Clinic with a great lab- what does that really mean?

reb259 · July 2011

I had my 2nd opinion yesterday...came away even more confused. Indifferent

Ok so a quick background...

2 failed IVF's (1 cp)- 8 eggs each time, 8 and 6 fertilized, 3dt both times. First time the 3 we transferred back were not good quality 30% frag. Second cycle I took a steroid and they had 0 frag and perfect 8 cell, we also did AH and embryo glue.

So here is my question... why does it matter how good the lab is if I am getting a good fert rate? Niether of us have any genetic/chromosome issues and we don't do ICSI. I am torn whether to go with this new RE who will be like 6K more (we are OOP) or stick with my current. I have another follow up with my current RE next week.

Any suggestions? Many thanks!

NMscubagirl · July 2011

I don't really know a whole lot about all of this, but I think I would go to the new RE in your situation. GL!

bmxxtease · July 2011

I would definitely wait until after the consult with RE #1. Although you haven't gotten your BFP, you are getting better results. See what they have to see about why the embryos didn't implant and what they are going to do differently this time. We are OOP as well as that 6K more scares me just because they have a great lab. Did they say what kind of protocol or meds they would put you on so that you can compare to your first RE? Is there a possibility of an RE #3? Good luck with the decision!

elisem42 · July 2011

they say some practices have better labs than others....and that the embryos develop better in the "media" of certain labs. do you know the live birth SART rates for your clinic? keep in mind however, some GREAT clinics have lower live birth rates bc they just take on harder cases....

i would ask on your local board where people feel they have had the most success. 6 K is A LOT and you don't want to switch practices if you are going to end up w/ the same result....you can also consult with RE # 2 and just get an idea of what they would do differently from re # 1 and see where you feel most comfortable...if you really feel that place # 2 has better stats and you feel comfortable there maybe tell them that you are considering a switch however the finances are a struggle....some places will work with you!

best of luck!!!

reb259 · July 2011

RE #2 said he would do the same protocol as my last cycle (micro-dose and steroid) as it seemed to be good results...except of course the BPN. He is running a bunch of blood tests, had to give literally 12 vials of blood yesterday.

I guess I will have to wait for my next appt with RE 1 to make a decision. This is our last cycle so we are going everything at it (that makes sense) but I agree I am not sure that an extra 6K is it without some really good answers.

naybird · July 2011

YES!!! It absolutley matters how good the lab is. Go with the better lab!

I'm in almost the same situation. My new RE told me, as a DR she can only do so much and after that, it's up to the lab. If the embryos aren't being correctly handled, they can die. Which, could be what was happening after transfer. I also was getting great fert. reports but zero implantation.

She gave me a lot to think about and also gave me hope that my next cycle would work. She basically told me that the old RE's lab was not the best around, and that was probabally the biggest obstacle standing in my way.

My new RE uses the RSC lab in San Ramon, and they have great numbers.

I'm about to leave the house, but I had to say, go to a consult with the new RE with the better lab. Just talk to them and hear what they have to say. You can pm me if you want, there's a lot more to my story!!

But definatley go with the better lab!!! Good luck, darlin!!! Big hugs!!

blueberries8 · July 2011

I think the lab actually matters a lot, even if you are getting a decent fertilization rate everywhere you go. I think one good sign of an excellent lab is the ability and willingness to regularly do day 5 transfers (I am not saying that day 5 transfers are the end-all and be-all and there are many cases where a day 5 transfer is probably not the best choice, but my current lab's resistance to day 5 transfer in general was a red flag to me that the lab might not be up to par).

Also, if you would like to freeze any extra embryos and do FETs, the lab becomes very important, because using dated freezing/thawing techniques can have a big impact on the ability of your embryos to survive thawing well (vitrification, which was introduced in the past few years, has improved the success rates for FETs a lot). I am actually planning on changing clinics if we do another fresh cycle based mainly on my misgivings about the lab at our current clinic.

reb259 · July 2011

Thanks for the responses... Since I don't get a large number of eggs we have always done a 3dt. My current RE is willing to do 5DT but with the low number, I have always opted to do a 3dt. I have always heard better in you than in the lab.

