# Why were my 3 embryos discarded without freezing or consulting me?



## mary k (Oct 27, 2005)

I have now had 5 ICSI treatments.
I did the last one whilst on the waiting list for a myomectomy. I know for definate (i have confirmed with clinic) that on the day of last ET I had 5 embryos. 2 were grade A and 3 were Grade B. The Grade As were transferred but the 3x grade Bs were discarded and not frozen. I was not consulted.
I feel very aggrieved that I was not consulted about discarding the embryos. 
When I rang the clinic they said their policy is to only freeze A grades due to the poor success of B grades.
I asked what the success rate with B grade embryos is and the man on the phone could not tell me - just that it was poor.
I pointed out to him that my chance of having a baby is already extremely poor (one consultant has told us<10% chance with ICSI due to all our problems) yet I am willing to spend a fortune on taking that risk.

I think I am particularly annoyed as my consultant knew I was about to have the myomectomy if the ICSI failed. It would be so much easier not to have to start from scratch again with an ICSI cycle if I had frozen embies. I would have liked to have been given the statistics and given the chance to spend my own money and blood, sweat on tears on FETs if I so wished.
Previous cycles have had v low fertilisation rates and v low numbers of embryos created. There is a high chance that the next cycle may produce no embryos. I am beginning to think I may never have kids of my own. These 3 embryos were the nearest thing to kids I may ever have. Should the decision about what to do with them not have been mine? At the VERY LEAST should the policy of the hospital not have been explained in advance to me?
Also, I am getting v close to 40 and the myomectomy will delay the next cycle by several months. The next batch of embryos.. if there are any are at a higher risk of abnormalities such as downs syndeome.
If I was to be cynical I would say that the clinic are only freezing As to make their stats look better or that they make more money by making me start from scratch with ICSI treatment again the next time.

When I calmly pointed out to the man on the phone that I thought that I should have been consulted he said that they didn't like to give people false hopes. I asked him if he had ever been in my situation and he said no. I held my tongue and did not ask the obvious question... why did he think he was better qualified than me to make the decision then?

Anyway I really want to find out:
What the policy is at other clinics? Perhaps this is not exceptional, Or even just hear other people's views or experiences?
Does anyone know what the success rate with frozen B grade embryos is? 
Has anyone got pregnant with a frozen B grade embryo?
Perhaps I shouldn't beat myself up about this but I think the feedback may, at the very least be interesting to several FF members and may even prevent someone else feeling robbed/bereaved like I do.

I am not sure if I have posted this message in right place as I would like everyone's opinion on this - not just the fertility nurse (altho their opinion would be v welcome). Therefore I will try and post on a general message board too.

Looking forward to hearing from you

regards
Mary K

PS I am aware that some clinics grade the embryos using different nomenclature but basically A is best at my clinic and D is worst


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## ritzi (Feb 18, 2006)

mary
firstly i'm so sorry this happened to you - you are so right in that it should have been your choice what to do with your embryos...
for your info my clinic do not use the A, B system, but grade them 1,2,3,4. that said though they never really talk about the grades unless pressed to.
My clinic would have destroyed my 6 surplus embryos from my IVF cycle in February as the quality was 'not good enough to survive the thaw', however my husband and i are practising Christians and so for our religion that would be forbidden - or seen as abortion....What we did was discuss all this before hand and we wrote it into the contract that 'all embryos were to be frozen regardless of quality'. The clinic were fine with this and did what we had instructed them to do.

In my FET cycle in march i had 3 thawed and 2 survived - a good and a moderate 4 cell 3 day old embryo. The success rate for a BFP was given as 15%. I did get pregnant! which the clinic never thought i would. I've since lost the baby at 9weeks and my NHS obstetrician said he sees this more often in frozen embryos - though it's more probable that have other issues that casued this....

if i were you i would definitely bring this up in your follow up appointment - though it should have been discussed before really. at least you may get some answers....

sorry if this does not help, but wanted to share with you how we deal with our 'low grade' embryos - don't beat yourself up...the clinic had the responsibility to ask what you wanted them to do before discarding....

hope you get some answers, nichola.x


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi

Firstly I am so sorry that you have had to go through this...to be honest I know very little about the whole process, other than what we have been through recently.

Could I just ask, since your embies have been graded A, B etc, can I assume that they were Blastocysts (or is this just the way your clinic grades)   I only ask since I was under the impression that 2/3 day embies were graded 1-4 & blastocysts were graded A-C...as per this info I found...

"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).

