Day 1 of the TWW

We had our transfer this morning around 11:20 mountain time.

We transferred our two highest grade embryos. The embryologist  said they thawed beautifully, twice.  During the procedure, the ultrasound tech did mention that I have a retroverted uterus (it tilts back instead of forward), but this is a non-issue.

After an hour on my back (and one bedpan visit later), I’m back in the hotel on bedrest for the rest of today and all of tomorrow.  My nurse just called with my lab results and they’re “beautiful.”  My estrogen is 942 and the progesterone is 52, so no med changes are needed

On Thursaday, life mostly returns to normal except for the anxiety and stress and paranoia about every little twitch, twinge, and decision between now and our November 29 pregnancy test.

But, in the meantime, I have papers to grade and a new semester to plan while we wait to see what these two little hatchlings do.



Tomorrow is Transfer #3

Tomorrow is transfer #3.

I’ll wake early, so my husband can stab me with my every-other-day progesterone shot. Then I’ll kill several hours (and take two more meds) before we arrive at the clinic at 9:45 (10:45 central).

We’ll check in, and I’ll have blood drawn to check my estrogen and progesterone levels then head upstairs to the surgery area.

Meanwhile, I’ll sip my bottle of water, filling my bladder, so the ultrasound can guide the doctor’s placement of our embryos. The clinic thinks I need a full bottle of water between the time I arrive and the time we do the transfer. They’re clearly unfamiliar with my bladder. I’ll pace myself.

(Our first transfer required an undignified experience with a bedpan during the hour long post-transfer wait–try to do that while lying flat on your back.  Our second transfer required me to partially empty my bladder before the transfer because it was too full and a speedy trip to the restroom the very second my hour was up.)

Once upstairs, I’ll change, and the nurse will run through our information again and give me  Valium.  It helps recipients relax and prevents uterine contractions.

Then we hang out until transfer: 11:45 (12:45 central).  The ultrasound tech will come and go checking my bladder, and we’ll meet the embryologist responsible for the shipping and handling of our microscopic embryos.

Eventually, our doctor will arrive, and our room will be filled with the many people we need to make a baby.  We’ll see our two embryos on the screen and confirm and verify (again) the number to transfer and the number remaining.

Then the doctor will thread the tiny catheter through my cervix and into my uterus, depositing our embryos, and I will spend the next hour flat on my back with my head tilted slightly down.

When the hour is up, we will go back to the hotel where I’ll remain on bedrest for the remainder of Tuesday and all of Wednesday.  I’ll be on my back or side, leaving the bed only to visit the restroom and take meds.

Thursday we go home, and my life mostly goes back to normal.  I won’t lift more than 10 pounds; I won’t raise my body temperature–so no baths or hot showers and no electric blanket.  I’ll keep taking all my meds.

And we’ll wait.




7 Days to Transfer #3

We are one week from our third embryo transfer.

And I’m in a really shitty mood.

Between work, my personal life, and infertility, it’s been a very stressful couple of weeks.  And now with all the “family” holidays here, the obligations and socializing and holiday stress is mounting too.  All I really want to do is go to bed and sleep until the new semester starts in January.  And even then I might pull a groundhog move: peeking out from under my covers and determining I need six more weeks of sleep.

I’m sure part of it (probably most of it) is the hormones, and I’m not even on that many yet.  Currently, I’m on a thyroid pill, 4 estrogen patches (changed every other day), lupron injections, baby aspirin, and prenatal vitamins.  Thursday, I stop the lupron and add the vaginal progesterone (twice daily), medrol, and doxycycline.  Friday, I become the human dartboard as my husband starts giving me the progesterone injections.  Then November 20, we transfer.

And no part of me is excited .

Why would I be?  I’m sure it’s going to fail again.  We’ve been here, done this.  Twice.  And we’ve failed twice.  And that’s after we failed trying to retrieve my eggs which came after we failed to get pregnant on our own. Why would this time be any different?  Sure, we have ten high-quality blastocysts, nine of which tested normal.  But plenty of people CCS test and still fail.  And the latest stats I’m hearing say it takes three to four transfers using donor eggs to get pregnant.  So why would this one work?  And if it doesn’t, I’ll find out at the end of November, ruining both my birthday and Christmas again (our first transfer fail was confirmed on December 26 last year).  Better yet, what new thing will go wrong?  There’s always another infertility shoe.  And if it does take, there’s no guarantee that it won’t be a chemical pregnancy or result in a miscarriage.

