FET Blasts
etiminsky - Jan 3rd, 2007 2:05 PM
[ Original Post ]

Dr. Smith:

Scheduled to do a FET tomorrow afternoon. I've had 3 chemicals out of 5 transfers.

My Dr. was on the fence regarding NK Cells, and encouraged me to do my own research. Per your suggestion we will use Solucortef and Dexamethasone empiracally for this transfer. My Dr. has been in contact with Dr. Miller, and I'm thrilled about any change in protocol. You know that saying about doing the same thing, and expecting different results...

We have thawed 4-3day embryo's. One has arrested. Waiting until tomorrow to see how many will make it to blast. I have 3 additional frozen blasts; however I believe they are all in the same straw, so thawing them for supplementation, would warrant consideration to transfer them all.

Past chemicals were with tranferring 3-Day 3, 4-Day 3, and then 3Blasts. (Abundantly clear in there, where I starting being a fan of yours.)

I'm 36. Have endometriosis. Past Graves Disease, now Hypo-thyroid.

I'm thinking statistically I'm likely to end up with 1-2 blasts in the morning from the original 4. if Solucortef solves the problem, transferring too many may be a waste, and I would be out of frozens for a future transfer. (aka sibling).

Ideally if the 3 make it to blasts I would only transfer those.

If 2 make it... well I don't know as I had my mind made up to transfer 3.

If I only get 1 blast, I think I should supplement.

And then obviously, if I get 0 blasts, I'll just transfer all the frozen blasts.

I am open to selective reduction. I would not reduce twins, but would be open to my Dr.'s advice on reducing anything beyond that. My cousin works in neonatal and I know that it is not worth the risk of carrying multiples, as most hopeful mommies end up with a lifetime of sick kids.

What would you do?

Thanks for all your great straight talk! It makes a world of difference in the reality of making these decisions.

Erin

Comment


 

Dr Smith - Jan 8th, 2007 2:54 PM

Well...

I was on vacation until today, so you already made your mind up. I agree completely with your thaw/transfer strategy. I hope things worked out O.K. on the thaw, but more importantly, I wish you the best of luck for pregnancy.

I thank you for your post about the dangers of high order multiple gestation (triplets and higher). So many patients don't realize the impact of their decision not to reduce to twins will have on their unborn children. I'm not a big fan of reduction (and I believe that the transfer of only one or two blastocysts could reduce the chances of triplets to virtually zero - yes, I'm on that soap box again) , but when people realize the danger to their unborn children, I would hope they would seriously consider reduction as an option.


etiminsky - Jan 10th, 2007 10:35 AM

So glad you're back. I've been worried! Hoping you had a restful vacation, in some warm part of the world.

Ultimately, there was no decision to be made. Of the (4) 3 Day embryo's, 1 arrested immediately. 2 grew to what my doctor descibed as "12 hours from blasts", which I assumed is morula's. The other arrested somewhere in there. Of the 3 frozen blasts, we ended up with only 1 to transfer.

So we transferred 3. I'm disappointed to be out of embryo's, but hopeful that 1 will hang on.

This is my 6th transfer. On the 1st day post transfer I did feel a little pulling. Since then, no twinges or anything indicative or something going on. (Which I think I have felt more in the past) I do feel a mild tightness in the belly, but I attribute this to the progesterone and/or just a canon sized knot in my gut.

I'm giving myself a 33% chance. What's your opinion?

Glad your back!

Erin


Dr Smith - Jan 11th, 2007 12:18 PM

I'm not so clear on what was transferred. You said 3 were transferred. One blastocyst and two morulas?


etiminsky - Jan 11th, 2007 6:44 PM

Correct.
One blastocyst, and two morulas. I've tried to compare my pictures of the morula's, to others on the internet. Mine did not look flat and shiny. More like the surface of a chocolate chip cookie. Don't necessarily know if that means they are just early, or if they were poor quality.

Thanks again.

Erin



Dr Smith - Jan 15th, 2007 11:42 AM

The "choclate chip cookie" embryos were at the early stage of compaction. Technically, they were morulas based on the number of cells (around 16), but the compaction process is esential in order to proceed to the blastocyst stage. They were transfered prior to compaction. This does not necessarily mean they were of poor quality, but they were behind in their development. I would be more conservative and say your chances are 15-20%. Call me Doctor Doom'n'Gloom, but I think that's more realistic.


etiminsky - Jan 15th, 2007 7:18 PM

Dr. Doom'n'Gloom:

My luck just must be changing. Day 8 HCG, 85, Day 10 HCG 188. Now I'm just banking on the Solucortef & Dexamethasone to get me to Day 20. (A tier I have not reached with increasing HCG #'s!)

I'm so excited, as these are the best numbers I have ever had. While I'm still cautiously optomistic, I'm excited about the steroid protocol. Thinking you may really be onto something!

Thanks for all your help!!!!

Erin


Dr Smith - Jan 17th, 2007 8:23 AM

Congratulations. Cautious optimism is the way to go. So far so good. I love to be proven "wrong" in my estimates of pregnancy, but it kills my Dr. Doom'n'Gloom credibility (not to mention mortally wounding my ego).

We've had pretty good luck with the Solu-Cortef protocol too. Its too early to draw any conclusion about the efficacy of Solu-Cortef in treating infertility, but its looking good so far.


etiminsky - Feb 12th, 2007 1:04 AM

Well Day 20 kicked me in the teeth. My HCG was over 7000, and had been more than doubling every 2 days. I know this as I had it checked every two days in hopes of easing my anxiety. But I bled very heavy that day. Did an ultrasound the next day, and there was a sac. Bedrest for 5 more days, and then another ultrasound, that looked terrible. No growth. HCG was 38. This is my 4th miscarriage, that happened between day 15 and day 20. What's happening genetically in that time frame? Do you know of any articles that I should read regarding genetics and early embryo development. I think I need to rule out a genetic incompatiability issue before moving onto a surrogate. I saved as much tissue as I could from my miscarriage, but I don't know if the embryo was developed enough to warrant any useful information. My clinic offers embryo adoption, and they have suggested that I consider it. Best case scenerio would be a live birth, but if I miscarried again we would know it's not the embryos, but rather something going wrong by me. Long story short, I need some leads to education myself on genetic compatability.

Thanks so much.

Erin