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824127 tn?1290516842

Should I do Blastocyst?

I had two IVF's this year first one 2 day 4 cell transfer of three eggs..quality 4 (1-5 , 5 being best) my Hcg levels were 8.1 on 5th day so was looking good but failed..2nd IVF April 2 with three frozen embryo's 1 -turned into 9 cell, 1 turned into 8 cell and 1 stayed at 4 cell they put back all three.. no pregancy...

I just returned from dr and I suggested doing blastocyst or having the eggs incubate longer, he said that it really does not improve the success rates transferring eggs on day 2, 3 day 4 or 5 and that you lose more eggs in the long run going to blastocyst stage.. he felt it was better to transfer on day 2 or 3.. after hearing him it is apparant that they do not do blastocyst often meaning they don't have much experience with it..

I asked him to increase the dosage of the Subcut puregon-originally he gave me a low dose 250ml and i produced 11 eggs 6 of which were good.. my antral follicle count is total of 37, he was afraid i would over stimulate if he gave me higher dose.. i read that if you give higher dose in first 5 days you can recruit more eggs, which would enable me to try to do blastocyst.. he said if i wanted to try to do this he would..he suggested that i could do a dose of 400ml or 600ml..he said since i do soo much reading he would let me decide what i want.. he normally would give me 400ml and keep it steady to see how many eggs we'd recruit..

i asked them to put more then three eggs in the most they can put back is 4, i know that i run the possibility of quadruplets but i'm 39 years old and so far really feel that i'll be lucky if i get one.. he also said he will try the assisted hatching this time and will do blastocyst only if i recruit alot of eggs this time otherwise he will leave eggs out 3 or 4 days if we want..

I need a second opinion.. the hosiptial is public hospital here they have the best success rate but i feel that they are not being agressive enough with my program..

19 Responses
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254689 tn?1251180040
When I first joined MedHelp in 2007, I ran across this article when researching this very subject for a friend - hopefully, this article will still be there -

http://www.sharedjourney.com/articles/3vs5.html.

You might also get more insight if you type in "three day vs five day transfer" in the search part for MedHelp.  I hope this helps - good luck in your decision - SSBD! - jen
Helpful - 0
824127 tn?1290516842
I wanted to thank you for sending this to me it really helped me with my decision..  My dr has advised depending on how many eggs i get with my next cycle transfer schedule for early July 2009 will depend on if we go to blastocyst stage, he says their hospital has a high success rate with 3day transfers not to worry we'll cross that bridge when we get there depending on quality of my embryo's..

Helpful - 0
901431 tn?1242066034
Hello I just did my first IVF on 5-6-09 My Doctor told me he wanted to do the blastocyst due to better out come mine were 5 day and I go friday for bloodtest. So im not sure which is better but his team said mine were HQ grade 4 and they were 8 cell. which they werent like that on day 3.
Helpful - 0
Avatar universal
I thought I will join the 39er group here.  I too am 39 and planning to go for IVF in May.  My RE recommended that I have a 3 day transfer and will not put back  more than 3 eggs.  

40smama, thank you for the link.  It helped me raise a lot of questions I need toa sk my RE before going for IVF
Helpful - 0
847328 tn?1289783114
Hi all!  I just wanted to say go 39ers!!  I'm having my first IVF at the end of June, so I am going to keep you all close to me so we can check in and support one another!
Helpful - 0
Avatar universal
40smama, What a fantastic article!!!  My clinic does all day 5 blasts unless it looks like the embryos aren't going to make it to blast, and then they do day 3.  But they didn't tell me all that the article said.  They just said the reason for going to blast is "natural selection," because if you have many good looking embryos on day 2 and transfer any 2, those might be ones with chromosomal problems that might stop growing in another day or so, and meanwhile the 1 embryo that has the genetic capability to become a baby would have to be frozen and might not make the thaw, etc, and you would have to pay even more money for another transfer of that embryo that you should have waited a few more days and transferred to begin with.  That article was highly informative and very interesting!  Thanks!
Helpful - 0
Avatar universal
Thank you for that link, the information was very good. I am so glad that I found this forum because I've learned so much! When I did my first IVF transfer, it was a day 3 transfer. I had 5 embies that did not make it to freeze. Now I am thinking that the 2 that were transfered did not even make it to blastocyst. My RE really wanted to do a day 5 transfer but I guess the embies were not developing as he expected.  I will be asking for a day 5 transfer for my second IVF cycle which will be coming up soon.
Helpful - 0
824127 tn?1290516842
Hi everyone,  Looks like there are some new women on this thread.  Its nice to know some other women going through same thing as i am.  I will be doing my 2nd Fresh Cycle IVF around July 4th..

My dr will go to blastocyst if i get enough eggs to do so, otherwise we will see how many after day 3 possibly day 4.

Good luck to all of you, wishing all lots of luck with your next IVF's.


Helpful - 0
Avatar universal
Like you, I have done two ivf's, both with top-quality embryos, but achieved no implantation.  I am also at a public hospital (in France), and they usually do 2-day transfers.  Both times, I requested waiting for 5 days, since everything I read says 5-day transfers work better, particularly with implantation failure.  I am frustrated with my doctor and his lab technician, as I do not believe they are tailoring my program to my needs, but rather prescribing "get 'em in, get 'em out" treatment.  I have only read of 2-day transfers at public facilities.  

