1/15/2009

Clarification on the number of 'normal' embryos

My last post was a bit confusing, especially the part about the number of normal embryos. It's very difficult to gather my thoughts and type these days.

With my 1st IVF here in Pensacola, we had 18 embryos. 17 of which made it to Day 3 for the biopsy. Our RE told us that he will screen for 13 and 15 specifically, as DH has the Robertsonian Translocation 13;15. BTW, this RE was the one who had Jerry karyotyped in the first place. Anyway... As I developed severe OHSS, it was a freeze-all. So the 8 'normal' Day 5 embryos were frozen the old-fashioned way. (The reason I say Day 5 instead of blasts is because this RE didn't check if they were actually blasts and did any embryo grading. We didn't find this out until after our 3rd FET with him.) So we had 8 'normal' Day 5 embryos in the freezer waiting for us. There were 5 boys and 3 girls.

My 1st FET was canceled due to nonsuppression.

My 2nd FET, the RE transferred 1 embryo. Because we already knew the sex of the embryos, we were given a choice on which sex to transfer. We really didn't care as long as the embryo was healthy. So we did a eeni-meeni-miney-moe thing and chose a girl. We figured that the girl embryo might not survive the thaw, given the odds of the freeze-thaw process. He said that if the first embryo that they thaw didn't survive, he'd go back and thaw another one until he got one that he could transfer. We were pleasantly surprised when this RE told us that everything is A-OK for the transfer. We thought, wow, first one thawed and everything is ok. We thought we beat the odds. Before he actually transferred the girl embryo into my uterus, I asked him one last time if this embryo was a healthy one. He assured me that the embryo was healthy. The transfer took place, the embryologist popped his head in the room just long enough to practically throw us a picture of the embryo. BFN.


My 3rd FET, the RE transferred 2 embryos. This time, we picked 2 boys to transfer. Whoa, we lucked out again that the next two embryos made the thaw. We thought that we beat the odds on the thaw yet again. Again, I asked if the embryos were healthy. And again, he assured me that they were. After the transfer, the embryologist tossed us a pic of the embryos. BFN again.


I compared the pics of our embryos to the ones on the Internet. I am not an expert, but clearly our embryos didn't look like normal healthy embryos. I had so many questions. I asked the IVF coordinator if this RE ever had any success with FETs. She put me on hold for a couple of minutes to look it up. She said that there were no successes as of yet. Then I asked her questions about our embryos. But everytime I would ask her a question about the embryos, she would tell me that she had to ask the RE and would call me back. I never did get a call back. So I called and requested a re-group with the RE.

At this re-group, I specifically asked the RE about the embryos qualities. I even showed him the pictures of the embryos and asked him to tell me if he thought the embryos looked "healthy." His answer was that he couldn't tell by the pictures and that he'd have to talk with his embryologist and get back to us. I also asked him if he did assisted hatching. Again, he said that he'd have to ask the embryologist. Then I brought out the PGD-FISH report on the 17 embryos. I pointed out that 13, 18, 21, X, and Y chromosomes were tested and asked him why wasn't 15 tested, knowing that Jerry has a Robertsonian Translocation with both 13 & 15. He said something about the percentage of the sperm having both 13 & 15 is very low or something to that effect. His answer didn't make sense to me at all. Then I asked him what he would recommend as the next course of action, being that we had 5 'normal' embryos left. He said for us to do another FET, possibly transferring all of them. I also asked him if he's ever had any success with FETs. When he said yes, I told him that I asked his IVF coordinator the same question and that she told me no. We left the office numb.

That evening, the RE called me. By this time, I even had more questions for him. I asked him if the embryos that he transferred were expanded blasts. What he told me made my heart sink. He told me usually healthy embryos re-expand within 7 hours. However, ours didn't re-expand. But he decided to transfer them anyway; he hoped that they would do better in the uterus. I was thinking, how could he tell me (with a smile on his face) that they were "healthy"? Not once but twice, each time before transfer. I was so hurt that he basically didn't tell us the truth.

