1 Really is the Loneliest Number

Wow, a lot has happened since I last wrote a blog post. This is for a few reasons. One, I was freaking busy trying to create embryos, working, and posting on social media, sometimes twice a day! Two, I wasn’t quite sure what to write or how to update on top of what I was already doing on social media. Lastly, honestly, I just didn’t feel compelled to. Until now.

So I made it through the egg retrieval and embryo making process last month. I was lucky enough to not have my cycle cancelled due to coronavirus, or my body not cooperating. I shot myself up with hormones for ten days, which was actually a lot easier than I expected. Probably because it was such a short protocol, which I’ll get into in a bit, but also my body just seemed to respond really well and had no crazy side effects. I didn’t bruise all over like a lot of women do, and I wasn’t a raging bitch, which I’m sure my co-workers appreciated. By the end of it and for a week after the retrieval I only felt really bloated, which is obviously expected as your ovaries are filled with lots of eggs ready to be extracted.

I’m not going to go into the nitty gritty of the shots, the retrieval and the aftermath, because you can see that on my Instagram and Facebook pages. I will get into what happened in the two weeks after the retrieval though, because I haven’t talked about it much and I know everyone has lots of questions about what it means for the future.

I ended up with four embryos that made it to what’s called a blastocyst. A blastocyst is an embryo (which begins as a single cell), that has continued to divide every 12-24 hours, and over the course of an average of 5 days, is about 70-100 cells.(1) A blastocyst contains two different cell types, one that will become the fetal tissue and the other that will become the placenta. A fertilized egg has to make it to the blastocyst stage in order to be frozen, genetically tested, and later transferred into the uterus for implantation. Not all eggs that are fertilized will make it this far, some may stop dividing and will therefore not be able to be transferred into the uterus.

Some clinics will do a fresh transfer of 3-day embryos, meaning that they are not frozen, and are put back into the uterus a few days after the retrieval with hopes of implantation. However, frozen transfers have been shown to be more successful than fresh. Due to both my age and my plan of saving these embryos for later down the road, I didn’t worry about the possibility of transferring any 3-day embryos, and to be honest, I didn’t even ask my clinic if they do this.

As I explained in my second blog post, my original plan was to do a round of IVF (in-vitro fertilization) first in order to have “younger” fertilized eggs available for the future, and then move on to IUI (intrauterine insemination, aka artificial insemination, think turkey baster but in a doctor’s office) after that when I wanted to start trying to actually get pregnant. Almost everyone I talk to forgets that this was the plan, so please, kindly go back and read that sentence again, it’s a very important factor in all of this.

When I got the news that I had four embryos make it to blastocyst I was pretty happy with that and thought I had a good chance of getting at least 2-3 normal embryos, and I could start trying to conceive via IUI in June, after giving my body a month off to recover. What is a “normal” embryo you ask? And why would you want to know whether an embryo is “normal” or not?

A normal embryo is an embryo that doesn’t have any abnormalities. Well, duh. Thanks to science we can get even more specific than that though. Genetic testing of embryos is done through PGS (Preimplantation Genetic Screening), now known as PGT-A (Preimplantation Genetic Testing for Aneuploidies).(2)

After PGT-A testing, embryos will fall into one of three categories, euploid (normal), aneuploid (abnormal), or mosaic (mixed). Euploid embryos have the correct number of chromosomes (46) in each cell, and therefore, have the best chance of implantation, a high likelihood of resulting in a successful pregnancy, and the lowest chance of miscarriage. Aneuploid embryos have an abnormal number of chromosomes per cell. They can have extra chromosomes known as “trisomy,” or not enough, a “deletion,” or both).

https://www.coopergenomics.com/products/pgt-a/

These abnormal embryos have a very unlikely chance of implantation and successful pregnancy, and a high chance of miscarriage. Aneuploid embryos are not recommended for transfer, in other words, you’d be hard pressed to find a clinic that will even do it.

Mosaic embryos, which have both normal and abnormal cells, have been shown to have the ability to correct themselves after implantation but this is not guaranteed, and therefore have a low, but possible likelihood of resulting in a successful pregnancy. Some clinics may consider transferring mosaics, but usually only if there are no normal embryos available.

You would think that I would’ve been obsessing over these incoming results after my retrieval, but to be honest, I really didn’t, maybe for the first week, but after that I kind of forgot about it. I was relaxed and focusing on other things, like my business and getting back to normal life. Until I called my clinic to report the first day of my new cycle, I was speaking with the nurse, talking about what my plans were going forward and she reminded me that we were still waiting on the results.

Two days later, as I was leaving work, I opened up my email before driving away and saw one from the embryologist. Of course, I couldn’t let it wait until I got home, and my stomach dropped as I read the results.

One normal embryo. All three others are abnormal. Not even mosaics, all abnormal.

I cried on the drive home, not much, but I had to let it out a little.

My mind raced as I thought about what this meant going forward. What does this mean for my egg quality? Is it actually not that great, despite my labs saying otherwise? Was this just a fluke? Was my protocol not long enough? Will IUI even be successful if my eggs aren’t as good as I thought they were? Should I do another round of IVF? Can I afford another round of IVF?? The answer to that is definitely no at this time, without going into more debt, which I really don’t want to do, but I would if it was possible and worth it.

