# Sequential Embryo Transfer



## Trishs1970

Hi Peter,

We had ec on Wednesday (20/0, which resulted in 17 eggs but due to egg donation gave us 8. 4 fertilised normally and are today at 4 cells. My clinic wish to do a day 3 transfer tomorrow due to having only the 4 embryos.

On our last cycle we had 6 excellent quality blastocysts, and I have queried the possibility of undergoing a transfer of one embryo tomorrow, then leaving the rest until day 5, and if any are good enough to have a second transferred on Monday. I know that this is a procedure carried out in other countries, but my clinic are so far reluctant to conduct anything but a day 3 transfer, despite our embryos looking to be of good quality at this stage.

Should I pursue this matter, or do you think there would be little benefit?

Many thanks.

Trish


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## peter

Trishs1970 said:


> Hi Peter,
> 
> We had ec on Wednesday (20/0, which resulted in 17 eggs but due to egg donation gave us 8. 4 fertilised normally and are today at 4 cells.
> 
> That's a low fertilisation rate, what happened to the other 4. Why did you have to give 11 eggs away?
> 
> My clinic wish to do a day 3 transfer tomorrow due to having only the 4 embryos.
> 
> I am a bit lost here. As you can only have 2 back I don't see why you need a day 3 transfer??
> 
> On our last cycle we had 6 excellent quality blastocysts, and I have queried the possibility of undergoing a transfer of one embryo tomorrow, then leaving the rest until day 5, and if any are good enough to have a second transferred on Monday.
> 
> This sounds like a good idea or just wait and have two blastocysts back.
> 
> I know that this is a procedure carried out in other countries, but my clinic are so far reluctant to conduct anything but a day 3 transfer, despite our embryos looking to be of good quality at this stage.
> 
> If they are inexperienced in blastocyst culture it would be best to have the day 3 transfer.
> 
> Good luck!
> 
> Peter
> 
> Should I pursue this matter, or do you think there would be little benefit?
> 
> Many thanks.
> 
> Trish


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## Trishs1970

Hi again Peter,

Thanks for the reply. We were unable to get the clinic to agree to sequential transfer as they stated that there was too much of a risk that we'd fail to get any to day 5, but as they told us it's not really worth freezing 2 I'm still confused.

Apparently our 4 embryos were between 2 and 4 cells yesterday (not all at 4 as I first thought) and today we had 1 at 6 cells and the others at 4 but all were grade 4 and all had divided since yesterday. We had the 6 cell and the best 4 transferred this morning.

I'm not sure what they're doing with the remaining 2 embryos as in the excitement I forgot to ask!

My clinic have the largest blastocyst programme in the uk (allegedly) and are 5th in the country for success rates despite having 15% of patients over 38, so they are quite experienced. The only reason I can think of for their reluctance is that they recently took on a new embryologist as their old one returned to her home country of Crete, but the new one is from The Lister in London, so I would expect that she is quite experienced.

Regarding your query about the number of embryos, we donated eggs and our clinic's policy is to do half and half, with the greater number going to the egg recipient if there is an uneven number. This left us with 8 out of the original 17. Not sure why the fertilisation rate was low - all 8 fertilised but 4 were abnormal. This is similar to last time when out of 18 eggs we had 11 good quality embryos.

What in your opinion should our next step be? 

Many thanks again.

Trish


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## Mummytoone

Trish

For your interest, I go to The Lister and they have only just started doing blastocyst transfer in the last 6 months so they are actualy very inexperienced at the moment.

i am feeling abit like a guinea pig there!!!

Good luck

Love Lou xxx


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## Trishs1970

Oh my God, that would suggest to me that the embryologist was a bit worried about going to blastocyst if she isn't experienced at it. I hope they haven't ruined our chances because of this 

Thanks for the info Lou  

Trish x


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## peter

Trishs1970 said:


