Average number of blastocysts per IVF cycle

It’s a really simple question – what is the average number of blastocysts per IVF cycle?  After our failed IVF cycle I posted a status update in my local resolve support group’s facebook page, I explained what had happened with our cycle: 14 eggs retrieved, 11 mature, 11 fertilised, 2x 5 Day blastocysts transferred (5BB & 5CC) on Day 5, 9 still alive on day 5, but 0 were of sufficient quality for cryopreservation.   Some ladies commented how they had similar results with 0 embryos making it to the freezer, and one lady posed the very good question how common is it to have 0 make it to the freezer? Perhaps it is more common than we think?  So it got me thinking…at no point has my doctor said what a typical number of eggs, embryos or blastocysts she would expect out of a cycle for us – the only stats we were ever told was all about our likelihood of a successful pregnancy from 1 cycle of IVF, and ultimately, a live birth.  And of course, that is the only statistic we only really care about, right?  This holds true, until you get a Big Fat Negative (BFN), then the other statistics start to matter and grind at you.

So I looked into it, and asked google – what is the average number of blastocysts per IVF cycle?  But I couldn’t find an easy answer, or at least one that I held great confidence in.  I’m the kind of person who needs to see the supporting evidence, and not just some seemingly arbitrary numbers some random person has posted on a website.  But although I didn’t find any national statistics per se, what I did find, made me feel a whole lot better about our last cycle.

The statistics that the Pacific Fertility Center in Canada are claiming are [1]:

11 – Average number of eggs retrieved

9 – Average number of mature eggs

7 – Average number of eggs that fertilise (approximately 80%)

7 – Average number of fertilised eggs that will form embryos (98%)

7 – Average number of embryos on Day 3 of culture

3.5 – Average number of blastocycts on Day 5/6 (50% of good quality day 3 embryos make it to blastocyst)

It was not clear if this was their clinic’s statistics or where the source of this data came from.  So my confidence is not high in it, I don’t know over how many cycles or patients this average is calculated.  But at least it gives you a flavour of what numbers to expect.  Note, it does not mention average number of blastocysts making it to cryopreservation!

Another clinic, Advanced Fertility Center of Chicago, provides a nice pretty chart of their own statistics, broken down by age for the period of 2003-2005.  First of all my first alarm bell is that is over 10 years old now!  Has anything changed in Assisted Reproductive Technologies in the last 10 years? Hmmmmm.  Anyway, here it is….

ivf-eggs-embryos-babies

Advanced Fertility Center of Chicago’s average number of eggs, mature eggs, fertilised eggs, 8 cell embryos and Day 5 blasts [2]

Their numbers are slightly lower than the Canadian clinic’s…but there could be many reasons for this because, again, there is no clue as to how many cycles/patients this average is calculated over.  This clinic does publish their statistic of how many blastocysts make it to cryopreservation.  And here is the money shot statistic people!!!!

number-embryos-frozen-age

Advanced Fertility Center of Chicago’s average number of blastocysts frozen per cycle in 2010-2011 [3]

Just look at how low these numbers are! An average of 1.7 for women younger than 35 years old.  And this statistic is a little bit more up to date than the ones above – this was for cycles from 2010-2011.

So what is the point of this post?  The point is that we didn’t have any blastocysts that made it to cryopreservation, but we did have 2 blasts that were transferred and 1 that could have been frozen, but they decided it might not survive the thaw.  For our first cycle we had one blast make it to the freezer.  The point is, we had high expectations for more to make it to the freezer, when in actual fact the reality is, we were better than average to have so many good Day 3 embryos and we were typically average with transferring 2 on Day 5. Yes, IVF cycle 2 was a failure, but we were pretty average with our second cycle!!! This doesn’t mean we are less likely to succeed with cycle 3, rather the odds ARE in our favour.

Happy dance Dani!!!

stay the path

[1] Source: http://www.pacificfertility.ca/our-resources/guide-to-ivf-lab-results/

[2] Source: http://www.advancedfertility.com/ivf.htm

[3] Source: http://www.advancedfertility.com/cryo.htm

 

 

Good plan batman

First of all, let me say a big thank you to everyone who showed us support by commenting on my last update.  It has been a really difficult weekend.  Full of emotional roller coasters.  Chris and I have been brought to the edge with our sadness and confusion about our second failed IVF cycle.  I couldn’t reply to your comments without crying.  I am sure some of you who have been there have felt that overwhelmingness.  I read each and everyone one and they mean a lot, so thank you for your support.