Kitttkattt · July 2011

The best embryo can die if not in the proper lab. The new thing right now is air purification system built into the lab,vitrification for freezing which makes sure almost all embryos survive the thaw and going to blast like some one else said. If the clinic has the same success rates as everybody else, then they have a good lab most likely.Look at the donor egg success rates. If they don't have the same success rate as other clinics with donor eggs,that's very telling. They are letting good embryos die due to the lab and/or embryologist.

heathergirl67 · July 2011

reb259:
Thanks for the responses... Since I don't get a large number of eggs we have always done a 3dt. My current RE is willing to do 5DT but with the low number, I have always opted to do a 3dt. I have always heard better in you than in the lab.

I know very little about this, so forgive my ignorance, but wouldn't a 5dt give a clearer picture of which embryo's are the strongest? Like, maybe some that looked good at 3 days have kinda stopped growing, whereas others have progressed so you know that they're stronger. Whereas if you were choosing based on their appearance at day 3 they'd look the same?

elisem42 · July 2011

heathergirl67:
reb259:
Thanks for the responses... Since I don't get a large number of eggs we have always done a 3dt. My current RE is willing to do 5DT but with the low number, I have always opted to do a 3dt. I have always heard better in you than in the lab.

I know very little about this, so forgive my ignorance, but wouldn't a 5dt give a clearer picture of which embryo's are the strongest? Like, maybe some that looked good at 3 days have kinda stopped growing, whereas others have progressed so you know that they're stronger. Whereas if you were choosing based on their appearance at day 3 they'd look the same?

my clinic has switched to the only 5 day transfer mode for this reason...they think if it won't make it in their lab to day 5, it won't make it in your uterus...it's a contraversial school of thought but it does make sense...! too bad, my embryos at day 3 look good and all fade by day 5....that's what makes it so hard to grasp!! hence moving on to another ivf cycle...but yes, some that look good on day 3 may not be so great on day 5....!!

Mayan2011 · July 2011

naybird:

YES!!! It absolutley matters how good the lab is. Go with the better lab!

I would definitely be leaning here, especially b/c you have indicated that this is the last cycle for you and DH.

I wouldn't make any hasty decisions, go and see what RE #1 has to say. I personally would go armed with questions about the lab RE #1 uses. Did you find out why the 2nd opinion RE claims their lab is better? If so, I would ask RE #1 questions directly related to RE #2's claims that their lab is better. It will likely help you sort through the differences, if there truly are any.

If there are.... 6k in the grand scheme of things is nothing - give it all you got for your last shot!

Good luck!

Mayan2011 · July 2011

heathergirl67:

reb259:
Thanks for the responses... Since I don't get a large number of eggs we have always done a 3dt. My current RE is willing to do 5DT but with the low number, I have always opted to do a 3dt. I have always heard better in you than in the lab.

I know very little about this, so forgive my ignorance, but wouldn't a 5dt give a clearer picture of which embryo's are the strongest? Like, maybe some that looked good at 3 days have kinda stopped growing, whereas others have progressed so you know that they're stronger. Whereas if you were choosing based on their appearance at day 3 they'd look the same?

You have to be careful here. Pushing a lab that normally does 3dt to do a 5dt can be dangerous. Sometimes the staff are not experienced with this - techonology and/or methodology can be lacking. Going to 5dt is not a one-size fits all solution. It really is lab dependent.

km0426 · August 2011

On your question pertaining to the lab, several RE's and OB/Gyne's have told me that having a good lab is 90% of the battle as the expertise in the lab can really make or break a cycle... so I would go with the better lab if it is feasible to do so.

On a side note.. It seems that your cycles have progressed much like my first 2 IVFs. Things didn't really change for me until cycle 3 and since I was seeing the same RE I attribute (at least in part) the differences to the additional supplements both DH and I are taking. Although we didn't have success with IVF #3, I think we at least learned a lot about what helps us since we seemed to have somewhat better embryo quality with the third cycle. DH and I have also struggled with moving onto anther RE because of the additional costs..but after 3 failed IVFs, in the end if their success rates are better and if their expertise seems more advanced we decided it was a sacrifice we wanted to make at this point. Tough decision and I am still struggling with it.. but hoping in the end it will prove to be the best decision we ever made.

Clinic with a great lab- what does that really mean?

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