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.  

2 comments:

  1. I'm not in your area to comment on therapists. I would ask your clinic or Resolve. I just wanted to let you know I'm thinking about you.

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  2. It sounds like you made really good decisions based on the information you had. It's hard to have to make so many with limited information. I know for me, the seemingly never-ending uncertainty was the hardest part. I hope your summer is otherwise relaxing. It sounds like you have a bunch of other great things going on. Sending you good luck wishes!

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