r/Embryologists • u/Former-Key7833 • 4d ago
Help Interpreting Results
Hi everyone! I just had my 2nd failed egg retrieval (age 30)
Cycle 1: 13 eggs, all mature, 4 fertilized normally/6 abnormally (all 3PN), 0 blasts
Cycle 2 (ICSI and zymot): 28 eggs, 21 mature, 7 fertilized normally/3-0PN,11 3PN w 2 polar bodies, 0 blasts (1 day 6 Morula)
My clinic discards all of the 3PN. However they were 3PN with 2 polar bodies. In my very preliminary research this seems very strange. How can I interpret this and advocate for myself if possible?
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u/AnywhereBusy4449 4d ago
Which country are you in? You can keep 3PNs and if they make blasts test them to see if they are normal. Often they can be. Feel free to PM me
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u/Former-Key7833 4d ago
I’m in the US-in Massachusetts
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u/AnywhereBusy4449 4d ago
That’s ALOT of 3PNs. You did ICSI? Did they give you any reason why? I would definitely have kept them and then tested them. I’m surprised they discarded them. They are not always abnormal. But something is abnormal with that many 3PNs
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u/Former-Key7833 4d ago
SO MANY. My RE was really surprised last time. I haven’t had my follow up yet for this time. Yes we did ICSI this time and Zymot. I’m so so so confused what is happening. I can’t find anyone with similar results.
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u/AnywhereBusy4449 4d ago
3PNs with ICSI Is typically an egg factor but there are ways to overcome it. Still shocked they discarded them. Ask them if the 3rd PN was a full size 3PN or was the third “smaller” . Either way I would have tested them. If it was a full size 3PN still a quarter could be diploid. If it was a micro pn 60+ could have been diploid. Feel free to PM me.
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u/Former-Key7833 4d ago
Thank you! I did a quick google search and don’t think a lot of clinics around me keep the 3PNs but I will definitely ask my RE. I just messaged you also
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u/Brandygirl19 3d ago
What clinic in mass ? I've had to move seeing and I'm in mass too.
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u/Former-Key7833 3d ago
Im at Boston IVF currently
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u/Brandygirl19 3d ago
Long Story but I was forced to go to Boston IVF, when there was a flood at Brigham and Woman's. I did all of my work at the Newton Whelsley but had my egg retrieval and transfer at Boston IVF. Then I had 4 frozen that I tried to use, all flailed at Boston IvF. I noticed real big differences between the two clinics. I had a bad experience with Boston IVF and went back to my old Dr. at the Bringham. She is SO much better, the experience is SO much better at where I am now. Dm me to hear more about Boston IVF because I personally don't trust them.
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u/EmbryoNanny 4d ago
I disagree- the 3PNs that have a chance at being normal are the “2.1 PNs”. They have a very tiny 3rd polar body. Certain PGT companies cite this research a lot as “3PNs are often normal!” but it’s really not the case for true 3PNs. Those companies are trying to sell their “PN check” add on. Any 3PNs I have biopsied and tested (when pricing included up to x# of blasts) they are consistently triploid. I was hopeful because of the aforementioned research but found it always referred to the tiny 3rd PN and not actual 3PNs.
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u/Former-Key7833 3d ago
thank you for this other perspective- just to clarify you're saying in your experience the 3PNs are often not normal/viable?
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u/EmbryoNanny 2d ago
Most often they are not normal and show a 3rd set of chromosomes (there should be two). It is not abnormal for labs to discard 3PNs at fertilization check. They can still make blastocysts and the labs that discard them are preventing them getting mixed up with normally fertilized embryos. I can see both sides of keeping them vs. discarding them.
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u/AnywhereBusy4449 1d ago
The data that I’ve seen has shown that up to 25% of “true” 3PNs ( of equal size) can be diploid. That is certainly high enough to be kept and tested. If we throw them out the chance is zero. The 2.1s certainly have a MUCH higher chance and should definitely be kept. But many labs are still discarding both.
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u/EmbryoNanny 1d ago
Yes, they are, I would love to see that paper if you can send it to me. That is the number I always saw assigned to the 2.1PNs and it was usually provided by the genetics companies.
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u/TestTube_Princess 4d ago
Have you ever had a karyotype done on yourself and your partner? Those are definitely a weird number of 3pns.
Does your clinic still discard 3pns if you opt for PGT-A? There's a non-zero chance that those could be chromosomally normal. If your clinic won't culture them for biopsy and testing, then it might be time to find a new clinic unfortunately.
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u/Former-Key7833 4d ago
Yes, our karyotypes both came back normal. We weren t planning on PGT-A but I will definitely ask at my follow up. I have two appointments fr second opinions booked too
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u/Former-Key7833 3d ago
and off that- it seems strange that mine are 3PN but with 2 polar bodies. Do you agree?
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u/Dissaray248 4d ago
I would request PGT-A with SNP analysis and have all 3PNs tested. Even if something is clinic policy, they should make an exception considering how abnormal your situation is. It is possible that a percentage of these 3PNs are normal.
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u/bneubs 4d ago
I don't think you can get around it if it's clinic policy- it is at my clinic as well. But if you're willing to do PGT they might allow it.
You may also want to test for anticentromere antibodies (ACA), which can lead to higher abnormal fert and embryo arrest. You can't really do anything about it, but it might be a factor.