Multicell embryos that recieve grade 1 or 2 often develop to the blastocyst stage, those receiving grade 3 or 4 rarely develop to the blastocyst stage. Sometimes the laboratory uses the reversed scale where a grade 4 embryo is equivalent to a grade 1 embryo on the above scale."


Either way, I personally am not sure why they would class a B grade embie (or blastocyst) as poor quality as it would appear to be of pretty good quality if the info I've read is anything to go by !!

When we had our meeting with embryologist, prior to starting ivf, he explained everything to us fully regards freezing and told us that they froze embies from Grades 1-3 (he didn't discuss blastocysts as it wasn't relevant to us) - anything less than this is not frozen as they would be unlikely to survive the freezing and then thawing process.  As part of our treatment costs, 3 yrs freezing is included (we can pay for longer if needed).  We were lucky enough, on day 2, to get 6 x Grade 1, 4 cell embies...2 of these were put back (sadly BFN  ) and we now have 4 frosties...this was automatic and we were told after the freezing...told when went for the ET in the afternoon that they'd been frozen that morning.  I find it awful that your clinic do not appear to have a proper process in place to contact you following fertilization to discuss what you would like to do 

As ritziowner (Nichola) has already mentioned, we were told that success rate of FET was 15%, assuming embies thawed ok...I believe its about 70% thaw success.

I wish there was something constructive I could give you but I do think you need to put everything in writing and discuss fully with your consultant at follow up appointment as it does seem that somewhere along the line, communication from your clinic was remiss if they didn't explain the freezing process to you in full.  The whole process is emotionally draining (as well as financially draining !!) without the added heartache of something like this happening.

Anyway, I'm not sure if I've helped at all but I wish you loads of luck in your ttc journey...
Take care
Natasha


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## mary k (Oct 27, 2005)

Minxy 
thanks for your v informative reply.
I do intend to take this further with the clinic so your info may be useful then.
I am not sure about whether my embies were blastocysts are not.
My clinic only ever refers to grades A-D with A best and D worst. The man on the phone told me that only 5% of embies on day of ET are A grade. Therefore it stands to my simple logic that B grades aren't too bad. (Incidentally a friend of mine has a beautiful daughter from a C grade embryo- however it wasnt frozen)

Nichola
Your reply has really made me think. I too do not agree with abortion.The clinic have made that ethical decision without consulting me. 
You have made me even more determined to get to the bottom of this.

More replies to my queries would be GREATLY appreciated.

regards
Mary K


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## MissTC (May 8, 2006)

Hi Mary.  Really sorry to hear about the situation you have been put in.

I can only reiterate what Minxy has told you really.  I would have thought however that if your embryo's were blastocysts then you would have been made aware of that fact.  I think embryo's only get to blastocyst stage after 4/5 days in incubator (or uterus if transferred on day 2)?  Did you have your transfer within 2 days of egg collection?  If so, I can only assume they were not blastocysts - please correct me girls if I am wrong on this.

At my last IVF cycle, I had 8 eggs.  6 fertilised, but 1 was rejected as it had been fertilised by 2 sperms and apparently they cannot transfer this type of embryo (not sure why!  nurse did say something about there being "too much man" in it).  Anyway, out of the 5 remaining the two best ones (both 4cell grade 1) were transferred to me and the remaining 3 (one 5 cell grade 2, and two 4 cell grade 2) were automatically frozen by the hospital.  I was told on the day of transfer that the remaining 3 had been frozen until I decided what I wanted to do with them.

I find it really really awful and unethical that you were not given any input or asked to be part of the decision not to freeze your remaining embryos.  I would encourage you to take this matter further honey.  

Sorry not to have been more help
Luv
Tracy


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## mary k (Oct 27, 2005)

Ruth has kindly replied to me on the 'ask a nurse section' ... interesting.
Still interested to hear from fellow 'sufferers' tho....


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## LizH (Nov 19, 2004)

Hi Mary K

I am very sorry to hear about what has happened at your clinic.  

I have just had my 3rd FET this week.  On my full IVF cycle last year I developed OHSS and all my embryos were frozen, I know that some of these were grade 2 and some were grade 1 as my consultant told me.  I was also told that when frozen embryos are thawed they can be a different grade to before they were frozen.

It is funny that you are asking about success rates with grade 2 embryos as I was looking at a poster with these statistics on for my clinic the other day.  Unfortunately I don't remember them, but I would imagine that most clinics will produce similar statistics.  Definitely worth asking about at your follow-up consultation.

