Failure to Reach Blastocyst

Hi there..

I'm currently going through my first IVF cycle after TTC for nearly two years with no pregnancies and no explanations (unexplained infertility). So I have turned to IVF. Everything seemed to be going ok up until now..

They got 10 eggs at my EPU
7 fertilised
6 Were still dividing nicely on day 4 but not to Blastocyst stage
One was an early blastocyst by day 4 which they transferred on day 5
The remaining 6 stopped multiplying leaving none left for freezing.. :cry:

This had created many questions in my mind so I thought I'd put them out there on this forum to see if anybody had any thoughts..

If the 6 stopped multiplying at day 4 and the 7th slowed down on day 4 and didn't progress past an early blastocyst does this mean there is a good chance it would cease multiplying as well once it was transferred or does the fact that it got to Blastocyst stage mean that it has a much stronger chance of battling on? Has anybody else had a similar situation where they got a BFP from only one blastocyst?

If the 1st cycle doesn't work and I do have to do another stim cycle should I still try to go to day 5 or would I benefit by doing the transfer at day 3? (they are only transferring one embryo probably due to the fact that I am 38).

Could the fact that all but one of my embryos failed to reach blastocyst stage be a possible reason why I have never fallen pregnant. (even after doing three rounds of Super ovulation/IUI).

Hope I'm not rambling but so many things are going on in my mind and I don't know who to talk to. My FS is not very communicative at all and I don't feel comfortable asking her, especially before my appointment which isn't until early August. Think I might have to switch.

Hi Emily

I know it is tough when we have good eggs and none to freeze and the question of whether one should have freeze some at day 3 raises many what ifs.

From my understanding, for first cycly you have a a very good collection of quality egg. Ususally in the first cycle not everyone gets mature eggs that would fertilise let along make it to embies. Take me for instance, got 22 eggs in first cycle, 10 fertilised and only 3 made it to freeze at day 3 but even so they were not so good and I didn't get good results with FET.

Also from what I know, culturing blasts are much more difficult because the embies have to survive outside the womb much longer (ie in vitro and that is harder). Not getting any good embies to reach blast is thus not uncommon. It is not proven as the cause of them ceasing but the theory is, the embies not surviving to day 5 could be because the inefffectiveness of the lab technology to "copy" the womb environment or that the embies themselves are lacking in the genetic capacity to grow anymore. If the latter is correct then no matter whether you freeze them at day 3 or day 5 you would probably still fail in the transfers.

What we know for sure is that if embies reach blast and survive, research shows success rate is much higher than day 3.

I think it is a balancing act, if you have a good collection of fertilsed eggs perhaps to freeze some at day 3 and grow the rest to day 5????

I hope the one you just had transfered would be all that it takes for you to get your long waited BFP.

Good luck.

Hi emily,

Just adding a note to Kahlan's great advice, my embrologist had told me that most embies have sufficient energy to grow to day 3, from there the sperm comes into to play, and they have a big development hurdle they need to get over to get to day 5. The quality of the sperm plays a factor in this. My DH was recommended Menevit along with a few other things to improve sperm quality. DH also had the sperm DNA fragmentation test done. This might be something to look into if you haven't already.

In my personal opinion I would now only do blast transfers, I think with the advancements they are making in the lab to transfer embies into blastocyct culture (providing you have a good lab), the increased chances of a BFP with day 5 embies is well worth the risk. Incidently I always had only early blasts for transfer on day 5, and all my frozen blasts were actually grown to day 6 (as they were slow growing). My last cycle which was successful I did assisted hatching, for the first time ever I had a hatching blast at day 5 ET, I think this made a big difference for me, this was my first ever BFP.

Wishing you all the best for a successful cycle, assuming you are still in your TWW. I hope it ends up you have nothing to worry about and get your BFP. xx

I Emily,

Firstly, welcome to BB.

I can only second what the girls have said - but particularly what BD says about the sperm taking over at day 3. This is exactly what my FS told me as well. Last cycle we had 10/11 fertilise, 10 perfect at day 3 and then only 3 by day 5. So DH is popping pills like nobody's business to try and improve quality.

Also, seriously, if you aren't comfortable talkign about things like this with your FS then you need another FS. There is no way that I could go through IVF without knowing that my FS (and nurses) were on the end of a phone whenever I needed to ask something and were always willing to give me the time that I needed to get things straight in my own head.

In the end you are paying for a service - and if you aren't happy with it then find a new provider. Lots of people here on BB can probably recommend someone in your area if you are looking for someone new.

Thanks so much guys..

I will ask my FS if my DH can get the SCSA test done. It's much better to find that stuff out now rather than later down the line after numerous failed attempts (which is what they often tend to do). I wish they would do more testing before hand rather than later on and give us more information. thank god for forums!

