FET after successful ICSI

[Timpani]

Hi,

We have a number of frozen embryos from our first and only ICSI cycle 6 ish years ago. We had our DS from that cycle and then had a natural surprise a year or so later. We've been trying for a third naturally for quite a few months now and I'm thinking of using some of our embryos. Our embryos are Day 2 and all have 4 cells.

Does anyone have any advice? What are my chances of it being a success? 1 or 2 embryos returned? Do they grow them from 4 cells to blast or not? It's been so long since I did the ICSI that I'd forgotten so much of it. We can't really afford repeated frozen cycles but do have many embryos to use.

Our fertility issues are MFI and embryos were made when I was onky 27 so should be the best possible quality in theory...

Any help would be really appreciated. Struggling to be back on this journey!

[JoJoSM2]

If you want to maximise your chances on the first go, then it definitely makes sense to have the embryos cultured to blast before transferring the best one or two.

The embryonic genome kicks in at around that 4-8 cell stage so that’s when embryos made with dodgy sperms begin to struggle. Going to blast would weed the dodgy ones out as they’d either arrest or be very slow/poor.

[Timpani]

Thank you! Despite being relatively clued up in the process being a bit of a researcher, I don't think I knew that!

[430West]

Yes, I agree with ^

I had day 1 embryos frozen, when I wanted to do the FET, they thawed them all, cultured to day 5 and transferred the best looking 2.

[Timpani]

Did it work?

We have 12 four cell so I doubt they would defrost all if they won't refreeze?

[JoJoSM2]

Why wouldn’t they refreeze? That makes no sense. I would expect the clinic to defrost all, culture to day 5, put one back and freeze any other blastocyst. If they’re a bit slow of the mark, they might need to carry on till day 6 and be frozen then.

[430West]

BFP, but MMC at 8 weeks.

Why would they not refreeze? Is that just a blanket policy?

Most of the better clinics are getting choosier about what they freeze/refreeze these days, but very odd to have a blanket ban on refreezing.

Why did they freeze On day 2? That quite unusual too. Much more common to freeze at either day 1 (more chance of surviving the thaw) or blast (so you have a better idea of their quality). Freeezing on day 2 seems like worst of all worlds tbh. Was there a specific reason given?

[430West]

Still, your chances look good op, lots to be optimistic about!

Woiuld def push for refreezing any leftovers though.

Do you mind if I ask which clinic you are with?

[Timpani]

It's pretty standard where I went! I had EC on the Monday and ET on the Wednesday.

They might refreeze - I just didn't know if they Did! Been a long time since I did all this.

[JoJoSM2]

They're your embryos - your potential children. It's not for other people to decide whether they should be in the bin or the freezer! Not to mention that a fresh cycle is expensive + you're that much older so it's a no brainer to keep trying with the exisiting embies.

[430West]

It's not for other people to decide whether they should be in the bin or the freezer!

The clinics do have a duty of care to manage the expectations their patients though. Freezing/storing/FET are all very expensive and clinics have a responsibility not to just take money from patients where there is little hope of success.

The clinics have a headline 'per cycle started' success rate published, so it is in their interests as much as their patient's to have a successful cycle.

[430West]

To give you an idea, at my clinic (Lister) all 12 would be thawed, potentially 10 to survive the thaw?

Assuming they all made it to blast, they would transfer the best 1 or 2 on day 5 and then freeze any that don't have anything lower than a '4' or a 'B' in their grade (so a 4BB would be the lowest grade they would freeze)

All clinics are different though OP...