Tuesday, January 13, 2009

Perspective on things

I’m still pretty shocked and numb from yesterday’s news on our embryos / blastocysts. I’m sure you must think that I just whine unnecessarily, and that in the past 1 week itself I’ve shown all kinds of varying emotions. I started with being worried about a low number of follicles, to being ecstatic about a good ER, to being devastated about the fert report, to being ok with the Day 3 report, to yesterday, when everything crashed around me.

I’m trying to see the positive side of things. DH and I sat down to analyze our results from our past IVF/PGD cycles and compare them with this current cycle. We think we’re seeing a little pattern here, and I’m going to try and explain it to you.

The obvious difference in this cycle was the fact that the biopsy for PGD / FISH testing was done on Day 5. Most other labs / clinics do the biopsy on Day 3. Had CCRM done the biopsy on Day 3, we would have had 12 embryos from the first batch, and possibly a couple more from the later batch that would have been biopsied and tested. And with that, the numbers would have been similar (and slightly better) than our previous 3 cycles.

In my mind, I’m trying to string together the results of the previous PGD cycles, with the outcomes on Day 5 with regards to the development of our embryos.

This is from October 2007. During this cycle, the normal / balanced 5AA blastocyst was transferred and we got a BFP. I had a missed miscarriage in the 9th week

This is from April 2008. During this cycle a poor quality (5CB) blastocyst was transferred. It ended in a biochemical pregnancy.

This is from June 2008. 2 blastocysts of 5AB and 5AC grade were transferred. This resulted in my ectopic pregnancy.

Do you see why I was stressing about needing higher numbers? See how many Unbalanced embryos we've had in the past. That is why, with a genetic / chromosomal abnormality involved, everything becomes a big numbers game at the end. 

On the other hand, do you see the pattern I’m talking about? It does seem like the embryos that were normal or balanced for the translocation did survive and develop into blastocysts. That’s on the one hand. On the other, all blastocysts were not always normal or balanced. We had some good-looking 5AA quality blastocysts, which had an unbalanced translocation.

So I’m yet again trying to hold on to the hope that the ones that made it to blast COULD be normal. I realize I must appear so desperate – clinging on to any straw of hope that I can. Who knows which straw will keep us afloat, really!

This one has by far been the most stressful IVF cycle I’ve been through. I’m pretty sure that after this my mind and body are not going to be ready to go through this again. (I am hoping against hope that I don’t NEED another cycle, but you know what I mean.)

I have not heard from the embryologists today. By this time yesterday I was climbing the walls in despair. Today I feel like the news can’t get any worse. The anticipation of the bad news phone call is gone. If at all, today’s news would / will be good news. If they call, good. If they don’t – well, what can be worse than going from 31 eggs to 2 blastocysts in under a week?

PS: Some of you mentioned my last post was technical, and that the grading was hard to understand. I will write out a post and explain the grading for the benefit of those that didn’t get it. But I will do that tomorrow.


Elana Kahn said...

I don't think you whine unnecessarily. If you go back to my IVF, I made a list of "worst case scenarios" that were really freaking me out. I started out with 8 eggs that they retrieved, only 4 fertilized and only 2 kept growing. They didn't want to wait until day 5 (just in case one or both of them didn't make it), so they transferred both on day 3. I have hope for you and your embies!!!!

JJ said...

Nikki, I think you make a very good point. It's clear that the balanced embryos seem to have a better chance of making it to blast. I think we can hold on to that hope. Did they tell you when you might expect your results?

Courtney said...

that's what I'm hoping that the reason they made it to day 5 is that they are normal. It was exactly what I was thinking this morning when I read your post from yesterday. When will we get the results back? We are all here for you Nikki. You have every right to vent, cry, stress. We all understand where you are coming from...big hugs.

Jill M. said...

Everything you are feeling is completely normal and you have every right to whine all you want. I can't imagine anyone could go from 31 to 2 and not feel all you're feeling. I did notice that your best embryos seem to be normal, so let's hold out hope for them. Hugs!

April said...

nikki, this is an emotional process, and we are all here to support you. this is the place where you can say anything and not have to worry about people thinking that you are whining. we <3 you!!

it's a lot to take. i am still hopefull that there will be something to transfer. ccrm seems to work miracles somehow...

Shelby said...

Your are no where near whining unnecessarily. It is completely clear why you feel the way you do. I'm already terrified of my embryology report and I'm still over a month and a half away from it. There has been so much that has gone in to getting where you are today and given that, I think you are handling it beautifully. My God, when I'm a basket case, I don't even have the strength to open my laptop, let alone blog.

And wow, what a pattern! All of your normals made it to day 5, so the chances are really there. I get the numbers game and two is a low number, but with what you've shown us today, I'm not counting your little ones out yet! I look forward to hearing more about the grading. I know the basics, but I could probably use a refresher course when I'm waiting on pins and needles for the embryologist's call.

Still thinking of you!

Lisa said...

You totally do not whine - I am very similar and can go from ecstatic to completely devastated in sixty seconds - poor Mr. M.

I really feel for you - to go from 31 eggs to 2 blasts must be a really big emotional roller coaster. None of my embies - we have had a total of 5 from 2 cycles - were even attempted to go to blasts because I have so few. I think it is a numbers game for all of us who have repeated losses....thinking of you.

Cassandra said...

People who don't whine at all during an IVF cycle are suspect.

Hope the embryologist calls with good news!

Caroline said...

Hi Nikki,
I am reading your posts every day and praying that this cycle will work out for you.

I don't know nearly as much about IVF as you do, but I can understand your concerns about the embryos. Particularly as you have had some difficult IVF experiences.

What I do know for SURE is that you are incredibly strong, smart and brave. I am so proud of you for getting through this.

I'm thinking, praying, hoping, wishing and keeping my fingers crossed for you.

I Believe in Miracles said...

I'm sorry I haven't been commenting on every post, but please know that I've been praying for you every day.

We will be here for your roller coaster. Because that is what it is - a roller coaster. The ups - 31 eggs retrieved - to the downs - only having 2. I'm praying that both those two are normal and will result in a very happy 9 months inside your belly.


Polly Gamwich said...

I think you are not a whiner and I think you have some very valid points! I agree, it looks as if the ones that survived are the ones that were balanced ... so here's hoping!!!

I can't wait for the report.

Anonymous said...

Dearest Nikki,
I don't think you whine unnecessarily at all. After all you have been through!
Please don't give up yet, I know it's so hard and I wish that it wouldn't be like this but try to hang in there just a little bit longer. You are still in the game at this point.

Clio said...

Nikki, I'm catching up here with the last news. What a roller coaster.
I'm so sorry for the low number of blastocysts, but then, following this latest reasoning, you are completely entitled to all hope you can get. I'm crossing everything here in hopes that they are normal.

Linda said...

Sending you BIG HUGS! I so totally know what you're going through, as my DH has a translocation as well. It's like adding another huge stressor to the mountain of stressors already. I so understand that with translocation issues, it is imperative to get tons of embryos. OMG do I know that!! I've even considered asking Dr. Schoolcraft if he will transfer *all* our embryos on Day 3, not even doing any PGD. Just put 'em all in and see what takes, if any. Desperate huh? I am so sorry that you're going through this. {{{{HUGS}}}}