PUPO take 3...

Well.....I'm PUPO (pregnant until proven otherwise)!  We had our transfer yesterday morning.  They transferred 1 blast and 1 morula.  The only other embryo remaining was a compacting embryo.  All the others stopped developing.  This is normal for a large drop-off from the initial fertilization number to day 5.  Only about 30% of embryos make it to blast stage.  However with this statistic in mind, our blast rate was a dismal 10%.  For our last cycle we were close to that 30%.  Also, the quality of the 1 blast that we did have was only a 2cc.  The explanation for this grade can be found here: http://www.advancedfertility.com/blastocystimages.htm

Below is a table from that site:

Expansion grade	Blastocyst development and stage status
1	Blastocoel cavity less than half the volume of the embryo
2	Blastocoel cavity more than half the volume of the embryo
3	Full blastocyst, cavity completely filling the embryo
4	Expanded blastocyst, cavity larger than the embryo, with thinning of the shell
5	Hatching out of the shell
6	Hatched out of the shell

ICM grade	Inner cell mass quality
A	Many cells, tightly packed
B	Several cells, loosely grouped
C	Very few cells

TE grade	Trophectoderm quality
A	Many cells, forming a cohesive layer
B	Few cells, forming a loose epithelium
C	Very few large cells

My grade of a 2cc means the blast cavity is at an intermediate stage.  At my clinic, they actually use 4 grades instead of 3 - A, B, C, & D - for the inner cell mass and trophectoderm.  So my 'cc' grade is really somewhere between the b and c grades shown above - the technical description they have is as follows:

• A is the same as Gardner's A 
• B is "not quite A, but still quite good" 
• C is "not quite B, but not bad" 
• D is for very few cells

So, this blast is a "not bad" intermediate blast.  I hear so many stories of beautiful blasts never forming babies and of ugly embryos making twins so there's really not much stock to be placed in the blast grading system.  Also, I learned that my son was likely a 3cc blast - not much better than a 2cc.  We got a picture of the embryos that were transferred.  Comparing the 2cc embryo with the 3cc embryo, they really look similar.  Really my disappointment stems from not having more than 1 blast to transfer.  If an embryo gets to the blast stage, this is a large milestone and means they are really strong.  But I only had 1 blast plus 2 others that were not there yet.  I guess I should be happy that at least we had 1 blast.  An embryo is at the morula stage typically on day 4 or early day 5 right before the embryo becomes a blast - so perhaps it would have been a blast in a couple hours.  The 3rd embryo that we have - a compacting embryo - is what we transferred the very first ivf cycle.  This embryo is very slow.  I don't have much hope for it.  They said that we could transfer it with the blast and morula but obviously the doc could not rule out triplets which did not appease my hubby.  So they are holding this embryo to see what it does today and will call me tomorrow with it's status.  If it has continued developing, they will freeze it.

Yesterday was my transfer.  The important commitment that I thought my hubby was going to have last Friday was actually yesterday.  So he could not attend.  The doc called him via phone to get his consent and discuss our embryos though.  I had the transfer, then went back to my parents house and hung out until after dinner.  Then I drove back home.  I could not lift my son and did not have my hubby to help me so I wanted to put him in the carseat and have him fall asleep with the intent of not stopping until we got home.  The plan worked.  My mom put him in his seat and within 45 minutes he was sleeping.  When we got home, hubby came out and took him to bed.

I'm having mixed emotions today.  I am 1dp5dt.  Of course I do not have symptoms.  Occasional cramping and uterine tightness - but all can be associated with the transfer procedure and with the progesterone shots that I've started doing again (oh joy!).  Trying to avoid google but that is really an exercise in futility.  Of course I'm going to google success stories with a 2cc blast.  It's just inevitable and I might as well accept it.  I will probably pee on a stick (POAS) sometime before my beta next Wednesday.  But I need to "test out my trigger" first.  This time I triggered with the full 10,000 units of HCG whereas last time I did a lupron trigger.  The pregnancy tests detect the HCG hormone and since it has only been 7 days since my trigger shot, I should still have HCG in my system.  Sure enough, I POASed and had a 2nd line this morning.  So my trigger is still there.  It should be gone by 10 days so on Thursday evening I will test again.  I'm thinking I might POAS for real Monday (assuming I'm able to test out by trigger by then - for some women, the trigger sticks around longer than this).

For now, I'm trying to focus on the positive - at least that's what I KNOW I should do; whether I am able to do it is another story...haha.  Thinking about what went wrong this time is not really something I should dwell on yet.  We will cross that bridge if we get there.  Still have a plan B though that would involve meeting with doc for a cycle review and then maybe trying again in the spring.  This however would be contingent on hubby getting a job.  Similar to last time, we have to pay quite a bit out of pocket as the whole cycle is not covered by my insurance.  This time it will cost about $5000 after all is said and done.  Some of this we have already in savings and in our HSA account and we are putting the balance on a 0% interest credit card that needs to be paid off by 3/2017.  If we have to do another cycle, that will be another $5k to add to our expenses and so we will really need to have a definitive 2nd income to support that.  But again, we will cross that bridge if we have to.  Until then, HAPPY THOUGHTS!!