So, you know when you have an embryo transfer for IVF....

[Fluffycloudland77]

How many days old was the embryo?

We have to have IVF and I am wondering if different clinics do it at different stages and if a more mature embryo has a higher/lower chance of implanting.

Should I ask when contacting them?

Different clinics do it at different times. The clinic I went to put the embryos back at 3 days although a lot do it later so they can see how the embryo is developing for longer. It is worth asking as it will help you prepare for the process.

I see...

the clinic we might have to go to, if my request for outside funding doesnt pay off transfers at two days.

I know someone who went there (it failed) and they said if she goes private (same clinic) they transfer at 5 days. I was furious for her that they didnt do that for her on the NHS.

I know some NHS clinics transfer at 5 days so don't think it is a private / NHS thing.

BTW - the results of my 3 day transfers are currently dancing round the sitting room trying to avoid going to bed so an early transfer doesn't mean it won't work!

It might be worth trying one round if you can't transfer your funding and if the extra time would help, you could try a different clinic if you can have another round.

We had a day 3 transfer and now have 19 week old twins. I'm not 100% sure, but I seem to recall looking into it at the time and finding out that after day 3, embryos are safer inside you than in the lab. I think keeping them in the lab would help you to distinguish the best embryos but wouldn't increase your chances of them implanting, from what I remember.

Hi mine was transferred at two days old ,he's 13 on Sunday ,his sister a frozen embryo from the same batch is 8 ,I truly believe it makes no difference, If it is meant to be it will work,good luck, just keep a positive mind and try not to stress I know that is hard .

It's not something that clinics have policies on (as far as I know) it's to do with how many embryo's you have and how sure they are of identifying the strongest one to transfer. I have poor AMH so was warned that I would produce few eggs and to expect a 2 day transfer as there would be few to choose between. As it happened I had 5, 3 fertilised and at day 2 the embryologist could not pick between them as they all looked equivalent. They rang me and rearranged my transfer for day 3 and by then one had more cells than the others so I had that one put in as it was considered to be the best. It's put back in to you rather than left in the lab as the view is that the uterus is a better environment than the lab.

My clinic absolutely preferred to take all embryos to Blastocyst stage and transfer at day 5, and the only reason they would do day3 transfers was if there had been a poor yield and there were just a couple of clear "front runners". The idea is that the longer you leave it the clearer the quality of the embryo becomes. they also only freeze tip quality blastocysts. This was at ARGC in London which is one of the most successful in the country. Hth x

It does cost more to go to day 5/blastocyst, I think we paid about a thousand pounds more? As bagofholly has already said, the longer they can leave it, the better idea about which embryos are healthy. It is a gamble though, as although the labs do their best, the environment is not ideal and many embryos perish between days 3 and 5, so some clinics won't do day 5 unless there are a good number of embryos that make it to day 3. My last round of IVF yielded 19 eggs, of which 16 made it to day 3, but only 4 made it to blastocyst stage, so you're looking at a 75% loss.

If you can get to blastocyst stage you have a 50/50 chance of pregnancy.

If transfer occurs at blastocyst stage it increases bfp by approx 10% depending on clinic. Not all Nhs cycles will fund to day 5 as more expensive . We went from 12 collected 8 good enough to fertilise 7 fertilised three to blastocyst on day 5 but one grade 3 and then another one next day now on ice good grade . So 4 out of 8

Hi All,

hugs to every one here,

It looks very much like DH and I will be heading in the direction of ICSI in the next 2 months.
I know IVF and ICSI are similar in some ways, but of course, different in others.

With the IVF the sperm is of course left to fertilise the egg on it's own accord, where as with ICSI, it is given the advantage of "free entry" so to say.

So with ICSI in the planning, how many of my eggs can I expect the specialist to harvest?

Fay

If an embryo is going to go on to become a bfp then it will most likely do that regardless of which day you put it back.

The big advantage of waiting until day 5 or 'blastocyst' as others have said is that you have a clearer idea by then of which are the best embryos and, especially if you are under 35, you'll probably opt for a single embryo transfer without reducing the chance of getting a bfp (and of course reducing the risk of a multiple pregnancy).

I had day 3 transfers with both my rounds of ICSI because I only got 3 eggs each time and only 2 fertilised and became embryos. Both times I had both embryos put back. The first round didn't work. The second go did and I'm currently (fingers tightly crossed) still pg with twins. My two embryos with my second cycle were high quality and would probably have made it to blastocysts (well I can now say I'm pretty sure they would!) but because I only had two the clinic didn't want to wait and see.

Fay in terms of eggs it's difficult to say! Depending on the condition of your ovaries/the reasons for the treatment/your age etc. the clinic will make a judgement about the dose of stimulating drugs they give you. They don't want to understimulate (you might not get very many eggs) but they don't want to risk overstimulating you as this can lead to complications too. I was told that between 10-15 eggs usually leads to the optimum results, with only a very small improvement between 10 and 15 and that there is limited evidence to suggest that getting more than 15 eggs improves the outcomes at all. However, as I say, i only got 3 eggs which is a very low yield but you really only need one good one

Thank you everyone, it's so confusing and we get a round of free ivf which I would like to make the most of eg not make a silly mistake choosing my clinic.

They tend to transfer quickly if there are a limited no of embryos as Hollybag & Ted explained.

It is absolutely not an NHS vs private decision it is made on the quality of the embryos and the decision is based on the embryologists expertise.

Fay I had ICSI too. The number of eggs isn't affected by having ICSI, they will harvest as many as they can safely. The number of eggs harvested can vary between 0 up to about 20. If you have more than 20 ish eggs ripening you are at risk of over stimulation, so they will manipulate your drugs to suit.

But thats what they told her, 2 days on the NHS and 5 Days if she pays privately. .

Fluffycloud, how much choice of clinic do you have? Have you looked at the success rates on the HFEA website?

Sometimes the NHS funding does specify what they will pay for - ie some fund IVF not ICSI (although this is rarer these days), some pay for freezing of embryos and others don't. One PCT I've heard of recently will only allow single embryo transfer. So it may well be there are PCTs who won't pay the extra for blastocyst culture.
BTW it is not the clinic that makes these decisions but your PCT.
I think next time I'm writing patient info about blastocyst transfer I'm going to get you folks to write it for me, you've all explained it so well! It is absolutely an embryo selection technique and if the embryologist can tell which are your 'best growing' 1 or 2 embryos at day 2 or 3 there seems to be no advantage to growing to blastocyst. We allow people to opt out of our blastocyst culture programme and just have one embryo transferred at day 3, but you can't insist on us growing your embryos to blast if we feel they are not good quality on day 3 (NHS treatment only at my clinic).