Anyone know why Stanford would transfer a 3day embie?

Anyone know why Stanford would transfer a 3day embie?

Joined: December 8th, 2006, 6:35 am

December 30th, 2011, 3:22 am #1

Hi:

I am waiting on my RE's review of my donor's records -- my donor just completed a cycle. Retrieval looked great - 21, 17 fertilized -- no other info. I just found out that they transferred 2 3 day embies. This is weird to me, with those numbers...

Just wondering if anyone out there knows about Stanford? They don't normally do 3 days with that many fertilized embies, would they? I have to presume sperm problem and/or embies were not looking like they would survive...
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Ariadne
Ariadne

December 30th, 2011, 5:20 am #2

I wasn't at Stanford, but the clinic normally did 5 day transfers. We got a call on day 3 to get up there for ET (3 hrs. away) & we transferred 3 day-3 embryos. The reason was that the fertilized embryos were not doing well & they were worried. Turns out only 1 made it to day 5 to freeze & it was mediocre in quality.

If they normally do day 5 transfers, my best guess is that there were embryo quality issues with the cycle. I believe we got 22 eggs & 17 were mature. We initially had 12 embryos, but things just didn't go well from there. (12 embryos from 17 mature eggs worried me from the outset, but we were told that was not cause for concern. This was a natural fertilization cycle & later, the RE told he he would recommend ICSI in the future, despite dh's "perfect" sperm.)

Now, our donor had a previous successful cycle & the clinic was shocked at our results, as dh has no sperm problems. At our follow-up, the RE said she would not recommend we use the same donor again. She couldn't explain the poor results but said sometimes a particular mix of eggs & sperm does not do well & they never know why. She didn't believe it was a lab issue b/c no other cycles had issues.

So it is a sign the cycle did not go well, but it also doesn't mean for sure that the donor has bad eggs. Not that any of that is particularly comforting. I understand.

I have my fingers crossed for you.

(For clarity, the clinic had 5 REs so the above were 2 of the 5. Our main RE was a man, but the RE we had for the follow-up - the one who so brilliantly & compassionately told me she believes "in Western medicine" when I queried her about immune issues - was a woman.)
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minniet
minniet

December 30th, 2011, 4:44 pm #3

Thank you so much for your response Ariadne. I really do not know what to do but wait to hear what my RE says. I think we will have to trust him, as I truly believe he wants our success. He has rejected other donors on our behalf, and has great stats, so I am just trying to hold tight.

They did ICSE half of the eggs and the rest were let alone to do their thing. That is why I wondered about the sperm...

Any other thoughts or feedback would be appreciated.

I had hoped to simply be making my (hoped for) last toast in 2011, but now, I can't help but worry about next week, when I get the doctor's review. (He is reviewing medical records and meeting with the donor).
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E&H
E&H

December 31st, 2011, 1:12 am #4

Hi:

I am waiting on my RE's review of my donor's records -- my donor just completed a cycle. Retrieval looked great - 21, 17 fertilized -- no other info. I just found out that they transferred 2 3 day embies. This is weird to me, with those numbers...

Just wondering if anyone out there knows about Stanford? They don't normally do 3 days with that many fertilized embies, would they? I have to presume sperm problem and/or embies were not looking like they would survive...
Many reasons especially at this time of year.

1. The recipient was out of town and wanted to travel back for Christmas.

2. Doctor going away for Christmas or lab closing etc.

3. Request of patient for some reason.

4. Lab or dr prefers doing 3 day transfers (I work with one clinic who prefers to do 3 day transfers and their results are good) Josie from here just did a cycle there and is having twins from transferring 2 8 cell embies on day 3 and she has 4 frozen on a split cycle of 10 eggs each.

5. Maybe they could already tell the best 2 embryos.

I wouldn't assume their is a problem with the donor, there are so many reasons at this time of year. There was one lady here who travelled to me to do a cycle, can't remember her board name but she came from USA to Malaysia as she was Singaporean Chinese - the clinic she went to ALWAYS does 5 day transfers and the donor was delayed a few days for some reason. The lady ended up doing a 2 day transfer as she had a flight back to USA that day - she got pregnant and delivered.

You need to get firm reasons why - are you cycling at the same clinic? Can't you go for a doctor consult and ask questions regarding the cycle - they wouldn't have to give you any personal info.

I really hope all is well for you as I know how hard it was to find your donor.

Good luck.
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minniet
minniet

December 31st, 2011, 2:02 am #5

I really really appreciate your thoughts on this.

From the donor's standpoint, she stayed in town and was available. I may be wrong, but I believe that the IPs were local to Stanford, so they should not have been pushing to rush things, as I believe there was no travel involved. Since the nurse at my clinic has received the records, honestly, if there were frozens, I can not imagine her not saying that...so I have to assume that there are none, which is pretty bad out of 17 fertilized of 21 retrieved.

She did have an unusually long stim period -- 16 days, which also worries me.

I absolutely have my RE both reviewing the records and also meeting the donor next week, on the 11th day of her cycle (she got a bleed on Dec 25), so they are assuring me that no way they will proceed unless they are confident she is a strong donor.