So many questions, so many unknowns. Per usual.

I called my mom a couple hours later and delivered the not so great news. Cried again, because I just can’t help it when I talk to her, I don’t know who can help it when lamenting to their parents, it’s nearly impossible for me.

I laid out all the different scenarios/options in my head, and later to friends and more family on the phone. I went to the grocery store, bought a weekend’s worth of fun food, wine and goodies to drown my tears in. Although, I didn’t cry again after that phone call and haven’t since. I did my usual sappy movie + aforementioned food and drink for a night, and took the rest of the weekend to just relax, clean, watch movies, work on self-care, de-stress and reorganize my brain. I put a little thought into my different options but I didn’t put any actual work into it until the following Monday, the beginning of last week.

I googled the specific results for my abnormal embryos, wondering if there were any possibility of transferring them and if it was worth it to use my free consultation to talk to the genetic specialists. Below is a picture of my results. If you’re curious you can google them yourself. For the ones that have a (+) then the number, just google “karyotype trisomy (insert number here).” For the ones that have a (-) then the number, google “karyotype (insert number here) deletion.”

If you do take the time to do this, you’ll likely come to the same conclusion that I did, and that is that I would never transfer these embryos, even if any clinic allowed it.

So, here’s where I stand with moving forward, these are my options and how I feel about them:

Scenario #1: Go forward with the original plan of IUI first, then frozen embryo transfer down the road.

• I’m now not as optimistic that IUI will actually work, so I may waste a lot of money trying at least three rounds of IUI (~$3000 per round), then have to do IVF again anyways. If I do get pregnant, then I only have one embryo to use later for a second child, and there is only a 30% chance of success with that one embryo.

• If I have to do IVF again (if that one embryo transfer is not successful) after getting pregnant and having my first child, I will then be 39, maybe even 40 by the time I can do the IVF again and 40 or 41 by the time I can try to get pregnant again, which makes things so much harder the older and older I get. And this is all assuming that I have no miscarriages or other events that would present a bump in the road, further delaying my timeline, so I could be even older than that.

• And FYI, getting pregnant after 40 is not as easy as it may seem, so I don’t want to hear comments or stories about how I can easily get pregnant after 40. It is not portrayed realistically in media, movies, the news, wherever you may have seen stories about women getting pregnant into their 40’s. It’s actually really freaking hard and a miracle it even happens at all!

• This scenario means coming to terms with the fact that I may only have one child. This is something I’m just not willing to accept at the moment. I have always wanted a big family, and while I may not get the three or four I always imagined, I think at least two is a good number. I think the possibility of having more than one child is still something within my grasp, and is something that is still worth working hard to achieve. I’m not willing to give up on this dream just yet. Of course, I would be eternally grateful to have one child, and would be happy with that reality if it came, but I would regret not at least trying for more than one.

Scenario #2:

• I can do another round of IVF to try to get some more normal embryos right now while I’m still as young as I’ll ever be. There is a cheaper clinic in Arizona that I just happened to hear about two weeks ago while I was waiting for my results. The only other lower-cost clinic that I know about is in New York so I didn’t really consider it at the start of this journey, I wanted to stay local if I could and thought the higher cost was worth the money.

• I can take the next few months to save the money and be able to pay out of pocket, without getting a loan. I can also take these few months to work hard to improve my egg quality with improved diet, cutting out alcohol and other recreational “products” completely until the next round (I smoke weed, there I said it) instead of just the month before, increased supplements, continuing to switch out toxic household and beauty products, and get more thorough testing and labs done.

• This will hopefully give me at least 1-2 normal embryos, if not more, and a higher chance of having more than one child.

• I may consider not doing IUI at all and only transferring frozen embryos to try to get pregnant but I can revisit this option once I’m done with the second round of IVF, as it all depends on those results.

I’ve decided to pursue option #2, as I’m sure you can tell after reading my feelings about each one. It just makes sense at this time in my life, and I’m excited for the next few months and working towards this new plan. As I’ve said in my blog posts before, this is pretty par for the course in the fertility world, and it would have been naive of me to expect everything to work perfectly. So I didn’t. I prepared myself for this possibility in my head. Sure it hurts and is a punch to the gut when you do get those results you weren’t hoping for, but the worst is not over, I’m sure there will be more bumps in the road to overcome.

I say bring it on! I’m ready and prepared to fight for my dream of being a mother and having a family of my own. With my family and friends by my side, I will accomplish my dream. I’ve been working on gratitude and manifesting, can you tell?!

I’ve already turned in the paperwork to request an initial consultation at the new clinic, which is $300 just for a consult, by the way. I love my current clinic and would love to stay, but unfortunately, just can’t afford to continue there. However, when it comes time, I will hopefully transfer that one normal embryo and get my first or second rainbow baby.

References:

(1) https://www.sdfertility.com/blog/what-is-the-difference-between-a-day-3-and-a-day-5-embryo-transfer#

(2) https://www.coopergenomics.com/products/pgt-a/