And there’s literally nothing I can do.

Okay, so that’s not quite true.  But I’m not buying into the wives’ tales and infertility myths.

I’m not eating pineapple core (*gag*).  And I’m not wearing custom-ordered “sticky embabie” socks (I’ve spent enough money on infertility already) or subscribing to a special infertility transfer package (but kuddos the woman who made that into a business).  I’m not doing any acai plan (nope, not happenin’) or eating only vegan, vegetarian, keto, or some other diet (really?  y’all know how much I hate cooking, right?).  I won’t be taking the two week wait off of work to “take it easy” (hahaha).  And I’m not eating McDonald’s french fries immediately after transfer (okay, I might actually do this one just because yum).

But I do have this guy.  He lives on the end table, overseeing my meds.


Because when your GP, who began the conversation with “I know there’s nothing scientific about it all,” offers to bring you the Aztec fertility statue she brought home from Mexico, you take it.  Unscientifically, she and her husband had an infant all but dropped in their laps within months of bringing home the statue, and her hairdresser got pregnant within two months of the statue coming to live at her house.  I do, however, fully recognize the irony in my receiving a fertility statue that has, very obviously, been seriously broken and hot-glued back together.

With so much of infertility and conception out of my control, I’m doing the only things I can.

I’m following my calendar and doctor’s instructions.  I’m mostly not thinking about the upcoming transfer and the following two week wait.  I decorated for Christmas because I know if we get bad news at the end of the month, I will have no desire to decorate, and as much as having no real reason to do so (no excited children or holiday traditions or presents under the tree) makes me sad, the lights and ornaments and greenery are cheerful.

So here’s my view for the next several weeks, just because the “pretty” makes me happy and I need all the happy I can get.

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(un)Happy Halloween

On good days, my level of awareness of our childlessness is a dull background hum punctuated by moments of sheer terror when I remember that I need to take medicine (even though the dose is hours away) or moments of breath taking shock when I’m blindsided by my infertility.  Bad days, however, put our infertility front and center, social media rubbing my nose in it at every swipe, babies and pregnancies highlighted at every turn.  Holidays are some of the bad days (along with the first day of school and every day of yet another pregnancy announcement or baby cuteness overload).

For some, holidays are times of joy and family and memories.  For others, holidays are sadness and missing pieces and unmade memories.  Those of us with infertility know the holidays will be hard.  Some will face never-ending questions about when we’re going to start a family–questions often accompanied by not-so-helpful conception advice and reminders of our advancing age.  Others choke back tears while forcing the socially expected smiles at the happy families creating their own traditions.

For some of us this has been a hard week.  We desperately want our own cute, little monsters and scary ghosts.  We fantasize about the pumpkin carving and costumes we could use to announce our own pregnancies.

Even with our transfer nearing, I’ve felt the spiral starting for some time.  Last weekend, I went back home to take photos; I had to finish up a couple of senior sessions and shoot a 13 month old.  I knew that one would be hard.  Not only was he adorable, but he’s the single happiest child I’ve ever had the privilege to photograph, so when he reached out for me to hold him, my heart broke.

Later, I helped with a Halloween party.  I hadn’t planned on it, and I knew going in that seeing all those children in their costumes would be rough.  It was.  There were superheroes and butterflies and policemen and even Dorothy with Toto in her basket and very polite T-rex.  The kids decorated pumpkins and played games and ate snacks.  My cousin and her children arrived, and I held her youngest while his older sisters ran from game to game.  Really, I only held him until I had to excuse myself from the festivities for an injection.  Another reminder of my own infertility–as if the hoards of children weren’t enough.

The next day, I definitely felt the burnout from over-exposure to other people’s children.  While photographing kids and helping with the party were fun, they were also draining.  I tried to keep it together because I had one more set of photos to take when I finally arrived home, and it would have been terribly unprofessional to show up with mascara streaks down my face.

