School me on embryo grading

jschwind22

I've tried to do some research on embryo grading, but I'm not finding anything consistent.  I'm guessing every clinic has their own protocol?  How does your clinic grade embryos?  I know my next question is very personal, but how do you decide how many embryos to transfer? Does the grade/condition of the embryo matte and if so, what condition are you looking for if you decide to just transfer one?  Thanks and I hope everyone is having a great Saturday.  

kflynn81

Yes everyone has their own protocol when it comes to grading, however, the basic idea of growth is this....a fertilized egg is one cell which should split into 2 by the first day....it should replicate itself and become 4 cells by day two and 8 cells by day three. However, that is just a jumping off point for "normal growth" since many woman are successful with less than 8cells and more than 8 cells for a 3dt it just means their embroys didn't grow "by the book" As long as the embryo is somewhat close to that pattern its considered good. 

Also there is probably going to be some fragmentation ( the cells are sort of being sloughed off)  which plays a role in the quality of the embryo. Even the great looking ones have some, but I think as long as its not more tha around 10% its not a concern. 

After the 3dt, the embryo becomes a blast and that is where I get lost because my RE's office ONLY does 3dt so I'm not sure about the A, B, C, ratings that I see often. Ask your clinic how they do it....is A the best or is A the worst? That will help you understand the quality when they tell you what you've got.

As for # to transfer...my RE specifically said only one. Her reasoning is that I have an arcuate uterus (kinda tilty hear shapey) and I have a clotting disorder. My first IVF we had a "perfect" 8cell embryo and I was happy with only transfering the one. However, my 2nd IVF we had two 5 cells and three 3 cells all with severe fragmentation. The RE that performed the ET highly recommended transferring two because of the poor quality , so that is what we did. Obviously neither worked for us, but its apparent there is a quality issue so hopefully this upcoming cycle we will have better embryos to choose from but still only putting one back.

Sorry for the essay...hope this helps

J&D2007

I agree with pp. I don't think there is a standard for grading. I asked my office what % frag, etc and they just say that they just grade with A,B,C etc. No numbers, no additional info. My RE always transfers 2, unless of course you ask for 1. She will not transfer 3.

rrdiva1

My office uses Excellent Good fair and poor method. I transferred 2 each of my cycle even with very high odds they gave me. It is a gut feeling, I figured if one didn't make it I had another one in there. This past cycle it worked, just wasn't the right embryo this time. GL hun!!!!!

ARS0805

rrdiva1:

My office uses Excellent Good fair and poor method. I transferred 2 each of my cycle even with very high odds they gave me. It is a gut feeling, I figured if one didn't make it I had another one in there. This past cycle it worked, just wasn't the right embryo this time. GL hun!!!!!

My clinic uses the same grading method.  My RE prefers to transfer one the first time, but will transfer two if it is what we want.  I go back and forth on this.  If we are lucky enough to have an Excellent blast, then I would be comfortable transfering only one.  If we do a 3dt or if we have less than Excellent blasts for a 5dt, I think we are leaning towards two.

 GL with your decision.

Sophistikitty

Morulas and blastocysts have different grading systems.  Here is a link that explains this further (my clinic uses these grading systems and I believe most large clinics do).  

 

https://www.sharedjourney.com/articles/time.html