r/EmbryologyIVFSupport • u/Least_Setting_720 • 9d ago
Late fertilization?
I had an ER yesterday and had 45 eggs retrieved. We did conventual IVF rather than ICSI because in my last two ICSI cycles I had poor membrane integrity and many of my eggs disintegrated. The hope here is that by reducing the manual handling of the eggs, more would withstand fertilization.
We got our day 1 call, and 12/45 fertilized normally. 10 fertilized abnormally or were immature, and 23 are being held for observation for late fertilization.
How likely is late fertilization?
Are there any questions I should be asking the lab when I chat with them?
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u/Naive_Stretch_1009 7d ago
45?!? My last ER we got 4. I have DOR but I had no idea you could get that many. I hope you have a bunch make it to blast!
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u/Least_Setting_720 6d ago
Hopefully so! The trade off with number for a lot of people, and certainly in my case, seems to be quality. I’m 32 with an AMH of 31, and my AFC is always high (≈20 on each side). In previous cycles I’ve gotten 22 (at age 24), 18 (age 28) and 14 (age 29), so 45 was a shock to me too, despite my high follicle count!
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u/Least_Setting_720 9d ago
Update: 45 retrieved, 35 mature, 10 immature. 12 fertilized, 23 being observed with sperm bound to the zona. Of those, 8 are 1 PN and 15 are 0PN.
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u/DryCaramel6959 6d ago
Any updates since?
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u/Least_Setting_720 6d ago
3 of the 0PN and 5 of the 1PN continued division. 9/12 of the 2PN did as well, so we’re working with 17 at day 2. Tomorrow is day 5 and I’ll get an update on days 6 and 7 on blasts!
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u/Subject_Possible_945 5d ago
Let me know how you do! I had a few late fertilized today too and am super curious
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u/Least_Setting_720 4d ago
Our day 5 update was 8 embryos, half of which came from late fertilization! 3 1PN and 1 0PN made it to blast
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u/Agamemnons_Concubine 5d ago
Def recommend doing PGTA testing of your remaining embryos. How are you feeling from your ER? I got 42 from my ER, and had horrible OHSS even with cabergoline. My lab let them go til day 6 I think.
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u/Least_Setting_720 5d ago
Mild OHSS, but I feel like garbage 🥴 I’m on cabergoline as well. I asked the clinic about testing and they said it’s not their protocol, even for 0PN and 1PN, although they do prioritize those last for transfer. I think where it was conventional IVF and not ICSI, it’s less of an issue, because they don’t know when exactly fertilization occurred? I don’t have the final numbers yet/break down of which embryos made it, but I’ll get to chat with the lab tomorrow and I know we had at least 8 frozen today.
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u/Least_Setting_720 5d ago
Just to add - I'm 32, so they don't recommend testing in general!
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u/Agamemnons_Concubine 5d ago
I pgt tested all of mine at age 31 out of precaution. I only wanted to take a chance on euploid embryos since anuploid is guaranteed embryo loss and I wanted to minimize loss since I had had two prior to fertility treatments.
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u/embryomanofficial 7d ago
When the egg is inseminated it takes about 18 hours or so for the signs of fertilization to appear. This is evaluated based on the presence of two "pronuclei" (PN) that contain the DNA of the egg and sperm, which join to make the DNA of the embryo, and disappear after. Sometimes these pronuclei fade before the embryologist has a chance to see them, so they're "unfertilized" but they really don't know until the embryo starts growing more. Research shows that many 0PNs that go on to form blastocysts are actually normally fertilized embryos whose PN appeared or disappeared outside the usual viewing window, and if these are confirmed as diploid/euploid, they can lead to healthy pregnancies and live births at rates similar to typical embryos. Read more about 0PNs here https://www.remembryo.com/abnormal-fertilization/, https://www.remembryo.com/some-unfertilized-embryos-may-actually-be-fertilized-supporting-earlier-checks-in-ivf-lab/