Today we had our follow up appointment.  Chris and I prepared for the meeting the only way we know best….by making a list.  We wrote a list of all possible scenarios for ways ahead on this pudding club hunt.  And then we individually wrote down what we felt about each scenario and exchanged our thoughts.  We discussed where there were differences.  It was difficult and emotional to do as we realised that we agree in some situations, but not in others.  It’s OK at this stage that we don’t agree or have the same point of view, but it was bloody hard and we had some very raw and honest conversations.  We used up a few boxes of tissues 🙂  But what was good about this exercise is that we were ready to come to this follow up appointment prepared for whatever the doctor was going to suggest doing next.

When my doctor spoke to me on the phone to tell me the bad news that our IVF cycle had failed she mentioned poor egg quality, I took away bad things from this when I needn’t have.  This was just my doctor’s first impressions report, she hadn’t really looked into my case in detail or reviewed my history.  But this is what she did at today’s appointment.

Our doctor was very positive and believes that our best chance is to try again.  We expected that, but she ruled out egg or embryo donation for us or the necessity for genetic testing.  Our chances are still high more than 50% success.  We will make a couple of minor adaptations to our next cycle with my medication protocol by switching from antagonist protocol to Lupron (Down regulation) protocol.  I am a good responder to stimulation so she believes this may help improve the egg quality.  We will also carefully review our Day 3 v Day 5 transfer options at the time.  I had some excellent Day 3 embryos this time around, similar to my first cycle when I got my positive.  May be my embryos don’t do as well in the culture afterwards.

But before we go into another round of IVF, I need to have a hysteroscopy.  This is a small surgical procedure where the doctor inserts a camera through my cervix to look at my uterus and fallopian tube opening closely to check for any potential damage from my suspected ectopic pregnancy, scarring or inflammation as well as checking for endometriosis and taking a small biopsy for further testing.  So I am scheduled for my procedure in two weeks time!

We have a plan we are both happy with.  I felt a huge relief off my shoulders because our doctor was genuinely positive for our next round of IVF – and we pushed her about it too (well Chris did!!) – there was no BS-ing!   So all things going well after the hysteroscopy, we are looking at an April IVF/ICSI Cycle:-)

Thank you all for sticking with us through this, it has been hard, but you make it all the better!!  XXX

butterfly

When to transfer? The pros and cons

Last update I had on the development of our embryos was Wednesday morning (Day 1)…we had 4 fertilised eggs.  Today (Day 2) we do not know what has happened to them.  Tomorrow (Day 3) at 7AM we are going in to potentially have a day 3 embryo transfer.  So we have been debating about our decision to do a day 3 or a day 5 transfer.  Without any knowledge of the status of our embryos everything is rather circumspect.  So we discussed the pros and cons of each scenario*.

Day 3 Pros

  • Good chance of actually having a transfer!
  • Maybe the embryos will be better off developing inside me.
  • Freezing on day 3 means we have more embryos to freeze.

Day 5 Pros

  • You get to transfer the best embryos
  • Physiological conditions – embryos (blastocysts) would normally be in the uterus at the stage – so they are in the right place!
  • Reduces the chance of multiples
  • If the embryos don’t make it to day 5, then there isn’t a 2 week wait to find out and therefore less medication.
  • good quality embryos (blastocysts) frozen.
  • Better chances body has recovered from egg retrieval.

Day 3 cons

  • A greater chance of multiples
  • Embryos normally would be in the fallopian tube on this day
  • Poorer quality embryos may be frozen
  • Lower quality or ‘wrong’ embryos may be transferred
  • Body not fully recovered from egg retrieval procedure  – I am actually still massively bloated, my abdomen is sore and hard, walking is still not my greatest past time at the moment, I still have constipation and I am still bleeding a little bit (Initially thought I was peeing blood today!).

Day 5 cons

  • Embryos may not grow to blastocyst (usually due to abnormal genetics – although isn’t this a good thing?)
  • There is a risk of no transfer at all (crazy emotions could be a point here)
  • Potentially less embryos to freeze
  • May loose some embryos that would have grown inside the body

After our discussions we both believed that we would probably want to wait to transfer to day 5, but we will wait to see what the doctor suggests.  I feel like we will have to make a decision on the spot which is a bit scary.  And it is both of our decisions, not just mine and not just Chris’s either :-s Eeeek, I’m nervous!!!

*This list was mostly adapted from the book: IVF: A Patient’s Guide by Rebecca Matthews

IVF a patient's guide