Helpful - 0
824127 tn?1290516842
I totally understand your frustration, what did your dr say to you when you requested to do blastocyst?  My dr. said he was willing to go to blastocyst as long as i had enough eggs from the stimulation this time to try and that he would definitely go to day 3 or 4 at the minimum if i did not have enough eggs..

How many eggs did you have from your stimulation? if its less then 15 usually dr's dont try to go to blastocyst..  

I'm not sure the conversation you had with your dr, but in the end you are paying for the treatment.. i know that going to blastocyst stage is more expensive then day 2 so this may be one reason why the hospital only goes to day 2, however, you also must consider whether the lab is experienced with doing day 5 transfer's (find out if they have ever done blastocyst and if they have how successful were they with it), if they have never done it before then they are not experienced in doing it and therefore you might want to reconsider asking them to do day 5 and losing all your eggs with an inexperienced lab.. You are better off having them try to go to day 3 or 4..

Another alternative would be to go to another hospital where they have experience with blastocyst or get a 2nd opinion from another hospital.

I hope this helps, don't lose faith i'm sure it will happen for you.
Helpful - 0
Avatar universal
The other thing to keep in mind is that in natural conception, an embryo isnt in your uterus til day 5 so putting a day three there is 'premature'. it's supposed to still be in your fallopian tubes that day. That is why i believe day 5 is 'best'. but again, if your eggs won't make it that long, you have no choice.
Helpful - 0
824127 tn?1290516842
I was wondering if any of you have taken menopur with your ivf if you feel it improved the success or any suggestions.  i have a friend from states who is telling me that it is highly affectective, i 've sent an email to my dr asking if we should use this for my 2nd full cycle of IVF due july 4th week.
Helpful - 0
655897 tn?1328018445
HI:)  I also am doiong IVF starting Lupron at the end of this month.  My ret. and transfer probably won't be until mid-later July.
Anywa, I saw your post and I have to tell you that Menopur has done wonders for me.  This will be my fourth IVF.  The first cycle, they only had my on Gonal F.  I had only 8 mature eggs out of about 20  and out of those 8, only 3 fertilized.  We had to have PGD done so they told us we shoudl do another cycle to get more eggs before we do testing so we did another cycle and I used Gonal F and Menopur.  I had a lot more mature eggs and 11 fertilized.  I had three transferred on day 5 and did not get pregnant.  I do not have good embryo quality due to a disorder that I have.  I also used Menopur and Gonal F last year for my most recent IVF.  I had 18 eggs retrieved, and all 18 were mature. 14 fertilized and 11 were able to be tested so Menopur made a big difference in egg maturity and fertilization.  The shot itself does sing a lot so with my last IVF I had my husband give it to me in my backside and it didn't hurt.  Have you started your Lupron injections?  When will your retrieval be?  Maybe we can be cycle buddies?
Helpful - 0
Avatar universal
My doctor says that he will let me wait for a blastocyst next time.  I don't think he much liked my challenging the 2-day transfers, but he didn't contradict the evidence in blastocyst's favor.  However, he warned that sometimes embryos don't make it 5 days, not because they're bad embryos, but because the lab process of waiting is tricky.  Still, everything I read strongly suggests that implantation rates are better with blastocysts, not only because they can pick stronger embryos but also because the endometrium-embryo relationship is more likely to take.
Is Menopur an LH drug?  Like Luveris?  Because in both of my cycles, my doctor or his nurses forgot to tell me to start taking Luveris on day 6.  I was on Gonal-F only.  Next attempt, I am going to make sure I have the Luveris, because my understanding is that LH helps with progesterone levels and implantation.
Helpful - 0
254689 tn?1251180040
hi ladies -

Everyone, I'm glad the article was helpful.  Now I've done further research and I've discovered that re's like to do day 3 transfers on older women (I hate calling us that!) because they're worried no embryos will make it to day 5 and they at least want some options so therefore they'll "roll the dice" and transfer the healthy embies on day 3.

I still don't understand day 2 transfers but from what I understand is that women in the early to mid 40s will probably do this because egg quality is lower than it is w/a younger woman (hate that too).

I'm looking for the link/article that I read about all of this so bear w/me.  I think it's more about survival so that there will be embryos to transfer at all.  I still believe like the shared journey article that day 5 embryos have a higher rate of implantation.

I'll share the link ASAP - SSBD, jen
Helpful - 0
824127 tn?1290516842
thanks for the information about the link - i've heard the same as well, is a little dissapointing since i'll be 40 in february..

I'll still try to keep the faith!

a
Helpful - 0
Avatar universal
Are you starting a fresh ivf cycle soon?  I should be doing so in a few days.  It might be interesting to compare notes since we're both considering blastocysts.
Helpful - 0
945508 tn?1259156758
If your facility is not comfortable with 5 day transfer I would do a 3 day.  From everything I have read it is harder to grow them until day 5.  I would rather chance them growing inside than in an inadequate incubator.  JMO....  Best of luck to you!
Helpful - 0
776366 tn?1295689591
I would lust like to say that I had already read that article and found it very helpful during our early consultations! Just remeber that the words of your RE are not scripture, sometimes only opnion. If your opinion differs because of what you've read.. Question it. You have a right to make decisions about your treatment.  
Helpful - 0
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