Frozen embies vs donor eggs

Hi

We have had five (difficult OHSS) failed icsi cycles now.

We are planning to do a donor egg cycle in Cape Town in April; have chosen a donor and started the process rolling, but I decided to do one last cycle with my own eggs just before Christmas (BFN)

In this last cycle my specialist transferred 2, day 3 embies. She also froze 3 day 3 embies (something that they refused to do before - they always insisted that they wait until they get to day five)

Have always produced around a dozen "great eggs"; most fertillised well but then would die or stop growing on day 4. I just get the feeling that y clinic is trying to get me to do another (frozen) cycle with them rather than have me go overseas....

What are the chances of the frozen embies actually defying the odds and making it? I am inclined to just leave them in the freezer for the time being and move onto donor eggs where there is a real chance of it being successful rather than going through all the anguish and disappointment yet again... and if the donor eggs fail - then use my frozen embies as a last ditch effort.

Anyone been in a similar situation???????

Hi RubyTuesdays,
Sorry no one has replied to you yet, and sorry to hear you are in this situation, unfortunately one a lot of us can relate to. I ended up having success on my 7th ET with fresh embies at day 5, but I have heard/read of plenty of successes for others on day 3 or day frozen embies, so there is every chance.

From what I understand with regards to your embies arresting around day 4, it is the male DNA that kicks in after day 3 and is responsible for getting them further, however assuming you have had your DH checked for these issues. Otherwise if you are using donor eggs you might be in the same position.

I guess you need to make up your mind which way you feel more hopeful for, if doing a donor cycle will make you feel more confident in your chances, then go for it.

Wishing you all the luck with what ever you decide. xx

Hi RubyTuesdays,
Wish I could offer practical advice, but I have not been in your situation and thinking about it can only imagine how hard it must be to make a decision.

I dont know much about day 5 embies vs day 3, but I think that my gut feeling would be to try them and then go to the donor option. But given the lenghts that you have prob been to organise a donor etc, then I can understand your desire to go straight to that and have your remaining embies as a back up. Tough call with no easy option.

I just hope that you end up making the decision that is right for you.

Good luck and wishing for you a BFP from whatever option you choose.
FG

Hi Ruby Tuesday

Thought I would add my journey for you to consider. I undertook 4 transfers of day 3 embryo's.

First transfer was a fresh cycle of 1 x day 3 embryo - which resulted in a BFP (chemical pregnancy)
Second transfer 2 x day 3 frozen embryo's - BFN
Third transfer 2 x day 3 frozen embryo's - BFP ectopic pregnancy
Fourth transfer 2 x day 3 frozen embryo's - BFP resulting in our 3 months old DD

At EPU we ended up with 10 day 3 embryo's & 5 day 5 embryo's and were fortunate that at each transfer we never lost any in the thaw. We still have 3 day 3's left plus all the day 5's. It is a hard call to make, but maybe a last try with your frozen one's could be an option before embarking on the donor egg option. If it was me I would always be thinking of the "What If" if I didn't use what I had, you never really know what will happen. Looking at my journey, they always say thay put the "best one/s" back at the fresh transfer but we had succes with an embryo that had been in the freezer for 7 months.

Good luck and hopefully you will get your BFP very soon.

Hi.

I have been in a very similar situation, unfortunately. I'm guessing that you are afflicted with PCOS like me to be hyperstimulating so often?

I did a total of three full stim cycles with ICSI. The first two saw me get OHSS quite badly. The second one had me in hospital for a week and off work for over a month. I stubbornly rode out the first one at home and I know I probably shouldn't have.

My first cycle gave us 26 eggs. 15 of those fertilised and 4 made it to blastocyst. Two were transferred and both miscarried. The other two failed to thaw.

Second cycle saw us with 32 eggs. 20 of those fertilised (we used ICSI with polscope this time) and 7 made it to blastocyst. I got two transfers from that batch - one miscarriage and a BFN. The other 5 embryos failed to thaw.

As you can see - the stats are not good. My FS said that the thawing problems were down to the OHSS and bad egg quality, but he also said that my only hope of getting pregnant was with a frozen blastocyst, and my one year old son is the result of a fresh day three transfer.

Which brings me to stim cycle number three - this time I was put on a VERY strict diet and exercise program from the moment we started down regulating. I still had daily blood tests once we started puregon injections and I took ketoconazole tablets while on puregon as well (my FS used this drug and others to help stop my ovaries being "leaky" while recovering from OHSS on previous occasions, it was used this time as a preventative measure). We managed to keep things mostly under control - my one slip with the diet nearly lost us the whole cycle and they took me to EPU a little earlier to help avoid getting OHSS this time. We got 20 eggs, but only 12 were mature and due to some unknown problem only three of those fertilised, even with ICSI. Due to low numbers it was decided that we would not grow to blastocyst but would transfer and freeze at day three. One of those embryos is now the 12 month old baby sleeping in the next room and the other two are still sitting in the freezer. I did actually get a mild case of OHSS on that cycle - but it was just before my blood test and was a result of the embryo successfully implanting.

I'd be asking what sort of measures your clinic can put in place to help prevent OHSS again... but I can also fully understand the absolute terror at putting yourself into that position - I barely had the guts to start on cycle number three, I think you're amazing for having got through five cycles with OHSS! I don't think it's something you can truly understand until you have been there.

While I don't have a great deal of faith in embryos defrosting, I know that I've only dealt with frozen blastocysts. I have no idea whether early embryos are more likely to defrost or not. In some ways, being a less complicated structure they may do better, but in other ways - less cells so they could be more greatly impacted if some cells die in the thawing process. However, I think I would be prepared to give them a go. I think it would be worth trying at least, before you take on the expense of a donor cycle.

I hope all of this has helped a little.

BW

Hi there,

My only thoughts are these:

Firstly, the thawing processes have changed significantly in the past two years and the results at Sydney IVF are almost as good as fresh transfers so I think things have moved on a lot since we had 5 blasties in the fridge five years ago (all resulted in BFNs).

My second thought is what someone mentioned earlier - a nurse told me on my last cycle (where I had five super good eggs) that it is the quality of the egg that gets you to day three and from there on it's the energy in the sperm that gets things to day 5 where you need a big jump in cell divisions - from 8 to around 120 I think they said. So I'm guessing you've had your DH tested too? I sometimes feel all the attention is on us and as my DH still smokes, and has done throughout our 9 long years of TTC, when I found this information out I was devastated thinking of everything we'd been through - everything I'd been through - to get to this point. Unfortunately for me, it's an addiction I have no control over and I really don't know if he can quit. It's very hard to reconcile. Anyway, something to think about.

My last thought is this: my sister-in-law conceived on a day 3 transfer. Sometimes I wonder if the best environment for them is inside us, rather than in a lab!

All the best to you and your husband and fingers crossed you'll have your BFP very soon!

Alice,
x