And then Halloween itself arrived and with it, the facebook flood of sugar-high trick-or-treaters and the Halloween-themed baby bumps.  And I broke.  I sat in my pajamas on top of my floor furnace and cried.  I cried for another year of no little goblins to dress up in themed costumes.  I cried for no trips to pumpkin patches and no evenings spent carving.  I took my personal pity party to the next level and even cried for Halloween chocolate.  (This no-caffeine rule is especially stupid at Halloween with all it’s many delicious mini-chocolate varieties; it’s doubly stupid when I’m all hopped up on chocolate-craving-inducing hormones.)


Then, as I looked at those pictures, I cried for the other men and women who stayed home with the lights off or avoided being home altogether because they couldn’t bear to see all the costumed kiddos.  I cried for the moms and dads who couldn’t help but see their missing superhero in their trick or treat crews.

And I cried because I feel guilty.

Those of us with infertility endure not only our sadness but also guilt because we know our lack of enthusiasm is written on our faces.  We feel guilty because we don’t want to dampen everyone else’s spirits.  We feel guilty because our joy is, at best, tinged with sadness and, at worst, drowned in sorrow.  We feel guilty because sometimes we want to just skip the holidays altogether. And because sometimes we do.


Mind over Injections

I’ve given myself dozens of shots.  Infertility will do that to you.  But it doesn’t seem to matter how many shots or how many days in a row, it’s still all a mental game.

Knowing that today was the first “big” day of our transfer prep, I finally organized all my meds.  I emptied the giant box of “leftovers” that lives under my coffee table, sorting out medications I could use for this transfer (and organizing them by expiration date).  Then I organized the new meds to use once the old ones were depleted.

med box

Periodically throughout the day, I checked the clock.  I added the Lupron (the shot I started today) to my medication app and set an alarm reminder as well.

At 6:30 I started paying attention to the clock.  I needed to finish posting and burning pictures, but I also wanted to soak in the tub.  Unfortunately, these two things couldn’t occur simultaneously, and I didn’t want to rush what would be one of my last relaxing baths.

At 6:47 I’d finished posting pictures but had only just begun burning their CDs.  I contemplated my next move. Should I eat while I burn?  That way I wouldn’t also have to eat after the bath (and feel rushed to get to bed at a decent hour) . . . but I wasn’t really very hungry.

At 7:00 my anxiety started to build, and my infertility OCD kicked in, so I checked my meds again, making sure I had the vial, syringe, and alcohol wipes.  Check, check, and check.  I contemplated drawing up my dose but talked myself out of it.

At 7:15 my alarm went off, telling me to get ready for the shot.  My stomach sank.

I went through my injection routine.  I washed my hands and gathered my supplies.  I opened the Lupron box, removing a single syringe and alcohol prep pad.  I opened the inner box, removing the vial of medication.  I tore open the alcohol prep pad and popped the cap off the vial and swiped circles on the top.  I placed the prep pad on it’s wrapper and waited for the vial to dry while I prepared the syringe.  I peeled the individual wrapper off like the skin of a banana.  I pulled the plunger back and pushed it in a time or two to help it slide a little more easily.  I slid it carefully to the line labeled 10, holding it up to the light to double check.

I removed the needle cap and gently slid the needle through the circled center of vial’s rubber top.  I inverted the needle and vial, so the needle was below the vial and pushed in on the plunger, the air from the needle filling the vial, changing the equilibrium allowing the the medicine to flow downward.  I slowly pulled the plunger down, drawing the liquid into the syringe.  It filled smoothly with only tiny bubbles at the bottom.  I flicked the syringe with my finger, encouraging the microscopic bubble to the top.  I pushed up on the plunger, forcing the air back into the vial and began pulling back down to continue filling the syringe to magic number–ten.  I double checked against the light, and it was ready.

It was 7:21.  I had time to kill.  I capped the syringe and waited.  I checked facebook and the clock.  7:22.  Then 7:23.



At 7:26, I caved and rolled my sweatshirt up, exposing my stomach.  I wiped slow alcohol circles to the right of my navel.  Still 7:26.  I waited for it to dry.

