Make an appointment with Dr. Robles to discuss your fertility options today! Who Benefits from PGS/PGD to Increase IVF Success? In a recent study of 98 women who had mosaic embryos, 32 (33%) elected to have at least one transferred. Group Owners uphold the core values of the brand by reporting content that violates the community guidelines. I am 43 and just did my first round of IVF, egg retrieval, had 8 PGs all 8 came back abnormal. The technical term used for this process is preimplantation genetic screening (PGS) or pre-implantation genetic diagnosis (PGD). PMID: 30246223; PMCID: PMC6338591. He is a Fellow of the American College of Obstetricians and Gynecologists and Member of the American Society for Reproductive Medicine. Note that this is per transfer data. One clinic determined IVF with PGS success rates to have a 10% higher pregnancy rate. Spontaneous (and obviously completely astonished at our luck) pregnancy. That way, you can avoid transferring an abnormal embryo which can lead to miscarriage or an unhealthy baby. Is there a chance that the donor was the issue? I will be using the terms interchangeably.*. BFN. Miscarriage can be tragic, but even more so after going through the time, money, and discomfort of in vitro fertilization treatment. Of those 7, 3 were abnormal, 4 were considered chromosomally normal. I was one month shy of 39 at retrieval. If they've got a few embryos, they might test them all to help pick the one with the best chance at becoming a pregnancy. March 24, 2016: FET# of 1 blastocyst. Most places allow up to 8 blasts to be tested for the the same price (but you have to pay for each IVF cycle obviously). Instead of seeing two copies of chromosome 21, an embryo with Down syndrome will have three copies (Trisomy 21). The key percentage to factor in is the number not mentioned with PGS testing. Other patients who benefit from PGS include: It is important to note that PGT is optional, and will add costs to your IVF treatment cycle. I have one left so still hoping for a happy ending. Yes, it happened to us. DS #1 conceived naturally, born Dec. 1st, 2008 . In round 2, 1 of the 2 was normal, and round 3, 3 of the 8 were normal. Theper retrievalstatistic helps to see the chancesbefore PGStesting. For women over 40 years old, the pregnancy rate decreases to 55 percent. It had been standard practice to implant or transfer 1 or 2 embryos if the patient's age was less than 32, 2 embryos if the age was 32-36, 2-3 embryos would be implanted if the patient was 36-39 years old and so on. I had 13 blasts tested from 3 cycles. I just expected better results. 8 fertilized, one normal.. 7 weeks pregnant :) only takes ONE!!! FZMM 5 yr. ago For example, PGS results in lower cases of Downs Syndrome than without it. And I hope your babies are super sticky too :) Congrats on BFP!!! Past protocols were simply based on the appearance of the embryos. However, PGT-A does not seem to improve overall pregnancy rates in women under the age of 35. Most clinics now believe that transferring better-developed embryos - i.e. Methyl folate Once again I like the Jarrow brand as it is. If all goes well, all of the eggs will be fertilized and develop into embryos (2-3 days) and then blastocysts (5-6 days). Patients in their 40's would routinely receive 4-5 embryos. We had 2 of our 10 make it to day 5 and both came back normal, they're both the same gender but we aren't finding out until after we transfer this month! My gut reaction was that it had to be wrong. Just sent 5 for PGS. 2005-2023Everyday Health, Inc., a Ziff Davis company. What Research Shows, What Is IVF Success Rate? October 2015: IVF Retrieval #2 - 19 retrieved, 12 mature, 7 fertilize w/ICSI, 2 frozen, 1 normal. I have been taking most for a few months, but will add a couple more to see if it makes a difference. Learn more about. Surprise BFP, chemical pregnancy. As part of the normal IVF treatment, women take medications to stimulate their ovaries and help the eggs to mature. Please whitelist our site to get all the best deals and offers from our partners. As PGT-A tests for the number of chromosomes in an embryo's cells and the identity of each chromosome, the results can identify embryo's affected by Down Syndrome. In PGS, a judgment is made about an entire embryo by testing a few representative cells. Wish I read it long before my first cycle. The rate of aneuploidy begins to increase significantly after the age of 40 and drops below 30% in women over the age of 41. A common question we get asked about the process is, How many normal (euploid) embryos will I produce? Demko et al addressed this very issue in a recent publication. Depending on the age of the women when the eggs were collected, approximately 60-75% of human embryos which have developed to the blastocyst stage and appear normal are