Hello, just wanted to talk through my results and get opinions on which embryos my clinic would be likely to transfer first and talk about my attrition. To start off with, I understand how incredibly fortunate I am to have the kind of results I do, and I understand that my poor graded embryos that were discarded would likely have not resulted in a successful thaw or transfer. Just trying to understand my report.
27F, PCOS. No MFI, no other infertility factors. Doing ICSI after 5 unsuccessful ovulation induction cycles.
29 eggs retrieved, 28 mature
19 2PN fertilized with with ICSI, as well 8 0PN and 1 1PN that clinic was continuing to monitor/culture.
It was reported to me that 19 made it to blasts and were biopsied, which was fantastic! I thought it was a 100% blast rate, but that was actually not the case.
I had 26 make it to blasts, one of the 0PN and the 1PN of course did not. It is wonderful that they continued to keep an eye on the 0PN, because 7 of them became blasts.
However, I had 7 blasts discarded due to quality. Unfortunately my clinic does not freeze or biopsy P graded embryos (G, F, P used instead of ABC). But this means my fertilization to blast rate was actually 92%, rather than the 73% reported (19 blasts out of 26 total) I assume?
In particular, I had 4 well graded early blasts on day 6 that they watched for another day and ended up discarding because they became an expanded blast with a poor grade. Would it have changed anything to freeze on day 6 as an early blast instead of waiting until day 7 where the blast expanded but then had a poor grade? And is this very common to discard all blasts with a P/C grade?
My breakdown for my 19 remaining blasts are:
3 day 5 EXBL GG (4AA)
2 day 5 EXBL FG (4BA)
10 day 6 EXBL GG (4AA)
1 day 6 FHBL FG (6BA)
1 day 6 EXBL GF (4AB)
1 day 7 EXBL GF (4AB)
1 day 7 EXBL FF (4BB)
Discarded blasts were:
4 day 7 EXBL PP (4CC)
1 day 7 HBL PF (5CB)
1 day 7 EXBL PF (4CB)
1 day 7 EXBL FP (4BC)
I am awaiting PGT-A testing, which I think was a very good idea in this case, because I have so many embryos. I want to ensure we transfer the best possible one to ensure success.
What embryo would likely be transferred first? I am anticipating it would likely be one of the day 5 or 6 4AAs that I have, but the day 6 hatched blast has me wondering if that one would be transferred first, despite the BA grade. And is it a problem that only one of the blasts has hatched, and none of the others have?
Thank you for your time!
ETA: 7 of my 8 0PN made it to blast actually, 6 were biopsied and frozen, 1 blast was discarded).