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I am being forced into a 3 day! long thread

December 16 2011 at 1:44 PM
Seymo  (Login Seymo)


Response to Day 3 transfer?

 
My donor took too long to get to trigger and because of the holiday lab closure I am being told that I must have a day 3 transfer.

Our reason for wanting a day 5 (blastocycst) tranfer is outcomes - they can put in the best single blastocyst and significantly reduce the risk for twins. They know more about the viability of the embryos once they make it to day five. At day three the embryos can be graded on the appearance and number of cells but they have not yet made certain developmental benchmarks so it is more of a guessing game to know which ones are best. Also overall outcomes are, (very) generally speaking, lower at day three compared to day 5.

In our case, we really do not want twins so we absolutely want to do a single blastocyst transfer. But at day three, because they know a lot less about which ones to put back, they generally put in more than one.

I looked it up for my clinic. If I want the best possible odds of getting pregnant with a day 3 transfer I have to put back in 2 embryos (55% clinical pregnancy rate) and that is the most common type of transfer that they do on D3. With that comes a 27% twinning rate. Importantly a two-embryo day 3 transfer clinical pregnancy rate is still lower than a day 5 single blastocyst transfer (65% clinical preg rate).

There is some self-selection bias going on in the data because, generally speaking, they do a day 3 transfer when there are fewer embryos to work with and/or less than two or three look like they will make it to day 5 (low grade on day 3) and they don't want to risk not having a transfer. For my clinic, the cut off for an in-town patient is three or less grade 1 embryos at day 3. For OOT town patients they will try for a day 5 transfer even if 2 are grade 1 on day 3.

My doctor explained to me that the predominant reason to do a day 3 transfer with a single embryo is because only one looked good enough on that day or that was all they had. He said that in my case it was rare that they would be forced into making the call for a day 3 transfer because they typically tell all OOT patient to expect a day five transfer.

Needless to say I am not happy. I feel I got sold a bill of goods - we choose our clinic because of their "culture" of preferred single blastocyst transfer. This entire cycle has been mismanaged from the start and delayed for months because of their mistake. As a result, I am now not getting what I paid for. Also my DH is utterly and completely against transferring more than one so now we are fighting about this. Argg!

I hope that info was what you were looking for. Your clinic could have great stats with day 3 transfer. I know I should not complain/worry because a 55% pregnancy rate with a day 3 transfer is quite good! But I am obviously biased about what I think is best so take my rambling for what its worth.

Good luck!


    
This message has been edited by Seymo on Dec 16, 2011 2:03 PM


 
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Responses

  1. Oh Seymo...I'm so sorry - Mrs. M on Dec 16
    1. Thanks I appreciate your support - Seymo on Dec 16
      1. GL with the conversation with DH. - Mrs. M on Dec 16
     
  2. I would be very upset at this too n/t - Anonymous on Dec 16
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