1st FET- Being Evasive about Embryo Grading (Pics)- makes me nervous — The Bump
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1st FET- Being Evasive about Embryo Grading (Pics)- makes me nervous

edited March 2014 in Infertility

Hello,

I'm new here, I had my first IVF cancelled last month due to risk of OHSS, I just did my first FET this past Saturday with one 5 day blastocyst transferred. Before the Embryo transfer, they showed me a picture on a screen as well as printed me a photo. When I asked my gyno about grading, he was very evasive about it, pretty much said something along the lines of "Grading is various to different places and aren't reliable, so therefore we don't grade them"-, this approach made me even more nervous- I mean, it makes me wonder what aren't they telling me? You know? So I then asked the embryologist about it and she just said= "It looks good and it's doing what it's suppose to do" and nothing else. Nothing about fragmentation, development. Nothing about anything. Curiously vague. I just want to know SOMETHING, I mean the entire process is already mysterious and doubt ridden anyway.

Okay, so since I didn't get any answers; I did my own research.... (din.. din.. diiiinnnn) I took the photo they gave me of my embryo and compared it to high grading and low graded blastocysts. Guess what? They don't look like any other blastocyst anywhere! Are they even blastocysts??!  Booth poor and high quality blastocyts have a cell mass that takes up the entire "circle"- but mine is a floating mass of cells in the middle? Does it seem highly fragmented to you as well?

I have been given two picture of the same single blastocyst that was transferred. Anyone with a bit of knowledge, please let me know exactly what you think.imageimage  I am aware that grading doesn't mean everything, but I still would like to know anyways?


Re: 1st FET- Being Evasive about Embryo Grading (Pics)- makes me nervous

  • edited March 2014
    PS Bad news is welcome! I am not that sensitive.... I prefer the truth!
  • I have to be honest in that I have no clue if your pic is good or bad. It doesn't look like mine looked like, but that's not saying much since mine didn't do anything once they were transferred! However, with an FET, the expanding process takes awhile. Perhaps these aren't expanded yet?

    For our fresh vs fet, the pics looked completely different and the embryos were all graded the same. So, I wonder if that's what you're seeing here??

    This being said, I would be very concerned about an office who is giving you vague info. If you aren't feeling comfortable with what you are being told, go with your gut. Keep questioning them! This is your body, your money, and your dreams. You deserve to know more. I'd call in the morning and ask more questions until you are comfortable with the answers you are getting. If they don't grade, I'd ask why. Yes, the grade isn't everything, but it would tell them something. For instance, if you continued to create poor quality embryos, depending on the day they started to look poor, they could point to if it is an egg vs. sperm issue, sometimes.

    Best of luck and I hope none of this matters and your embryo is busy snuggling in as I type this!!

    BabyFruit Ticker

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  • pblgepblge
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    I have extremely little knowledge, but I'm wondering if these are closer to morulas (morulae?) that full blastocysts. Google some images of morulae and youll see that they don't fill the....whatever the hell the outer circle is...completely, either.
    http://www.embryology.ch/anglais/evorimplantation/furchung01.html

    I'm really not sure the grading means all that much, either.
    **********************siggy/ticker warning**********************

    ***Losses mentioned.*** TTC #1 since May 2012. Me: 37, OH: 41. Ectopic August 2012 => tubal damage. :'(  Stage 1 endo removed June 2013. IVF #1 Oct/Nov 2013: Long Lupron with Gonal-F. 7R, 7M, 7F. 2 [email protected] Nothing frozen.  => M/C @ 8 wks. :'( Selected RPL panel all normal. Very hyper and brittle response to stims. IVF #2 (antagonist protocol) Feb 2014 => Converted to IUI (Perfect conditions). BFN. IVF #2.1 w/ new RE June 2014: Antagonist protocol. 33R, 31M, 30F, 19 blasts to test!!! I made it through without crashing!! :) Hats off to Dr. Fancypants!! ET of one 5AB blast. BFN. 13 10 CCS'ed snowflakes! FET #1 PUPO as of 7/29 Betas: 8/[email protected], 8/[email protected], 8/[email protected] (etc.) Two sacs on 8/15, one seen on 8/18 after a bleed. U/s 8/25 (6+3) "perfect": 5.9 mm + [email protected]! U/s 9/4 (7+6): 15.9 mm + [email protected] bpm! Please, PLEASE stick this time!!!!
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  • edited March 2014

