Average number of blastocysts per IVF cycle

February 21, 201624 Comments

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….

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!!!!

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

February 16, 201626 Comments

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

IVF Diary Vol II: 29-30 Jan 16

January 30, 201626 Comments

Medication(s) administered and dosage(s). Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2. Remember I was taking baby steps with self injecting the progesterone? Well, I have not progressed any further, in fact I probably regressed. I am really struggling to pull back the needle to check for blood and keeping the needle still, then I freak out when the needle is moving around in my butt!!! I have yet to take the plunge with putting the needle in myself. I am feeling pretty miserable with my lack of progress. I’m not going to give up, but I’m feeling frustrated at myself.

Medical procedures undertaken. 5 Day Embryo Transfer! Our transfer was scheduled for 7AM on Saturday, so we were up super early again. I learned my lesson from last time around. No tea before the procedure. Usually I am a real grump without my morning cup of tea, but as tea is a diuretic I decided to avoid it this time. I also didn’t drink anything until I arrived at the clinic. For our first IVF cycle, in addition to tea, I also drank 3/4 of the recommended water to take 30 minutes before the procedure (24oz) and I was painfully busting to go to the toilet. So, now knowing my bladder size a bit better, I decided to drink just a third of the 24oz recommended water (and no tea). I was a little nervous it wouldn’t be enough, but the ultrasound clearly showed my uterus (Dr also commented on the severity of my retroverted uterus as if it was a surprise!).

As I got onto the table ready for the transfer procedure the Doctor gave us a run down on the status of our 11 embryos. This time, she showed us the report (last time the Dr just told us we had 2 eight cell embies). We had not been given an update since the fertilisation report so I was very nervous!!! Amazingly, all 11 embryos were still alive. We had three blastocysts, graded 5BB, 5BB and 5CC. The other 8 embryos were still only 9-5 cells. They were going to wait one more day to see if they would catch up. When I said ‘so this means we will have at least one to freeze?’, she didn’t seem particularly confident that we would have any. But I will remain hopeful that the rest will catch up!! We were transferring the best two blastocysts we had, and I am happy with that!

We have named our embies Petrie and Spike…can you guess why we ended up naming them this?

Introducing Petrie & Spike – our Day 5 Embryos – now on board! (We think that weird stickie looking thing is a scratch on the petri dish – that or I will be giving birth to some stick man)

The Dr prepared me for the procedure, she washed out my ‘baby house’ as she called it, then practiced inserting the catheter, everything went smoothly! Then the embryologist came to confirm my identity, he went back to the embryology lab to show on the TV screen in our room our name on the petri dish and then a zoomed in picture of our embryos. Then he came back in the room with our embryos ready to be transferred. The Dr quickly did the transfer as we watched on the ultrasound monitor the liquid with the embryos in it go up into my uterus. Chris later described it looking like a ‘shooting star’. I thought that was a lovely way to describe this! I was wheeled back to the recovery room and I had to lie down for one hour before they would let me either pee or leave!!!

What are my symptoms? I think the estrogen and progesterone are starting to kick in and I had a good old cry last night. It wasn’t helped by my failure to do my own progesterone injection.

How do I feel today? I was pretty relaxed with the whole procedure today and I am feeling positive still. Woohoo!

Any results? I am thinking of doing a home pregnancy test everyday from 7 days past the 5 day transfer – last time I tested the day before the beta. But this time I am thinking of testing simply in the name of science. I don’t know why, I’ll have a think about this – I’ve got a while anyway! 2 Week Wait here we come!!!

What’s next? Beta HcG test will be 13 days from now :-s

Weight. NSTR.

Waist. The Dr showed me my squished uterus today from my stimulated ovaries – there were some pretty big follicles still in there. I am not surprised I am still bloated as I am. The Dr told me to keep up the drinking to help flush them out.

Boobs. Definitely growing.

~~Hours of Sunshine 🙂~~ Deleted from my diary…what’s the point? The one sunny day at a weekend – I am on enforced bed rest!!!

*Notes. I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily. NSTR = Nothing Significant To Report.

When to transfer? The pros and cons

August 5, 20158 Comments

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