It's been a few days over a year since I last posted and I am ready to start this up again. We started TTC again in March 2014. I weaned N around that time for fertility reasons, which was a difficult choice.
In early June we thawed our four frozen day 3 embryos. Our hope was to thaw them on day 3 and try to grow them to day 5 and then do SET if any of them made it blastocyst. We knew the embryos weren't great quality and we didn't want to transfer more than one because we were explicitly trying to avoid twins because of what happened with our first twin pregnancy. We figured growing to day 5 would be a good selection device.
I guess it was too good of a selection device, because after preparing a fluffy lining with a couple of weeks of estrogen, none of the embryos progressed to day 5 after thawing. It was disappointing to have nothing to transfer, but I guess it also wasn't shocking since we knew the embryos weren't great and I didn't regret that we chose to attempt a day 5 transfer.
After the transfer that never was, I had a meeting with my RE to decide where to go from there. I knew that I wanted to get pregnant soon and never having had a spontaneous pregnancy, I knew that I wanted to continue with treatment. I was uncertain whether I wanted to start with something less invasive and emotionally consuming like Clomid IUI or whether I wanted to dive right back into a fresh IVF cycle. I also didn't know what our health fund would cover based on our circumstances at the moment.
Our RE advised that he would support me in whatever treatment that I wanted to do and in whatever order or combination I wanted, but that he still thought IVF was our most efficient path to pregnancy. Fair enough. After talking it over with Y and some soul-searching, we decided to proceed with our fourth fresh IVF in July 2014.
We did the antagonist protocol and the stimulation went fine. We got 10 eggs, which is pretty standard for me. Unfortunately, only 5 fertilized with ICSI which is a pretty low fertilization rate for us. Our embryos were in an incubator with an embryoscope, a time lapse imaging system that takes video of the developing embryos. It is a pretty cool recent invention that is supposed to help in embryo selection and gives the embryologist and RE real-time info about the embryos without disturbing them in the incubator.
Our hope was still to do a day 5 SET but based on our lower fertilization rate and underwhelming embryo quality, my RE advised we do a day 3 transfer. We weren't so psyched about this, both because day 3 hadn't brought us success in the past and because suddenly it made the question of how many embryos to transfer much more confusing, since day 3 SET doesn't have such great results.
The day of the embryo transfer, the embryologist and our RE reviewed the video clips from the embryoscope. Our RE told us none of the embryos were more than 6-cell, all had significant fragmentation, and none of them met the freezing criteria. He and the embryologist recommended that we transfer three (!) We decided to settle for two, even though Y had significant reservations since we were (and are) still both traumatized from the pregnancy with Aminadav and Naava.
Needless to say, much to the shock of our RE and myself (and not to Y), we got pregnant with twins again. I am now 17w3d pregnant with a boy and a girl, and it's been a challenging and scary road so far. I had light bleeding from weeks 5-7 due to a subchorionic hematoma. At the NT scan I was diagnosed with partial placenta previa, and during week 13 I was hospitalized due to a major bleed. This was really scary since chronic bleeding is what we believed caused PPROM (premature rupture of membranes) with Aminadav and Naava -- basically due to blood wearing down the amniotic sac like sandpaper. I rested at home for a week and then returned to work.
I also had a worrisome cervical length ultrasound about a week ago. It shortened significantly based on that measurement but then when another technician measured it a few days later, all was good. I am not sure whether my cervix is dynamic or whether maybe the first measurement was incorrect or what, but I will ask my doctor what she thinks when I have my regular appointment next week.
This whole ride is very scary for us....every day I just feel thankful to wake up still pregnant. The only way through this is to make it to each new day as uneventfully as possible -- 10.5 weeks til our first big goal. Meanwhile, N fills our lives with so much joy (and activity!). We are so blessed to have her here with us.
