Embryo Grading Abroad

[BettyBe]

Dear ladies, just looking for some opinions please...

We decided to continue IVF journey abroad after we cancelled own cycle in Jan. Due to age (44) we decided to go with donor eggs abroad.

In the past I had 21 eggs collected at 41, we managed to get 3 blastocysts embryos (one was our son) 5ab, 4bb, 3bb.

Second round in Sept failed at 43 - we had 16 eggs with 4 blasties - 4bb, 4bc and 2 x 3bb.

We decided to go abroad and use a donor as my eggs just weren’t working ☹️

We recently had the eggs fertilised from our donor and all I can say is that I feel really disappointed. Our donor is 22 years old so I guess I was thinking we would have super results!

We have 3 x 5 day blasties grades 3aa, 2aa and 1aa.

Can anyone tell me / give me an opinion of the quality please? I know from my ivf clinic in the Uk that they wouldn’t use anything under a 3. I feel a bit deflated - I was hoping to use the 2 embryos of 2aa and 3aa but is there much point in freezing a 1aa embryo?? Just feeling a bit bleh from the news and sad, can anyone shed any light please xx☹️🌺xx

[treezuk]

Im not to sure of the grades and how it works all i know is we got 2xAA and 2xAB each time but that was the grading/and amount of embryos not the actual number of the embryo if i make sense

[BettyBe in reply to treezuk]

Thank you Treeuk, it makes total sense, just feeling nervous about it all and worried incase it doesn’t work ☹️ thanks for your reply, hoping this time it works... so much money and time put into this, I really want it to work!!

[treezuk in reply to BettyBe]

Check with your clinic about how they grade and what explaining that means hopefully that can put your mind at rest clinics wouldnt suggest normally freezing anything they didnt think could or would be viable.

Try not to stress my twins are the 2XAB from a 27 year old donor ( i realised this today when i looked back all this time i thought donor was 21 haha 😂) so just shows you anything is possible.

[TheFoxes]

I think it is not the grading that matter so much as whether the embies are chromosomally normal and therefore able to make a baby. As your donor is 22 it’s more likely that her eggs would be “normal” and therefore have the ability to grow and produce a full term pregnancy. I think it’s definitely worth freezing a 1aa. X

[BettyBe in reply to TheFoxes]

Thank you Thefoxes, I know it’s quality over quantity and her age means they would have a far better chance than mine.

I keep comparing it to what UK clinics have said in the past about not freezing under a grade 3 and what their reasoning is behind it, just thinking to transfer the two and question the third - as they won’t do another round if any eggs are frozen 🌺 xx

[JenRoy]

All your embryos are grade AA so that’s great! You can’t get any better. Morphologically perfect 👌

The number explains the degree of embryo expansion of the blastocyst cavity and its progress in hatching out of the zona pellucida. Maybe they’re growing a little slowly?! Our clinic gives an extra day or so for high quality blasts to expand further.

I think it sounds really positive. Good luck!! 🍀

[LSandJ]

I wouldn't worry about the grades at all!! I had loads of top grade embryos but they've failed, and will be transferring slightly lower quality next! If they are good enough to reach blast they are good enough they can reach pregnancy as long as they are chromosonally normal. To be honest where my clinic grades, 1aa is the best anyway! But mostly women use their best few first and most women don't get pregnant first time, so they end up using their worst graded ones on the transafer that does work. I wish they didnt tell us grades any more as it really doesn't matter!! I also wonder if they should use the lower quality ones first as most people don't get pregnant first go! But really it doesn't matter, they've made it this far so there is a great chance. Good luck and baby dust xx

[BettyBe in reply to LSandJ]

Thank you for your kind words and encouragement! I guess I’m just feeling a bit jaded by the whole ivf journey and flat. So many tries now that I’m just hoping it works!!

