What is more important, PGT-A test or embryo grading? 4CC euploid embryo

[AdviceforJane]

I have a PGT-A tested embryo due to be transferred later this month. It is our second of two and is a 4CC grade.

My clinic have focussed very much on the importance of getting euploids and say they have a high success rate with them.

But 4CC still feels like a very low grade. It seems like most clinics don’t even bother testing or transferring them, they just discard. It also seems like there is a greater chance they won’t thaw.

There is a lot of conflicting info about grading vs PGT testing. Surely even though it is euploid the low grading must reduce the chances a bit? Eg if you have two euploids the 4AA will surely still be more likely to implant than 4CC.

We also have a 4BA low level mosaic which is suitable for transfer so just wondering if we are better to go with that or even to transfer two (really not keen on that idea because of twin health risks but maybe it is the right answer now).

Was anyone successful with a CC grade, tested or otherwise?

Is a 4BA mosaic better than 4CC euploid?

[Ranchu90]

If I was you I would have transferred both 😁. Actually I was in a similar situation as you. We had 2 normal embryos and one was 5BB and the other 5BC. We transferred both as we thought that BC might not have a chance for life birth, fast forward my 5BC embryo is one of my twins now😂. I agree with you that it might not make the thaw process a CC grade so transfering 2 probably will increase your chances.

I also had a mosaic embryo but we decided to discard it as chances of having a miscarriage will be high. I had 3 chemical pregnancies in the past so didn't want to experience the same emotions once again.

Of course the decision is in your hands and you know better what is best for you. Just wanted to say that embryo grading can be very subjective, embryologist dependant.

Take care 💕😘

[AdviceforJane in reply to Ranchu90]

That's brilliant about your twins! I am going to talk to my clinic tomorrow xx.

[Pnw2020]

Hi. It depends on the grading system but at my clinic ‘C’s is average not poor - I have just put 2 CC babies to bed - both untested. Hope that reassures you!

[AdviceforJane in reply to Pnw2020]

That is really reassuring, thank you!

[Ivfmomma2025 in reply to Pnw2020]

I needed to read this. I just had a miscarriage with my first 4AA euploid and now I only have a BC and CB left and am so scared! I wasn't sure if I needed to just do another retrieval.

[LSandJ]

Euploid makes all the difference!!!!Other grading is literally just how it looks externally and is so subjective. (also most people don't get pregnant first time and end up pregnant with their lower grade ones, so you are fine!!)

I also had a low level mosiac and a euploid left, they wouldn't let me transfer both as one was mosiac. So I'd definitely go for your euploid (and forget about the other grading!) euploid is amazing and high chances! (I've still had euploid fail, but all due to implantation issues, not embryo quality). Nurses always seem so pleased to have a euploid and I've heard them say they're like gold dust, and once you've got one you can just forget about the other grading!

Keep the low level in case you want to use it later!

Good luck!

[AdviceforJane in reply to LSandJ]

Thanks! My clinic have seemed really positive about the euploids too so until this weekend I hadn't really bothered thinking about the grades. I just got a bit worried this weekend because CC does seem like such a low grade. But perhaps I am overthinking it! We are going to try steroids with this one and I wish we'd tried them with the previous euploid that was a higher grade.

[Ivfmomma2025 in reply to AdviceforJane]

I know you wrote this 2 years ago but wanted to see how you did with your CC euploid? Thank you!

[Lelo3479 in reply to Ivfmomma2025]

Hiya, you can click on people's names, on their 'about' tab sometimes people write a bio/history. They have and this screenshot shows their history. Best wishes x

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[Bexarama83]

Hi Jane. My clinic don’t even grade anymore as they say people get so hung up on the grading. The fact that it is euploid and was good enough to test, surely gives it a better chance of succeeding than any “grade” which someone gives it by eye? Interested to hear your outcome as I’m about to have PGTA testing done on my embryos as I’ve previously had 2 miscarriages. Best of luck xxx

[AdviceforJane in reply to Bexarama83]

I can definitely see that the grading is subjective. I have photos of all the embryos from day 5 / 6 and the 4CC looks the same as the 5AB!!

We opted for the PGT-A after 2 natural miscarriages. I can see the arguments for and against, but for me it was important because it rules out one of the most common causes of miscarriage / implantation failure. I got a bit fed up with people saying just keep trying, it's bad luck, it's a numbers game. Of course that is true for some people but it isn't true for others who might have another undiagnosed issue so the PGT-A seemed a way of ruling something out and moving to the next step quicker.

We had one fresh transfer that was untested which failed, and another PGT-A tested which failed. I wish we had frozen & tested the fresh one as it would have given us more information about what is going on. We are trying steroids for this final euploid transfer and hoping that will make the difference.

Good luck with everything!

[Sarah770]

My embryos were made in the US and were pdg-ed there. My preparation treatment is given me by a Spanish doctor (where I live now) but my transfers are made in a Greek clinic: I travel there for every transfer, from Spain. Prior to a transfer, my Greek clinic grades my embryo and send the picture to my Spanish doctor who also gives me his grade according to his standard.

my third child, when still an embryo, was graded 3BC by my Greek clinic and 3CC by my Spanish doctor. The latter said that he would have transferred two because he had poor chances of implantation. He is now a super sweet bubbly and super smart little man of 1.5yo.

Grading is a rather subjective beauty contest only, while PGD is an actual testing giving concrete result as to viability. Just relax, trust the process, there were many success stories.