Showing posts with label snowbabies. Show all posts
Showing posts with label snowbabies. Show all posts
Nov 14, 2014
Aug 7, 2011
moving on to FET #2
Today I went in for my clinic appointment. We have two frozen embryos left in a single straw at this point - a 5-cell BC grade and an 8-cell B grade. I saw the youngest RE in the practice today and I must say that I found his no bullshit responses refreshing.
He basically said what I thought all along - that the 5-cell BC is basically junk and while it is technically possible to get pregnant from an embryo of that grade since the classification schemes we have now are imperfect predictors of an embryo's potential, it would be very usual. Since all of my embryos lost cells last time in the freezing/thawing process, it is very possible the 5-cell embryo will lose too many cells in the thaw to remain viable anyway.
However, the 8-cell B grade embryo is a good embryo and if it thaws well, it has a chance just like any good day 3 embryo. We are going to clean out the freezer and do another medicated FET this month.
I also asked whether the fact that all of my embryos lost cells last time during the thaw was in any way a reflection of the quality or competence of the embryos and he said that it is really a technical issue with the lab and not any embryo-specific problem. I guess that was reassuring in some sense, but it also reaffirmed my feeling that our current clinic is not so up to par in its lab.
I have an appointment in 2 weeks with another RE for a second opinion as we contemplate moving clinics for our next fresh cycle if this FET doesn't pan out. I guess I have mixed feelings about this - I am used to the way things work at my current clinic and I feel a certain sense of loyalty to them. It is also by far the most convenient option for me and I feel like I have a good relationship with the nurses.
On the other hand, I have been at the same clinic for 13 months now with no viable pregnancy (ironically despite what everyone keeps assuring me is an amazing prognosis), I have serious doubts about the practices and quality of the lab, and the institutional attitude is just not so proactive.
It is maddening constantly wondering whether I have just been really unlucky with the last 5 embryos transferred (but do indeed have a great prognosis) or whether there is something major going on that just hasn't been uncovered. Of course, the truth of my situation could certainly lie somewhere in between those 2 possibilities but I have a little trouble sometimes with the many shades of gray:) I also oftentimes wonder whether during many of those IUIs, we also had eggs that fertilized and became embryos but never implanted.
AF arrived full-force late this afternoon so tomorrow it's back to the clinic for baseline and assuming all is clear, back to little blue pills and estrogen headaches...yum.
Lastly, thank you so, so much for all of the support over the past week. Your comments mean so much to me and truly brighten my day when I am feeling down.
He basically said what I thought all along - that the 5-cell BC is basically junk and while it is technically possible to get pregnant from an embryo of that grade since the classification schemes we have now are imperfect predictors of an embryo's potential, it would be very usual. Since all of my embryos lost cells last time in the freezing/thawing process, it is very possible the 5-cell embryo will lose too many cells in the thaw to remain viable anyway.
However, the 8-cell B grade embryo is a good embryo and if it thaws well, it has a chance just like any good day 3 embryo. We are going to clean out the freezer and do another medicated FET this month.
I also asked whether the fact that all of my embryos lost cells last time during the thaw was in any way a reflection of the quality or competence of the embryos and he said that it is really a technical issue with the lab and not any embryo-specific problem. I guess that was reassuring in some sense, but it also reaffirmed my feeling that our current clinic is not so up to par in its lab.
I have an appointment in 2 weeks with another RE for a second opinion as we contemplate moving clinics for our next fresh cycle if this FET doesn't pan out. I guess I have mixed feelings about this - I am used to the way things work at my current clinic and I feel a certain sense of loyalty to them. It is also by far the most convenient option for me and I feel like I have a good relationship with the nurses.
On the other hand, I have been at the same clinic for 13 months now with no viable pregnancy (ironically despite what everyone keeps assuring me is an amazing prognosis), I have serious doubts about the practices and quality of the lab, and the institutional attitude is just not so proactive.