However, I just can not imagine having no report at this point -- either a positive pregnancy or blasts frozen. So, either they had a sperm problem (which, despite best scenario, gives me a lot less information) or she has bad eggs for no reason I know of.

But, of course, anything is possible. I have a lot of confidence in my RE, as he was with Sher and is immune focused and really follows studies and makes presentations. So, I have no concerns about the evaluation.

I am just scared that we will lose a donor we love and not be able to move forward. The way our lives are now, I just do not see us finding another donor. We have a lot of business stuff going on and this was the one area that we felt was moving perfectly, although I know that is silly sounding...

I would have preferred the previous IPs shared some info, after all, their cycle and delays have really slowed us down...

I just have to hold tight and wait for my RE's feedback and analysis. So hard!
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E&H
E&H

December 31st, 2011, 6:05 am #6

a donor who takes 16 days to stim doesn't sound good. We generally do 10 days of stim but rarely go as high as 12 days of stim before trigger. I wonder being a first time donor if she gave the meds wrong to start off with so they had to re-educate her on it and got it right at the first scan on day 5 and tried to rescue the cycle????? I think there are lots of questions here.

Questions I would ask...

How many Antral follicles on day 2 of period before starting stims.

How many follicles on first scan at day 5 and what was the size of those follicles. I would expect to see between 8 and 10 mm on that day. Also I find the number of follicles on day 5 to be the normal number of mature eggs at egg collection.

Was her medication increased after first scan? From what to what? An increase of more than 50 iu would make her produce bad quality eggs and a decrease of more than 50 iu also has an effect on quality.

Was E2 tested on day 5 and any other days - what was the value?

What was the reason of going to Day 16 with meds, was it because there were many small follicles - this can be due to increasing meds on day 5 too much which would produce lots of follicles and make the ones she already had stagnant until the small ones catch up - again making the quality poorer.

Don't also forget that the RE will learn the mistakes on the first cycle of a new donor and hopefully be able to rectify those mistakes on the second cycle.

Good luck.

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SMRC
SMRC

December 31st, 2011, 3:25 pm #7

Hi:

I am waiting on my RE's review of my donor's records -- my donor just completed a cycle. Retrieval looked great - 21, 17 fertilized -- no other info. I just found out that they transferred 2 3 day embies. This is weird to me, with those numbers...

Just wondering if anyone out there knows about Stanford? They don't normally do 3 days with that many fertilized embies, would they? I have to presume sperm problem and/or embies were not looking like they would survive...
and don't know if this is totally applicable, but I received great information in response to my own concern about my recent 3-day transfer at C.ornell.

Here's the link in case it's helpful. SMRC

http://www.network54.com/Forum/57451/me ... +transfer-
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minniet
minniet

December 31st, 2011, 5:21 pm #8

a donor who takes 16 days to stim doesn't sound good. We generally do 10 days of stim but rarely go as high as 12 days of stim before trigger. I wonder being a first time donor if she gave the meds wrong to start off with so they had to re-educate her on it and got it right at the first scan on day 5 and tried to rescue the cycle????? I think there are lots of questions here.

Questions I would ask...

How many Antral follicles on day 2 of period before starting stims.

How many follicles on first scan at day 5 and what was the size of those follicles. I would expect to see between 8 and 10 mm on that day. Also I find the number of follicles on day 5 to be the normal number of mature eggs at egg collection.

Was her medication increased after first scan? From what to what? An increase of more than 50 iu would make her produce bad quality eggs and a decrease of more than 50 iu also has an effect on quality.

Was E2 tested on day 5 and any other days - what was the value?

What was the reason of going to Day 16 with meds, was it because there were many small follicles - this can be due to increasing meds on day 5 too much which would produce lots of follicles and make the ones she already had stagnant until the small ones catch up - again making the quality poorer.

Don't also forget that the RE will learn the mistakes on the first cycle of a new donor and hopefully be able to rectify those mistakes on the second cycle.

Good luck.
My RE will be analyzing this, but yes, I was also concerned when I heard about the extended stim.

I do know the AFC before meds and Day 5 were excellent - I think around 18? I will look for the rest of the information you mentioned after his consult.
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Joined: December 20th, 2010, 7:38 pm

January 1st, 2012, 1:51 am #9

Hi:

I am waiting on my RE's review of my donor's records -- my donor just completed a cycle. Retrieval looked great - 21, 17 fertilized -- no other info. I just found out that they transferred 2 3 day embies. This is weird to me, with those numbers...

Just wondering if anyone out there knows about Stanford? They don't normally do 3 days with that many fertilized embies, would they? I have to presume sperm problem and/or embies were not looking like they would survive...
and they don't want to take a chance.

I know many patients including myself that are convinced to do dt3 at Stanford, and we all believe that the lab's ability, or the lack thereof, is the primary reason for that.
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Joined: October 22nd, 2004, 7:49 pm

January 1st, 2012, 2:11 pm #10

unless they have changed embryologists recently, I had success in 2007 with fresh 5d blast and success in 2008 with frozen 5 day blast from the same fresh batch from 2007.

Best,
Kyra
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