Unsuccessful 1st ICSI cycle and going for 2nd

[anonymous007]

Hi all,

Though Ivisit this forum regularly but i m posting after a long time. We just had an unsuccessful ICSI cycle. Just a day before my pregnancy test i had a little blood stain and was very worried. My doc adviced to go for the test that day only (it was already 16dpt), which turned out to be negative. It torned both of us like any thing. Today my husband just picked the embryo pics from our worship place. I just could not hold myself. My husband is still not out of it. It was like we lost our two kids. Why did this happen to us. Its just so painful. we have an appointment on tuesday to decide further move. We have 10 frozen ones. Last time we put 2 and this time i m planning for 3. Does this make any difference. I m so scared this time. Whats difference is there in chances of success in fresh one/frozen one.

One more thing, is bed rest neccessary. how much movement is ok in that period. what extra could we do to make it a success.

Baby dust to all the aspiring mothers.

[anonymous007]

I hope u didnt get my 'break' wrong. By break i mean break from treatment and not from our chat :-)

[anonymous007]

I am gonna take a break for a month. After i have period this month (around 23rd), there will be a scan on day 10 and accordingly FET will be done. I think it mgiht be in the second week of May, if every thing comes out to be fine.

[LvnEmbryos]

I know at our particular office day 3 embryos may survive the thaw but do not go on to develop as blasts in culture as well.  In fact, we do not freeze embryos on day 3 because of this.  This of course is no guarantee that they do not develop well in the uterus but our pregnancy rates were not as high with day 3 freezes.  It does vary a lot from clinic to clinic though, so I do not want to concern you.

There is a more old school mentality that just thinks embryos develop better in the uterus, and while I cannot speak for all clinics, we have pretty much shown equal pregnancy rates because you can choose better when we can see them.  But as always if you feel you can trust your RE, you should do what they say because they know your whole medical history.

Any ideas, when your FET will be?

[anonymous007]

I m sorry. Actually i didnt ask doc in specific. But if i guess from the conversation with him that it was done on day 3.

Thanks for your patience.

[LvnEmbryos]

I mean day 3 or day 5, or 2PN -- do you know?

[anonymous007]

Yes.The embryos were frozen on 13 March, 2 days after aspiration.

[LvnEmbryos]

Do you know what days your embryos were frozen on?

[anonymous007]

I was just thinking tht if my embryos can survive the thaw process, then why cant they grow to blastocyst, as you have mentioned earlier that only the best embryo can survive the thaw process. And if my doc doesnt want to go for Blastocyst transfer even then the surviving embryos have the greater chances to make it to implant inside me. Am i right in thinking so?

I know i am just asking too much, but i was trying to get something positive out of our discussion.

[LvnEmbryos]

I have never really heard of making the decision based on sperm quality.  A lot of times sperm can be the reason the embryos do not make it past day 3 (they never become blasts) but if this is the case, then they will probably not make it to blast even in the uterus.  I am not saying this is fact, your RE may just rather have them in the uterus sooner than later because that is the natural environment.  Keep the faith!!

[anonymous007]

Good luck to you too. I have finally got an apartment with lift and near to my hospital. We will be shifting next week.

Today i met my doc. I got know that out of 40 eggs 24 were mature and 14 got fertilized and only 12 could make to next level. Now i have 10 embryo with me. Out of these 2 are average and 8 are of good quality. They will grade them only whn they are thaw.

My doc adviced me to take rest for 1-2 months and then go for next trial. Even i think that way. but he also said that blastocyst transfer is not possible coz of poor sperm quality. so we have to go for embryo transfer. Could you please explain this point.

will keep on updating. Thanks for ur great and timely help.

[LvnEmbryos]

Good luck on your house hunt...I am in the same situation looking for a place.

Sometimes to ultrasound can be decieving because they only tell you how many mataure follicles you have, but when you actually go in for the retriveal they will aspirate every follicle, so the number tends to be higher, but 40...WOW that is a lot of eggs.  I am surprised you did not hyperstimulate.  Are you feeling well?

