13 Responses to “Embryo Grading: CGH-Normal Blastocysts Have the Highest Success Rates”

1. melissa says:

   September 20, 2009 at 7:32 am

   Thank you as always for educating us on the newest breakthroughs in fertility treatment,etc. I have read so much contradictory information from medical professionals and fertility clinics on the do's and don's during IVF that I need some clarity.

   For example, besides the factors that we cannot, as patients, control (age, ovarian reserve, uterine competency,etc) what CAN we do do assure a successful outcome? Vitamins? Also, I have read that during ovulation stimulation a couple should abstain from sexual relations, is this true? What about following the egg retrieval and embryo transfer, how long must sexual relations be avoided? What sports and activities should be avoided and for how long. What about caffeine and alcohol, is it better to completely abstain?? For many of us, this is an incredibly stressful time as we cannot control many factors, so it is helpful to know exactly what we CAN do to maximize a successful outcome. Yes, I have heard many times to remain calm and not to stress too much, but your opinion on this could be very helpful. Maybe an idea for a future blog article.
   Thank you!

   Reply
2. Geoffrey Sher, MD says:

   September 20, 2009 at 11:00 am

   I cannot answer all the questions you raise. the influence of exercise viamins, and stress etc, there is greatcontroversy about their benefit. A great deal that has been written is anecdotal and represents unvalidated opinion. As far as alcohol and tobaco—comon sense says avoid these after ebryo transfer.

   I can tell you that when it comes to insuring the best treatment and the nbest possible outcome, it is very much dependent on the expertise, and skill of the medical and laboratory team and experience of the IVF center that you seek services at.

   The factors that affect IVF outcome are a)those that impact egg/embryo quality ("competence") b)those that impact uterine receptivity and, 3) technical expertise of the treating team.Many of these are vspelled out in the articles on this blog, through several books on the subject and and through website information that you will find at sites such as http://www.haveababy.com.

   Geoff Sher

   Reply
3. Schlaura says:

   June 10, 2010 at 2:02 pm

   Hello,

   I am wondering if a blastocyst was graded AA by the Gardner grading system – does it have a lower chance of having chromosome abnormalities such as Down's Syndrome, etc?

   Thank you for your response.

   Laura

   Reply
4. Geoffrey Sher, MD says:

   June 11, 2010 at 3:38 pm

   Lower yes. Absent chance..No!

   Geoff Sher

   Reply
5. Jonathan says:

   August 9, 2010 at 7:07 am

   Dr. Sher,
   Has anyone studied the correlation between embryo quality and miscarriage rates? It is clear that embryo quality correlates positively with successful implantation, but once pregnancy has been achieved, is there a positive correlation with rates of live births?

   Reply
6. Geoffrey Sher, MD says:

   August 9, 2010 at 8:59 pm

   The commonest cause of both failled embryo implantation and of sponateous miscarriages is the same…chromosomal abberations (aneuploidy). Thus age is the common denominator. The older you get the more likely you are to have failed implantation as well as miscarriages.

   Geoff Sher

   Reply
7. Jonathan says:

   August 10, 2010 at 5:22 am

   Dr Sher,
   I understand that age is a known factor. Given that, however, a woman of a particular age may produce at different times different quality embryos, which would be graded and known in the case of IVF prior to transfer, is there any known correlation between miscarriage rates and the actual grade quality of the embryo. For example, if a 40 year old woman achieves chemical pregnancy after the transfer of 3 top grade embryos, is she more likely to carry to term than that same woman achieving chemical pregnancy after transfer of 5 medium grade embryos?
   It seems logical that this would be the case, but I can't find any studies that have explored this.

   Reply
8. Geoffrey Sher, MD says:

   August 10, 2010 at 10:49 am

   Indeed, the poorer the morphologic quality (Grade) of the embryo the greater the likelihood of chromosoamal problems and aneuploidy. However, advancing age is an independent vatriable,such that even the highest graded day 3 embryos are more likely to be aneuploid. However, even beautiful looking embryos can be aneuploid and are more likely to ber so if derived from an older woman's egg. As an example; if 2 embryos are both of excellent grade on day 3 but the one (emnryo A )is from the egg of a 30 year old and the other (embryo B) is from an egg of a 45 year old, then the likelihood of embryo B being chromosomally abnormal (and thus not implant or result in a miscarriage would be about 8-10 times greater than for embryo A.

   But you are right! There are no definitive studies to confirm the obvious.

   Geoff Sher

   Reply
9. TaShana says:

   December 31, 2010 at 12:11 pm

   Hi Dr. Sher, I am wondering how long the CGH test takes? We have always done PGD on day 3 with a day 5 transfer since you get the data back on late day 4 or early day 5. Can you help me understand that – particularly if we freeze and aren't bound to do a transfer by day 5.

   Reply
10. Suzanne says:

    February 24, 2013 at 10:03 am

    Dr.Sher,
    We did a fresh transfer, but it did not result in a pregnancy. I am fine (26), my dh (29) has severe male factor.
    We had 10 grade 1(best) embryos. We transferred two blasts. Was wondering if the transfer could have affected our results. I had a mock embryo transfer 2 weeks before the transfer, everything went great.
    The day of the transfer I had an intern,(not my Dr.) do the transfer. It took over an hour for the procedure. He tried 3 different caths, and it was very painful. It seemed as if he did not know what he was doing. We will be meeting with our Dr. soon to discuss this.

    Reply
    • Geoffrey Sher says:

      February 24, 2013 at 6:56 pm

      You are correct, the transfer is a critical part of IVF and it needs to go smoothly. However, if at your age (so young) two blastocysts of good quality were transferred but you did not conceive, an implantation issue must also be considered and carefully assessed before you try again.

      Geoff Sher
      800-780-7437

      Reply
11. Ingrid says:

    May 3, 2013 at 3:59 am

    I have just had two 3 day embryos transfered, one of them was an A grade embryo with at least 8 cells. Is this still less likely to implant than a blastocyst? I was pregnant with quads 2 years ago and had a selctive reduction but miscarried my twins at 18 weeks. I have since had 3 cycles of IVF including this one but the first two failed. I am now 35 and have a low ovarian reserve. if this does not work what are my best options?

    Many thanks

    Ingrid

    Reply
    • Geoffrey Sher says:

      May 3, 2013 at 6:26 am

      Yes, it is less likely to take than an expanded blastocyst because may abnormal embryos cull out and do not reach blastocyst.

      With DOR you might want to consider a more aggressive and a very strategic stimulation protocol followed by staggered IVF with selective embryo banking (see below).

      Please go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.

      1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)

      2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”

      3. “Agonist/Antagonist Conversion Protocol”

      4. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)

      5.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)

      6. “IVF success: Factors that influence outcome”

      9. “Staggered IVF”

      10.“Embryo Banking”

      Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail

      Geoff Sher

      Reply