blastocyst quality question

[Jo99999]

I just had a fresh transfer of a blastocyst of 1BB quality. I only found out the quality of the blastocyst right before the transfer as it is a fresh cycle. I am on a 3-cycle package with Create and had 2 previous freeze-all cycles which gave me 1 x 4AA and 1 5BB blastocyst frozen for later. I just wonder if this fresh transfer is a bit wasteful as I have higher quality blasto in the fridge but transferred the lower quality blasto first.

I previously had an FET at another clinic with a 2-3BB blasto which did not stick. Is 1BB worse than 2-3BB?

I don't know how much I can hope out of this fresh transfer.

Heya was this a day 3 or day 5 blastocyst?

Its difficult to judge whether a 1BB is worse than a 2-3BB - I guess if it's a day 5 and only at stage 1 then that might be something to worry about but then again I'm having twins and one of them is a day 6 4bb so on day 5 must have been at a similar stage?

I was with Create and also did the 3 cycle package - sounds like they favour doing a fresh transfer rather than thawing one of your ones from a frozen round? (I had to thaw mine and transfer because i didn't get any blastocysts on the final egg collection cycle)

@ivfbeenbusy, thanks, blastocyst is day 5. I only wanted to transfer day 5. I don't have much faith in day 3 embryos which can be top grade on day 3 but not develop further on day 5 or 6. The 4AA and 5BB in the fridge are day 5 and I also have a day 3 frozen but I don't count on it much. I guess I have to wait and see.

@Jo99999

My experience with the embryologists at Create was very good - they talked me through all the options for transfer and we sort of decided together.

They tend to err on the side of caution so I'm sure they wouldn't have transferred something which was really low quality over a better one?
I do think they like to have the "active" ones go back in first though - because none of my fresh made it they thawed my day 3 and transferred that on day 5 with the day 6 (I'd already agreed on transferring 2 at a time)

@Jo99999 I can also say Create's embryologists have been open and informative with me so far, so don't be afraid to ask more questions. Martin if very helpful there and explains things clearly.

I have read stories of 5AAs not sticking and women then being successful with a lower grade, so i think once you get a day 5, there is still an element of luck as to what happens afterwards.

I'm doing PGS with Create and i was told that embryo grading has no bearing on whether it will be PGS normal. I'm no expert, but to me that means the top grade embryos are not the be all and end all.

Perhaps the 1BB would not have survived the thaw so they decided to give you a chance now, given you have two good ones on ice? Just a guess. Good luck, you have lots of hope left.

I had a sheet from them explaining grading. The number is the stage it is at so 1 means it is a very early blastocyst. 2 is early blastocyst. 3 expanding. 4 expanded. 5 hatching, 6 hatched

@IslandStars

That's true about PGS and embryo grading - my friend transferred a "perfect" 5aa and had to TFMR.

I PGS tested some with Create and didn't get any "normals" - when I joined a Facebook group for abnormal/mosaic embryos it's really
Common to see that for most of the members their lower graded embryos were in fact the normal ones

@ivfbeenbusy thanks, that's really interesting and takes the pressure off aiming for top grades all the time.

Did Create let you transfer any abnormal/mosaic? I think it's policy not to as far as i understand. PGS is such a gamble, but i'm hoping it's for the best in the end.

@IslandStars

Create agreed to transfer my low level mosaic - it was a monosomy 11 so a proportion of the cells biopsied was missing chromosome 11

I was given a success rating of 30% by Create which I didn't think was that bad to be honest (had it been a normal embryo they would have given it a 80% chance of success). It did end in a BFN though

It's illegal in the U.K. to transfer abnormals but if you should be able to transfer low level mosaics or segmentals. I don't think you'd be able to get them to agree to a high level mosaic

Also depends on the chromosome which is affected - I'll dig out the table of which ones have better success than others. Most clinics won't touch anything with 21, 18 and 15 (downs, edwards and pateus)

Depending on your result there is a good Facebook group "my perfect mosaic embryo" lots of knowledgeable members on there especially from America where it's normal to transfer abnormals abs have success

@IslandStars

I would also say don't be disheartened if you get bad results. I was 36 and devastate to get zero normals. I decided not to test again but changed protocol to natural modified and am now pregnant with twins from 2 untested embryos

@ivfbeenbusy Thanks so much for the info, I always feel more comfortable being well informed beforehand. If I don’t get any normals, I think I will give it one more single round without testing just so I have covered all bases, but at 42 the mc odds will be high. What an inspiration your story is, congrats!