IVF#2: Embryo Development Day 3

So last year, we had 14 fertilized embryos on day 1, 11 of which survived to day 3.

Today, I got an update that all of our embryos are at the appropriate 6-8 cell stage, with one embryo having 10 cells already. Normal for day three is anywhere from 4-10 cells, ideally 8 cells by the end of the day, so we’re good there.

Now, of the entire batch of embryos:
6 are grade 2 (good quality, minimal fragmentation)
5 are grade 3 (average quality, moderate fragmentation)
2 are grade 3-4 (poor quality, a lot of fragmentation)

Judging by the total count of embryos here (13), I’m guessing that the single slow grower from yesterday caught up to the group.

The grading made me a bit nervous though, as I wonder why I don’t have any perfect grade 1 embryos. Is the grade 1 embryo just super rare? Is my egg quality not great, or is the grade 1 embryo a mythical creature like the unicorn?

Everything that I have read says that both the grade 2 and 3 embryos have good implantation potential. And a greater indicator of making it to the blastocyst stage is the embryo making the expected number of cells for its developmental day.

OHSS Watch:

Weight: down 1 pound
Umbilicus circumference: down 1 cm

I got out of bed today, and had minimal problems dressing myself (yesterday, DW had to help me put on my pants and socks- which was actually quite enjoyable). Peeing and pooping still hurt, but changing positions is accompanied by only mild pain now. My ovaries are still sore on palpation, but more like a sore muscle than active inflammation. The bloating is still there, much worse at night, but sleeping and peeing lots overnight seems to bring me back to a less bloated baseline.

DW and I started watching this show called “Transparent”, which has been really fantastic. It’s about a Jewish Patriarch who comes out as transgender to her family of quirky adult children. It’s got this really interesting tone to it. A humorous backdrop, with really deeply somber and tender moments. I’m loving it, and have to try hard to savour each episode rather than binge watch it.

Tonight though, is the Bachelor, and while I object to the whole premise of the show, I can’t seem to look away. Why is there always so much crying?

PS- embryo transfer is happening in T-minus 48 hours!!

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FET#4: The Little Embie that Could?

Embryo transfer was yesterday, but I’ve been struggling to post about it because I feel like I am in shambles.

The day started off perfectly. I woke up early, saw that DW was still asleep, so we cuddled a bit and I fell back asleep for a bit too (sleeping in is such a guilty pleasure for me). When I woke up again, DW surprised me with a vanilla coconut milk decaf coffee in bed, and a curious little box (seriously, so many gifts lately!).

It was a jewellery box.

And in it were the most stunning diamond earrings.

My jaw dropped.

While I am not immune to liking expensive things, DW and I have been somewhat frugal with our money because of “project baby”. Several years ago, I had mentioned that I loved diamond earrings, but that they were too expensive, and well, maybe on our 10 year anniversary, we could look at some for me. Each year, at Christmas time, DW asks me what I want, and I say diamond earrings. It’s almost a joke now because I knew that I didn’t want puny little ones that you get for your niece, but sizeable ones you buy for your WIFE, which are way too expensive for two gals working in the public education system.

But she did it. She went and bought them.

And I love them. But I do feel a bit guilty because of the extravagance, as the weight of them is heavier than the big-ass diamond on my engagement ring. I’m also not a materialistic person, so well, yeah. But I love them. And I am so touched by what DW had to overcome to purchase them (she is even more minimalist than me. She asked for a set of saw attachments for her reciprocating saw for Christmas).

Anyway, after the shock of my pre-transfer sparkling diamonds, we showered and got dressed to leave for our transfer.

All was good, I wore a very lesbian outfit to meet Little Spark: long-sleeved thermal shirt and tights, a sleeveless cotton dress on top, Christmas socks, and Blundstone boots. It didn’t look pretty, but my goal was to stay warm, as it was below freezing temperature.
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Christmas socks.

We got to the clinic, settled in and changed, and waited.

One lady went in before me, but then was soon escorted out and told that they would rearrange the schedule and see her later (I think her bladder wasn’t full enough for the ultrasound?). I went in next, hopped on the table, and was ultrasounded. My bladder was too full, so they asked me to go let out a full cup and come back. Just as I was climbing off the table, the embryologist came to the door and said she needed to talk to the nurse. The nurse walked out of the room with me, and I could overhear some of the conversation she was having with the embryologist. There was a problem with an embryo. (I didn’t think this was that significant until later).

After peeing, we waited for the RE for 50 minutes. In that time, I had to pee two more times. The ultrasound technologist kept imaging my uterus, I think because she was bored. There was a poop in my descending colon that was creating shadows over my uterus, so we had fun making fart jokes. The poop looked like glitter on the screen, which pleased me.

