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Transfer Day: Survival of the Strongest

Quick recap:  Last Saturday (Egg retrieval day), Dr. Jarrett retrieved 11 mature eggs.  The following day, 7 eggs had fertilized.  We received a call Tuesday with a transfer time of Thursday at 8am.

I arrived at Dr. Jarrett's office this morning at 7am.  I was instructed to drink 32oz of water (this allows for a full bladder that helps get a better view of the uterus on the ultrasound scan) and take a valium as soon as I pulled into the parking lot.  It only took about 5 minutes until I felt like I was flying high as a kite.  When the nurse called my name to head back to the triage area, Kellen and I followed and I'm pretty sure I walked into part of the wall.  Nobody noticed.  ;-)

After filling out all the necessary paperwork, and having Kellen sign the important stuff -- since you know, I'm high -- the embryologist came in to deliver the news; the much anticipated news that I have been trying to patiently and calmly wait for.  The news that myself, Kellen, our friends and family have been praying for over the past five days. 

She's always so calm and collected.  Like she does this every day or something!  :)  She tells us that we have 2 GREAT looking blastocysts and a third that can be frozen.  She asks us if we want to transfer one or two, in which I pretty quickly responded, "two."  I mean, we're not messing around.

At 8am sharp, we headed back to the operating room.  I walk over to the lab window and state my name and date of birth.  Then, I lie on the table and saddle up in the feet stirrups (that's what I call them).  Dr. Jarrett comes in shortly after and makes his way to the lab window.  Kellen's sitting in the chair behind my head.  I'm guessing that this is protocol, for him to sit back there, but I find it interesting that he hung out behind me while I was giving birth to Khloe, too.  I guess getting all up in the excitement isn't his thing.  

The transfer isn't something I would call painful, but then again I measured my pain at a "2" when I was 8cm dilated and in active labor with Khloe.  The worst part of it, for me, is that metal cranking thing that they use (I'm sure all the ladies out there know what I'm talking about).  The computer screen is to my left and the nurse shows us where the uterus and bladder is.  She talks to me for a minute about my ovaries, which had just underwent serious over-stimulation for this IVF cycle, and said that they are still large but will shrink back to normal over time.  The worse part about that is that it's comparable to the shrinking down of your uterus after having a baby.  They contract, and that sucks.  Pain meds are still my friend.

We watch the screen and see the 2 blastocysts being placed in my uterus by Dr. Jarrett.  He removes his equipment and helps me back into a comfortable position.  Then, he shakes my hand and wishes me good luck, shakes Kellen's hand, and everyone heads out of the room while I wait for a few minutes.  Shortly after, the nurse comes back in and in a matter of five minutes we're walking out the door and headed to Starbucks drive-thru for a sausage breakfast sandwich.

That's it.  Overall, I'd say the experience went as well as possible.  My first pregnancy test will be June 22.  Until then, I'm spending the first 48 hours on bed rest and the remainder of this waiting period on very limited activity. 

Below is the breakdown of the quality blastocysts we're working with.  These are the best embryos (in 6 total cycles) that we've ever had.  This is also the first time we've ever had any to freeze.  Dr. J is the man.

2 blastocysts transferred today -- grade 3AA.

The number refers to the degree of expansion of the embryo’s cavity and goes from 2-6
  • 2 = small cavity filling a third of the embryo
  • 3 = partial expansion of the cavity filling 70% of the embryo
  • 4 = fully expanded cavity 100%
  • 5 = embryo has expanded so far that it has split open the shell and is starting to hatch out
  • 6 = embryo is totally hatched out of the shell
FIRST LETTER: the first letter refers to the inner cell mass (ICM) quality. The ICM is the baby making part of the embryo.
  • A = well defined clump of cells
  • B = less well defined and may be grainy in appearance
  • C = few dark cells or may be no visible mass

SECOND LETTER: the second letter refers to the trophectoderm quality. The trophectoderm is the cell layer that makes the placenta and the membranes surrounding the baby.
  • A = many smooth cells of equal size forming a neat layer
  • B = irregular cell layer with some grainy cells
  • C = very irregular cell layer with few cells.  Cells may be dark and or grainy

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