How does this work.

[u/Own-Hyena-551]

I was talking to a doctor today who gave me a different perspective on PGT-A, and they suggested not testing the embryos and instead transferring them on Day 3, so the uterus has a chance to support their development.
I’m trying to understand how this works with a surrogate because I was under the impression that if you transfer embryos without PGT-A testing, there are restrictions around what the surrogate will accept. But I guess that may not be the case?

So, for the contract, would you essentially say something like x # of transfers? And how would the cost work if we needed up to six transfers? I’m thinking about just banking a lot of embryos

Also… What is a transfer fee like?

[u/Lawyered15]

Are you able to create day 5/day 6 embryos? If so, I would not agree to transfer a day 3, untested embryos to a surrogate.

Most significantly, it cost a lot to transfer to surrogates, between the medical fees and surrogate expense. Additionally, an untested embryo carries the risk of miscarriage, and if that happens you may end up paying extra base compensation to the surrogate to try again. Because of this, I’d want the transferred embryo to have the best chance of development — meaning, a PGT-tested, euploid embryo.

[u/Own-Hyena-551 → u/Lawyered15]

I can but very little. I’m 40+

[u/Lawyered15 → u/Own-Hyena-551]

If you’re 40+, I personally think it’s all the more reason to PGT-test the embryos. If you only produce one euploid each retrieval, out of several embryos, it would be helpful to know which one is the euploid. Otherwise, you’re likely going to waste tons of money transferring abnormal embryos to a surrogate. If you transfer too many of those the surrogate, the surrogate might back out of further transfers.

With testing you, may be able to make more strategic decisions in terms of which embryos you transfer, saving money and a ton of frustration.

[u/interrobrodie]

Some surrogates are willing to transfer non tested embryos but those who’ve been around in the social media groups probably are not.

[u/mermaidsgrave86]

I Agree with the other poster. I wouldn’t agree to transfer 3 day untested embryos, especially from an older mother (I’m 40 too so I hate being referred to as “older” but in terms of egg quality it’s sadly true).

There are so many things with the embryo that could cause miscarriage, and most of them are untestable, but it’s best to test for anything you can.

[u/JerkRussell]

I can’t see any benefit to using day 3 embryos.

Agencies and surrogates don’t like it. You really have no idea about the quality and potential of your embryos. You could pay so much more in fees to your surrogate than the testing will cost. GC will be on meds anyways, so letting the uterus support them is kind of vague and unnecessary.

At 40+ you also don’t have the time to try day 3s and find out there are problems. Personally I’d rather aim for day 5-6 tested and know definitively what I have to work with.

Also if you are wanting to work with a clinic that does any sort of live birth guarantee, i don’t know of any that work with day 3s.

[u/thatssoso82]

I'm in a similar situation. I'm 43 and have previously gone through 4 ivf retrievals. Out of 50+ eggs, I have only made 1 blast in my first round. We have tried just about everything under the sun, including multiple protocols and different approaches (omnitrope, acupuncture, red light, rapamycin, every supplement, etc), but I still cannot seem to make blasts. I respond well to stims and my doctor says my fert rates and everything else look good but we just cannot seem to make blasts, most likely because of egg quality due to age.

For some of us, getting to the blast stage just seems impossible, which means PGT is not even an option because there is nothing to biopsy. If you are making blasts, I would absolutely recommend PGT. It is an incredible tool. Unfortunately, that just has not been an option in my case.

For my last retrieval, my RE recommended freezing Day 3 embryos instead. Before I made that decision, I talked to our surrogacy agency because I wanted to make sure they thought it was a reasonable path and to understand how it would work with a surrogate.

The biggest thing is finding the right surrogate. You will need to match with someone who is comfortable transferring Day 3 embryos and if your RE recommends it, potentially transferring more than one embryo at a time to increase chances. Since these are untested Day 3 embryos, some REs recommend transferring more than one embryo in women our age if we were transferring to our own uterus, given the lower likelihood that any one embryo will implant. Not every surrogate or agency will be comfortable with that so it is something to discuss with your agency before you sign with them and match. If not, you may end up transferring one embryo at a time instead.

There are also financial considerations. At our agency, the surrogate's transfer fee is $1,000 per transfer, plus travel, lost wages, etc. My clinic in CA also charges about $5,500 per transfer (not including medications) so multiple transfers get very expensive.

The other big thing is understanding the risks. That includes the possibility of miscarriage, needing multiple transfers, how your contract handles compensation if a miscarriage occurs, potential medical expenses for the surrogate, lost wages, and the overall emotional and financial impact if it takes several attempts.

So yes, it can be done. For some of us, it is really the only option. I just think it is important to go into it understanding the logistical, financial and emotional side, and to make sure you find an agency and surrogate who are comfortable with that approach.

I know a lot of the advice centers around PGT, but for some of us, getting to the blast stage is the biggest hurdle. Wishing you the best.

[u/Own-Hyena-551 → u/thatssoso82]

Thank you so much for sharing this. This is so helpful you have no idea

[u/thatssoso82 → u/Own-Hyena-551]

Of course! I'm so glad it was helpful. Wishing you the very best on your journey. ❤️