June 2016 - IVF #3, Retrieval & Day 1 & Day 3 Reports

It has been a while since I’ve provided an update.  Several of you have texted, and for that I’m very grateful that you’re interested in getting the latest!  This is the most critical time of round 3, but I have found myself flat out of energy at the end of each day since the retrieval.  Thank you for your patience, and I’ll get right to the state of things, which have been busy, and exhausting, but (spoiler alert!) if you saw the title of this post includes "Day 1 & Day 3 Reports", you have probably already figured out we had some level of success.

The Retrieval:

Retrieval Selfie!  Feeling fairly confident and cheery post-IV, waiting for them to bring Michael back to wait with me.

The retrieval on Saturday went fairly well, but did not yield the 4 eggs we had expected.  Perhaps I jinxed it by saying we haven’t had this issue yet…Two of the follicles, the larger ones on the right, were ultimately “empty” follicles.  This is a bit of a misnomer, as a follicle can’t exist without an egg inside, so what it means is that the egg did not develop properly and likely remained stuck to the inside of the follicle wall.  When the RE flushed and drained the follicle, the egg remained inside the follicle, and being very tiny, the equipment can’t find it and knock it loose.  In all likelihood, those two eggs were not chromosomally normal due to a bad initial division (i.e the 46 chromosomes often don’t split to perfect 23-23 pairs). 

As reassuring as it is to know that these eggs were a lost cause from the start, it was disheartening news to hear upon waking up from the retrieval, which I had gone into with more calm and confidence than either of the previous two.  “We were only able to retrieve 2 eggs,” rang in my ears for the rest of the day.  In my hazy and exhausted state, I felt tears rolling down my cheeks as we drove away.  We had worked so hard and long for those 4 follicles to grow (total of 80 injections and 10 blood draws), and now the chances that this could be our lucky / final round were abruptly halved. 

The new reality: If we get one blastocyst from this round, we should consider ourselves lucky.  On the bright side, that would double our inventory of blastocysts from 1 to 2 on ice.  But more to come on our thoughts and feelings about this.  I promised a quick summary to get you up to speed on what’s happening now…

After waking up from this retrieval, my ovaries felt more swollen and angry than usual.  I made a mental note to remind them that if they were to simply cooperate, we might not have to do this again.  The nurse gave me some heavier pain medicine…I’m guessing that the extra efforts to flush the follicles on the right were to blame.  The rest of the day Saturday was spent sipping my chocolate milkshake (tiny victory!) and sleeping.

Day 1 Report:

Sunday morning I woke up intensely sore and anxiously waiting for the day 1 report, which wouldn’t come until a little after 10am.  Michelle, the sweet-tempered lady whose job it is to deliver the fateful news, was on the other end of the phone.  She said BOTH eggs were mature, and they BOTH successfully fertilized!  We were very relieved…neither of us wanted to be back in the 1-embryo situation of round 2. There is still a chance for both of them!  Go lefties, go!

Hanging up, I knew that the next update wouldn’t come until Tuesday morning, which felt like FOREVER away, but at least we had some hopeful news to tide us over until then.  Plus, this week has been tremendously busy with work.  If I could have chosen, this week of IVF events and this week of work would NOT have overlapped.  Every year we hit a peak level of activity around planning the following year’s budget and targets…this is all happening now.  Additionally several senior managers were in town, and working remotely (on Friday before retrieval, and Monday post-retrieval) wasn’t as solid an option as it had been in the last two rounds.  I tried to be stealthy about my discomfort standing and sitting, but I'm guessing I looked a bit like I had overdone it at the gym.

The benefit of all this activity, is that the time has seemed to roll by quickly, and while waiting is still the worst part of this whole process, at least the Sunday to Tuesday morning span wasn’t completely torturous.  I did my best to think happy 8-10 cell thoughts!

Day 3 Report:

Tuesday morning came and I turned my phone ringer on around 9am and I carried it everywhere just to be sure I didn’t miss the call.  Thankfully the soreness from the procedure had mostly abated, now it's just the waiting.

Michelle called at 10:30am with the day 3 report.  Both embryos are still growing.  Partial relief!!  When they checked on them that morning, one was exactly where they would expect, 6 cells and with 0% fragmentation.  The other is growing slowly at 3 cells and with 25% fragmentation (similar to round 2).

6-cell embryo (not mine, just from Google)

Not bad news…there is still a reasonable chance for success of round 3.  For those of you curious, here's an explanation of fragmentation that I found helpful:

• "As cleavage embryos divide, sometimes a small portion of cytoplasm breaks off and forms a fragment. Fragments are not considered cells because they do not contain nuclei. The cause of fragmentation is not understood completely, but it is thought that embryos that contain a lot of fragmentation are at a disadvantage because the embryo loses a lot of the cytoplasm needed to sustain the cell." 

This means that a slow-growing embryo with fragmentation is not a great sign.  Not impossible, but not likely to make it.  We have had 2 embryos perform this way before...neither made it.

While I had been thinking happy thoughts up to that point, the realist in me had worked hard to keep my expectations in check…I knew from the start that for an average person, only 50% of eggs retrieved can be expected to make it to blastocyst stage.  Plus, we know from our own rounds 1 and 2, that our individual experience indicates our chances are less promising.  The news of the 6 cell embryo was wonderful to hear, looking as proportional as it can at this stage, and seemingly on track. 

There is definiltely worse news that we could have faced at this point.  Next update isn’t until Thursday morning (day 5 of embryo growth).