Day 5 is here!

My heart is calm. I have been patiently waiting for the call from the doctor to let us know how many of our little cells have turned into blastocysts and are ready for biopsy and being frozen.

I try not to read all the different experiences people share online of how many eggs retrieved, how many fertilized, how many make it to day 5 & 6, etc… but it’s hard not to look.

These last few days have felt deflating. In my mind, I have obtained a goal (of sorts), something I was focused on for many weeks, and now I just sit and wait.

My body is recovering, but still not back to normal. I continue to reheat the rice-hot pack in the microwave and melt into the couch.o-GIRL-WAITING-BY-PHONE-facebook.jpg

We receive a call, today is day 5. It’s nurse Christine calling to report 1 of our eggs have reached blastocyst stage so they have biopsied it and put it in the freezer (my heart drops… only 1).

The remaining 11 are still under observation and they will call us tomorrow with the final count.

Oh, my nerves!

I continue to trust in this process… the process I cannot control and have to simply accept.

The following is taken from Fertility Smarts to help explain the process:

On Day 5, embryos that have continued to grow to become blastocysts will have formed a fluid-filled cavity in the center of the embryo surrounded by a flat layer of cells called the trophectoderm (the part that makes the placenta). These embryos should also have a clump of cells called the inner cell mass (the part that makes the baby). Blastocyst embryos have a more complicated grading system based on 3 factors:

  1. The size of the embryo – based on the degree of expansion of the cavity (graded 2-6)
  2. Appearance of the inner cell mass cells (graded A-C)
  3. Appearance of the trophectoderm layer of cells (graded A-C)

Therefore an embryo with a grade of 4AA would be classed as a good quality embryo. Anything with a B grade is classed as average and a C grade would be quite poor quality.

Embryo grading is not an exact science and it just helps us to get an overall picture of the appearance of an embryo. Grading helps the embryologist to choose which embryo to transfer within your group of embryos.

Embryos with a higher grade are more likely to implant with the uterine lining, most likely because these embryos have a higher chance of being chromosomally normal. In other words, not all embryos are created equally and it is possible to select the genetically normal embryos that are more likely to grow.

What if my embryos have a poor grading?

Most people have a range of grades within their group of embryos from an IVF cycle and the embryologist will pick the best ones out of that particular group. We have seen babies born from different grades of embryos, so try not to focus on the numbers too much.

Although lower grade embryos have a less of a chance of implanting than their more handsome counterparts, it’s still possible to achieve a pregnancy from embryos that are not ideal when viewed under a microscope.

Try not to over analyze the exact grade of your embryos as we have seen babies born from all grades of viable embryos.

On Day 5 we know:

  • The number of embryos that have continued to grow and the quality of these embryos.
  • On average, only half of all Day 3 embryos will continue to grow to the blastocyst stage and the other half will stop growing after Day 3. Embryos usually stop growing because there is something wrong with their chromosomes. If an embryo stops growing in the lab it would most likely not have made a baby if we had transferred it.
  • Not all embryos grow at the same rate. Some will grow faster and be ready for transfer or freezing by Day 5 and some will need another day’s growth to get to an advanced stage. This is a normal growth pattern.
  • The best embryos are either transferred or frozen on Day 5 according to your clinic’s policy. In general, pregnancy rates are better when blastocyst stage embryos are transferred rather than Day 2-3 stage embryos.

Any embryos that are frozen are kept in the lab storage tanks until you need them. Any remaining slower growing embryos are kept in the lab overnight and there may or may not be more embryos to freeze Day 6.

Lab Rats

Laboratory-malpractice-Maryland.jpgIt feels as though we are lab rats.

Hubby and I both went to CCRM for a morning of tests that will give Dr. G more information about the two of us and what might be the best course of action to take.

Starting with a urine sample to ensure I am not pregnant, I sort of thought it would be such a fun surprise if they came out and said, “well, we have bad news and good news. The bad news is that we will not be able to do any testing this morning and the good news is you’re pregnant!”

They didn’t.

I proceeded to have a Baseline Ultrasound ($400) where everything looked better than I expected. My uterine lining is thicker than normal and I had 7 follicles in one ovary and 8 in the other! The technician thought I was mid-cycle, pretty cool!

Not sure what that means for us though.

I then was pricked for a blood draw to test: ($555).

Hubby went for his test to see if he has any sperm antibodies that might be hindering the “egg search” ($117).

Then I was taken for my HSG, where they shoot dye up into my uterus and see it move through the fallopian tubes into the ovaries and then out into the body. I was able to see it on the screen as the dye was being injected and sure enough, it spread throughout just as it is supposed to. It was not as painful as the FemVue (the bubbles) I had done 6 months ago, just uncomfortable with minor cramping.

Here’s what I learned:

  • The uterus flips and flops on a regular basis and so today mine was tiled upside down essentially. The technician was not concerned as she sees them flip and flop almost daily.
  • I have a heart-shaped uterus (either a partial septate or bicornate uterus). Today it looks more like a “Y”. This is a bit more concerning.bicornuate_uterus.jpg
  • If Dr. G feels it’s too deep of a “Y” then there may need to be a surgical procedure before moving forward with any medication. A normal uterus is more of a triangle shape at the top with a stick coming out the bottom.

So either:

  1. We move forward with medication as Dr. G is not concerned
  2. Dr. G will want a closer look through a hysteroscopy (where he looks through a microscopic camera) to get a better look at what’s causing the “Y”.

It could be the way my uterus is formed, increased cells gathering or some mass resting on that part of the wall. With a Bicornate uterus, there are greater chances of miscarriage, breech birth, higher deformities and disruptions in the in-uterine development, and possible automatic C-section during birth.

Yuck, I do not like this news.

I am not going to get too wrapped up in the facts and details until I talk with Dr. G. Although it would stink to have to go in for another test procedure, I’d rather know what we are dealing with to ensure a healthy, safe home for our baby to grow.

Today, I go in for my annual OB-GYN appointment and get a full head-to-toe exam plus some more cell gathering and an additional blood draw.

Our follow-up appointment with Dr. G. to understand what’s going and the next steps won’t be for another few weeks (busy man), but I’m ok with that. Give me a chance to work on other things in my life and practice faith in God and what He’s doing and trusting in His timing.

Besides, I need a break from all this prodding and poking!