Tuesday, August 25, 2015

Details on our embryos (why we aren't worried about triplets)

Our three embryos for transfer are: (drum roll):
  • Embryo #11, a Day 7 FISH/Microarray normal 4BB blast
  • Embryo #15, a Day 6 FISH/Microarray normal 3BB blast (my bets are on this one)
  • Embryo #20, a Day 6 FISH/Microarray no result 3BC blast
What does all that mean? I'm about to go all technical on you guys...so skip to the bottom if scientific explanations are not your thing.

Day 6 or 7 means the day that the embryo reached the blastocyst stage. Ideally, this would be on Day 5, but Day 6 is ok too. Day 7, not so much. In fact, most clinics don't even culture to this stage.

And then the 3BB or 4BB, etc., is explained in the graphic below. But in shorthand:
1. The number refers to how developed the blast was
2. The first letter represents the quality of the inner cellular mass (which becomes the baby)
3. The second letter describes the quality of the trophoectoderm (which will become the placenta).

So an embryo graded 4AA, 5AA, or 6AA would be most likely to develop into a baby (note, none of ours are AA. In fact none include the letter A at all).

Here is a pictoral explanation:

Finally for the few readers who are super interested, this link will take you to a well explained, detailed explanation of blastocyst grading and multiple super cool photos.

For what it's worth, Magpie developed from one of three euploid blasts: either a Day 6 3AB, a Day 7 4AB, or (more likely) a Day 6 4AA that didn't fertilize on time and had to rescued with an ICSI fertilization the second day (God bless the Denver clinic - most clinics would have just thrown that egg away as non-fertilized). All of those arguably better than any of the three we have left, but it is what it is.

So from what we have for this time:

Embryo #11 is 4BB and so looks fairly good, except for the fact that it didn't go to blast until day 7, which makes it a big outlier and unlikely to implant, according to Dr. Schl. But hey, you never know.

Embryo #15 at 3BB maybe looks like the best bet for this cycle, Day 6, euploid, reasonable quality. Maybe!

Embryo #20 is a 3BC that didn't culture on FISH or microarray so we don't know if it is chromosomally normal. I'm betting it's not and will die off. It's also pretty bad quality for the trophectoderm.

Have any of you out there have a baby from a 3BB or 4BB, or a 3BC or (rarer still) a Day 7 blast? Would love to hear from you if so.

Three more days! I can't believe it.

Fingers crossed.


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  1. No experience with blasts but I will keep my fingers crossed for you.

  2. I have high hopes for your day 6 3BB! And you never know for the other two!!! My blast transferred most recently was a 3BB and so far so good! One of my twins is a 4BB. When I found out about the grades of my embryos I obsessed over their grades none of mine were perfect AAs. I've seen lots of successes with BB CCS normal embryos!

    Excited for you!!!

    1. thanks, lindsay, that's really helpful to read! wishing you the best of luck!

  3. I have no clue what ours were graded, just that IVF 1, 2, 3 were 3 day transfers and then IVF 4, 5/FET 1 were all 5 day blasts. I should have asked. Either way, we ended up with 1 from IVF 1, 1 from IVF 5 and 1 from FET 1, so it must have been OK! Sending lots of prayers your way!

  4. hi mo- i also have a day 7 blast on ice and schoolie told me that he wouldn't rule it out- but you are right- its less likely- hopefully you have seen some of the japanese literature that shows that there can be a 23% chance of implantation with day 7 blasts? that is better than 0/

    1. yes, I'm familiar with the japanese literature, and you're right, 23% is SO much better than 0%!

  5. My little 3BC is currently gestating in my gestational surrogate's uterus! Good luck!

    1. awesome! what day blast was it, do you know?

  6. Hi Mo, just going to run down all our stats for you:

    Morula (fresh, day 5) = BABY
    Grade 1 Blast (fresh, day 5, no letter grades given at that stage) = BABY
    3CC (frozen, day 6) = didn't survive thaw
    3BC (frozen, day 6) = didn't survive thaw
    4CB (fresh, day 5, hatching) = 2 BABIES (best guess this was our identical twins)

    So yes, quality-wise I have babies from 3 that were worse than the ones you're asking about, however they were fresh and day 5.

    It's so hard to know what will happen, but I get why you're choosing to do 3!

    1. sonja, maybe i shouldn't be so sure there's no worry about multiples! given our dismal history and the fact that none of my embryos made it to blast on day 5, i'm not so worried. ok, after reading this...a little worried...but not too worried ; )

  7. Fingers and toes crossed!

  8. My twins were the result of a frozen cycle. We transferred two and they both took - 4BB and 5 BB. Two healthy, full-term babies. Good luck!

