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Nicole the Fertile Chick: Embryo Transfer – Day 3 or 5?

Nicole The Fertile Chick

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Our IVF sisters will immediately know what this question refers to. It is the dilemma of many-an-IVF process – what day, exactly, to transfer the fertilized embryos. But let me backtrack a little…to educate those of us for whom this phrase might sound alien.

Some weeks ago, we talked about the “joys” of injections and meds of an IVF process. Those were essentially to stimulate the production of eggs. When these eggs are nice and ripe, they are harvested (during what is called the egg retrieval process, or “ER”), after which they are mixed with the partner’s semen in a petri dish for natural fertilization, or directly injected with sperm (in a process called Intra-Cytoplasmic Sperm Injection, “ICSI”). Whichever the case, you should hopefully now have a few fertilized eggs, i.e. embryos. This brings us to the question at hand: when is the perfect day to transfer these embryos to the uterus?

The common theory is that, it is best to groom these embryos till day 5, when they are now blastocysts. The theory for this makes a lot of sense. By day 5, it is more possible to identify the stronger embryos to transfer. Weaker embryos, or those with chromosomal abnormalities, are expected to have arrested before they reach the day 5 mark. In effect, since only “strong” embryos will be transferred at day 5, the chances of pregnancy are expected to be higher. And in truth, generally, success rates with day 5 transfers are actually higher…but there is still a BUT…and I’ll get to that shortly.

The other school of thought is that fertilized embryos should be transferred to the uterus as soon as possible. This is based on the theory that these embryos are better off in their natural environment, i.e. the uterus. Today, I see the logic with this theory…but a few years ago, it would have been unheard of for me.
I have talked about the online community I was a member of, at the time I started my own IVF cycle. There, having day 5 transfers was the order of the day. Sure, there were the few people who opted for earlier transfers, but almost everyone opted to get to blastocyst stage. And their success rates seemed quite impressive, so I was all the more determined to also have a day 5 transfer.

So, from the very beginning of my sojourn at the first clinic where I cycled, I told everyone who cared to listen…the doctors, the nurses, the accountants…everyone whom I had cause to interface with…that I was definitely having a day 5 transfer. When the time for my egg retrieval came by, I paid the extra fee required to take the embryos to blastocyst, and prayed I would have enough embryos for this to happen, as the clinic’s policy was that there had to be at least 5 embryos to attempt a day 5 transfer. Luckily, I had 9 embryos, so I felt good to go! Everyday, I called their Embryologists to check on my embryos, and was excited with the progress reports I got…at first. They were dividing excellently, and were in perfect condition….but that was until they got to day 4, after which they appeared to stall. By day 5, only 2 of the embryos had gotten to blastocyst stage…the rest were still morulas (what they are supposed to be at day 4). Needless to say, that cycle failed.

So, I returned to my longtime Gynaecologist, and decided to have my second cycle with him. As usual, I came armed with my request for a day 5 transfer, and was shocked when he vehemently refused. He apparently belongs to the school of thought that favours earlier embryo transfers. I then started arguing about why I HAD to have a day 5 embryo transfers, citing all the statistics I had gotten off the Internet. He listened patiently as I reeled all these off, before pulling out my case notes to discuss my prior cycle. He explained that, apart from the fact that he believed embryos fare better in their natural environment, a lot of Nigerian hospitals were not equipped enough to take embryos to blastocyst stage. Apparently, after day 3, the medium required to store these embryos to blastocyst stage is a different one, and this is where a lot of local hospitals falter. And then like a typical Oprah light bulb moment, it hit me. At the other clinic, my perfect embryos suffered a sharp decline after day 3, i.e. when their storage medium was changed. It was apparent to me that they had probably been ill-equipped to offer day 5 transfers. With this realization, I surrendered and decided to go along with his plan for an earlier transfer, which in my mind was a day 3 transfer… except, it wasn’t. The day after my egg retrieval, my doctor told me he would rather transfer the embryos at day 2, and asked me to return to the clinic the next day. To say I wasn’t devastated would be putting it mildly! Day 2 ke? When I was only just going to manage day 3! As disappointing as it was, I knew I just had to trust my doctor…and, most of all, trust God. So, I proceeded to have a day 2 transfer…and I have my babies today.

