I'm absolutely brand new to this IVF lark - has anyone had blastocyst transfer, or want to give me a (generally encouraging) view about it

[OldBint]

Having had a fairly disasterous first round, where we only managed to produce one measly egg from my knackered old ovaries, I've now gone into overdrive!

This cycle they harvested 17 eggs of which 12 fertilised. Apparently 6 are "above average" and several more are average, so they are recommending going to a day 5 blastocyst transfer rather than embryo transfer. Which I understand to be A Good Thing.

Has anyone had this done and is it a bit better than embryo transfer or a lot better?

Am 43, BTW, and have 2 DCs already, so this is not the be all and end all for us - I can take it if you want to say "Nah, not really much difference".

I didn;t have blastocyte transfer it was relatively new when I had IVF. I think the reaosn is that if they allow the cells to keep dividing and get to blastocyte stage they can pick the ones which are the best and its a better judge than at the earlier stage. Downside is rick that none proceed to blastocyte stage but if you have 6 above average I wouldn;t think that risdk was high. Perhaps someone else has more experince...

Thanks Kewc (am regular namechanger, BTW ).

I think it is fairly new, which is why I haven't really heard of it before.

I had a blastocyst transfer for my ICSI cycle in 2006. I had two blastocyst embyros replaced back on day 5 (post fertilisation).

Normally, embryos are replaced on day 3 and are around the 8 cell mark. By day 5 however, the cells have multiplied into hundreds and the embryos are at the pre-hatch stage (the embryo 'hatches' out of the outer shell and implants into the uterine wall. The outer shell will become the placenta and the inner will become the baby...). By day five I was able to see the fetal pole in one of the embryos that they put back into me - it was that developed.

Blastocysts have a much higher success rate (usually double the statistics they quote you) as embryos that reach the blastocyst stage are usually very strong and very likely to implant. By not replacing them on day three, clinics are able to assess (and therefore replace) the strongest embryos.

The downside of blastocysts is that there is a small risk that the embryos will suddenly arrest and 'perish' before they have had a chance to put them back into you. Embryos tend to do better inside the human body than in a petri dish and so you do run the small risk that you will lose the embryos. However, it is a small risk and clinics seem to think it is more than balanced out by the fact that you get much higher success rates with blastocyst transfer.

Our chances were put at around 35% for our ICSI cycle, but because we had blastocysts it went up to 70/80%. I've no idea how they calculate these statistics, but they sounded pretty good to me. In fact, our chances were so improved that we had to fight the clinic to put two embryos back rather than the one they advised (they were concerned it would be twins).

If you had the chance to go for blastocyst transfer I would go for it. I had 8 fertilsed eggs and all were developing well by day three. However, on day 4 two of the strongest embryos suddenly stopped developing for no reason. They gave no sign of doing so - they just stopped. Had I had a three day transfer these two embryos could well have been the ones that they put back and my cycle would have failed. As it was, we waited until day five and my twins are now 20 months old.

Hope this helps and good luck. It's also worth mentioning that blastocyst transfers are more expensive due to the extra lab work involved - it added another £500 to our bill, so it's worth checking this with your clinic. It's why a lot of NHS clinics don't offer it.

Kitstwins

Thanks kitstwins, that's really interesting and helpful.

re twins! We've been asked to think about it because they will put 2 back in (as I'm quite old they are fairly relaxed about this and don't need persuading) but I have been told that my risk of twin pregnancy is 1:3.

Eeek!

Glad it was helpful.

As for the twin risk, it's a balance and only you can make the decision. At this stage, a clinic can only strongly advise you - they can't force you either way - so the ultimate decision rests with you and your husband. We decided to replace two as we wanted no 'what ifs'. Had we put one embryo back and the cycle had failed then we would have kicked ourselves. And had we put two back and the cycle still failed we would at least not had to wonder and regret; we would have known we gave that cycle our best shot. But we had to have a mini argument with the embryologist (me with my legs in stirrups - not the best place to argue your corner). In the end my husband pointed out that we'd rather have twins than a failed cycle and they accepted that. In fact, the embryologist said "in your shoes I'd probably do the same".

Good luck. If you can get to the blastocyst stage then you're in with a really good chance of success!!

Kx

I had a blast transfer - we had 9 excellent 8 celled embryos on day 3. Because there was nothing between them the lab took them to day 5 - the theory is that the weak/abnormal embryos won't survive & you'll just be left with good ones to transfer.

Of our 9 only 2 made it to blast (which is kind of the point) both were transferred & I ended up pg with twins. Unfortunately we lost both of them (one early & one at 16 weeks). You do have a higher chance of identical twins as well (especially if you do assisted hatching too), blasts are much more likely than 3 day embryos to split. I know a surprising number of people who transferred 2 blasts & ended up with triplets.

Another advantage is that you only have to wait 9 or 10 days until the pregnancy test (equivalent of 14 or 15dpo).

Good luck!

"I know a surprising number of people who transferred 2 blasts & ended up with triplets"

Eeeeeeeekkkkkk!!!!

I think we are going to go for 2 transfers for the reasons kitstwins sets out and that we can get ourselves comfortable with the twins thing. Realistically, this is pretty much our last chance at this and as long as we are reasonably happy I can have a healthy pregnancy, then I think the "having 2 babies/children at the same time" thing is something we can live with. We have one of each currently so have every conceivable thing for a baby of either type. We would not need to move house or anything.

I would find triplets a very different proposition, but TBH I'm putting that into my "not really worth thinking about" basket (its got my pension concerns in there to keep it company!)

Its very odd to think of these little blastocysts developing merrily away. DH assumes they are probably squabbling and at least one of them is saying DD's favourite phrase "you're not my friend anymore".

Oh God, its all so surreal!

Minster sorry to hear about your loss of twins.

We were warned about the triplet thing too - apparently there is a greater risk of embryos splitting with a blastocyst transfer. I'm not sure why (I'm not even sure that the embryologists entirely understand why - blastocysts are still fairly 'new' territory I think). Anyway, the second embryo (the one we argued over) was flagged as "likely to split", although it looked pretty normal to me......

As it turns out, I may have been pregnant with triplets as I had a bleed at six weeks into the pregnancy (that scared the living daylights out of me). By the time of my first scan at 6 1/2 weeks there were two embryos happily throbbing away in there, although no sign of a third sac. But I've always wondered......

Not sure how we'd have coped with triplets (badly, my husband says!) but I know we'd have been stupidly deluded excited. My major fear now is getting pregnant again and having triplets on top of my twins. It's enough to bring a girl out in a cold sweat!

Best of luck with your cycle.

Kx