Talk to me about numbers of fertilized eggs

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. Probably looking at a 5-day transfer, according to my RE. He likes the looks of at least 3 of the embryos right now.

That's wonderful news! Keep us updated! Grow embies grow!

Thanks, PP. I'm glad I logged back in at the end of the day & skipped ahead from the other banter about studies to hear your words of encouragement. I do find this forum to be *mostly* supportive and helpful. Your post certainly was.

I'm one of the posters who both offered an encouraging story and information about the science behind your question. I think the great thing about this forum in contrast to others is that people actually discuss issues, instead of just exchanging hugs and kisses and pep talk. I could do without the frequent snark (of which I haven't seen much on this thread), but the intellectual level here is (overall, not always) a lot higher than on the nationwide fertility and pregnancy forums, which mostly bore me. If you are bothered by people discussing the issue you brought up and don't find it helpful, you might be better off at FertilityCommunity.com etc.

+1

[Anonymous]

Anonymous wrote:OP here. Probably looking at a 5-day transfer, according to my RE. He likes the looks of at least 3 of the embryos right now.

Sounds like a gamble.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thanks for the responses. Please keep the good thoughts rolling in - I promise to do the same for all of you on your journeys. On day two (today), we have 2 embryos at the 4-cell stage, 1 at the 3-cell stage, and 1 at the 8-cell stage. Awaiting word on whether it'll be a day 3 or day 5 transfer.

With a low number of embryos (I was in the same situation, posted above), I would not risk waiting for day 5, and my guess is your RE won't want to do that either. Too much of a chance that they won't survive in the petri dish, while they might well survive inside you.

The reason the other poster said higher number of embryos equals better chance of pregnancy is that you usually have more embryos to choose from, and a greater chance that some will be top notch. But I've been told that ovarian response is not directly linked to egg quality, so even if you have few, they may be good. The only indicator they have for egg quality is age, although of course someone of a younger age could have worse eggs than someone who's older. It's simply that they can't test for quality, so they have to guess by age. FWIW, I'm 39 and while my response was comparatively low, my eggs seem to have been fine, as I got pregnant with twins on the first try.

No, the reason why I posted it is because the data, for all age groups, show clear correlation between number of eggs retrieved and proportion of pregnancies achieved. Why is that, I don't claim to know.

http://www.advancedfertility.com/eggspregnancyrates.htm

Fair enough, I shouldn't have said that's why you said it, but that those are the facts behind your statement. The link you posted confirms exactly what I said. They do hypothesize that there is a relation between egg quantity and egg quality, but when you read their page on that topic, it ultimately comes down to the fact that a woman with more eggs has a greater percentage of good ones - so again, it's a selection issue rather than an intrinsic link between quantity and quality.

They hypothesize because they don't know - and nobody really knows. I am not sure why it is important what causes the correlation, though. The fact of the matter is - more eggs, greater likelihood of pregnancy (at least up to a point). You don't need to know why that is the case in order to gauge your own chances.

What I meant is that they do offer hypotheses about the causes for the correlation between quantity and quality because, as I said above, they don't know for sure if there is an intrinsic link. Both quantity and quality, of course, are correlated with age, but it would be interesting to know to what extent there is a direct correlation between the two factors, because someone who is 37 but has a low response to the stims might have better egg quality than someone who is 40 and still produces more eggs. For now, it still looks like more eggs just give you better chances because you have a greater number of embryos to select from, not because you necessarily have better egg quality. Conversely, you could have few embryos, but they could be good quality. I brought this up because I thought it would be encouraging to OP, but she doesn't seem interested in this discussion.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Probably looking at a 5-day transfer, according to my RE. He likes the looks of at least 3 of the embryos right now.

Sounds like a gamble.

+1. I'd do a day 3 transfer, unless you REALLY want to avoid multiples and are hoping to transfer just one and freeze the others. But there is no doubt that the uterus is the most conducive environment for embryo growth.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thanks for the responses. Please keep the good thoughts rolling in - I promise to do the same for all of you on your journeys. On day two (today), we have 2 embryos at the 4-cell stage, 1 at the 3-cell stage, and 1 at the 8-cell stage. Awaiting word on whether it'll be a day 3 or day 5 transfer.

With a low number of embryos (I was in the same situation, posted above), I would not risk waiting for day 5, and my guess is your RE won't want to do that either. Too much of a chance that they won't survive in the petri dish, while they might well survive inside you.