Of course, 4 years down the line, I am sure the faulty storage medium issue is no longer the case for most local hospitals. Over the years, a lot of these clinics would (or should) have been able to refine their processes and systems, so I’m sure taking embryos to blastocyst stage won’t be a problem for them. But I’ll bet there are still a few hospitals not well equipped for this service, but which will keep offering it anyways…so beware! If you are cycling in Nigeria, and wish to have a day 5 embryo transfer, just be sure you do enough due diligence on the clinic you are using, and make sure you ask A LOT OF QUESTIONS. Whilst I don’t generally believe in clinic success rates, in this case, they are extremely important. You want to know how successful they have been with their day-5 transfers. If this number is low, my advice will be for you not to waste your money and opt for an earlier transfer jeje!

The bottom line is, yes there are a lot of benefits of having a day 5 transfer, but day 3 (or even day 2, like I had) transfers have theirs as well. It is important to weigh all your variables, with respect to the number of embryos you have, the clinic you are using, and your general circumstances, to be able to decide which is a better option for you!

Good luck!

Photo Credit: Dreamstime | Michael Zhang

Nicole is a woman in her late 30s, with a passion for all things fertility related. She suffered infertility for the first 3 years of her marriage, and found it extremely isolating. After she had her kids, she started The Fertile Chick (www.thefertilechickonline.com) to create a community and happy-place for all women, in various stages of the fertility journey.

33 Comments

  1. Kachi

    July 20, 2015 at 8:34 am

    Hi Nicole. Nice one. Frowning at day 5 transfer, that means frozen embryo is not an option?

    • nicolefertilechick

      July 21, 2015 at 2:50 pm

      Hi Kachi. Frozen embryo transfer is most definitely an option. A lot of women opt for it. I didn’t destroy my embryos, so might have a frozen transfer soon 😉

  2. Me

    July 20, 2015 at 10:51 am

    I’m here for the first time…I’m 24 and Dr’s said I ll need to have an ivf due to removal of my tube after an ectopic pregnancy,d other tube was repaired due to adhesions so chances of pregnancy are very low…I feel sad and depressed cos I’m not Evn married and only me knows what I’m going through…quite sad but I’m grateful to god for life! I ll cross the bridge when I get there by God’s grace

    • nicolefertilechick

      July 21, 2015 at 2:50 pm

      Hello Me. So sorry about your tubes, but don’t be discouraged. IVF might seem daunting, but it has helped a lot of women. If you want to talk more, you can email me at [email protected]

  3. Me

    July 20, 2015 at 10:52 am

    *God

  4. Madge

    July 20, 2015 at 11:27 am

    Please use Napro Technology. IVF is against the dignity of humans and God’s plan. Women are treated like guinea pigs and the underlying problems are never addressed. Unwanted embryos ( potential human life) are discarded like trash. Please people, I know it’s hard. I know the desire for a child, but it should not come at any cost. Investigate Napro Technology, morally ethical and with a higher success rate than IVF.

    • Fabulicious

      July 20, 2015 at 12:08 pm

      Aunty please this page is not for Naprotech,maybe you can get a column from BN to gain followers for your method.That child that is born through IVF who is the class genius and goes ahead to win scholarships and does big things for their family is God’s child and God’s great plan for the world as well.You have no right to tell women what to do with their bodies.Nicole’s articles are about awareness and support.

    • molarah

      July 20, 2015 at 3:42 pm

      Are we still referring to ‘women’s right to their bodies’ on a post talking about child bearing? So what then are these children? Just appendages or a whole life on their own?

      She raises an important point on ethics, and if it has to do with human life (which includes zygotes, embryos, babies, children), then it must be aired. Don’t try to muffle her with this ‘women’s rights’ business.

    • Madge

      July 20, 2015 at 7:10 pm

      No Aunty, I don’t want a column. I merely presented an alternative. I don’t need a roll call on all the achievements of IVF babies, I know one myself and she is beautiful in everyway….but that’s not the point. All this bleating about no one should tell women what to do with their bodies is EXACTLY my point . Modern society has reached a point where anything goes, under the banner of ” rights”, all manner of evils are permitted. We don’t like being inconvenienced. We are all knowing and prideful , chanting imported mantras like ” just do you” & “so long as you’re happy”. Well sorry. The truth is no one has a RIGHT to a baby. Just because you can, doesn’t mean you should.

    • Madge

      July 20, 2015 at 7:19 pm

      Yes, let’s just call Gods name multiple times and any sin is legitimized. Like the people who stand up and give sweaty testimonies in church for the blessing of their new Lexus jeep which arrived via fraudulent means. Yes, everything is a blessing. Hallelujah! Mscheww!

    • ShopperOflife

      July 20, 2015 at 5:24 pm

      @Madge, My sistas children thru Ivf are thriving. One will enter Uni next year. She waited for three years and took things into her own hands even as doctors kept saying there was nothing wrong. She could have waited forever.

