In this episode of Ask The Egg Whisperer, Maree writes in with this question,” Hi Dr Aimee! Love your jokes and sense of humour. We are so lucky to have you as a positive beacon of hope on this fertility journey. I am 40 years old, my AMH is.46, and FSH is 8. At my first retrieval, we fertilized 2 eggs. One made it to day 5, no blast, the second blasted! But it was not genetically normal. Is it useful to get the embryo report from the lab even though the blastocyst wasn't genetically normal? Can the grading of the egg still be useful in learning more about my egg quality?”
My answer is that it is helpful to get the embryo report. I like that Maree says that her embryo “blasted,” because when I email my own patients about blastocysts, I usually make the subject line “blast off!”
Reaching the blastocyst milestone in IVF is a really good sign. In making a decision as to how many cycles to do for a patient who is 40 or over, I use blastoff and having a blastocyst is a sign that it's okay to keep going. Sometimes, it can take several cycles to even get one healthy embryo.
My DIAMONDS mnemonic is helpful in this situation. Embryos are like diamonds: they're sparkling on the outside. Unfortunately, you really can't tell their implantation potential without either transferring or doing genetic testing, or a little bit of both because sometimes even an embryo that has normal chromosomes might not implant.
D: Day your embryos were frozen. It’s very important to know whether it was a day, five, six or seven.
I: Implantation rate per embryo. If the embryo is tested, then you can calculate that rate.
A: did the embryo came back as abnormal?
M: is the embryo mosaic? Up to 40% of the time of a mosaic embryo can turn into a healthy live birth. So that's why I knowing if an embryo is mosaic or not is important.
O: Official Reports. Be sure and get the reports from the lab and review with your doctor.
N: Normal Embryos. Consider PGT testing to confirm that the embryo is chromosomally normal.
D: Dreams Come True. Make sure that when you are growing embryos, you have enough to have the family size of your dreams.
S: Sperm Matters
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