Fertilization Report

We return to our comfortable, cozy, familiar home in time to receive the call from Dr. B with the update on our little eggs.

My heart falls heavy, again.

It turns out we actually retrieved 17 eggs which is wonderful and 13 of them are mature, even better.

The upsetting news is that only 4 of them fertilized.

I want to cry.

If I was more naïve to this process, I would be thrilled.

“We have 4 fertilized!” I would shout.

Instead, I am full of fear and doubt and sadness and question.

“What happened?” “Why such a low fertilization number?” “What’s wrong with my eggs and Hubby’s sperm that they didn’t fertilize well?”

As you can see in the chart below, we have had high fertilization numbers in the past with zero to one healthy PGT genetically tested blastocyst (which is now our daughter).

Here’s a little comparison chart:

Year2018Early 2021Spring 2021 (this cycle)
Final follicles 1717
Mature eggs131013
Fertilized eggs1274
Day 5 Blastocysts21TBD
PGT- genetic test- healthy10TBD

The science and the data point to this being an unsuccessful cycle and I can’t help but wonder if it’s because of the misstep by the clinic regarding the HCG trigger shot a few days ago.

24 additional hours of egg growth could have over-ripened the eggs and the eggs could have become too mature.

An additional day of ‘build up’ on Hubby’s part could have also changed the mobility of the swimmers.

A few unknowns leave me unsettled and those are questions we won’t have answers to.

I can’t control that.

What can I control?

At this point, I need to control my thoughts.

I receive this text from my dad “4 is better than none- love you!”

He is right.

I can be so grateful we have four little ones in the lab.

It just takes one!

This is a space where God can show how big of miracles he can perform. Against the science, against the numbers, He can prevail.

He is the giver of life and right now, today, he has given us 4 little ones.

Now, we must wait, in prayer.

I will pray for His will be done while also asking for these 4 to continue to grow healthy and strong and be formed perfectly for us to be able to transfer into a pregnancy.

In the same space, I learn of a friend’s miscarriage.

God, I am so sad to know the end of a life, the loss of hope.

While also planning a friend’s baby shower and celebrating the gender of another pregnant friend.

How do we hold these different emotions?

How can I feel the disappointment in my own life and not be consumed by the self-centered nature in which I so easily am drawn?

I say I want what god wants, but have a difficult time accepting what is while also staying present and grateful for the facts of what is given today.

If I were fully present and not doubting the past days or wondering what the outcome will be in a few more days, I would be excited that we have 4 little potential lives living in the lab.

God, help me accept today exactly as it is.

Help me show up for friends who are celebrating new life and new adventures while mourning with and for the loss of life.

It truly does remind me that life is not ‘fair’ and any suggestion or promise that it is comes from misguidance.

Life is.

It’s time for me to start accepting it exactly as it is.

Today is a New Day 1

It hurts to move.

I woke up a couple time last night to visit the bathroom and relieve the pressure on my ovaries. My body is not happy with me.

I am grateful that I am giving myself good nutrients to heal and space for my body to repair itself.

With light spotting of blood, I’m reminded that the doctor pierced through my lining into my ovaries and it will be more than just getting the hormones out of my system.

At 2:30am, I am awake. WIDE awake.

I spend some time reading and praying, thinking and praying and around 4am I drift back asleep.

With a slow start to my morning, I give myself permission to hunch over and shuffle.

We wait for the call from Dr. O’Brien to know the progress of our little ones.

Today is day 1– Fertilization check day

Approximately 16-20 hours after the insemination process takes place the embryologist will check to see if fertilization has occurred. The embryologist is looking for evidence of 2 nuclei (pn) – one from the egg and one from the sperm. This is how the embryologist determines if normal fertilization has occurred. Any more or any fewer nuclei present and the embryo is considered abnormally fertilized and is not kept in culture. Once normally fertilized, the embryos are placed back into the incubator and are not disturbed until day 3. The embryos are grown in a specially designed culture dish which contains a small drop of culture medium overlaid with oil. 2pn.jpg

This embryo culture medium contains the proteins, amino acids, and enzymes that mimic the fluid found in the fallopian tubes essential for embryo development. One factor (of many) that contributes to successful embryo development is the constant maintenance of temperature and pH level of this embryo culture medium. The temperature and culture medium pH level is dependent upon the CO2 environment and the heat that is provided by the incubators. Since the embryos are grown in a very small drop of culture medium it does not take long for the temperature to drop and the pH level to change in that drop containing the embryo once the dish is removed from the incubator’s environment. Severe changes in the temperature and pH level of the culture medium can have potentially detrimental effects on the embryos. The embryologists are very protective of the embryos in the lab and this is the reason why the embryologists do not like to disturb the embryos too much and will not look at the embryos on a daily basis.*

We get a call from Dr. O’Brien around 9am, of the 20 eggs retrieved, 13 of them were mature. This is a little less than was expected but MORE than what we saw on the monitoring screen a few days ago (which was 8).

Of the 13 mature eggs, 12 of them were fertilized!!

Yippee! The statistic is that 75% of mature eggs will fertilize, we had a 92% fertilization rate!

This means we go into the next 4 days of waiting knowing we have 12 potentials for a baby (or babies) to grow.

Dr. O’Brien keeps my expectations low as she mentions it’s typical to have 1/3 or 1/2 of the eggs survive the next 4 days. She would expect for us to have 4-6 blastocysts on Day 5. Although she cannot see the future or know the strength of our little growing cells, I can trust in her experience and let 4-6 be a success.

Here’s to a weekend of waiting, healing, and praying!

*Information from Fertility Smarts