My email back to the nurse:
From speaking with many other patients at other clinics across the country I’ve learned that other clinics freeze and transfer such embryos, and have success. Perhaps I should have investigated your polices before deciding to seek care here. And yes, we’re very happy with the pregnancy, although it’s still very early, and looking long term, I doubt I’ll feel comfortable seeking another cycle here for future children.
Thank you for the information,
Response from the Embryologist:
The nurse shared your concerns with me. I can provide you with the details, but I realize that the details may not be helpful.
The good quality blastocyst (expansion grade 2, quality grade BB) that was maintained in culture overnight was graded as a fair quality expanded blastocyst (expansion grade 4, quality grade CC) on culture day 6. The volume of blastocoel of the embryo was greater than half of the embryo, but was not as large as the one in the embryo that we transferred (expansion grade 3, quality grade AA) or cryopreserved (expansion grade 4, quality grade BA).
We require embryos to have an expansion grade of 4 and a quality grade of BB or better in order to be cryopreserved. This evidence-based criteria was established after the first 10 years of blastocyst thaw results that demonstrated low survival and implantation rates with embryos that were cryopreserved with lower blastocoel volumes (expansion score <4).
We have 95% survival rates with our vitrification system when expanded blastocysts are cryopreserved and ongoing pregnancy rates in the vitrified/warmed cycles are identical to fresh cycles.
I hope that was not too much information. I am sorry that you’ve been disappointed with our service. I sincerely wish you and Eric all the best. When, and if, you are ready to ship your embryo to another facility, please contact us and we will send you the release consent.
And my response back:
Thank you for explaining further. I guess I’m most disappointed with the communication I’ve received, not on your part, you’ve been great, and actually you’re the only one who has really taken the time to explain throughout this process. Overall though, the clinic gives very little information and is very impersonal, in my opinion, with their patient information line. No one really wants to hear only 1 of their 5 embryos was frozen through a voice message with no further information offered.
On the day of our transfer we were told we had several embryos that were looking good in regards to freezing. If I’d known then that the chance of them not being frozen was so great, I would have certainly transferred two embryos instead of one and at least given another, perhaps one not graded as well, a chance at survival. We were strongly encouraged only to transfer one, even though I really had my heart set on two. If I’d known they were going to be discarded I would have certainly pressed for two embryos to be transferred.
I realize the clinic here is conservative and I want to believe it’s in the patients’ best interest, but from a patient’s perspective, mine, it’s been difficult to truly feel our bests interests are the priority when so many decisions regarding our care are made without our input. In speaking with other IVF patients across the US I’ve learned there are drastic differences in clinic procedures. Looking back, I just wish we’d known more at our transfer and hadn’t been lead to believe so many of our embryos were doing well.
In regards to future cycles I would like to explore other opportunities, perhaps at a smaller clinic where care is more personalized.
Thank you again for the information.
I have a hard time believing only expanded blasts thaw well, as other clinics are freezing embryos at all stages. I’m just so sad and angry. I honestly feel as through they threw away my children. I’m more sad about this than I was after our miscarriage.