By Alease Daniel Barnes, Embryologist, B.Sc.
So you’ve been monitored for 10 days and you’ve finally made it to egg retrieval! Now what? You’ve been getting updates and info every other day from your nurse or your doctor, but now you have no idea when to expect updates from the lab. Often, patients are so focused on getting through stims and to the egg retrieval they forget to ask when they’ll get updates on their embabies from the lab.
Having a general idea of what to expect before an egg retrieval can help you prepare for the process and know what questions to ask.
Keep in mind, every clinic is different and the timeline below is for general educational purposes. We encourage you to discuss your timeline with your nurse and doctor beforehand so everyone is on the same page.
The first update usually comes shortly after your egg retrieval. This is considered day 0. At the very least, by the time you leave the clinic, you should know how many total eggs were retrieved. This information is usually given to you by the physician or nurse. Since egg stripping comes a couple hours later, you won’t know how many eggs are mature right away. Insemination, whether ICSI or Conventional, typically happens around or after lunch time.
Now that it’s been a day you’re hopefully feeling a little better post retrieval and you should receive fertilization results in the morning of day 1. In this update, you should get an overview of how many eggs were retrieved, how many eggs were mature and inseminated, and how many fertilized. They may also include information on sperm or egg quality. Many clinics also keep abnormally fertilized or unfertilized eggs for observation. These are usually cultured separately.
This is the day that has the most variability between clinics.
Since a lot of clinics have moved away from doing day 3 transfers, some check on the embryos on day 3 while others prefer to wait and not disturb them. This is a good question to ask before your retrieval so you know when you can expect an update.
If your clinic checks your embryos on day 3, you can expect an update that includes how many cells your embryos have. The “good” range is between 6-10 cells. Some clinics will also give the embryos a grade based on the amount of fragmentation the embryo has. These are numbers 1-4, with 1 being the highest quality/least fragmented and 4 being the lowest quality/most fragmented.
I know waiting for that day 5 update is the hardest! This is the first update that tells you how many blastocysts you have. If you are doing a fresh transfer on day 5, you will likely receive an update on the morning of day 5. If you are not planning a fresh transfer, don’t be alarmed if you don’t receive an update until the end of the day. This is another opportunity to ask questions before the egg retrieval to understand your clinic’s timeline.
Oftentimes your embryos are checked in the morning, but aren’t quite ready to freeze or biopsy until later in the day. Your day 5 report will tell you exactly how many embryos were transferred, biopsied and/or frozen and usually includes how many embryos are still being watched.
It can be discouraging when you don’t have embryos on day 5, but keep in mind that only about 30% of patients have embryos on day 5, but around 80% of patients have embryos on day 6!
The last report you will receive includes days 0-6 (or 7, if your clinic cultures to day 7). It will be an overview of all of the checks they did as well as how many total embryos were transferred, biopsied and/or frozen. Some clinics will include the embryo grades in this report, but if your clinic doesn’t, reach out if that is information that you want! This report may also include next step information as well as the timeline for receiving PGT results (typically 2 weeks from when the samples are shipped). I have written a guide to help make embryo grading make sense, which can be accessed here.
It is important to ask your clinic what days you should expect results from the lab and how you will receive them!
Some clinics call, some email, some portal, some do a combination and some even include pictures along the way. In my experience, clinics that send emails or portals are likely to send out reports as soon as they do the checks, whereas clinics who call you are more likely to call at the end of the day. Embryologists do their best to provide you with regular updates, but try to avoid taking dishes out of the incubator, so daily updates are very rare.
Alease Daniel Barnes is a graduate of North Carolina State University, where she graduated Summa Cum Laude in 2018 with a B.S. in Genetics and a minor in Biotechnology. Her goal to give every person going through IVF the knowledge they need to advocate for their care and feel empowered on their journey. Along with serving as an embryologist helping fertility patients, she offers courses and educational resources through her website, https://aleasetheembryologist.com/, and can be found on Instagram and TikTok.