      Pls. Gerrararahere. Take your advertisement elsewhere.

  5. Etebefia

    July 20, 2015 at 1:35 pm

    @Madge…….. I did you a favour and decided to goggle the Napro technology, The way you pass your message will determine people’s response to it. Don’t stuff it down anyone’s throat, neither should you condemn anyone. I almost certain that you have not dealt with fertility issues…………..Well, News flash, for every beautiful sister out there who is going through one, there is a fixation that bothers on insanity when you are trying to have a child, and sometimes you are willing to try anything. IVF is something that has given couples around the world so much joy. As every mother who has procreated through IVF will gladly tell you, if having my babies through IVF willl lead me to hell, please show me the way.

    • Madge

      July 20, 2015 at 7:03 pm

      Look, the truth is neither comfortable nor popular. My intention was not to shove Napro down anyone’s throat, it was merely to inform that there are alternatives. IVF clinics are quick to tout their successes, they rarely highlight the trail of heartbreak they leave behind. Evil cannot be permitted merely for a so called greater good. It is also a highly lucrative business that pretends to be in the interests of women and children.

  6. misty me

    July 20, 2015 at 2:19 pm

    No I am not Nicole- i am a woman who is battling infertilty due to menopause at 20. My only option of birthing children is through an egg donor which IVF offers me. Nicole’s articles help encourage women like me who have had our hopes dashed by a multitude of doctors. They are educative articles. If you have something valid to say – kindly request from bella Naija for your own column. But please let those of us who need hope be able to find it in peace, not with *** like you making us feel further worse about our situation.

    Bella naija- there is free speech but the mess above is not appropriate if youare really trying to help women battlingissues such as infertilty. Infertilty is not purely physical it affects mental state greatly. So please make this space garbage free if you really intend for us to find some sort of respute here.

  7. Niji

    July 20, 2015 at 2:41 pm

    U don’t understand d pains childless women undergo,IVF is a very good choice .kudos to d all fertility clinics in nigeria.

    • Madge

      July 20, 2015 at 7:15 pm

      How do you know I don’t understand?? And you give kudos to Nigerian fertility clinics?Really ? Like the ones that shove a gazillion embryos inside a woman ( a practice that is not permitted in the West) Or the one run by a Dr. who openly stated in a national newspaper that he encourages gender selection at his clinic?? SMH goodluck .

  8. Me

    July 20, 2015 at 3:01 pm

    Just got the result of my 4th IVF procedure today and still ‘Negative’…… This is just too heavy for me, How long will I go on like this? May God help us all in this struggle…. Amen

    • N

      July 20, 2015 at 8:34 pm

      I had to reply you to encourage you. God will see you through. Do not give up. I can’t say I understand what you’re going through because I don’t. But i can only imagine that pain you’re feeling. Just hang on to God. Whatever religion you are, just pray and seek God’s face. Maybe take a short break so your body can rest from all the stress and procudures and renew your mind. The book of exodus 23:26 says “no one will miscarry or be barren in your land”. If you’re a christian you should claim this verse and say it to yourself everyday WITH FAITh. Believe it and declare it and it’ll come to pass. Also know that God’s timing is not the same as ours. So learn to trust God and be patient and work with his time. And i assure you he’ll bless you with beautiful children. Everythig will be perfect in HIS time. Hang in there sister.

    • Wow

      July 20, 2015 at 8:55 pm

      Cyber hugs to you! Don’t give up; this will end in praise for you. Just keep at trying and don’t lose hope…..

    • dumebi

      July 21, 2015 at 1:36 am

      Your wait won’t be in vain. God has not forgotten you. He will do it soon. Amen.

  9. chy

    July 20, 2015 at 3:12 pm

    Its really a struggle , I thank God for IVF cos many homes has been blest thru it, @ME God wil do it,I pray God visit us all I wish there is something I can do about my AS genotype cos most serious guy are same genotype with me, d pre selective process is expensive to venture in God pls visit my case

    • dumebi

      July 21, 2015 at 1:40 am

      I had the same struggle with my AS genotype but God stood by me and blessed me with my husband who is AA after turning down alot of potentially beautiful relationships. He will do same for you

    • nicolefertilechick

      July 21, 2015 at 2:54 pm

      Good luck chy! I pray you meet a nice AA gentoyped gentleman (like I did). Don’t give up hun!

  10. Looku Looku

    July 20, 2015 at 6:35 pm

    Thank God for creating humans with the ability to continues to explore the world. I pray this IVF gets to the point where even middle income earners can afford it.

