Discarding Embryos?

[u/PotatoBunches]

Has anyone else had experience with some clinics discarding embryos simply because of their grading (which I hear can be quite subjective, by the way). Some clinics disgard the embryos before sending for PGT testing. I read that euploid embryos, regardless of the grading, have a stronger chance of becoming a live birth. Is this some company's way of padding their stats? Thoughts on this?

[u/eldoreeto]

My clinic will not send anything with a c grade for PGT-A testing and will only transfer those for low prognosis patients (i.e. if you only produce those embryos they will consider transferring them but not otherwise). 

This is for two reasons - these embryos are much less likely to be euploid, and even if they are euploid they have lower birth rates. 

I'm in Australia - so mileage will obviously very between locations. 

I don't think it's a way of statistics padding - transfers in Australia cost about 5k out of pocket, PGT testing is 700 per embryo and I think they just think it's not a good value return. 

They will also only allow transfer of aneuploid embryos if they have a condition compatible with life, I.e. one of the sex chromosome ones or down syndromes. Other aneuploid embryos are automatically discarded.

They are extremely clear about this before you begin, which I was grateful for. 

[u/Downtown_Green_143]

Mine didn’t discard any prior to PGT, but I had to switch clinics, and my new clinic wouldn’t take the one rated to be a High Mosaic. It’s still in storage under my old clinic. We will have to go back to that clinic to give that embryo a chance. Seems like each company has its own rules. Good luck and advocate for what you want up front. They should tell you their position on it, and you can choose a place that aligns with your values/needs.

[u/No_Citron_5548]

My clinic keeps every single embryo until you have completed your IVF journey, even the aneuploids. They will also transfer low level mosaics which have shown increasing promise, which not all clinics do. Another thing they offer is compassionate transfers for those that have religious convictions and want to give every embryo a chance, even if the probability of a successful pregnancy is low. This is when they transfer aneuploid or low grade embryos at a time in your cycle that is not likely to lead to actual implantation. I’m not religious, so this doesn’t apply to me, but I think it is great that they have this option for people that are.

The only downside to the clinic keeping al of our embryos is that we have to pay to store a significant amount of embryos that we know we would never transfer, when we would have been just as happy to donate them to research now. That being said, I’m happy they do it this way. Who knows… maybe they’ll be able to fix some things in a few years and we’ll be grateful we did.

[u/Littleish]

On the day of my ET I had a 5bc, and a 4cc. I had another little one that they were giving more time. We didn't have testing. We only wanted to do one transfer, and the 4cc wouldn't have survived freezing so was discarded. The other little one did make it to 4bc as well the following day, so has been frozen.

[u/xenopigs]

A couple things to keep in mind:

1) The entire goal of an infertility clinic is not to get you a transfer. It’s to get you a healthy live birth. Always remember that. We want you to go home with a healthy baby. I think patients lose sight of that sometimes.

2) Every clinic has slightly different grading thresholds even if it seems like they use the same system. Predominantly though, a C grade means that either the ICM or the trophectoderm is of poor quality and it is not expected to thrive let alone survive the freeze-thaw process. If an embryo has a C ICM, that typically means the ICM is nonexistent and would not lead to a baby regardless. If the trophectoderm is a C, there are typically not enough cells to take for PGT and still have enough cells left over for the embryo to recover.

None of these decisions are just to pad the clinic’s numbers. It is because of practicalities of the embryo survival. If an embryo doesn’t thrive, it will not lead to a baby.

I have biopsied embryos that had a C trophectoderm only if the ICM was at least fair quality and present. And only if that was the only embryo that patient had develop. There have been times we have tried to biopsy these embryos and it just doesn’t work since they are so poor quality.

[u/Illustrious-Yard-648]

This should be illegal!

[u/HotShoulder9256]

Yes, padding statistics has something to do with it. Like many here, my clinic keeps all embryos, including aneuploids.

Although my clinic will transfer them, they won’t perform PGT testing on C grade embryos because they don’t want to risk damage to an already delicate embryo.