My Maybies

I've always found it funny that you are already considered to be two weeks pregnant just after conception. Not that you know yet, in most cases. On my Egg Retrieval date, I conceived twins, and I wasn't even in the room! Heck. I wasn't even in the same city! And they were already 2 weeks along!

We gnawed our fingernails for 3 days, waiting for the Embryo Transfer date. Based on our Day 3 transfer last time, and the lack of embryos to try and choose from this time, they were pretty confident in scheduling us for a Day 3 ET. But based on my poor embryo quality last time, and my even poorer egg numbers this time, my hopes weren't very high. I tried calling on Day 2 to get an update on quality, but all they could tell me was that the cells were still dividing. Well. Not bad news, at least.

4/19/11 - So we go in for our ET. Since we were scheduled for the afternoon, we were able to get Nana to come down and babysit, so we wouldn't have to worry about Little Z. Ironically, this time she could have been in the room with us, since it was a different area than the ER and we got to stay in our room the whole time. Ah well.
The ultrasound tech came in and checked my bladder, then had me drink more water and wait 5 more minutes. When she came back, all was well. Then we got to talk to the embryologist.
One of our embryos was 7 cells and the other was either 8 or 6, I can't remember. I think 8 though. And when we asked about fragmentation, she looked a little sad and said that one of them had 30% fragmentation, which was not good, since they don't like to see more than 20-25%. I could have whooped for joy. 30% was our best one last time. The other? 15%. I was so happy I cried.

The top one is the 30% 6 -or-8-cell one, bottom is 15% 7-cells.
Since they aren't babies yet, I called them my Maybies. 

For some reason they recommended transferring both embryos, even though my doctor told us initially that they usually only recommend one, since in her experience multiple embryos doesn't increase the chances of pregnancy, just the chances of multiples! We had discussed leaving the number of embryos to transfer open, based on quality, but that if we had a good one, we might just try one. Otherwise probably 2. And if they were really poor quality, 3 or more, just so they wouldn't get thrown out.
So I was mildly concerned about transferring both, since I got pregnant off a 30-40% fragmented embryo last time. Chances are good that they'd both implant this time. Last time, I was willing to have multiples. It would be hard work, but anything's better than nothing. But multiples on the way with a pipsqueak at home already? Hard. Harder than hard.
But my husband was leaning towards their recommendation, even though they couldn't tell me why they recommended two. Eh. Go for it. I'll go in on the 30th for a blood pregnancy test. It'll be a looooong week-and-a-half!

E.T. Phone Home

I get a call at work the day after retrieval. They harvested 13 eggs. 10 of them were mature enough to try and fertilize, with ICSI. Of those, 8 fertilized.

At work we had 2 shift schedules for the next 2 weeks, since a Day 3 transfer would occur on the Friday of one schedule, and a Day 5 transfer would occur on Sunday, the first day of the next week's shift schedule. I managed to only have to involve one other tech in swapping shifts last-minute. Because we all had to rotate working weekend days, and tried to give people 3-day weekends if they had the weekend off that cycle (since Sundays are in a new week, you'd have Fri/Sat off one week, and Sun and another day off another week. Everyone worked Mondays!) So I was normally scheduled to work that Sunday, but if I needed her to work it, she wanted Friday off, so she could at least have 2 days off in a row. So I was scheduled to have Friday off, and work Sunday, with a back-up schedule if I needed to switch either week.

We get a call, saying that they've decided to do the Embryo Transfer on Day 3, instead of Day 5.

Friday, September 21, 2007
We go in. I didn't bother taking the Xanax they prescribed for this visit. I had thought it was silly when I first saw the prescription list. I mean, why would I be nervous? I could have used a Xanax on the retrieval day, sure. But now? This is the first day of the rest of my life!
I've been downing water all morning. Since they'd be doing an external ultrasound to guide the tube into my cervix and to watch and make sure everything goes in (you can see the fluid as it moves in, plus the saline wash they follow up with just to make sure everything with the embryos in it goes on. (Although at this point, they are also technically zygotes. Until Day 4. Then they also become blastocytes.) We had done an SHG (sonohysterogram) with a saline wash in the weeks earlier, as a test run, so my doctor knew how my cervix was angled, and if she'd need to make any adjustments. And while my legs and butt were sore from the progesterone injections, it was very nice to finally be free of the yellow or pink (depending on dose) gloppy goop I'd had squelching from my nether regions every day for the past year+, from the vaginal Prometrium suppositories.

