Posts Tagged ‘embryo transfer’

The Wide World of Frozen Embryo Transfers


Oooo, I know! I know the benefits of transferring a 5 day blastocyst!

A few months ago, some of you may have read my post, “IVF 101.” As my husband and I are getting ready to embark on a FET (or Frozen Embryo Transfer), the questions have again started to surface. 

So, what is a FET? Many people wonder if it is related to In Vitro Fertilization, how the embryos are frozen, and why anyone would do something so weird in the first place. So here is your answer – the fertilized eggs are kept in your freezer. I keep mine in an old popsicle box. When you are ready to use them, you thaw them for 24 hours and……yes, I am totally kidding. 

Frozen Embryo Transfer can be the result of a couple things. First, and in my case, you have gone through an IVF cycle but were unable to transfer the fertilized egg or blastocyst. This is usually due to ovarian overstimulation. If you cannot transfer right away, you need to freeze the eggs so you can use them at a later time when you have a better chance of success. You may also have to do a FET if your last transfer was unsuccessful, or you are using a donor egg. There are other reasons, but you get the picture. 

The Freezing 

When it comes time to freeze, you will have either fertilized eggs (embryos) or blastocysts. A blastocyst is a five-day or older embryo that has started to experience cell division. Should they need to be frozen, they are paired up in twos – like at the Ark – and placed in a little cryopreservation tube. This process will cost you a good amount of cash, so go ahead and ask to see the pictures of your embryos before freezing if possible. Also make sure you know how many you have and what each one is graded (meaning quality). It’s nothing weird like naming them or anything, it is just being an informed patient. You worked really hard to get these embryos, so make sure you are comfortable with what is happening. 

When it is time to freeze, the tubes are placed in cyclinders of liquid nitrogen, which keeps them in a static state. They remain alive, but the cells will not continue to divide until they are thawed. It does take some time to get used to the concept, because theorectically you could freeze some eggs tomorrow and thaw them out in ten years time to implant. 

This is NOT how you will freeze your embryos.

 Your mind will start to think about all sorts of philosophical, scientific, religious, spiritual, hypothetical circumstances and scenarios at this time. It’s normal. After all, you are most likely still pumped with drugs. So to clarify, these are embryos. Yes, they are amazing and beautiful, but they are not little humanoid creatures. Just saying. Some people are not sure. WE ARE NOT FREEZING BABIES HERE, PEOPLE. This is not that out there. 

OK. Moving on. 

The Transfer 

Once you are ready to attempt conception, you will begin preparing your body for implantation. For some people that mate normally this consists of a nice dinner at Ruth’s Chris and one too many cocktails. In your case, its time to dust off your trusty dusty needle kit. Yep – you are back to about 4 weeks of shots and pills and shots and pills and blood work and ultrasounds and shots. Oh yeah, and pills. Basically what you are doing is allowing your uterine lining to grow thick and healthy. Without this, and without sufficient progesterone, your embryo will be unable to implant and sustain itself after transfer. And that would just be sad. So you go through a much easier yet still needley version of what you did when you grew all the eggs in the first place. 

Once your uterine lining looks good and your blood work looks good, you are a go! By the way, the normal “compliments” that you used to revel in are not so coveted now. Instead of “cute shoes” (you will be living in flip flops and slippers) or “have you lost weight” (you are going to get some chunk, so just go with it), you now light up when you hear “Your lining looks great!”  

I love you, healthy uterine lining!

At this stage the embryologist will review the egg’s quality with you and choose which tube to thaw. I am actually not sure how they do this, I imagine they just set it out on the counter and head to Starbuck’s, but I have not asked. The morning that you come in for your transfer you will decide how many babies-t0-possibly-be you will transfer. Single Embryo Transfer is becoming quite popular, and if we have a very healthy one we may go this route. Regardless of how many you have decided to use, you will come in that day on valium. This is not so that you agree to go ahead and put 6 back because, hell, they’ll be adorable. This is so that when the embryo is being introduced into the womb you will not cramp. If you cramp, you may actually hurt the chances that the embryo can implant and begin to grow. Think about it – when you are settling down to go to sleep at night, exhausted, and then your spouse hugs you REAL TIGHT you cannot get comfy, right? He may even push you out of the bed. With valium, your body just responds better to a skinny straw being threaded into your itty bitty cervix. 

The Wait 

By this point, you have gone through a lot. In my case, it  took about 6 months to grow the eggs, get them out and fertilized, get them frozen, and prepare my body for our upcoming transfer. Once the embryo / embryos are in, you just have to chill out and take it easy for a couple weeks. I think that AVOIDING the home pregnancy tests would be wise in this case. Often times they take intially, but just as in nature, don’t last more than a few days. So it is better to just bite the bullet and wait for the blod test at the doctor’s office. You can avoid possible heartbreak this way. Either way, having it not work is hard regardless. Nothing about this process is emotionally easy. 

