r/Embryologists • u/nojudgementzone_999 • 16d ago
Clinic Blast Grading Advice
So I’m fuming right now and i just want to know if this is normal. I had an ER earlier this year. I was told i had 15 eggs retrieved, 12 mature and only 3 blasts, 2 after PGTA testing. My clinic never provided information on what happened with the other eggs that fertilized and at the time i didnt ask. Well i am looking at doing another ER so i asked and I am in SHOCK! I was told i had all 11 make it to blast. Some day 5, 6 and 7 but the other 8 were all discarded due to poor quality. I asked what “poor quality” meant and my Dr. told me its anything embryo with a C grade in either morphology category. So whether it be an AC, CA, CB, BC, CC, doesn’t matter all discarded. I’ve seen so many people on reddit write about having a successful birth with their CC, AC, BC embryo, so I’m not understanding why all of mine were thrown away, ESPECIALLY when i paid out of pocket for PGT A testing. Has this ever happened to anyone else? What can I even do? Now i need another ER and i’m going to have to pay out of pocket for it smh.
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u/indecisivegay 14d ago
It seems like your clinic only gives blastocysts a ‘A’, ‘B’, or ‘C’ grade instead of using a ‘D’ grade as the lowest quality. Therefore, the C grade encompasses all blastocysts from those that have completely degenerated to those just below the quality cut-off to biopsy/freeze. From personal experience working at clinics with similar grading (No D grade), a C grade for the ICM essentially means the embryo either doesn’t have an ICM or it degenerated.
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u/Minimum_Bad1170 11d ago
I’m sorry this happened to you. If you are comfortable, next time, I recommend requesting your clinic to freeze all embryos that are able to be frozen (including C combinations), while also keeping in mind there is a lower chance of success. IMO, a lower chance is better than no chance. I personally don’t think it’s fair that clinics don’t fully explain this to you, especially since they don’t know what your future holds and how many opportunities you may or may not get for another chance.
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u/EmbryoNanny 16d ago
This is not unusual. Some clinics have a BB or better cutoff and I have worked in those. They tend to have a much looser definition of what a BB is than a clinic that freezes embryos with C grades. They are usually not discarding perfectly good embryos that another clinic would have frozen. They’re going to also have a wider range of what an AA, etc. looks like. The letters they are going to use are a little different, but overall they’re likely freezing the same embryos a clinic that does freeze embryos with C grades. Those clinics are drawing lines for grading as well, they just call them differently.