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Embryo quality


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#1 claudia_ann

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Posted 11 August 2016 - 10:36 AM

Second opinion from a professional..

 

I just finished a fresh cycle 2 months ago.  I retrieved 12 eggs, 9 fertilised without ICSI and out of those 9, 5 grew to day 5.   Out of the 5 we put back one which was graded 19 out of 20 buy our clinic. 

I achieved a chemical pregnancy which I know because I took pregnancy tests early to confirm negative (I didn't want to get a positive because of my trigger shot) and then took a pregnancy test a few days later and got a faint positive at 6 days post a 5 day transfer.  I took a test every two days for a week (I had that many tests so I figured I would use them).  Every test came back positive, slightly darker in the results but not HUGE.  Then on 13 days post a 5 day transfer my tests started coming back negative.  So according to what i read, that seems like textbook chemical pregnancy.  

 

When discussing with our clinic during our follow up, they said that even though you can have a "perfect embryo" it doesn't mean that there are no genetic abnormalities and that my body acts as a natural screen by rejecting the embryo.  While this is reassuring that my body is doing its job.. I'm nervous that all my embryos could have abnormalities.  We have 4 frozen, which at the time of freezing we ended up with two blasts graded 19 and 20, and we have two early blasts graded 9 and 10.  The doctor said that if they thaw them, they would let them grow a little more and then give them another grading if they make it to extended blasts.    But really, they feel the two best quality ones are the best I have. 

So here is my thing. We didn't do genetic testing on our embryos as 1) my doctor didn't feel it necessary. I am 37, have a 4 year old son that was conceived naturally, and I have no explained fertility issues.  and 2) it was an extra 5000 to do the testing and we just didn't want to put more financial strain on us.

 

My doctor recommended that "if" we went through all 4 embryos and are not successful, and if we decide to do another protocol, she would THEN recommend genetic testing.

 

I guess my question is this...  if the one we implanted had a genetic abnormality, does that mean likely all my embryos have the same problem?   Also, could i have achieved a chemical pregnancy and there NOT have been a genetic problem?  Perhaps something else wasn't going well and my body stopped?   I'm just looking for a sliver of hope that one of my remaining embryos could be our baby.  As I am sure you know, this process is so hard on the heart and I just need hope.

 

Thank you for any advice you can offer.

 

Extra info:

I took menupur and Gonal F shots for 10 days before my retrieval. Doctors said that I responded well to the drugs and that my lining was thickening up beautifully prior to implantation.    


Me: 37 DH: 37

DS born Jan 2012
TTC since Dec 2013

MC April 2014

IVF May 2016 - Long Protocol

12 eggs retrieved

9 fertilised  

5 made it to day 5

transferred 1, froze 4.

Chemical Pregnancy

 

FET #1 Sept 2016
 

 


#2 amp77

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Posted 11 August 2016 - 11:11 AM

I am not a professional but, to answer one question, just because one is abnormal, does not mean the rest are.  Don't quote me on the stat but, if you are over 40, something like 60% of embryos are abnormal.  So, if you have 5, you would expect 3 to be abnormal and 2 to be normal, on average (again, I may have the % wrong, but it's just an example).

 

I hope someone has more answers and wishing you success on your upcoming FET!


Age 40, DH 44 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son and our first FET brought us our second son in 2017.  Our family is complete!

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

FET #1 - September 2016 - BFP - 5B-BB and 3 frosties (2x4B-BB and 3B-BB)

June 18, 2017 - Matthew William was born at 2:46 am, weight 8 lbs, 11 oz and 21" long.  He is perfect in every way too!

 

 


#3 claudia_ann

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Posted 11 August 2016 - 12:55 PM

Thank you.   I'm under 40. but not by much.. 37..  so perhaps that's a way to think of it..  So maybe one or two of the ones i have left are good.  Oh i so hope so. 


  • amp77 likes this

Me: 37 DH: 37

DS born Jan 2012
TTC since Dec 2013

MC April 2014

IVF May 2016 - Long Protocol

12 eggs retrieved

9 fertilised  

5 made it to day 5

transferred 1, froze 4.

Chemical Pregnancy

 

FET #1 Sept 2016
 

 


#4 amp77

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Posted 11 August 2016 - 01:00 PM

Thank you.   I'm under 40. but not by much.. 37..  so perhaps that's a way to think of it..  So maybe one or two of the ones i have left are good.  Oh i so hope so. 

For sure.  Each egg is unique.  Each sperm that fertilized it was unique.  Think of it like fraternal twins.  Fertilized at the same time but the babies can come out one of each sex or looking completely different.  I have male fraternal twin cousins that look totally different and with completely different personalities.  


Age 40, DH 44 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son and our first FET brought us our second son in 2017.  Our family is complete!

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

FET #1 - September 2016 - BFP - 5B-BB and 3 frosties (2x4B-BB and 3B-BB)

June 18, 2017 - Matthew William was born at 2:46 am, weight 8 lbs, 11 oz and 21" long.  He is perfect in every way too!

 

 


#5 amp77

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Posted 11 August 2016 - 01:02 PM

Thank you.   I'm under 40. but not by much.. 37..  so perhaps that's a way to think of it..  So maybe one or two of the ones i have left are good.  Oh i so hope so. 

For sure.  Each egg is unique.  Each sperm that fertilized it was unique.  Think of it like fraternal twins.  Fertilized at the same time but the babies can come out one of each sex or looking completely different.  I have male fraternal twin cousins that look totally different and with completely different personalities.  


Age 40, DH 44 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son and our first FET brought us our second son in 2017.  Our family is complete!