genetically abnormal. Thanks for your encouragement! Yes, that is true, most supplements take a couple of months to have an affect. It's very interesting. Hysteroscopy Tues. 8/21 I have a whole page dedicated to mosaic embryos. A Group Leader is a What to Expect community member who has been selected by our staff to help maintain a positive, supportive tone within a group. Liebermann et al. Please re-enable javascript to access full functionality. On average, women in their late 20s had four euploid embryos (day 3 or day 5) per cycle, but this number decreased linearly (R2 R 0.983) after 35 years of age. But that is on a per-transfer basis. Patients often hear PGS-normal embryos have a 60 70% success rate. Doctor hinted I might be cleared to go back to IVF as soon as September. Implantation Failure in IVF - Why Does It Happen? What to Expect supports Group Black and its mission to increase greater diversity in media voices and media ownership. Patients often hear "PGS-normal embryos have a 60 - 70% success rate." But that is on a per-transfer basis. I know how you feel, but it's awesome you got 2. December 2015: IVF Retrieval #3 - 31 retrieved, 24 mature, 21 fertilized w/ICSI, 8 frozen, 3 normal. Why does a "normal" embryo from a 35-year-old woman have a better chance to survive than a "normal" embryo from a 40-year-old? Dr wants to first get 2-3 PGS normal embryos before doing immune testing. Bradley et al. Dx: Mild Endo, Immune Related Issues, Unexplained. 2019 Dec;112(6):1071-1079.e7. As of right now, the exact cause of autism is unknown and thought to be due to multiple factors. From this point, it will be 10-14 days until we receive the report of your genetic testing results. He provides weekly summaries of the latest IVF research and posts on Facebook, Instagram and TikTok regularly. I had specialist review my PGS report. Make An Appointment With Dr. Robles To Discuss Your Fertility Options Today! In our study, when the possibility of finding at least one euploid embryo for transfer was evaluated according to maternal age, the percentage of cycles with at least one transferable embryo decreased steadily from age 35 (p < 0.001), with a continual decrease until 39 and a steep decline from age 40 onward (p < 0.001) which became even steeper . Although I strive to provide accurate general information, the information presented here isnot intended for the prevention or treatment of infertility and it isnot a substitute formedical or professional advice. They concluded that (1) 33% to 50% of all embryos screened in women aged 18 to 48 years are aneuploid and (2) the number and percentage of euploid embryos decreases with advancing maternal age. Embryo mosaicism is when an embryo contains two or more genetically distinct cell lines. So those 2 could have been normal but they didn't get a reading on them. (2017)found a reduction in embryo survival (from 98% to 93%) and a reduction inlive birth rate(50% to 27%). However, Dr Esteves cautioned that other factors might also affect the likelihood of obtaining a normal embryo. For the last round, I ate a higher protein diet ( esp plant based proteins), organic foods, Omegas, etc. Even though I ended up with no good embryos I recommend it because I think it's good to know now and not later with a miscarriage. It can also be a complex aneuploid, having multiple missing or additional chromosomes. Risk Factors that Impact IVF with PGS Success Rates. Diagnosis: Repeated Pregnancy Loss + DOR + Advance maternal Age. Unfortunately, 1 did not survive the thaw, and none of the other 3 resulted in a successful pregnancy. For women ages 41 to 43 the live birth rate drops to 45%. IVF: Approach to Selecting the Best Embr yos for Transfer to the Uterus. Unfortunately, chromosomally abnormal eggs will develop into chromosomally abnormal embryos following fertilization. I was drinking about 2-3 glasses of wine per week, mostly on weekends so I will stop that. Third one in the past few months doing a medicated cycle. It also depends on what day embryo you have, day 5 - 80% chance of success, day 6 - 70% chance of success, day 7 - 60% chance of success. hbspt.cta._relativeUrls=true;hbspt.cta.load(389004, '2f6d41b7-5446-4753-b5dc-09cba35bf859', {"useNewLoader":"true","region":"na1"}); Dr. Karande is Board Certified in the specialty of Obstetrics and Gynecology as well as the subspecialty of Reproductive Endocrinology and Infertility. Success rates for frozen embryo transfer after PGT. I knew I could easily donate normal embryos but with all the negatives people give to abnormal embryos no one would want them. Based on our most recent PGS data for 2018, women in the age category of 38-40 had an 82% chance of pregnancy with a PGS Cycle. For example, some cells appear chromosomally normal, while others showed some form of aneuploidy. In