Happy New Year (belated)! Day 5 ET for Natural Cycle IVF.
Posted Jan 27 2010 12:00am
Well here we are at the end of January and somehow I managed to avoid posting any blogs for the past 2 months. I am not proud of this fact but I will apologize for my failure to stay on schedule. This past month has included a bout of food poisoning with salmonella and a weekend visit to Boston to visit my Mom who was in the hospital for a few days with some respiratory issues. Fortunately, Mom is now back home but her health is a bit tenuous and I don't think that she will be going on the computer for a while so that means one less reader for this blog. No one can have a better fan than your own mother and I hope that she feels well enough soon to go back online...
Meanwhile back at the ranch we have made some interesting changes here at Dominion. First and foremost we have decided to push all Natural Cycle IVF patients to Day 5 ET. We looked at our data for the past 18 months and it seemed to make sense given a number of patients who failed to conceive with a Day 3 NC IVF transfer but ultimately had success with a Day 5 ET.
But wait, you might say....aren't you the same DrG who years ago was not convinced that Day 5 ET made sense??? Guilty as charged. But some changes in the lab have led to my new postition. First of all, the commercially available culture media has made going to blast a much more reliable proposition. Secondly, in stimulated cycle IVF the excellent pregnancy rates following vitrification (ultra-rapid freezing) of blastocysts has allowed us to take patients to blast without the fear that the extra embryos of good quality were going to be wasted. Finally, the evidence from our Natural Cycle IVF patients suggests that there is improved synchronization between embryo and endometrium with a Day 5 ET. No way to prove this opinion but it sure seems to make sense. Finally, if the embryo arrests between day 3 and day 5 then it seems unlikely that it ever would have resulted in pregnancy, although no way to test this opinion. Interestingly, we had several cases of 4 and 5 cell day 3 embryos developing into beautiful blastocysts and successful pregnancies....so we feel confident that the good embryos will go to day 5 and the poor embryos will arrest.
So Happy New Year to all. I wish you all the best in 2010. May all your embryos implant and all your pregnancies be low-risk!
For a good laugh, I encourage all of you to visit Fertile Grounds (http://fertilegrounds.dominionfertility.com) and check out my video blogs. They are a work in progress and I am not ready to quit my day job and do stand-up....