Why did so many embryos not make it. :(

[Zamzam21]

Hi everyone

Before I start this post, I don't want to sound ungrateful. I am very blessed to be able to afford and go through IVF and complete a cycle.

So I have concieved easily before. I have one boy who is 3. Since then I have been diagnosed with one blocked fallopian tube so we decided to go for IVF as I am 35. Husband had super sperm so no issues there.

I am with ABC and on a short protocol. I had 19 eggs retrieved and 12 fertilised. Day 3 i had all grade 1 embryos and they froze an 8 cell grade 1 embryo.

By day 5 I had one 5AB hatching, and the rest were early blastocysts. On day 6 I got told they are freezing one more that was 5CC. So thats three embryos for a freeze all cycle. I am very happy that I managed to get to this stage. But I am worried. Why did 9 top grade day 3 embryos not make it to blastocyst?

Can anyone help?

That is a significant drop off given they were all grade 1 on day 3 - I'm with Create the sister clinic of ABC and they say that they expect 90% of Grade 1 to make blastocyst

When they say grade 1 were they all 8 cells??

Usually the genetics of the sperm takes over from day 3 (up until that point it's the maternal dna of the eggs largely dictating how things progress) so I would say there is something in your DH's "super sperm" which stopped their development?

I'd have his sperm checked for dna fragmentation or a variocele or more in depth investigation done on him than the usual spent count/motility/morphology

@ivfdreaming

Congratulations! I was following your story on another thread and I am so happy for you!

So, I got the final report today in more detail. Two of them were 8 cell embryos (one which they froze) and 6 more were between 6 and 10 (mostly uneven numbers) and the rest were more than 10. So on day 3 i technically had 6 embryos that were grade 1 with the optimal number of cells. (not including the frozen one).

I will mention the tests during my follow up appointment. Thanks for replying!

@Zamzam21

Thankyou! It's been a long road to get to this point and still away to go!

I'm surprised they graded them as grade 1 if they had an uneven number of cells and not the optimum 8 they usually look for? None of mine were graded grade 1 if they had anything other than 8 cells but I know every embryologist scores differently

I'd ask them about how they were dividing between days 2-3 - did they divide evenly or did they jump from day 1 cell to 4 cell etc? Did you pay extra for the time lapse embryoscope?

@ivfdreaming You hundred percent deserve it. Sunshine after a storm - relax as much as you can and enjoy it! Your story gives me hope as I am in the secondary infertility band too.

Yes, maybe that's why I was so suprised at the drop off rate. I wasn't aware an uneven cell number can lower a grade according to diff embryologists. I'm predicting that the 8 cell that wasn't frozen made it to my best 5 grade. I didn't pay for time lapse, I wasn't even aware I could. But the dividing question I will definitely ask. At the moment I'm grateful I have embryos to transfer and a couple to freeze.

I'm surprised they froze a 5CC. I thought a C grade was a no hope case? Do you know anything about that?

I think a CC is the cut off - the grading is only really for freezing purposes but I've seen people still have success with them

I think ABC has the same company policy as Create as they are the same company in that they have to freeze at least one on day 3 - they usually freeze the very best one so id feel positive that when they thaw that one it also ends up a good grade?

I transferred my frozen grade 1 day 3 which was cultured to day 5 and became a 5BA with a frozen day 6 4bb and both implanted

Ah so you do have an option to culture after defrosting an embryo. I thought they have to put the same grade in, and the embryo can't really change.

When I have my follow up consultation I will question the grading. 9 embryos supposedly grade 1 to 2 blasts is different than potentially only 2 grade 1 embryos and the rest of varying quality.

Food for thought for sure!

Embryo grades, after googling have such varied reponses. You can't believe all the statistics I think it depends on individual cases. What worried me was the big drop off between day 3 and 5. Hence the long winded post!!

@Zamzam21

Yes. I was a bit confused as last year when I cycled with Create they didn't have the day 3 freeze policy. I was doing a 3 cycle package this time so had to freeze from the first 2 egg collections and only transfer after the third. I asked them whether just to pop it back in on day 3 - my embryologist team is great and I had several Hour long phone calls talking through our options.

They said they'd only transfer on day 3 If it was our only embryo and it looked like it was struggling. They also said they prefer to culture to day 5 so that they know its good quality and active when it's going back in rather than only just being thawed a couple of hours before transfer. And obviously transferring hatching blastocysts have a much higher success rate and they wanted to make sure it was of the same quality or better than the other ones othwrwise they would have refrozen it and thawed the others - very complicated!! 🤣

Oh wow that does 'sound' complicated! Is it terrible that I understood all of it 😂

I have read so much about embryology from google since I started IVF, including plenty of medical studies! I'm considering a career in embryology as I feel somewhat qualified and confident to grade embryos!

But the googling is calming to me, I like. To be in control of what's going on. I never thought I'd be a control freak. IVF taught me I am!