Saturday, November 10, 2012

Plans for Frosty the Embryo

I've had a cold for a week and a half and it's really tiring.  I started my Lupron injections on Monday night, and the sleeplessness/restlessness kicked in solid a couple of nights ago.  So, physically, I'm not feeling my best.   I also haven't really been in the mood to write - have been trying to get to this post for days, for example.  I'm not sure why, except I think I'm just tired and sick, so it takes a lot of energy to get done the stuff I have to do (work and professional commitments), it leaves little for the stuff that is for me.  Which this blog is supposed to be.

This morning, through bleary eyes, I'm gonna finish this danged thing up!


We met with Dr. Tran on Wednesday to go over our failed IVF cycle and to talk about our upcoming FET cycle and other potential future plans.  I have said it before, and I'll say it again, but I love Dr. Tran for his straightforward manner, his sense of humor, his honesty, and his desire to really share all of the details of things with us while guiding us in making decisions, but not deciding for us.  So, he showed us all the data from our IVF cycle - the follicles I had, the expected number of eggs, the actual eggs etc.  He said the only thing that he felt disappointed about what that I really only had 10 m2 (mature) eggs, and it had looked, based on my follicles, that I'd have closer to 15 or 20.  We were still in the range he had estimated for us (10-20), so it's not a concern, just was a disappointment for him.   My estrogen levels got pretty high toward the end of the cycle, but not high enough, obviously, to cancel the cycle, and he feels like those levels were appropriate for the number of eggs that I had.

On the plus side, our fertilization was excellent.  On this front, we out-performed averages and his estimates for us in that 100% of our mature eggs fertilized and 100% lived to day 3.  Of those 10 embryos, we transferred two last time, and will thaw and transfer two more this time.

Our clinic grades the embryos with 3 numbers, and I got to see them for all our embryos.  The first number is how many cells the embryo has.  On day 3, 8 cells is grand.  6 or 7 is AOK.  Below that is less ideal, but potentially still fine.  Ours were mostly 7s and 8s.  We had a few 9s and a couple of 6s (if I remember correctly).  The second thing they look at is symmetry and the third thing they look at is fragmentation.  On both of those scales, our embryos fared pretty well.  No amazing perfect ones, but none that were duds either.  So we have a whole batch of good embryos.  Again, he is a little disappointed that none were AMAZING EXCELLENT, but this is still a great result.

I asked him some of the things I was curious about - How do we decide what day to transfer?  (Answer: it really is much more flexible than during our IVF cycle and can be determined a little by schedule.)  How many do you thaw?  (Just as many as you plan to transfer.)  What if they don't survive the thaw?  (There is time to thaw more if that happens.)

So, our plan is to transfer 2 embryos during the first week of December (I'm hoping for early in the week, so it doesn't affect our travel to Switzerland later in the month in terms of when I have to take my beta tests).   And we are going to add a couple of things this time.

1.  Assisted Hatching - Dr. Tran doesn't necessarily think this is required for us, but it can't hurt and it might give our guys a better chance of implanting.  Because of our long history of infertility (I hate even writing that, but let's face facts, it's a reality at this point) he feels like this is not a bad path to follow.  When I asked if there was any down side he said, "Just on your wallets."  Ok, so we are in.  Assisted Hatching (AH) basically just means that the embryologist will give the embryos' shells a bit of a poke just in case a thick shell is causing implantation issues.  It's so funny to realize that we hatch out of shell, sort of like chicks, just at a much much earlier stage in our development.

 2.  hCG Wash - I can't find very much about this on the various Internets, but Dr. Tran says that they have had some success with this for FETs and it seems like it's sort of a cutting edge new thing that's being done some places.  Basically since we aren't doing an hCG trigger shot, he's just gonna shoot some hCG up in there during the transfer.  This can help to make sure that my uterus is ready for some implantation.

At our clinic, the doctors rotate weeks in terms of who does the actual procedures (monitoring, transfers, and retrievals) and we are excited that Dr. Tran will be the actual doctor on duty the week of our FET.

The only other news is good news!  Dr. Tran told me that if I get pregnant, he'll let me switch from the PIO shots back to Crinone (the Vagina Glue), so I won't have to be doing those giant needles in the butt for potentially months and months!  I was so happy I almost cried.

We also discussed future plans if this FET doesn't work.  There is the potential to thaw embryos and let them grow for a couple more days to the blastocyst stage.  At this point they can remove cells without damaging the embryos and do genetic testing on them.   This can allow for a more accurate picture of which embryos are "best" and most likely to implant and survive.  So, it's something to think about.  It, of course, adds cost, and there is also the potential of losing embryos if you keep them growing outside of the body.  But the longer you go on the path of no success, the more these costs stop outweighing the benefits.  Just something for us to think about as we move forward.

In the meantime, Ian and I have done so little travel this past year compared to a normal year, because of all of this and we realized that we hadn't stayed in a hotel together since February, when we were in Tahoe with friends.  So we are going to Sonoma tonight when I get off work, just for one night to stay in a hotel, eat delicious dinner and brunch, and pick-up wine at a pick-up party at the winery where we are members.

Here's a tiny short video about Assisted Hatching, and a tiny short video that actually shows an embryo being hatched with assistance.  I love this shit.  #sciencenerd


  1. Was thinking about you and when you were going to start again. Thanks for doing an update too! Enjoy the hotel!

  2. I think that sounds like a great plan - yay for plans and upcoming FETs! My clinic did the hCG Wash on me for my last FET and it is supposed to help a lot (one of the "new" facts coming out - so that's good your clinic is up to date on that, as well). have fun on your upcoming trip :)

  3. Good luck this time around! I will be following right along with your journey and hoping the best. Good to hear all of your awesome raves about Dr. Tran- I've really liked him so far too! If you ever want to meet up when you're at UC, let me know!

  4. Switzerland yeah! I hear that place is amazing. And no matter what happens, you will be supplied with the most incredible array of chocolate, which will be so helpful whichever way this one goes ;)