I want all of you to know everything my patients learn during their IVF cycle. I have patients that come to me from all over the country and the world and I’m so surprised how they go through cycle after cycle and they just don’t know these four basic things. I say what was this thing about your IVF cycle, and they say, “I don’t know. I didn’t even know that I could ask that question. I should’ve been told.” If you don’t know these four details, how are you going to know how to do things better or different with the next cycle?
Here are the four things…
Number one is the quality of your eggs. Certainly, there are tests that you can do. FSH, estradiol, AMH, these are fertility screening tests that you can do between cycle days one through four. These can tell you about the supposed quality of your eggs. But just because your levels are normal doesn’t mean that your eggs are going to be good. You don’t judge a book by its cover. That’s a really good one. Clearly, I still don’t have a laugh track, no one is laughing at me tonight here.
Along those lines, there are some genetic fertility tests that you can do to see if you have genetic variants that might tell you that you could have lower quality eggs. At the end of the day, your IVF cycle is the most valuable learning experience, so learn from it.
Q, the quality of your eggs. Are they dark? Are they grainy? Do they have endoplasmic ventricular vacuoles, we call them SER vacuoles. How was it when the embryologist tried to penetrate and fertilize the egg, was there something about the zona pellucida that they noted?
These are all things that are going to be listed as comments on your embryology report. Ask your doctor. Ask to speak with the embryologist. Find out more. This information will guide you as to what you should be doing next, so you don’t have to be going through more cycles. Hopefully, with this information, you can do things that may improve your chances the next time or change what you do differently.
Number two is fertilization. You have the eggs. Now what? You’re going to take sperm and put it into the egg, that’s ICSI. You can put the sperm on a plate called PICSI and then take a sperm and put it into the egg, that might increase your chances of pregnancy. Or you can take a droplet of sperm and put it on top of the egg, and that’s called insemination. Typically for my patients I prefer to do ICSI, and the reason is if you think that there might be a fertilization issue, you don’t want to find out the hard way that yes, indeed there was.
How many eggs were fertilized is number two, also called the rate of fertilization. What is also important is to know how many mature eggs you had. The quality of the eggs, how many mature, how many fertilized is number two.
Number three is embryo development and progression. I call that blast-off. Some people call that blastocyst. Blastocysts are embryos that are 400 to 500 cells or so, and we see them about five to six days after the egg retrieval. As an embryo grows and develops, it’s a dynamic set of cells. When it reaches that blastocyst stage, we give those blastocysts a quality assessment.
We basically tell people how beautiful they are, but we’re used to things being beautiful on the outside and inside. When you look at a diamond, you’re like this diamond is so beautiful, it must also be beautiful on the inside, because it is. You take a little microscope and you look in and you can grade that diamond.
Blastocyst embryos just aren’t the same way. You can look at them on the outside and say you’re so beautiful, there’s a really high chance you’ll turn into a pregnancy, but you don’t really know until you actually transfer the embryo and see if it becomes normal or turns into a normal pregnancy, or you do genetic testing. That’s the last thing, number four. We talked about the quality of the eggs, the fertilization rate, the blastocyst formation rate, and if they are normal or not.
Not everyone chooses to do genetic testing, and that’s okay. If you’re going to do testing, there are certain things that you can learn from your embryos. Not only are they genetically normal or not, but you can also learn about their mitoscore, the amount of mitochondrial DNA that is within each embryo can also tell you potentially about the implantation rate.
These are all the things that I want people to know; the quality, fertilization rate, blast formation rate, and if your embryos are normal or not. You’ve done your IVF cycle, you’ve spent so much energy on it, and if it hasn’t worked, think of it as a great learning experience. Sadly, some IVF cycles don’t work, but you can take that information, take that knowledge and apply it to a new cycle, and hopefully you’ll see the success that you deserve.
Here at Egg Whisperer, I believe that personalized fertility care means understanding you. Everyone is an individual, everyone is so different, and everyone is going to have a different set of four things that we learn from their IVF cycle. Not every egg turns into an embryo, but certainly it just takes one.
Thank you for watching tonight’s show. I hope you’ll watch next week’s show. We have a lot of exciting stuff coming here in the future, and I hope you continue to tune in. Have a great night.
Catch more of me and topics like this through The Egg Whisperer Show. Episodes are aired on YouTube, Facebook, Twitter, IGTV and Apple Podcasts . Sign up to get my newsletter. Tune in to The Egg Whisperer Show on YouTube. and Sign up for The Egg Whisperer School.
