Cautiously Optimistic

Eli is so much like Clay.  Even its progression.

Got an update this morning that Eli is now a 4 cell grade 1 embryo on day three.  Clay was too at this stage.  You can read about it here.  We were so devastated the last time it happened.  We had to make a quick decision the morning of the day three transfer if we should transfer the embryo.  I cried.  It was a very tough decision to make.  We were not prepared for it.

Today, the situation was totally the opposite.  I was at my Bible Study leaders meeting.  I was trying to be good and not check my phone for an email from Dr. E until after the  meeting was over.  There was no news when I checked the first time.  The email came about 20 minutes later.  Dr. E, like last time, gave us a choice.  The following is her email:

“It’s a 4 cell grade 1 today.  We can: a. transfer today  b. still wait and transfer it with the frozen day 5 c. transfer the day 5 frozen embryo only if this one doesn’t make it.  I’ve seen 4 cell grade 1 embryos turn into beautiful blasts.” 

Bob and I talked on the phone.  I was relieved to see that it isn’t a 3 cell grade 3 embryo like Daisy who did not survive.  It’s grade 1 just like Clay.  Just a little slow.  It would’ve been nice for it to be 5, 6, 7, or 8 cell at this point. But it is not.  We have to accept that and move on.  Bob was jumping up and down with joy.  He thinks that we still have a good chance for Eli to survive, just like what Clay did.  He’s happy that it’s a grade 1.  So our inclination is to wait until day 5, see how it grows, and put it back with Clay.

Chatted with Dr. E afterwards.  She told me that not too long ago, one of her patients had a 4 cell grade 1 on day three that turned into a 5AA blastocyst and a pregnancy.  Anything is possible.  So we as a team decided to wait and see.  We’re definitely transferring Clay.  Let’s hope that Eli continues to grow and we will have both put back without any hesitation.

Grow Eli grow!

Thumbs up? Or thumbs down?

Bob and I feel that we have grown a whole lot individually and as a couple in the last couple of days.  This has been such a huge emotional roller coaster ride.  I do not wish this upon anyone.  Infertility sucks.

Dr. E called on Friday to let us know that one of the embryos had been growing better than the other two.  In other words, the other two weren’t doing well.  That one good embryo was a grade one, two-cell embryo, which was where it should have been at on day two.  She said she’d update us the morning of transfer on day three.  Needless to say, I was happy that we had one good one but was a bit bumped about the other two.  One thing I helped myself to be sane was NOT to consult with Dr. Google.  I decided to be an ostrich and buried my head in the sand.  I didn’t look up any information online and just proceeded to have a very good rest of the day.

Saturday was supposed to be transfer day.  We were getting ready to go to my pre-transfer acupuncture session at 8:30 when Dr. E called.  Unfortunately my phone had been acting up lately and her phone call went straight to voice mail.  She emailed me for me to give her a call.  It can’t be a good thing when your own RE wants to talk to you right before transfer, right?  When I called her back, she was about to begin a retrieval.  She promised to call us back after the procedure was done.  My heart was pounding so hard.  I was trying to guess what the news would be.  On our way to acupuncture, she called us back and said we have to discuss how the embryos were doing.

Here is the gist of it: the one good grade-one embryo was still a grade-one.  However, it was a four-cell embryo rather than at five- to six-cell.  Dr. E said that she had one patient with a pregnancy resulting from a four-cell embryo with a day-three transfer eight years ago.  In other words, it’s very rare.  It’s not impossible, but rare.  So the pregnancy success rate with a day-three four-cell embryo is low.  What we could also do was to wait until day five and see if the embryo turned into a blastocyst.  If it did, then the implantation and pregnancy rates would increase greatly.  However, since it was only a four-cell embryo on day three, the chances of it becoming a blastocyst would still be low, but not as low as getting pregnant with a four-cell embryo on day three.  Our job was to make a decision two hours before the scheduled transfer and let her know.  She also mentioned that the lab we are using is very good with culture so the embryo being cultured at the lab will be as good as being in my uterus.  She said that letting it grow to day five will give us a lot of diagnostic information for the next round if it doesn’t work for this round.

