Transfer!

The day after the retrieval, the IVF coordinator called to tell me that 8 of the embryos had fertilized.  They didn't know yet whether they would be doing the transfer three days after the retrieval or five.  If the embryos weren't growing well on day 3, they would transfer them that day under the theory that they might do better in the uterus.  If they were growing nicely on day 3, they would wait until day 5 so they would reach the blastocyst stage.  A blastocyst is formed when the cells have divided enough that you have an inner cell mass that will become the embryo and an outer cell mass that will become the placenta.

On day 3, the IVF coordinator called to say that the fertilized eggs were doing great.  Five of them were 8 cells and three of them were four cells.  It was decided to wait until day 5.  This was good news for us, because it's likely they would have put three in if they had decided to move forward on the 3rd day, since the embryos would have a lower likelihood of surviving.  This would have introduced the possibility of having triplets, which would be overwhelming to us. Holding off until day 5 was good news.

The transfer was pretty amazing.  The instructions were to drink about 32 ounces of water starting 90 minutes before the appointment and finishing up 45 minutes before the appointment, and to take a couple Valium with those last few gulps. The Valium is supposed to help you relax before the procedure and I think also assists with cramping. I had been warned that I would be extremely uncomfortable even before the appointment started due to the amount of water I had to drink, but I wasn't. It wasn't until the procedure actually started that I began to feel a bit uncomfortable and it never got to be too terrible.

The appointment started with a medical assistant telling us what to expect, and then the embryologist came in with our embryo reports.  I had been a little concerned that we'd lose all of them between day 3 and day 5 (that's the risk of waiting), but the embyrologist told us that we had two fantastic embryos ready to go.  One was graded 5AA and the other was graded 3AA.  The number indicated the degree of expansion of the blastocyst (1 being the least expanded, six being the most expanded).  The letters indicated the quality of the inner cell mass (the part that would become the embryo) and the outer mass (the part that would become the placenta).  A is the highest rating.  AA is the best rating, and both of our embryos got it!

The embryologist also told us that two of our fertilized eggs didn't make it and that they were watching the remaining four to see if they would grow enough to be frozen.  Everyone wants to be able to freeze extra embryos as it's a lot less expensive to do a frozen embryo transfer than it is to go through the whole egg retrieval process again.

After telling us about our embryos, the embryologist gave us a picture of the two they would be transferring.  And here it is:

As you can see, one of the embryos is larger than the other - that one is the 5AA. The other is the 3AA. The embryologist assured us that the size doesn't really mean anything at all in terms of success rates.  I read online that boys tend to develop more quickly, so I'm kind of hoping that this means we transferred one girl and one boy.  This, of course, is based on absolutely no scientific knowledge.  They could both be boys or both be girls.  IVF seems to tend to produce more boys than girls, from what I've found online.

The doctor came in and I got to have a normal, stomach-centered ultrasound (instead of the other kind) but then she inserted a speculum, so.  You know. Maybe not so comfortable, but not bad at all really.  Straight in front of us on the wall was a flat screen t.v.  The embryologist had moved to the lab, in the room directly next door and she had control of the t.v.  She first flashed a shot of the container holding the embryos that had my last name and my birthdate typed on it.  After that, she gave us a live video feed of the actual embryos.  Okay, I admit it, I was all "AWWW!  Look how CUTE!"

Just a few seconds later the best part happened.  The embryologist was pulling the embryos out of their liquid with a catheter.  I didn't notice the catheter at all, but all of a sudden both little embryos just seemed to scurry off to the left of the screen, one after the other.  It was the sweetest little thing.  A moment later the lab door opened and the embryologist brought the catheter in to the doctor.  The doctor inserted the catheter and used the ultrasound to pick the best spot to place the embryos in the uterus.  I couldn't really see the screen much at that point, but after she finished I could see where she had marked where each embryo had landed.  Everyone said that it couldn't have gone more smoothly and we were feeling pretty optimistic.

After getting all of the medical stuff removed, Mark and I stayed in the room with me lying down for fifteen minutes and then I ran out to use the bathroom (remember those 32 ounces of water? pretty darn uncomfortable at this point).

Instructions were to go home and stay mostly in bed for the remainder of Sunday and all of Monday.  I've been on the couch for most of the time (which explains my sudden batch of posts!)  Everyone seemed to think I'd be worried that the embryos would fall out, but I'm not worried at all about that.  I'm worried that I'll move around too much and they won't be able to latch on.  Kind of like being on a rolling sailboat in a storm - you just start thinking you're going to be able to grab something to hang onto and the waves roll you away again.  I hope that's not what it's like for the embryos.  I'm also already feeling like I need to hold my stomach when I walk around, which I admit is completely and totally ridiculous, but it's this weird impulse I've got.

Last night I added two little Vivelle patches, which are estrogen patches to my medications.  I put them on Sunday and Wednesday nights, on my stomach.  With all of these hormones, every time I have a stressful moment I end up stopping and wondering if it's the hormones.  So far I'm fairly even keel though.

They called today and let us know  that three of the remaining embryos made it to blastocyst stage and are being frozen.  I didn't think to ask about their grades, but it doesn't really matter to me just yet.  We'll get our results on October 6th.  Until then, progesterone shots and estrogen patches plus a whole lot of positive thoughts.

It has occurred to me that if this works, it does have one major advantage over natural childbirth.  I get to see the baby (babies?) from the very beginning.  I got to see the moment they arrived in my uterus, and I have a picture of them.  It's not enough to make me want this to happen (for anyone!), but it is a tiny silver lining.