Thursday, October 31, 2013

Grading IVF embryos

The high point of an IVF cycle is the embryo transfer. Making embryos is the one thing which good IVF labs are good at doing and most women get emotionally attached to their embryos. They fondly refer to them as embies, and think of their embryos as their future babies. This is why many women start crying when they see their embryos in the IVF lab – especially when they are of textbook quality. This is the moment they have been waiting for – the climax of their IVF treatment
Of course, not all embryos are going to be Grade A embryos – and many women get upset when they find their embryos are Grade B or Grade C. They are worried that these embryos will result in abnormal babies .
Please remember that embryo grades are simply medical shorthand , which helps doctors and embryologists to communicate with each other regarding embryo quality . An embryo is graded as Grade A when all the cells are equal and there are no fragments. If it has more than 10% fragments or if the cells are unequal, it is called Grade B. It is true that a Grade A has a better chance of implanting and becoming a baby as compared to a Grade B embryo. Thus , if the implantation rate of Grade A embryos in a good clinic is about 20%, for Grade B embryos it will be about 15%. However, if the embryo does implant, the baby will be completely normal.
The fact is that it's impossible for doctors to accurately predict which embryos will implant and which will fail to do so. There’s no reason to get disheartened even if all your embryos are of poor quality . While this does reduce your chances of success, remember that embryos are living organisms, which do have the ability to self-correct. All embryologists have seen embryos which were 6-cell and Grade B on Day 3 turn into gorgeous blastocysts by Day 5 !
When there are lots of embryos, and the doctor has a choice as to which embryos to transfer, he will obviously select the Grade A embryos as compared to the Grade B embryos. However, not all Grade A embryos become babies – and many Grade B embryos do become Grade A babies !
Also, if you do miscarry after the transfer of Grade B embryos, this does not mean that it was the quality of the embryos which caused the miscarriage. The fact that the embryos did implant means they were of good enough quality to grow and develop further in utero after the transfer !
It’s important to insist that the IVF lab provide you with photos of your embryos – even if they are Grade B.  This will increase your confidence in the services provided by the lab , because it shows they are willing to be open and transparent. This information can be very valuable in case your cycle fails and you need to get a second opinion. Every good IVF lab  routinely and proactively provides patients with photos of their embryos.
Sadly, we find that lots of IVF doctors use all kinds of specious reasons for not giving patients photos of their embryos. They claim that taking embryos out of the incubator will damage them ; or that the exposure to light when taking photos will harm the embryos. These are all useless excuses ; and should serve as a red flag that the doctor is trying to hide or cover up information.
Need help is grading your embryos ? 

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