# number of cells



## neptune (Nov 1, 2007)

Hi, can anyone tell me about the optimum number of cells that is good for embryo transfer please? x


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## Diz74 (Jan 1, 2007)

I think it depends on what day the transfer is.  For e.g I was told by embryology last week that on day 3 they look for more than 5 cells.  I don't know any more specific details though.

HTH a bit.

Diz


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi

It would depend entirely on what day transfer you had.

Here's some info...

"Day 1 Check eggs for fertilization (the presence of two pronuclei or PN's) 
Day 2 Embryos at the 4-cell or more stage of development 
Day 3 Embryos at the 8-cell or more stage of development 
Day 4 Embryos at the compacted morula (16-32 cell) stage 
Day 5 Embryos at the blastocyst stage of development

...Critical points in development are (1) fertilization, (2) 4 to 8 cell stage and (3) morula to blastocyst stage.

Although you also have to remember, it would depend on how long between EC and transfer (or freezing) the embies are eg it may be that on day 2 you're told the embie only has 2 cells but that this is perfectly fine, it may be that it was just checked early and not given the full 48 hours since it was fertilised, just as on day 3 you may have a 6 cell embie and told this too is perfectly fine. We've had 6 and 7 cell embies on day 3 and been told absolutely fine and nothing to worry about as they were just checked a little earlier than 72 hours after fertilisation.

With regards to grading, some clinics use the reverse scale so that Grade 4 is best...you would need to check with your own clinic (ours uses Grade 1 as best) and some clinics don't grade at all...

Numeric grading systems for multicell embryos usually have 4 levels (this showing Grade 1 as best):

Grade 1: even cell division, no fragmentation 
Grade 2: even cell division, small fragmentation
Grade 3: uneven cell division, moderate fragmentation 
Grade 4: uneven cell division, excessive fragmentation

Blastocysts are graded differently with a number and two letters.

The number refers to the degree of expansion of the blastocyst (1 is the least expanded, 6 is the most expanded). The first letter (A,B, or C) refers to the quality of the inner cell mass (the part of the blastocyst that is going to be the baby) and the second letter (A, B, or C) refers to the quality of the trophectoderm (the part of the blastocyst that is going to be the placenta).

Sometimes the laboratory uses the reversed scale where a grade 4 embryo is equivalent to a grade 1 embryo on the above scale. Check with your lab

And here's some more info...

http://www.ivf-bath.co.uk/treatments/embryo_grading.htm

However, lower grades and less cells doesn't necessarily mean that won't implant, just as higher grades can't guarantee success...

This website shows pictures of the different embryos and uses the reverse grading where grade 4 is best...

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

Many clinics only freeze best quality embryos (ours only freeze grade 1's - 1 being the best) so I'm assuming if you're having FET that your embies are good quality.

It's not uncommon for embies to lose cells during the thaw process but many will continue to divide (cleave) and grow so nothing to worry about.

I wouldn't hold too much with grading/cell number etc as if the clinic didn't believe there was a chance with the particular embies then they wouldn't replace them 

Good luck
Natasha

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## neptune (Nov 1, 2007)

Gosh, thanks Natasha!


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## nickate (Mar 2, 2007)

Hi Neptune,

We have had grade 1's and never made it past 4 cell, but all grade 2's have. Our current blastocycts grade 2 up to morella (now in me) were all over the place and the embryologist said she has seen babies from grade 2,3 and worse. They even had a baby from a 3 cell on day 3. So dont rely too much on text book stuff. I have one text book and one slightly-off textbook inside me now. Who knows what will happen.

After the 3rd IVF we did not allow the clinic to discard any of our embies and in future if needed (second child, being positive) will keep all and take to blasto bit by bit. Id hate to think they discarded our embies as not textbook when there is plenty of evidence that it works with slow cells and less than grade 1 embies. Even if the textbooks say there is less chance, we are not taking the risk, it is alot of work to get them!. I do hope that all works out with you and this helps  Fairy baby wishes to you.

P.S/ We even get them to put the ones that do not move overnight back in on a two day transfer as you can see with our signature; my doc says you never know. Who cares about disappointment, not risking it makes us feel better.

Kate


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## neptune (Nov 1, 2007)

Hi nicknate, 

Thanks for your reply. On our first cycle they discarded a grade 1/2 because they didn't freeze single embryos, luckily now they do, which is the one I have in me at the moment which is a 2/3. Thanks for your wishes and lots of luck with your lovely blasts.


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## nickate (Mar 2, 2007)

Neptune,

We reckon they work on the stats; and stats do say grade 1's produce more babies; we are now using them all, as we do not fit  in with the stats and even if we did, there is evidence and plenty of it to say other grades produce babies. I asked my doctor and he said they dont know, which ones will go to babies on day 2 they just work on stats and the stats say higher pregnancy rates with grade 1's and normal moving cells!!!! I wonder what that is? Wonder what the stats say about the others- who knows? 1 of our blastos from a grade 2 all the way up to morella turned into textbook; Wolla to stats there! But you never know what will happen, hoping to prove the stats wrong like plenty of other ladies on this site;we hope it has all it needs (and the other one) to turn to babies! Hope it works for us this time, otherwise fresh IVF in Feb (months rest 200 I do hate that buserlin!!!.  My hubbie aint to keen on it either; I am wicked on the stuff!!!  

Baby fairy wishes to you   I wish everybody    

Kate


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi Nickate

I'd be interested to read any articles you have re stats stating that grade 1 embies produce more babies ? (and this is assuming that grade 1 is top as some clinics use reverse numbering)  I've read that there are no guarantees with any specific grades...a grade 4 is just as likely to be successful as a grade 1...which is why some clinics do not grade as it's really no real sign of a "live" birth.  However, if an embie reaches blastocyst stage then this can be a good sign ie survival of the fitest...but sometimes an embie is just better off in the natural environment of the womb, rather than false environment of the culture medium + petri dish.

With regards to freezing, the reason many clinic will not freeze embies below grade 1 is nothing to do with the success rates of lower grades, it's to do with the thawing process.  During thawing the cells can become damaged and if there is fragmentation (as in case of grade 2's and below) then this can mean less success with thawing.

Good luck
Natasha


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## nickate (Mar 2, 2007)

Hi 

One of our consultant said it was based on stats, whether we believe what the consultant says, is another thing One of my consultants said one thing and my other consultant doesnt agree, as I said who knows?  Maybe I should have mentioned that. I do law and nothing is certain with that and I am sure that it is the same about embryology- who knows what will happen . Now I wish I had become an embryologist so when trying to read the academic articles it makes sense; all that technical language  is all bliggity to me unfortunatley I would love to know more about making   As for freezing I dont know either, but on a good note have had grade 2s frozen and all defrosted okay, thankgoodness . This cycle they were frozen at pronuculate stage and of our 17 embies 15 defrosted okay and most were grade 2. My consultant has said that they are best in me, but with so many, we went for blast. Hopefully it will work for us  we want it so much    

Just the fact that we have a blasto is a milestone for both of us as it means that future treatment if this does not work will be done with more hope and courage; we started in 1997 and sometimes we need a little extra encouragment.   I do hope that your treatment is successful -Fairy baby wishes to you         My diary for anyone to read is on the FET under nickate.

Kate


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