The reason the other poster said higher number of embryos equals better chance of pregnancy is that you usually have more embryos to choose from, and a greater chance that some will be top notch. But I've been told that ovarian response is not directly linked to egg quality, so even if you have few, they may be good. The only indicator they have for egg quality is age, although of course someone of a younger age could have worse eggs than someone who's older. It's simply that they can't test for quality, so they have to guess by age. FWIW, I'm 39 and while my response was comparatively low, my eggs seem to have been fine, as I got pregnant with twins on the first try.

No, the reason why I posted it is because the data, for all age groups, show clear correlation between number of eggs retrieved and proportion of pregnancies achieved. Why is that, I don't claim to know.

http://www.advancedfertility.com/eggspregnancyrates.htm

Fair enough, I shouldn't have said that's why you said it, but that those are the facts behind your statement. The link you posted confirms exactly what I said. They do hypothesize that there is a relation between egg quantity and egg quality, but when you read their page on that topic, it ultimately comes down to the fact that a woman with more eggs has a greater percentage of good ones - so again, it's a selection issue rather than an intrinsic link between quantity and quality.

They hypothesize because they don't know - and nobody really knows. I am not sure why it is important what causes the correlation, though. The fact of the matter is - more eggs, greater likelihood of pregnancy (at least up to a point). You don't need to know why that is the case in order to gauge your own chances.

What I meant is that they do offer hypotheses about the causes for the correlation between quantity and quality because, as I said above, they don't know for sure if there is an intrinsic link. Both quantity and quality, of course, are correlated with age, but it would be interesting to know to what extent there is a direct correlation between the two factors, because someone who is 37 but has a low response to the stims might have better egg quality than someone who is 40 and still produces more eggs. For now, it still looks like more eggs just give you better chances because you have a greater number of embryos to select from, not because you necessarily have better egg quality. Conversely, you could have few embryos, but they could be good quality. I brought this up because I thought it would be encouraging to OP, but she doesn't seem interested in this discussion.

I understand what you are saying, but at the end of the day, the fact remains that more eggs, on average and within some substantial range, lead to a greater probability of pregnancy. May that be only because there is a greater chance of finding a good embryo, but it still matters. I think most of us going through IVF are hoping that, of course that cycles are not cancelled, there are no complications etc, but also, while knowing that that does not guarantee anything, to have 10-15 eggs. Few of us (or our REs) would, I think, would choose to have 3 or even 5-6 eggs.

Obviously, I hope the cycle works for OP as well as for all of us here in any current or future cycles. Like you (I think that was you!) I much prefer the intellectual engagement of this forum to the average fertility forum.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thanks for the responses. Please keep the good thoughts rolling in - I promise to do the same for all of you on your journeys. On day two (today), we have 2 embryos at the 4-cell stage, 1 at the 3-cell stage, and 1 at the 8-cell stage. Awaiting word on whether it'll be a day 3 or day 5 transfer.

With a low number of embryos (I was in the same situation, posted above), I would not risk waiting for day 5, and my guess is your RE won't want to do that either. Too much of a chance that they won't survive in the petri dish, while they might well survive inside you.

The reason the other poster said higher number of embryos equals better chance of pregnancy is that you usually have more embryos to choose from, and a greater chance that some will be top notch. But I've been told that ovarian response is not directly linked to egg quality, so even if you have few, they may be good. The only indicator they have for egg quality is age, although of course someone of a younger age could have worse eggs than someone who's older. It's simply that they can't test for quality, so they have to guess by age. FWIW, I'm 39 and while my response was comparatively low, my eggs seem to have been fine, as I got pregnant with twins on the first try.

No, the reason why I posted it is because the data, for all age groups, show clear correlation between number of eggs retrieved and proportion of pregnancies achieved. Why is that, I don't claim to know.

http://www.advancedfertility.com/eggspregnancyrates.htm

Fair enough, I shouldn't have said that's why you said it, but that those are the facts behind your statement. The link you posted confirms exactly what I said. They do hypothesize that there is a relation between egg quantity and egg quality, but when you read their page on that topic, it ultimately comes down to the fact that a woman with more eggs has a greater percentage of good ones - so again, it's a selection issue rather than an intrinsic link between quantity and quality.

They hypothesize because they don't know - and nobody really knows. I am not sure why it is important what causes the correlation, though. The fact of the matter is - more eggs, greater likelihood of pregnancy (at least up to a point). You don't need to know why that is the case in order to gauge your own chances.

