Unsure whether to freeze day 3 embryo or let it grow to day 5 — would love advice

[ttc2488]

Hi everyone,

I’d really appreciate some advice or experiences from anyone who’s been in a similar situation.

We’ve just had our egg collection and have two embryos one is a 9-cell, grade 1 and the other is a 7-cell, grade 2. The clinic has suggested freezing the 9-cell embryo today (day 3), but part of me is wondering whether to let both grow to day 5 first.

My worry is that if we freeze on day 3, then later thaw it, it might not survive or make it to day 5 when it’s back in my body. But if we try to grow them both to day 5 now, there’s a risk they won’t make it and then we’ve got nothing left and have spent all that time, money, and emotion for nothing.

Cost is another factor: it’s £2,000 to freeze and then another £2,000 for a transfer and meds, so I’m trying to be realistic about whether it’s worth freezing now if we might get a good day-5 blastocyst anyway.

I guess I’m torn between:

• Freezing now: play it safe and keep what we have
• Letting them grow: higher success per transfer, but risk losing both

Has anyone faced this choice? What did you do, and would you do the same again?

Thank you, I just want to make the best decision before speaking to our consultant again.

Hi OP,

Its a hard choice but I will share my experience.

I wasn’t in the same scenario but I was in a similar position of having to choose whether to transfer on day 3 vs leaving to day 5 (twice I was in this situation). I decided both times to transfer on day 3 and if I’m honest it is actually my biggest regret with our IVF journey. The embryos were top quality on day 3 and I was sucked into the narrative that a body is better than a lab. However both times the embryos failed to implant and I am convinced they never would have made it to day 5 anyway. If I would have waited until they got to day 5, yes I would have been really sad that they didn’t make it, however I would have saved a lot of heartbreak and time of having failed transfers. One thing that is precious in IVF is time.. everything takes soooo long. I regret wasting time in the TWW then letting my body recover, waiting to get a period etc when I don’t think my embryos were destined to work.

After that I moved to a different clinic whose policy was that they would only transfer a day 5 or 6 blastocysts. I was surprised at the drop off from day 3 to day 5. On one round we had 7 all looking perfect on day 3 and 2 blasts on day 5.

What is their plan with them after they freeze on day 3? Will they then culture it to day 5 before transferring it or will they transfer on day 3?

Day 5 blasts definitely have better chances. Why do they want to freeze now?

I think I am a broken record about Emma the Embryologist, but she's really good - here's her post about it: https://www.instagram.com/p/DIeV313sTgz/

Not the same but I have had 1 3 day fresh embryo transfer and it was successful first round, it was my very first ivf cycle and i didnt know better and back 12yrs ago, day 3 was the standard, i was very nieve at the time but very fortunate it worked. Im still with the same clinic and the new standard of practice is now all embryos are transferred and or frozen on day 5 as this is suppose to have higher success rates. Im in Australia and day 5 embryos as far as my knowledge goes is now standard practice for all clinics in australia. My advice is have a hard, open and honest conversations with your clinic around their reasoning in to why they have decided that your embryos need to be frozen on day 3.

I was successful with 3 day fresh transfer, although admittedly my later 3 day FET to try for a sibling ended in an early miscarriage.

My clinic said they pushed to blastocyst if people got about 5 or more 3 day embryos. But they said if you only get a few embryos (as I did) then they’d had greater success by putting them back in the uterine environment early. I got 4 embryos and we did double transfers, as at 40 it was likely some of my embryos would have been poor quality. Since one of them became my son I have to trust their strategy was right in my situation. Maybe if you are younger you stand a better chance of getting blastocysts?

I don't see the point of freezing at day 3. Either transfer fresh or wait until blastocyst. Otherwise you are paying to freeze and then paying again to transfer with no idea of its quality.

Thanks so much for all the replies. They found fluid in my uterus, so a fresh transfer wasn’t an option this cycle.

We had a call today to say that our day-5 embryo made it to blastocyst, graded 5BB and that one has now been frozen too. So we currently have one day-3 (9-cell, grade 1) embryo frozen, and one day-5 (originally a 7-cell, grade 2, now 5BB) frozen.

I’m just not sure whether I should have let the day-3 embryo continue to day-5 instead of freezing it earlier. I’m also wondering if they’ll automatically use the 5BB first, even though the day-3 one was the stronger embryo at the time.

They'll use the 5BB first; the success rates are a lot higher.

Sounds as if you have good possibilities - good luck with it!

That’s great news. As pp said, they will likely use the blastocyst first as obviously every bit of further development is a positive step.

My understanding is that grading only really makes a difference if multiple embryos are otherwise identical in terms of being 3 day, 5 day etc - then grading comes into play in terms of which they decide to put back first, but plenty of people have had success with supposedly poorer grade embryos, both at day 3 and day 5. What really makes a difference is whether the embryo is euploid and you can’t tell that from grading. Good Luck!