Monday, September 14, 2009

Fertilization Report

Tony got the call as I had meetings all afternoon.

I just got an email back confirming what hubby told me and getting more information. (Sometimes husbands are not reliable sources of information...especially ones who refer to embryo implantation rather than embryo transfer).

The report. Seven of the nine were mature. Seven of the seven fertilized and were characterized as "good fert". (Last time four of five fertilized, but only two were "good fert".)

I am thrilled once again!

So now, I am going to throw some options out into the blogosphere and hope you guys can help me make some decisions.

[Now that I've typed this, it seems pretty long. Please bear with me...I need some opinions.]

The Background: I pretty much have to be at work on Thursday. (OK, I know I don't HAVE to be at work, but I have to...one of those things...something will be happening in the department, and as the manager I should be there). I am just sick that I am even considering work at this time, but I've been disappointed so many times that it gets harder and harder to put your life on hold for IVF.

RE and I agreed to do a three day transfer when this work situation came up under the assumption that we would have few eggs and that quality might suck like last time. (Why wait for a five day to see which ones are the best when you have so few?)

In the meantime my retrieval kept getting pushed back so that now a 3 day transfer would be Wednesday and a 5 day transfer would be Friday. (We had assumed that a 3 day transfer would be Tuesday and a 5 day transfer would be Thursday).

So here are my options:

Option 1: Do a two day transfer tomorrow and get a full 24 hours bed rest on Wednesday before walking into a shit storm at work on Thursday.

Pros: Bedrest. More time for embies to settle in before emotional turmoil. RE doesn't seem to think a 2 day vs. a 3 day is a big deal.
Cons: Might be hard to choose best embryos. I'm unclear if two day transfer will affect results outside of better embryo selection. (i.e. if I transfered the same embryos on day 3 would I have a better chance?)

Option 2: Do a three day transfer and have about 12 hours of bedrest (keeping in mind the most physical thing I do at work is walk).

Pros: Perhaps better embryo selection. Don't have to worry that selfish work concerns affected results.
Cons: Reduced bedrest and stressful day less than 24 hours after transfer.

Option 3: Wait and see if there is anything to transfer on Day 5.

Pros: Transfer happens after shitstorm. Better embryo selection. All the other good things that a five day transfer entails.
Cons: Might have nothing to transfer again, go insane and end up in nuthouse.

What would you do? Talk about mixed emotions...I'm so happy and frustrated that I have this problem.

32 comments:

sprogblogger said...

Wow! Fantastic results!

If it were me, I'd probably try for the 5 day. I have become somewhat superstitious about the few days after transfer - the only time I did not get a BFP was when I went back to a stressful work situation the next day.

So I'd try to bank on the benefits of letting them winnow themselves out for a 5-day transfer, and then having the weekend to relax.

Of course, if they don't make it to the 5-day, I'd be kicking myself forever.

And, btw, just to throw in a vote for the other side, my first BFP was on a 2 day transfer. I agree that there's not much difference - other than picking the BEST embryo - between a 2 or 3 day.

Whatever you decide - GOOD LUCK! This sure sounds like a charmed cycle for you!

SS said...

Hi- FWIW, here's my advice-

I think the bedrest thing is not really all that well proven. I would let me RE determine whether they wanted to do 3 or 5-day transfer, based on how the embryos look on Day 3. I would not do a 2 day transfer. GOod luck,a nd congrats on 7 fertilized, that's fantastic!

IVF 40+ said...

Tough one. If you an get to 5 days I always thought 5 day blasts were a better bet than 3 day. Could you ask your doc on day 2 what they look like? If they are slowing then pop 'em in??
What does your doc say?

Oh and CONGRATULATIONS!!!!

Sarah said...

Do the 5 day - they are way better than last time! Or, ask your doctor what his/her opinion is on that. If the doctor thinks there is a strong chance there will be blasts, then I say go for it.

Heather said...

Congrats on the great fertilization report!

I'd probably be inclined to do a 5 day transfer if possible, but for sure see what the doctor recommends at day 3.

Incidently, I just read this article on 3 versus 5 day transfer. You might want to take a look. http://www.ivfauthority.com/2009/08/blastocyst-vs-early-embryo-transfer.html

Good luck!

