One little, two little embryos..

Today was transfer day! I didn’t feel nervous (or maybe I was telling myself that I wasn’t) but who are we kidding?

We arrived at the clinic with not much time to spare and they handed me a tiny nondescript manila envelope containing a pill and said, “take this”. We were escorted back to a room where I was instructed to assume the position. The nurse came in to tell us that we had 2 beautiful grade 2 embryos to transfer today and that we would discuss the others after the procedure. We were given a picture to keep of the two we were transferring.

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My bladder wasn’t quite full enough and they ended up having to cath me and insert what to me felt like approximately 5.5 gallons of fluid. That was seriously one of the worst feelings I’ve felt in my life! It was incredibly uncomfortable and made me eyes tear up! They inserted the catheter into my uterus and called for the embryologist to transfer the embryos. I wasn’t able to see the screen but W said it was pretty awesome to watch what was going on. The transfer went very well and the doctor had mercy on me and chose to cath me again to remove the fluid from my bladder. Thankfully, I was able to stay horizontal for the full 30 minutes without having to get up to go to the bathroom!

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We went over our calendars, lab draws and remaining embryos. Here’s the breakdown of what we have left:
⭐️THREE (grade 2) embryos that are frozen
⭐️THREE additional (grade 2) embryos that are expected to make it to freeze
⭐️A couple of embryos that they will continue to watch to see if they will make it to freeze.

We will get the final frozen count on Thursday.

We were given a 50-60% chance of pregnancy with a 25% chance of twins based on my age, etc. We should know in a couple of weeks if it worked and if so, a couple weeks after that how many. I’ve been instructed to be a couch potato today and then I’m allowed to resume mild activity tomorrow.

Thank you everyone for your well wishes, thoughts and prayers. You all mean a great deal!

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Embryo Development Day 3

I had a “relaxing” day yesterday with my gatorade while W went hiking with some friends. I must admit, I was a bit jealous to not be able to go. The highlight of my afternoon was going to the grocery store to pick out some new gatorade flavors. My go to drink when I wasn’t feeling well in the past was gatorade but I feel like our relationship is changing!

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I also snuck out of the house for a couple hours last night with W and friends again. We went to dinner at Wicked Spoon at The Cosmopolitan. I tried to eat mostly sodium filled, high protein food (to help my OHSS) but I may or may not have had a few desserts! After that we went to see Penn and Teller at the Rio. Teller was nice enough to take a selfie of all of us with my phone.

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I got the update from the clinic about our embryos! Good news again! All 12 are STILL growing! Here’s the daily dirt on what’s to be expected..

“Within 72 hours of fertilization (day 3) it ideally should be 6-9 cells and by day 5 or 6 it should have reached the 100-cell+ stage with a fluid filled cavity inside (expanded blastocyst). Embryos that fail to reach 6-9 cells within 72 hours of fertilization are developing too slow or too fast and more often than not are aneuploid and “incompetent.” Also, cleaved embryos that contain significant cell fragments (fragmented embryos) are also more likely to be aneuploid.

Our research has demonstrated that failure of an embryo to reach the expanded blastocyst stage within 5 to 6 days of fertilization is almost always associated with aneuploidy. As stated such aneuploid embryos are thus “incompetent”.

On average, a 6-9 cell day-3 embryos transferred to the uterus would have about a 20-25% chance of propagating a live birth. If left in culture for 2-3 days longer, many (but not all) such aneuploid embryos will stop growing (arrest) and be culled out in the process. Those that make it to blastocysts are then more likely (35-40%) to develop into babies. Those that fail to survive to the blastocyst stage are “incompetent” and even if they had been transferred to the uterus earlier on, would almost always have failed to implant.”

Here’s the break down of what we have on Day 3 (all with minimal fragmentation):

  • 3- 7 cells
  • 7- 8 cells
  • 2- 10 cells

The clinic nurse said in a normal cycle, 50% of these embryos won’t make it to blastocyst stage (the stage where they would transfer). She said to not be alarmed if the numbers start dropping. I’m thankful to still have 12 so hopefully our end number will allow for freezing some. The tentative plan is to transfer on Tuesday if my OHSS is deemed well enough to the RE. We will (God willing) transfer 2 embryos and freeze the rest for future use. Image

Embryo Development Day 1 & 2

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Good news! We got a call yesterday that all 12 of our eggs had fertilized using ICSI! Today (Saturday) will be an observation day and we will get another call tomorrow to see how many are still growing. W thinks it’s slightly comical that there were a dozen collected and fertilized. He’s been calling me his hen! Here’s some information on what’s been taking place..

