Post # 1
Are there any IVF experts that would be able to give me their opinion/insights?
D.H. and I have dual factor infertility – and therefore are doing IVF w/ PGS & ICSI. We were recommended by RE to do early embryo banking (EEB) so we can have enough embryos now while egg quality is good, to have at least 2 children.
I’ve completed two rounds, and now need to decide if I’m doing the 3rd round. If anyone has the experience on the subject, I would really appreciate feedback to help me decide if a 3rd round is wise, or not needed. Here are my numbers from the first 2 rounds:
- Round 1: 6 eggs –> 5 mature –> 4 fertilized & frozen (antagonist protocol)
- Round 2: 14 eggs –> 12 mature –> 10 fertilized & frozen (microflare lupron protocol)
- Total: 14 2PN
If I do a 3rd round, I’m anticipating a response similar to my 2nd round, which could leave us with 20-something 2PN embryos. My understanding based on average statistics (since that’s all I can really go off of), is that I can expect about half to make it to blastocyst, from there based on my age, about 2/3 to test genetically normal, and from there about 70% success rate.
I’m having a hard time deciding if I want to take the chance with the 14 I already have, or if that’s cutting it too close for comfort. I know the decision’s mine, but I’m struggling since I could technically stop here, the numbers tell me it could be ok… But I feel like I don’t have the resources to make a confident decision.
Pros of doing 3rd round:
- better response if I do 3rd round now due to vitamins and “momentum”
- better egg quality now vs. later
- D.H. may need to do TRT which could further impact fertility – would be good to get IVF behind us so he can focus on his health
- cost savings on 3rd round EEB vs. 1 stand alone round in the future
- peace of mind when it comes time for transfer
Cons of doing 3rd round:
- $$$ – extra meds & 3rd round
- more embryos than we need
- would need to work remote for a week and a half to do treatment since we recently moved
Post # 2
This is a tough decision as there are so many variables. I am by no means an IVF expert, but I also did IVF with PGS. Is there a reason they didn’t freeze them at the blastocyst stage? Mine were frozen as blasts so we knew how many we had for PGS testing. I had my retrieval at age 33 and they retrieved 13 mature eggs, 10 fertilized (not ICSI) and 7 made it to blastocyst. Of those 7, 5 were genetically normal. Our first FET was a missed miscarriage and our next FET resulted in my 12 week old son. We have 3 more frozen embryos that we hope to have one more child with. If egg quality is a concern and you are ok knowing that you could possibly have several embryos left over and need to decide what to do with them, I think if I were in your shoes, I would go for the 3rd round. Better safe than sorry.
Post # 3
summerlove23 : is there a reason they froze so early? My clinic waited until day 5 to see how many made it to blast and then froze so we weeded out the duds early.
I would weigh how you’d feel about running out vs. having too many to decide on round 3. I’m biased because I did IVF w/ ICSI and we did a fresh transfer that resulted in our daughter. We got really lucky, but I know I’ll have a little guilt if we get lucky on the first shot again and don’t use all our frozen embryos (we’re going for a FET this summer) even though we’ll donate them to research.
Post # 4
MsTrulove22 : LilliV : good question! They knew we would need to do multiple rounds since I’m DOR, and they offered a discount to do “Early Embryo Banking”. In other words, they:
- do 1st round – freeze on day 1.
- do 2nd round – freeze day 1
- do 3rd round – defrost first 2 rounds at the same time, so that all grow together at the same age to blast. This way they can do the PGS testing all together and save some money.
Essentially we are doing 3 rounds for the price of 2, it was considerable cost savings. Still very pricey, but knowing we’d need to do more than 1 round it made sense. It does leave us with uncertainty though.
Post # 5
I would absolutely keep going. Even with your age on your side, 14 is not that many and assuming 50% make it to blast is by no means a guarantee or fixed number. I’ve retrieved 37 eggs and only had 9 make it to blast. Plus, if you have male factor, poor quality sperm cannot be fixed with ICSI – it can contribute to the embryo arresting between days 3 and 5. I don’t see a lot of downsides to a 3rd round unless you have a moral opposition to having extra embryos
Post # 6
I’ve never heard of an office freezing so early. My Day 5’s were biopsied and PGS tested in both rounds where the embryos had good grading on Day 5. (Our failed IVF turned into a fresh transfer “Hail Mary”)
Honestly, so many crazy things can happen that unless you can find enough other bees with the same protocol you’re doing to give you advice, I recommend listening to your RE.
