Transfer Day

Ahhh, one part of the wait is over and the bigger, scarier wait is upon us. I am fully loaded up. My uterus has embryos in it. And those embryos are beautiful Bryce babies!

After I wrote my post about waiting to wait, we did actually get a Day Three update in the evening. Which made me feel better, because the thought of not receiving any news on our growing potential progeny until transfer day was making me twitchy. I was going to go with the flow, but the flow was definitely not in my comfort zone.

Our day three update: THREE of Bryce's four fertilized eggs were "amazing" 8-celled embryos! THREE! 75% kept on keeping on! Amazing. We also had "a good number" of 8-celled embryos from the donor (no specific number, but seeing as how we had nearly 3x the donor embryos to start, we weren't worried). Then no more updates until Transfer Day so the little guys and gals could rest undisturbed and do what they needed to do in the optimal conditions.

We were amazed at the progress of Bryce's embryos. We honestly weren't expecting such a robust response--we were hoping for one, best case scenario two. The wait wasn't over, there was still time for the dastardly attrition to kick in that always does for us, but so far, so good. Starting with only four fertilized eggs with Bryce's DNA felt like a scary low number, but a bit less so after our good news. (Not gonna lie, caused a little WTF feeling too, like, "is it really the sperm if we have so many out of so few?" BUT, blast development is only the second of four hurdles for sperm so we couldn't get too ahead of ourselves.)

On transfer day itself, we were driving to Buffalo (well, Bryce was driving to Buffalo, because I had to take my Valium for cervix/uterus relaxation and maybe a little Jess relaxation) and we got the call, right as we were at the BUFFALO: An All-American City sign on the thruway.

THREE. We had THREE Bryce embryos still, two days later. They weren't quite blasts yet--they were morulas. But beautiful morulas (look at my last post for the chart on embryo development... morulas are what they're supposed to look like on Day 4). No degeneration, no fragmentation, just a little poky. But, some were already entering the transition phase to blast. Well color me ecstatic, because the fact that THREE made it to Day Five was SPECTACULAR! So what if they were a bit behind? I teach special ed, I know that not everyone develops at the same rate but it doesn't mean you're any less brilliant! I loved them already. We also had SIX embryos from the donor--some early blasts, some also transitioning morulas, but not obviously different from Bryce's so far. And, actually, when you think about it, Bryce had a 75% rate while the donor had a 55% rate of embryo development. GO TEAM BRYCE! Interestingly, the ones that were furthest ahead were the ones that had been fertilized in the dish (the IMMATURE eggs, I might add, that would have been discarded at another clinic...blows my mind). The ICSI ones were further behind. Something to say for that whole Darwin aspect of the fight for the right to fertilize...

Now we had a choice. How many?

This is where I feel a tiny bit like a hypocrite. When we were doing donor egg and I was researching like mad to make sure that we did the best things for the best outcomes, so much came up about Single Embryo Transfer. SET is predominant in countries with insurance coverage for IVF, SET sets you up for a healthier pregnancy and less chance of the NICU, SET allows that one embryo a primo chance for implantation without any others in the mother ship. Except... SET might have been good for our first fresh donor egg cycle, but for a cycle with our own eggs and stuff? Apparently not recommended. Given that this is our 9th transfer (ugh I hate putting that in writing), and we have serious implantation issues, and I'm 38 now, it's just not our best option.

However, we had TWO options on transfer day. Transfer two and hope the third freezes, or transfer all three. Transferring all three sounded crazypants, but our doctor explained that there were several compelling reasons to do it. 1) embryos weren't on-time blasts, they were a step behind; 2) three is still within the ASRM ethical guidelines for transferring to someone like me who is like the Death Star for embryos; 3) given our history and our previous transferring of three thawed frozen blasts, I've only ever gotten pregnant with a singleton that miscarried; 4) we might not get to freeze that last Bryce embryo if we didn't choose to transfer it. BUT, on the other side, 1) I love all my embryos but the idea of triplets makes me full on convulsive, not twitchy; 2) even a twin pregnancy holds higher risks to babies and mama, and a trip to the NICU becomes much, much more likely; 3) triplets or more (splitting is not off the table) hold the risk of the selective reduction conversation, a conversation I desperately do not wish to have ever ever ever, even though 3 or more babies can mean serious risks and life threatening situations for everyone involved.

