We have recently gone through our first donor egg cycle. I was diagnosed with DOR six years ago and my husband has no known problems and is 36 years old. We chose a 21-year-old donor with an AMH of 9.3. This is her first time donated, she was genetically tested, and she came through the testing with flying colors. The clinic did not tell us her antral follicle count. She was monitored twice in eight days and then two days in a row before her trigger shot for a total of three monitoring visits. She produced 32 eggs of which 19 were mature and 18 fertilized. On Day Three, six embryos were 8-cell, six embryos were 6-cell, and six were of lower quality. By Day five, there was only one blastocyst to transfer of 3AB quality. On Day 6, there were two more to freeze of 4bc and 3bc quality. On Day 7, there were another two that were 4bc and 3bc. When I started reading about the quality, I realized that these do not seem to be high quality embryos, particularly for a donor, according to the embryologists. When I asked the embryologists and our doctor they use extremely vague language, although one embryologist did tell me the quality was "unusually low" for a donor. I understand that embryo grading can be subjective. Here are my questions: What are the possible reasons for lower blastocyst quality and how can these be prevented? Is this pattern indicative of sperm or egg quality? Is it possible she was overstimulated if she produced so many eggs, and her estrogen was in the 1800s on Day 8 and her trigger was on Day 9? What is the effect on her eggs if this happens? What are the percentages of live birth rates and miscarriages with each grade of these blastocysts? This is of great importance to know, because we are in a two-year contract with our clinic that requires us to transfer all of our blastocysts before we try another donor. I am trying to come up with a plan on how to proceed, and I am scared of having more miscarriages and the health risks associated with those.
Any useful information would be amazing!
