Saturday 20 October 2012

FET Report & Grading

First of all, I received an email from SCI advising me that the frozen embryo transfer (FET) went well on October 20. Four embryos were thawed and all for survived the thaw. Embryos transferred included 2 blasts with 3AA and 3BB grade (explained later), Grade 3 morula, and Grade 4 with > 16 cells. There are a lot of stats out there but in the end, my blasts have the best chances. Morula transfers can be successful while I don't put much hope on the Grade 4 embryo that was transferred but you never know!

The pregnancy test is scheduled for October 31 - Halloween! So given the stage of the embryos transferred, instead of the 2ww, I have 10 days before the beta HCG pregnancy test... aka 10dw. With the time difference between Delhi and Vancouver, I'm hoping to wake up to wonderful news on October 31! I'm sure my surrogate is also hoping for the same result - I hope to meet here in 9 months or so!

Halloween is one of my favourite days of the year so hopefully that is a good sign! I found these "monster embryos" online - cute but not something I would purchase. LOL!

Secondly, for those of you wondering what is in the FET Treatment Summary Report, here's what it contains:

General Information
  • Name of patient (me)
  • Date of birth (my DOB)
  • Date of FET

Embryo Information
  • Embryos thawed
  • Embryos survived thaw
  • Embryos cultured to day 5
  • Embryos transferred
  • Details of embryos transferred (i.e., cell stage and grade of each embryo transferred)
  • Whether laser assisted hatching was completed

Embryo Transfer Details
  • Position (doral versus lithotomy)
  • Vaginal discharge (normal versus abnormal)
  • Cervix (healthy versus cervicitis)
  • Transfer Grade (I - no holding cervix, II - cervix held, III - dilater used)
  • Transfer (easy versus difficult)
  • Type of catheter
  • Mucus on catheter (yes or no)
  • Blood on catheter (yes or no)
  • Re-insertion of catheter
  • Date of beta HCG testing (aka pregnancy test)

Finally, some of you are experts with embryo grading given your previous experiences with fertility treatments; however, for those who are new to the embryo grading (which can vary from clinic to clinic), I thought I would provide a basic summary.

It appears SCI grades their embryos from 1 to 4 with Grade 1 being the best. Grade 1 embryos are "morphologically perfect, with round, symmetrical cells. They have the appropriate number of cells for their stage of development. Cell division is even, and there is no visible fragmentation. Only 20% of embryos receive the highest grade. Most embryos have slight imperfections, and this is normal and expected." Grade 2 embryos have "the correct number of cells for their developmental stage, and usually have even cell division. They might have slight unevenness of blastomere sizes and/or a small amount of fragmentation (<20%). Grade 3 embryos have "uneven cell division and moderate fragmentation (>30%), or are behind in their development, or have similar irregularities. Finally, Grade 4 embryos have "uneven cell division and extensive fragmentation (>50%). They may have few viable cells or be completely fragmented."

Generally, lower grades are associated with poorer chances for a viable pregnancy. Two of my embryos transferred were graded 3 and 4. However, keep in mind that success does occur with lower grades albeit a lower chance of success. You may just be one of those individuals who are in that minority of success with lower grade embryos. Plus there are other factors that will determine success.

SCI also grades with a number and two letters. "The number refers to the amount of expansion, the first letter to the quality of the inner cell mass that will develop into a baby, and the second letter to the quality of the outer cell mass that will become the placenta." My blasts are 3AA and 3BB - depending on the grading scale used, 3AA would be excellent to good while 3BB would be good to fair. Again, in the end, percentages and other factors aside, you just need one to make it to the finish line.

Thank you for letting me share this part of my world with you!