'Murgdan' said...

Wow! and Wow! Did I mention Wow! So glad you are in this conundrum. Can you possibly wait until the next report to make the decision? Will they update you tomorrow and then you can make the call. For example if all 7 are going strong in the morning, it might be a good plan to hold out for blast...if not, then just go for the 2 day.

So many pros and cons. Do what feels right to you.

The Patterson's said...

First, let me say congrats on the 7 mature and fertilized! That is great news!!

As for the transfer options, I think I would go with a 5-day transfer. I know that is what my doctor would have suggested had we had as many embryos. I can't imagine that you won't have a couple to transfer still at that point.

I know this is a tough decision, but you will make the right one.

Good luck!!!

JB said...

Stellar! Agree with the above suggestion to ask for a status update on Day 2 before deciding...with 7, your odds of getting to day 5 are much improved. Would your RE (or you) consider transferring 3 2-day embryos with the hopes of getting 1-2 out of the deal?

K said...

Go 5 if it looks like you're going to have several. Go 2 if you're not. The 3 is cutting it too close to the shit storm in my opininon. Give yourself a break, if you can.
Best wishes, BTW ;).

lifefamilysanity said...

OK, I'm not an IVF'er so you can feel free to tell me to shut up and go away, but here's my thought anyway...

If there's nothing left at 5 days, chances are pretty good a 3 day transfer wouldn't have been successful, right? Plus, with the 5 day transfer you have the weekend and lot of time for rest afterwards and the stress is over. I personally believe from my experience that stress has a rather big impact on pregnancy.

So, I guess, it seems to me that transferring on Friday would be best. Again, I don't really know what I'm talking about and am going entirely off of the IVF stories of others.

Kate said...

I'd aim for a day5 transfer, keeping the option open for a day3 transfer if it didn't look like enough embryos were still going strong on day3 to wait till day5.
I've heard of others booking a day3 transfer, but asking the RE to call that morning to tell them not to come if things were looking promising for a day5.
I think I had a total of 48 hours to chill after the transfer before going in to run around a trauma + OB hospital for a busy night of anesthesia call with no sleep. Things turned out ok for me. I went grocery shopping either the afternoon of transfer or the next day and lugged way too many pounds of groceries home, and was sure I'd ruined everything. My RE doesn't believe in bedrest after transfer. No vigorous exercise or hot tubs or trampolining or sex. Other than that, life as normal. If I did the day3 transfer, I'd consider only going in briefly for the meeting/event I had to be at the next day, and then heading home to relax after though.
Wishing you more great embryo reports and some good ones to transfer!

PJ said...

Oh, huge decision! No pressure, right? :)

I'm inclined to go for the 5 day. Seems like after all of the blog reading I've done, that those 5 day transfers have a better chance of sticking.

Good luck, whatever you choose! SEVEN is an awesome number! I know you must be ecstatic!!!

Meg. said...

Ooooo! 7! (another great number)

This may have already been said, but...

maybe you could transfer the best 2 or 3 on Day 3....and then freeze any remaining embies on Day 5? That way, even if the 3-day transfer doesn't work, you have stron, beautiful blasts waiting for you in the freezer?

I have no idea. =) I'm just glad that your embryos are rockin' out this time!

ASP said...

I tend to agree with Meg about the Day 3 transfer. Who knows if you'll have anything (devil's advocate) to transfer on Day 5 and I don't think I would want to chance it. Obviously, if you're doctor calls on Day 3 and says that you should wait until Day 5, then I would definitely go with a Day 5 transfer. I would x out the day 2 transfer though. I don't think enough fertilization has gone on to determine which ones will or won't work at that point.

I'm so super excited that you're having good luck with this cycle! Could be THE one! Congrats!!!

Pundelina said...

Seven embies!! That's fantastic! I would be inclined to take it day by day and see what's happening with them. I agree with a PP about crossing off a Day 2 transfer though, my clinic puts no stock in bedrest so I wouldn't worry too much about that. See how many are growing well at Day 2, then see what's happening the next day etc. If I were in your shoes I'd like to transfer a blastocyst.

