5-day transfer without checking at day 3?

[Luxnuova]

Hi there, just posting to see if anyone has any experience with this. We just had EC, and had 9 eggs retrieved. Learnt this morning that 8 were mature and 5 fertilised. We're cautiously pleased, as these are average numbers for our clinic. More would obviously have been better, but we know we're also lucky to get that result.

Anyway, embryologist called this morning and she said that they're not going to check any of them at 3 days. They say that with that number they think it's better not to disturb them, and will grade what's available at 5 days for transfer then.

This is a surprise to me, as from everywhere online and in their handbook, it says they check on them at 3 days. I'm terrified we'll reach 5 days and none will be suitable to transfer or freeze. I've heard of quite a few cases of people doing last-ditch transfers with less-than-perfect embies at day 3, and conceiving. What if none made it to day 5, but we could have transferred a less-pretty embryo at day 3. We won't even have that chance. Anyone have experience with this? Should we just accept the thinking that 'if they don't make it to day 5 they wouldn't have made it at all'?

[closephine85]

Hi Lux, I don't have experience of this but I don't think I'd feel very comfortable with that either. I have also read a few success stories from people who decided to transfer at day 3 as they weren't looking good. If you ask them to, will they check? We had quite a big drop off between day 3 and day 5. Out of 9 eggs that fertilised on day 3 there were still 8 and then by day 5 we had 4 left. See how others respond, but I think I'd be asking them to check at day 3. Good luck though, pleased to hear you got good numbers and fertilisation, it's such a nerve wracking time!

[Wanda354]

Our clinic did the same thing. We had 6 fertilise. Don't worry. I think they take the view that if you've got a handful fertilised, it would be best to leave them undisturbed as every time they are taken out of the incubator, their environment changes.

We got 2 x 5 day blasts in the end, 1 grade 4AB (v good) and 1 grade 4BC (OK). Had 1 put back and 1 frozen. Fresh cycle didn't work, unfortunately. At least we have one frozen.

[Wanda354]

Should add: I think the whole point is that embryos which stop developing between day 3 and day 5 are unlikely to have developed further in the uterus anyway. So by waiting to day 5, they are choosing from the ones with the best chance of continuing to grow. Statistically, you have a greater chance of success with a 5 day blast than a 3 day embie.

[JoJoSM2]

I can see why you aren't comfortable with this. But I can also see the embryologist's point and presumably they will have a lot of experience and would suggest this if the risk of ending up with nothing to transfer was high. Have you asked how often it happens that embies make it to day 3 but then arrest? And their view on some not-so-great day 3 embies becoming babies?

[laurelstar]

Hi Lux our clinic also checks only at 5 days. It's seen as much safer not to disturb the embryos too early. Embryos that don't make it to 5 days are much less likely to be normal, so there is no benefit in checking, according to the latest research.
Good luck!

[Luxnuova]

Thanks so much for responses, all - this is super reassuring, and I'm glad to hear other's experience with similar protocol at their clinics. I can totally see the thinking - no point opening the oven before the cake is cooked, etc. It's just the fear of how gutted we'll be if we reach Day 5 and there's nothing viable in there. Even if a day 3 had nearly zero chance, I think perhaps I'd find it easier with a slim, tiny hope.

After reading this, we've formulated a plan to see how this cycle goes, going with their advice. If what we feared happens, we may aim to ask them to check at day 3, and see if they'll consider freezing any embryos at day 3, if it doesn't look like they'll get to blast. All the odds and possibilities in this process are doing my head in .

[Luxnuova]

Oh and JoJo thanks for that advice. Those are useful questions to approach them with. Given what I've read (admittedly all anecdotal) about not-so-great-looking 3-day embie success, I'm really interested to see what the clinic has to say about their experience with/ thoughts on that.

[JoJoSM2]

Perhaps I'm being overly sceptical and distrustful, but I do wonder if, say, a poor day 3 embie had a 10% chance of success (I don't know the actual numbers), they are reluctant to put it not to spoil their statistics. Or could be a case of saving their patient from heart-break in case of bfn or CP.

[laurelstar]

Good luck lux! I like your plan. Hopefully it will work this time and you won't need to do it again, but if not you can ask more about freezing or transferring earlier.

[Smidge001]

I'm surprised to hear this. My clinic only did 5 day transfers, but they always gave an update at day3, because they would transfer them at that point to a different solution that is meant to better represent the conditions in your body at that stage. So given they were transferring anyway, they would update on the quality/stage etc. Mine was private so maybe that's an extra expense that not all clinics undertake. But the change of solution is definitely something I'd read about via Dr Google, it wasn't just the place I went to, so I thought that was normal.

Having said that, we never actually had success after transfer so maybe leaving them alone would have been better!!