Dear biglemon,
Day 5 blast tends to have a higher success rate than day 3 cleavage embryo because the extended time in the lab allows us to do a better selection for you. In other words, by doing day 5, we do not increase the success rate by increasing the number of competent embryos; we only increase the "speed" to success by shortening the time-to-pregnancy because we are able to de-select those embryos that cannot make a baby.
My lab does both day 3 and day 5 freezing, with freezing of good-looking embryos which we believe to be competent as on that day. This belief is based on morphological appearance only. The decision of day3 vs day5 is often patient-driven or doctor-driven. I can't tell you what is worth to freeze, but I can tell you what is NOT worth freezing. Again, it is a de-selection process, or trying to narrow down to the right embryo(s) by eliminating the incompetence. Therefore, we may end up freezing some incompetent embryos as appearance doesn't tell the whole story; but we never throw away any embryo that appears to have potential to make a baby.
1.Is early cleavage embryo has higher euploidy rate? (from PGD or CGH result)
2.In lab , are we normally check the meiotic spindle alignment of an embryo to assess aneuploidy ?
3. Just wonder for those patitents with higher day 14 HCG have greater chance of euploidy ?
Dear BabyGaga21,
1) I think your doctor will start you on 375 on your 6th cycle. Since he knows his job, you should not need to ask for a more aggressive amount.
2) This is a check on the embryos, not on you or your husband. This test (preimplantation genetic diagnosis, or screening; short form = PGD or PGS) may not be available from your doctor or your lab.
If your tube is not blocked, it doesn't relate to implantation. It is only when there is fluid trapped in the tube(s), a condition called hydrosalpinges, that affect implantation because the accumulated fluid will go down to the uterus, negatively affecting the embryo and its implantation.
3) On your part, there is no extra you have to do. I can't say you need to keep on trying until you get lucky, because you always have a right to decide stopping ivf and moving on with your life. However, I am positive that your upcoming cycle, if done soon enough, should get you a similar no. of eggs as your 5th cycle. Your doctor will also try to optimize everything for you. One thing I had mentioned in the last post was endometrial stripping/biopsy, which is a simple procedure you may ask your doctor. But I am not really sure if your doctor will be comfortable in offering it. Even if he will not do it, there is nothing to regret about.
Hi jenjen1234,
For FET, using natural cycle is easy and no medication involved; but in some cases can be difficult to control e.g. In women who have irregular and/or long cycles. 人工cycle needs to take a very tiny dose of estradiol and later progesterone on a daily basis, but this allows easier timing of the actual transfer day for better logistic management. Side effects of these medication should be minimal, and since its not long-term use, it should not be a major concern.
As for taking 12 weeks of these medication if pregnant, this is very subjective to your doctor\'s preference; in most cases it\'s a peace of mind rather than scientifically proven to be necessary.
Some say Vit E improves endometrial thickness; in any case these supplements won\'t hurt. You can still take folic acid and vit E during 人工cycle, no adverse interaction is observed.
Hi jacky400,
1. what do you mean by "early cleavage" embryo? Are you referring to an embryo that has its first cell division (i.e. from zygote to 2-cell) upon 24-26 hours post insemination? They don't necessarily have a higher euploidy rate.
2. To assess ploidy status, the lab has to take out one cell from a day-3 embryo or a few cells from a day-5 embryo to check the number of chromosomes present.
3. HCG levels have nothing to do with ploidy status.
Hi cutecutetown
我31歲，今年八月做了Ivf 第一次放了兩個A級鮮胎，結果失敗，今個月4號放了兩個A級雪胎，但放胎第七八日都流鮮血，之後停了兩天，第十一二日又再流鮮血，流量似M第一天，請問有流血情況是否多數失敗？M到還是什麼原因導致流血？如何知道胚胎有沒有著床？著床血是怎樣的？我下星期一18號才到e院抽血驗孕，我現在可以停止塞藥和停食Estrofem和阿士匹靈嗎？心情很失落，只剩下一個雪胚胎，如果今次失敗後下個月應繼續放雪胎還是要休息一個月再放雪胎較好呢？
不好意思很多問題，麻煩你用中文解答，真的謝謝你！
as I want to do IVF in Feb , my doc prescribe me marveling for 3 cycles ,, however as I read other jm sharing, they normally just have one cycle of mavelon. my doctor ask me to take marveling from this month , continue for 3 cycles, is it necessary and normal ??