vitro fertilization (IVF) helps thousands of people become parents each year. October 8th, thyroid is now fine. Nov-Dec 2015: Freak out that out of almost 50 eggs, only 1, 1! At the age of 25, 75% of a woman's eggs are chromosomally normal. The lack of a difference in these age-related declines between day-3 and day-5 biopsies indicates that embryo attrition during this period can . In women under the age of 35, approximately 60% of embryos will be chromosomally normal. I have done 4 IVF cycle and so far we had one normal from each cycle. Hopefully, one or more embryos will make it to the blastocyst stage on Days 5, 6, or 7. I suggest reading or listening to the book on improving egg quality "It Starts with an Egg". It's wonderful! Our results from PGT-A are even better than we initially expected. I had no more normal boys left but did have 1 abnormal boy left (mosaic monosomy 6). Doctors also prescribe medication to women to suppression ovulation. Embryoman (Sean Lauber) is a former embryologist and creator of Remembryo.com. The team hope that the research will . Nov. 1st - start .5ml buserelin each night. Some are faster, and some are slower. Patients often hear PGS-normal embryos have a 60 70% success rate. This is because PGT-A/PGS is not a one hundred percent test, however most of the labs that are carrying out PGT-A with NGS have a very high diagnostic rate so most of the time you have a very good . But what about the women who didnt get blasts? However, mosaic embryos do have as high of live birth rates compared to euploid embryos. I donated my last two normal females embryos to my friend. For more up-to-date information on this topic check out my other posts that are tagged withPGS (PGT-A) success rates. qs. The PGT biopsy is a fairly safe procedure when done on blastocyst embryos. FET#1 Jan 2017 - BFN. Me: 42 DH: 37 Thank you. But for the same PGT testing on a thawed frozen embryo, the success rate is 55-65 percent. Whitney et al. What percentage of PGS embryos are normal? The other thing to consider is that not all clinics report the same results. The reason for the success, according to the clinic, is the perfection of the process. Then we did a FET, that ended at 8 weeks, a missed mc. One great, three good, and one fair quality. C. Hanson, T. Hardarson, K. Lundin, C. Bergh, T. Hillensj, J. Stevic, C. Westin, U. Selleskog, L. Rogberg, M. Wikland, Re-analysis of 166 embryos not transferred after PGS with advanced reproductive maternal age as indication. BFN. About 3 out of 4 of these euploid embryos will implant on average (75 percent implantation rate), with high pregnancy rates per transfer. Following the miscarriages, she also learned that immunological issues and other complications contributed to her infertility. If the embryo is missing a chromosome and has 45, this is known as monosomy. I will also stop drinking alcohol which I did not stop until before the retrieval. IVF involves several different types of tests, screenings, and procedures in order to increase the likelihood of success. We did the PGS on embryos that we had frozen, there were 7 total that were thawed and biopsied and sent for the testing. Transferring an embryo after a PGT-A test, therefore, reduces miscarriage and improves pregnancy rates per embryo transferred. Your eggs will be fertilized with sperm on that day. I am 7 weeks pregnant from my first FET! The world says give up! 2018). Meaning that if you begin a cycle, retrieve eggs, produce embryos, then do PGS testing, and at least one embryo comes back normal, 60 - 70% of the time it will lead to a live birth. The term "recurrent miscarriage" means at least two consecutive pregnancies ended prematurely; this affects between 1% and 3% of all women. I guess for me I had 2 other normal embryos but had these mosaics that I didn't want to wonder what if. In a small study,Bradley et al. The rate of aneuploidy begins to increase significantly after the age of 40 and drops below 30% in women over the age of 41. . If it contains an extra chromosome and has 47, this is known as a trisomy. So what if the embryos are euploid? PGT-A is very reliable for detecting aneuploidy. You can research them. Make sure you buy a brand that you see that uses Kaneka material (it'll reference it on the back of bottle) as that is the one with studies some others are Chinese and it is not the same. However, a larger biopsy is taken, it can potentially harm the embryo. Another study agrees with these data (Franasiak et al. END MENTS We have 1 more normal embryo. How many embryos came back normal after PGS? The good news is that I am 10 weeks today. Required fields are marked *. Hi I'm I am curious to learn if you chose to do pgs testing what your results were I'm currently awaiting my second round of IVF pgs result. PGT-A can detect Down syndrome if it is present in the embryo. I just expected better results. 