Embryo Transfer

Day 19 IVF Cycle - 0dp3dt

Today was Embryo Transfer.

It’s been an exciting few days in between Aspiration Day and today.

On Day 17 we found out that 11 of the 16 eggs had fertilised, that’s a fertilisation rate of 68%, above average.  My mother in law starts referring to them as her grandembies.

On Day 18 we found out that 9 of the 11 fertilised Embryos were on Grade 1 or 2 and that Embryo Transfer would be the following day. I am very excited. This makes it a 3 day transfer (3dt).

So now the million dollar question is - how many embryos to put back?

BioArt are usually keen on transferring 3.  The majority of the research I am doing is pointing me to an article in the Lancet Journal, Jan 2012.  Indicating that more than 2 embryos do not increase the chances of a live birth.  I resolved yesterday to only put 2 back.

I want to be pregnant. We want Children, 2 or 3, but not 3 all at the same time.  We are quite comfortable with the thought of having twins - I have wanted twins since I was able to consider how many kids I would like to have in the one day realm.  My Brother and Sister in Law have twins, and they make it look just dreamy.  And we love those kids!

I am absolutely freaked out at the thought of having triplets though!  Not just the hard work factor, but the financial stresses and the medical risks involved in a trip-pregnancy, both for mother and babies.  No, trips are really not something I want.  Hubs question is "So if the choice was between not being pregnant and having triplets which would you want."   Argh! Tough one!

I wonder if I would be disappointed deep down if we put 2 back and only got 1 live baby. Maybe I would wish I had put 3 back to increase my chances of having 2.

10 am we arrive at the clinic. I immediately get sent back down the road to the hospital next door for a Progesterone blood test.  Back at the clinic and I am rewarded with 2 white tablets, Buscopan for stomach cramps and Dormicum, a sedative.  Nice one!

I chat to the lady waiting next to me. She was aspirated on the same day as me - we were in the recovery room together.  This is her third transfer, and she has yet to have success.  The first one, fresh cycle, she put 2 back.  The second cycle, frozen embies from the first, she put 3 back, and now, she has just finished a fresh cycle again and she is putting 4 back. I start to rethink my resolution to only put 2 in.

I get taken into Aspiration room number 2 - a different room to Aspiration day.  Smaller. Hotter.  It’s a long time, almost 45 minutes before the Doctor comes in.  Lucky for me I have the Dormicum to keep me calm and chilled.

I have a list of questions for the Doctor, who is also not my usual Doctor, which irritates me a bit.  But actually this guy seems a bit more interested and less "cool".  I have a list of questions for him.

1.  Were all 16 eggs mature?  Yes, all of them were mature; he shows me the embryologists report from aspiration day.

2.  What was the quality of the eggs?  They can’t know that, they can only know that once fertilisation takes place.

3.  What was the quality of the sperm sample?  They did not do a sperm assessment, if we wanted one we should have asked, and there are no notes on the sperm

4.  Did they ICSI all 16 or did they IVF half of them?  They ICSI’d all of them, probably indicating the sperm quality wasn’t great.

5.  What is the status of the Embryos today?
 3x Grade 1 (Best Quality, perfect structure no fragmentation)
 1x 8 Cells
 1x 7 Cells
 1x 6 Cells

3x Grade 2 ( Fragmentation < 20%)
 1x 8 Cells
 1x 7 Cells
 1x 6 Cells

3x Grade 3 (Fragmentation > 20%)
Unusable

Okay so we now have 6 usable embryos.

6.  Can we get a picture of our embryos please?  A picture is passed through the pass through window into the lab.

7.  When do I do Intralipid 2 and 3? Intralipid 2 is 1 week after aspiration day, and Intralipid 3 is on the day of your positive pregnancy test.

8.  What happens to the left over embryos?  They will be frozen so that you can use them if you need to. They will freeze all 6 because they have more chance of surviving the more that are frozen all together.

9. I really really don’t want triplets - how many embryos should we put back?
2 if trips are absolutely out of the question. But we recommend putting 3 back; your chance of having triplets is only 5%.  20% for twins and 45% for a single live baby. (At this point I was in information overload, so I could be misquoting the percentages, but I am sure about the 5% for trips, and Hub remembers the 45% for a single pregnancy).

He said that if you put back 2 embryos you have a 35% chance of being pregnant, and 1 embryo is 25%.  So basically the likelihood of having a pregnancy improves by 10% per embryo you put back.

We decide on putting 3 embryos back. My favourite nurse is in the room, and she nods at me, as if to reassure me that this is a good decision.  The embryologist has already prepped the 3 in one dish.  She clearly knows the drill.

We are putting back the Gr1 8 cell and 7 cell embryos and the Gr2 8 cell embryo.  The Embryologist is worried about the Gr1 6 cell being too underdeveloped for transfer. I wholeheartedly agree with her.

Back into my favourite stirrups.  The doctor involves me in the process - he can see that I am interested. He uses those Vagina Clamp thingys and then inserts the long catheter containing our embabies which is passed through from the lab straight into the room.  My favourite nurse positions the ultrasound scan to make sure that the catheter has reached near the top of the uterus, and points it out to me on the screen.  She is saying what a nice shape my uterus is and that my ovaries are looking all swollen, as if they are in torsion, from the IVF stimulants, they of course are not in torsion; it’s just how they look.

The doctor hands back the apparatus to the embryologist who checks to see that no embies have been left behind. "Clear" she says.  All 3 Embabies are aboard the Mother ship!

I lie there for 20 minutes and then go find Hubby who has brought the car around to the front entrance.  He opens the back door for me and I ride home lying on the back seat, sleepy from the Dormicum.