The ups and down of this infertility stuff is really getting to me. I thought I used to be a strong woman. After being a young single mom for many years, going through a few heartbreaking failed relationships searching for Mr. Right, to suffering 3 miscarriages and an ectopic pregnancy when I finally did meet him, to having to get both fallopian tubes removed after my ectopic ruptured. I made it through all that, was still a happy and caring person, not bitter or resentful, still loved and trusted the Lord ans His plan, and kept moving forward, no matter what. I thought, hell, if I can make it through all that, than surely I can make it through anything! Well, the strong woman I thought I was…I’m not so sure anymore. I feel like I’m losing it over here. It seems like my biggest fears with this cycle are coming true.
We got the fertilization call at 9:00 this morning. Out of the 9 eggs retrieved yesterday, 5 were mature and 3 fertilized using ICSI. It was not the report we were hoping for. Based on these new developments, my nurse told us that Dr. K wanted to do a 3 day transfer and transfer all 3. I felt like I got punched in the stomach. This is not good. First of all, the fact that he now wants to do a 3 day transfer as opposed to a 5 day (like originally planned) makes me think that he wasn’t even that confident in the 3 that had been fertilized. And the fact that they fertilized our eggs using ICSI is another issue entirely. You see, we had talked to Dr. K a a couple different times about our feelings regarding the ICSI procedure. This is where a single sperm is injected directly into an egg. The embryologist will choose a strong looking sperm, suck it up with a super small catheter with a tiny little needle at the end, and directly inject it into the center of the egg. They typically do this for male factor infertility or in cases where the woman’s exterior to the egg is too thick or hard for a sperm to penetrate. Based on the fact that Mr. B’s SA (semen analysis) came back excellent, and the fact that we have been pregnant (4 times) in the past year, neither of these were known factors in our fertility struggles. Knowing this, we told Dr. K that we wished to forego this procedure. The IVF process is so chocked full of science and technology, we wanted to keep a little bit of nature, faith, God, and survival of the fittest factored into the equation. Maybe not the smartest move, but we felt strongly about this and these were our wishes. Dr. K said that he understood, and since everything seemed to point to our eggs fertilizing on their own, he was okay with our decision.
When we got the fertilization report this morning is when we learned that our eggs had been fertilized using ICSI. After we got through talking with the nurse, we asked to talk to Dr. K. He called us back at 6:00 tonight. After an entire day filled with tears, research, and worry…as you can imagine, we had lots of questions for him. He first addressed the ICSI issue and let us know that if there are 5 or less mature eggs, they ALWAYS perform ICSI. He said that with so few embryos, he doesn’t want to risk any of them not fertilizing. This is the rule, and the embryologist is the one that makes the call. Apparently, when the embryologist saw that we only had 5 mature eggs, she went on the protocol of “5 or less, perform ICSI”. I’m pretty sure our file was never referenced to see whether these were our wishes or not, it was just protocol. This kind of upsets me. Actually, it really upsts me. We were NEVER told that this was their protocol. And it is not written in the consent forms anywhere, I checked. I really feel that Dr. K should have told us of this major detail after seeing that we got 9 eggs. He surely knows that not all of those will be mature, right? And 5 is not that far away from 9, so bringing this up could have opened up a whole new conversation and we could have decided what we wanted to do if it came to that, together. I mean, who knows, maybe it’s a blessing in disguise…because who knows if any would have fertilized on their own. And if going our route, we may have ended up with even less than 3 fertilized. But I have to believe that at least a couple would have made it. And whether it was the right call or not, I feel like we should have got a say in how it all went down. I mean they are our eggs, they are our sperm, and we did just give you a shit load of money, right? Maybe a phone call letting us know that we only had 5 mature and the “procedure” with this number was XYZ. Who knows, we may have decided to go ahead with the ICSI at that point, or we may have stuck with our original “natural fertilization” plan. But whatever we decided, it would have been our choice. I feel like we should have got that, and we didn’t.
I trust my RE and I understand that him and his team have to have protocols and draw the line in the sand somewhere. I get that. I also know that they are doing the very best job they know how to do making babies and getting women pregnant. I know this, and I am so very thankful for this! Based on their experience and statistical data, they are doing whatever they can and know how to do to have the best outcome for each cycle. To have the very best outcome for us. Because of the fact that I trust him, that is why I am having such a hard time questioning his next step for us.
I am scared to death of transferring 3 embryos and ending up with triplets. I am not scared of having 3 healthy and happy babies at once (okay, maybe just a little) but more scared of the health risks of a triple pregnancy. There could be severe health risks for the babies and me. And hell, I’m only 105 lbs at 5’2″…honestly I think I’d die with a triplet pregnancy. However, Dr. K assured me that this is a VERY slim chance. 5% was his estimation. Along with a 30% chance of twins and a 50% chance at a singleton. Honestly, a 50% chance at one seems very high considering our circumstances, and based on all the other stats I have been reading, I think he was sugar coating this number quite a bit. And hey, maybe I would too if I had a crying lunatic of a patient on the other end (yeah, I was that girl today). However, I wanted him to give it to me straight. I needed him to give it to me straight. I want to know exactly what our chances are here. But you know what I’ve learned throughout this journey…these doctors, these RE’s…they really have no idea. No one has any idea how it will turn out until you just do it. I remember sitting in Dr. K’s office back in June talking about moving forward with IVF. Based on our history, the fact that we have both conceived children, and that my tubes were our only known issue…he gave us a 70% chance of success. We were thrilled with this stat. Well, now that this number has been stomped on and thrown out the window, I realize that it was just a number. A number and a sense of hope that I was holding onto. We had no way of knowing how this cycle would really play out. And we still don’t.
