Thanks for writing to DoctorSpring.com with your health concern.
Sometimes what matters is not the number of eggs, but the quality.
Also, when a lot of eggs are retrieved, the quality exponentially declines.
Sometimes, when just 10 eggs are retrieved, they turn out to be overall better than 14 eggs, which are not of a very good quality.
Also, as you mentioned, there was a problem with your husband's semen count.
When the semen count and motility is low, then majority of sperms have poor chromosomal content.
These sperms might be able to fertilize the ovum, but then the development does not proceed as normally, hence the blastocyst arrest can be explained by that.
Another possibility is that the quality of preservation at the laboratory might not be up to the mark.
If the ambient temperature and other factors even deviate slightly, the embryos go into maturation arrest.
Yes, it is quite normal to worry over the one that is implanted.
However, factors inside the uterus are far more conducive to pregnancy development than in a laboratory.
There is no reason to assume that the implanted embryo would also be blighted.
However, in case this cycle fails, and you decide to go for a second cycle, make sure you go for PGD ( pre implantation genetic diagnosis ) and DNA fragmentation tests.
IT will tell you the reason for what happened, and possibly, an solution too.
Right now, just cross your fingers, and stay positive.
All the best. Would be glad to answer any follow-ups.
Patient replied :
Hi Dr. Vazirani,
Thank you for your incredibly thorough and clear response!
I have one two other questions-
We went through ICSI. Would this be your recommendation or would you recommend regular IVF? During ICSI do they have the capability to select the best sperm?
Also, we did have genetic testing prior to IVF and it came back clear for both my husband and I. Is that what you mean by PGD or is this an actual test they can do on embryos already retrieved?
Again, you are very informative and thorough and I thank you for that!
Thank you for the appreciation.
Firstly, for both ICSI and IVF the best sperms are processed and selected, as in the most motile ones. However, this encompasses only the motile looking sperm. Actual quality of the sperms can be assessed by the DNA fragmentation test which is specific for the quality of sperms, vs the quantity.
ICSI and IVF are both comparable, as the processing of the sperms is the same, but ICSI is preferable, because the sperm is directly introduced inside the egg, thereby increasing chances of fertilization, particularly in men with counts on the lower side.
Genetic testing is for both of you, PGD ( pre implantation genetic diagnosis ) as the term implies, is a genetic testing performed on the embryos that are harvested PRE implantation, or just before transfer, to select the genetically superior embryos to be transferred, thereby increasing chances of implantation, and decreasing chances of failure.
All the best.
Please feel free to contact me anytime.
Wish you luck!