D3 vs D5 Fresh Transfer

cxsimo08

Anyone elect to do a D3 over D5 transfer? All the doctors in my area do D5 only but my last cycle we had no blasts on D5 (10 originally fertilized eggs, 5 made it to day 3-4) and I don't want that to happen again.  My doctor will consider D3 due to my prior circumstance.  Any thoughts or concerns I should be thinking about before pushing for D3 over D5? 

[Deleted User]

Not sure.  ***TW*** ivf success

<div class=" Spoiler">Completely anecdotally, my BFF did a fresh D3 transfer of her only two little starts, and one did stick from her one and only ivf cycle.</div>
In her case, no one was talking about waiting for FET in the first place, tho, but I'm not sure why that was, if it was her AMH or what

emmasemm

@cxsimo08 it's a much debated question!

For more info/evidence could check out the podcast on "creatingafamily" which talked about day3/day5/frozen and I think there is one on Beat Infertility too.

General TW for all of below I guess

My RE has said if there are lots of good quality embies on day 3, then he prefers to wait for day 5 - but also takes into consideration how hard and long the stims were for, and if OHSS is a risk. Also uterine lining is a key factor at play.

However if there are not so many fertilized eggs in the first place then he starts to change his decision parameters - especially if there are only 1 or 2 embies on day 2/3 then he will advise to transfer on day 3.

However he said it very much depends on the patient emotionally too - if 1-2 embies don't look so strong, irrespective of quantity, some ladies prefer to transfer them to "give them a chance" (however small), whereas others don't want to go through potentially more BFNs/CPs.

The rates for day 3 vs day 5 transfers are shown from the research not to do with the day, but more that most doctors in the last few years only transfer on day 3 when embies are perceived as lower quality, whereas the "best" ones are transferred day 5.

(And you get the same effect when you compare fresh with frozen - the longer they are cultured and the more time for testing, the more you can be sure of selecting the best embies for ET, thus increasing the success rate)

But still some of the "poor quality" day 3s go on to give healthy live births, some great quality day 5s don't. And you can't ever know if those "poor quality" day 3s that are transferred and successful would have made it to day 5 in the lab or not. So it's not an exact science.

LadyMillil

My RE prefers day 5 transfers because the clinic has a higher success rate with those, with the idea being that if an embryo survived that long in the lab it will have a better chance of a BFP. However, if you have a low number of embryos or they aren't growing well he does a day 3 transfer because the embryo might do better in the uterus than in a lab.

cxsimo08

@emmasemmThank you! That's really helpful info.  I will definitely check out the podcast you recommended today on my drive.  It's good to understand what your doctor is saying re: D3 v. D5 because my RE didn't have as much info given she doesn't do them.  That makes sense that if you didn't have many good quality embryos on D3 to transfer them and give them a shot at growing inside of you.  You mentioned he takes into account "How long the stims were for" I hadn't heard of that one before.  Is there an ideal length of time for stims? Last cycle I did 11 days worth (TS on 12), this time i'm likely 1 day longer with an Estate primer instead of BC so 12 days of stims, TS on 13.   How are you feeling with your Sept first IVF?! ~ where you are Day 8 is when I started feeling it! I hope it's going well for you!! 

@LadyMillil That's exactly what my clinic is saying as well as to why they don't do D3 transfers. I would be a major exception for them so it's a hard decision to go with my gut (and past results) and ask them to do D3 for me or follow their typical protocol.  Thanks for the response! Your gif made me LOL!!

Hopeful_mom

cxsimo08 how old are you?  Ladies that are older do have D3 transfers as our eggs like to be back in the natural spot sooner then later.   TW  on my fresh transfer D3 I had 3 embabies that cycle and they transferred all 3 but thats also cause I just turned 40 at the time.  2 stuck but I MC both at 10wks with no good reason why.  Could just be cause I was carrying twins

Its a tough decision for sure and I wish I cold to a fresh transfer now but because of my age and needing to bank embryos I have to go the FET route.  If your concerned about non making it again I would certainly try at least one to transfer and see if the others make it to day 5...u know I've heard of some people doing a double transfer...a day 3 and a day 5.  I know it sounds crazy but it has been done.

Thats my 2 cents as you've already been given some great advice above!

good luck to you!! 

cxsimo08

Thank you @hopefulmom! I turned 31 this week so for my age I guess it's less done in the area for a D3 transfer, but given the results last time I definitely want to consider it.  It's funny that you bring up D3 and D5 because I asked my doctor to do that (logically speaking it sounds like the best option because you give yourself a chance at D3 and if any make it to D5 you have that option as well) but she said that they will only do one or the other due to the strain on my body.  I'm not sure about how I feel about that answer but it definitely sounded like something they would not do.  

