When I first went over the basics of IVF fertilization and embryo growth wasn’t included as a step. While it’s technically not a stage of IVF it was definitely separate from the egg retrieval and not included as part of the transfer. From here on out, I’m calling it a step. It was definitely on it’s own level in the middle of this process.
As you know, my egg retrieval yielded an outstanding 35 eggs. After retrieval there are three separate reports. The first report is day one after retrieval (so the next day), and involves the number of mature eggs and the number of fertilized eggs. The second report is on day 3 after retrieval. The third and final report is on day 5, usually the day of the embryo transfer.
Prior to my egg retrieval it was suggested that we try ICSI on half of our eggs. ICSI stands for intra-cytoplasmic sperm injection. Basically, ICSI involves injecting a single sperm into a single egg. This differs from conventional fertilization where they pretty much dump a bunch of sperm on each egg and let them fight it out. Generally ICSI is used for couples with male factor infertility – aka sperm issues. My nurse explained that it was recommended to us, despite Casey’s super sperm, because we have unexplained infertility. According to her ICSI can improve fertilization rates in couples with unexplained infertility. This could potentially point to an issue with the fertilization process, or my eggs, but it’s mostly just more effective over all. It was to be treated like a safety net, so we bit the bullet, forked out the extra cash, and decided to use ICSI on half of the eggs retrieved.
Day One: On day on I received a call from my nurse tell me that I had 14 eggs left fertilized and growing. Fuck. Logically, I knew that there would be a drop off between retrieval and fertilization. I knew because I have done buckets of research, and because they told me at least 12 times. Logic did not prepare me for that number. Not even a little. It is heart wrenching.
Out of my 35 eggs 25 of them were mature. This means that 10 were out of the game right away. Immature eggs are to be expected, not all follicles grow at the same rate, so there are going to be some that are too small to produce a mature egg ready for fertilization. The 25 eggs were split for the fertilization process, with 13 eggs being fertilized with ICSI and 12 eggs being fertilized with conventional fertilization. Out of the 12 eggs conventionally fertilized only 4 properly fertilized. Out of the 13 ICSI eggs 10 fertilized. I never really got an answer as to what this means, if it indicates a potential problem for us or not. To me, that is a VERY significant difference in the percentage of eggs fertilized. That’s 33% vs 77% for anyone who doesn’t want to do the math.
I’m happy we did ICSI on at least half of the eggs. If we end up needing a second round of IVF I will definitely choose to fertilize all of my eggs with ICSI.
Prior to the retrieval I was told about 70% of the eggs retrieved will be mature and about 70% of the mature eggs will fertilize. If we apply this to my eggs I would have ended up with 17 eggs fertilized, so I came in a bit below average. It was disappointing to say the least, especially after my awesome response to my stimulation medication and large number of follicles retrieved.
Day 3: The second report involves how many embryos are still growing/dividing properly. One day 3 we were left with 9 embryos, and were told that they were looking and growing right on track. My nurse said we would lose about 60% by day 5, and that we wanted 6 embryos left on Day 5. (60% of 9 is 5.4 for anyone wondering).
Day 5: Waiting for Day 5 was the most difficult wait. I was terrified that none of my embryos would make it, and that I would have nothing to transfer. Early morning on Day 5 I got a call from not my nurse giving me some basic instructions and telling me that we do have embryos to transfer and to show up at 11am. No report on my remaining embryos by phone, I had to wait until I arrived at the office to hear about them. When I arrived we had three embryos ready for transfer, all grade A. Yes, A is the best in embryo grading too. We also had 5 embryos remaining that they were going to watch into day 6 to see if any progressed to blastocyst (the stage that they want to freeze at). My doctor was hopeful that some of those 5 embryos would be ready to freeze by the next day.
I’m saving the embryo transfer story and final embryo report for my next post, it deserves it.
I could have included all of my fertilization and embryo growth reports with my retrieval, or my transfer. But it was very much it’s own thing. Waiting to hear how many made it was excruciating. Making embryos was a lot more emotional than expected. I get grossly sappy just thinking about it. For the first time, I knew for sure that we made something together. I’m not going to argue about when life begins, but dammit – Casey and I made these tiny little starter humans and I am fucking proud of every one!