Embryo Degeneration Post Thaw...

By Dr. Avanthi Vellala

She was 35. Five years of marriage. Decreased ovarian reserve. And on his side cryptozoospermia, one of the most severe forms of low sperm count where sperm are barely detectable in a sample.

They had already been through one IVF cycle at another centre. Four eggs retrieved, three mature, two fertilised, one transferred on day three which didn’t work. They took time to process that. Came to me a year and a half later.

When I looked at everything together diminished ovarian reserve, cryptozoospermia, a failed IVF behind them. I knew we had to be very deliberate. We tailored a protocol for her.

She started with 8/5 follicles. Stimulation went well. We expected around 13 eggs , retrieved 11, all 11 mature, 7 fertilised. A good response.

We biopsied the two best blastocysts for genetic testing. The remaining four were frozen without biopsy.

Both biopsied embryos came back genetically abnormal.

She didn’t say much when I told her. But I could see it in her eyes, a tiredness that had nothing to do with sleep. The kind that builds up over years of trying, over procedures and results and waiting rooms.

We planned a frozen embryo transfer with the remaining four, the ones we hadn’t biopsied. Decided to transfer two.

On the day of the transfer, the embryologist called me.

The two blastocysts that were thawed were showing signs of degeneration. Poor expansion. Not what we wanted to see.

I went to her and explained exactly what was happening. That we had two more embryos. That I wanted to thaw those and transfer instead. That it was her decision.

She looked at me and said

“Just do it. Whatever.”

That’s not indifference. Those three words carried more exhaustion.

We thawed the last two. Transferred them.

She conceived.

Now I need to tell you something I had been planning for a while.

She’s a fellow BTS ARMY. And the moment she turned positive, I ordered her BTS merch. Quietly. Waited. Kept it ready.

On the last day I referred her, I took it out and handed it to her.

Her eyes filled with tears. The good kind.

Any ARMY reading this will understand, merch hits different. Big or small. It doesn’t matter. It’s never just merch.

Dear patient who is your bias? I’m not sure if I ever asked. Or maybe I did and I’ve forgotten.

I hope you’re doing your prenatal sessions with OT7 playing in the background. Her due date is in October.

I’m waiting to hold a baby ARMY.