Is anyone by any chance an embryologist ....... ?

[missbrightside]

Hello

We've had two failed IVF cycles this year. Both times our embryo quality has been poor (with none of our embryos reaching blast stage by the time they are transferred) and presumably responsible for the failure.

(I say 'presumably' as have been so hacked off with our clinic that haven't even bothered to go back for a review following the second failed cycle. But that's a different moan ... !)

I've now developed quite a good knowledge of procedures/medication etc - but where my knowledge lets me down is in relation to the embryological (sp ?) side of things. In this respect I really feel that we are in the clinics hands.

The question I'm really trying to get to is can a embryological department be 'better' than others ? I've always understood that once the sperm and eggs are mixed they are then left untouched and therefore the result would be the same in any department. But is that correct ?

Thanks in advance for any words of wisdom !

x

I think Fertility Friends has an "Ask an embryologist" subforum so you might want to try there. Sorry to hear about your unsuccessful cycles. This whole process is incredibly tough.

I believe they can differ. The environment (eg fluid) the embryos are in is important, as well as the lab, and I'm sure some clinics do have more success than others. Perhaps if you look at defrosting success rates it might give you an idea?

I have hearad embryologists say they've seen successful pregnancies come from only so-so embryos. After all they are alive and can change. But in my experience you're more likely to get success with a better looking embryo.

How were your eggs in the run-up to collection? I had poor eggs (and poor embryos) when I was on a low dose of drugs and I just knew it wasn't going to work :(

Thank you Euro. That forum is now 'read only' on FF (and believe me, I've spent HOURS reading it). Shame as the embryologists on there seemed really helpful ..... !

Thank you also Mysterious. Yes, I definitely think some labs have more success than others - I just am not entirely sure I really understand why. In terms of eggs we get loads. They fertilise at expected rates - look 'normal' on days 2 & 3 - and then only seem to get to early blast/compacting stage at day 5 (when they should be a fully formed blastocyst). That said, I understand that some labs are leaving embryos until day 6 as it's now accepted that some develop slower than others .... !

The whole reason for me questioning this is because we are contemplating having one final shot at ARGC (or rather DP is contemplating. I'm ready to go ) I'm convinced that by better control of medication (I was also only on a low dose) that we might just have a chance of getting better quality eggs which in turn will lead to better quality embryos. I keep telling DP that they have the 'best embryologists' in the country - but luckily he hasn't questioned on why I think that can justify us gambling both our emotions and a significant chunk of cash with them

(I've convinced DP to go for an initial consultation so I'll obviously raise these issues with them - so must find out more about the lab procedures before we go)

xx

Hello.
As an embryologist I would say that lab facilities actually vary little from unit to unit - a lot of the lab protocols are fairly standardised, but what varies are the techniques available and how tightly the ship is run. The HFEA and ACE (Association of Clinical Embryologists) have worked hard to regulate and maintain standards in IVF labs, and British embryologists are probably the best trained and most regulated and assessed in the world!
We always blame the doctors and the stimulation regime when things don't go well and take the credit when everything is fine! Seriously though the quality of your embryos is really determined already by the quality of your eggs and DPs sperm, however some things can make a difference - eg if you need ICSI then having a skilled practitioner can make a difference to fertilisation rates and a new technique called IMSI seems to improve pregnancy rates in couples who've had poor outcomes with ICSI or IVF.
Growing embryos to blastocyst in the lab is not always the best thing if you have had poor development in the past - the lab environment does not suit all and while there is a 'survival of the fittest' element to growing embryos on, some embryos that don't grow well in the lab may have done better in the uterus. It is worth discussing this with whichever clinic you choose.

Obviously you are not my patient and I have no knowledge of your case but ARGC is a massive outlier in terms of success rates (I do know they are selective in who they treat and also when they treat) - and their cycle monitoring is the most intensive I've ever heard of. They have a very small team of embryologists I think, so run a 'tight ship' as I mentioned above.
HTH

Freelancescientist (You are true to your name !) Thank you so much for taking the time to write such a detailed reply. That's really kind of you. You have confirmed so eloquently what I thought was the case ! And you've added fuel to my fire to convince DP that a 'tight ship' (albeit probably more at the stimulation stage) is what we need in light of what seems to be questionable egg quality. I salute you !!!!!

Take care xx

Good luck wherever you decide to go.