What I meant is that they do offer hypotheses about the causes for the correlation between quantity and quality because, as I said above, they don't know for sure if there is an intrinsic link. Both quantity and quality, of course, are correlated with age, but it would be interesting to know to what extent there is a direct correlation between the two factors, because someone who is 37 but has a low response to the stims might have better egg quality than someone who is 40 and still produces more eggs. For now, it still looks like more eggs just give you better chances because you have a greater number of embryos to select from, not because you necessarily have better egg quality. Conversely, you could have few embryos, but they could be good quality. I brought this up because I thought it would be encouraging to OP, but she doesn't seem interested in this discussion.

PP here again. Actually, the page you linked doesn't show such data for all age groups. They compare a 28 year old to a 42 year old, which is a very stark comparison. All they show is that there is a correlation between quantity and quality because both are also overall correlated with age. They still cannot explain why (or test for if) someone with a low response, in some cases, might have a higher percentage of good eggs than someone who produces more. Still, of course, someone who produces more eggs but has a lower percentage of good ones might still have a greater absolute number of good eggs than someone who produces a a low number but has a higher percentage of good ones, but this is not necessarily the case if the parameters aren't as far apart as between the 28 and the 42 year old. Bottom line is, though, that the odds for good eggs are higher when you produce more of them - yet you shouldn't assume your eggs are bad just because your number is low.

[Anonymous]

18:02 - I cross posted with your last post. I agree with you on what you said - everybody, of course would rather have 10-15 eggs, but I'm trying to convey that under ten eggs can still mean success, especially if the woman is younger.

I like to contemplate this issue because my RE thought there would only be a very small chance for me to get pregnant with twins, as I was 39, and diagnosed with DOR, so we'd have a low number of eggs, most of which (guessing based on my age) would be of lower quality. Yet even though I produced only 7 mature eggs (on very high doses of stims), I am now almost in the third trimester with twins (I was hoping for twins, so that was good news for me). What this anecdotal experience shows is that while they can predict your ovarian response, they cannot necessarily predict your egg quality.

[Anonymous]

Anonymous wrote:18:02 - I cross posted with your last post. I agree with you on what you said - everybody, of course would rather have 10-15 eggs, but I'm trying to convey that under ten eggs can still mean success, especially if the woman is younger.

I like to contemplate this issue because my RE thought there would only be a very small chance for me to get pregnant with twins, as I was 39, and diagnosed with DOR, so we'd have a low number of eggs, most of which (guessing based on my age) would be of lower quality. Yet even though I produced only 7 mature eggs (on very high doses of stims), I am now almost in the third trimester with twins (I was hoping for twins, so that was good news for me). What this anecdotal experience shows is that while they can predict your ovarian response, they cannot necessarily predict your egg quality.

Hi PP, I remember your case probably because I am also 39 and, if not daring to hope certainly would not mind twins (I am one of the pro-twin posters from recent threads). Are you the one whose RE said about 7 out of 10 eggs at our age are compromised?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. Probably looking at a 5-day transfer, according to my RE. He likes the looks of at least 3 of the embryos right now.

Sounds like a gamble.

+1. I'd do a day 3 transfer, unless you REALLY want to avoid multiples and are hoping to transfer just one and freeze the others. But there is no doubt that the uterus is the most conducive environment for embryo growth.

I'm not sure if OP is still reading, but please don't post your personal opinions here and provide baseless criticism of treatment options a poster has worked out with their RE. You don't know OP's situation (i.e. age, egg quality, history), so you don't know the basis upon which her RE is suggesting a day 5 transfer when she has 3 embryos on day 2. [Aside: I had two embryos that were dividing well on day 2, and waited until day 5 to transfer...both made it, transferred 1/froze 1.] If she is young and the embryos are dividing well, then it might make sense to wait even if she's planning to transfer two. It's not a gamble to follow your doctor's advice. If you think it is, you should find a different doctor. I'm not saying you shouldn't ask questions and make sure your RE understands your preferences and range of acceptable outcomes, but different clinics (and REs) have different protocols and approaches. That's part of why you might choose one clinic or RE over another. If you have explained your comfort level with various outcomes to your RE and you understand (and agree with) the basis for your RE's recommendation, then it is perfectly sensible to follow it. If we simply assume that RE's are robots following protocols mindlessly, why do we pay them so much money? They do have expertise that you can't glean from extensive web research...it doesn't help to make people on this forum question whether they should follow their doctor's recommendations.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. Probably looking at a 5-day transfer, according to my RE. He likes the looks of at least 3 of the embryos right now.