7:27.  I reminded myself to breathe as I stared at my stomach.  I turned off my alarm.  I didn’t want to hear it ring.

7:28.  I uncapped the needle and gripped the prepped skin and told myself to breathe.

7:29  I realized I wasn’t breathing and took a breath.  I imagined sticking the needle into my stomach.  I knew it would hurt but that it wouldn’t hurt as badly as I thought it would.  It never does.

7:30  My med app chimed.  It was time.  I froze like I do every time.  I told myself to just do it.  I didn’t move.  I breathed.  I imagined the needle sinking into my flesh.  But it didn’t move.  I breathed again.  I imagined the dart-like motion.  Nothing happened.

7:30  My hand flexed but didn’t make contact with my skin.  I breathed again.  Told myself to just do it already, get it over with, to hurry up, I needed to take my birth control pill RIGHT NOW too.  I realized my ears and face were hot.  I was holding my breath again.

The sting of the initial contact came as I finally committed.  I slid my hand up the syringe to the plunger and pushed.  The plunger didn’t move.  I pushed harder.  Still no movement.  Finally the burn of the liquid was followed by a wave of heat as the red ring of the medication appeared under my skin.

I wiped the tiny red dot from my skin as I removed the needle.  It thunked into the red container.  The first of many.

“You can’t possibly understand”

Years ago, I casually posted on facebook that I “needed” someone to come clean my house and fix supper, so I could just go to bed.  My work week had been extremely stressful week, and I had caught a bug from my students.  I didn’t feel good, and I was exhausted.

The first reply quickly suggested that I was lucky to be able to take the night off–I didn’t have to juggle my life and children after all.  I left teeth marks on my tongue.

We’re so quick to judge women who aren’t mothers as incapable of understanding love, pain, fear, and struggle.  I’ve heard it countless times, “You think you’re busy [or stressed or worried or tired or or or…..]?  Just wait ’til you have kids.”

We are incredibly dismissive of non-mothers, as if we are unworthy in comparison:

  • “You can’t understand because you’re just a step-mom.”
  • “You wouldn’t know because you’ve never stayed awake at night worrying for your kids.”
  • “You can’t possibly understand what it’s like.”
  • “Adopting’s just not the same, ya know?”
  • “What kind of a woman doesn’t want kids?”
  • “What kind of mother gives her kids up?”

One of the very first messages I received when the blog went live was from a woman who is “just” a step-mom and an aunt.  She wrote to express her frustration with these exact sentiments.  Weeks later, I got another message from woman who mothers daily but is also daily dismissed because she’s “just the stepmom.”

But stepmothers aren’t the only ones who are judged; society judges all kinds of mothers.  We judge women who have c-sections as “taking the easy way out.”  We judge working moms for “abandoning their children” and stay-at-home moms for not “setting a good (enough) example.”  We judge single moms and teen moms and older moms and moms of only children and those of bigger (than “normal”) families.  We judge strict moms and lenient moms, helicopter moms and lawnmower moms, moms who buy the wrong sunscreens, snacks, clothing, toys, and baby products.  We judge and criticize and challenge and suggest and advise.

And as much as we intellectually know it’s bullshit, we internalize those criticisms.  We judge ourselves. And because, at the bidding of society, we’ve torn ourselves all apart, we then subconsciously turn our internalized self-criticism on each other.  And the circle of judgement is complete.

Mostly, we’re quick to judge women.  We aren’t allowed to experience our lives on our own terms.  We’re conditioned to put on a pretty face: “Oh, everything’s great.  Just a little busy.”  We’re trained to be self-degrading: “Please excuse the mess; our house doesn’t always look this way.” We’re taught to think of others before we think of ourselves: “Oh, no, go right ahead.  I don’t really like dessert anyway.” We’re not allowed to be stressed or sad or pissed because someone somewhere else has had a different experience than we.

Notice I said different.  I didn’t say harder.  That’s part of the rhetoric that gets us in trouble.  It’s divisive.  Worse yet, it’s destructive.  It drives us underground.  We bear our burdens in silence, sinking under their weight.  We become less than we should be, crippled and stunted by the expectations and the pressure to hold it all together and not be honest. Because to admit that life is a messy, stressful, fear-inducing struggle is to fail.

