# DEIVF 3rd time - Blastocysts or Day-3 transfers?



## molly1966 (Apr 10, 2010)

Hi,

I am about to get my 3rd ET done next week with DE. At 44 yrs I am wondering if I should go for 2 blasts, given the possibility of having twins (which we are not keen on) vs the fact that we are running out of time (or so it feels!). Can anyone advise on whether blasts do give overall better chances of pregnancy?

Molly


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## daisyg (Jan 7, 2004)

Molly,

Generally speaking with DE, your age is not an issue as far as how many to transfer because you are using young eggs.  Good quality blasts give a higher chance of pregnancy statistically. Two blasts may well have a higher chance of twins but it depends on several factors:-

Quality of clinic and quality of embryos.  You need to take advice from your clinic's embryologist on quality of the embryos on the day of transfer and discuss this with the doctors.  What are their stats. for twins with blast transfer?  Are they experienced in blast transfer??  Have you got enough embryos to go to blast as some may be lost along the way?

Why have you failed before?  Were your other ivfs DE and was a reason given for failure.  If you or DH have any issues (e.g. sperm, clotting, thyroid, infection, uterine, autoimmune etc) then it makes no difference what is transferred, you may have issues which are preventing pg and need to be diagnosed and treated.

If you transfer two blasts then realistically you need to be prepared for twins as a possibility. But this is the same with any ivf transfer of more than one embryo.  However, if there is something else preventing you gettting pregnant you chances are lower or nil and these issues need testing.

Two blasts for DE transfer is not unusual and is considered statistically a higher pg chance than day 3 transfer of fresh donor embryos taking into account all of the above issues.  

If you really don't want twins, then your only choice is to transfer one blast after making sure you and DH have completed as many of the above tests as possible.  If you are using day 3 embryos, then take the clinic's advice on quality, but transfer no more than 2 (but you still run the risk of twins).

Best
Daisy
x


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## molly1966 (Apr 10, 2010)

Daisy,

thanks very much for this.

I've been rather torn about the tests because I'm not sure when to begin thinking of failed cycles as 'repeated failures'. I did consult Dr Gorgy about the tests and after weighing cost and time issues (would have had to postpone the cycle by a few months) decided to go ahead with a fresh cycle. If this fails of course it means there are possible underlying issues that need to be tested for before any FETs.

At the moment I am treating immunes empirically, and doing other things - acupuncture once a week, high dose vitamins etc. So I'm really hoping for the best here! The issue of blasts has to do with giving myself as high a chance of conceiving on this round.
I'll speak to my clinic in Spain (and the embryologist on the day of transfer) and then decide.

Thanks again,
Molly

ps: congratulations on your twins - you've obviously had a long journey but seems so worth it and I do admire your tenacity!


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## daisyg (Jan 7, 2004)

Molly,

Don't forget that you don't have to have the most common tests done by Dr. Gorgy.  Your GP can run some of the most common tests e.g.

Thyroid
Karyotype for DH
DH's sperm testing?
Your uterus - testing (what is your lining like, do you achieve triple stripe?? Any fibroids/polyps?)
Basic clotting panel
RA factor, Antinuclear antibodies etc

What meds. are you using empirically and what vitamins?  Be cautious with aspirin if not prescribed professionally.  Vitamins recommended would be 5mg folic acid/50mg B6 and 1mg B12 started at least 2 months before cycling.  Fish oil another beneficial supplement to take but be very cautious with this if you are on anticoagulants as the two can be contraindicated.

It would be much better to postpone this cycle and get tested properly than wasting money in my opinion.  However, if you do fail next cycle (and I really hope you don't) then testing is a good idea.

What reason was given for your previous failures?  Were they DE or OE?  3 failures begins to look like other issues potentially.  More than 2 DE failures is 'repeated failure' IMHO.

Best, 
Daisy
x


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## molly1966 (Apr 10, 2010)

I've had two DEIVFs only, no OEIVFs (not enough eggs was the reason, was given 5% chance). I've been pregnant once before 10 yrs ago (but chose not to carry for personal reasons). I was given no reasons for failure of previous 2 cycles.

Since then I've had a hysteroscopy (all fine), various bloods, thyroid etc, and DH's sperm is low count, low motility. Any other tests would need to be higher level, although I could get a basic clotting panel. 

Anyway, its too late to cancel the cycle as the donor and myself have started our meds and I'm due for Et around Dec 12 or 13.
So now its a matter of      - tests to follow if it doesn't work 

thanks again, Molly


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## daisyg (Jan 7, 2004)

Sorry Molly,

Wasn't sure where you were in cycle and apologies for not reading your profile information.

Wishing you and DH the very best of luck for this cycle.
Daisy
xx


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## Helen3 (Dec 2, 2010)

Hi Molly,
Have just been reading this thread with interest. I am in a similar position altho' older than you (4. We have frozen embryos (when I was 44) but know there is only a very slim chance that these would make it (however we want to look into assisted hatching, blastocyst transfers etc). Daisy also made the point that we should be tested first for everything before going ahead with either another FET or DE, which makes sense & we intend to do.

Out of interest, which clinic in Spain are you using for DE? We went to Eugin in Barcelona once for DE but it didn't work. We still have 2 FEs there.

Very good luck this time
Helenx


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## molly1966 (Apr 10, 2010)

Hi Helen,
We're going to Procreatec in Madrid. We actually moved our FEs from Ceram because felt it was too impersonal. Jennifer Rayward at Procreatec is lovely, and we are very happy with her care. The fresh cycle would be with Procreatec for the first time, so we are inclined to also give this a shot before going down the route of further testing. Wish you all the best with your future cycles too. Do let me know how it goes.
Best, molly


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## Helen3 (Dec 2, 2010)

Thanks Molly, especially for the speedy reply! Good luck!


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## molly1966 (Apr 10, 2010)

Hi,

Just thought I'd let you know that I got a BFP and am truly thrilled about it! I had 2 blasts transferred, and I'm not sure what made the difference this time but am still keeping my fingers crossed that the next few steps are OK. Week 6 scan is on Jan 7    

best,
Molly


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## Helen3 (Dec 2, 2010)

Hi Molly,
I've only just picked up your post - CONGRATULATIONS!!! I am so excited for you tho' I know you are not out of the woods yet. I will keep everything crossed for you both. Keep us posted. Gives us all hope....
Helenx


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## Lirac (Sep 18, 2008)

Many congratulations Molly!

For the record, my first DEIVF was unsuccessful with 5 day blasts and the second was successful with 3 day.
Think it is all down to the quality of the embryos at the end of the day ...

Lirac x


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