Frozen Blastocyst Grade Questions & Vitrification

[MPTTC3]

Hi! I'm new to FET. I haven't had one either. I'm in the 2ww for a fresh cycle My clinic called me today with the other embryos status. The embryologists make all the decisions, because my clinic requires certain criteria for freezing. On 2 days post retrieval, I had 8 embryos (one 2-cell, one 3-cell, five 4-cells, and one 5-cell). We transferred three 8-cell embyros on day 3 (7/26), and until today I was curiously waiting to see what my other embryos would do. I made a call yesterday and heard that they were watching four of the five that were leftover, and that they were all "early blasts". Today, I got a voice mail that "they froze two of them", and it's day 6 today. I called back for details, and they told me that they froze (via vitrification) two AB Blasts. The remaining 3 were as follows: a 2CC, a 2CB, and an 8-cell. What does that mean? I was so upset that they didn't freeze them with the others to possibly even give them a chance at a later date, but the embryologist said something about if the intercellular mass portion hasn't fully formed at this stage, then it's not worth saving. Can anyone elaborate or explain the grading? So, am I correct by assuming that if we had transferred some of those lower quality blastocysts that they didn't freeze on day 3 (at whatever stage they were then) since the intercell mass never formed in the lab, it wouldn't have formed inside me either and established a pregnancy? Or, did the intercell mass never form because it was sitting in the lab? What are the quality of the other two embryos that they froze (2AB)? Also, my clinic uses vitrification. They claim that vitrification reduces ice crystals, and there's a 95% success rate when they thaw. My clinic totally pushes this vitrification process. Anyone know the pros and cons of it? Thank you so much!

[shannij]

are you in Atlanta at RBA? I had a similar experience. I have done only FETs because all my embryos were frozen at day 1 because of hormonal issues. So my last FET(#5) we had 5 embryos there were left and I had wanted this to be my final transfer because I do have 2 ds. Well we talked about taking them to day3 and if necessary day 5. Well on day 3 we had 2 eight cell, 2 five cell and 1 four cell. We transfered the 2 eight cells and were watching the other 3. On day 5 I called and was told one did not make it and they were watching the others till day 6. I sort of freaked out thinking they were "stressing" the embryos so I emailed my RE and this is what he said.
Simple answer; some blastocysts don't reach the stage adequate for freezing until morning of day 6. The 2 we have today are probably either late morulae or uncavitated blasts..meaning we can't see the inner cell mass (the part that becomes the baby) yet. Freezing an embryo at the blast stage without knowing the ICM is good is a waste of time so the lab is probably waiting until the morning to reassess. There will be NO testing of the embryos other than to observe them by the way. If you mean 'challenged' or 'pushed' by the word testing...we don't do that either. Frankly (and fortunately) the lab doesn't know your inner feelings about all this (though I do) and we let them make decisions based on reasonable science when we don't have specific directives to discard from a patient.

So on Monday morning I called and was told we had 2 great refrozen day 6 blasts.
On the Vitrification I think RBA has pioneered it but could be wrong. I read a bunch about it and think the freezing and thawing process is easier on the embryos. I imagined it sort of like flash freezing and thawing. There are not many icicles on the embryos so they thaw better. The cells are not damaged during the thaw. It is a new process but apparently the success rates are high.
Best of luck I hope this helps ease your thoughts a little.

Here is a link to an article I read about the vitrificaton process

www.atlantamagazine.com/may2009/deepfreeze.aspx

[MPTTC3]

(BFP ment)

Thanks Shannij. No, I use FCI in the Chicago suburbs. Thanks for sharing your experiences. Your situation sounds similar to mine. So, from reading your doctor's response and from the info that I gathered, the embryos that didn't have an intercell mass by day 6 probably wouldn't develop one, wouldn't develop a pregnancy, and they weren't worth freezing. My two grade AB blasts were vitrified on day 6. So, today is 9dp3dt for me for the fresh embryos. I had experienced very mild cramping 1dpt and some left side pressure & pulling. I remember during my first IVF cycle in 2007 (never had a frozen cycle) that I had period like cramping during the 2WW, and it turned out to be a good thing because it was the beginning of my twin pregnancy. This time though, I've really only had that left side discomfort. Since I haven't had any cramping, I was getting bummed and just decided to POAS on Sunday. Well, it was a very very very very very faint positive. At first, of course, I was thrilled. However, after the left side discomfort persisted, it began to worry me because I've had an ectopic in the past (after an IUI). Looks like we have that in common too. My ectopic was missed, and I had to have an emergency surgery, and I was in the middle of taking gonal-f for the next cycle! I called the nurse every day with concerns about my period being so long that cycle (because my flow usually only lasts 4 days). By day 10 and I was still bleeding, I was extremely worried. The RN just kept dismissing it, and saying that "every woman has an "off-cycle". I was 35 at the time and never had an off-cycle, and I just wanted someone to listen. Anyway, that's why I'm so cautious this time. So, I e-mailed the RN yesterday (a different RN but who knows my history), about my left discomfort and my BFP, and here's her response:

"The HCG trigger was far enough ago that it is not an issue now. The cramping and pulling is normal and even if you have an ectopic there is no way to tell at this time and it would not be big enough to cause any issues now.
If the sensation bothers you, you can take Tylenol only. Plan on coming for your preg test as planned and we will follow you carefully.
Where you are feeling the pulling matters not at this time. Pregnancy keeps your ovaries enlarged for up to 12 weeks of pregnancy so you can feel either side or both.
Relax! Don’t look for trouble……"

My response:

"Okay, well do. Not trying to look for trouble. That pressure/pulling on the left side has been there all day today. It's been on and off since the embryo transfer, but it has really increased today. Just wanted to report it. See you Friday."

Her last response:

"Reporting is good…panicking, not so much. Take a breath, babe…..
m"

Anyway, I think I have good reasons to have concerns and am not panicking. Just wanted to know how your ectopics were caught. I want to be thrilled for my recent BFP, but I'm also very cautious. Thanks again for your input.

[shannij]

Not sure how long ago your HCG was but her response makes sense.
Each of my transfers have had different symptoms, none have been completely alike. My first I swore was another ectopic I made the u/s tech search and search but it turned out bfp. It would be too soon to tell so just hang in there till Friday for your beta.
Hard not to be paranoid I know after going thru ectopics.
Good luck!