Embryo batching/back to back cycles?

[frenchgal]

Hi
39yo- secondary infertility (my son is 6.5yo)
Going for egg retrieval tomorrow (just triggered last night) and they told me I may need to do embryo batching - ie back to back cycles before PGT-A, as at my age, not expecting many eggs nor a high yield.
has anyone done this? Apart from the cost, what is worrying for me is the idea of wasting time and egg quality decreasing if I did another cycle in 6 months vs now.
my clinic (CRGH) told me day 3 is a very important call as I will need to make decisions (about whether to proceed with PGT-A if i am lucky enough to get a blast embryo or whether to do another cycle and test all of them at the same time). I am driving myself insane thinking about numbers, percentages etc.
thank you and good luck to all of you.

39 year olds can and do have success in IVF. I think with PGA, it’s very expensive and not guaranteed. It doesn’t automatically avoid failed implantation or miscarriage and good embryos can be ruled out. I am currently 40 and was 39 at time of my egg retrieval and transfer and currently 16 weeks. I ended up with two embryos and my first transfer worked. This was my second cycle at 39 and my first one (NHS) ended up as a chemical. Does your clinic have a good track record with patients 38+? I honestly think the clinic is such a big factor for success in our age group. Good luck for tomorrow x

I did 2 egg collections back to back last year at age 38. In the 1st, I got 8 eggs, 1 day 5 embryo (pgta tested, euploid). My clinic changed my meds and put me on a higher dose for longer and went again as soon as my bleed started, next round got 9 egg, 7 embryos, 5 euploid. We got super lucky on this round for sure, but changing the meds helped I'm sure. I was prepared to do a 3rd round but because it went better than expected, we stopped there

Personally I think pgta, while expensive, is well worth it. Yes a pgta embryo may implant, but it's much more likely to and if you have e.g. 2 non tested embryos that don't implant versus 2 pgta that don't, it's quite a different picture in terms of what might be going wrong/what to look at next. I was told 60-65% chance of implantation with a pgta tested embryo and 50% chance live births, and implantation rate goes to 80-85% with 2 pgta embryos. It also reduces miscarriage rates substantially, and itsbeen a big relief for me to rule out major chromosomal issues as I had a TFMR for this reason in the past and unfortunately these become more likely the older you get.

Best of luck for your egg collection!

@frenchgal do you need to make a decision about testing them all together on price grounds? You could let your collected egg number steer you.

@Orangewillow thank you for sharing your experience, and I am really sorry you had to experience a TFMR. Amazing results with the second round, this is wonderful, and amazing what a protocol change can do. I am definitely going to do PGT-A, my question is whether I do it immediately or batch and wait until my second egg collection. Did you test them all together or did you testing after your first cycle ?

@sirensong cost is definitely one parameter (3200 pounds for PGT-A at my clinic for up to 8 embryos per cycle), the other fear is that if I did not batch, got a euploid embryo and had a failed FET, this would delay my next cycle by quite a few months and potentially decreasing my egg quality, as at my age (39), I understand it’s a rapid decline.
and yes the number of egg retrieved may steer me, although it seems not to be a reliable indicator of outcomes(?), which is why my clinic says day 3 is probably a better indicator of how many blast & eventual euploid I may get.

@confused2025 thanks for sharing your story , it gave me hope. Hope your pregnancy is going well.

@frenchgal ah see what you mean - my clinic charged testing per embryo, plus a set up fee, so we tested round 1 from fresh 5 day blast, then had that frozen while we waited for the results and did the 2nd egg collection. You can freeze, thaw, and test all together if that works better - I believe the loss rate is very low and if embryos don't survive thr thaw and refreeze they probably wouldn't have made it anyway. I very much wanted to get on with embryo creation and our plan was to aim for 4 euploid embryos in the bank before a transfer in the hope that woukd give is a good shot at 2 kids!

Hi
We are doing batching with CRGH at the moment and are about to start our second cycle. We felt getting as many embryos as possible now was the best idea, as the transfers can be done in the future whereas egg number/quality declines. We got one good embryo last cycle to day 3 and so we feel batching is the best option and doing the PGTA testing once we have done a few more cycles. Our consultant recommend batching as she knew we our numbers would be low.

The consultant did mention they may be offering alternative pricing for the PGTA for people with less embryos and to ask the finance team.

The process is intense and you do not get any recovery period inbetween cycles as you start the medication again the day after egg collection.

@lilacrab starting immediately after collection is a duostim cycle not what is usually meant by back to back - is that the CRGH batching default?

Sorry what I meant was that you start the down regulation drugs the day after egg collection.

Thanks so much. I had my egg retrieval today - they collected 8 eggs (I don’t know how many were mature, I was expecting a call but they didn’t call me). So let’s see how many (if any) blast we get.I’ll defo speak to finance team about options to PGT-A test straight away from this cycle - thank you for letting me know this could be an option.

I will speak to my consultant but thinking I’ll do another cycle (long protocol, with down reg) from my next period (so not dual stims), so with egg collection end of mid/end of October, as I have a lot of work travel in September.

good luck to you. It’s a lot.

@frenchgal if your retrieval was today you should get an update tomorrow on how many were mature and fertilised. Sending you good luck x

I did three back to back egg collections with PGT-A a couple of years ago at the age of 38, mine was different than the person who posted above as I bled after egg collection and then took Norethisterone on day 14 to time the start of my next cycle. The PGT-A results took just over a week to come back so we knew how many were euploid before deciding to start the next cycle. We did have a consultation with CRGH but chose another clinic, at the time CRGH were saying they would freeze the unbiopsied embryos until you had enough to make it financially worthwhile to pay the setup fee and then unfreeze and re-freeze them after biopsy. Their published success rates were really good so I assumed it wasn’t a problem to do the thaw and re-freeze. Our clinic charged £500 per embryo with no setup fee and you could decide on day 5/6 once you knew how many embryos you had if you wanted some or all of them to be biopsied which worked out better for us.

@CharlotteYorkMacDougal thank you for sharing this. I am waiting for my bleed to start norethisterone for the second back to back collection, might do a third one right after.

May I ask how long after your third collection did you start the FET? What did the process look like ?

@frenchgal For me It was seven weeks from the last egg collection to embryo transfer but there was a slight delay as I needed a hysteroscopy in between. I bled on day five after egg collection, started Norethisterone on day fourteen of that cycle and stayed on it until after the hysteroscopy and then started oestrogen tablets on day three of the next cycle with transfer on day twenty two (I think). The hysteroscopy added about a week to the timings so I’d say six weeks from last egg collection to transfer would be usual at my clinic. Best of luck with your treatment, I found all the waiting the hardest part so hope your wait between cycles passes quickly