Day 1: The eggs are assessed for evidence of fertilization. Normal fertilization is evidenced by the presence of two pronuclei, one from the egg and one from the sperm. If there are too few or too many pronuclei, the embryo is considered abnormally fertilized. All normally fertilized embryos are put into a culture media that mimics the tubal fluid found in fallopian tubes and placed in an incubator.”

Day 2: The embryos are assessed for cell division. Most embryos develop 2-4 cells by day 2. Embryos are graded based on an embryologic grading system that incorporates number of cells, cell regularity and degree of fragmentation.”

Speaking of growing.. That’s what my poor belly has been doing since the retrieval. I showed a picture to a fellow NICU nurse friend of mine and she agreed that I could easily pass for 23 weeks pregnant. I spoke with the nurse at the clinic and she said mild OHSS was common with girls like me who have PCOS and produced a lot of follicles. She said as long as it doesn’t get markedly worse and as long as I’m not in significant pain that the best thing to do is drink fluids with electrolytes and hope for it to resolve soon. I can’t believe I’m posting this awful belly but I know that I appreciate being able to google other’s blogs and see real pictures of what to possibly expect!

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Here’s a brief description of OHSS. “During IVF, the stimulation medications cause the body to create and grow many follicles (versus the one a month a woman’s body produces without medical intervention). As these ovarian follicles grow, they release a number of different substances, the most important of which is estrogen. This estrogen allows the lining of the uterus to thicken so that the embryo can implant and snuggle in. Once the follicles have reached maturity, an IVF patient takes a “trigger” shot of HCG to cause ovulation. Harvesting of the follicles for eggs is now done and the follicles are aspirated with a needle, releasing all of the fluid. After this, huge amounts of estrogen-rich fluid pour out of the swollen and enlarged ovaries and into the abdominal cavity. Many women will then experience some mild OHSS symptoms (bloating, some abdominal discomfort, etc.) after retrieval. After retrieval, the follicles refill with fluid and are called corpus luteum, because they contain large stores of cholesterol that are used to produce the steroid hormones estrogen and progesterone. In addition, the follicles start to produce a number of other growth factors and chemicals like vascular endothelial growth factor (VEGF) and kallikrein-kinin, which then coat the lining of the abdominal cavity and cause it to become leaky. This is called ascitis. Fluid literally pours out of bloodstream into the peritoneal (abdominal) cavity because of the leakiness of the lining. The ovaries balloon in size and the abdomen swells.”

BINGO! Apparently I win. Hoping this will all be worth it in the end! (We were able to sneak out for a bit with some friends to do some shopping, have lunch and watch the fountains at the Bellagio. Put $5 in a slot machine and won $40. Might have to go back tonight and see if we can find some more IVF reimbursement! -ha)

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*On a side note: I keep reading these posts about fellow women who are struggling with infertility resenting their friends and family who get pregnant or have kids. They say that these pregnant women are insensitive to our struggles and that they should somehow put a cap on their excitement or filter everything they say. While I understand how hard it is to feel as if life is passing you by and to watch these women take for granted something that doesn’t come easily to us, I can’t help but think that sometimes WE are the insensitive ones. Who says that we should get to celebrate our BFPs (pregnancy) and they should keep quiet as not to upset us? It’s not their fault that they didn’t go through the same struggles as we did. Every woman deserves to celebrate such a precious time in their lives any way they see fit. We should be supporting each other as women, fertile or infertile instead of debating who gets to celebrate and who is insensitive. Yes, they may not know all of the pain, hormonal rages, stress and heartache that we go through but that’s a badge that I will wear proudly. You don’t have to know about my struggles or tiptoe around them because I know that everything that I’ve gone through has only made me stronger and has shaped me into the woman that I am today. You can’t control other people’s actions, only how you respond!