A downgraded 4BC euploid embryo led to pregnancy for a 37-year-old patient, after two failed FETs with higher-graded euploid embryos and a shift in protocol.
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📊 Story Snapshot
👩 Age: 37📆 Years trying: Not stated
🧬 Embryo: Day 6 4BC euploid
🧪 Retrievals: 1
🐣 Transfers: 3
💊 Diagnosis: Unexplained infertility
📈 Outcome: Pregnant at 23 weeks
I’m currently 23 weeks pregnant with my first baby, and my first time pregnant ever. After 3 failed IUIs, my husband and I moved to IVF to help us conceive. Considering that all our tests came back normal (AMH, sperm analysis, etc), we were hopeful that IVF would work for us and our unexplained infertility diagnosis.
At the time of my retrieval, I was 37 and my husband was 32. My egg retrieval went smoothly and they were able to retrieve 32 (!) eggs of which: 28 were mature, all 28 were fertilized via ICSI, and we ended up with 14 blastocysts. We then sent the 14 embryos to be PGS tested, as we were concerned that many of those might be abnormal given my age.
We ended up with 6 pgs normal embryos: one 5 day 4AB, one 6 day 6BA, three 6 day 4BB, and one 7 day 4BB.
Naturally, our RE told us to start with the strongest embryo, which was the day 5 embryo, graded 4AB. We were so confident this going to work for us! Unfortunately, our first FET with the highest graded PGS embryo did not result in pregnancy and was a total implantation failure. We were devastated as our RE could give us no answers as to what could have possible been the problem.
After a few months, we decided to try FET #2 and chose the next highest graded PGS embryo, a day 6 embryo graded 6BA. Again, this transfer resulted in implantation failure. We were very distraught and knew we had to do more testing and get second opinions (we were very unhappy with the coldness of our RE and clinic and lack of follow up care, or even follow up testing).
After switching clinics, our new RE urged me to do an ERA, and I asked for the Receptiva Dx test to rule out endometritis and endometriosis. As bizarre as it sounds, I was hoping one of the tests showed something was wrong, because in this case, we could possibly identify a potential issues. All the test came back normal: no endometritis, no endometriosis, and my ERA was pretty much fine. However, there was a small discrepancy: at my old clinic, the transfer time was done at 120 hours. I tested receptive at 124 hours, so my new RE decided to schedule my 3rd FET on the exact hour.
We prepared, mentally and physically, for FET #3. Since all our remaining day 6 embryos were graded the same (4BB), we decided to try the male embryo (the first two were female). In addition to timing the FET to my receptive hour, I added new drugs: dexamethasone, lovenox, Pepcid ac, and claritin (in addition to estrogen and progesterone). I never tested for blood clotting disorders but my RE, upon my request, was happy to let me try lovenox.
On the day of the transfer on August 2, my RE showed us the picture of the thawed embryo and informed us that upon thaw, the embryologist graded the embryo as 4BC, instead of its initial grade of 4BB. With my legs in stirrups, I tried not to get upset, yet it was hard to imagine that this poor graded embryo would lead to anything, considering that our first 2 failed FETs were with better graded embryos. Despite my RE saying that this embryo had a great chance, I felt discouraged and dismayed.
The next 10 days until beta, I put the transfer out of my head. I avoided google, I avoided the internet, and completely distracted myself as best as possible. Yet I could not shake the nagging thought that this 4BC embryo, despite being PGS tested, would not result in a pregnancy. How could it? The better graded embryos failed to even implant!
On the day of the beta, as we waited for the phone call from the clinic, I mentally prepared myself for another disappointment. After 2 failures, I thought I was incapable of ever getting pregnant, and this 4BC embryo was surely not the one to make it, right? When I heard “congratulations” on the other end, I was left utterly speechless. I asked the nurse, “Are you sure? Are you sure you’re not punking me?” But I was indeed pregnant with a beta of 156 at 10pt. We were elated and beyond happy! We knew this was just the first step of many milestones to pass to achieve a healthy pregnancy, and thus baby, but we had never ever made it this far.
I will never truly know what made the difference. I think in essence it was a confluence of all the factors: new RE, new clinic, different protocol, my mental attitude/shift of perception, and of course, this 4BC embryo!
I am happy to report that ALL checkups went perfectly well. We graduated from my RE’s clinic at 9 weeks, and all OB checkups have been perfect: NIPT scan, blood tests, and the anatomy scan. He is even measuring a week ahead!
I am not a superstitious person, and I’m a pragmatist/agnostic logic-based person, however, I believe in my heart of hearts that this little poor graded 4BC embryo, my son, was meant to be my child. I want to give hope to other folks out there who feel hopeless by the infertility experience – I never thought it was going to happen to me, and much less with a poor graded embryo. These babies deserve a shot and I am so happy this 4BC will be my beautiful boy!
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