    Thanks for your responses! I was also thinking this mustn't be a picture of a blastocyst, but some other stage.

    I am also annoyed that they were so vague, seeing that they aren't protecting me from anything; the less I know the worse it seems for me, maybe not others. Not having them even roughly grade them is worse them being told they are low quality. I mean, it's expensive and I don't want to be felt like I'm having the cotton wool pulled over my eyes. It's playing on my mind.

    Worse thing is feeling like your being a pain for being curious about the science behind it, that's what it felt like when I was asking about the grading. Has anyone else felt like that? That if you question or press an issue of what they are telling you- that they will do a sloppier-quick job because you annoyed them and they want you out of their fast? Lol, that's what I fear happening. That's why I don't want to press the issue too much now, it's been done.

    :(


    I'm still open to any other opinions about this.

  • SKLHSKLH
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    I'm sorry they were so evasive with you. What I WILL say is that I've had embryo transfers at 2 different clinics and I've seen how both clinics handle transfers very differently!

     

    1st clinic: I sat down with RE for 20 mins before ET and we discussed the chances/odds we had... he told us the "grade" of our embryos, etc.

     

    2nd clinic: I arrived and went back to the area where they do the transfers. About 15 mins later the emrbyologist came and brough pics of my emrbyos and explained to me how they were doing etc. but no grading at all. She was more than willing to answer any questions I had, etc. One of them looked alittle different than the other and she told me it was b/c it was a "early" blast and the other was expanded... But still not dicussion of "grade"

     

    IMO: I'd prefer not having the grade. I feel like at my first clinic they ALWAYS told me the grade (2 transfers) and I honestly always had good embryos so my hopes were SO built up and when they didn't work I was totally devestated. I also felt better at the second clinic b/c they didn't really bias me one way or the other so the entire 2ww i felt like I had a pretty fair shot but wasn't overly confident (b/c I had such a awesome "graded" embryo) and wasn't disappointed with a negative feeling (b/c my embryos weren't of the "best" quality). Truthfully, I still get pissed when I think about how much false hope my first clinic gave me. They SWORE my emrbyos were "first round" quality and I"d be pregnant in a few days. I'm on my 4th transfer this week!! lol

     

    Hang in there! If it makes you feel more comfortable I"d call and just ask "I wanted to just touch base and find out if my embryos were morulas or blasts when they were transferred" and go from there.

    Me (28) DH (32)  Endometriosis                                                                                   IVF  #1 (1/2013) - 17 Retrieved, 16 Mature, 14 Fertilized- 2 transferred- BFN
    FET #1 (7/2013) - 2 embryos - BFN
    FET #2 (9/2013) - 2 emrbyos - BFN
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    IVF  #2 (2/2014) - 25 Retrieved, 19 Mature, 16 Fertilized, 9 blasts.
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    FET #3 (4/2014) -1 embryo -  BFP! Beta#1: 35 Beta #2: 16 :(
    FET #4 (5/2014) -1 embryo -  BFP! Beta#1: 321!!! Beta #2: 727.9!
    6/5/2014 Heartbeat! 144bpm It's a girl!
    Due January!
     

