Tuesday, January 13, 2009

Day Six Report

Unfortunately our hopes for more blasts than last time were dashed today. In fact, we’ve ended up with fewer. The embryologist called to let us know that only three of the nine good-looking embryos developed to the blastocyst stage. One of them was biopsied and vitrified (flash frozen) yesterday at day five and the other two today because they took longer to develop into blasts. Their grades are as follows:

1. 4BA
2. 4BB
3. 3BB

The number refers to the stage of blast development, 3 being a full blastocyst and 4 an expanded blastocyst – I was told that this is not as important as the letters. The first letter refers to the cells that will become the embryo and the second letter to the cells that will form into the placenta. The embryologist told me that the 4BA embryo is near-perfect and the BBs are very decent quality. Our one chromosomally normal embryo from last cycle is a 4AB, also close to perfect. However, the embryo quality has nothing to do with their chromosomal make-up, which is what we’re testing for. A perfectly graded embryo can be abnormal and very often is. It’s the embryo grade, combined with its chromosomal viability that leads to success, so long as the uterus is also receptive. We know the grades, but we must now wait two months to find out if any of them are chromosomally viable.

Needless to say, we’re extremely upset by this news. While things could always be worse and we could have had even fewer or, heaven forbid, none at all, this leaves us with an agonisingly long and terrifying wait for our results from the biopsies. The statistics for our age group leave us with, at most, one normal embryo to hope for. However, we know that it’s touch and go whether there’s a normal one among them. Last time we had one normal embryo among four blasts. At this point, we’d be over the moon with one normal in this group of three, because that would give us two embryos in total to transfer together sometime in late March or so. Transferring two would significantly increase our chances of one implanting and developing into a healthy baby.

How we’ve developed this problem of growing embryos to blast, I just don’t know. In our local cycle last March, we had seven blasts out of ten fertilised embryos, a much higher percentage. Of course, that cycle didn’t result in a healthy pregnancy so we can’t class it as a success. Our fresh transfer failed because of a mechanical issue at transfer and the frozen one ended in miscarriage. We didn’t have the embryos tested so we have no idea how many of the seven were chromosomally normal. CCRM are stricter about the quality of blasts, but the seven we had locally were of a decent quality and would most likely have passed at CCRM as well. Since the laboratories at CCRM are known to be fantastic, this situation is even more of a mystery to us. CCRM expect about 50% of fertilised embryos to grow to the blast stage and this should have given us five or six. We have to face the fact that our ages are really going against us and that this could be a contributing factor, even between last March and now. Mercifully my ovarian reserve, meaning the number of eggs still remaining, is far above average for my age group, so at least we start with a lot of eggs. Thank goodness for that, since otherwise we really may have had none at all to biopsy. But to go from twenty one eggs retrieved to just three blasts is a devastating blow.


  1. I'm so sorry to hear of your disappointing results! I have the same issue, I start out with lots of eggs (23 last time) and dwindle down very fast. Out of 3 IVFs, I have only made one blast. I'm considering a CGH cycle, but am terrified of not having anything make it to day 5. I'm so relieved you didn't end up with none, but only 3 is still very disappointing. Let the dreaded 8ww being! Thinking of you and hoping this time goes by fast and that you get great results. Hugs!

  2. Jess, I'm holding your hand through this. You know that. You and I are in the same damn boat as far as dwindling numbers is concerned.

    I hope that you have at least one normal in there. I really do.

    I know the next 6-8 weeks will be tremendously stressful and excruciatingly long, but try and get some solace in the knowledge that you have 1 viable embryo waiting already. And all we need is the one that will stick.

    Take care of yourselves. I'm sorry this is so hard, but I can definitely say I know what you're going through because I'm going through it as well.

    Hugs to you!

  3. Oh I'm sorry! I hate that. Lately, it seems I am hearing not-so-great news from CGH cycles! But, I think you are ahead of the curve a little since you definitely have at least one "normal" so far...and the grades are great (though I know as well as most of us that this doesn't mean much, it still gives me hope!). Argh. Well, I'll be following in your CGH footsteps soon. If my body cooperates, I should have an ER at the end of February and then on to my scary 5-6 days of stressful fert reports and then 8 weeks of waiting (praying we make it even that far!). Try to enjoy the wait a little...at least you aren't on meds for a few months...and if you are at all like me, that means you might finally lose a few pounds in the next few months! (oh, and maybe have a glass of wine?).

  4. I read through all of your posts just now, and whoa, what a ride! Reading about your drive to CCRM brought back memories of our last two driving trips there (July 2008 & November 2008), and we're about to make another driving trip in a couple of weeks or so. I smiled when I read about the tumbleweeds along the highway in Kansas. Yep, I saw them too! :)

    I know you're a bit disappointed in the number of blasts this cycle, but I am totally stoked for you. How awesome it is to know that you already have one perfectly normal frozen blast! I'm hoping that your wait is short and that you will be pleasantly surprised. :)