Tick tock, tick tock

The clock seems to be moving so slowly. Our pregnancy test next Wednesday seems so far away. Getting ready for school should keep me busy and distracted, but all I want to do is hide under the covers for the next eight days! Or go to the beach. Or something! It doesn't help that I'm not going to the gym this week, so I am a bundle of nerves with no outlet.

Brent called the lab yesterday. Of the four remaining embies, three were still progressing and one looked like it might be good enough to freeze today. We'll find out on Thursday. Even if none of them make it, I'm pleased that one was still looking good. That bodes well for the three we transferred, which were of higher quality to begin with.

PUPO: Pregnant until proven otherwise

We had a great transfer this morning! We transferred three, and they looked good. They grade embryos on a scale of 1-5, 1 being best. Last time the embryos had crapped out by now - we had two six-cells and one 7-cell, graded 2 and 3. But today we have a 9-cell grade 1 and an 8-cell and a 6-cell, both grade 2!!!! So they look much better. (And that 9-cell is just about perfect, at grade 1 and nearly double yesterday's size.)

Because they were progressing well, we had the option of waiting for two more days. But the doctor recommended going ahead. Even though the last cycle ended in miscarriage, the fact that I got pregnant suggests that day 3 embryos find me to be a hospitable home. It was also pretty aggressive to transfer three. Given the quality of the bigger two and my age, standard practice would be to transfer two. But he asked if the worst case scenario was not getting pregnant or getting pregnant with triplets. We agreed that not getting pregnant was much worse than triplets! (And I suspect he suspects that 6-cell isn't really going anywhere anyway.)

And we still have four left that might make it to freeze. In all likelihood, we'll end up with at most two frozen, but that's something.

I am feeling much better!

Cell division

As of this morning we still have seven embryos:
1 5-cell
3 4-cell
1 3-cell
2 2-cell

It's almost exactly identical to last time:
2 5-cells
2 4-cells
1 3-cell

The goal is 2-4 cells today, so they're all fine. But because it looks about the same as last cycle, they want to do the three-day transfer again. (It sounds like they probably wanted to see six or seven at the 4-cell stage in order to keep going to day 5.) So we go in first thing in the morning. We'll want to see the four biggest at 8 to 10 cells tomorrow. Last cycle, their growth slowed and our largest was 7 cells. If we're at 8 to 10 cells tomorrow, I'll feel a whole lot better about this cycle. I'll be curious to see how many they want to transfer tomorrow; I'll probably push for three or four.

I'm sad and disappointed. I really wanted to hear, "They look great! We'll transfer Monday." I'm afraid this will end the same way as the previous cycle.

100 percent!

All seven fertilized normally. We have embryos, and "they look good." We are very happy here, and thrilled we didn't ruin everything Monday night! We'll be back with another update tomorrow.

Next steps

Well, I am certainly glad the last week is over! After a rough couple of days, I woke up Sunday feeling all better physically. A long night's sleep in a luxurious hotel bed without a snoring partner (love ya' babe!) after delicious alone time with my brother and his GF, my BFF, and my parents was just what I needed. Not surprisingly, perhaps, Sunday was a more difficult day emotionally. At brunch with my parents, brother, and his A, the hostess presented a rose to my mother. I LOST it and ran out of the restaurant in tears. It was the first time I had really cried about this miscarriage. It was probably good for me; my practical stoicism is not always healthy. After a hug from my dad and some whining about the unfairness of it all, a mimosa perked me right back up. And I was fine the rest of the day, focusing on my mom and grandmother.

And at Mother's Day dinner, all the women got roses. And it's appropriate, I think, because don't we all "mother" somebody or somebodies?

Then we were on to the next hurdle, having some early skin cancer removed from my back. The procedure went smoothly, though the incision now alternates between stabbing pain, burning, and itching. It's fun ... or not. The stitches will be in for three weeks, which seems interminable. But it's for the greater good, and I'm relieved to have the spot gone.

Today was my post-op visit with Dr. R. Mostly he wanted to talk about politics and the Dead Sea Scrolls. I was like, "Dude! You have other patients waiting. This is not a social call!" But we get good treatment because he likes us, so I can't complain. As I expected, he isn't particularly concerned that we've found only bum embryos so far. He said, "The class of July 2010 is different from the class of March 2010" and made an analogy to my law school students. And it's true, some years are better than others. He also reminded us that only 30 percent of fertilized eggs ever turn into babies and we just need to keep trying to find our 30 percent. He did send me for some bloodwork for autoimmune issues and an updated check on my thyroid. But none of us think that's the issue. We're just dealing with old eggs and bunk sperm and we have to be patient.

