retrieval and fertilization report

First thing Friday morning we went in for our retrieval. The experience at the small private hospital was much more pleasant than the experience at the large university hospital. No waiting around forever...it was amazing! We got there at 7:30am and got to leave by 9:30 (it's true we were really pushing it - Y HATES waiting around hospitals which is ironic given his profession and also his place of employment...he was ready to take out my IV himself). For comparison, at my previous clinic I got there at 8am for retrieval and wasn't able to leave until 3pm, mostly because it took hours for a doctor to come and sign off on my chart.

I also had a much, much easier time recovering from the retrieval this time around which also made it a much more positive experience and as I mentioned previously, my friend T (who was the one who actually recommended my current RE) had retrieval immediately after me, so it was really great to have a comrade in all of this (as I have said to her, I like to imagine our embryos hanging out in the incubator together becoming friendly in their pre-life :) ).

This time around we got 10 eggs, which is two less than last time. It is about what we were expecting. I had 13 follies at my last monitoring appointment, but of those 13, four were still just barely measurable, so it would seem that one of those little guys was able to catch up and the other three weren't. I do think I had a slightly smoother stimulation this time than during my last fresh cycle. Last night we found out the 8 fertilized, and as of today, we still have 8 embryos. Last fresh cycle we also had 8 embryos, but coming from 12 eggs, so this was a higher fertilization rate. Like last time, we did a split-batch of 1/2 ICSI 1/2 regular IVF. I am still not sure what proportion of eggs fertilized via ICSI vs. natural fertilization, but I will be interested to know.

The decision of whether to try to grow the embryos to blastocyst or not was much more agonizing than I thought. Dr. T. basically left it up to us to decide. He did suggest the possibility of transferring 1 embryo on day 3 and then attempting to grow the rest to blastocyst with the option of transferring another embryo on day 5. I guess the idea is that this would be a sort of insurance policy if none of the remaining embryos made it to blast. Another consideration is that the lab is apparently not super adept at freezing and thawing blastocysts, even with vitrification, so by attempting to do a day 5 transfer, we might be limiting our possibilities with pursuing frozen transfers from this cycle.

I guess the thing that nags at me most is that all the doctors agree that the reason we are probably not getting pregnant is due to a very high proportion of genetically incompetent embryos, even if they morphologically look nice on day 3. If this is true, it seems to me that our most efficient strategy is probably to eliminate as many abnormal embryos as possible and not even bother transferring them and growing to blastocyst gives us a better selection device than we have had in the past to accomplish this (ultimately, CGH testing would probably be the best selection device, but it's not really an option for us here in Israel right now).

Soooo....in the end we decided to try to grow the embryos to blastocyst. I just know I need to be emotionally prepared to lose all of our embies and/or pursue another fresh cycle in a few weeks if it doesn't work. I still must say I am feeling better about this cycle than our previous ones and I am quite happy we switched clinics and grateful for our RE, who allows us to be much more involved in the process than our previous clinic.