     

  • I'm no expert about the pictures, but if they are morulas, that could explain the lack of grading. I know my RE only grades blasts.




    dx:  Unexplained IF
     TTC since May 2011, 1 year trying, and then 3 TI, 2 IUI = BFN
    IVF #1 (May 2013):  Antagonist Protocol: 
    24R, 18M, 15F w/ICSI; 5dt of 2 early blasts, no frosties = BFN
    IVF #2 (August 2013):  Lupron Stop Protocol: 
    28R, 23M, 15F w/ICSI; 5dt of 1 partially hatched blast, 7 frosties = BFP
    EDD 5/23/14, blighted ovum (6w6d), D&C (8w6d)
    FET #1 (April 2014):  transferred 2 5d blasts = BFP
    C.J. born 01/09/15


  • Maybe it's an early blast, those aren't graded. My clinic doesn't grade but they do tell you if it's a(n) early/expanding/expanded/hatching/hatched blast.
    TTC #1 since 2011 · Me (35, PCOS, AMA, abnormal eggs) and DH (47, MFI)
    2012-2013: 3 Clomid cycles, 3 IUIs, all BFNs
    IVF #1 January 2014: 14R/12M/9F 1 transferred, 3 frozen = BFN
    FET #1 March 2014: 1 transferred = BFFN · FET #2 May 2014: 2 transferred = BFFN
    IVF #2 June 2014: 24R/11M/10F 6 PGS tested: 1 normal embryo, 1 with no result
    FET #3 in March 2015: 2 transferred = BFFN
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  • I can't tell anything by looking at the pictures, but try not to worry too much (easier said than done)! Regardless of what the grading is on the embryos, they're inside you right now hopefully getting ready to implant. I've heard people transfer really low quality embryos and get pregnant. My fingers are crossed for you!
    TTC since May 2012
    Me: 32 H: 31
    DX: MFI-Very Low Count, I have Hashimotos.
    IVF prep September 2013 cancelled due to Ovarian Cyst
    IVF #1 October 2013 Antagonistic Protocol with ICSI  ER 10/31/13 (18R 16M 11F- 6 blasts to freeze)
    ET delayed due to OHSS 
    FET scheduled for July 8. Delayed due to a crazy high TSH (it had been under control for YEARS!)
    FET #1 8/5/14 sET BFN 

    All welcome!
    PurpleTulips84
  • interzoneinterzone
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    edited March 2014
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    A couple years ago I did FET for the same reason as you (OHSS) and transferred 2 blasts, graded 3BB and 4 AA. I posted the pics my RE showed me. When I saw them I thought they looked awful and was convinced that there was no hope of them sticking, but he explained that the freezing process can make them look funky and that it just takes a little time for them to 'reorganize' and look like fresh embryos again. Maybe that's part of the reason some people say it takes longer to get a BFP during FET than a fresh cycle? Best of luck!
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  • For what it's worth, my RE seemed to be kind of evasive with my embryo grades. I felt like I had to drag it out of them when we were deciding how many to transfer -- and I had a 5AA and two 5ABs!  I think RE's don't like patients to focus on a grading system. Plenty of low-quality embryos will take and sometime perfect ones will not. 

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  • edited April 2014
    interzone said:
    SAIF, CHILDREN MENTIONED





    A couple years ago I did FET for the same reason as you (OHSS) and transferred 2 blasts, graded 3BB and 4 AA. I posted the pics my RE showed me. When I saw them I thought they looked awful and was convinced that there was no hope of them sticking, but he explained that the freezing process can make them look funky and that it just takes a little time for them to 'reorganize' and look like fresh embryos again. Maybe that's part of the reason some people say it takes longer to get a BFP during FET than a fresh cycle? Best of luck!
    Thanks for the info! I asked why they didn't look like blasts and he said I should compare apples to apples- something like; that's what a blast looks like when they are frozen- they then fill back up with fluid and expand again- and I'm comparing my blasty pics to blasty's that are fresh... Something like that.

    Pretty much a blast clusters back up when they are frozen. That just makes me wonder if they took the pic too early or if they transferred it before it was fully thawed properly? I don't know, I don't feel comfortable asking anymore questions. There's nothing I can do now!

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