In my opinion 14 Day 2’s is probably not enough if you want more than 1 child. They still have a looong way to go between thawing, growing to Day 5, biopsy, PGS, transfer, implantation, and then hopefully developing normally once in your womb.
Post # 7
summerlove23 : what’s the cost savings? And when do you want to transfer? Those answers would also play into my decision. When I did IVF I was already two years into TTC and I was just ready to get pregnant already. I wouldn’t have been patient enough to wait and do a “just in case” round. That said – my IVF was covered by insurance so cost wasn’t a factor for me.
Post # 8
LilliV : If we stopped now, we’d get $18k refund, and would save on $6k meds – so $24k savings.
On the flip side, the $18k has already been paid for – so proceeding would only be $6k extra for meds.
We’ll probably do a transfer towards the end of the summer. We are moving into our new house in July, and I just started a new job, so I want to get a little settled before transfer.
Post # 9
littleanchor : dgirl715 : This is very helpful. Thank you so much for your feedback.
Part of the struggle is feeling somewhat alone, and not having very many resources available to hear real feedback, or get real advice. I’ve listened to podcasts and talked to the Dr. but I keep wishing I had a friend who’s been through it that could help me work through the pros & cons.
Post # 10
The dropoff from fertilization to blastocyst is typically more llike 75%. This is especially true when you have MFI and sperm issues (this is when you tend to see a higher drop off between days 3 and 5). If you want two kids, statistically you’ll want 6 PGS normal blasts. I’d do the third cycle.
Post # 11
you’ve got a lot of embryos!
i do 2 fresh rounds. round 1, my progresterone was too high to transfer. i think i had 7 retreived, 5 fertilized with icsi, 2 were freeze quality.
round 2, 9 retreived, 5-7 fertilized with icsi (can’t remember), 4 excellent quality. i transfered, resulted in my son. other 3 frozen.
FET, 1 transfered from frozen batch #1. resulting in my daughter.
now i have 4 left and will not be using them. we didn’t know the transfers were going to be successful on the first time each time. i wasn’t comfortable with only having 2 frozen and starting transfers, especially since i bought secondary insurance oop to cover IVF and met the OOP max. so everything i did relating to IVF needed to be completed that year or we wouldn’t have been able to afford it. and it still cost us almost $30k with insurance.
so to me, with 14 embies, you don’t need another fresh round.
I’d also suggest joining the Resolve message board. Resolve is the national infertility association. The people are so wonderful and everyone is going through the same thing.
Post # 12
I’ve never heard of freezing fertilized eggs but based on the fact that the third round will involve defrosting all the fertilized eggs, the cost savings and the hypothesis that egg quality is better today, I’ll say go for another round if your body and mind can sustain it. My experience is not the norm but all my fertilized eggs converted to 5-day blasts and all are PGS normal.
Post # 13
Sorry you’re in such a tough spot. I’d personally want to skip the 3rd round and save that money, but honestly, if you feel like your body and finances can handle it, doing that third round gives you some insurance. At this point, you don’t know if you’ll have a normal drop-off or not. I’ve had friends that ended up with as many 5 day embryos as fertilized eggs and friends with 26 fertilized normally and 0 that PGS tested normal. IVF is just this terrible set of unknowns and its even harder when you don’t have a support network that knows what you’re going through and understands the hard and costly decisions you have to make.
Post # 14
I read studies that say 2PN embryos had just as good, or better, pregnancy rates as blasts. I thought that was interesting. Not sure if this is helpful or not, but I recently spoke to my RE about testing our frozen embryos. He said they’ve been studying the effects of thawing, testing, and refreezing embryos and they’ve found that success rates drop 10-15% when you do this. I think 14 sounds like a very good chance that you’d have enough for two kiddos, but without ever having tried a FET and not knowing how many are genetically normal, plus you’ve essentially alread paid for three rounds, I might just go for the third.
Post # 15
Thank you all for your thoughtful advice and feedback! It was one of the most helpful things for me to make the decision on our next step here.
We decided to proceed with the 3rd round and am currently priming / preparing to start stims in the next few days. Taking it day at a time, and can not wait for 2 weeks from now when I’m done with shots and hopefully done with this stage of the process for good.
WISH ME LUCK!