Dr. Smith replies again
You're right that many programs will transfer the embryos on day 3 when they are concerned that the embryos may not develop to the blastocyst stage. HOWEVER, its not because they feel the embryos will do better in the uterus. They know there's no scientific evidence to back up this assumption. It is because they do not want to face the patient and infom them their embryos failed to reach the blastocyst stage. They are afraid that you will think the embryos failed to grow because of suboptimal lab conditions. As I explained, the embryos fail to reach the blastocyst stage because they are genetically incapable of doing so, not because anything anybody did or didn't do. In our program, we attempt to grow ALL embryos to the blastocyst stage. We have at least 1 blastocyst stage embryo for transfer 96% of the time.
You'll notice in your research into the pactices of other programs that no programs claim that their pregnancy rates improve when failing embryos are transferred to the uterus on day 3. The rationale for a day 3 transfer is to get out from under the "blame" for the failing embryos. By transferring failing embryos on day 3, the program also transfers the responsibility for the subsequent failed cycle to the patient. It is a subtle manipulation of the patient's emotions. Here's the scenario: "We're so sorry the cycle didn't work, but you know the embryos were still growing when we transferred them. We don't know what you did to them afterwords. Wanna try again?" Using this pyschological manipulation, it becomes the patient's fault the cycle didn't work, not the programs's. See how it works?
Interesting. This is what I hate about If treatment, no consensus amoung docs. So frustrating.
ReplyDeleteThank you for checking out my blog! This is a subject that I am interested in also. I know at my clinic they push for a day 5 transfer. What they told me (this may or may not be true) is that if an embryo makes it to day 5 there is a higher chance of success. That being said they tried to use the rational that sometimes embryos just prefer to be growing in us than in the lab so don't take a day 3 transfer negatively. I know this likely doesn't help.
ReplyDeleteOne thing I can tell you is that I read recently on a board for my clinic that a couple was called on day 2 (that's the protocol at our clinic - a day 2 decision regarding a day 3 or day 5 transfer) and they were told they would go to a day 5. Well on day 5 they went into the clinic only to be told all of their embryos arrested on day 4 (but no one called them!) so they had nothing to transfer.
Good luck to you!
Hey there--I did a day 3 transfer with my son...well, that obviously worked. We did it b/c there weren't many embryos (5) and they wanted to transfer something. Fast forward nearly 3 years. Now, my clinic only does day 5 transfers b/c they are better able to differentiate between the embryos as to which were the better ones. The way my RE describes it: imagine you are observing a 5 lap race. If you stop the race on the 3rd lap and chose the top two runners, you don't really know WHO would have won the race. The leads on lap 3 may not be the leads on lap 5. Day 5 hasn't worked for me yet...but maybe this time.
ReplyDeleteC- thanks so much for sharing all of your dr's thoughts on day 3 vs day 5 transfers. He confirms my thouhts. Hope it will help you be calm about whichever day you end up transferring.
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