Thursday, July 31, 2014

The Latest

1.  I am not pregnant.  I don't want to talk about it.  I don't feel sad.  I don't really care.  But I also don't want to talk about it or be consoled.  Got it?  Cool.

2.  The three embryos we sent off for testing are all healthy.

3.  There is nothing else that I know or really want to share.

Thanks for caring.  (Not sarcasm.  I know, it's hard to tell with me sometimes.)

Thursday, July 24, 2014

Numbers (A List of Lists)

The Plan:

  • Do an egg retrieval.
  • Take resulting embryos and the three frozen embryos we have leftover and grow them until they are 5 days old.
  • At five days, see if they have become blastocysts.
  • At five days if we have 3 or fewer blastocysts, just tranfer them then without genetic testing.
  • At five days if we have 4 or more blastocysts, send them for testing and freeze them, doing the transfer in a different cycle.

Reasons for plans to grow Embryos to Blastocyst instead of transfering at day 3 as we usually do:

  • I only wanted to do ONE MORE transfer.  Over this.  So over it.  
  • To maximize chance of pregnancy and minimize risk of miscarriage.  See following bullets.
  • Would like to test embryos before transfer to transfer only healthy ones, making another miscarriage far less likely.
  • Blastocysts have slightly higher chance of implantation than 3-day embryos.

Risks of this plan:

  • Many embryos will not grow to blastocyst outside the body, so you will always lose some.
  • The ones you lose are not necessarily "bad ones" that wouldn't have worked at day 3.
  • The one time we tried to do this before none of our 6 embryos made it to blastocyst.

How it Went

This Egg Retrieval:

  • 20 eggs
  • 16 mature
  • 15 fertilized

Eggs Retrieved from my ovaries so far:

  • 16
  • 20
  • 20

Eggs Retrieved from my ovaries so far that have become human babies:

  • 0

This cycle's embryos on Day 3:

  • 15 fresh +
  • 3 frozen and thawed =
  • 18 day 3 embryos

Embryo Quality on Day 3:

Fresh:

First number = scale of 1-4 looking at fragmentation.  
1=excellent, 2=above average, 3=average, 4=below average

Second number = number of cells, with at least 6 cells being a great number.
  • 2 8
  • 2 10
  • 2 9
  • 2 8
  • 3 6
  • 3 8
  • 2 8
  • 2 8 
  • 3 5
  • 2 6
  • 2 8
  • 4 7
  • 2 8
  • 2 8
  • 4 5

Thawed:

"excellent" with the following numbers of cells
  • 6
  • 6
  • 9

Stages for an embryo to go through before becoming a blastocyst:

  • plain old embryo
  • morula
  • early blastocyst 1
  • early blastocyst 2
  • blastocyst

What stage embryos need to be in to be genetically tested (by Day 6) OR to have a decent chance of resulting in a pregnancy if transfered on Day 5:

  • blastocyst

Embryos morning of day 5:

  • 8 - morula
  • 8 - early blastocyst 1
  • 2 - dead/plain old embryo/not mentioned so who knows

Difficult decision:

  • Transfer the three best that afternoon, although a very low likelihood of resulting pregnancy, and a risk of genetically unhealthy embryo becoming a pregnancy.  If we wait, there may be none to send for testing, and we would get not a single transfer/chance.  Dr. feels unlikely any will make it to blastocyst.  This retrieval was particularly painful (still in pain a week and a half later) and I would regret not even getting one try out of it or at least knowledge that they aren't healthy and thus aren't worth transfering.

Best 3 embryos at time of transfer on day 5:

  • blastocyst!
  • blastocyst!
  • early embryo 2

Difficult decision 2 of the day:

  • go through with the transfer anyhow because still not enough to make it worth genetic testing and still not looking promising that more will grow.  A gamble, with the downside being that we, again, still don't know about the genetic health of embryos, hence risk another miscarriage. 
  • Transfered 3 embryos - Friday July 18th - day 5

Embryos morning of day 6:

  • 3 = blastocysts - sample cells sent off for testing and then embryos frozen and waiting
  • 12 = not blastocysts -sent to wherever bad embryos go
  • 3 = in my uterus so who knows

Final Thoughts:

  • Of course, had I know that 3 more would be champs, I wouldn't have had the transfer on day 5.  Would way rather have sent 5 or 6 off for testing and tranferred only healthy ones in one transfer.
  • But we made the best decisions with what we knew.
  • If the ones inside me do not result in a child, and any of the 3 sent for testing are healthy (we will know in about a week) then I will likely do another fucking transfer.

Next Steps if None of that Works:

  • We have a lot of thinking to do and I don't feel like sharing publicly where we are with all of that yet, as we are really in a state of flux in terms of where we want to go next.  Far less sure than we felt before about further plans.
  • If you know a good Bay Area therapist who specializes in Infertility, let me know.