Reply to Seriously... day 3 or day 5 is better?

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[quote=Anonymous][quote=Anonymous]You've hit on one of the many things with ART that can be based on an RE's experience, rather than good data.  In other words - many of the REs form treatment preferences based on the limited cases they see (and often the successes that stick out in their minds) and it amounts to superstition.  It happens in other areas, and even sometimes where there's good data to show what course has better outcomes.

SGF did look at their day 3 vs day 5 outcomes and they base their day 5 preference on the fact that while day 3 has higher BFP rates, day 5 has higher live birth rates.  When I was there, the did bend the rules a bit - I did a day 4 and then also transferred on day 5, even though nothing was at the blast stage yet.  I think day 5 is where the data is going. Dominion also will not do day 3 transfers (at least when I was last there about a year ago), for the same reasons as SGF.  The stats don't tell you everything, though - you can never know on an individual basis what is best.  With day 3, you run a higher risk of miscarriage (so higher potential for waste of $ and emotional upheaval).  For DOR or poor egg quality where you get few blasts, I certainly wouldn't rule out day 3 (although I wouldn't PGS test even if I went to day 5).

At these top clinics, I don't think lab quality is a big concern.  It was a MAJOR concern a number of years ago, but they've improved the culture media and other techniques, such that the major clinics are all on pretty much the same footing now.  Clinics will still promote lab quality, but I think it's only relevant when you're comparing the top tier to others.

Cornell's DOR stim protocol (which is essentially a mini-IVF, although they don't want to call it that), was better for me - I have poor egg quality.  Other REs will do it, if you ask, but most want to start with high stim doses.  I think with poor egg quality and DOR, it's just harder to figure out what works best for the specific person.  If you look at the success rates for 40+, you can get something of an idea about how a clinic does with what is likely to be DOR and/or poor egg quality, but it unfortunately, there's no good info on success based on diagnosis.  I do think Cornell is probably the best for DOR, though.[/quote]

how come you wouldnt pgs test even if you went to day 5?[/quote]

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