I realized this morning that I didn't update with yesterdays lab report. I looked forward to that call so much yesterday morning. I got up early and made coffee and sat watching the phone with my fingers crossed. Luckily they called really early again so I didn't have to wait long. All 10 made it through the night again! The nurse who called didn't have a detailed report but said that they are of mixed quality. She put me on hold and talked with the lab techs and they said I'd be transferring on day 3 (today). Apparently I didn't have enough high quality embryos to qualify for a day 5 transfer.
There is a significant increase in success rates when transferring on day 5 rather than on day 3. In our IVF teaching the statistics they quoted were 60% success rate on day 3 transfers and 80% on day 5 transfers.
So you might ask why do anything other than day 5??
The reason day 5 transfers are so much more successful is because they were already strong enough to make it to day 5 outside of their natural environment. Not many embryos are that strong, and there is a risk that you could lose all embryos before getting to day 5 and have none to transfer.
Embryos flourish in their natural environment - the womb, so if they are not doing so great int he lab, it's better to get them back in their natural environment as soon as possible. Before day 3, the embryos have not developed enough to properly judge which ones are developing better than the others which is why they wait until the 3rd day so they can choose the best to transfer back.
Originally I was hoping that I'd be able to do a day 5 transfer so that I'd be confident in that 80%. It would also mean that I had a bunch of amazing looking embryos; so many that I could afford to take the risk. But that's not the case. Mixed quality meant that of the 10 I had, some were really good and some were only ok. If I pushed for a day 5 transfer, I could be risking losing all of them. I'd rather have them safe in my belly were I could nurture them and keep them safe instead of in a lab.
Generally with a day 3 transfer, they transfer 2 embryos to increase chances of success. With day 5, the will only do 1 except in extenuating circumstances; eg. over 40. Transferring more than 1 embryo on day 5 does not increase the chance of success, only the chance of twins.
D and I had a discussion last night and both agreed that the risk of twins was acceptable on a day 3 transfer and would transfer two if that's what the RE recommends.
I'll be back later with a transfer day post!
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