Question for Ghost -- Blastocyst quality / grade

[sophietobe]

Dear Ghost,

I am 35 years old. Our identified issues are severe endometriosis and male factor. I got pregnant naturally and miscarried last year. I then went through one round of IVF earlier this year with mediocre results. 6 mature eggs retrieved, 4 fertilized and continued to developed, transferred 2 best quality (8 cell A) embryos on day 3 and BFN. The other two didn't make it past day 4-5.

I am in the middle of the second round now (microsdose lupron flare protocol this time). It has gone much better in general. 14 mature eggs retrieved, 12 fertilized, 11 "great" embryos on day 3. I did a day 5 transfer. On day 5, there were 8 blastocysts. They transferred the best two -- 2BB and 2BC (1AA is the best, 3CC is the worst at my clinic).

Questions--do I have a chance with this quality? Is it a bad sign that of 8 blasts these are the best two I have? Could this be an indication generally of the quality of eggs/sperm? I will find out if there were able to freeze any of the rest tomorrow, but I am trying to manage my expectations. Any thoughts would be appreciated.

Thanks!

[Ghost]

Dear Ghost,

I am 35 years old. Our identified issues are severe endometriosis and male factor. I got pregnant naturally and miscarried last year. I then went through one round of IVF earlier this year with mediocre results. 6 mature eggs retrieved, 4 fertilized and continued to developed, transferred 2 best quality (8 cell A) embryos on day 3 and BFN. The other two didn't make it past day 4-5.

I am in the middle of the second round now (microsdose lupron flare protocol this time). It has gone much better in general. 14 mature eggs retrieved, 12 fertilized, 11 "great" embryos on day 3. I did a day 5 transfer. On day 5, there were 8 blastocysts. They transferred the best two -- 2BB and 2BC (1AA is the best, 3CC is the worst at my clinic).

Questions--do I have a chance with this quality? Is it a bad sign that of 8 blasts these are the best two I have? Could this be an indication generally of the quality of eggs/sperm? I will find out if there were able to freeze any of the rest tomorrow, but I am trying to manage my expectations. Any thoughts would be appreciated.

Thanks!

There are a lot of scoring systems, some where 1 is best, some where 1 is worst. Typically the number gives the level of expansion, the first letter grades the inner cell mass (future fetus) and the second letter grades the trophectoderm (future sac and placenta). All of these are important.

Keep in mind most patients do not have "perfect" blastocysts. Sounds like yours were pretty typical, especially that first one (2BB). Also, while the grade correlates with implantation, it does not perfectly determine it. Average blasts implant all the time, just not as reliably as those top grade blasts.

So yes, I'd say you definitely have a chance.

[sophietobe]

Thanks, Ghost. That gives me some hope!!