Day Three Embryo Report

The embryologist called again this morning and I think I may amuse him. And by amuse I mean annoy. Not really. Or maybe. You see, I can't let any decision be simple. It is just how I am made. I have to analyze things over and over, and then usually just go with my original gut feeling. I just can't leave anything unsaid (or more accurately, unasked). On a number of occasions I said, I know there is no clear answer, or, alternatively, I know the answer is obvious, but I just need to ask this question... I know from experience with Fletcher in the NICU, it is the things left unsaid that will haunt you.

Our five embryos are still progressing (thank the Lord). All are eight cell and looking good (however, and I learned this just today from this link about blastocyst transfer, "during the first few days, the embryo relies on the mother's egg for all its nutrients, however, in order to survive past day three or four, the embryo must activate its own genes. Not all embryos are successful. In fact, only about one-third of the embryos become blastocysts"). So, looking good at this point--while, well, good--doesn't necessarily mean that the embryo will progress to day 5 (blastocyst stage, when my clinic does the transfer). The status of the embryos tomorrow will be a better predictor.

And already, before they are even fetuses, let alone born, I have to make the hard decisions. Because all five are still progressing, we have decided to pursue PGD, which means today, if not already this morning, one of the eight cells of each little embryo will be biopsied and federal expressed cross country for evaluation. How weird is that. If we don't do it, transfer a defective embryo, and then do a frozen transfer, we have effectively spent the same amount of money (PGD and frozen cycles are roughly, plus or minus a couple hundred of dollars, the same cost) and have reduced our chances while at the same time put Angie through a possible miscarriage or failed cycle. If we do PGD, and transfer an embryo that is proven (although not 100%, there is always room for error) to be genetically viable, then we have maximized (although not guaranteed) our chances of success, especially considering we are only transferring one embryo, instead of the usual two (which is a whole separate topic of discussion). Of course the best case scenario would be to not do the PGD and still transfer one genetically viable embryo that implants and grows to a full-term pregnancy; but, alas, I have no crystal ball, and reproductively speaking, who am I kidding, the odds are never on my side.

I have to add that I am, obviously, very happy that all five are progressing and look good. Last cycle at this time we had seven, but one was already falling behind at this point. Check back for day four report tomorrow (but don't expect any genetic testing results... those come in at the eleventh-hour, just prior to transfer, you know, to add a little drama to this boring process).