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9 - Elizabeth Unexplained
Lots of data but no answers
I got the expected call from the nurse today. Our 13 eggs have yielded 9 embryos. That is not a bad number at all. I have to keep reminding myself that quantity is no guarentee of quality, and for us quality is also an issue. Still, it's hard not to be encouraged.

Now the big gamble. We'd said we wanted to try blastocyst transfer this time if at all possible. Our reasoning runs thusly: we don't know if any of my embryos have ever gotten to the blastocyst stage, and given that research seems to indicated that the largest percentage of embryos are lost at the transition to the blastocyst stage it seemed prudent to find if we could make an embryo that would survive that long. The advantage of doing blastocyst transfer is that for women like me who have had prior IVF failures pregnancy is much more likely in the case of a blastocyst transfer. Of course the big if in all that is, it's much more likely to happen if you have something to transfer on day 5. If we wait until day five we increase our chances of having nothing at all to transfer, if we do the usual thing and transfer on day 3 we're pretty likely to have something to transfer, but we know less about the embryos and it's more of a gamble as to whether they will take or not.

So, the plan is that RSC will call us tomorrow morning around 8:30. They will tell us whether to come for our 9:30 transfer appointment or whether we get to wait until Monday, when we presumably will get another call telling us if there is anything left then. In either case the three best (if we have that many) will be transfered. In the unlikely (but no longer insanely improbable) event that there are more than three decent looking survivors on day 5 the extras will be frozen for later use.
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enugent From: enugent Date: October 8th, 2007 04:45 pm (UTC) (Link)
Don't you know that the chemical pregnancy must have made it to blastocyst?

Good luck, anyway. I hope you get some good information about the ones you left to grow. Oddly, the only one of my "extras" that made it to blastocyst was the 4-cell - the 9-cell and the 5-cell arrested. (They wouldn't tell me much about the quality of the frozen one, but I don't think it was very good.) I think embryo grading is barely better than a guessing game.
psychohist From: psychohist Date: October 8th, 2007 08:24 pm (UTC) (Link)
Dr. Lee was skeptical as to whether that was actually a chemical pregnancy.

I personally think the photographs of the embryos they put in this time look better than any we've seen photos of in the past. The one that I think is a four cell looks to me like the cells are all very much the same size, so the only reason I can see for giving it a "fair" symmetry rating is that the cells are in a tetrahedral arrangement instead of a planar square arrangement. This clinic's measure of "fragmentation" includes all egg volume not within the cells, and where in the past much of that was small fragments, this time it just seems to be the unused space in whatever spherical close packing the cells happen to be in.

I'm starting to get skeptical about the usefulness of the number rating - and not just because there's a lot of judgement in deciding whether something inside the egg is a "cell" - good - or a "fragment" - bad. Looking for higher numbers is just selecting for faster dividing cells, which is different from longer dividing cells. As you say, it's really just a guessing game.

I have to give a lot of credit to the doctor in charge of the clinic for instantly understanding why we wanted to continue to culture the rejects, and also both for being positive about it and for pointing out the weakness, that the rejects aren't randomly selected.
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