Andrea said...

I'd do the five day transfer, I think. Hopefully they'd let you know if there was an issue with having enough to transfer at that point. I mean, they keep their eyes on these things right?

Congratulations! I'm so excited for you. As someone who's about to start their first IVF cycle, I've been watching your story with my fingers crossed. ;)

Moky said...

I would ask myself what I would do if working on Thursday wasn't a consideration and then go with that. I get the "high stress, I really need to be there" mentality because I tend to do the same thing...but the question I ask myself is which decision will I regret, in a week, a month, a year or on my death bed?

If whatever is happening at work on Thursday is something, a year from now, you would still look back on and say "I should have been there" then by all shoot for the five day transfer.

Does that sound stupid and new-agey?

Regardless of what you choose, I wish you the best of luck!

Cassandra said...

Hooray for the great fert results!

My clinic is a Day 2 fan, and their research says it's better for the embryos to be inside the uterus than in a dish, but most other bloggers' clinics seem to prefer 3 or esp. 5 day. And, it seems to me that whatever a clinic thinks they personally do best is the wisest course of action. Plus there's the issue of day 3 female DNA vs day 5 male DNA.

But all of that aside, just on the basis of the pros and cons you listed, I would rather have nothing to transfer on day 5 than to transfer embryos that were never meant to be anyway and go through the torture of a futile 2WW. But with 7 embryos right now, the chances are very very good that you'll have at least a couple to transfer.

Whatever you decide, good luck!

hope4joy said...

Congrats on the 7 embies! That is awesome. I would say do whatever will make you feel at ease, helpful right? Maybe you can check with your RE about the 3 day vrs 5 day transfer. Whatever you decide I am praying for you.

Shannon said...

I don't know what to tell you.

In the IVF we just did last week. We had 20 eggs retrieved, 12 fertilized and 7 divided normally. we did transfer 2 embryos, one that was compacting (preparing for blast) on day 3. we had 3 to freeze.

Theres a good chance you will have embies at 5 days, and I agree with other that said it would be nice to transfer beautiful blasts rather than great day 3 embies that wouldn't have made it. But I also agree that the uterus is a better environment for the embryos than a petri dish, so whats to say the embies wouldn't have survived better in the uterus right?

Tough decision, but its a great decision to be left with don't you think?

Congrats. To think just a week ago I was upset hearing 7 made it for myself, now I truly know what great news that is!

M said...

yay for great fert reports!!

i'm in the minority of ivfers and i'm inclined to push for day 3 transfer. (i've had two day 3s that have now resulted in positive pregnancies.) my clinic also believes that embies are better in bodies than dishes and so only does day 3 transfers. given your past history, i'm not sure i'd risk pushing it out to day 5, even though you have great numbers now.

(my clinic also just recently did away with bedrest, so i think you're better off day 3 with little rest than day 2...)

all that being said though, you've got to do what feel right to you. all we can do is offer opinions :) BEST OF LUCK! can't wait to hear how it turns out.

Just me said...

THAT ROCKS.

Mine was a 3 day transfer, so I guess I'm biased but I'd choose that. My doc doesn't even suggest bedrest... juts "take it easy" until the next morning.

Whatever you choose, I have my fingers crossed for you!!!!

Xillary said...

After reading the comments, I think you should do whatever your doctor "normally does". My doctor only does 5 day transfers, because the embryologist does blastocyst transfers. It's going to be a tough decision, so once you decide there can be no regrets:) Good luck!

shannon said...

Whatever the choice is I pray it works!!!

Alice said...

Congrats on the great results! I'll be pulling for you.

There is no right answer. I've watched my "perfect eggs" dwindle significantly from day 3 to day 5 so I actually might go for day 3 unless they all seven still look fabulous on day 3. but, there are pros and cons either way. I've also never done bedrest so not sure how big of a difference that makes. It would be so much easier if we knew all the answers! Good luck!!

Mrs.X said...

What wonderful news! 7 is a great number.

If I had the choice, I would do 5d transfer all the way. My clinic is very much about the 5dt because the embryos that make it to that day are the best of the best and the most likely to develop into actual babies. There is still come controversy over whether 3dt are inferior to 5dt.