> Hi again Peter,
> 
> Thanks for the reply. We were unable to get the clinic to agree to sequential transfer as they stated that there was too much of a risk that we'd fail to get any to day 5, but as they told us it's not really worth freezing 2 I'm still confused.
> 
> They sound scared to me!
> 
> Apparently our 4 embryos were between 2 and 4 cells yesterday (not all at 4 as I first thought) and today we had 1 at 6 cells and the others at 4 but all were grade 4 and all had divided since yesterday. We had the 6 cell and the best 4 transferred this morning.
> 
> That's good, good luck!
> 
> I'm not sure what they're doing with the remaining 2 embryos as in the excitement I forgot to ask!
> 
> Probably dumping them!
> 
> My clinic have the largest blastocyst programme in the uk (allegedly) and are 5th in the country for success rates despite having 15% of patients over 38, so they are quite experienced. The only reason I can think of for their reluctance is that they recently took on a new embryologist as their old one returned to her home country of Crete, but the new one is from The Lister in London, so I would expect that she is quite experienced.
> 
> I know the peopleinvolved and they are both experienced.
> 
> Regarding your query about the number of embryos, we donated eggs and our clinic's policy is to do half and half, with the greater number going to the egg recipient if there is an uneven number. This left us with 8 out of the original 17. Not sure why the fertilisation rate was low - all 8 fertilised but 4 were abnormal.
> 
> Probably fertilised by more than one sperm although this is also very high incidence of this if that was the case. You ought to quiz them about this.
> 
> This is similar to last time when out of 18 eggs we had 11 good quality embryos.
> 
> What in your opinion should our next step be?
> 
> Quiz them some more and if this cycle does not work or if you are not satisfied change clinics.
> 
> Good luck!
> 
> Peter
> Many thanks again.
> 
> Trish


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## peter

Lou said:


> Trish
> 
> For your interest, I go to The Lister and they have only just started doing blastocyst transfer in the last 6 months so they are actualy very inexperienced at the moment.
> 
> i am feeling abit like a guinea pig there!!!
> 
> Good luck
> 
> Love Lou xxx


There you go then! Only use blastocsyt culture if the clinic has a proven track record with the technique,otherwise they are practising on you!!

Peter


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## peter

Trishs1970 said:


> Oh my God, that would suggest to me that the embryologist was a bit worried about going to blastocyst if she isn't experienced at it. I hope they haven't ruined our chances because of this
> 
> Thanks for the info Lou
> 
> Trish x


You still stand a good chance of success but don't go down this path again unless you change clinics.

Goodluck!

Peter


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## Trishs1970

Hi Peter,

Sorry to be a pest but I have the latest installment!

As my clinic (Essex Fertility Centre, byt the way) had not told me what happened to our remaining 2 embryos, I rang today to ask. Karen, the embryologist, said that they had been discarded as they had stopped growing, but when we had our transfer on Saturday she told us that all 4 were at grade 4 and all had divided since the day before! Is it common for grade 4 embryos to just arrest development all of a sudden?

Does this mean that they watched them following transfer of the other 2 and they stopped growing, or would they have discarded them when they did the transfer?

Sorry to ask, but she seemed reluctant to provide much info. (Our experience was much different last time with Corinna, who kept us really well informed).

Unfortunately our consultant went on holiday on Friday so I'm not able to contact him for further information.

Many thanks for your help.

Trish


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## Barnstormer

Hi Trish,

Sorry to hear about everything that has happened to you recently.

I also go to the Essex Fertility Centre, and I wonder if it would help if you spoke to Andy Glew there who is the senior clinical embryologist and has been since the clinic opened - he is definitely experienced with blastocyst culture and has always been willing to chat to us and answer any questions regarding our embryos. 

If you want to IM me regarding the clinic or anything else please do.

Good luck with the ones they have transferred


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## peter

Trishs1970 said:


> Hi Peter,
> 
> Sorry to be a pest but I have the latest installment!
> 
> As my clinic (Essex Fertility Centre, byt the way) had not told me what happened to our remaining 2 embryos, I rang today to ask. Karen, the embryologist, said that they had been discarded as they had stopped growing, but when we had our transfer on Saturday she told us that all 4 were at grade 4 and all had divided since the day before! Is it common for grade 4 embryos to just arrest development all of a sudden?
> 
> Does this mean that they watched them following transfer of the other 2 and they stopped growing, or would they have discarded them when they did the transfer?
> 
> Sorry to ask, but she seemed reluctant to provide much info. (Our experience was much different last time with Corinna, who kept us really well informed).
> 
> Unfortunately our consultant went on holiday on Friday so I'm not able to contact him for further information.
> 
> Many thanks for your help.
> 
> Trish


This sounds like a bit of a confused mess. I would get an appointment to see the director or person responsible in the clinic and ask for a clear explanation of waht went on.

Good luck!

Peter


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