I was wanting to write a post about all the nesting instincts I was having recently. I was counting the days in my mind, thinking of all the "clearing up" and "sorting out" I had to do before we leave for Denver, because "When we come back, I'll be in my 2ww, and then I'll be pregnant, and won't be able to do a lot of the stuff I want to do".
And get this, I even started knitting!!!! If you're someone who knows me, you'll know how UNLIKE me that is! Knitting! I have nothing against it, and have a lot of respect for people who can create beautiful things out of yarn and needles. My mom knits, and I love the stuff she makes for us. But somehow, it's never been something I would pick up on my own to do. Yet, this weekend, I had this huge urge to knit. I went and got yarn, and needles, got on the internet, learnt how to cast stitches, and began to knit. It's not a very ambitious project, it's just a scarf, but hey, for me, that's the most "nestive" I've been!!
And then today, we got a call from the genetic counselor at CCRM. Apparently they have decided we are going to do a freeze all cycle. So essentially, POOF!! There goes my visions of coming back from Denver during my 2ww, and getting a BFP after that. I need to re-adjust my vision to - come back from Denver after ER, and go back in 6 weeks AGAIN!!!!!!!!!!
Let me explain what they are planning to do. See, because DH has a balanced translocation, our embryos need to go through PGD. The process of PGD requires a biopsy - where they remove one or more cells from the embryo, and then a FISH analysis, which is the process by which they do the actual testing.
So far, the local clinic (and most other clinics in the nation) do the biopsy on day 3, get the PGD results back by day 5 for a transfer on day 5 itself.
Dr Schoolcraft and CCRM's embryologist / geneticists suggested that we try a slightly different approach. They said they would biopsy the embryos on day 5, instead of day 3. This could be helpful in 3 ways:
1) On day 3, the cells are not yet divided into the inner cell mass and the trophoblast. (The inner cell mass is what forms the baby, and the trophoblast forms the placenta and membranes around the baby. The genetic material in all these cells is the same) So when they biopsy, they could be taking out a cell which would potentially have grown to form part of the inner cell mass, which forms the baby. (Note - there is no evidence that this harms the baby, but in the event that it COULD, the RE was wondering if we could avoid the biopsy on Day 3)
By day 5, the inner cell mass and trophoblast are defined, and the biopsy could be done such that cells are removed from the trophoblast only.
2) Since by day 5, the blastocyst has 60-80 cells, we COULD take more than 1 for biopsy. This way we can reduce any error rates the lab may have. If they have a doubt, they can have a backup cell or two to repeat the tests.
3) By day 5, we will also know much more about the general health of the embryos.
So they plan to do the biopsy on day 5. At first they told us we would do a day 6 transfer (which could be touch and go, because embryos MAY not survive in the lab culture beyond day 5). Even for a potential Day 6 transfer, we were going to have to really hope and pray and keep our fingers crossed that the results came back within the 24 hours between the biopsy and Day 6.
Well, CCRM has decided to leave the guessing out of the game. They have decided they will biopsy on Day 5, and vitrify the embryos right then. It could take 24 to 48 hours for the results to come back, but they want us to come back maybe in 6 weeks for a FET.
Advantages of FET under these circumstances:
1) We aren't going to be left wondering if the embryos will survive in the lab culture beyond Day 5.
2) My body will have time to get rid of the effects of the stims that I will be on, and will have time to prime up my uterine lining for ET.
We were worried that since we usually have only 1 or 2 normal embryos after PGD, and since the thawing process kills 30-40% of the embryos, what if the 1 or 2 good ones die? But they tell us that the new process of freezing that they use - flash freezing or vitrification - has ensured that they haven't lost any embryos to thaw related deaths.
My first reaction when I got off the phone today - complete anger and frustration! How much longer must this whole thing drag out??? In the time that I have been waiting to get started since my ectopic pregnancy in June/July - people have almost their third trimesters of their pregnancies!!!
CCRM had told me when they gave me the IVF calendar that we COULD freeze all, and that we would decide that after ER, depending on how the embryos are growing, and how things look then. So we could have received this news right at the nth hour.
Somehow, even though we have advance notice of it, I'm still mad. I'm mad that this whole process is so much out of our control, and that there's nothing we can do to change that fact. I'm mad that I've put my whole life on hold - all of 2008 has gone in just waiting.
I know I will have to accept this, and that it's probably for the best, and that the doctors are doing what they can to improve our chances, but I'm just feeling so impatient right now! I know I'll be more relaxed about it tomorrow. I know that I will take this too in my stride tomorrow - but right now, I feel like screaming.