You should definitely ask how many of your eggs were mature, that would be good to know for looking at how low your fert rate was.

I am guessing they use the same scale as we do if they were a 4 and a 5 those are fantastic embryos.  If your frozen embryos are equally high quality that is fantastic news.

Keep me posted and gl 2 u.

[anonymous007]

Hi, Sorry for replying late. actually was busy in hunting house which is close to hospital and has a lift.Right now I am staying in an apartment (3rd floor) which does not have a lift. This time i just dont wanna use staircase, so will shift soon.

When i had scan two days before extraction, it was told to me that 6-7 eggs are ready to be extracted and i need one more puregon shot. After two days when i had extraction (11 March) the count came out to be 40. We got 12 embryos out of which 2 were implanted inside me on 13 March.

We didnt ask why the fertilization rate was so low and how many were inseminated. I have noted down this point now and i m gonna discuss it this tuesday. Let me tell you that one embryo transfered was grade 4 and the other was grade 5. The rest (10 embryo) they say are in very good condition. I will ask the grading definitly.

I will keep posting the progress at my end. Thanks a ton.

[LvnEmbryos]

You are so welcome, I am happy to help.  Was there any discussion of why you had such a low fertilization rate?  We are used to seeing a fertilization rate of at least 60% and usually about 80%.  Do you know how many eggs were inseminated? (in case not all of them were mature, the % isn't really out of 40).

I think you should definitely ask about the grades of your embryos.  There is a very specific grading scale for embryos and can tell you a lot about embryo quality.

The advantage of a blastocyst transfer with OHSS is it gives your body more time to heal in between the retrieval and the transfer.  It lets the levels kind of settle down over time, so I am not surprised they wanted to extend the culture of your embryos.

How many embryos do you have frozen and what stage are they frozen at? This can make a HUGE difference.  I will give you a better idea of survival rates if you can give me a better idea on stage at cryo and if you know what grade they were when they were frozen.

Let me know!

[anonymous007]

Thanks a lot LvnEmbryos,

Thanks a lot for quick reply. I had 40 eggs and 12 were fertelized, among those 10 were told to be good and 2 were ok type. Thats what i know about the stage of embryo. After negative test, i asked the nurse again about my embryo which were transfered. She said they were excellent.

Before transfer, i had mild OHSS. Doctor asked us if we wanted the transfer. The embrologist said that as sperm quality was not so good so they cant try for blastocyst stage. Though i didnt understand fully, we decided to have the transfer done (after 2 days of extraction). After 3-4 days of transfer i started feeling normal, no bloatedness, nothing.

now when i m thinking for the next cycle, can my embryo be able to survive the thaw process. what should i ask my doctor/embryologist regarding the reasons of failure of last cycle and what should be done to improve the chances for the next cycle.

Thanks a lot. You are such a great help. God bless you.

[LvnEmbryos]

So sorry to hear about your terrible news.  I don't think most people understand that an early miscarriage feels just as much like losing a child as a miscarriage later in the pregnancy.  I will be thinking of you over the next few days.

The success rates for frozen embryo transfers are pretty consistent with fresh cycles.  Some people even believe they are more successful because only very healthy embryos will survive the freezing and thawing and make it to a place where they are ready to be transferred again.  Do you know at what stage your embryos were frozen?  This can make a big difference on success.

Do not be disappointed if not all of the embryos survive the thaw, 100% survival is very rare but good embryologists will thaw enough to get you the number you want for transfer.  Depending on the stage, we can estimate how many to thaw to get the desired number for transfer (in your case 3).

The number only affects the success in that the chances of implantation are about 50% so if you do that three times, your chances are higher because of this fact.  It does not increase the individual success rate of each embryo, you just have a better chance that at least one will implant.

Be patient, it is an easier process to go through an FET (frozen embryo transfer) but it still takes a month or two of preparing your body for the transfer.  Good luck to you and baby dust!!!