# FET and how to proceed?



## Teela (Jun 7, 2009)

Hi Ladies,

Can help me with a decision, or at least help me make an informed decision please.   

I am hoping to return for my little frozen embies from my cycle of IVF next month.

When I did my IVF i had 3 day embies put back and the rest were then frozen as all good
quality. I am contemplating going to blast on my FET and have read a article called Transcript from 3 day
vs Blastocyst transfer by a guy called Dr Timothy Smith. He seems to be saying that if the embies dont make
it to blast they wont make it in utero as not viable embies, thats not to say people dont have sucess with 3 day
embies. He always takes the embies to blast and states if the embies genetic makeup is good they are better of in
the lab as the culture they are in is more like the fallopian tube anyway and the embies not possesing the genetic make up
to continue growing will be weeded out!!He also goes onto say how it is easier for the clinics to culture to 3 day and then if it
does not work shift the blame to the patient as they were growing when transferred, but would they have continued to?
It has made me think maybe I should take all my embies to blast, if they survive at least I know there good enough  
If not I understand I loose them all and thats the risk, but would I not then at least know if the embies are good enough 
quality? 

Also if I go to blast on them all would you have one or two transferred?

I would appreciate your opinions and what you would do, if this fails its back to another fresh cycle.

thanks
Teela
x


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## blueytoo (Oct 5, 2003)

There is much research to show that if an embryo doesn't make blast then it won't make it anyway. All of the best clinics worldwide prefer blast transfers and it does lead to better success rates.

The other thing to consider is that when you have a day 2 or 3 embryo put back this is not "natural" as at that stage of development the embryo would still be in the tube and not in the uterus. Therefore with blasts you are not only putting back the strongest embryo, you are putting them back in the correct place at the correct time.

If I was doing another cycle with my own eggs then I had agreed with Stepan that irrespective of how many fertilised eggs I got, I wanted them all left until day 5 and if it meant nothing to transfer then that was the risk I was willing to take. He said it was a very sensible approach and agreed. I had decided and got his agreement to  have 3 blasts back if I got that many. As it is my next cycle will be with donor embryos and they are grade 1 blasts and I will be having two put back. He did say I could have 3, but as it will be donor eggs from a younger woman, I am happy with two blasts.

I would personally never have just one embryo transferred as I do have both infertility and immune issues and don't believe that one embryo gives me any chance of success at all. But I also have no qualms or worries about having twins. So I guess everyone has individually decide whether the possibility of having twins, triplets or quads is an issue for them. If that doesn't bother you then it makes sense to have 2 put back to try and maximise your chances but if it does bother you then one is probably going to be the number for you, not forgetting that you can still have twins from one embryo, but your chances are lower of course.

I hope that helps a bit.


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## Maya7 (Sep 9, 2008)

Hi Teela - tough decision ahead for you ... Am certainly no expert but to share my own experience, I had read up on the 3 day versus blast debate and understood that most feel blast to have more potential for success. However, at the point of decision on whether to go 3 or 5 day, I had what i can only describe as an overwhelming need to have the embies implanted.(Defies any logic..) I couldnt wait to see if they'd go to blast. My Dr shared my belief that my 'natural environment' was better than any artificial one in the lab...my embies were well developed for 3 days so this doesnt necessarily contradict Bluey's hypothesis..

As to the number to transfer, that will depend on how many survive...I had 3 good embies but wasnt allowed to transfer 3 on first IVF even though I _really_ wanted to. I would have loved twins so I didnt worry about multiple births ...I had two 3 day 'almost blasts' implanted. Sadly I was told that my 3rd embie didnt make it to blast for freezing. Would it have survived on a 3 day implantation? I dont know... I would say that you would have to consider the possibility of multiple births if more than one blast is transferred. Also, with only one embie, multiple births cannot be ruled out either... I guess you'll have to inform yourself as much as possible, but go with your instincts too if you can.

HTH..

 
Maya


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## lulumead (May 29, 2008)

Don't think I can be of much help, other than adding that my clinic believes that embies have more time back in the uterus as quick as possible and are now doing more 2 day transfers. I've had 2 day/3 day and 5 day embies out back, all of which have been good quality and only had a biochemical on the 1st go which was 3 day embies....so not sure!


Good luck making your decision...I don't think it can hurt going to blast.


xx


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## Teela (Jun 7, 2009)

Thank you Blueytoo, Maya and Lulu, very informative as I would expect from all of you lovely ladies.

I have continued to do some research and pretty much decided to take my embies to blast, I feel as Bluey mentioned
Blasts are at the right stage of development to be returned then and I will know if my embies are good enough quality.
So its all my eggs in one basket as they say, a risk but one I am willing to take. Need to talk to the clinic now on Monday
as I know some are not so keen to go to blast but I think that's more about them not being so successful at culturing to blast,
however as Bluey said, in the states particularly they always seem to go to blast.

thanks again
Teela
xx


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