Sounds like a gamble.

+1. I'd do a day 3 transfer, unless you REALLY want to avoid multiples and are hoping to transfer just one and freeze the others. But there is no doubt that the uterus is the most conducive environment for embryo growth.

I'm not sure if OP is still reading, but please don't post your personal opinions here and provide baseless criticism of treatment options a poster has worked out with their RE. You don't know OP's situation (i.e. age, egg quality, history), so you don't know the basis upon which her RE is suggesting a day 5 transfer when she has 3 embryos on day 2. [Aside: I had two embryos that were dividing well on day 2, and waited until day 5 to transfer...both made it, transferred 1/froze 1.] If she is young and the embryos are dividing well, then it might make sense to wait even if she's planning to transfer two. It's not a gamble to follow your doctor's advice. If you think it is, you should find a different doctor. I'm not saying you shouldn't ask questions and make sure your RE understands your preferences and range of acceptable outcomes, but different clinics (and REs) have different protocols and approaches. That's part of why you might choose one clinic or RE over another. If you have explained your comfort level with various outcomes to your RE and you understand (and agree with) the basis for your RE's recommendation, then it is perfectly sensible to follow it. If we simply assume that RE's are robots following protocols mindlessly, why do we pay them so much money? They do have expertise that you can't glean from extensive web research...it doesn't help to make people on this forum question whether they should follow their doctor's recommendations.

I don't think they are robots, but I don't think that pay that much attention to individual cases either. And even if we accept you premise that "following your doctor's advice is not a gamble", finding a doctor is a gamble. So, by implication, sometimes what your doctor tells you is a gamble (as another, equally experienced doctor, would tell you the opposite). It's easy to say "find a different doctor", but realistically one can't interview more than a few doctors, and even then, one can't judge what they are truly like until one is in the midst of a treatment.

[Anonymous]

Anonymous wrote:

I don't think they are robots, but I don't think that pay that much attention to individual cases either. And even if we accept you premise that "following your doctor's advice is not a gamble", finding a doctor is a gamble. So, by implication, sometimes what your doctor tells you is a gamble (as another, equally experienced doctor, would tell you the opposite). It's easy to say "find a different doctor", but realistically one can't interview more than a few doctors, and even then, one can't judge what they are truly like until one is in the midst of a treatment.

Even if everything you say is true, it's not helpful to tell someone that the treatment option they are pursuing is a "gamble" without any rationale...or just saying that something doesn't make sense except for in one specific case (especially if that's not even true). There are many reasons to pursue one option over another. And there are many reasons to wait until day 5. Unless you can offer reasoned critique of what a person is doing (and I don't think either of the PP's did that), telling someone they are making the wrong decision does not help anyone.

And FWIW, I do think some RE's pay a fair amount of attention to individual cases. They might not always have the best stats, but part of that is the fact that they do modify their recommendations based on what their patients want and are willing to take on harder cases. It's true that you can't know everything about your doctor beforehand, but you can assess whether they would be willing to help you get what you want out of their treatment or what they think you should want. There is also a lot of information on forums like this that gives you some insight into what a doctor is like and his/her philosophy before you make an appointment. It's true doctors make different recommendations, but in most cases it's far less arbitrary than a random post on a forum coming from someone who knows no details about any specific case. [I understand that obviuosly no one is obligated to follow a random post on the internet, but when emotions are high and everything is uncertain, it's hurtful to have someone tell you you're taking a gamble with your treatment.]

[Anonymous]

Anonymous wrote:

Anonymous wrote:

I don't think they are robots, but I don't think that pay that much attention to individual cases either. And even if we accept you premise that "following your doctor's advice is not a gamble", finding a doctor is a gamble. So, by implication, sometimes what your doctor tells you is a gamble (as another, equally experienced doctor, would tell you the opposite). It's easy to say "find a different doctor", but realistically one can't interview more than a few doctors, and even then, one can't judge what they are truly like until one is in the midst of a treatment.