It is maddening constantly wondering whether I have just been really unlucky with the last 5 embryos transferred (but do indeed have a great prognosis) or whether there is something major going on that just hasn't been uncovered. Of course, the truth of my situation could certainly lie somewhere in between those 2 possibilities but I have a little trouble sometimes with the many shades of gray:) I also oftentimes wonder whether during many of those IUIs, we also had eggs that fertilized and became embryos but never implanted.
AF arrived full-force late this afternoon so tomorrow it's back to the clinic for baseline and assuming all is clear, back to little blue pills and estrogen headaches...yum.
Lastly, thank you so, so much for all of the support over the past week. Your comments mean so much to me and truly brighten my day when I am feeling down.
Aug 3, 2011
10dp3dt=BFN
It looks like this is how FET#1 is going to go down...I keep thinking of those 3 embryos and wondering what happened to them.
Jul 24, 2011
18 cells heavier
Today was our embryo transfer for our FET. We put back three 3-day embryos, a 5B, 6B, and 7B and now all there is really left to do is hope and pray that 1 or 2 (or 3?!?! eek) will stick and thrive and blossom into souls we will have the privilege of meeting again come spring.
I wrote before how the original plan was to thaw the straw with the 2 embryos that remained from those that were fertilized by regular IVF, an 8B and 5BC. It seemed really questionable, though, whether the 5BC would even have a decent chance of surviving thaw. I still find it odd that they bothered to freeze the 5BC at all. Instead, they decide to thaw all 3 of our ICSI embryos, which were originally rated 8B, 9B, and 9B. All three survived thaw, but not without sustaining battle wounds: one 9B became a 5B, one 9B became a 7B, and the 8B became a 6B. Since none of them survived fully intact, we decided to transfer 3.
To be honest, I had a pretty naive and uninformed view of the thawing process - I thought the embryo would either thaw intact (a viable embryo) or not (a non-viable embryo). I was oblivious to all of the shades of gray in the thawing process - that some of the cells could die, but that if over 50% of the cells remained alive, the embryo would still be considered viable.
No one told us the embryos looked good or said we had an excellent chance or anything like that. Honestly, I don't think our chances of a live baby from this cycle are that great but I always have to keep hoping that this is the time that things will be different...
I wrote before how the original plan was to thaw the straw with the 2 embryos that remained from those that were fertilized by regular IVF, an 8B and 5BC. It seemed really questionable, though, whether the 5BC would even have a decent chance of surviving thaw. I still find it odd that they bothered to freeze the 5BC at all. Instead, they decide to thaw all 3 of our ICSI embryos, which were originally rated 8B, 9B, and 9B. All three survived thaw, but not without sustaining battle wounds: one 9B became a 5B, one 9B became a 7B, and the 8B became a 6B. Since none of them survived fully intact, we decided to transfer 3.
To be honest, I had a pretty naive and uninformed view of the thawing process - I thought the embryo would either thaw intact (a viable embryo) or not (a non-viable embryo). I was oblivious to all of the shades of gray in the thawing process - that some of the cells could die, but that if over 50% of the cells remained alive, the embryo would still be considered viable.
No one told us the embryos looked good or said we had an excellent chance or anything like that. Honestly, I don't think our chances of a live baby from this cycle are that great but I always have to keep hoping that this is the time that things will be different...
Jul 6, 2011
overwhelmed
Today I had an appointment so we can get started with a FET. I am feeling overwhelmed and disappointed, which is how I seem to feel after most of my appointments. I may really consider switching clinics sometime over the next few months because I just consistently feel like we're not being given the very best shot at success. It is difficult for me to tell whether this feeling is just a consequence of my general negativity or whether there is a deeper nugget of truth in it. In short, my 5 frozen embryos are much poorer quality than I thought. My RE would like to transfer an 8-cell B (our best remaining embryo) with a 5-cell BC (in the same straw) for this cycle.
