Day 6. How Many Embry-babies?

I have butterflies in my stomach. Today is our call with Dr. O to find out how many of our remaining 11 are still growing and are viable blastocysts. Although we have 1 confirmed, we still have another layer to get through before we can move towards the transfer, genetic testing.

We have no reason to believe we will have any genetic abnormalities, but we also never know what’s going on in these genes and dividing cells.

I am so scared that the results will be so small that in the end we won’t have any to work with. I have to turn my thinking around.

My body is hot as I think about the call (in 10 minutes).

We have waited and prayed and although my prayers were for 7 blastocysts, I have come to peace that no number will guarantee a baby.

Instead, I turn my thinking to accepting what is and letting it be the story of faith that even if we just have the one that goes into genetic testing, that all will be exactly as it is supposed to be.

I want to control the outcome.                                                                  I can’t.

I want to protect my emotions.                                                                 I can’t.

I choose to feel with a healthy openness to being vulnerable to the desire of my own biological babies balanced with low expectations of the outcome.

Regardless of the number, God is in control.

Not me.

~~~~~~

We get the call.

Dr. O’Brien first asked how I was feeling and was sensitive to hearing how my recovery has been over the past 6 days. She hesitated to give me both the Lupron and HCG shots as my trigger shots for this very reason, it makes the bloating and swelling worst.

This discomfort is worth it to me if we are able to have babies.

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Then she let us know, we had one more egg make it to the blastocyst stage and was biopsied and frozen this morning.

There is a possibility for us to have one more, which we will have confirmed tomorrow.

All others did not progress and in a sense ‘died’.

My heart sank.

From 11, there are 2. Maybe 3. (Just confirmed we have 2, 1.9.19).

These are not the final embryos we will use to transfer.

We have one more stage, on more hurdle, to get through, which is the PGS- genetic testing.

We will know in two weeks what our final number of embry-babies will be.

Until then, I just have to keep waiting and trusting that God knows what he’s doing in all of this.

My heart feels quiet. I have no words.

 

Here’s some more information from Fertility Smarts about Day 6:

Day 6 in the IVF lab – Final Number of Embryos Known

On Day 6 we know the final number of embryos suitable for freezing. Day 6 is the final day in the lab for the embryos at most clinics. The embryologists will assess the remaining embryos and if they have continued to grow overnight they will freeze all that are of good quality. Embryos that have not made a blastocyst by this day are not viable and will not be frozen. Most labs do not grow embryos longer than Day 6 because they need to either be frozen or to be in a uterus after Day 6.

Chromosome Screening

If you choose to undergo chromosome screening on your embryos, a single cell called a blastomere can be taken from each embryo on Day 3, or a small group of 4 to 5 cells can be taken at the blastocyst stage around Day 5/6. This is called embryo biopsy and is done before the embryos are frozen.

Chromosome screening allows the lab to select and thaw only genetically normal embryos for transfer in a frozen embryo transfer cycle. This type of screening is recommended for women who have had multiple failed IVF cycles or are of advanced maternal age (38 or older). The pregnancy rates are very good for all ages of women when the embryos have been screened before transfer.

 

 

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Bio Lesson: Cells the Grow into Human

Here’s what will be happening with our little cells while we wait:

*Day 2 in the IVF Lab – Embryo Divides

On Day 2 the embryos start to divide and should have 2-4 cells. The embryo itself does not grow bigger; the single cell that was the fertilized egg divides to become 2 cells and then 4 cells with each cell being half the size of its predecessor.

They can start to see slight variations between the embryos in the group and they could be graded at this stage. Most clinics do not look at the embryos on this day but it is possible to do an embryo transfer or freeze the embryos if that is the clinic’s policy. It is usually better to wait as long as possible for transfer and freezing as this allows more diversity within the group and enables the embryologist to more easily select the best embryos. The splitting of cells to create identical twins happens on day 2 or 4.

Day 3 in the IVF Lab – Embryo Grading and Potential Transfer

On Day 3 the embryos should be around 8 cells. This is the day when some clinics move them into a new Petri dish with different media (solution to support growth) that is similar to uterine fluid for their next stage of growth. They grade the embryos but still do not know how many will continue to grow to the blastocyst stage (Day 5 and 6).

Some clinics perform embryo transfers and freezing on Day 3 and some clinics wait until Day 5. This depends on the number and quality of embryos that you have available and also the clinic policy. From what I understand, Shady Grove does not touch the cells until day 5 to let them grow in a healthy, untouched environment.

On Day 3 we know:

  • How many cells the embryos have
  • If the embryos are of good appearance up to this point
  • An average of 95% of fertilized eggs will grow to the Day 3 stage
  • The appearance on Day 3 does not tell us how many embryos will continue to grow

Day 4 in the IVF Lab – From Cleavage Stage to Blastocyst

Day 4 is a transformation day where the embryos are in between the cleavage stage and blastocyst stage.

What is a blastocyst?

  • A blastocyst is a fertilized egg that has developed for five to six days and contains 3 distinct features. These features include a fluid-filled cavity and two distinct types of cells:
    • Trophectoderm (T) cells – T cells consist of a single layer of cells around the circumference of the embryo that become the placenta and embryonic sac.
    • Inner cell mass (ICM) – The ICM is a distinct clump of cells that form the actual baby

The clinic usually does not look at the embryos on this day, but if they did they would see that some of them would be making the transition from a multi-celled embryo with clear cell outlines to what is called a morula which is the stage before an embryo becomes a blastocyst. Sometimes embryos do not reach the morula stage until Day 5.

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*Information from Fertility Smarts