And there’s no way we can admit failure.

The truth is our struggles don’t make any one of us better than another.  They unite us.  Instead of playing the who-has-it-worse game, we should be sharing our stories and holding each other up.  The details of our stories differ, but it’s ALL hard.  And far too many of us do it alone.

simply love


When You’re Tired of Waiting

You know how people joke about sending someone to the bathroom in the restaurant, so your table’s food will finally arrive?  Apparently that works for infertility, too.

Monday, I had given up.  I was tired of waiting for Cycle Day 1.  With no way of knowing how much longer we’d have to wait, I was afraid we’d get too close to the end of the year when our clinic closes for several weeks for the holidays.  I didn’t want to push the transfer, with all its medications, into 2019, especially since we’ve already met our deductible.

So I called my nurse to get the orders for an ultrasound and blood work.  Based upon those results, we would figure out the next step (perhaps starting birth control immediately or perhaps “encouraging” cycle day 1 with a progesterone shot).  Unfortunately, I did not get a call back from my nurse during the day, so I sent a message through the clinic’s system, knowing someone would answer it the next day.

Tuesday, I received a reply from a substitute nurse confirming that we were going to try to trigger my period.  Upon confirmation, she sent me the orders.  Unfortunately, it was late enough I couldn’t try to make a local ultrasound appointment.

Wednesday morning, I learned I wouldn’t have to.  Cycle Day 1 finally arrived saving me hundreds of dollars in tests.  aunt floSo, instead of calling my local clinic for an ultrasound appointment, I called the Denver donor nurse line.  (Wednesday is my nurse’s usual day off, and the substitute nurse told me that my nurse was off until Thursday, so I didn’t even bother calling her directly.)

Late Wednesday, I got a call back from another sub nurse.  That evening I downloaded my transfer calendar and monitoring orders, and today, I picked up some of my medications (and scheduled delivery for the one that comes from the specialty pharmacy).

So, we’re officially on the countdown.  Tomorrow, I start birth control.  Near the end of the month, I start the first injections, and at the very end of the month, I start the estrogen patches.  Mid-November, I add all the other medications.

And November 20, we’ll transfer two embryos.

When Your Body Betrays You

For a blog about infertility, I haven’t written anything about menstruation.  Well, stand forewarned readers, this is it.  We’re going to talk about periods, so if all “that” talk makes you squeamish, feel free to skip this post (or read on anyway to learn about the complicated relationship we women have with our bodies).

body betrayal

I’ve often heard women faced with infertility express frustration and even hatred at their own bodies for betraying them.  After all, for those of us with infertility, our bodies flat refuse to do precisely what they were designed to.

I, however, wasn’t one of those women.  Certainly, I’ve been upset and frustrated and angry–just never at my body.  It wasn’t my body’s–or my–fault.  I’m just infertile.

Today, however, is different.


It’s different because I’m late.  And I’m not just a little late.   I’m really late.  My cycle has always been somewhere between 28 and 32 days with months and months exactly the same.  As a teenager, I was so regular I knew not only the day I would start but also the time.  Twice a year my cycle shifted going from either around 28 days to closer to 32 or reversing from close to 32 to around 28.

And since I started in February of the year I was 16, I have never missed a single period.  That’s almost 20 years of clockwork.  That’s 12 periods per year right on schedule.  That’s 235 timely visits from Aunt Flo.

So, why the hell, is #236 suddenly an issue?

My cycle is currently somewhere between 37 and 46 days.  I don’t know for sure.  As I explained in my last post, I screwed up and didn’t write down the actual day of August’s Cycle Day 1 (CD1).  I do know, however, that it was sometime after our donor’s CD1 and before her retrieval (Aug. 22).

But, my poor documentation doesn’t really matter, and it certainly doesn’t piss me off.

My body’s betrayal does.

For all my infertility issues, my period was the one thing I could count on.  I didn’t suffer from irregular and unpredictable periods like other women.  I knew when it would happen.  I could count on it.