One of the other two embryos decided to join in the race and turned into a two-cell embryo on day three.  Dr. E said that miracles do happen but we probably wouldn’t think too much about this one embryo.

My first instinct was to let the four-cell embryo grow to day five.  Bob’s first instinct was to put it back and see what happened.  There were so many what-ifs.  We had to go into my acupuncturist’s practice, apologize for being late, talk to her, talk with each other, and go out to pray.  We prayed and talked some more.  It was almost the toughest decision that we had to make when all of our hopes and dreams for this cycle are riding on this one tiny embryo.

I had been trying to be strong in this whole journey since things were going quite well for us.  I finally couldn’t hold my tears and cried like a baby.  Why does it have to be so hard?  Why couldn’t we just have a couple of embryos that looked fine so that we could put them back?  Why did we have to struggle with a decision that could mean baby or no baby?

Bob wanted to give the embryo a chance in my uterus instead of letting it die in the lab.  We decided to go ahead with the transfer.  I went inside to get my acupuncture done while he called Dr. E.  A couple of minutes later, Bob knocked on the door and said that Dr. E wanted to chat with me.

Lying on the acupuncture table, tears streamed down my eyes and soaked my ears.  Dr. E wanted to protect me physically and emotionally for the next two weeks.  If we did the transfer and got a BFN in two weeks, the physical and emotional toll on me would be great.  She called this IVF naivete and that we would make a very different decision if we had done a few rounds of IVF already.  If we still decided to transfer today, she would be 100% supportive of our decision.  Dr. E’s words, expertise, and my trust in her helped us decide to let the embryo grow until day five.

In a matter of days, we went from three embryos to potentially none.

While I was in the acupuncture session, Bob chatted with Dr. E about the embryos and all the implications.  The lab normally doesn’t give an update on the embryos on day four but Dr. E would request for one and let us know how they are doing.

The rest of the day was fine.  Bob and I picked ourselves up, went and enjoyed a very good day together.  Sitting in front of the ocean in our car, we talked about our hopes and dreams, what we had to go through to make a baby, and how to trust that God would provide.  My mind has already gone to plan B, C, and D.  Even the words “donor eggs” came across my mind.

Bob kept on joking that at four-day old, his offspring is already like him, being very slow in growing and taking its sweet time.  Got to appreciate a funny husband at times like these.

With a few more tear drops last night, I went to bed thanking God for giving us a great RE.  I prayed for a healthy embryo and for God’s will to be done.  I woke up this morning feeling refreshed.  Bob usually has his phone on mute.  At 8:45, he went and picked up his phone and just happened to see that a call was coming in.  It was Dr. E calling bright and early in the morning!  When I knew it was her, all my muscles started tensing up and I buried my head in the comforter.  I could hear a bit of what she was saying to Bob.  Once I heard the words “great news”, I jumped up and looked at Bob.  He put the phone on speaker so we both could hear the news.  The four-cell embryo yesterday decided to do a bit of a catch up and it is now a very good looking morula!  Apparently the morula stage is where it is supposed to be on day four right before it turns into a blastocyst on day five!  Wow it went from a four-cell to a morula in a matter of one day?!?  Dr. E said that there is a 95% of chance that it will turn into a blastocyst tomorrow!  Talk about a major turn of events.  We went from a 5% chance of it turning into a blastocyst to 95%!  The other embryo also turned from a two-cell to an eight-cell embryo.   It’s a grade-three so quality isn’t as good.  We don’t know what will happen to it.  We’ll just have to wait and see.

Dr. E told us to get ready for our transfer at 10:15am tomorrow, five days after our egg retrieval.

We went from a high five, to an okay, and now maybe one thumb or two thumbs.  Will it be a thumbs up or thumbs down?  Only God knows.  🙂  I can’t wait to see what the future holds.