8 fertilized. Your chances are good with two normal embryos! Bleeding During IVF - What's Normal and What Isn't? We sent 8 to be PGS tested and 7 came back normal. Positive. Twins & Multiples: Your Tentative Time Table. Then I opened my eyes and researched them extensively and spoke to specialists and came to the conclusion that PGS may only be good for those who have a known family genetic abnormalities. In a study analyzing 4,515 patients with up to three consecutive Single Embryo Transfers (SET) of chromosomally normal, or euploid, embryos, 94.9% achieved a pregnancy. The live birth rate declines to 55% for women ages 35 to 40. For women and couples with a higher risk of passing on genetic abnormalities, this information can be very useful and reassuring. However, if it does not, patients and their physicians will need to determine whether or not to keep the embryo or discard it. ***tw*** we transferred one, and I'm 14 weeks along. Congratulations, that's such a heartwarming story. For now its probably best to avoid having to thaw and biopsy if possible. doi: 10.1016/j.fertnstert.2019.07.1346. Infertility issues are so heartbreaking already! Segmental aneuploids: the main source for PGT-A false positives? Preimplantation genetic testing for structural rearrangements looks for larger genetic defects. It's a dark time. This includes preeclampsia and other hypertensive disorders, and possibly small for gestational age fetuses. Neal, S. A., et al. Start avoiding phalates, eating more plant-based proteins, and doing anything else I can find, legitimate or not, that promises to increase egg quality. This allows doctors to time IVF treatment precisely, and to schedule an appointment to retrieve eggs, rather than letting the body ovulate and release just one egg (which is what normally happens). Once the blastocysts are formed, embryologists remove cells from each blastocyst and send them to be tested, or perform the tests in-house. The presence of an abnormal number of chromosomes in the genetic profile of early-stage embryos may be far more common and potentially less threatening during normal human development than is currently believed, according to new research from Johns Hopkins University biologists. Both situations can be emotionally difficult to endure. I am 32 with dor and poor egg quality; DH has MFI. So far HCG is doubling properly Good luck! Any of the 23 human chromosomes can be abnormal in different ways and have one too many (called a trisomy) or one too few (called a monosomy). Be sure to read the next two sections to get an idea of how grades and growth rates (Day 5, 6, 7) affect IVF with PGS success rates, as well as this section further down. Any one of you did you try again, how were the results again? The model shows not only that the chance of getting a euploid embryo decreases with a woman's age, but that the odds worsen progressively year on year. However, live birth rates are not necessarily higher with PGS. I took this for about 2 wks before my transfer so now I will take consistently moving forward. Preimplantation Genetic Diagnosis - PGD involves screening of IVF embryos for a specific genetic condition prior to embryo transfer. I went to a good clinic in Toronto. I'm now awaiting results curious finding out your numbers how many were normal that were tested and what the gender was if you found out? Hi ladies, I am so sad because my third transfer with a tested, 4AA embryo failed last week. Therefore, the IVF with PGS success rates should be higher than without it. Couples with recurrent pregnancy loss (aka RPL or recurrent miscarriages), Couples with a known structural chromosomal anomaly. Simon et al. Entire Website 2003 - 2020Karande and Associates d/b/a InViaFertility Specialists, Age and Number of Eggs Obtained After Preimplantation Genetic Screening, Intro to Assisted Reproductive Technologies, Demko et al addressed this very issue in a recent publication, make an appointment at one of InVia's four Chicago area fertility clinics, Top 10 Questions Our Fertility Nurses Answer, Don't Delay Frozen Embryo Transfer After Failed IVF. made it to a chromosomally normal embryo. Check here for the full glossary (please excuse the repeated terms!). Or they did but they were all aneuploid? Cleared to start IVF. There are no suggestions because the search field is empty. PGS screens for numerous different genetic diseases that involve chromosome number abnormalities. Second round we had 15 eggs, 13 were mature and ICSI, 9 fertilized, we had 1 5 day hatching blast that we transferred (BFN), and then 1 day 6 blast. The effect of maternal age on the possibility of retrieving at least one normal embryo was similar, with a rapid exponential decline (R2 14 0.986). Determining IVF with PGS success rates is possible, but contextually it's important to realize that without it, embryos that have chromosomal abnormalities can be transferred fresh, or frozen for later transfer. 