He said to call when my cycle starts again. The nurse was, again, horrified, "Aren't you supposed to wait SEVERAL months? He's bending the rules!" Aaah, yes, but it'll be fine. After all, there's a rumor that women are more fertile in the months right after a miscarriage. So shouldn't we capitalize on it? Given how quickly I'm recovering, though, I anticipate that we'll wait two months, starting the birth control in early July and doing retrieval and transfer in early August, just before school starts.

In the meantime, we bit the bullet and filled out our first adoption application, for a very old and apparently well-respected agency in Fort Worth. They have a domestic infants of color program, as well as an Ethiopia program, which are our top choices. Even if we are ultimately successful with IVF in the next six months, we are very interested in pursuing adoption for child #2, so we figured it couldn't hurt to get the ball rolling. But I think we should probably fence the swimming pool if we have any hope of passing a home study. The to-do list grows longer.

4dp3dt: Laughter

The last embryo didn't make it to freeze, but that's pretty normal, so we're okay with it. We had a visit to the clinic this morning to check my progesterone level, which is fine. (B is apparently doing an excellent job of giving me a shot in the a** every night.) Dr. R came out from an exam room when he heard my "unmistakable laugh."

It reminds me of the video some of my students shot of me last week for the annual mock-the-professors show this week: "Professor Bangs, why is your laugh so loud? I mean, really, we can hear it all the way in the pit." Because it brings you joy, Jeff, because it brings you joy.

Halfway through the two-week-wait from retrieval to test; six days to go.

2dp3dt: Early blast

I just got a call from the clinic, which has been keeping an eye on our two remaining embryos. One stopped growing, but the other is hanging on and is in the early blastocyst stage (just about on track for day 5). Since the embryos they transferred back were of higher quality, and I quote, "there's every reason to think" one or more of those have continued to progress in their natural environment. The last embryo at the clinic isn't well enough along to freeze, but they'll check it again tomorrow to be sure.

Wee, bright flicker of hope -- eight days to go.

Day 3 transfer: Embryos on board

This morning brought mixed news: fragmentation was minimal (5-15%, when what they want to see is less than 20%) but growth had slowed considerably. They should have doubled overnight, to 8-10 cells. But we had only 5, 6, and 7 cell embryos this morning. So they decided to do the day 3 transfer, figuring that being in their natural environment might perk them up. We also transferred three, instead of the clinic's usual two, because of their size. There's about a 35% chance of pregnancy, about 5% of triplets (compared to a 60+% chance of pregnancy if the embryos had made it to a day 5 transfer).

Nevertheless, the embryologist and the doctor were very optimistic. Dr. R. assured me that he was not just being "rah rah cheerleader." But he did answer my questions about a second cycle, if this one fails, instead of just telling me to go home and think positively! That made me happy; I always cope better with a plan B.

But in the meantime, I will think positively. I'm at home in bed/on the couch for two days, being waited on hand and foot. Then ten days until the pregnancy test.

2dpo: Good news and bad news

The good news is that we still have five growing embryos, and they're growing at a good rate:
2 5-cells
2 4-cells
1 3-cell
(The goal is 2-4 cells on day 2, so we have two that are even a little ahead.)

The bad news is that they're not very pretty. And we only want a cute baby.

The report from the embryologist this morning is that there is too much asymmetry (cells are different sizes) and too much fragmentation (portions of individual cells have broken off and are fragments are floating around inside the cell). If that trend continues, we'll transfer tomorrow instead of day 5.

Rates of pregnancy with a day 3 transfer are somewhat lower; with asymmetric and/or fragmented cells, much lower. So I'm definitely feeling a bit discouraged today. But I'm hanging in.

1dpo: Fertilization report

We're celebrating! We have six embryos this morning, an exceptionally good fertilization rate. The one egg that didn't fertilize actually didn't survive retrieval. So we had a 100% fertilization rate, truly unheard of! Since we've had a confirmed embryo only once before (the miscarriage last spring), we are jumping for joy. We might get to be parents! The lab will call tomorrow with a report on how they're growing. We'll likely lose some before the week is out, but this is a terrific start.