I am not going to lie, the 5 BC sounds really crappy (no offense to you, little guy!) and I am just not feeling it. My RE would then like to do a 2nd FET following this one to exhaust all of our so-so frozen embryos before moving to another fresh cycle. This just sounds like a really low-yield plan to me and it seems unrealistic that all of them will thaw successfully anyway. Perhaps I am just impatient but I find this plan pretty disappointing. Instead, I proposed attempting to thaw all 5 and then culturing the ones that survive the thaw for a couple of days in an attempt to push them to the blastocyst stage and using this as a selection device to weed out the less competent embryos.
My RE was not a fan of this idea and my best guess why is $ - it would be more labor intensive and costly for the lab staff to attempt to grow my embies to the blast stage and it would also mean moving on to another fresh cycle sooner if the FET fails - more costly as well. Just some of the less nice realities of socialized medicine and full IVF coverage. The RE pointed out that by thawing everything and attempting to culture them to the blastocyst stage, we might lose everything and that that would be very disappointing for us. In truth, I would find it much more emotionally draining and disappointing to go through two FETs with not so great embryos and a very low chance of success than to lose all of our embryos and never make it to a frozen transfer.
I guess all of this is sort of a moot point - first we have to see how many even thaw successfully. If we are poised to transfer the 5BC and I am still feeling very negative about things, I could insist on adding in a third since one of our embryos is in a straw by itself. Since we are more or less unexplained at this point (I'd say the mild ovulatory dysfunction/lean PCOS is debatable and I would have gotten pregnant via ovulation induction and IUI if it was the main issue), I asked about the possibility of considering endometriosis or immune factors but the doctor felt that at this point, further testing is unnecessary and would only delay us further in proceeding with treatment.
Lastly, the RE implied (though did not directly say) that he agreed with me that my ER was probably a couple of days too late and that this could have potentially affected the outcome. Tomorrow I go in for bloodwork and ultrasound and if I get the green light, I will start estrogen for the FET tomorrow. So....that's where we're at and as usual I am praying to be pleasantly surprised.
I am not going to lie, the 5 BC sounds really crappy (no offense to you, little guy!) and I am just not feeling it. My RE would then like to do a 2nd FET following this one to exhaust all of our so-so frozen embryos before moving to another fresh cycle. This just sounds like a really low-yield plan to me and it seems unrealistic that all of them will thaw successfully anyway. Perhaps I am just impatient but I find this plan pretty disappointing. Instead, I proposed attempting to thaw all 5 and then culturing the ones that survive the thaw for a couple of days in an attempt to push them to the blastocyst stage and using this as a selection device to weed out the less competent embryos.
My RE was not a fan of this idea and my best guess why is $ - it would be more labor intensive and costly for the lab staff to attempt to grow my embies to the blast stage and it would also mean moving on to another fresh cycle sooner if the FET fails - more costly as well. Just some of the less nice realities of socialized medicine and full IVF coverage. The RE pointed out that by thawing everything and attempting to culture them to the blastocyst stage, we might lose everything and that that would be very disappointing for us. In truth, I would find it much more emotionally draining and disappointing to go through two FETs with not so great embryos and a very low chance of success than to lose all of our embryos and never make it to a frozen transfer.
I guess all of this is sort of a moot point - first we have to see how many even thaw successfully. If we are poised to transfer the 5BC and I am still feeling very negative about things, I could insist on adding in a third since one of our embryos is in a straw by itself. Since we are more or less unexplained at this point (I'd say the mild ovulatory dysfunction/lean PCOS is debatable and I would have gotten pregnant via ovulation induction and IUI if it was the main issue), I asked about the possibility of considering endometriosis or immune factors but the doctor felt that at this point, further testing is unnecessary and would only delay us further in proceeding with treatment.
Lastly, the RE implied (though did not directly say) that he agreed with me that my ER was probably a couple of days too late and that this could have potentially affected the outcome. Tomorrow I go in for bloodwork and ultrasound and if I get the green light, I will start estrogen for the FET tomorrow. So....that's where we're at and as usual I am praying to be pleasantly surprised.
Subscribe to:
Posts (Atom)