Monday, 6 March 2017

The (First) Call & A Big Decision

After our egg collection and the news that we had 19 eggs, I was hoping for an easy night because I wanted to be up early for the call from the hospital to let us know what we had to work with. Of course eggs don't equal embryos or babies, so you're still having to spend some time in that limbo that's so familiar during IVF treatment while you wait to find out how the next step of the process has gone.

Immediately after the collection, while I was recovering, getting my shiny new Flow Book For Paper Lovers as a gift from Mr Click, and we were travelling home, a highly skilled professional was washing Mr Click's contribution to our future and stripping the outer cells off of my eggs. Once this was done they would be able to see how many mature eggs we had and for each egg a single sperm would be caught (they immobilise the poor things by whacking their tails!) then injected directly into the egg.

After this they're left in an incubator overnight to be checked the following morning to see if fertilisation has occurred. It's a bit of a nerve-wracking time because things could go either way at this point.

We were having ICSI treatment at this stage as opposed to traditional IVF. The difference being that instead of letting things happen 'naturally' with the eggs and sperm being allowed to get it on in a petri dish, we knew that none of our IVF eggs fertilised last time, so we're using the more invasive method. I was cautiously optimistic that since we had a very good rate of ICSI fertilisation last time that this time would be just as good. But there's no way of knowing until you actually get the call.

Last time we got the call at about 10:30am so I was expecting a similar time frame for the call this time. We planned to be up at 9am to allow us time for a bit of a lie-in. It was much needed because I had a pretty terrible night's sleep. I was uncomfortable from the egg retrieval and in my fragile state I had caught Mr Click's cold so I was snuffly and sneezy and coughy all night (which did just about zero to make me feel more comfortable, as you can imagine).

When we got up and made our way through to the living room (our phones don't get a signal in the bedroom) and I discovered I had a missed call from around 8:30am. I immediately felt like the worse parent in the world, not there to answer the phone when my potential babies were there in Glasgow and their babysitter was trying to get in touch with me.

Luckily she phoned back very soon after we got the message and it was with really good news:

The Embryologist let us know that of the 19 eggs collected, 12 of them were mature and suitable for injecting (immature eggs won't fertilise so they don't inject those ones). By that morning ten of them had successfully fertilised.

And so we had a choice to make.

The original plan had been to freeze everything we had on Day 1 (that day) but we had so many embryos that we were being given another option. We could allow them to grow on to Day 5 (blastocysts) and freeze them then. There's pros and cons to both options.

Freezing on Day 1 would mean we would know we had ten embryos, but we wouldn't know what quality they were. They could be potentially fantastic embryos, or they might not make it past Day 1. From what I understand they also use a slightly different technique for freezing them at that stage. When we came to use them they would defrost roughly half of them and try to bring them all on to Day 5. The bonus would be that if it looked like they were struggling we could do a Day 3 transfer.

The other problem with freezing on Day 1 is that they only have two cells. When an embryo is thawed it can lose cells and losing a cell when you have only two is pretty problematic (though an embryo can regenerate its cells). By Day 5 they can have 30-40 cells so losing a cell is less of a big deal.

Of course, taking the embryos to Day 5 isn't without its problems as well.

One thing in our favour was that we had successfully taken embryos to blastocyst stage before. The risk was that last time we'd been on alert to go in for transfer on Day 3 if they had started to struggle; this time that wasn't an option because we couldn't do a fresh transfer. So you could leave them all to grow for five days and end up with nothing at the end of it.

The pro to going to Day 5 is that it allows the Embryologist to identify the quality of the embryos. When they are only two cells there's not much to go on so they are (in her words) 'freezing blind'; they might be great or they might not, the only way to tell is to let them grow.

Mr Click and I hadn't really discussed this too much beforehand and there was a bit of pressure to make a decision with the Embryologist on the phone (I don't doubt that if I'd asked for a little bit of time we could've called back a short while later to let her know our choice). I'd kind of made up might mind of what I wanted to do while she was explaining our options, but of course they're Mr Click's embryos too and I needed to let him hear the options and have a say in what we did too.

So I laid it out for him and he straight away came to the same decision as me. We had to give them a chance to get to Day 5. It would be heartbreaking to lose any of them, but it would be more heartbreaking to freeze them, go through all the process for a frozen transfer and then not have anything to work with. At least letting them grow for five days would allow us to know where we stood (more or less, since there's still the risk of the thaw failing) by the end of the week.

With that I gave the word to the Embryologist and rang off.

And it was time to wait a little longer and wonder if we'd made the right decision.


Let me know what you think. :-)