# Going for 3rd IVF - 3 day transfer or blastocyst ?



## kittypops (Apr 30, 2009)

Hi Crystal,
Ive just had my 2nd failed IVF.  I'm 40 and my husband is 41.  He has no probs but I have a low Anti Mullerian Hormone level at 2.6.  Some of the consultants see this as more of a problem than others. I've looked it up - is it a big issue? 

In our first cycle we got 4 eggs from 3 follicles, 3 eggs fertilised. We got (grading on a 1-4 scale) 3 x grade 2 , 1 at 6 cells and 2 at 4 cells. 2 embryos were transferred on day 3 but I had a -ve HPT.

This cycle we got 3 eggs from 3 follicles only 1 fertilised it was a grade 2 and had 6 cells.  I tested today, tomorrow is 14 days after transfer when I was supposed to test but it was clearly -ve.

I have phoned to get my review with the consultant.  I want to ask about assisted hatching, and blastocyst transfer instead of 3 day transfer.  What would be your opinion on these alternatives?  Can you think of anything else that could help with implantation? Do you think asprin can help?  I took asprin until 5 days before my EC as I'd heard about it and my consultant didn't mind either way but he did not say to start it again after ET.  I am a biology teacher and have done a bit of research but I'm still at a loss to understand this.  Please help if you can.

Many Thanks,

Kittyx


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## CrystalW (Jul 25, 2007)

kittypops said:


> Hi Crystal,
> Ive just had my 2nd failed IVF. I'm 40 and my husband is 41. He has no probs but I have a low Anti Mullerian Hormone level at 2.6. Some of the consultants see this as more of a problem than others. I've looked it up - is it a big issue?
> 
> In our first cycle we got 4 eggs from 3 follicles, 3 eggs fertilised. We got (grading on a 1-4 scale) 3 x grade 2 , 1 at 6 cells and 2 at 4 cells. 2 embryos were transferred on day 3 but I had a -ve HPT.
> ...


Hello Kitty,

AMH is generally regarded as an indicator of how many eggs you might be expected to get at egg collection. The lower the AMH, the lower the number of eggs. As not all eggs are good it is always hoped to get a reasonable number at egg collection so when fewer eggs are collected it can be more difficult to find a good egg. Some clinics like to see a minimum number of follicles before going to egg collection so a low AMH may effect this.

Blastocyst culture is only useful if you have a number of embryos to choose between. It does not make the embryos any better, it just makes choosing between them easier so if you only have 3 or less (at 40, you can have 3 embryos out back) then they should be put back on Day 2 or 3.

AH may be worth doing - this involves making a small hole in the embryo in case the shell is too hard for it to hatch out of. Lots of studies have shown it does not make much difference but i have seen it work nicely for some individuals. Ask your Consultant how much AH they do and if it has increased their stats.

Ask about aspirin - i know its not suitable for everyone and it is not always compatible if you are taking other medications, only your Consultant can decide if i might be ok to take.

The problem is often egg quality, as maternal age increases egg quality is affected and there are fewer good eggs, so sometimes it is just unlucky that a good egg or embyro is not generated in that cycle. Your consultant should be able to advise you of the pregnancy rates.

Best wishes


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## kittypops (Apr 30, 2009)

Thank you very much Crystal.

Kittyx


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