  9. Forgot to add - mine were both Day 6 embryos!

    1. cool! good to know! thank you for sharing!

  10. I love all the science-y talk :)

    no idea about ours but we had an 8-cell and a 9-cell on day 3 (that's all we were told)

    Wishing you all the best.

  11. 3BA day 6 CCS normal = currently gestating 14w
    4AB day 6 CCS normal = RLB

    so there ya go, Mo,
    2 CCRM CCS normal frozen on day 6, one RLB, one on the way (as a donated embryo... not in me!!)
    both, btw, created when I was a month shy of 40

    I have had extensive, wonderful talks with FLC embryologists (John, Jeff)
    as well as CCRM's genetic dept. about the details of these "outliers"
    'does day 6 matter? how about "lower" grades like BB's and how about 2/3's? what about how many times the embryo got thawed and biopsied?'

    you know, trying to gleen the "real scoop" from them.

    last conversation summed it up good...
    CCRM/FLC does *not* freeze embryos that they don't feel confident will fall into their "65%" ongoing pregnancy/live birth stat for CCS normals.
    if they got frozen, they have that potential, no matter their grade, the day, biopsies, etc.

    now, they absolutely clarified that when choosing which embryo(s) to transfer, there is a triage they go by- obviously normals before no-results, day 5 over day 6, A's over B's, 5's over 3's or 4's, etc... the less they have been manipulated (freeze/thaw cycles, biopsies) dictate which ones are preferred for FET...
    but that does not mean that they do not fully believe that there is potential in embryos that have been thru multiple freeze/thaw, more than one biopsy in attempt to re-screen a no-result, 2/3s, day 6's less than stellar grades, etc... or they simply would not freeze them.

    now, we all know the caveats- age of eggs, age of sperm, medical history (like cancer treatment, etc), condition of womb, etc... normals don't always work by any means, but if FLC freezes them, they have what it takes as far as any of the embryologists know at the time or can know or will ever know about each specific case.

    so, that's what I know about that mo.

    I have one thought...
    personally we would not transfer any of our no-results. didn't want the unknown risks. I am curious as to your thoughts on transferring a no-result with your euploid embryos... do you have any concerns about the possibility of that embryo complicating/harning a multiple pregnancy, or T21, T18, T13, etc.? please don't take any judgement from me, I am just wondering what your thoughts are. we had a manic history of loss, so I was very risk-averse when it came to transferring anything but CCS normals. our no-results are still frozen.

    did FLC or CCRM discuss any stats of facts about no-result transfers there?

    will be keeping you and will constantly in my thoughts... all my best to you for your FET woohooooooo!

    1. thanks for your detailed response! super helpful! I figure our chance of any pregnancy is so low, and this is our last shot, that we'll throw in the no result with the others and see what happens. if we are lucky enough to be pregnant, we will do Marterniti-21 test, etc., so we'll get a good read on what's going on in there. wouldn't want to pass on any embryo that could possibly be a take home healthy baby.

  12. Yeah,especially given the possible (mitochondrial?) issues, triplets ARE unlikely here. Out of curiosity, do you have embryoscopy data on these? Does that give a better picture than embryonic morphological grading, which is a rather shitty predictor? Nobody should know that better than me: I made 3 beautiful 4 AA blasts and 1 3AA blast by day 5, but none of them implanted in the surrogate----they probably would have implanted in me, only to end in grief later. Gauri came from a 4 AA blast too, and I have to say, she was textbook perfect looking, but both beautiful blasts and scraggly looking blasts can make equally adorable babies. I do not know whether that reassures you or makes it worse, but I am so glad this ball is rolling....excited for you!!

    1. Jay, you have me stumped. I don't even know what embryoscopy data *is* - thought it was for early stage miscarriage, and I've never heard of anyone doing it anyway... enlighten me!

  13. I have a Day 6 4bb 2 year old napping away!! He was the only embryo that survived out of 21 eggs retrieved at RMA NJ.

    1. oh! that's awesome! thank you for sharing!

  14. Just wondering what you did to prepare? I have one son after 6 years of ttc and I've had 6 losses, the last two from FETs remaining embryos from my sons cycle (and a few failed adoptions ;(
    We will be starting IVF again in January with PGD. I have never done PGD before but since my losses are poor egg quality we are going this route. I am so afraid I won't have any normals. My last cyle only 1 out of 27 eggs made it to baby. My doctor recommend COq10 and ovasitol which I have started already. Just wondering if you did anything special!

    1. this is just an FET, not a fresh cycle, but I've done a bunch to prepare. See my june 30th post: "getting our ducks in a row...."

      for a fresh cycle, i did a bunch of stuff as well...see my april 22, 2010 post "colorado cocktail."

      wishing you all of the best with your next cycle!


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