Freeze All Cycle or PGD on Day 3 ***bfp mentioned***

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• AlohaKumu member

  December 2017 Answer ✓

  Many clinics are doing frozen transfers now (ours requires it) because some of the most recent literature suggests your body is “rested” from the treatments and tends to do better. Also, day 5 embryos have a much better chance of making it than day 3. (Are you doing PGD or PGS?)
  
  Money wouldn’t be a factor for me in this case. I would go with the day 5 tested embryos, even if it meant doing a FET. If I’m going to spend the money, I want the best chance of success! But this is definitely a major personal decision and I realize that money is an extremely important factor, too. 

  Me: 35 DH: 28
  TTC since June 2016
  Azoospermia diagnosis (zero count) Dec 2016
  AZFc chromosome microdeletion discovery March 2017
  Unsuccessful TESE for DH in August 2017
  October 2017 IVF with donor sperm
  29R, 24M, 16F, 2d5, 4d6 (6 embryos total)
  Only 3 could have PGS. 2/3 normal. 5 embies frozen
  12/15/17 FET #1 (1 embryo)--CP
  2/7/17 FET #2 (2 embryos)--BFN
  Chronic endometritis diagnosis May 2018
  ERA Sept 2018--borderline receptive--12 more hours of progesterone
  Abnormal SIS Oct 2018
  Repeat hysteroscopy Nov 1. Treated recurring endometritis.
  12/4/18 FET #3 (2 embryos)--BFN
  Our journey has come to an end.
  

  ~*~*~Nevertheless, she persisted~*~*~
  

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• [Deleted User] member

  December 2017 Answer ✓

  My clinic doesn't do fresh transfers unless a patient's insurance mandates it.  I have only ever heard of them doing what your doctor mentioned, testing on day 5 and freezing for FET.

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• J1006 member

  December 2017 Answer ✓

  My clinic also only does FET unless there is a solid reason to do a fresh transfer. FET with PGS testing at day 5 is the normal protocol at my clinic.
  
  This is my thought about him telling you you would be saving money. If you test 10 embryos at day 3 you wouldn’t do a transfer with all 10. You would eventually have to do a FET. My clinic typically transfers 1 so looking at your math if you tested 10 embryos at $2500 and did a fresh transfer that failed you would then pay an additional $1730 for an FET to transfer one of your other embryos. Maybe that is his thinking?

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• emmasemm member

  December 2017 Answer ✓

  The current recommendation to be able to run NGS (the latest version of PGS) is to use day 5 embryos - or embryos which have reached the blastocyst stage. The rationale is 2fold. One from a blast they only take cells from the traphectoderm which means the cells which would form a baby later are not affected in any way. If you sample on day 3 from an 8cell, you don’t know if the cell would have gone on to form the traphectoderm or the fetus itself. So at day 3 there is a greater risk of the testing making the embryo non viable. The second reason is that at day 5 they can take more cells and I believe compare around 2 million base pairs to see if they are in the right ratio to suggest normal chromosomal makeup.
  
  For PGD the rationale is similar, but not quite the same as the probes are designed to look for specific groupings of base pairs which represent a specific gene or genes.
  
  Testing for PGS/PGD on day 3 was standard practice some years ago before the culture medium was improved to secure the growth of more embryos to day 5.
  
  There was a really useful podcast on “creating a family” recently regarding PGS and PGD Testing.  If you go on iTunes and search Creating a family or the titles I would recommend are “Interpreting results of genetic testing on embryos” and “what preimplantation and prenatal genetic testing can and can’t tell us”.

