***This is going to be a long post!***
Bridget asked how long until they'll transfer the embryos back to where they belong...
There is a 3 day transfer or a blastocyst. Blastocyst is done five days after retrieval. It will depend on how well the embryos are developing. If they are not developing well, they'll be transfered after three days to get them into the best place for their survival... meaning my womb. If they are developing well, they will allow them to get to the blastocyst stage and transfer after five days. The advantage to the blastocyst transfer is that it is easier to to determine the healthiest embryos. I believe some clinics use the three day transfer as the standard, but I believe Dr. Shamma prefers the blastocyst transfer if possible.
Lauren asked how we make the decisions about how many eggs to fertilize, how many to implant, etc.
First of all, our nurse made it clear that it is our decision, not Dr. Shamma's. His job is to guide us and educate us as the specialist, but ultimately it is our decision. We found that early on you have to know where on stand on everything. Selective reduction for an example. They want to know if you would consider selective reduction aka abortion if you ended up with more than twins. We, of course, would not. But by knowing that... Dr. Shamma can help us make the best decision not to be in a position where selective reduction would be suggested. They cannot make you do that. But they're more likely to suggest fewer embryos for people who would not consider selective reduction to avoid high risk, multiple pregnancies.
How many embryos to transfer depends on a few factors: the mothers age, the fertility issues, health of the embryos, risk level for multiple pregnancy, etc. Older women and certain fertility issues are more likely to transfer more than three embryos. However, IVF technology is improving to where the need to transfer higher number of embryos is dropping. In very few cases, would Dr. Shamma transfer more than four embryos.
As of right now, our plan is to transfer two. That gives us two opportunities for a successful pregnancy. And we know that we can manage twins. Now... that is not set in stone at this point. But unless something changes and Dr. Shamma feels strongly about either more or less... that is our plan.
Now taking a step back, how many eggs to fertilize... we will be fertilizing all of the healthy eggs retrieved. That may end up being a low number or a high number. We could fertilize 15 eggs, but that doesn't mean all 15 eggs will survive or become healthy embryos. The remaining embryos that are not transfered, if healthy enough will be frozen. That way, when we are ready for more babies... we will not have to go through this process again. We'll essentially be able to jump straight to the transfer.
There really are many, many decisions to be made. Many are so personal and require a lot of prayer and soul searching. So we take what we know, feel, and believe, and consider the advice of our specialist and do our best to make the right decisions.
Secondly, after just talking to my mom about how stable and at peace I've been with this process... I had my first freak out. Yes... I definitely freaked out last night. I was supposed to take my trigger shot, which is the most important shot, exactly at 11:30. The retrieval has to be done exactly 36 hours after the trigger shot. And the purpose of the trigger shot, is to tell the eggs... OK get ready! Well... next thing I know, I look at the clock and its 12:10! I missed it. OH CRAP! I immediately started to panic. I sat at the table and started mixing... until I realized instead of the ratio 1 cc to 1 unit... I used 3 cc to 1 unit. I just over diluted the drug, the most important shot that I was already late taking. OH CRAP! Then came the tears. So I grabbed the phone, still panicking, to call the emergency on call nurse for the second time in just a couple days. She assured me that its ok as long as I get all 3 ccs in the injection. And she said, its ok that its late, we just need to make sure the operating room in Rochester knows and can plan accordingly. So even though Betsy told me it was all going to be ok... I was certain... absolutely certain that I just blew it all. It took many more tears and Nathan talking me down until I was able to relax.
So this afternoon, Betsy called, which is normal protocol, to verify what time I took the shot. And again, her kindness was just so surprising. She made sure I was OK after last night's drama and was just so sweet and supportive. She also asked, otherwise, how I was feeling because of my estrogen levels (the levels they checked in the blood work every other day.) Apparently my ovaries are working just about as hard as they can work. And she was very surprised at how well I've been doing. It'll be very interesting tomorrow to see just how many eggs they retrieve.
And I might have said this before, but I am definitely very much at risk for hyper stimulation and they are kind of expecting that the few days following retrieval may be a bit rough for me. I hope I surprise them some more by doing really well!!
I think a lot of last night's panic, after Betsy assured me, was a reflection on some of the inner anxiety I might be having. This is it. Tomorrow is what every shot, every blood test, every ultra sound has been working towards. Its really kind of terrifying. But this is definitely the most... emotional day I've had yet. I guess the anticipation is just overwhelming. I mean... tomorrow... is essentially conception day?! Its just... overwhelming on so many levels.
But in preparation of being out of commission for a few days... I'm going to spend the afternoon and evening while Nathan's at work cleaning and making sure things are taken care of. If nothing else, it should be a good distraction.
Please, please say a prayer for us tomorrow. My procedure is tomorrow morning sometime between 11:30 and 12:30 (because of my screw up!) The procedure itself should only take about a half hour. Specifically, pray that we end up with healthy eggs and swimmers and that God truly works a miracle in creating our baby or babies. And also that my recovery is quick and easy as well with no hyper stimulation.
My next post will likely be sometime tomorrow evening... even if I am laying on the couch and Nathan's typing!
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