Day 3 or Day 5 transfer

[Anonymous]

Ladies I want to know if there is any advantage of doing a day 3 transfer over a day 5 transfer and vice versa. Right now I am scheduled to go in tomorrow to do a day 3 transfer but was told it is possible I would get called in the morning to have it moved to a day 5 transfer depending on how the embryos look. I had 7 eggs retrieved that all fertilized. As of this morning all 7 are still fertilized and dividing. Is a day 3 transfer better than day 5? Any input would be more than greatly appreciated.

[Anonymous]

It seems most REs think a 5 day transfer is better if you have enough embryos, since you can let nature select the strongest ones to transfer back. Usually, you see 3 day transfers done when there aren't many embryos at day3. 7 is pretty good, but if your RE feels there are 1 or 2 front runners, then a 3 day transfer is fine (always better for them to be in their natural environment).

[Anonymous]

ditto the previous poster.

If you have some obvious frontrunners at day 3 then it is always best to get them back in your uterus.
However, if you have a large number of good looking embryos at day 3 then it is best to let them self select by growing them out to day 5. However, you can expect a normal loss of embryos to occur from days 3-5 so most REs will not push embryos to a day 5 if there are less than 6-8 nice looking embryos on day 3. Pushing for a day 5 may cause some otherwise viable embryos to die simply because of the stress of the added days in a dish. Not a big deal if you have a bunch to start with but a huge deal if you are only starting with a handful at day 3.

For what it's worth, in our last cycle we had 5 great looking embryos at day 3. We were on the borderline between having a day 3 or a day 5 transfer but we wanted to go for broke and push for a day 5 because we hoped to do an elective embryo transfer (we already have twins). We knew by doing this we could end up with nothing left to transfer at day 5 but were willing to take the risk even it it meant doing another cycle. It worked out that by day 5, all but one embryo had slowed down and/or died. We tranferred the remaining one and got pregnant. However, we could have just as easily have lost 5/5 to the stress of being outside of the womb.

[Anonymous]

Most of the REs I've consulted with think that a 3-day transfer is better, on the basis that the embryo does better inside the uterus. But the benefit of waiting to 5-day is that, if you have a number of embryos, it can help you can decide which to transfer. One question is - how many were you planning to transfer? If your age and previous failures dictate you transferring a good number, like 4, then you may not want to wait.

[Anonymous]

OP here....this was my 1st IVF attempt. I am 34 and was planning to transfer 2 embryos. My RE has decided to push the transfer to day 5. I have three 8 celled embryos, one 7 celled embryo, and the rest are 4-5 cells as of this morning. What do you think?

[Anonymous]

I would follow the advice of your RE. We did 3-day transfers and had success. Personnally, if I were in your shoes I would transfer the 8 cell ones and if the remaining ones grow sufficiently I would freeze them.

[Anonymous]

in re: freezing -- keep in mind, day 5 don't thaw/tolerate the freeze NEARLY as well as day 3 embryos.

[Anonymous]

Hey there, I was in a similar place to you, but with less embryos. If you want twins, then ignore my comment, but I really didn't, and for first time trys, if you're under 35 years and you have many embryos, transferring only one has the same success rate (around 67%) as does transferring two, but you have a huge chance of them both taking. I was amazed that my doctor didn't know the stats and wasn't up on the latest studies (I did my own research on PubMed - National Institutes of Health, and Shady Grove has good stats about this). So, given better health outcomes for baby and mom with only one baby, think hard about it, especially if you are going to have extras for later and since you're transferring on day 5 and can be more selective about what embryo to put in. I was 33, put one in on first try (with 3 total, froze two), and am now almost 6 months pregnant. I'm really glad I didn't take my doc's advice to put 2 (or all 3 - since freezing one wasn't 'cost effective') in. For me, the problem was more with my husband than me, though I hadn't been ovulating for a while either (no other problems on my side though, otherwise healthy).

To answer your question - day 5s better since you can be so selective and since you have so many to choose from.

Good luck!

[Anonymous]

PP here - For a quick primer, see this link - http://www.shadygrovefertility.com/eSET_success08

[Anonymous]

I also think one of the previous posters is wrong - day 5 tolerates freezing better, not day 3

[Anonymous]

OP here....to previous poster 23:33, is a single transfer considered to give higher success rates than a multiple transfer?

We are completely ok with twins and quite frankly would welcome the thought. We have always wanted 2 or more children so if we start with twins we would be more than happy. Plus, if we never have to step foot into another fertility clinic it wouldn't be too soon.

[Anonymous]

definitely ask your RE about freezing if you're worried about freezing, i'm almost certain day 3s freeze better plus you could always thaw a day 3 and see if it goes to day 5 later down the road.

[Anonymous]

22:33 Well, you can see that single transfer is considerd slightly better at Shady Grove. Across the board with real studies, I think it's a very similar rate. So, if you're good with twins, then go for it. It's just that both the mother's health and the baby's health outcomes are better with only one baby. This is why there is finally a trend towards elective single embryo transfers in cases where there situation looks good. Physicians are finally being more responsible. Though, hey, I can also understand not wanting to go through it again. But if you're successful on your first round, you probably will be on your second round. And life will be that much easier with one baby at a time...