I am trying to remind myself that we have 3 fertilized embryos. 3 that could potentially be our baby. Don’t get me wrong, I am so thankul for those 3. They get my heart fluttering just thinking of them. And I am praying sooooo hard for them. It could be so much worse. We could have zero. But we don’t, we have 3. So why can’t I be thrilled with that? It’s so funny because the people I have told about our fertilization rate that are not in the “infertile world” think that it is excellent that we have 3 fertilized. And the people that have hung around these infertile parts, know that our chances don’t look so hot. You see, IVF is all a numbers game, and the more embryos you have to work with, the better your chance at a successful pregnancy. Statistics show that only 1/3 of the fertilized embryos will make it out to a 5 day transfer. Starting out with 3, this means we may have 1. Of course, that 1/3 is an average, so of course there are some that are above that statistic, as well as others that are below. The scary thing is, we have no room to go down on that scale. That would put us at zero, which would be devastating.
I am so torn about a 3 day transfer vs a 5 day transfer. I have done lots of research on the topic (surprise, surprise) and there is evidence that supports both. However, in the world of IVF, a 5 day transfer is becoming the norm. At day 5, the embryo is multi-celled and has even started to break out of it’s shell. This is called a Blastocyst. There is much supporting data that shows that a Blastocyst has a much better chance of hatching and implanting, resulting in a successful pregnancy. Also, in natural conception, the embryo is just reaching the uterus at day 5, which means that you are putting the embryo back into the mother at exactly the same time it would be occurring in nature. All good things. With a 3 day transfer, the embryo would typically still be in the fallopian tube, so the uterus may not be the best place for it, yet. I have also read data that supports the other argument. That the mother’s womb is the very best place for the embryo and transferring on day 3 gives it the best chance. However, I find that hard to believe when the industry has started to move towards 5 days as the norm. When we talked to Dr. K about this today, he said that they typically always do a 5 day transfer unless one of two reasons. 1) The woman is older and the eggs don’t look as strong or 2) in the case of very few embryos. Lucky us, we fall into the latter of the two. He said that a 5 day transfer is helpful to do when there are multiple embryos because you really can’t tell at day 3 which ones are going to continue to grow and divide and which ones are not. He said that by growing them out to day 5, you have a clearer picture of their quality and thus selecting the best to transfer is easy. So, sticking with that logic, I thought…well, then why not grow ours out to day 5 and see if any would even make it. If not, then they probably weren’t good quality anyways, right? Dr. K said that is not always the case and that he has seen many times where a embryo results in a successful pregnancy after a 3 day transfer, where he doesn’t believe it would have made it out to a 5 day blast in the lab. Huh? How does he know this? Obviously there is no real way to test this theory. I tend to think that they transfer on day 3 because they just don’t want to risk none of them making it to day 5. And then they’d have to call the couple prior to their transfer and let them know, “I’m sorry but you have zero embryos left to transfer. None of them made it.” I wouldn’t want to make that call either. And so they think, well, let’s just put them back and see what happens. Maybe we’ll get lucky. But again, I am so torn on this. I would rather know that we are transferring good embryos that are continuing to divide and grow (even though this doesn’t always mean that they are healthy or they will stick) rather than just throw some spaghetti at the wall and see what sticks. But what if we decide to wait until day 5 and then we have none make it? Will I have wished we had put one, two, or all of them in to at least give them a chance. Probably.
As of right now our transfer will be on Saturday. How many we are going to transfer is still up in the air. We have lots of praying to do on the topic, among other topics. Dr. K said that he will call us Saturday morning and if our embryos are looking excellent, or if even one or two are looking excellent, he would be open to letting them grow out to day 5. It really all depends on these next 2 days. Please babies, grow! I don’t want to have to make any more hard decisions. I am exhausted.
Oh, and to top off this already crappy day, my car batter died this afternoon at the kids school. I was stuck in the car for over an hour, in the pouring rain, with 3 kids (carpool). It was the most perfect ending to a perfectly suck-tastick day. So glad that tomorrow is almost here. Hoping it brings some sunshine and good news.
Family and friends. Just pray. Pray hard. We need prayers for our 3 embryos to grow nice and strong. We need all of them to make it! We also need prayers for Dr. K and the embryologist. I need them to have wisdom and know what to do when the time comes. Scott and I also need some peace about these decisions coming up. I want to know that whatever we decided to do, it’s because it’s God’s plan and not our own. We just need his light to shine on us and show us the way. We feel so lost right now.
Thanks for your continued support,
~ xoxo Mrs. B