Sunday, January 06, 2008

Le lupron est arrivee

I started lupron last night. It was fairly anticlimactic. Wait, that would imply that I was expecting something, er...climactic in the first place. For the record, I wasn't.

For those first few IVFs, the first shot was always eagerly anticipated. I counted down the days, I made calendar entries and alarm prompts so I wouldn't forget them. I kept thinking "this time next week, I'll have started" or whatever. There was always a build up of hope, of anticipation, a thought that this cycle could finally work and I'd get pregnant.

This time is very different. I feel like I am just going through the motions, and that there's no real actual hope of it working. Part of this is of course because I am so beaten down by failure. But I think part of it also is because I am putting up defenses and reminding myself at every turn that the embryo could very well not survive the thaw, and then we have to skid to a halt right there and then. Perhaps if it does survive, then I will start getting excited. Well, OK, I will start getting very excited. This could very well be my last big hope with my own eggs.

The embryo is from my second IVF cycle, or, depending on how we are counting, my first. The first IVF that made it to retrieval and transfer, and wasn't cancelled for a poor response. I count it as my second though, because once you've been through all the IVF build up, all the meds, all the ultrasounds, all the pre-op stuff and been cancelled basically on trigger day, it's a whole different ball game from any other IUI cycle. So anyway, on my second cycle after a protocol tweak, I ended up with 7 embryos. We did a day 3 transfer, and put back one 8-celled grade 2 embryo, one 7-celled grade 2 and one 6-celled grade 2. I was told these were my best embryos, and that was that. What they didn't tell me until later was that I did actually have two grade 1 embryos on day 3 (grade 1 being the best, and relating to the amount of cell fragmentation, even development, etc). The problem was that my grade 1 embryos were 4 and 5 celled so they were slower developers than they should have been. When they took them out to 5 days, and I think somewhat to the clinic's surprise, they had caught up to the proper schedule, and the 5 celled embryo became a grade 3BB blastocyst, and the 4 celled embryo became a grade 3CC blastocyst. In this case, the grade 3 means it's an average blastocyst - an expanded blastocyst would be a 4, a hatching blastocyst would be a 5, and a morula would be a 2. So, really, a 3 is right on schedule, and 4's and 5's are over achievers. The letters relate to the size and condition of both the inner cell mass (which eventually becomes the fetus) and the outer cell mass? layer? - something or other. So a 5AA blastocyst would be the best, but a 4AA and a 3AA are just fine too. My local clinic only freezes grade 3BB blastocysts and above, so they only froze one of them and sadly discarded the 3CC. The two other remaining embryos had apparently given up the ghost by that point and stopped developing on their own. 3BB ain't bad at all, though, in my opinion. It ain't bad at all. And if I'd been doing a fresh blastocyst transfer, the 3CC would have been good enough to transfer so you never know. It could have been just fine too.

We didn't use the frozen embryo up straight away, because the RE thought that it wasn't worth doing an FET with only one embryo, given that it might not survive. So he suggested going to another fresh cycle, hoping we'd get at least one more frozen embryo and then have 2 or 3 to work with when it came time for the FET (for the sibling, you understand). Of course, that didn't happen and it's been a long hard road since then. But the delay does mean that IF it survives the thaw, it could be my best chance because (a) it'll be my only blastocyst transfer, (b) I know it was a grade 1 on day 3 and thus hopefully the quality is good, and (c) more importantly, this is from a cycle done when I was 37 years and 6 months old. Which is huge in terms of ovarian aging - it's nearly two years ago. So there's much more of a chance that this little embryo is chromosomally normal than anything I can produce today.

For the moment, however, yeah, lupron. Blah. Terribly dull. Oh, another cycle? Well, of course we must tell ourselves for the next month that it might not happen. We must under no circumstances get excited. We must just go through the motions. Again.

3 comments:

Almamay said...

You hit the nail on the head. I couldn't have been more excited about my first IVF. Now as IVF number 8 approaches it feels like something I need to do like cleaning the house.

joanie said...

thinking about you today. been skulking around your blog for awhile, with nary a comment in sight. i'm an IVF nurse and we see sooo many different cases. just sending you some good luck and positive thoughts from the garden state, good ole jersey....

June Bug Momma said...

Oh gawd Sarah...I hope your embaby is the one that you make you a momma!! I'm keeping my fingers crossed and wishing only the best for you!! Good luck!! :o)