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

FET #1 - September 2016 - BFP - 5B-BB and 3 frosties (2x4B-BB and 3B-BB)

June 18, 2017 - Matthew William was born at 2:46 am, weight 8 lbs, 11 oz and 21" long.  He is perfect in every way too!

 

 


#6 returnable

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Posted 11 August 2016 - 01:12 PM

I agree with amp77 and the fact that just because one may have been abnormal, does not make the abnormal. To answer your other question, you can have a perfect embryo even genetically, and still it does not take. There are so many variables and steps to the process. So many DH and I have talked how hard this process is that going through IVF you are in tune to where you "should" be in the pregnancy calendar, whereas someone trying naturally wouldn't even know they had a "chemical". Keep your hope. Yes there are not guarantees, and I agree that perhaps if you have to do next round of IVF do the genetic testing. It's expensive, but it may answer some questions, and perhaps save you money in the long run.



#7 piggypower

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Posted 12 August 2016 - 11:36 AM

Thank you.   I'm under 40. but not by much.. 37..  so perhaps that's a way to think of it..  So maybe one or two of the ones i have left are good.  Oh i so hope so. 

In terms of fertility, 37 is much better than 40, so try not to think of yourself as a 40 year old yet! :)  I'll echo what the ladies above have said- each embryo is different so one embryo's abnormalities do not impact the others. When I did genetic testing on my embryos, all of them were abnormal, but each in a different way. Not to say that will happen to you, I'm a bit of a rarity in that regard. Hopefully the rest of your embryos will be normal! :)


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#8 schlepp

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Posted 12 August 2016 - 05:51 PM

I was just at the RE reviewing our situation and he showed me a table with PGS tested embryos and % normal (their data is from the lab that does their PGS testing). They broke it down by number of day 5 embryos resulting from the cycle and then age brackets. For my bracket, 37-39 years old, and 1-3 embryos retrieved, the % of normal embryos was 49%. We have one day 5 embryo frozen and there is basically a 49% chance it is normal. I think the % in my age bracket for when you retrieve 4-6 embryos was quite similar or a bit higher number...I feel like it said 58%. But then for my age bracket when you had 7-9 from that cycle the % normal started to decrease. 

The graph here also shows by age the number of genetically abnormal:

http://www.advancedf...tic-testing.htm


  • Elizabeth22 likes this

(age 38) June 2016 IVF #1 antagonist, 13 mature eggs, 4 fertilized, 1 blast frozen

October 2016 FET #1 cancelled, thin lining

Changed clinics

(age 39) April 2017 FET #1.1 BFN

July 2017 partner has vasectomy reversal

Feb & March 2018 - Medicated IUI x2 - BFN (even with 7 mature follicles on the 2nd IUI)

(age 40) May 2018 IVF#2, lupron flare, 7 mature eggs, 5 fertilized, 1 blast & 1 morula fresh transfer, BFN. 1 low quality blast frozen

June 2018 IVF#3 mini stim, 1 egg, immature

Sept/Oct 2018 IVF#4 antagonist with HGH - CANCELLED due to high estrogen/29mm cyst

Oct 2018 IVF#4.1 antagonist with HGH - 7 eggs, all mature, 6 fertilized, 2 blasts on day 6, PGS tested/euploid

November 2018 FET #2 w/immune protocol and 1 PGS tested -  BFN

Locus Medicus testing for virus, bacteria and immune issues. Husband treated.

(age 41) April 2019 IVF#5 converted to IUI#3 due to follicle growth. BFP 12 day post IUI. Di/Di twins.

Dec 17 2019 - Baby boy and girl born at 36 weeks + 2 days. Everyone very healthy. 

 

See my 'about me' page for more detail on my treatment history.


#9 schlepp

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Posted 12 August 2016 - 05:55 PM

Also, I wouldn't focus as much on the quality/grading of the embryo. My understanding is that it is a bit of beauty pageant and doesn't reflect if they're genetically normal. I think someone said it does impact their ability to thaw which is why clinics have a cut off for the quality of the embryo if they're freezing. I can see this in my own cycle as the one that looked the best at day 3 actually arrested the next day. 

 

Your early ones still have a great chance if they froze them!


(age 38) June 2016 IVF #1 antagonist, 13 mature eggs, 4 fertilized, 1 blast frozen

October 2016 FET #1 cancelled, thin lining

Changed clinics

(age 39) April 2017 FET #1.1 BFN

July 2017 partner has vasectomy reversal

Feb & March 2018 - Medicated IUI x2 - BFN (even with 7 mature follicles on the 2nd IUI)

(age 40) May 2018 IVF#2, lupron flare, 7 mature eggs, 5 fertilized, 1 blast & 1 morula fresh transfer, BFN. 1 low quality blast frozen

June 2018 IVF#3 mini stim, 1 egg, immature

Sept/Oct 2018 IVF#4 antagonist with HGH - CANCELLED due to high estrogen/29mm cyst

Oct 2018 IVF#4.1 antagonist with HGH - 7 eggs, all mature, 6 fertilized, 2 blasts on day 6, PGS tested/euploid

November 2018 FET #2 w/immune protocol and 1 PGS tested -  BFN

Locus Medicus testing for virus, bacteria and immune issues. Husband treated.

(age 41) April 2019 IVF#5 converted to IUI#3 due to follicle growth. BFP 12 day post IUI. Di/Di twins.

Dec 17 2019 - Baby boy and girl born at 36 weeks + 2 days. Everyone very healthy. 

 

See my 'about me' page for more detail on my treatment history.