You’re right about telling us grades, they should keep it quiet as it can become a fixation ... like me now!! 😂 good luck for your next transfer 🌺🥰

[Biancad]

Try using DHEA for 12 weeks and using your own eggs again here is a link to the worlds best ivf clinic for over 40s DHEA reverses the aging of your eggs in women over 40 to the age of a 20/30 years old this clinic swears by it centerforhumanreprod.com/do... the dr says you should try DHEA when ever they tell you donor eggs are your only resort. Worth a try as seems the 22 yr old eggs were worse than yours. 🙏🏽

[BettyBe in reply to Biancad]

Thank you Biancad, it sounds selfish and egotistical perhaps but I am disappointed with the results from the young donor... I don’t know what I was expecting - some miraculous number and 5aa’s across the board!! Maybe I set my expectations too high.

I didn’t know about dhea, only issue is our frozen sperm has been shipped to the clinic now (which is why we started ivf 5 years ago). Thank you for the link and info, I’ll definitely look into it 🌺 x

[Biancad]

That quality is not good the first number is the level of development so the scale goes from 1-6 6 being the best abd meaning fully hatched so 3,2 and 1 is not good you would want a 4 at least. first a after number is quality of cells that will become embryo second a is quality of cells that will become placenta. So the quality of the cell embryo and placenta is good but not the actual development of the embryos. So 3aa is not developed very well neither has the 2aa or 1aa hope that helps it’s a shame coz the quality of the embryo it’s self is good just the chance of them developing to blasties is very low ☹️

[ClaudiaS in reply to Biancad]

You are half true... the blastocyst change stage from early blastocyst (1) to hatched blastocyst (6) to 18 hours and the number the clinics gives you is the time an embryologist saw them... an AA( perfect quality blastocyst) wich is in early stage(1) after 2 hours may is at stage (4) ...The important is the quality and AA is a perfect quality blasto

[BettyBe in reply to Biancad]

Thank you, that’s what I’ve been reading and have been told in the past, just hoping it works and we have a miracle as this is all we have now!! Xx

[ClaudiaS]

Hy betty , my opinion is that you should be very happy with the results! Do not compare an AA blastocyst from a 22 yo donor with your results ...An AA blastocyst from a young donor is alone a 40% chance of pregnancy if an embryotransfer made with success!!!

2 aa blastos is the max number you should transfer and your age doesn’t matter to this!!

As you said your have a boy probably from an AB blastocyst of yours so you should fly to the moon with the possibility your donor is giving to you for a perfect embryo transfer fresh and another one frozen!

Good luck and remember that psychology matter the most for good results!

[BettyBe in reply to ClaudiaS]

Thank you ClaudiaS, I don’t want to come across as ungrateful as we are in a good position, I know 🌺

My hang up stems from why the clinic in London always said they would never use an embryo under a grade 3?? It’s just been bugging me and thought I’d ask advice from ladies who have more knowledge / experience xx

[ClaudiaS]

Day 3 embryos have another grading Grade 1 best

Grade 2 not so good

Grade 3 not good at all

Maybe it was not blastos in london?

[BettyBe in reply to ClaudiaS]

Thanks Claudia, these are all day 5 blasties - Greece and UK xx

[ClaudiaS]

My baby came from 1 blastocyst from 23eggs and 16 fertilized....Only one blastocyst at day 5

Stage 2 grade BB....

thats the reason i hated london clinics... only money and their statistics matter to the most of uk fertility clinics as i saw it with my eyes...

[BettyBe in reply to ClaudiaS]

We had a similar experience in London, we started fine and we were lucky first time and then it felt very much like statistics and money. Thank you for your reassurance 🌺

[Facingreality in reply to ClaudiaS]

You're right about that. That was my experience too at one of the leading fertility clinics in London. All they seem to care about is money and statistics. Recently, they were pushing me to buy a load of medication when it was reasonably clear that my cycle was going to be cancelled. Even after pointing this out, the nurse went on urging me to collect the meds (so they can charge I suppose). My consultant once told me he does not like to cancel cycles (he had wanted to go ahead with a transfer even when there was an issue with the lining). When I opted for a fully natural cycle for FET, my consultant was rather hostile and quite unsupportive, even went as far as telling me that since I am opting for natural, no point testing blood for progesterone and estrogen, he wanted it done 'blind' so to speak and I wondered whether it was that he wanted to prove natural doesn't work. When I once complained about overmedication, the reply from a senior nurse: "Yes, we overmedicate, but look at our statistics." Go figure.