Argh. I'm not gonna lie to you -- I wanted to do all three. And not necessarily for the most logical reasons. I AM SO FREAKING TIRED. I also wanted to give Bryce's embryos the best chance possible of doing the trick. And, at this point, twins (while scary) sound pretty appealing. To be done in one shot selfishly makes me feel less icky about the risks. PLUS I know people who have transferred well over three and had twins. And I know people who have had triplets and everyone was healthy. I know this is the exception, not the rule. I also rationalized that I suck at getting pregnant and the idea that all of them would suddenly implant was laughable. We simply don't have the history for that. BUT, Bryce was terrified at the prospect of three. The prospect of risks to my health and the health of our babies. The fact that my lining has been pretty darn impressive this cycle was a worry to him, because what if that means I'm suddenly way more receptive than I've ever been? What if they all take because this cycle is so awesome? THEN WHAT?

We talked it over with our doctor, both on the way and in person once we got there. And the upshot was, three was our best chance. We upped our chances of getting pregnant with twins pretty significantly, and triplets are a possibility but a very, very small one. I didn't want to leave any Bryce embryos behind. I felt confident enough that we weren't sure if they would all make it to blast that transferring three felt less crazy. And so... The Three Babyteers are hanging out in my uterus right this very minute.

Sometimes I freak out when I think, OMG, we put THREE babylings in me. What the hell were we thinking? And then I think, you know what? What will be will be. These are embryos 21, 22, and 23 to enter the (I hope previous) wasteland of my womb. I welcome you all, but with my track history, it will be something else if you all make it to the finish line. So we are nervous, of course, but feel mostly that we have made the right decision.

Looking over this incredibly scary loading of three babylings into my relaxed uterus was my beautiful Buddha statue that Bryce gave to me for Christmas after our miscarriage. It was supposed to go in the Secret Garden, but then we didn't want anything to happen to it so we kept it on the baker's rack in the dining
room, where we can see it all the time. The Buddha is in the form of a little boy, holding an open book in his lotus lap. In the center of that open book is a rose quartz heart that a fertility friend sent me for good luck, because rose quartz has healing properties supposedly and is good for fertility. I put the heart facing out, pointing at me on the ultrasound table and Bryce holding my hand. There was something beautiful about the symbol of our lost baby looking over a new beginning. I didn't cry this time, fearful that we were sending our embryos to sudden death. I felt peaceful. We watched the flash that indicated that the babylings were home, and then it was over.

Interestingly enough, I did not rest long on the table. My doctor said that there have been recent studies that show that the 20-30 minute rest on the table is not necessary, that in samples where women rested and where women got right up and walked out, the walking women got pregnant more often. Very interesting. So I compromised and laid there for 5 minutes or so, then got up and tried not to freak out about it. We left with our Buddha in my arms (I really did not care at all if people thought I looked weird; YOU try doing this 8 previous times and see what crazy stuff you're willing to entertain!) and had a healthy (but ridiculously expensive) lunch at an organic cafe down the street, and then I went home to rest on the couch. Again, not to lie down for days, but to rest upright on the couch and then take it easy the next day. I went to school on the third, and so I was on my feet (but not doing anything crazy). IT MADE ME SO NERVOUS, at first. But really -- do the fertiles lie down for days after they boogie between the sheets? I know the stakes are higher for us, but does it really make a difference? I guess we'll find out.

Our ninth transfer, done. I feel pretty calm and peaceful, not the tight mess I usually am. I am determined not to examine every little twinge for signs this time. Last time I swore I was pregnant, and I wasn't. I give up. I am not a pregnancy divining rod wielder. I have no clue. So I surrender. I surrender myself to this process, I surrender myself to my embryos, I surrender myself to my lining, I surrender myself to the mystery. What's going to happen will happen. And, according to a timeline I once saw on Operation Baby Gage's blog (at the bottom), if it's going to happen, it's already begun and I can't stop or start it. I can only hope that this is the end, the ninth's time's the charm, that our last shot with Bryce's material is the jackpot. (Incidentally, we froze FOUR donor blasts, so maybe part of my Zen is that we have insurance in the freezer.) It's so hard to truly, truly let go. But I'm going to try, even though that's kind of an oxymoron. With letting go there is no try, only do. Thanks, Yoda. I'm going to be really good to myself over these next long days of wait, longer than usual because the clinic does 17 days from retrieval for the first beta. SEVENTEEN DAYS! Torture, but then the results are indisputable. No wiggle room. No doubt. I can do this. We can do this.

Thank you for all of the waiting with me -- it helps make the wait feel less lonely. There's strength in numbers. Please hold me, and Bryce, and our Three Babyteers in your hearts during this time... we can use all the positive energy we can get to stay calm, stay centered, and hopefully stay pregnant, not just Pregnant Until Proven Otherwise.