(I m PCOS and high prolactin, also taking cabergolin once a week )
Hi kaka62587,
If your doctor gives you 3 months of mavelon, there must be a reason. He/she knows your medical background the best, the mavelon will help to better regulate your menstrual cycles in the belief that your eggs will start up about the same size. As you mentioned, You have PCOS, which often causes you to have irregular cycles and anovulation.
Cabergoline relates to your prolactin.
I'm going through ivf. it is a bit harsh than what I expected.
I did egg retrevial surgery, got 15 pieces. But yesterday the lab called and said to me only 4 eggs are mature. the rest are immature and too small and there's nothing can be done.
I was disappointed coz I thought I got enough eggs. Now hopefully the 4 will do well. Do you know why so few eggs can be used for further procedure while others are immature? Is that because I have done the egg retrieval procedure too early?
I told my dr that I choose not to put the embroys back into my body this month as I am feeling very uncomfortable with my swelling belly and breast. But in this case if the quanity of egg is so little, should I forget about freezing them coz I heard the defrost procedure could potentially damage the embryos. I guess I do not have anymore to loose
Dear imconfusing,
It depends on how many mature follicles you had (on the day of hcg trigger). You might have ~4 mature follicles and the remaining follicles were of very slow progress. During egg retrieval, most doctors retrieve everything including these small follicles; this could be one of the reasons why you had 15 eggs but only 4 mature.
Very often, doctors need to balance the no. of mature vs. immature follicles. If they want the immature to grow a little further, they may sacrifice some of the mature ones because the mature ones will grow more and become over-mature (i.e. old).
If your 4 embryos grow well, you may still have them frozen. Your swelling feeling may be due to the ovarian stimulation; when the body returns to a natural state, the uterus may be more receptive compared to a stimulated cycle. If you worry, you may consider transferring one embryo (only if you don't develop any symptoms of OHSS [ovarian hyperstimulation syndrome]). Then you still have 3 as your "safety net".
Thank you for your information. you have been always very helpful to us =) I had fresh embrayo trasfer. Just one embrayo( B+ grade). the 4 matures are A-, B+ , B and B, which will be frozen soon. At the first place I want to wait and see till they are day 5 but they claim that it is a bit risky. is that true?
is there a big difference between A grade and B grade? how many grades are there? ABC only?
And indeed 6 immature eggs are hatching at day 2 so they will see if they could live .But my embroyolist claim that those quality would be inferior. So now I do not expect much on that. Is quality really an important indicator? do they have a strong correlation with the rate of success?
Meanwhile, can I do workout/ light exercise as usual? it's been really stress to stay home and lie on bed. I feel it is very stressful and I cannot do anything but to keep worrying about this and that when i'm at home. what do u think?
Dear imconfusing,
There is always a very very little chance of damage during freeze and thaw. The risk is real, but minimal.
On this ABC grading system, there are grades ABCD. As you mentioned, there are A- and B+; I think there may only be very small difference between A- and B+, but the difference may be larger between A and B.
Egg quality does have a correlation with success. However, it is not a simple yes or no relationship. When an embryo derived from a "poor" egg can develop on time and to a reasonable grade, there is always a chance that it will implant.
I totally support your idea of workout/light exercise as usual. Nothing is worse than feeling the stress and worrying at home. But be mindful when you work out, I hope you are not running a marathon, right? While you want to get rid of the stress, do not push yourself too hard exercising either :)
Do you know why so few eggs can be used for further procedure while others are immature? Is that because I have done the egg retrieval procedure too early?
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