Even if everything you say is true, it's not helpful to tell someone that the treatment option they are pursuing is a "gamble" without any rationale...or just saying that something doesn't make sense except for in one specific case (especially if that's not even true). There are many reasons to pursue one option over another. And there are many reasons to wait until day 5. Unless you can offer reasoned critique of what a person is doing (and I don't think either of the PP's did that), telling someone they are making the wrong decision does not help anyone.

And FWIW, I do think some RE's pay a fair amount of attention to individual cases. They might not always have the best stats, but part of that is the fact that they do modify their recommendations based on what their patients want and are willing to take on harder cases. It's true that you can't know everything about your doctor beforehand, but you can assess whether they would be willing to help you get what you want out of their treatment or what they think you should want. There is also a lot of information on forums like this that gives you some insight into what a doctor is like and his/her philosophy before you make an appointment. It's true doctors make different recommendations, but in most cases it's far less arbitrary than a random post on a forum coming from someone who knows no details about any specific case. [I understand that obviuosly no one is obligated to follow a random post on the internet, but when emotions are high and everything is uncertain, it's hurtful to have someone tell you you're taking a gamble with your treatment.]

I think the rationale here is pretty obvious - namely that OP has very little cushion to work with and two long days to go. One of the PPs specifically mentioned minimizing the risk of multiples as a reason to go to 5 days transfer. Maybe the gambling comment was not very tactful, but you know what, we are not here only to serve OPs needs... There are several other people who follow the discussion and at least one of them found that comment worthwhile (so to speak).

[Anonymous]

Just my experience. I was 39, 4 eggs fertilized. I did a 5 day transfer of 2 blasts. I got pregnant with twins, but lost one at 10 weeks and ended up with a beautiful baby boy. The other 2 eggs also made it to day 6 blast.

[Anonymous]

Anonymous wrote:

Anonymous wrote:18:02 - I cross posted with your last post. I agree with you on what you said - everybody, of course would rather have 10-15 eggs, but I'm trying to convey that under ten eggs can still mean success, especially if the woman is younger.

I like to contemplate this issue because my RE thought there would only be a very small chance for me to get pregnant with twins, as I was 39, and diagnosed with DOR, so we'd have a low number of eggs, most of which (guessing based on my age) would be of lower quality. Yet even though I produced only 7 mature eggs (on very high doses of stims), I am now almost in the third trimester with twins (I was hoping for twins, so that was good news for me). What this anecdotal experience shows is that while they can predict your ovarian response, they cannot necessarily predict your egg quality.

Hi PP, I remember your case probably because I am also 39 and, if not daring to hope certainly would not mind twins (I am one of the pro-twin posters from recent threads). Are you the one whose RE said about 7 out of 10 eggs at our age are compromised?

Yes, that was me. Good luck with your treatment!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. Probably looking at a 5-day transfer, according to my RE. He likes the looks of at least 3 of the embryos right now.

Sounds like a gamble.

+1. I'd do a day 3 transfer, unless you REALLY want to avoid multiples and are hoping to transfer just one and freeze the others. But there is no doubt that the uterus is the most conducive environment for embryo growth.

I'm not sure if OP is still reading, but please don't post your personal opinions here and provide baseless criticism of treatment options a poster has worked out with their RE. You don't know OP's situation (i.e. age, egg quality, history), so you don't know the basis upon which her RE is suggesting a day 5 transfer when she has 3 embryos on day 2. [Aside: I had two embryos that were dividing well on day 2, and waited until day 5 to transfer...both made it, transferred 1/froze 1.] If she is young and the embryos are dividing well, then it might make sense to wait even if she's planning to transfer two. It's not a gamble to follow your doctor's advice. If you think it is, you should find a different doctor. I'm not saying you shouldn't ask questions and make sure your RE understands your preferences and range of acceptable outcomes, but different clinics (and REs) have different protocols and approaches. That's part of why you might choose one clinic or RE over another. If you have explained your comfort level with various outcomes to your RE and you understand (and agree with) the basis for your RE's recommendation, then it is perfectly sensible to follow it. If we simply assume that RE's are robots following protocols mindlessly, why do we pay them so much money? They do have expertise that you can't glean from extensive web research...it doesn't help to make people on this forum question whether they should follow their doctor's recommendations.

You are right that we don't know her whole situation (most importantly how old she is), but my comment was not based on web research. It was based on what my RE told me when I was in the same situation in terms of number of embryos, and the rationale I was given for making the decision. The purpose of making the comment was to make her aware that there may be an issue, given that she might still be able to question her RE on it.