2 5-day blasts transferred (Assisted Hatching -AH used). *The following PGS/PGD success rate reports are base on the latest CDC data published in April 2021 (Preliminary 2019 Data) with more than 20 transfers. All tests normal. (2018)found a reduction in clinical pregnancy when embryos were thawed, biopsied and re-frozen (the odds were about half). think twice before sharing personal details, foster a friendly and supportive environment, remove fake accounts, spam and misinformation, delete posts that violate our community guidelines, reviewed by our medical review board and team of experts. Chromosomal translocation occurs when chromosomes are not arranged in a typical way. If autism is present in your family it is important to get a genetic carrier screening test to look for other conditions you might carry in your DNA. What about paternal age? Women 24 to 35 years old have the highest percentage of euploid embryos. For us if this one doesn't work out, we are ready to move on to DE. In this case the clinic will need to: So the embryo would have to go through multiple rounds of freezing/thawing/biopsy, and this might have an impact on its potential. Many people don't get any PGS normal. Here is a list of supplements that I have been taking. Nov. 28th- Embryo update: 12 eggs retrieved. The pregnancy rate for embryo transfers following PGT is 70 to 75 percent in women under the age of 40. Any way you can delay your next IVF? We sent 6 embryos for transfer and none were normal (various abnormalities in different chromosomes). PGS/PGT-A testing prices can range between $4,000 and $10,000 for screening on eight embryos. Jul 12, 2017 5:59 AM. Its worth noting that the reason for testing is to avoid the transfer of embryos with irregular chromosome counts. High cellularity of trophectoderm biopsy adversely affects pregnancy outcomes.. The maximum post-PGS live birth rate for women younger than 35 is 60%. I have sent 6 from 3 retrievals and only 1 was normal which we transferred one last week! It tells you what the supplements do and what studies have been done on each. 1. Abnormal chromosome counts can lead to failed implantation, miscarriage, birth defects, or other genetic conditions. Congratulations, that's truly wonderful. Be sure to speak with your doctor to learn about your individual risks and benefits and if PGT can help you achieve a healthy baby! In a woman under age 30, about half of embryos are aneuploid. If you do PDG that does NOT test all 23 chromosomes--some tests only look at the ones that are most commonly a problem, such as 21 (Down's) and a few others--the false positive rate is higher because other chromosomes that don't get tested could be bad. These forums were a critical source of support when we were in the midst of fertility treatments, and even now as I struggle with accepting that it is over. This is a fancy way of saying, does the embryo contain the correct number of chromosomes? 2. Although I am a physician by profession, I am not YOUR physician. 361 Hospital Road, Suite 333 The findings could have significant . Dr. Alex Robles is a Spanish-speaking Latino-American Reproductive Endocrinologist and Infertility specialist in New York City, and a board-certified OBGYN. ttc 1 year, 1st ivf, 5 made to day 5. I did PGS testing. Having a euploid embryo does not guarantee a live birth. 144 abnormal (aneuploid/mosaic) embryos and their outcomes. I wish you tons of baby dust!!! These studies were particularly small so drawing conclusions isnt really possible yet. Recommended protocol to take baby aspirin. This is because chromosomally abnormal embryos are more likely to arrest during early development compared to chromosomally normal embryos We have 13 fertilized growing right now. Find outstanding clinics from more than 400 fertility clinics in the USA. I'm so sorry it happened to you. If you want to read more about rebiopsying embryos, check out my archives for embryo rebiopsy. I had a consult with RMA in USA (one of the best clinics) and they told me that they never get that kind of a reading 'chaotic profile'. This is when the biopsy will be performed and sent for genetic testing. For more background info, check out my post onPGS Testing. Its unclear why there is an inconsistency with live birth rates, while miscarriage rates are lower. 2 came back "normal." MENTS we transferred a 6AA that didn't implant. 