3dt success?

After 1 failed fresh and 1 failed frozen cycle, we're back at the beginning and trying to come up with a plan.

We're dealing with MFI and a short LP - no other known issues. I had a hysteroscopy last week and everything is perfectly fine (which they anticipated it would be since there are no signs of issues). I've gone for additional blood work but again, they don't expect to see much.

Last time we had 21 retrieved, 17 fertilized, 17 made it to day 5, transfered 1 and by day 6 we lost all but 2 (which we froze and used in the FET).

We're a couple weeks away from starting another fresh cycle and we consulted with another doc in the same practice. His suggestion was, since I react so well to meds and we also fertilized a good number, to put back 2 on day 3 and freeze the rest also on day 3. He believes embryos work best in their 'own environment' - he said while still good, he does not believe the lab is the better environment. Our risk is not knowing which will go to the blast stage but our benefit is possibly having upward of 15 to put back in frozen transfers (if we have a similar cycle to last). Of course we know he isn't giving us any guarantee or any scientifically proven info, but we're thinking it may be worth a shot. We could also freeze half of them at day 3 and let the rest go to day 5/6 - but that would be a random sample and we wouldn't know if any will make it to do 5/6

With 50% OOP I don't know how many more fresh cycles we can do (this will likely be the last one or possibly one more after at best).

Wondering if anyone has thoughts or experiences that may shed some light?? TIA!

Re: 3dt success?

While I don't have direct experience with this, I do have some advice.

3dts can be very successful. However, when dealing with MFI it's not always so straightforward. What are the MFI issues? That would weigh heavily into my decision. And are you using ICSI? If it's just a count issue, then a 3dt may be fine. If it's quality, I'd hold out to a 5dt.

My reason is this - the egg dna is primarily responsible for the embryo quality until day 3. At day 4, sperm dna kicks in, which is one reason you'll see so much differentiation between embryos.

When I did IVF, dealing with MFI, we had all A and A+ embies on day 3. By day 5 they had all slowed and only had morulas (stage before blasts). Needless to say, the IVF failed because of the quality of the sperm. If you have MFI regarding quality of sperm, I'd hold out to a 5dt to get the best embies to put back in. Or, you can do a 3dt but let the other embies grow to day 5 and freeze then. My personal opinion is if it's going to work, the embies should be strong enough to live 5 days in a lab. Otherwise, the cycle probably would not have stuck anyway.

Re: 3dt success?

For my first IVF, we did a 3dt. I had around 30+ follicles, 9 eggs, 6 mature, and 4 that actually fertilized.

Since I only had 4 embryos, my RE wanted to give me the best chance since it was likely we would not have any to freeze (which ultimately, we did not) .. so we transferred back 3 embryos. Two embryos implanted and one split, so I had triplets. I ended up miscarrying all 3 for reasons unrelated to the fact that it was a 3dt. I had a subchorionic hematoma and my care was very badly mismanaged.

A 3dt is standard at many REs and (as you can see) they absolutely could end in success stories! (despite my miscarriage)

I think since your cycles are somewhat limited due to $$ you should consider getting another opinion from a different practice just so you can say you covered all your bases. That's something I wish I did MUCH earlier in the game.


Good luck!

eta: I was on my phone when I originally read your post and guess I missed the male factor part - we are not dealing with male factor issues. Still, I think it's worth it to seek out an opinion from an entirely different practice. These days..... taking a break from constant cycling and seeking out other opinions is advice I can't stress enough!

Message edited 11/26/2012 2:15:24 PM.

Re: 3dt success?

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Re: 3dt success?

Posted by mrsanonymous

Posted by PennyCat

I think since your cycles are somewhat limited due to $$ you should consider getting another opinion from a different practice just so you can say you covered all your bases. That's something I wish I did MUCH earlier in the game.

Thank you for sharing your story and advice. This is something I've been thinking about a lot. Part of me feels like I should go elsewhere and part of me feels like I've drained so many ideas/tests/etc that I'm not sure what another practice can do for us. I know so many people who were successful with my doc which is why I started going there to begin with...but then there's the what if I'm one of the cases he can't resolve.

