicles, and at retrieval we learned one follicle was empty. My FSH levels are extrememly high, but my RE believes that high FSH levels alone is not the end all of determining factors. He believes it's more indicative of age, and that it might or might not play a role in fertility. The egg looked good, it fertilzied and the embryo was very high quality, so we were happy. For patients over 35, they do not wait for blast, as they believe the embryo has a better chance to go to blast in the uterus. In other words, if it didn't go to blast in the lab, it might have in the uterus. Sadly, I did not get pregnant and we are now considering donor eggs. In retrospect, and after taking a randam FSH level (20.9), he feels that it probably is indicative of low quality/qty of eggs which is why we are considering donor eggs at this point. It's a hard decision of course, as it's hard letting go of the dream.
You mentioned you often choose a 3 day transfer for patients with few eggs, or high quality 3 day embies. So in these cases then, you don't risk waiting for the 5 days and canceling the cycle if they don't go to blast? I'm curious what you would have done with a patient my age - transfered at day 3? Of course I'm hoping that's the case, as it's too late for me now and I'd hate to think that we should have waited and just cancelled the transfer if it didn't go to blast... but I would like to continue to educate myself in all opinions, in case we do another IVF with my eggs (highly unlikely though... we pay for this out of pocket, and doing a second cycle will put us in debt - so might as well go with the best odds).
Lastly, even a great embryo on day 5, once transferred, can still end up NOT developing/dividing correctly, and therefore not acheiving a pregnancy, right? In other words, there is still so much more that needs to happen once in the uterus, that the best of the best still might not be "good enough" for a pregnancy? Otherwise, women would be having multiple births every time! It's just hard, when high quality embryos go in, and it still doesn't work...
Again, thanks so much for your participation in this forum. The women are incredible and as you already see are grateful to have you here. :o)
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