1). Damaged embryos may not implant, or could ultimately result in irreparable harm leading to miscarriage and IVF failure. March 2017. (2017)found that Day 5 euploids had a higherongoing pregnancyrate vs Day 6 euploids (51.9% vs 32.7%). The normal boy ended in a miscarriage at 6 weeks. Wishing you all the best!! IVF#2 Fall 2012 1st FET; BFP--only 5 weeks and praying it sticks. Rates of live birth after mosaic embryo transfer compared with euploid embryo transfer. So in some ways, it is futile to compare IVF with PGS success rates to IVF without it, because chromosomally abnormal embryos do not have the same chances of success. Being 37 and based on those stats I was expecting 4-5, not the 22% we got. Women aged 40 and over should always opt for PGS/PGD if it is an option at their clinic because the risks are so high. A blastocyst is a human embryo that's five or six days old. Of those only 2 were normal. I can't help but think about all these moms that got zero normal results and their story could have turned out like yours. IVF with PGS/PGD results in a lower number of miscarriages than without it (from 9-10% lower with PGS to 38% lower with PGD). Congratulations on your pregnancy! The inner cell mass is what will form the embryo. Up to age 40, most women will have at least one normal embryo. I am 40 and had to do many, many rounds of IVF (6) before I got any PGS normal. Pricing varies by fertility clinic, and determining the exact cost of PGS/PGT-A testing will vary from patient to patient. Long story short we transferred our so called "abnormal" boy this past March and I am currently 24 weeks pregnant with a NORMAL HEALTHY baby boy!! That is why we always recommend that you get some form of non-invasive prenatal aneuploidy assessment in early pregnancy at the very least. Transfers using excellent grade blastocysts have a pregnancy rates of about 65%. IVF #3 - May 2013. (2018)looked ateuploidembryos (aCGH/SNP) in women <35: Irani et al. Fertil Steril. Instead of retesting to confirm the ERA findings, we went for the transfer. February 2012 IVF #1 -BFN. Preimplantation genetic testing is meant to tell you if your embryo has a specific genetic abnormality or not. In fact, the pregnancy rate from transferring a normal embryo does not exceed 60 to 70%. eggs will be fertilized with sperm on that day, make it to the blastocyst stage on Days 5, 6, or 7. We had 6 out of 10 retrieved make it to day 5/6. Group Black's collective includes Essence, The Shade Room and Naturally Curly. Embryo Grading and Success Rates Once fertilized, embryos are graded according to their form and quality. At 28 years old, approximately 30% of her remaining eggs have chromosomal abnormalities. However, we have also realized that there is even more genetic abnormality in eggs that we previously thought. In these women, it is thought that other genetic factors other than chromosome number also affect the embryo and hence pregnancy as the egg cell ages. They also reported the number ofblastsbiopsied. I had 30 eggs, 21 mature, 20 fertilized, 8 made it to blast (6 of them on day 5 and 2 on day 6). Hi I am new to this terminology but I have not heard of chaotic profile. (2014)found no difference inongoing pregnancieswith Day 5 or 6 euploids (about 50%). Age is the best predictor of aneuploidy and a major factor to consider when thinking about aneuploidy. Thank you for your response. Embryo screening may improve success rates. (2018)looked at about 650 transfers ofPGS tested euploidembryos (based onSNPtechnology) across various ages: So it looks like the success rates hover around 60-70% in most cases, with women >42 having about a 50% live birth rate per transfer. 79% of the eggs studied from women 40-45 years old were found to have an abnormal spindle appearance and at least one chromosome displaced from proper alignment. IVF#2- Sept 2016 (Freeze all/PGS). For female above 45 years of age. Thats a major benefit and source of assurance to women who have suffered many miscarriages prior to IVF with PGS. More studies need to be done. All we can tell you is that this particular embryo has or doesnt have the condition. I am out of money and almost out of hope. Meaning that if you begin a cycle, retrieve eggs, produce embryos, then do PGS testing, and at least one embryo comes back normal, 60 70% of the time it will lead to a live birth. Generally, Day 5 embryos perform better than Day 7 embryos. It had an extra chromosome from the sperm and another from the egg. I also try to buy the Jarrow brand as I worked for them up to last Sept before I quit to prep for IVF process. Your email address will not be published. Several functions may not work. How long after IVF will you conceive? I have some immune issues related to my losses I think so I'm betting the doctor would recommend putting a girl embie back in first. Hi everyone, we just got PGS results back and I'm a bit shocked. those that have reached the blastocyst stage - makes an ongoing pregnancy more likely.

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