Excellent Embryos

As I sit here writing this post, our future child (or children) is sitting in a petri dish across town dividing like crazy.  On Tuesday, the doctor was able to remove 19 eggs from my ovaries.  Of these, 18 were mature and one was overly mature (too old to fertilize).  The embryologist fertilized the 18 good eggs using a process called Intracytoplasmic Sperm Injection (ICSI).  Traditional IVF put several sperm in a petri dish with each egg and let them fertilize at will.  For ICSI, they hand pick individual sperm, remove the tails, and directly inject them into the egg.  This is ideal in circumstances when the sperm is not very strong.  At our clinic, they do it for every single patient because it is more predictable.

Beginning with 18 eggs, only 11 fertilized normally.  Unfortunately, this is a testimony to the overall quality of the sperm used.  However, today, all 11 of the 11 that fertilized are not just alive, but thriving.    Dr. Magarelli informed us at our appointment this morning that 6 of the embyos are Grade A and 5 were Grade B.  He said, and I quote, "You really couldn't have hoped for better."  

The grading system works as follows:

Grade A:  Even, equally sized spherical cells with no cellular fragmentation that are viable.

Grade B:  Embryos have uneven or irregularly shaped blastomeres, less than 10% fragmentation and are viable.

Grade C:  Embryos have up to 25% fragmentation, may be viable.

Grade D:  Embryos have 25-50% fragmentation, may be viable.

Grade E:  Embryos are considered non-viable with lysed, contracted, or dark blastomeres.

When it comes to embryo transfer, both Grade A and B are transferred with a high rate of success.  Grade C may be transferred, but has a much lower rate of success.  Grade D and Grade E are not typically used for transfer.  So, basically, we have 11 excellent embryos.  Yay!  My biggest concern with doing a Frozen Embryo Transfer (FET) was that we wouldn't have any embryos that were high enough quality to freeze.  So far, it looks like that is not going to be the case.  They will continue to watch the embryos divide until Sunday, then freeze all of the remaining ones that are viable.  By day five, ideally they will be blastocysts and will be ready to implant into the uterine wall.  Here is a little diagram of what they should look like over their five day development with the first picture being day 0 (egg retrieval day):

They did an ultrasound at today's appointment and found that I still have some fluid in my abdomen from the Ovarian Hyperstimulation Syndrome (OHSS).  When Dr. Magarelli walked in he said, "I really wish you felt terrible so you'd believe me when I tell you that it's not safe to proceed.  You probably think I'm just being overly cautious because you feel so good."  He's right.  It's hard to understand why I can't just move on when I feel good.  But, at least with the ultrasound I could see the fluid that wasn't supposed to be there.  

They told me that I should recover completely by the time my next menstrual cycle begins.  Also, they told me that they would be able to do the FET at the end of September!  That's only a month or so away.  I know that my doctor is trying to protect my well-being, and I appreciate that.  However, it is a little unnerving to tack a month onto the process and to shell out more money for the FET.  I feel good about things after today, though.  I was starting to feel my little flame of hope flickering out, and now it's back.  We may get to have a child of our own after all.