E & H your opinion please (everything mentioned)

E & H your opinion please (everything mentioned)

Anonymous
Anonymous

September 20th, 2011, 3:50 pm #1

I am just checking with you to get your insight. After a bad cycle this past Spring that ended in M/C, I have been waiting forever it seems to cycle. I finally got started with my donor who is 29yo with 3 kids, never cycled. We decided to do a flare cycle, she had been on a month of BCP. They started her at 150 Gonal then quickly lower her. Her day 3 check was many big follies, E2 of 3000, at day 5 they decided to retrieve her on day 7. (Thus she only got 5 days of FSH) They retrieved 13 eggs, only 9 were mature and of those 6 fertilized. Today is day 3 and they said their is mild fragmentation and they are 4-6 cells. They wanted me to come in and transfer today but were willing to wait to day 5 at my insistance. I think their fear is that they will arrest by day 5 and they won't be able to transfer. My understanding is that day 5 is preferred unless you are transferring almost all back. My April was a day 3 transfer for that reason. I am one who always gets pregnant, has a good lining, even got pregnant 7 out of 8 tries with my old eggs, they were all BO but one, my DD. Do you think I am being crazy to not transfer today? I am really disappointed, I had expected frozens from this which it appears isn't going to happen. In your experience, when someone stims that quickly does it negatively effect the quality?
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Anonymous
Anonymous

September 20th, 2011, 6:33 pm #2

I would transfer all at three days.
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Joined: August 6th, 2011, 6:43 am

September 20th, 2011, 7:22 pm #3

I am just checking with you to get your insight. After a bad cycle this past Spring that ended in M/C, I have been waiting forever it seems to cycle. I finally got started with my donor who is 29yo with 3 kids, never cycled. We decided to do a flare cycle, she had been on a month of BCP. They started her at 150 Gonal then quickly lower her. Her day 3 check was many big follies, E2 of 3000, at day 5 they decided to retrieve her on day 7. (Thus she only got 5 days of FSH) They retrieved 13 eggs, only 9 were mature and of those 6 fertilized. Today is day 3 and they said their is mild fragmentation and they are 4-6 cells. They wanted me to come in and transfer today but were willing to wait to day 5 at my insistance. I think their fear is that they will arrest by day 5 and they won't be able to transfer. My understanding is that day 5 is preferred unless you are transferring almost all back. My April was a day 3 transfer for that reason. I am one who always gets pregnant, has a good lining, even got pregnant 7 out of 8 tries with my old eggs, they were all BO but one, my DD. Do you think I am being crazy to not transfer today? I am really disappointed, I had expected frozens from this which it appears isn't going to happen. In your experience, when someone stims that quickly does it negatively effect the quality?
I only ever hear transfers on day 3 and day 5. Could you wait until tomorrow and transfer at day 4? Also, are you ok with multiples?
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Piper
Piper

September 20th, 2011, 7:40 pm #4

I am just checking with you to get your insight. After a bad cycle this past Spring that ended in M/C, I have been waiting forever it seems to cycle. I finally got started with my donor who is 29yo with 3 kids, never cycled. We decided to do a flare cycle, she had been on a month of BCP. They started her at 150 Gonal then quickly lower her. Her day 3 check was many big follies, E2 of 3000, at day 5 they decided to retrieve her on day 7. (Thus she only got 5 days of FSH) They retrieved 13 eggs, only 9 were mature and of those 6 fertilized. Today is day 3 and they said their is mild fragmentation and they are 4-6 cells. They wanted me to come in and transfer today but were willing to wait to day 5 at my insistance. I think their fear is that they will arrest by day 5 and they won't be able to transfer. My understanding is that day 5 is preferred unless you are transferring almost all back. My April was a day 3 transfer for that reason. I am one who always gets pregnant, has a good lining, even got pregnant 7 out of 8 tries with my old eggs, they were all BO but one, my DD. Do you think I am being crazy to not transfer today? I am really disappointed, I had expected frozens from this which it appears isn't going to happen. In your experience, when someone stims that quickly does it negatively effect the quality?
You need to trust your doctors and the embryologist. If the embryos are only 4-6 cells on day three, that means that they are already not growing at the expected rate (should be 8 cells) and by attempting to take them all to blast, you risk having nothing at all to transfer.

The problem is that this is still an imperfect process. The embryologists are making educated guesses about which embryos are the most likely to keep growing, implant into the uterine wall and continue to divide and produce a healthy pregnancy-there is no tool that is going to tell them this information.

Despite the premise that embryos transferred at the blast stage may be a little more likely to keep going, there are lots and lots of babies which came from bad-looking and less than optimal embryos. (Our ds is from a three-day transfer of one 6 cell and two 5 cell---many years ago, mind you!)

