Friday, November 18, 2022

How many IVF embryos should I pool ?

We are now routinely pooling embryos for many patients who want to postpone having a baby. These are usually young women , who don't want to have a baby right now because they want to pursue a career, but understand that babies born from the eggs of older moms have a higher risk of being abnormal; and older women , who understand that time is at a premium for them , which is why they need to generate as many embryos as possible , before they can think about transferring them .

As a woman gets older, it’s her ovarian reserve which drops , while her uterine receptivity remains the same , no matter what her age .

The tricky question is - how many embryos should they store , before they start transferring them. Now, if the implantation rate was 100% and they wanted 2 babies born a few years apart to complete their family, then we would need to freeze just 2 blastocysts, and transfer them one at a time.

Sadly, we know that about 50% of top-quality blastocysts will have genetic defects , and will not implant . Sadly, we do not have the technology to either prevent this or diagnose it, because PGT ( preimplantation genetic testing ) is unreliable and flawed, and generates incorrect information .

This is why we tell patients that if they want to have one baby, they should plan to store at least 4 top-quality blastocysts, because the cumulative conception rate is more than 80% if you transfer these 4, one at a time , over 4 cycles . This way, not only have you stacked the odds in your favour , you also have peace of mind that you have done your best !

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