I wanted whatever the clinic said would give me the best chance and that was a 5dt.

That being said, you do gamble - you may not have anything at 5d. I would talk with the embryologist and see what chances he gives you for a 5d and if the clinic tries to take them out that far as a matter of course.

In the end, I think the embryos should dictate what you do, not your work schedule. Just my opinion.

Either way - GOOD LUCK!!

Valerie said...

Wow, difficult decision to make!

Let me preface by saying its been 5 years since we did IVF and a lot has changed in that time....I didn't even know 2-day transfers were options! Now they can grade sperm...good grief! I can't believe I even ended up pregnant!

Our clinic was big on the 5-day transfers and the 24-hour bedrest; they were pretty adamant about not standing on my feet..especially since it was the eve of Thanksgiving for our transfer (ha!).

Here's my feelings on bedrest...when a woman conceives naturally (which I did AFTER a successful IVF pregnancy), let's face it...she's probably on "bedrest" or at least resting in bed for a few hours! LOL

Yes, you get up and go on your merry way after doing the deed, but conception is taking place in the fallopian tubes; in an environment that hasn't been perfectly recreated in the petri dish/laboratory.

Whether you transfer a 3-day fertilized egg or a 5-day embryo into the uterus, I think you need to be off your feet if even for just one day...one has enough mental stress having gone thru the IVF w/o work issues on top of that!!!

I feeling positive for you and can't wait to read your posts on the dreaded "two week wait"!!!

Blessings,

Valerie

Jem said...

Got no advice (justin starting my first and hopefully last IVF cycle. But I am sending loads of good vibes your way.

IF Optimist, then... said...

Wow Megan, congrats on 7. That is really awesome. I'm going to chime in here with a slightly different point of view. People are posting as if the "3day" vs "5day" transfer are different embryos. They aren't. It's the same batch of embryos, it all just has to do with picking the right few. 7 is great, but it's not 20 either.

My RE and embryologist agree that your body is better than any petri dish/culture solution and while some don't make it due to chromosomes others succumb to the harshness of their lab environment. I would do whatever your doctor and embryologist recommend. Ask them, if I were your daughter/wife/sister, what would you recommend strongly I do? On Day 3 they can tentatively plan a transfer, then look at them and decide if waiting to sort on Day 5 looks promising.

I know you are the manager and there's a big shitstorm going on. I get it. I really do, but I agree with Moky's comment. I wouldn't want to put myself into a position that would cause me any second guessing or regret. You're a smart woman, I know you'll make the right decision no matter what and I'm hoping and praying that things will go really, really great. :-)

Tiffany said...

Megan wow! Congrats on the awesome EPU and fert report.

Make sure you get advice from the gals on FT on this issue as well as on here.

My opinion is go for 5 day transfer. There are all the benefits of a 5 day transfer - you get to see which embies are stronger and my RE also says that research indicates the lining is better for implantation later on. I got 7 eggs and three embies on my last cycle. I have NEVER gotten ONE egg prior to this so I was already in the nuthouse trying to decide what to do. I transferred two A grade, 8 cell embies that were compounding and on their way to blasto. And the result....BFN.

It tis a very hard decision and I would like to say don't stress over it too much but having been there I know that's impossible.

Also, FORGET work! I don't know what you do for a job but you and your embabies matter the most. I feel like my biggest mistake with my transfer was going back to wqrk the next day, if at all for that first week.

Perfect scenario: day 5 blasto transfer and take Thurs AND Friday off work, leading into the weekend. If you can make that happen - DO IT!

Nicole said...

So glad to hear good news! I'd shoot for day 5--the stress of working and having to deal with all that may not be the best for your happy uterus. But, make sure you feel good about the day 3 report and what the doctor advises.

I know from experience, that no matter what you decide, we all second-guess after the fact. So just do what makes you get as close to peaceful now.

Here's to a day 5 transfer!

callmemama said...

I have no experience whatsoever to offer an informed opinion, but I think taking your job completely out of the equation and allowing the doc to do whatever he thinks would be best makes sense.
Good luck with whatever decision you make!

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