I'm sorry to hear about your MC, that must have been so difficult going through so much to get that news.  I've heard FET has higher success rates so fingers crossed that that will be the case for you as well! 

Hopeful_mom

cxsimo08 thanks so much I hope so!  I get your RE saying no only because I"m sure its risky.  When I heard about it I actually thought I heard wrong and asked them to go over it again.  Our RE do want to get us pregnant BUT they sometimes need to go outside of the box.  You are young which usually plays out better for you.  DO you have unexplained infertility?  I know its hard and scary BUT you are young so you can take some time and try some different things.  I don't think a day3 transfer will hurt.  I know I say these things as it did work...just not long enough...this time will be different please g-d!!

cxsimo08

@Hopeful_mom yes I'm unexplained! I had one slightly elevated FSH level the cycle after IVF ~11 and the poor IVF results above, but those are my only two "symptoms" so far.   I spoke to my doctor this AM (it's the last appointment before my retrieval tomorrow) and she's good with a D3 transfer so long as I'm not hyper-stimulated so fingers crossed! 

When is your FET?

cxsimo08

@BusinessWife I'm so sorry, I didn't see your response because I'm new to the board and didn't realize you can hide part of the message.  That's really good to hear that she had success with D3  and put all her eggs in that basket! Thats kind of the place I got to with my RE.  If I have 20 embryos or 1 little guy I'm still going to want to do a D3 transfer, because with no embryos making it to blast on D5, I would rather have them in me cooking in me at that point, then in the lab.  Retrieval was today, transfer Friday so fingers crossed I will be just like your friend! 

Hopeful_mom

cxsimo08 said:

@Hopeful_mom yes I'm unexplained! I had one slightly elevated FSH level the cycle after IVF ~11 and the poor IVF results above, but those are my only two "symptoms" so far.   I spoke to my doctor this AM (it's the last appointment before my retrieval tomorrow) and she's good with a D3 transfer so long as I'm not hyper-stimulated so fingers crossed! 

When is your FET?

I had my transfer on Monday so I really hope my bean is cooking!!

hiw did ur ER go? Hope ur feeling well! And u get a great fert report today!!!

cxsimo08

@Hopeful_mom how did your transfer go? You did D5 FET right? Thinking of you! When is your next blood work? Do you have to do progesterone shots with FET as well?

ER went well, thanks for thinking of me!!! We had 14 eggs but unfortunately not a great fert report. Only 8 we're ICSI because the other 6 were not completely mature, but they had stripped away the supporting cells so they couldn't do natural insemination on them at that point- kind of a waste. Out of the 8 ICSI, 4 fertilized and 3 made it to D3. We transferred a 7 cell and an 11 cell and are hoping that by Monday we will know if we can freeze that extra guy. The hard thing is last time my embies looked great on D3 but stopped growing D4 so just praying they are happy in their new home inside me vs. lab! FX!!! 

Hopeful_mom

ugh sorry to here more didn't make it...my RE would do 1/2 and 1/2 I think the ones they assumed were on the mature side they let fert on their own...BUT I will say in the end I don't think any of them were normal...so don't lose hope.  4 is really a great number...sometimes all I got were 4 eggs so you're still in it!!!

CONGRATS ON BEING PUPO or being PASP...I just learned that new one  Its great you got 2 transfer 2 great babies I'm feeling really exciting and hopeful!!  11cell is ahead of the game  I think your pnuts will be happy in their new home.
 Sending you extra sticky vibes!!!

AFM: i'm considered 5dpt and first my vag is bothering me from the crinone 2x a day I think i'm to sensitive to it soooo I think its PIO for me everyday now with crinone 1x a day and 2mg still of estrace.  I did crinone for my fresh transfer but I don't get what the issue is this time around.  I took a shower and just ran cold water to try and get relief.  I would like to think the pain from this is taking my mind off other symptoms i could be having!!  I was pretty nauseous this am actually and know its too soon, 6 wks to the day is when that started with twins.  I keep reminding myself its one so its ok if i'm not feeling the same things prior.  I actually thought my boobs felt a tad sore for a sec and got excited...talk about grasping at straws   
My BW came back with E2 at 617 and Prog at 8.1 so i was switching to PIO every to her day anyway.  They say these numbers mean nothing and I dont have anything else to compare it to.

For my fresh transfer I only did crinone 1x a day and estrace 1x a day of 2mg as well this time I'm on way more.  PIO I think does well for many on FET so thats why they added it for me and now that i'm having issues yet too I'll have to deal with the extra shots.