PCOS Message Board - View Single Post - IVF: Cdn doctors' thoughts on 1 vs 2 embryos

BeetleGirl · 06-24-2008, 03:38 PM

You know the story the tortoise & the hare?
Do you remember the moral?
This is kind of a bad analogy but the point is that in the Petri dish, the speedy ones the sometimes look good at day 3, aren't always so healthy at day 5. In many cases many embryos only begin to stop developing around then. You just don't realize it because once transferred, you always tend to hope for the best.
There will always be controversy about which is better. However, many labs do not have the expertise, knowledge, or adequate lab to actually help culture a blastocyst. So in this case, obviously transferring the embryo and putting it in a natural environment, would be best. However, if the embryos are healthy, it doesn't matter where they develop. Unfortunately Canada does not have the same reporting standards as the U.S. but using a top educated & experienced clinic no matter where it is will have better stats using a blast than using a 3 day embryo. Labs that aren't quite up to par, will appear to have as good success rates with 2/3 day embryos, and actually give the illusion that statistically are as successful as 5 day transfers, when in reality studies show otherwise.
Having done both a 3dt & 5dt, and doing much research, I would definitely go ahead with a 5 day transfer, if another cycle was an option but that’s just me.

There are other things that should be considered before doing an IVF cycle. If you plan on using on injectable medications, and you have not done so for any other cycles(Ex: IUI cycle), you might want to speak to your doctor about this. There is nothing worse than spending your life savings on a cycle to find out that you are not optimally responding to a medication that the doctor opted to use. Just like with anything, not everything works for everyone. Therefore, it can be upsetting to know that you put everything in to your cycle, but risk effecting egg quality because of e2 levels, developing too quickly, or not quickly enough. At least doing a cycle prior you have opportunity to have a better idea of how you will respond, and reduce the chances of developing serious health risks like OHSS. I can’t count the couples I have met that on the advice of their RE’s skipped the basics and went to straight to IVF, only to discover that the woman didn’t respond the way the doctor thought, the cycle gets cancelled or converted to an IUI and $$$ unnecessarily wasted.

I have been to 5 + clinics across the country, and although some of them were top clinics, they all had their share of issues. Many missed things that should have never have been missed and because of their faults we had to learn from their mistakes.
Another thing to consider to help increase the chance of success is low dosage ASA. Many clinics do not use this in their protocols, while some do. The theory is that blood is thinned, and with additional blood flowing through your reproductive organs, it increases the quality & the lining of uterus, and the quality of your eggs. Dexamethasone helps reduce male hormones and is only used by some clinics in Canada. Reducing the male hormone while cycling makes sense to me. But again it can be considered controversial so many clinics just don’t even consider it an option.
Other clinics have their patients start taking HCG, once they get a BFP to help support the pregnancy.
But again, these are all things to talk to your doctor about.

If you are waiting to proceed with your cycle, see what other tests your clinic offers. Many clinics only offer additional tests once you have had multiple losses. To me this seems silly. If a person can avoid the possibility of miscarriage by having some blood work done, why should someone be denied the tests until after the heartache?

Anyways, I hope this helps. Again, I would suggest you try asking around on the TTC forums because there is more information there about this stuff since not everyone on the Canadian forum is TTC or has in the past.

Good Luck!