Embryo Grading at Boston IVF | NIAW 2021

[@lisaapollo9597]

Thank you sooooooooo much for taking the time to make this super informative and easy to understand video! I was really concerned that my embryos were bad. Also, previous to your video, I thought day 5 would be the number grade with letters following. My report showed Day 5 and Day 6 embryos, followed by other numbers with letter. I had no idea what that meant until now. Thank you again

[@Boston_IVF]

Hi Lisa! We are very glad we were able to help shed some light on the subject! We are also offering a Instagram Live with Jess Bailey this Wednesday 4/27 if you want to check it out. instagram.com/boston_ivf/

[@lovejones8282]

This was awesome!! Very clear information!

[@Boston_IVF]

Thank you, glad you found it helpful!

[@stephncolman]

I’ve seen some research that says day 6 embryos have lower success rates than day 5-can you discuss this?

[@Boston_IVF]

Hi Steph, here's some more information about that from Chief Cryobiologist Jessica Bailey: That was an older way of thinking as there was originally some data that suggested that there was a higher rate of aneuploidy (an abnormal number of chromosomes) among day 6 embryos when compared to day 5 embryos. However, today, we look at this very differently. Many embryos used for frozen embryo transfer are genetically tested and only the euploid embryos (those with a normal number of chromosomes) are transferred. In this case, the concern for ploidy has been addressed. Additionally, based on our data of 100,000s of embryos, both those genetically tested and those that are not, we have found that day 5 and day 6 embryos have near equal implantation potential. Instead, we focus on the elements among the grading that do show some significant difference among the implantation rates. We have found the grade for the trophectoderm cells (those that become the placenta) are the most key factor for implantation and use this grade first when selecting embryos for thaw and transfer to the patient’s uterus.

[@Parmar.angelk]

I’m 48 using donor eggs with my husbands sperm. We had four eggs, two never made it past fertilization. We now have two embryos, day 6 2BB and a 1BB. My IVF coordinator is saying only transfer one but I spoke to the embryologist and she suggested that we transfer both to increase our chances. What would your advice be in this situation?

[@Boston_IVF]

Hi Wild Southern Rose, thank you so much for this question! While unfortunately we cannot offer tailored medical advice, we do have some information from one of our fertility specialists that we are happy to share: The grading system applied to your embryos is not the same as Boston IVF, so it would be difficult to know how those grades definitively equate to a standard system. However, if PGT has been performed, it would be recommended to transfer only one euploid embryo since pregnancy rates are reset to match that of younger patients. If these are untested embryos, it is estimated that patients over 42 have less than 5% euploid embryos and may benefit from the transfer of 2 embryos at the same time. It is important to note that there may be insurance or regulatory restrictions, depending on where you are being treated. At the end of the day, make sure to talk all your options through with your IVF coordinator, as they will have the best understanding of your circumstances. We wish you all the best!

[@vanshikavashisht5086]

Very informated video thank you🙏🙏Mam my AMH is 2.3 and on the first day of ivf i had 8 eggs before starting ivf injection but at the time of egg retrieval only 7 mature eggs we got. Is it normal? Please please please reply back.🙏I'm 36

[@Boston_IVF]

Hi Mahi! Antral follicle counts are performed so the practitioner can forecast the patient's potential ovarian yield post-stimulation. It is not uncommon to get more or fewer eggs post egg retrieval. Stimulation can recruit additional follicles yielding more eggs and an eager lead follicle can shut down growing follicles yielding fewer eggs. Oocyte maturation can also be correlated to the antral follicle count.

[@chiaradegiacomi2636]

Does a 3BC graded embryo have any chance to continue expanding after thawing until the hatching stage?

[@Boston_IVF]

Hi, Chiara! Yes. After thawing, the embryos will continue to grow, just as they did prior to the freezing procedure. They will pick up where they “paused” and should continue through the steps towards hatching and implantation.

[@chiaradegiacomi2636]

@@Boston_IVF Thank you so much! you're giving me hope!

[@Boston_IVF]

@@chiaradegiacomi2636

[@lotusflo12]

Thank you

[@Sulin3tt3]

would the success of a b4cc (day 7) be none, since its already a day 7? or what are the chances when the grading is cc day 7?

[@Boston_IVF]

Hi Sulin3tt3, here's an answer to your question from Chief Cryobiologist Jessica Bailey: Unless the embryo is arrested, the chance is never zero. I do not have a concrete statistic for a poor day 7 embryo, since we generally are not selecting these embryos for transfer. In fresh cycles, we never transfer beyond day 5. In a frozen cycle, the body will treat the day 5, day 6 and day 7 embryos all as if they are day 5. In general, we see about a 20% reduction in implantation rate for day 7 embryos with good quality, and therefore select these for last. A poor-quality embryo would reduce the implantation rate even further.

[@devikalaishram6040]

What are the chances for day 3 grade c 8 cells embryo

[@Boston_IVF]

That's an excellent question, Devika. We recommend you ask your care team this!

[@meenasharma5657]

Hi mam with c grade blastocyst embryo pregnancy is possible

[@Boston_IVF]

Hi Meena, here's an answer to your question from Chief Cryobiologist Jessica Bailey: Having a C grade embryo does not mean that there is no chance of pregnancy. We often transfer C grade embryos in the fresh cycle. These embryos are still growing and should continue to grow toward becoming a pregnancy. However, it is difficult to freeze C grade embryos since there are less cells to tolerate the freezing and thawing procedures. Though they may survival, the thaw pregnancy rate among C-grade embryos is significantly reduced. Additionally, we would be unable to biopsy C grade embryos since there are too few cells to remove some for testing and retain enough for uterine implantation, a critical step for achieving pregnancy.

[@meenasharma5657]

Thnx doctor but in my case doctor use frozen embryo transfer because the risk of ovarian hyperstimualation. Only one c grade embryo.

[@Boston_IVF]

Hi Meena, your fertility care team will always be your best resource for getting information and support!

[@meenasharma5657]

Thnx

[@tinabobby9356]

Would the success of a 6AA embryo be low since it is already starting to hatch?

[@Boston_IVF]

Boston IVF uses the Gardner scale to grade our embryos. 6AA is the top grade for the Gardner scale. This means the embryos have completely hatched from the zona pellucida (eggshell)--something all embryos must do prior to implanting into the uterus. Additionally, a 6AA has exceeding expectations for both the number of cells in the ICM (first letter) and the trophectoderm (second letter). This embryo, whether a day 5 or day 6 embryo, would be amongst the first to select for embryo thaw and transfer.

[@tinabobby9356]

@@Boston_IVF thank you so much for the information!

[@Boston_IVF]

@@tinabobby9356 Of course!!

[@citlallinayeliorozco-mcgin4915]

What about a grade 3m and 3l>9?

[@Boston_IVF]

Great question! We recommend you ask your care team this, as the grading system applied to your embryos is not the same as Boston IVF, so it would be difficult to know how those grades definitively equate to a standard system.