  Me 43 DH 45
  Married 12/2016
  TTC #1 since 04/2015
  AMA, DOR (AMH 0.65, AFC 2-4) and autoimmune issues (RA, APS), low TSH, adenomyosis
  7 retrievals, 3 transfers
  

  Jun19 FET BFP, due date 7th March 2020, DD born Feb20

  Sep17 IVF1 - 1ER, 1F, 1ET, BFN
  Nov17 IVF2 - 1ER, 0F
  Jan18 IVF3 - 3ER, 1F, 1ET, BFN
  Feb18 - second opinion and additional testing
  Apr18 IVF4 - cancelled (E2 too high)
  May/Jun18 IVF4 - 4ER, 0M, 1F, 1 frozen day 3 (not best quality)
  Jun/Jul18 IVF5 - 5 ER, 3M, 2F, 2 frozen day 3 (not best quality)
  Jul/Aug18 IVF6 - 4ER, 3M, 2F, 2 frozen day 3 (good quality)
  Aug/Sep18 IVF7 - cancelled (cyst)
  Sep/Oct18 IVF7 - 3ER, 3M, 2F, 2 frozen Day 3 (excellent quality)
  Oct18 IVF8 - Cancelled (cyst and too low TSH)
  Oct18-Jan19 bringing TSH under control
  Feb19 ERA and hysteroscopy
  Mar19 Investigation for fibroid and adenomyosis
  Apr19 adenomyosis confirmed, polyps removed
  Jun19 FET after 2 months Lupron, autoimmune protocol, transferred two day 3 frozen embryos

  Sep17 - Pergoveris 10-17 Sep, Orgalutran 15-18 Sep, Ovitrelle 18 Sep, ER 20 Sep for 2 follies, 1 mature egg, fertilized, ET 1x 2d 4-cell embryo 22/09, 05/10 BFN
  Nov17 IVF2 - Pergoveris 2-14 Nov, Orgalutran 5-14 Nov, Ovitrelle 15 Nov, ER 17 Nov for 3 follies, 1 mature egg, did not fertilize
  Jan18 IVF3 - Pergoveris 30 Dec - 8 Jan, Orgalutran 5-8 Jan, Ovitrelle 9 Jan, ER 11 Jan 3 eggs, 2 mature, 1 fertilized, ET 1x 4d 12-cell embryo 15/01, 24/01 BFN
  May/Jun18 IVF4 - Rekovelle 25-29 May, Menogon 30May - 2Jun, Zomacton 25 27 29 31 May and 2Jun, Cetrotide 30May - 3Jun, Gonasi 3Jun, ER 5Jun 4 eggs, none mature, two matured overnight, 1 fertilized with ICSI, Frozen day 3 but not good quality
  Jun/Jul18 IVF5 - Rekovelle 21-24 June, Menogon 25Jun-3Jul, Puregon 4-5Jul, Zomacton 21 23 25 27 29 Jun, Cetrotide 25Jun-5Jul, Gonasi 6Jul, ER 8Jul 5 eggs, 3 mature, 2 fertilized with ICSI, 2 frozen day 3 but not good quality
  Jul/Aug18 IVF6 - Rekovelle 26-29 Jul, Menogon 30Jul-7Aug, Buserelin 26Jul-7Aug, Zomacton 26 28 30 Jul 1 3 Aug, Gonasi 7Aug, ER 9Aug 4 eggs, 3 mature, 2 fertilized (normal IVF), 2 frozen day 3 good quality
  Sep/Oct18 IVF7 - Menogon 19-30Sep, Buserelin 19-30Sep, Zomacton 19 21 23 25 27 Sep, Ovitrelle 1 Oct, ER 3 eggs, 3 mature, 2 fertilized with ICSI, 2 frozen day 3 excellent quality 

  Fav Quote: The greatest thing you'll ever learn is just to love and be loved in return

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• lablover78 member

  December 2017 Answer ✓

  I was also told this week by my RE that he no longer does fresh transfers for the reason mentioned above- that it allows your body to rest and be in a better position when the transfer is done.
  
  With women men like me he also does some type of clean-up regarding possible bacteria they are finding in the uterus in between ER and FET that is a combo of antibiotics/procedure/copper IUD- although this protocol is brand new since the summer (which is why he’s allowed me to do an IVF cycle now).

  TTC since May 2013

  Mild PCOS, Compound Heterozygous MTHFR
  No Folic acid/pharmaceuticals/supplements (too many to list- private message me if interested), IVIL infusion
  

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