Small blastocyst?

[Anonymous]

Hi -

I only have 1 blastocyst which was sent for PGS testing. When I asked the embryologist how does it look, she said it's graded BB, looks fine just small. Now I'm searching on forums to see if small blastocysts have less chance of being euploid or lead to a live pregnancy. Any insights appreciated.

Also, though I trust my clinic, I can't help but think do they upgrade embryos (as they don't biopsy poorly graded embryos), or biopsy embryos which might not be where they should be, just so they can get the biopsy and PGS fee (thousands of dollars)? Since I only have 1, as long as they biopsy the one and send for PGS testing, I lose my money.

Thanks

[Anonymous]

Are you saying that you suspect your embryo isn't a blastocyst and shouldn't have been tested and they are just upgrading it so they can charge you?

I feel like that ship has sailed. I have three embryos and this is partially why I am not testing - I don't really know what you are getting out of this when you only have one.

Good luck!!

[Anonymous]

Thanks!

Exactly. Forcing it to be tested so I can be charged.

This thought only popped in my head because this is my 3rd ER having only 1 blast to test. Though first 2 times it was with a different clinic - 1 was euploid other was aneuploid. So not sure if anyone has any insights whether clinics in the DMV will do this. Or I just have bad luck always ending up with 1 blast because of DOR and AMA.

I've always done PGS testing as the 2 clinics I've been with have recommended it, though the research is not perfect, I am inclined to trust my REs. I have 1 child from IVF, so I know to a certain degree it can work, so that's why I keep on going though it's been difficult.

[Anonymous]

I had a small one that they implanted on day 7 bendy they wanted to see if it would grow. Happy healthy 7 yo now. Good luck!

[Anonymous]

Anonymous wrote:I had a small one that they implanted on day 7 bendy they wanted to see if it would grow. Happy healthy 7 yo now. Good luck!

That is awesome!

[Anonymous]

If you’re only getting one per retrieval, are you banking? If not, I’d be inclined to do fresh transfers and/or not bother testing. Testing doesn’t improve outcomes for a given blast, may actually shave a bit of viability off a given blast, and mostly can make things more efficient if you’re choosing among multiple blasts. But if you have so few, I wouldn’t risk it myself.

[Anonymous]

Anonymous wrote:If you’re only getting one per retrieval, are you banking? If not, I’d be inclined to do fresh transfers and/or not bother testing. Testing doesn’t improve outcomes for a given blast, may actually shave a bit of viability off a given blast, and mostly can make things more efficient if you’re choosing among multiple blasts. But if you have so few, I wouldn’t risk it myself.

No, I am not banking. Per insurance if we have viable embryos we need to transfer. So far I've had 3 FETs with euploids: 1 live birth, 1 CP, 1 BFN

When discussing option of not testing or doing a fresh transfer considering my low number of blasts (we only had 2 cycles with more than 1 blast), my REs still recommended PGS testing due to my age to minimize the risk of miscarriage. If we don't test, not only are we wasting time doing multiple FETs which wouldn't be successful as most of my blasts would be abnormal, if we have a miscarriage that will be more downtime and with my age we just don't have time to waste. I discuss this with my RE at every WTF appts and in the end we always listen to the REs and continue PGS testing. With testing, I am just more concerned about disposing good blasts, or abnormal blasts which can still self correct and implant, especially as they're not testing the inner mass.

[Anonymous]

Anonymous wrote:Hi -

I only have 1 blastocyst which was sent for PGS testing. When I asked the embryologist how does it look, she said it's graded BB, looks fine just small. Now I'm searching on forums to see if small blastocysts have less chance of being euploid or lead to a live pregnancy. Any insights appreciated.

Also, though I trust my clinic, I can't help but think do they upgrade embryos (as they don't biopsy poorly graded embryos), or biopsy embryos which might not be where they should be, just so they can get the biopsy and PGS fee (thousands of dollars)? Since I only have 1, as long as they biopsy the one and send for PGS testing, I lose my money.

Thanks

isn't the fee to the pgt lab (igenomix or whoever you use, not your clinic?)

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hi -

I only have 1 blastocyst which was sent for PGS testing. When I asked the embryologist how does it look, she said it's graded BB, looks fine just small. Now I'm searching on forums to see if small blastocysts have less chance of being euploid or lead to a live pregnancy. Any insights appreciated.

Also, though I trust my clinic, I can't help but think do they upgrade embryos (as they don't biopsy poorly graded embryos), or biopsy embryos which might not be where they should be, just so they can get the biopsy and PGS fee (thousands of dollars)? Since I only have 1, as long as they biopsy the one and send for PGS testing, I lose my money.

Thanks

isn't the fee to the pgt lab (igenomix or whoever you use, not your clinic?)

The clinic takes the fee to biopsy the embryos to be sent for PGS testing, which is $2,000.
And with my current clinic, the lab is also internal so on top of the biopsy fee, they also pocket the $2,000 to test the embryos.

[Anonymous]

I get the logic of testing but I would consider pushing back but if you are only getting one or two each retrieval and just trying implanting if they are able to freeze these or even do the fresh transfer.

[Anonymous]

It's a low quality blast and given you mention age very likely it's abnormal.

[Anonymous]

Thank you all for the feedback.

I'll be discussing my options again at the next WTF appointment if this doesn't work. I agree testing only having only 1-3 blasts each cycle might not be so worthwhile.

I am just praying for a miracle. My last AA blast was aneuploid (severe chromosomal abnormalities incompatible with life) vs my AC blast was normal, though I know statistically speaking better graded blasts have more of a chance.

Some days I really regret not starting this fertility journey earlier - If I was 5 years younger things would be so much easier.

[Anonymous]

What about doing fresh day three transfers of whatever makes it that far? I know that’s a protocol some REs recommend for women who don’t make a lot of high quality day 5s. At this point, I don’t see the testing as helping really and if you do fresh transfers, you’re not really spending much more time relative to freezing and FETs etc. The 5 days plus test plus freeze then thaw is a stress on blasts and doesn’t seem to be working for you so why not try something different, or at least get a consult at another clinic.
As for age, there’s a big difference between 37 and 43….

[Anonymous]

Anonymous wrote:What about doing fresh day three transfers of whatever makes it that far? I know that’s a protocol some REs recommend for women who don’t make a lot of high quality day 5s. At this point, I don’t see the testing as helping really and if you do fresh transfers, you’re not really spending much more time relative to freezing and FETs etc. The 5 days plus test plus freeze then thaw is a stress on blasts and doesn’t seem to be working for you so why not try something different, or at least get a consult at another clinic.
As for age, there’s a big difference between 37 and 43….

My clinic said they usually don't do day 3 transfers, day 5 fresh potentially. I asked specifically about day 3 fresh transfer this cycle as I only had 1 fertilized I was afraid it won't make it to day 5, but was told that doesn't seem to be a possibility for this cycle but I'll discuss it further with my RE at the regroup.

I started using Omnitrope at this clinic which seemed to make a difference, so I am hoping it would give me another euploid. I am almost 40, have always been told I had egg quality issues. My first ER with this current clinic gave me a euploid but I ended up with a CP, so my RE is optimistic the protocol is working, especially considering I had a successful pregnancy 2 years prior. We're doing the same ER and FET protocol as the last one since it almost got us there.

This is my second clinic in the DMV already. I thought about consulting with CCRM Lone Tree or one of the other more talked about clinics before giving up, as I don't want to have any regrets.

[Anonymous]

I never tested. I had one blast (4BB) at 43 after years of IF due to DOR. She’s a healthy 2.5 year old now.

My oldest DD (7) was from a day 3 fresh transfer.