It could be his sperm. I still think he drinks a bit too much alcohol and doesn't eat as healthy as I'd like him to. He also just gave up smoking 3 months ago. (thank god!!). This can all effect his sperm.

Has anybody's DH taken the SCSA test which showed DNA fragmentation, and if so, what happened?

Also, if anybody else has any ideas on the test or Blastocysts (or lack thereof) please let me know.

Emily

Yep I think I am going to switch. She is just so unapproachable. Only plus is that she is in the same building as Monash IVF. I tried to call her today to ask if my DH could get the test but just got the answer phone so I've left a message.

I live in Brighton, Melbourne and saw one not far away in North Brighton which had the Monash IVF sign out the front. But if anybody has any suggestions of a good FS in the south eastern suburbs, I'm all ears.:D

Emily

Just looked him up.

His name is Dr Peter Lutjen in Halifax Street, Brighton. Anybody heard of him??

Hi again Emily

I can't help with the FS - but there are plenty of girls who use Monash. Maybe start a thread asking which Monash FS people use?

With SCSA - my DH had one and it was really bad. There have recently been some studies that have shown that high dose antiozidants can reduce DNA fragmentation but the jury is still out on what effect DNA fragmentation has on fertilisation and viability of embryos. But I figure that it can't hurt to do the best that you can with what you have so DH is on high dose antixoidants (he hates it - he says he feels like he lives in a pharmacy - I just wave my injecting stuff at him and he goes quiet LOL )

You also need to remember that sperm takes 2-3 months to develop so it isn't what your DH is doing now that affects his sperm - it is what he was doing 3 months ago.

Good luck with your TTC journey.

Thanks for all your helpful replies..

Still thinking of doing the test although the doctors don't think it's that worthwhile. Not sure why not. Will have to persevere with that one.

However they said we can still do it if we want to. It has to be sent up to Sydney. We're in Melbourne.

Does anybody know how much the test costs? Esp. if you have to send it up from Melbourne? has anybody else been told it's not worthwhile?

Thanks Emilyb

HI Emily, i go to Dr Lutjen, he is very good, very positive, and very approachable. In fact, the last time we had a failed cycle, i was cursing him because i thought he was too positive!!! Seriously, he is very good - we have been with him nearly eight months, and he always has time to answer any questions or tell you why something is a certain way. I would definitely recommend him. I found him via my friend who is a GP and she researched it for me and said he is very well respected.

Last stim cycle we had 11 eggs, 8 suitable for fertilisation, 6 fertilised, one inserted and one frozen which i was dissapointed with but he said was a good result. I asked him if the ones that did not make it to five days probably wouldnt have resulted in a pregnancy and he said he suspected so, but i dont think its proven, so i kind of looked at it as a natural selection process anyway.

I dont know if he is taking on new patients, because whenever we go there you have to book a long way in advance, so i would give them a call even if you are thinking about it, and you can cencel later.

AFM, we had a scan this morning and 25 follicles!! I was very excited. ONly 11 last time, but having higher doses this time. Looks like egg collection will be wednesday.


Good Luck.

Hi Jaye Jaye,

That's great to hear :D

We went to see him last week and found him very positive so we've swapped and he is now our FS. I am starting a new cycle in couple of weeks and was surprised to find out that his stim cycles only take one month and not two as I had not heard of this method before. So much better than the gruelling two month process that the other clinic did. Did you do your stim cycle in one month as well?

Good luck with your egg collection... 25 follicles is excellent! :dance:

Emily

Hi Ladies, just thought I would pop in - one of the things I have heard that works is luveris - in conjunction with gonal f. My friend found out about luveris and then found out that pregnyl in very small doses does the same thing as luveris can cost $1000's. Where as pregnyl is covered under medicare. She used it and it worked for her. I am trying to find out more info on it and if anyone on here has tried it!

Last cycle only 2 of my 9 eggs got to day three they didnt even make day 5. I am worried about my egg quality also.

If I get anymore info I will pass it on.

Hi Krikkit,

Sorry to hear about your eggs. We really are on a bumpy ride aren't we!!

I haven't heard about Luveris. I have been told by my old FS (and read various studies online) that if the male partner ejaculates every day for at least a week up to egg collection it can help with the quality of the sperm - especially DNA Fragmentation. That's why I was told it wasn't worth doing the test as the ejaculating on a daily basis would more than likely combat any fragmentation anyway.

My DH is now taking Menevit, zinc, vitamin c and a detox powder as well as ejaculating on a daily basis. He has also cut back to 4 glasses of red wine a week (this was the hardest bit!).

I'm doing everything I can to make sure we get quality embryos and feel that DH should be too.

hi emily. both my stimulated cycles were within one month - i dont think i could handle the stress of longer than that!

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