[BettyBe in reply to Facingreality]

Wow! That’s really outrageous!! We cancelled our cycle in January due to very low egg stimulation. I decided to stop as they wanted to just up the drugs and up the drugs. When I told them I wanted to cancel I was met by hurtful comments that I’m too old, sperm isn’t great and I was extremely lucky to have a son and so forth. They were very happy and encouraging when I started my cycle though!! It was rather a slap to the face!! Maybe it’s the same clinic 😉 x

[Purpledoggy]

Hi, my last round in in the UK I had three 5-day blastos frozen - they were a 4, a 3, and a 1-2. I don't know the a/b grading but the embryologist said they were all 'top quality' so I assume all aa or ab. The number mainly tells you how expanded they are and not the primary indicator of how good quality they are, and the expansion can change on thawing - sometimes up and sometimes down. The assumption is a more robust blasto will have expanded more and so a higher number (up to 5, 6 is fully hatched and less successful) suggests the blasto is more likely to be successful, but female blastos expand more slowly than male and so lower numbers may be partially a gender difference rather than a 'robustness' difference with lower expansion (as a consequence, there is a small bias towards male babies with IVF).

I can understand your disappointment as on paper your own eggs seem to have done better, but as someone else said a young person is less likely to have chromosomal abnormalities and egg quality often won't tell you if that is the case. xx

[BettyBe in reply to Purpledoggy]

Thank you so much for the detailed reply. Much appreciated and thank you for the explanation, hoping they expand more and a little girl would be more than welcome 🌺 I just need to have faith and chill out!! Xx

[Purpledoggy in reply to BettyBe]

Best of luck - really hope it works out for you xx

[BettyBe in reply to Purpledoggy]

Thank you xx

[Mei19]

Hello, it seems that grading is now less reliable as it’s only based on the blastocyst ‘appearance’. It’s better to test for genetic information as some so-called bad grade embryo might still be a healthy one and viceversa.

[BettyBe in reply to Mei19]

Thank you, I’m not sure if they’ve frozen them already to test but I can ask xx

[Boo718]

Hello I agree with the genetics tests. I had 3 very good graded donor egg embryos all of which when tested were chromosomally abnormal. So we had nothing to transfer. I remember thinking ... Christ I could get nothing to transfer on my own 🤦‍♀️

[BettyBe in reply to Boo718]

Oh no! Hopefully you are lucky soon! I’m now trying to think positive and read into everything when it’s something I don’t have much control over!! Xx

[Boo718 in reply to BettyBe]

I’m exactly the same I swear I’ve read sooo much. Possibly too much at times then u start to over think things. One day it will happen. It’s important to look after yourself and enjoy a bit of life too xxx

[BettyBe in reply to Boo718]

Very true! Too easy to get absorbed by all of this!! Xx

[Facingreality]

Hi. AA are the best, as far as I know. The grading depends on the clinic. I recently learned that at my clinic, 2 is expanding (more than half filled), 3 means fully expanded, 4 is hatching and 5 is fully hatched.

[ChloeDE]

Not related to grading but we did donor eggs too. First round, we got two blastocysts, transferred both, one stuck but miscarried.Did another round and only got three blastocysts. Two resulted in twins and one frozen. The clinic uses different grading (just gives them a number 1-3) so can't compare that but just to give you hope that three blastocysts can result in a baby (or two).

I would ask your clinic about grading/quality though. Our clinic guarantees 2x grade 1 or 2 blastocysts. That said, I don't think it means too much. They evolve and change so rapidly.

[BettyBe in reply to ChloeDE]

Thank you, that’s really encouraging. Really grateful for this site and help that you can reach out for and advice 🌺💗 xx