Day 3 transfer of fragmented embryos

[nf2952]

I'm 33 yo with presumed poor egg quality though we have not check for sperm fragmentation. I have had 5 egg retrievals over the last year. The first 3 were to bank embryos and the fourth one was in Nov 2023 where we did a fresh transfer of a day 5 early blastocyst that failed.

I usually make around 11-17 eggs with varying levels of maturity depending on the cycle with good fertilization naturally and with ICSI. I typically have between 5-9 fertilized eggs that look great up until day 3 when they start to fragment and most arrest by day 5 resulting in 1 poor quality blast on day 5 or 6 (like 4BC/4CC level bad).

I just had my fifth egg retrieval on Sunday and was surprised when my doctor called me in for a day 3 transfer. This time, we had 11 eggs, 9 mature, 9 fertilize with ICSI and all 9 started to fragment by the afternoon of day 3 so I went in and he transferred the best 2 looking embryos on day 3 (7CM and 8CM, which I believe means 7 and 8 cell grade 3/c [moderate fragmentation]).

He did NOT seem optimistic at all. He said they used 2 different culture medias and zymot to chose the best sperm and its the same pattern as my previous cycle.

I feel like it has already failed and there's no way my embryos are going to head in the right direction and implant. I feel so doomed and hoping we at least have something grow to day 5 so we can try again.

Is there a reasonable chance of success??

[Football61]

Hi, I just wanted to wish you the very best of luck. My consultant and embryologist told me that Days 1-3 are all about the quality of the egg, and that the sperm kicks in from Day 3. I carried out two IVF cycles last year and had a huge drop-off both times from Days 1-3 - presumably down to my age (44) and very poor egg quality. But yours tend to fragment from Day 3? It might be worth testing your partner’s sperm? Good luck x

[neonpg]

I'm sorry you're going through this. I've had two retrievals myself that have panned out a similar way, with high numbers of mature eggs and good fertilisation, but v.low blast rate. Most recent retrieval I had 4 grade 1 and 2 embryos on Day 3 (rest were grade 3 and 4) and yet by Day 5 ended up with only one early blast that failed to implant.I really hope you have a positive outcome from this. I truly believe that they wouldn't transfer any embryos that they didn't believe had a chance of implanting. Lots of people have had success from day 3 transfers and I'm sure if you search online you can find those success stories.

And if you're sadly not successful then I wonder if it's time to make some changes. It sounds like your clinic are being supportive and troubleshooting the issue, but if you feel like you are just doing the same thing over and over then it may be time for an honest discussion with your consultant and perhaps considering a new approach.

[Tamaa]

Hi. Please explore the sperm parameters and DNA fragmentation before doing further rounds. It can be something that can be fixed with a few basic changes like lifestyle, and supplements. You are only 33 and egg quality should be presumably good rather than bad. All the best!

[Kilk22 in reply to Tamaa]

I second this. Definitely get the sperm dna checked. It seems like a sperm issue to me. Best of luck. 🙏🏼

[Banana77]

Wishing you all the best - my thoughts are they wouldn’t transfer embryos that they thought wouldn’t implant x