I hope that clarifies what FET is. There is no scary little man in a florescent, sterile lab. Oh wait, yes there is. Sorry. But he’s there to help your embryos grow, so if people ask you about this weird Frozen Embryo process, let them know the deal. 

Peace and Love, 

Sarah

Santa! I know him!


I need to laugh. I desperately need something or someone to light a firecracker on my funny bone and make me cry silent tears of hysteria. Before that, I am taking just one, guiltless moment to whine about being sick of having to force patience into my daily repertoire. I found out today that, after injecting myself with powders and saline and eye-of-newt, counting down the days of May with bated breath, and finally getting to the point where I believed the stick would turn – aha! One line to two! – I get postponed another month before we can finish this IVF cycle. Come on, now! I know a month is like the blink of an ant’s eye in the grand scheme, but I was not born with that patience virtue. Being on Earth and having to go about life I have tried to mimic it, but I don’t enjoy being patient. It’s like sitting in the hot sun waiting for a bus. Nodding off at your desk and its only 1:00. Waiting for Direct TV to show up between 10:00 am and when Hell freezes over. But I have had to be very patient – I was patient for two years recovering from a nasty illness. And I have been patient now, waiting for my baby. But I need for once to just be an indulgent girl and say that I don’t want to wait another four or five weeks to keep going. It’s more limbo. It’s not the end of the World, it’s just annoying.

So I really need to laugh. I need to share things with you that make me bust out laughing. Some things are just pretty much always amusing. Hmmm…..Will Farrell in Elf is just funny. The scene when Santa comes.Yes, it’s June, but please just watch his face. You might pee yourself a little. If you don’t think he is twisted and funny, you need to keep watching until you see it.

I am feeling so much better. Going to have to keep sharing the love. This next kid puts a massive smile on my face.

It’s a shame that YouTube does not have any good clips of SNL Jeopardy – especially with Sean Connery. I now find myself having wasted well over an hour watching YouTube and Hulu, and I feel much better. It can just be frustrating to realize that you have not been living in the moment, which is so important yet so difficult to maintain. I think the best that we can do is to just stop and try to enjoy what’s going on now as often as we can remember – even if what’s going on now is being able to sleep in late on the weekends, read an outstanding book, or just trying to find ways to laugh. There really are so many things that I have been rushing, or sometimes even just avoiding, because I am almost living from one appointment at my RE (Reproductive Endocrinologist for those of you not trying to reproduce) to the next. It always feels one scan or one shot away from The Beginning of The End.  If you follow this blog because you are in this process, or getting ready to start it, stay hopeful and remember it’s a journey before a destination. If you can write about it, laugh about it, or try to learn from it while your on the hike, you might be doing yourself a really huge service. I guess sometimes it’s easier to give stellar advice than to follow it. But if it gets too huge and the waiting is just too much, take a day off work and off the hamster wheel and try to just enjoy a moment of relaxation – even it’s just a moment.

Cryopreservation – The Final Frontier


Today was transfer day. The day that they put one or more embryos back into the uterus. This day feels special for IVF couples because it is the day that you are possibly welcoming your new baby into your family. But we knew in the back of our minds, due to my OHSS (Ovarian Hyperstimulation Syndrome), that we might have to postpone. And we did. And it was sad.

My doctor told me that, with the enlargement of my ovaries and the amount of free fluid squirming around my pelvis region (which is just TMI, I know) that he could pretty much guarantee a long and possibly dangerous hospital stay should I become pregnant. When he mentioned patients who needed to be drained or intubated, we had pretty much resigned ourselves. I do not want to begin a pregnancy on life support, because if I am put in a ward like I was last week I might pull my own plug. Of course I teared up when I realized today was not The Day, but apparently this is not uncommon and we can move forward in a month or so when things have cleared up. But….. I saw pictures of the blastocysts! And I’m not getting all weird, I know they are not little humans yet, but we have 6 to 9 really pretty blastocysts hanging around. If you are not familiar with what a blastocyst is, you used to be one, so I shall explain.

A Blastocyst is a fertilized egg about 5 days after the fertilization. The cells have divided and other things have happened that will allow it to implant into the uterus once it is released from the fallopian tube. (Or in my case, the scary long catheter.) I know that is not very scientific, but Wikipedia called it a “parasite” before it rambled into something that would bore you and make you stop reading my blog. And we can’t have that.

So, we had to have our little bundles of hopes and dreams frozen. As in cyropreserved. Very Deep Space Nine, very Austin Powers talking about all things “quasi-futuristic.” And there is a little Russian Roulette involved in that, because they do not all make it out of thaw. It also makes me wonder if my kids will have a natural predisposition towards things like the Polar Bear Club, ice hockey, snow cones, the Ice Capades or igloos. But mostly it just makes me feel like I was forced to decrease my chances just a bit this round. I still feel in my heart one of those blastocysts will one day be waking me up at 3:47 am, but sometimes patience sucks. Even though patience and I have had to become BFFs.