As you can see I'm quite torn...wishing I had a crystal ball to tell me the 'right' thing to do! (I'll share if I find one!)

Thank you again, going to talk to DH about this

Re: 3dt success?

Thank you again. My other hesitation is that the ONLY other thing we can think of is related to auto-immune issues (I've had a positive ANA since I was was very young) but the only doc I've seen (locally) who specializes in that is Braverman. I've see some *not so great* reviews on him but more importantly, from what I understand he is out of network only and is more costly? I may be grossly misinformed...guess it's worth a call.

3dt success?

I had a 3dt success! We also were dealing with MIF. My DH had 140M count with only 1% normal form. Yes still possible to happen naturally, but we saw a RE after a year of trying. Thankfully because not only were we dealing with MIF, my tubes were also blocked. I had 17 eggs retrieved. 1/2 ICSI. Zero fertilized on their own and only 6 of the 9 ICSI fertilized. I was fortunate to have 2 to transfer. But we had none to freeze. We were very lucky to have 10k max for our ins. I knew that if it didn't work we wouldn't be able to afford to pay for a cycle OOP. Its hard when all your hope is banking on that cycle. Best of luck to you!

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3dt success?

I had a 3dt success! We were unexplained IF and had 2 chemicals afer 5d FETS. I had 18 out of 24 eggs fertilize my first ivf, but due to hyperstimulation, we froze what we had at day 5 - which was 4 blasts. After 2 new consults with different REs, which switched practices. My new RE felt that although we had good fertilization rates, something may be going on from day 3 to 5. Therefore my next round we chose a 3dt before my cycle began. This time i had many less eggs b/c i was petrified of hyperstimming again and my RE chose a very conservative treatment plan. 3dt can absolutely be successful!!! Good luck!

Message edited 11/26/2012 4:51:47 PM.

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I don't have any input, but I just wanted to send out some hugs and prayers for you. It is so hard to know what to do, especially when funds are limited.

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I also forgot to add we paid oop for everything. It was a tough decision to do the 3dt when you hear everyone else talk about 5dt but I went with my gut and what my RE felt was the best plan for us given our unexplained diagnoss and history with 5dt. Good luck

3dt success?

please call me...i would love to weigh in on this with my opinion but my carpel tunnel hands cant type that much :)

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Thank you for all those that sent well wishes. Congrats Anne44...so glad t hear your wonderful story!! Thank you for the additional insight. Julie...def going to call tomorrow! Hopefully we get in touch. NYCGirl...I think what you're saying makes very good sense. It's been in my thoughts and is the reason I even mentioned it to the doc. I have to think there is somethg to it...going to see what additional info I can find.

Thanks again ladies...you guys are the best!

Message edited 11/26/2012 11:44:43 PM.

Re: 3dt success?

I did 3dt for both of my IVF cycles, the second of which gave me my DS!

We dealt with male infertility as well, and had to use poor quality frozen sperm. The first cycle, I had 5 eggs retrieved, 2 fertilized with ICSI. We put back both on day 3 and That resulted in a chemical. For my 2nd cycle, 11 eggs were retrieved, 10 were mature and only 3 fertilized with ICSI. We put all 3 back and one took.

Both 3 day and 5 day transfers have good points- my RE also believed that embryos do better in a uterus than a dish!

Good luck!

Re: 3dt success?

We have done both a 3dt and a 5dt. Both times we were using less than ideal quality embryos and both times we ended in a BFN. We are dealing with severe MFI and using poor quality frozen sperm.

ShhhTTCin11 - I know we were dealing with similar issues - what was the sperm quality you were working with like?

3dt success?

I don't have a huge amount of advice - I just wanted to say that we did 3dt (frozen cycle) and it worked the first time. All my frosties are day 3.

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Thanks, ladies. Your experiences give us a lot to think about. For me, one of the scariest parts of IF is that there are too many choices on what to do and you just don't know which is the right path. We are spending the next couple of weeks to think out all the options and hopefully come year/end we'll have a plan.