We had decided at the beginning of this process that we were going to attempt to transfer 3 embryos. Apparently the standard is 2, but I don't know if the doctor told us that or not. But we were willing to keep 3 babies, without having to resort to selective reduction. In fact, if all 3 had implanted and split, we would have done our best to keep all 6, if we could keep us all as healthy as possible. Any risk of miscarriage due to the selective reduction was too high a risk for me, and how could I choose? What if we weeded out all the girls, leaving me with all boys? What if we kept the sociopath, and removed the one who would have discovered the cure for cancer? Obviously, I would spend my whole life "knowing" we chose the right one(s), but I'd still wonder about the others.
Plus we wanted to hedge our bets. Since we could really only afford this once, we needed it to work.

Then the doctor comes in and talks about our eggs. She says that of the 8 that fertilized, they were all lower quality than standard. She explained about something called "fragmentation," which is where you get extra blobs of stuff in the embryo, from when the cells split, but without any chromosomes in them. She says they can't gauge what is normal when the whole thing happens naturally, but that for all the IVF embryos they've experienced, the normal fragmentation rate is 20-25% (where that's the percentage of space taken up by extra blobby bits. I think. It may mean % of cells making extra blobby bits.) Our best embryo was 30%. Next best was around 35%, then 40%. Another at 45%. I can't remember the rest, other than that they went up to 80%. This was why they wanted do do the transfer on Day 3. They wanted to get them into a uteran environment as quickly as possible, in the hopes that they'd have a better chance of survival. Plus they didn't want to watch them all fail over the next 2 days and have us get mad at them. But that's just my take on things!
She wants to transfer the best 3, and try and freeze the next one.
At this point, part of me is thinking. "Go ahead. Huck that one in too." Plus I thought that trying to freeze the 4th one would be a waste of effort (and our money.) But I'm usually too shy to speak up, until I've had time to think things through, which we certainly didn't here.
Off we go to the special, super-sterilized transfer room. First they spend about a thousand years showing me the little blobs in a petrie dish, magnified a bajillion times. Then they show that my and my husband's names are written on the paper under them, so we can verify that these are ours (yeah. Like I've been watching them 24/7 to make sure no swaps were made. And like I know that that paper stayed with them the entire time. But whatever.)
We get to watch the process via ultrasound. Tube. Squirt. Back-up squirt. Withdraw tube. Ta-dah! They want me to stay lying down for a while, and they know I probably have to pee (oh, very yes!) so they give my husband a bedpan to hold under me and pull the bed apart at just the right spot so I don't even have to move. Nothing says "I Love You" like holding your bedpan for you.
So I pee. And pee. And pee. Did I mention I'd had a lot of water? I tend to over-prepare for ultrasounds. My bed pan was almost full, and I wasn't done yet. My husband hands me some TP to wipe so he can dump out the pan, and the paper lightly brushes the top of the liquid and gets sucked in, because its sooooo full! We can't stop laughing. At this point the doc comes back in, and now, not only do I still have to pee, but I'm not wiped properly. Ugh. Oh well. It's not like they don't clean the linens between patients. (I held in my pee though.)
They wheeled me back in to the recovery room, and told me to stay lying down for at least some amount of time, and then we could go whenever we were ready. They gave us pictures of our 3 embryos, all blown up, and a photo of the ultrasound at the moment of transfer. I fell asleep. Then, when I woke up, we got our stuff together and went home. And forgot our pictures. :(
At home, I was a Pretty, Pretty Princess for the rest of that day and the next. Thirsty? DH got me a drink. Bored? He'd find me a book. I got to control the remote.
I sat on the couch, reclined, and did my best to implant me some embryos!