So, I am curious to know what other folks do when you want to pamper yourself and tend to your wounds for the day. I still had to stay home from work in recovery, and I nursed mine by laying on my tookus all day and catching up on two seasons of Weeds I have missed. Watching the story of a woman whose 14 year old son has orgies and delivers fatal blows to folks with a croquet mallet of some sort made my issues look real, real small. Still, my mom is out of the country and I can’t call her, so I did not have the motherly words of comfort I so desired. I turned to slothlike laziness and emotional eating.

Now tomorrow, as a result from the nasty OHSS, I will return to work looking like I have a fat baby in my belly without having a baby in my belly and I am just going to have to deal.

Hope you guys are ready to learn about Frozen Embryo Transfer in the weeks to come…..

In Vitro Fun


So, about a week ago I wrote a post about my medicine cap telling me to “Flip Off.” I thought people would think I was being REALLY over sensitive and ask me to drop the menopur syringe and step away from the blog. BUT, you guys got it. You also thought it was odd! And guess what? I opened another fresh box yesterday morning, and what did I see peeping back at me but a bright green vial top! No gray….and to my surprise, it does not say “Flip Off” anymore! In fact, it gives no directions at all. It just has some typical fertility drug name on it like “Life Plus” or some nonsense, but no directions. 

Do you realize what this means? It’s another small triumph! Every morning that I have to take that shot I am going to look at that green cap and it will remind me that maybe the tides are turning. It’s IVF, baby! In Vitro Fun!

A few of you have asked me what this process entails. It means a lot to me that people ask how it all happens. So I wanted to explain the basics – for those of you that care about someone going through it, and also for those of you considering doing it yourself. So, here’s how it goes in a very Cliff Notes kind of way.

IVF 101

  • At this point you have probably tried everything from Clomid (spawn of the devil) to IUIs. An IUI is when you are inseminated at the doctor’s office with your partner’s sperm. It’s not too comfortable and there is no lollipop afterwards. That’s about all I am going to say about that. It’s just not as fun as the old fashioned way of making a baby.
  • Assuming nothing else worked it is time for IVF. Now they need to get your ovaries to be quiet. After spending all these months, or even years, trying to get them to just contribute and ovulate, you need them to become submissive. This is called Down Regulation, and it is done with a combination of birth control pills, a daily shot of something called Lupron, and high doses of Xanax in the event that you are totally not cool with taking birth control pills while desperately trying to procreate.
  • Once your ovaries are knocked out, it is time for Stimulation. Again, not as fun as the original meaning of the word. This  is where all the shots come into play. You will take two to three shots a day for anywhere from 8 to 12 days. During this time you will get to personally know many of the nurses at your clinic, because you will be there so often you wonder why you leave at all. This is when they will take your blood to measure your estrogen, and they will also monitor the eggs development through ultrasounds. (Not the sweet kind that they rub over your belly, either)
  • If you get a good bunch of eggs, then it will be time for the retrieval. Surprise, surprise – this involves another shot!  This one is called Ovidrel and it makes your eggs get plump and healthy. But you have to be careful to have the retrieval done before the 36 hour mark, or else this shot will make you ovulate all these eggs and there will be nothing left to show after all of your blood, sweat, and tears. (Literally, you will give all of these things.)
  • For the retrieval, they give you this killer “twilight sleep.” Yes, it is as fun as it sounds. …for about 2 minutes and then you pass out. Now you are intoxicated and on a table with your flimsy gown pushed up around your knees. Just how you always pictured this special moment of conception would be. The doctor uses a thin needle and an ultrasound wand to find the follicles and extract the eggs.
  • Once the eggs have been taken, they are placed in a petri dish with your partner’s sperm. If they do not get along swimmingly on their own (HeeHee), the sperm may actually have to be injected into the egg.  Hopefully, at least half of the eggs will fertilize.
  • Three to five days later, one to three embryos are typically placed back into the uterus while you are on some Valium. The number of embryos put back into the body will depend on their quality. Remaining embryos of high quality can be cryopreserved for future use.

There are many steps in-between, and I am not even going to go into the finances, but that is the basics. During this time you may find you are told not to exercise, eat chocolate, have orgasms, drink coffee, or BECOME ANXIOUS! What a riot! Give up those things for awhile and let me know how you feel. I’m curious. Really. For these reasons, it is advisable that you do not tell someone in an IVF program that they should relax.  Just help them to laugh. To me, it’s the best way to roll with the process.

Have a happy Monday,

Sarah

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