Day 3 results not predictive of day 5 success?

[ocean]

Carole - I'm looking over my day 3 and 5/6 PGD results and feel like there's zero correlation between day 3 healthiness and normal results. In my 2 cycles, 20 embryos fertilized, and all but 1 had 6+ cells on day 3. Vast majority had 8 cells, with varying answers of Y and N for Align and Clvge.

The 3 expanded blast embryos that ultimately had normal results had 6, 8, and 8 cells on day 3, again with varying answers of Y and N for Align and Clvge.

The 3 embryos that made it to blast but were abnormal (complex, trisomy 4/18, and monosomy 16) had 8, 10 and 8 cells at day 3. Interestingly, both abnormal blasts from cycle 1 were frozen on day 5, whereas both normal blasts were frozen on day 6. One of those normals had been graded a 3 on day 5 and then improved to a 2 on day 6.

The two 10 and 12 cell embryos either were abnormal or didn't make it to blast...so I'm wondering if growing quickly isn't a great sign.

A lot of detail here but I'm wondering if it's typical or atypical that day 3 results seem to have little to do with normal blast results? For reference, I'm 37, nearly 38.

[Carole]

Thanks for your question. While some research studies have shown a positive correlation between embryo progression (right timing of cell divisions -not too fast or too slow) and the correct number of chromosomes, there are plenty of examples to disprove a correlation between the appearance of an embryo and whether or not it has a normal number of chromosomes.

For instance, with patient consent, we routinely froze abnormally fertilized eggs (those eggs that had three pronuclei instead of the normal two pronuclei) for research. Why? Because whe thawed, they routinely grew into beautiful looking-- but 100% abnormal --blastocysts so they were good stand ins for biopsy practice or freezing practice or just moving around between drops practice for the newest technicians. They were a wonderful gift to the lab and to our future patients because we could get better technically.

So it does not surprise me in the least that some of the nice looking embryos were abnormal. That is a pretty normal occurrence. Growing too fast- reaching 10-12 stage without compacting can be a troubling sign as well. Day 3 results aren't always predictive of day 5 results, because an embryo that looks great on day 3 can decide to stop growing and grow too slow, or with lots of fragmentation and unequal divisions so will score low by day 5. Fortunately, you have some chromosomally normal embryos- that's the most important characteristic.

Wishing you Much Good Luck!!!
Carole



Carole - I'm looking over my day 3 and 5/6 PGD results and feel like there's zero correlation between day 3 healthiness and normal results. In my 2 cycles, 20 embryos fertilized, and all but 1 had 6+ cells on day 3. Vast majority had 8 cells, with varying answers of Y and N for Align and Clvge.

The 3 expanded blast embryos that ultimately had normal results had 6, 8, and 8 cells on day 3, again with varying answers of Y and N for Align and Clvge.

The 3 embryos that made it to blast but were abnormal (complex, trisomy 4/18, and monosomy 16) had 8, 10 and 8 cells at day 3. Interestingly, both abnormal blasts from cycle 1 were frozen on day 5, whereas both normal blasts were frozen on day 6. One of those normals had been graded a 3 on day 5 and then improved to a 2 on day 6.

The two 10 and 12 cell embryos either were abnormal or didn't make it to blast...so I'm wondering if growing quickly isn't a great sign.

A lot of detail here but I'm wondering if it's typical or atypical that day 3 results seem to have little to do with normal blast results? For reference, I'm 37, nearly 38.

[ocean]

Thank you Carole! Explanative as always. I'd happily donate my abnormal embryos to help train embryologists if my clinic asked me.