And I have predictable symptoms: my breasts are so tender I can’t roll over in bed without instant pain; my joints, especially my hips and ankles ache so badly they keep me awake; and the cramps are so intense I’m immobilized in bed with a head pad, any movement causing another round of nausea and gut-twisting agony. Sometimes I bleed so heavily I spend two days carrying extra clothing in my car.

But this month?  No breast pain, no achy joints, no cramps.  This month, my body is refusing to do the one thing it has always done.

Maybe I’m too stressed.

Maybe this is my latest menopause symptom.

Maybe the universe has a really sick sense of humor and has chosen now as the time to give me a break from the pain and aches and cramps.

Maybe my uterus heard me say that if this baby thing doesn’t work out, I should just have it removed and not have to deal with periods anymore.

So, today, on day 37 (or 46), I finally gave in and called our nurse.  I explained the delay and made the somewhat (but not really) off-hand comment that maybe this was menopause.  She confirmed it could be.  Then she explained that 90% of the women she works with are pre-menopausal or in menopause; this isn’t an issue.  She asked if I had taken a urine test (I had).  She also mentioned that every woman misses a period, so I countered with my extraordinarily regular cycle.  Her reply?  Yeah, but we want it to come this time.  (And she’s not wrong . . .)

Currently, I have two options:
1) wait (sooner or later, it’ll start) or
2) go in for labs and an ultrasound (which aren’t covered by my insurance) and depending on the results, perhaps take a progesterone shot to trigger my period

Today, I chose to wait.  We still have time to get the transfer done this year (while my deductible is met and before the clinic shuts down for the holidays).

So, tonight, like every night for the last 37 to 46 days, I’m going to bed without the heating pad or the fear of bleeding all over the sheets while I sleep.

Waiting on CD1

We had a phone consult with our doctor on Friday.  He was very impressed with our egg and blastocyst count.  His exact words were “hall of fame.”

I asked about the 50% DNA testing failure.  He confirmed it was a high rate of abnormal blasts for a young donor like ours which lead him to believe that the sperm were contributing to the anomalies.  The clinic has seen this scenario before, where a repeat donor has different rates of abnormality with different male partners.  (This also likely explains why we had such a low number of embryos with the first donor–three–and perhaps why none of them were successful–we didn’t test them.)

That said, he is thrilled with the number of blasts we have (10) and assured us that they are all equally good quality.  He said repeatedly that we have more blasts than we will ever use.  Then he asked if we had a calendar, and I had to say no because we’re still waiting on cycle day 1.

Waiting on cycle day 1 (CD1–the first day of a woman’s menstrual cycle) is a contentious topic for infertile couples for a lot of different reasons.  For some women, CD1 is evidence of yet another month of failure, spiraling them into another bout with disappointment-induced depression.  For others, it’s a shining moment of joy because fertility work revolves around CD1, so it’s arrival signals the beginning of a hopeful timeline.

When we were trying naturally, CD1 didn’t really upset me.  I understood from the start that it was very unlikely that we’d conceive right away.  Most women don’t. And at my age, I knew it would take some time.  So, we just kept trying and waiting.  Then we started calculating and tracking, and CD1 became the marker for planning and scheduling.

When it became clear that we weren’t going to conceive on our own, CD1 took on another significance.  It became the basis for taking medications and making appointments.  When the clomid didn’t work, CD1 was evidence we needed to find an expert.

For the last couple of years, CD1 has been the marker for testing, medication, and procedure schedules.  This month is no different–except I screwed it up.

I don’t quite remember what all was going on last month, but I do know that I was busy and stressed and quite frankly didn’t care much, so I failed to note the date of August’s CD1.  It didn’t really matter because our donor’s CD1 was much more important.  On my CD1, I do remember thinking that I wasn’t too far behind our donor, and I think I made a note about the approximate date a while later.

Unfortunately, my poor record keeping now means I don’t know the projected date of September’s CD1.

It’s now September 22.  According to my inaccurate note, I’m late by over a week.  I’m fairly regular, but it’s not unheard of for my cycle to go long by up to a week once or twice a year.  But I have no way of being sure where I’m really at now.

