An education on embryos and their quality.

As you know, the doctors were only able to retrieve 6 eggs from my 12 measly follicles. Of the 6, 5 were mature enough for the doctors to use ICSI to fertilize them. They pick up a living sperm with a teeny pipette and inject it directly into the mature egg instead of letting those little swimmers battle it out in a petri dish (really it’s more of a medical tube but most people are used to imagining a petri dish with IVF).

Of the 5 eggs that underwent ICSI, only 2 fertilized and showed signs of growth after 24 hours.

Here’s the basics of what you need to know, because yes, per usual, I acquainted myself with scientific journals and the likes on embryo development after my transfer. Google for the win!

Embryos should have at least 2 to 4 cells after 2 days and 7 to 10 cells by day 3.

Here's an example of a perfect 8 cell day 3 embryo. If you don't count 8 that's because some cells get overlapped by others. But it's still a good looking embryo!

It is best if all of the individual cells within the embryos are of similar size. So you want to see 7 to 10 dimes, not 7 to 10 nickles, quarters, dimes and pennies in your embryo.

You also want to see those dimes very clearly without any sort of clouding, from dirt, pocket lint or stray tumbleweeds in your embryos. Those fuzzy bubbly pieces are what’s called fragmentation or blebbing; they are portions of the cells that have broken off and are separated from the nucleated portion.

Basically the more fragmentation you see, the poorer the embryo quality and the less likely they are to implant. Now the good news is that fragmentation is common and many beautiful babies have resulted from these low quality embryos but they are a worry, at least for me.

Here are a couple of embryos with varying degrees of fragmentation. Anything above 25% is relatively bad.

So we now know that not only do you want your embryos to be quite beautiful, have the right number of cells and be very symmetrical, you also need for them to be chromosomally normal and that is something you can’t tell without genetic testing. Even the most perfect looking embryos can be chromosomally abnormal which will lead to miscarriage.

Now that you're an embryo expert, we go back to our case...

We only have two embryos. We did not know their stage of development or anything about them, if they were still developing or had arrested, until I was lying on the table waiting our transfer. I am telling you that those 3 days were the slowest of my life. I stayed awake racked with worry and cried every night. I’ve never prayed so hard before either, and I’ve sent up thousands of prayers especially within the last year and a half.

On the table, I learned that we had one 7 cell embryo with slight fragmentation and asymmetrical cells. We also had a 4 cell embryo that looked perfect if only it wasn’t slow in development. Overall not so hot right?

We transferred both babies per our doctor’s guidance. It wasn’t even a discussion, which made me really nervous. My doctor is Mr. Positivity but he is also Mr.Twins-are-a-medical-risk. So much so that he spent the better half of our last consultation, dare I say, scaring us with all the dangers of having twins only to do a 180 and told us we were just going to transfer both embryos.

His response tells me one thing, he was nervous. Now I do not make a point of disagreeing with a trained physician but I can’t account for him telling us our embryos “looked good” and insisted on transferring two. Let’s give him the benefit of the doubt and say that he knew our financial circumstances and knew how badly we needed this to work and made his recommendation based on that vs. out of fear that our embryos weren’t the best in terms of quality.

I mean, he should know better than to tell me that my embryos looked good and have me take his words for it. I did after all tell him I was a googling FIIEENDDD last time we saw each other. I can tell the difference between a perfect 3 day embryo, a poor quality day 3 embryo and a 5 day blastocyst.

Ok. Confession time, I came home and did a crap ton of googling and stalked people who I know have had IVF success on social media to see the quality of their embryo. I looked to see if their babies were day 5 blastocysts or day 3 embryos based on their transfer day picture. Yes. I’m crazy and I readily admit it.

What I got from “research” was this. Although the quality of first the egg and then the embryo gives doctors some idea of how likely the patient will become pregnant, it is not a hard science. Meaning that there are so many other contributing factors involved that it’s basically still a crap shoot.

There are cases of women who become pregnant with a 4 cell day 3 embryo (which is my case), or a low quality embryo (also my case). But they also see perfect looking embryos failing to take. The true genetic potential of an embryo therefore relies on their chromosomal make up.

Now remember when I said we chose not to genetically screen these babies? What that now means is that we don’t know for certain that our implanted babies will even make it past the first trimester, or the second should they miraculously stick. It takes SO MUCH to make a child and I think we tend to forget that everything has to line up perfectly for a baby to come into the world. Every single child is a miracle and we are still waiting for ours.

I have so many fears because I know so much can go wrong. I dived a little too deep and definitely followed a rabbit or two down the rabbit hole. I worry even though nothing is in my control. I can’t sleep because I longed to know if my baby or babies are still living inside of me.

I jump at every pain and every ache. I am living in limbo; half refusing to believe that everything we went through will be for naught, half preparing myself for the disappointment of yet another failed pregnancy test, an empty bank account and a broken heart. Worst of all I worry that my positivity is fading and fear that I will never, ever get to be a mother no matter how hard I try.

The waiting kills, but when the day comes I’m sure I will wish I could stay in limbo forever because right now, as far as I know we are pregnant until proven otherwise. At least that's how we choose to look at it and that is all the hope I can hold onto.

I don’t know how so many women choose to go through this process so many times. Anteing up with their wallets, body and emotions. Putting all their hopes and dreams on a small chance that the thing they want most in the world will happen for them. Some will never become a biological parent. Some will have motherhood taken away with miscarriages.

Also, even if you have not gone through IVF or experienced infertility, you are a damn hero if you have survived the loss of a child due to miscarriage. I am so sorry for your loss. Your pain is so real. Don’t ever let anyone tell you any different. Don’t believe them when they tell you that your loss did not matter.

Anyways, If there’s anything I do know, it is that I’ve been blessed with a lot in life. Most especially the most insanely wonderful husband who will hold my hand through it all, who won’t let my resolve falter. No matter what happens I know at the end of the day, when I’ve had all I can take, he will let me cry on his shoulders, hug me tight and tell me he loves me and that “we will be parents if it kills us”.

Babies, we want you so dang much! Please hang tight to mama. We’d love to meet you and show you how much you mean and shower you with so much love.

Here's our first ever family picture