The next morning, the embryologist called me. I asked him about the embryo grading, and he said that they were very good quality. I tried to get him to pinpoint down a specific grade, but he couldn't tell me. He told me that he didn't have my chart in front of him. Um, then how could he remember that they were very good quality? Interesting. I asked about assisted hatching, and he told me that he always does assisted hatching on frozen embryos. I was confused, as I thought assisted hatching was already done before doing the biopsy. I mean, don't you have to poke a hole in the shell before removing any cells? So if that's the case, would doing it again be detrimental to the embryo? Ugh. It's been over two years, and I'm still thinking about our experience with the first RE here in FL. I've prayed about it many times, but I just can't get over the sorrow of our going to this RE and not giving our embryos the best chance at life.

About a week later, we had another question, so we called the IVF coordinator. Guess who's no longer working at that clinic? Yep, you guessed it. The IVF coordinator. So we decided that we didn't ever want to go back to this local fertility clinic. That left us in a predicament. What will become of our remaining 5 frozen embryos? Finding CCRM in Denver was a Godsend. We had the 5 frozen 'normal' embryos transferred to CCRM. They will be thawed in conjunction with my IVF #2 (July '08 at CCRM). Three of the 5 embryos didn't survive the thaw, so we never found out if they were normal for both 13 & 15. The two that survived the thaw were re-biopsied and sent with the 23 fresh Day 3 embryos from IVF #2. Of the two frozens, 1 came back normal for 13 & 15 and the other came back no result. Both were re-frozen (vitrified this time). Of the 23 fresh embryos from IVF #2, 7 came back normal for 13 & 15. Only 1 made it to blast to freeze and we transferred 2 grade AA blasts. BFN.

Then with this latest IVF cycle (#3), we had 22 embryos. However, 15 embryos made it to the blast stage for biopsy for CGH. Out of the 15, 8 came back abnormal and 7 were no results. So we had the 7 no results thawed and re-biopsied for FISH analysis. Out of the 7, only 1 came back normal for 13 & 15.

So to date, we have a total of 5 frozen blasts, 3 of which are normal for 13 & 15 and 2 no results.

Whew, that was a long story. But I felt the need to clarify.

6 comments:

Sue said...

Wow, your old RE's office sounds like my old RE!!! It was so painful to find out that we spent so much time and effort and emotion with really no chance of success! It hurts to think of the embies that didn't get a chance at life because of those doctors! I am praying for your 3 embryos. You really never know what is likely to create life or when things are meant to work. Are you planning a transfer soon?

Nikki said...

Your old RE sounds like a quack! Like someone had said in comment to one of my posts - What do you call a doctor who graduates at the bottom of his class? "Doctor".

Linda - I'm so sorry you've had to go through so much uncertainty. You know I totally understand your position - because I have a DH with a BT too. I'm now dealing with the fact that we apparently don't make too many blasts!

The positive side to your entire trauma is the fact that you do have 3 normal blastocysts waiting for transfer. Agreed that one has gone through a lot, but it's survived so much, hopefully it will survive the de-vitrification as well.

What is your plan? Are you planning to do an FET sometime?

onemuse said...

I see you have an FET coming up in February! How exciting! Praying praying praying for you guys....

Erin said...

Hey Linda,

Just stumbling upon your blog... you situation sucks. Mine does too. It's lonely here, isn't it? Well I'm beside you, wishing all the best.

E

brunettechicagogal said...

I am appalled! You have been through so much, and on top of it, it sounds like your FL RE is a bit, um, unethical. Holy cow. Have you considered reporting him to the AMA?

Anonymous said...

Wow, I just had an FET and the doctor's office told us that both embryos "had survived the thaw." Well, when we got there to do the transfer we found out that one had one cell left, and the other had two cells left. Both had less than 50% of the cells survive, which means the chances for pregnancy are <1%. They give most of the money back if they don't do the transfer, so I feel they lied to us to keep the money. I know other people who tried our clinic and then went to another one because they were unhappy. We got one baby from this clinic and felt good about going back. Not anymore.