Friday, April 25, 2014

Scrambled eggs

The day of my retrieval, we had 17 eggs. (1 more than last time!) And I was not at risk for OHSS. Score!

Of those 17, 14 were mature. Of those 14, 11 fertilized. (79% fertilization rate.**) Of those 11, 3 fertilized abnormally and 1 stopped dividing. 7 fertilized and were dividing normally.

When they checked the 7 remaining on day 2, all looked good and were rated "level 2."*  6 of them were doing well--6-8 cells. The last one was "only" a 5 cell and, as the tech told me, "probably won't make it." (Poor guy!) So we decided to let them keep growing and go with a day 5 transfer--like last time. (If we only had a couple and they were not doing well, we might've done a day 3 transfer.) About 50% of the day 3 embryos make it to day 5, not all of those will make it to blastocyst, and their ratings can change. So we just had to wait to see who made it--and what they looked like--the day of the transfer. (If none make it to blastocyst for day 5, they'll push the transfer to day 6 to give them more time to grow. They will freeze the remaining blastocysts--if any--up to day 7.)

*At my clinic, they have 3 levels for rating the embryos. Level 1 is no issues spotted, i.e. they are perfect. I have been told those are very rare (less than 5%). Most have some nominal issues (60%) and are level 2. The ones with more significant issues are level 3. I was also told that the level 1s and level 2s have similar success rates (although the level 1s are higher), but the level 3s see significantly less success.

**Last time, we had a 93% fertilization rate. Unsurprising that it went down, considering we're 3 years older. I've read that fertilization rate can be a predictor of implantation rate--that is the better your fertilization rate the better your chances of implantation:

http://rinaudolab.ucsf.edu/rinaudolab/pdf/rinaudo.pf4.pdf 

Our doctor suggested that might be true for a low fertilization rate (less than 50%), but did not think our small sample size (93% to 79%) meant much because they were both still pretty good.

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