The current rate of growth is not optimum--if you transfer the best of the bunch now at three days, you may hit the right embryo. But it is highly unlikely that these will make it to blastocysts without arresting.

Listen to your RE and the embryologist.
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E&H
E&H

September 20th, 2011, 11:47 pm #5

I am just checking with you to get your insight. After a bad cycle this past Spring that ended in M/C, I have been waiting forever it seems to cycle. I finally got started with my donor who is 29yo with 3 kids, never cycled. We decided to do a flare cycle, she had been on a month of BCP. They started her at 150 Gonal then quickly lower her. Her day 3 check was many big follies, E2 of 3000, at day 5 they decided to retrieve her on day 7. (Thus she only got 5 days of FSH) They retrieved 13 eggs, only 9 were mature and of those 6 fertilized. Today is day 3 and they said their is mild fragmentation and they are 4-6 cells. They wanted me to come in and transfer today but were willing to wait to day 5 at my insistance. I think their fear is that they will arrest by day 5 and they won't be able to transfer. My understanding is that day 5 is preferred unless you are transferring almost all back. My April was a day 3 transfer for that reason. I am one who always gets pregnant, has a good lining, even got pregnant 7 out of 8 tries with my old eggs, they were all BO but one, my DD. Do you think I am being crazy to not transfer today? I am really disappointed, I had expected frozens from this which it appears isn't going to happen. In your experience, when someone stims that quickly does it negatively effect the quality?
I am 13 hours time difference than USA. I have never known a donor to stim in 5 days to be honest, but with the flare protocol eggs are collected when the first few reach 17 or 18 mm. the fact that there were a number of mature ones suggests that the egg collection was at the correct time for that particular donor, she may have started stims on day 2 or day 3 of her period which means her eggs were growing those extra few days prior to starting meds. Now I have probably missed the day 3 advice but I am one that would probably go ahead and transfer on day 3 and transfer more than normal. Personally I did a 3 day transfer of 4 embryos and started with triplets, mine were 2 x 5 cell, 1 x 6 cell and 1 x 12 cell (the worst) all with lots of fragmentation. We also do 4 day transfers as someone else suggested - normally when we have done CGH or PGD OR FISH on day 3. If you didn't transfer today I would consider transferring tomorrow on a day 4 transfer of the best 3 embryos - lots of us have beautiful babies from 3 day transfers of not so beautiful embryos. Good luck.
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Joined: March 7th, 2011, 4:03 pm

September 21st, 2011, 10:53 am #6

I am just checking with you to get your insight. After a bad cycle this past Spring that ended in M/C, I have been waiting forever it seems to cycle. I finally got started with my donor who is 29yo with 3 kids, never cycled. We decided to do a flare cycle, she had been on a month of BCP. They started her at 150 Gonal then quickly lower her. Her day 3 check was many big follies, E2 of 3000, at day 5 they decided to retrieve her on day 7. (Thus she only got 5 days of FSH) They retrieved 13 eggs, only 9 were mature and of those 6 fertilized. Today is day 3 and they said their is mild fragmentation and they are 4-6 cells. They wanted me to come in and transfer today but were willing to wait to day 5 at my insistance. I think their fear is that they will arrest by day 5 and they won't be able to transfer. My understanding is that day 5 is preferred unless you are transferring almost all back. My April was a day 3 transfer for that reason. I am one who always gets pregnant, has a good lining, even got pregnant 7 out of 8 tries with my old eggs, they were all BO but one, my DD. Do you think I am being crazy to not transfer today? I am really disappointed, I had expected frozens from this which it appears isn't going to happen. In your experience, when someone stims that quickly does it negatively effect the quality?
I always appreciate your input! Thanks also to the other responders. She started lupron on day 1 of her menses but FSH on day 4. She has FSH day 4-8. Retrieved day 10 of cycle. I decided to see how the embys are doing and seriously consider transfer today. I agree that ugly embys can make beautiful babies, my OE DD is proof. I really want twins this cycle. I have a set of twin girls that are 2yo so I know what it entails. I am 46yo and would prefer to be done after this cycle/pregnancy. To the other poster, I wouldn't take the chance in transferring 6 back, I'm not okay with high order multiples. I am thinking if they look like they did yesterday, four might be the right number, but I'll wait until they call this am. My plan had been to transfer 3 tomorrow.
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Joined: August 6th, 2011, 6:43 am

September 21st, 2011, 4:09 pm #7

Well if you really want another set of twins then transferring three seems reasonable. Yikes, I would be so afraid of having triplets though. I hope after looking at them today the embryologist can give you a really good idea of what to do. Wishing you luck today!
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