Embryo pic and grading...any input carole pls?

[deaks66]

Hi Carole,

The attached embryo which has been frozen and is due to be transferred in january was graded a B/C. i have read many times how the grading isnt the be all and end all but what bothers me most about it is that i cant identify the ICM... there must be one surely for them to have graded it? Do you think this embie stands a chance of thawing ok and implanting? i was given a 40-45% chance which isnt much considering we are travelling overseas.

Thanks for any input at all!

IMG_0692.JPG

[Carole]

Hello deaks66,
The picture quality is very poor so I am not surprised that you don't see an inner cell mass. Depending on how the embryo is turned around--remember it is basically a ball of cells, you can get a better or worse view of the inner cell mass. Embryologists score an embryo by rolling it around under high mag, not from a photo. I can't tell whether it has an ICM or not either from this pic but there are a couple of areas that could be an ICM. It is hatching which is a very good sign for viability. Yes, assuming that the lab has a good vitrification program, the embryo should survive very well. The 40-50% chance was probably the chance of pregnancy, not the chance of thaw. Good Luck!!

[deaks66]

Thanks Carole, its so good to have a bit more detail. Can i ask do you feel that if an embryo does survive the thaw that the quality can improve or do you tend to see a deterioration?

[Carole]

Thanks Carole, its so good to have a bit more detail. Can i ask do you feel that if an embryo does survive the thaw that the quality can improve or do you tend to see a deterioration?

If the embryo is vitrified and the procedure is done properly, you can expect all the cells that were alive at the time of freezing to be alive after thawing.This is much improved over older slow freeze methods when we were pleased if more than half the cells survived. Freezing does not improve quality but it sure can make it worse. We don't grade after blastocysts stage based on morphology because we can't grow them longer in culture and don't track them after the transfer. The test, after transfer, of quality is did that embryo implant and start a pregnancy. If yes, then I would say it's "quality"improved post-thaw. If not, then it died and quality is not an issue anymore. I hope this helps. Good Luck!!

[deaks66]

Thanks carole!

[deaks66]

Hello deaks66,
I can't tell whether it has an ICM or not either from this pic but there are a couple of areas that could be an ICM. It is hatching which is a very good sign for viability. Yes, assuming that the lab has a good vitrification program, the embryo should survive very well.

so can an embryo get to the hatching blast stage without an ICM? if it can, presumably the embryologist at HRC wouldnt have given it a grade and would have said it wasnt healthy enough for freezing/transfer right?