See, I am doing a new thing! Now it springs up; do you not perceive it?

I am making a way in the wilderness and streams in the wasteland.

Isaiah 43:19

Wednesday, 7 November 2012

Waiting - Fertilisation to Biopsy Results

Our clinic do PGD using arrayCGH testing (they actually had the first aCGH baby in the world!). They do the testing on day 3 and the transfer usually on day 5, but occasionally on day 6.

Day 1 - Fertilisation Report

On the morning following egg collection, I had a call to say 'Good news!' Of my 23 eggs, 13 were mature, and 11 had fertilised.

To be honest, 23 to 11 seemed like a big drop and I felt pretty deflated and disappointed following this conversation. However, looking back, I can see that God answered a very particular prayer I had been praying throughout the stimulation phase - that I would have the RIGHT amount of eggs, and not too few (giving anxiety over the testing phase) or too many (leading to OHSS or decreased egg quality). In retrospect, 13 was indeed the perfect number - and it is indeed a very good number of mature eggs and had someone told me at the start of the process that I would have 13, I would have been very pleased - but it worried me at the time.

Day 2 - Embryo Development

The next day I was very nervous about the call as the day before's hadn't gone as I had hoped. I needn't have worried! The embryologist reported that ALL ELEVEN fertilised eggs were now embryos, and all on track for this stage. We had one 3-cell grade 3, and the other 10 an even split of grade 1 and 2 (our clinic grades 1 as the best quality). We were completely over the moon, I had never expected so many to keep growing or to be of such good quality. The embryologists were very pleased indeed with how things were going. A wonderful day.

Day 3 - Biopsy

On the afternoon of day 3, I had the call I was most nervous about thus far: to tell us how many embryos had been able to be biopsied. ArrayCGH does not just screen embryos for a known genetic condition (i.e. translocation), but for a range of chromosomal abnormalities. This is really good news as even younger women (under 35) have up to 40% of embryos developing spontaneous chromosomal abnormalities, and chromosomal abnormalities are reckoned to be the biggest cause of miscarriage, so it is great to know that the embryo put back inside you has such an increased chance at health and life. However, when one factors into account a genetic condition as well, this leads to a high number of unviable embryos. For me, the translocation affects 50%, but the clinic expect around 80% to be unusable, due to spontaneous abnormalities. So I was really really hoping that at least 8 of our embryos would have survived to biopsy; I know from other peoples' PGD journeys that 8 would be a great number to have.

Imagine my shock, therefore, when the embryologist tells me that ALL ELEVEN were able to be biopsied!!! One was sadly lost (stuck in a pipette) during the biopsy, so we were waiting on the results of 10 embryos, and I knew this was a really great position to be in. However, with PGD, there are no guarantees and sometimes even high numbers of embryos are all affected, so waiting for the biopsy results was the hardest time for me of this whole procedure (so far! imagine the day before pregnancy test won't be great!).

Day 4  - Booking the Transfer

Our clinic don't check the embryos on day 4. They check them on the morning of day 5 and update the patients after that, with the biopsy results (I know some clinics give biopsy results on day 4, lucky patients!). So we were booked in for transfer the following day, without anyone knowing whether we'd have an embryo to transfer, as the clinic were at pains to inform me!

Day 5 - Biopsy Results and Embryo Update

On the morning of day 5, I had a work training session, so hubby took the call and I had to wait until midday to find out! It was absolute torture, especially as the training session overran. I ran from work to the car to meet my hubby, trying to judge his facial expressions as I approached...

We had 3 viable embryos!!! We were both so ecstatic! 2 of these were really good quality, meaning we could transfer 1 and freeze the other, but the third was not looking good quality so the clinic weren't going to freeze it. (They did leave it until day 6 and checked it again, but it hadn't improved.) Another wonderful day!

And so now onto the best part so far, the holy grail of embryo transfer...

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