Part of me, like all infertile women I know, wonders . . . what if?  Should I test?  Most of me–the vast majority, in fact–knows that I shouldn’t waste my time or energy.  While I cannot say that it’s completely impossible that I could be pregnant, it is extremely unlikely.  Frankly, I don’t want to be pregnant.  If I was, between my poor egg quality and whatever is going on with my husband’s sperm, the pregnancy would most likely end in miscarriage, and it would just mean more wasted time before we can transfer.

Ultimately, though, my poor record-keeping doesn’t matter much.  We can’t do anything until CD1 anyway, and there’s not much do to but wait.

Grading the Blasts

To recap, the retrieval yielded 29 eggs of which 24 were mature.  Twenty-two fertilized, and 18 made it to the blastocyst stage on Day 5 or 6.  Those 18 were biopsied, removing just enough DNA for Comprehensive Chromosome Screening (CCS). The embryos that were correctly formed were then graded.

First, the blastocyst stage is graded 1-6.
stage 1

Stage 1
Early Blastocyst:
Blastocoel (fluid filled cavity that results from the splitting of a fertilized egg) is less than half the volume of the embryo.



stage 2


Stage 2
Blastocoel is more than half the volume of the embryo.



stage 2-3


Stage 2/3
Blastocoel completely fills the cavity, but the ICM and trophectoderm are undefined.



stage 3


Stage 3
Full Blastocyst:
Blastocoel completely fills the embryo.



stage 4


Stage 4
Expanded Blastocyst:
Larger blastocoel and thinning zona pellucida is seen.




stage 5


Stage 5
Hatching Blastocyst:
Trophectoderm is herniating through zona pellucida.



stage 6


Stage 6:
Hatched Blastocyst:
Blastocyst has escaped from zona pellucida.



For blasts graded as stage 3 to 6, the Inner Cell Mass (ICM) and the trophectoderm are also graded.  The ICM will become the fetus, and the trophectoderm will become the placenta.  Both are graded on a letter grade scale: A, B, C.

ICM Grading
A: Tightly packed, many cells
B: Loosely grouped, several cells
C: Very few cells

Trophectoderm Grading
A: Many cells forming a cohesive epithelium
B: Few cells forming a loose epithelium
C: Very few cells

Our blasts were also classified as day 5 or day 6 embryos (identifying the day they reached blastocyst stage).  Last week, we got the report card.

Embryo Report Card:
#1: Correct: Day 5: 4BB
#2: Correct: Day 5: 5AB
#3: Correct: Day 5: 5AB
#4: Incorrect
#5: Correct: Day 6: 6AA
#6: Correct: Day 6: 6AA
#7: Correct: Day 6: 5AB
#8: Incorrect
#9:  Did not fertilize
#10: Did not fertilize
#11: Did not fertilize
#12: Did not fertilize
#13: Correct: Day 5: 4BB
#14: Incorrect
#15: Correct: Day 5: 5AB
#16: Incorrect
#17: Incorrect
#18: No result: Day 6: 5AB
#19: Correct: Day 6: 5BA
#20: Incorrect
#21: Incorrect
#22: Incorrect

Of our 18 blasts, 9 were incorrect, 1 had no result, and 9 were correct.  The incorrect embryos had an anomaly in their chromosomes–likely lacking a chromosome (or part of a chromosome) or having additional copies.  These embryos were discarded.  The no result for embryo #18 was because not enough cells were extracted for testing.  We have the option of having it retested or transferring it without testing.

Day 5 embryos are better quality than Day 6 (they grew more rapidly).  Likewise, higher stages are better than lower (but both Stage 5 and 6 are good), and A’s are better than B’s which are better than C’s.

Our best three embryos are Day 5: 5AB: #2, #3, and #15.  The next best two are Day 5: 4BB: #1 and #13.  Then we have two more from Day 6: 6AA: #5, #6 and an additional two Day 6: 5AB: #7, #18.  Finally, we have one Day 6: 5BA: #19.

As part of the chromosomal screening, the sex of each embryo is also known.  Of our 10 embryos, 6 are male and 4 are female.  We did not find out which embryo is which gender.

We have a follow-up with our doctor on Friday to discuss our results and which embryo(s) to transfer.  Once, we hit cycle day 1, we’ll have our calendar and be on the countdown to transfer again.