Liz


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## Luc (Jan 30, 2006)

hi mary, 

im so sorry you have had to go thru this. i think what your clinic has done is teriible and in actual fact, i would certainly make a compliant in your shoes. i have just had my second icsi cycle and i had 9 embryos. of those two were put back yesterday. one was a grade 1 and the other a grade 2 to 3. of the remaining 7 they said only one had carried on dividing and the rest had stopped dividing. they suggested i discarded the lot, as they said the ones which had stopped divided had arrested and effectively died and the felt there was no point in frezing a sole embryo when the success rate for freezing is only 75%. they said they wouldnt put me thru a fet cycle in case i had nothing to put back based on one frozen embie. i said i wasnt happy to discard a healthy embryo and so they agreed to freeze it with the intention we may add to it if we were to have another icsi cycle in the future. i certainly feel it should have been your decision what to do and not theirs.  again im just so sorry your in this position.

nichola, i was wondering did your clinic even freeze embies that had stopped dividing for you, or not as those are effectively dead?

mary take care 

Lucy


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## ritzi (Feb 18, 2006)

hi lucy

just to say our clinic agreed to freeze all embryos - the only exception being if they perished. We had 6 frozen on day 2 and all were 2 or 4 cell...for all we know some could have stopped dividing but they were still frozen. We have not been given these details from the clinic and wouldn't ask for them - I think we would be on dodgy ground (religiously) knowing then what to do. If an embryo stopped divding we would freeze it - it would then perish in the thaw and that is acceptable to us as we gave it every chance we could. 

The only embryo we discarded is when i had 3 thawed and one perished ....the clinic had said if all 3 survived the 'spare' could then be refrozen. My clinic will only do this because of my religion and ordinarily the 'spare' would be destroyed (though some london clinics routinely refreeze).

we would also have had a single embryo frozen and would go through a FET with one before doing a fresh cycle - and again because of our religion the clinic would let us 

i know our 'rules' are very strict - but for us they work and we have no problems with how other people deal with their embryos etc......lucky for us our consultant understands our religious needs (that in our eyes any embryo is life already and must not be destroyed) and has given us the space to make our own decisions etc...even though for them it has meant extra paperwork and doing things they wouldn't normally do 

so glad you have had your embies put back where they belong - so hoping it works for you this time lucy - are you on any steroids etc?

nichola.x


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## Luc (Jan 30, 2006)

hi nichola, 

thanks for replying. i asked because i was quite uncomfortable with them discarding my embies which they said had stopped growing as i felt maybe if they'd left them a day more they would have started growing again. anyway they were quite insistent that they wouldnt do start to gow again so there was no point. anyway its done now and im glad i chose to freeze that one i know was helathy even against their advice. 

no im not on any steroids, i had my immune tests with mr ******* cos i was worried about implnation probs. he said my nk cell activation result indicates that i dont have a problem with implantion but cos i have a high nk cell count i would be liekly to have a m/c problem if i were to get pg. when i spoke with my own consulatant about the results he disagreed with mr s and said there is not enuf research into nk cells and i shouldnt be taking steroids when in his opinion i dont need to. i decided to stick with my consultants opinions for now. how about you? how are you doing? and have you made any plans about where to go next?

Lucy


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## ritzi (Feb 18, 2006)

lucy

embryos - i think it's a long shot that they start to grow again - for us it was more about not destroying them - the thaw is up to them......bit of a cop out really but emotionally/religiously works for us. 

we see our NHS consultant on Thursday for baby's results   and our karyotyping test results. although my clotting etc came back fine from the clinic he ran them all again just to make sure. So Thursday brings lots of results.

our consultant wanted us to wait till august but clinic are fine for us to start now - so if he says yes we aim to FET this month - AF due on 10th though i'm not regular. 

if the genetic tests show something we will hang fire till we know the exact problem but at some point will use the embryo's without PGD testing and just accept what happens. 
if i have clotting problem or similar we will hang fire till we know more i think
if all is well on Thursday we are going ahead with aspirin, heparin and prednisolone - just to be safe.....

like you i'm not certain about all the nk stuff but i have ulcerative colitis which is a big immune problem and so we are doing it just in case. i've been on steroids lots (and had 2 natural pgs by chance on them) and so figure it won't hurt. it's a hard decision though and i can see why you've gone with what your consultant said  

we are fairly certain this is our final go so we can but see 
lets hope it works for both of us this time.......

nichola.x


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## Luc (Jan 30, 2006)

good luck nichola, 

hope it all goes well today. 

Lucy


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