Dear Prof. Winston,

I am a 28 year old lesbian who is trying to conceive. We tried using a known donor, and did get pregnant but I miscarried at week 5. We then had the donor’s semen tested and his sperm was recommended only for ICSI due to morphology issues.

We have now had a cycle of mild stim IVF and have 1 grade 5BC 6 day blastocyst and 4 8 or 9 cell 3 day embryos, grade 1. I’m waiting for a polypectomy before a FET.

My question is, how do I go about deciding what to do with my frozen embryos, in order to make the most of what I have? So much of it is luck, but with IVF costing SO much, we are desperate to get the most out of the process. Do we stand a better chance if we thaw all the embryos and see what happens after a couple of days? Or transfer the 3 day embryos? Is it better to let them develop in a lab, or in my body? Each transfer costs £1000. This is a lot of money for us. I feel like it’s so hard to get decent advice about all of this.

I also wonder what your opinion is on IVF versus IUI, for women with no fertility issues (that I know of). We were told IVF has much greater success rates that IUI is a waste of time – but is this true?

It’s such a minefield, and I’m so anxious about how to navigate all of this.

Thank you so much for your time. It means so much.

Dear A.,

It seems to me you are a bit stuck now having already gone through IVF.  Of course, my first choice would have been IUI and frankly, I don’t understand why you were not told this as it is cheaper and less invasive – and doesn’t involve decisions like the one you now have to make.  What reasons were you given for the miscarriage?

As regards which embryos you have transferred, I am not sure I feel that strongly.  I repeatedly pointed out on this website that embryo grading does not necessarily reflect the quality of an embryo – why clinics give this misleading information to patients remains a mystery to me.  I am inclined to think that the blastocyst you have may give you the best outcome.

Best wishes


Leave your thought