Sparkly diamonds, glittery poop, Little Spark is coming home.

When the RE finally arrived, he looked at our stats, made some random small talk, and then transferred Little Spark back to his/her rightful place: my womb.

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Do you see him/her? Right above the arrow.

Because I hadn’t heard back from him about the Cipralex, I decided that between my legs was right time to ask him about it since we had his attention. He laughed, asked what it was for, I said “It’s an SSRI, I am having some anxiety and trouble sleeping”. He laughed again, looked at DW, and said, “She doesn’t look stressed! Just drink some wine!”, totally dismissing my mental health struggles, and the months of work that it has taken to be able to even talk about it with my family doctor.

I felt humiliated, and DW was PISSED. “Wine? I hope not!”, gesturing at my PUPO (pregnant until proven otherwise) belly, legs still in stirrups, exposed ass facing the RE.

He then stood up, shook our hands, and left. In every single previous FET, he would rant and rave about how excellent the quality of our embryos were, and how we’d end up with twins. This time, no such optimism. In fact, when I asked about what he thought of the embryo’s grade, he just pursed his lips, and bobbed his head side to side, “It’s o-kay”.

All was good, I was giddy even despite the stupid Cipralex exchange, until I found out the grading of our embryo post-thaw.

Last FET, the embryologist explained that we had two good/excellent 5AA and one fair 5BC blastocysts, and that he only recommended transferring one if we were planning on using the 5AAs. So when they were transferred, they selected one of the excellent blasts and the fair blast, leaving an excellent remaining in freeze.

Well, that excellent grade blastocyst did not thaw very well. When re-graded post-thaw, it was graded as a 4BC. My heart just sank when I heard this, and all day yesterday, I tried to resist googling what this meant for our chances of success.

I was already bummed out about only having one blastocyst to transfer. Now I find out that it’s of fair quality. Fair = bad. It went from being a 5AA –> 4BC. What. The. Fuck. All of our other embryos have improved grading after thaw. Most of them were graded as 5BB or 5AB, and then ended up re-graded after thaw as 5AA.

My willpower for avoiding seeking advice from Dr. Google is weak. So I started frantically searching things like “4BC embryo success”, as I just really needed to hear some positive stories. Instead, I find shit like this, which tells me that my prognosis is poor:

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From: http://www.oregonreproductivemedicine.com/about/laboratory/embryo-grading/

And the general consensus in frantic IVF forumland is that usually C-graded anything isn’t generally worth freezing because of how poor of a prognosis it has for implantation and pregnancy.

Let’s break it down: 4BC

4: means that the blastocyst has fully expanded, but has not yet started hatching

B: refers to the inner cell mass that becomes the baby- this is a good rating

C: refers to the trophoectoderm, which are the cells that become the placenta- this is a bad rating, and basically means that there are not enough cells and that they are not organized as they should be

Obviously, I want to believe that this will work, but I find it so hard to establish a balance between informed pessimism and false hope. On one hand, I think of the stats and how the chances of a BFP with an excellent single blastocyst transfer is only about 30%. Then I think about how we’re working with a “poor quality” blastocyst, and the stats in my mind plummet to “I should just crack open that bottle of wine now” level. On the other hand, frantic IVF forumland has many anecdotal stories of people who have had live births from 4CC and day three embryos, so it could happen. Plus, during my research of morphology grading and incidence of chromosomal issues, there was less correlation than people believed. So a poor grade blastocyst could still be normal and grow to be a bouncy baby.

These are the thought bubbles over my head, and I have been very upset during the past 24 hours, but haven’t been able to really even express this to DW, because I know she worries about my anxiety spinning out of control, and I don’t want to upset her with what the reality might be for this FET.

I will also admit, that it has also been very difficult for me to post about this because I feel like I’ve put out more negativity this quarter than I would like. But the truth is, that life really does suck right now, and I need your support more than ever. Normally, the TWW is full of (tentative) hope and excitement, symptom spotting, PSOAS addictions, but it is really awful going through a TWW feeling like the odds are stacked against you. Like, the rhetorical question, what is the point.

But I’m still taking it easy, doing stuff around the house, trying to keep myself busy and to think positively.

I am talking to my belly, to Little Spark. Little Spark I love you, and I would love if you stayed. You have a maman whose love is the greatest that I have ever felt, and furry sisters who can’t wait to help you walk, and clean food off your face. You have grandparents who will spoil you, and have been waiting for you for a very long time. Your mama has friends in the Blogosphere, who have been sending you love and kind wishes before you were even conceived.

You can do this Little Spark. You are so strong because you come from me, and together we have overcome my past, which is a great accomplishment. I believe that our strength is greater than my fear, and I will cherish whatever time we have together. You inside me, and my hope inside you.