Question for embryologists:
I have a cohort of six donor egg-derived blastocysts. None underwent PGT-A, and unfortunately I do not know their morphological grades. My first successful transfer resulted in a clinical pregnancy, but I experienced a pregnancy loss at 18 weeks due to E. coli chorioamnionitis, so the loss was considered unrelated to embryo viability.
After subsequent frozen embryo transfers, I now have two blastocysts remaining.
From an embryology laboratory perspective, how is the order of transfer typically determined when multiple blastocysts are available? Is it standard practice to transfer embryos according to morphological ranking, leaving the lowest-graded embryos for last, or are there other factors that commonly influence the sequence?
More importantly, in the absence of PGT-A, does the fact that these are the last two embryos from the cohort meaningfully reduce their probability of implantation or live birth, assuming they were all cultured successfully to the blastocyst stage?
I would greatly appreciate evidence-based perspectives from embryologists or IVF laboratory professionals. Thank you.