  11. bobotablet

    July 20, 2015 at 8:10 pm

    It is well even though inside well

  12. tade

    July 20, 2015 at 8:56 pm

    @ me,I feel u and I pray God in His infinite mercy will answer our prayers..My sister had gone through 7 IVF and surgeries but she is not giving up..At Madge and co,I know it good to share opinion but if you dont know wot to say,it better to keep quiet.Do you think pple going thru IVF are happy putting their body in such manner.God please,open the wombs of pple trusting u.This has ruined most marriages.God have mercy.

  13. new bride

    July 20, 2015 at 11:29 pm

    There’s a fine line between constructive and insensitive and you have definitely crossed it!

    Why do you immediately assume that all the people who decided on IVF are ignorant or don’t have the ability to google other options like you did? If they’ve chosen IVF in a Nigerian clinic by a Nigerian doctor, the least you can do is respect their choice especially since you’re not helping them foot the bill.

    Considering that you probably don’t know these people at all, there’s no need to sound so judgmental. At the end of the day, God is the only one who knows those who are truly serving Him and so judgement should be reserved for Him.

    As some other people have suggested, if you’re that passionate about IVF alternatives, please start your own blog or request for your own Bellanaija column, don’t come here to upset people who are already feeling vulnerable.

  14. dami

    July 21, 2015 at 1:47 am

    Honestly every morning when I pray I specifically mention the names of my friends who are waiting unto God for their babies. And I know it will happen. To o of such friends have been struck off ny list cos they have been blessed now. So to you all remember that “none shall be called barren in his land”. Ope,ugo,lili,Tina,chika,funmi,folabi,the cries of your babies in your homes won’t be far off from now. I know so,I pray so.amen,

  15. Etebefia

    July 21, 2015 at 8:40 am

    @Madge……….”.Look, the truth is neither comfortable nor popular. My intention was not to shove Napro down anyone’s throat, it was merely to inform that there are alternatives”. So i read through your first comment and i still believe that there are better ways to pass a message of alternatives. Fertility is a very very sensitive issue. I did not feel any empathy from you, all i felt was judgement and condemnation. It is obvious that you are Catholic and you belong to the school of thought that says life begins at conception, but you also have to give room for other school of thoughts. Napro Technology will not solve the issues of a twenty-five year old, who has had a hysterectomy due to a medical complication. if she has her eggs stored, she still can fulfil her dream of having a baby through surrogacy. You have to admit that Pro life still has its issues, Like the ten year old ”CHILD” from Paraguay who was refused an abortion, she is 60 times more likely to die from this pregnancy, now they are considering an emergency caesarian, Or is it the Indian woman who lost her life in Ireland because the hospital refused to terminate the pregnancy. So Madge…………..please give room for the thought that God blessed us with the technology of IVF so that impossibilities can become possible. We also have to thank our Heavenly Father. He is not man…………He is God and he alone has the right to judge.

  16. Etebefia

    July 21, 2015 at 8:53 am

    @ Me, I am so sorry that everyone, including myself are all preoccupied with Madge’s Comments. This is a forum for people like us, who are empathizing or going through fertility issues. So sorry about your failed IVF cycle. Maybe you should take a break, go on a holiday and just keep your mind at peace, then try the Vitamin B supplements to keep your hormones calm. I would also suggest that you copy Nicole and take a break from the office when you go through your next round. stay relaxed for a week and watch a lot of comedy. My dear, it is well with you and loads of baby dust to you.

  17. nicolefertilechick

    July 21, 2015 at 2:59 pm

    Dear Madge, thank you for your comment. Napro Technology is one of the great options available to a lot of women battling infertility…just as IVF is. Both of them have their disadvantages and advantages…so it is left to each individual to decide which works best for them.

    And a lot of people no longer destroy embryos. All mine from my last cycle are frozen, and I will hopefully use them in the future. That is one of the reason I am against procedures involving embryo selection, such as gender selecting, etc. Destroying embryos is totally against my ethical values…as is the case with a lot of other couples.

    I really appreciate your feedback, but assure you that IVF isn’t as bad as you think 🙂

  18. Me

    July 21, 2015 at 6:32 pm

    Big thank you to you all for your words of encouragement …. Your comments has surely lift my spirit…

  19. Newday

    July 23, 2015 at 2:29 pm

    Hi Nicole thanks for all the info you make available, for those of us TTC. Could you please tell which fertility clinic you used, because they seem like a very professional lot. I ask because I have already had one failed ICSI and one failed FET and would like to try somewhere else.

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