We were disappointed for our recipients that the first embryo transfer did not work. Originally they told us they wanted three children, all full genetic siblings. That was a long shot to begin with since we only had three embryos to offer them. With only a one in three change of success per embryo (assuming all the embryos thawed) it was likely that our recipients would end up with one, or possibly two children.
On the other hand, there was also a possibility that they would have either zero or three children from the three embryos. But now that the first transfer had failed, it was almost impossible that their dream of having three genetic siblings would come true with our embryos (identical twins are much more common with IVF so there is a slight chance they could still have three genetic siblings).
We knew these wonderful women wanted to be mothers with all their hearts. We wanted to help them. Since my eggs had been used to create the embryos, I felt like I was at fault for the failure of their first attempt.
WHY IT DIDN'T TAKE
It is impossible to know exactly why the embryo did not implant. We know that embryos of the size this one had achieved have at least a one in 3 chance of becoming a baby. But they have a two in 3 chance of failing to implant, just as they do when conceived the old fashioned way.
There were several factors that probably contributed to the lack of a pregnancy:
1) The embryo was only grade C. I had never before produced a grade C embryo, all my previous embryos being higher grades, but it's not surprising that this embryo was of lower quality. I was 37 when these embryos were created. That's not super-old for successful reproduction, but it's not considered young. Most clinics won't even accept egg donors in their mid to late 30's.
2) This cycle had been rather stressful for the recipients. There was the mix-up with the prescription, first-time jitters, meeting us for the first time, traveling to a new area, and so on. Stress is known to have a significantly adverse affect on IVF outcomes.
3) We later learned that both women had a common bacterial infection known to cause miscarriage and failure to implant. The clinic requires these infections to be treated before a cycle can begin. I am not sure how the infection was overlooked, but it could certainly have had an affect on their chances for success.
Well, at least they had two embryos left. The recipients looked into ways to increase their odds of success for the next attempt. One thing they did was treat the infection. Another thing involved me, and shortly after the failed transfer they wrote to me to see what I thought about it.
More on that next time.
Showing posts with label first cycle. Show all posts
Showing posts with label first cycle. Show all posts
Saturday, June 9, 2007
Friday, June 8, 2007
TRANSFER RESULTS
Each day my recipients did an early home pregnancy test and each day they wrote to us to say the result was negative. We appreciated them involving us in their pregnancy attempt but we did not expect it. The embryos were no longer ours. The recipients had a contractual obligation to notify us if they gave birth, but they were under no obligation to tell us anything else before the baby came.
As each day passed with no indication of pregnancy it seemed likely that the recipients were not pregnant. Still, there was a reason the doctor schedules the test for two weeks after the transfer: that's when enough hormones should be present to truly indicate if a pregnancy had occurred. Until that date it was entirely possible that the negative results simply indicated it was too early to tell.
The day before their final pregnancy test was scheduled at the doctor's office we did not get the daily update from our recipients. It seemed clear to us from this that the last home pregnancy test had been negative.
Several days passed with no word. Had they rescheduled their doctor's visit? We gave the recipients their space and privacy. This was their family and their business, not ours. Several days after their last email, we received this message, sent to a dozen members of their immediate families:
We were disappointed for Jenny and Erin. They had been waiting so long to become moms. We had hoped to help them and we still might, but not yet.
As each day passed with no indication of pregnancy it seemed likely that the recipients were not pregnant. Still, there was a reason the doctor schedules the test for two weeks after the transfer: that's when enough hormones should be present to truly indicate if a pregnancy had occurred. Until that date it was entirely possible that the negative results simply indicated it was too early to tell.
The day before their final pregnancy test was scheduled at the doctor's office we did not get the daily update from our recipients. It seemed clear to us from this that the last home pregnancy test had been negative.
Several days passed with no word. Had they rescheduled their doctor's visit? We gave the recipients their space and privacy. This was their family and their business, not ours. Several days after their last email, we received this message, sent to a dozen members of their immediate families:
"We had our blood test completed today and received a call back confirming
that we are not pregnant but wanted to send a thank you to all those who were so supportive and thoughtful during this whole process. It would be much harder without the great support system we have. We are truly lucky to have such great family and friends.
We are still not down for the count! We will be trying again hopefully late Spring early Summer! So until then we are counting our blessings and saving our quarters for next time."
We were disappointed for Jenny and Erin. They had been waiting so long to become moms. We had hoped to help them and we still might, but not yet.
Monday, June 4, 2007
THE RESULTS
A few days after Jenny and Erin's fertility doctor transferred one of my spare frozen embryos into Erin's womb they tried an early home pregnancy test. It was too early for a valid test but they thought they'd give it a try. It was possible they they might have a hint if the embryo had attached.
As expected, the test was negative. That was to be expected. Jenny and Erin thoughtfully let us know that they had tested. It is hard to wait the two weeks to find out if the IVF procedure was successful. Doctors ask their patients to wait the full two weeks before testing at the doctor's office to avoid false negatives which can be disappointing.
There was still a week and a half to go before the final test by the doctor. Jenny and Erin decided not to stress out. Another test might have a better result. There was always tomorrow.
As expected, the test was negative. That was to be expected. Jenny and Erin thoughtfully let us know that they had tested. It is hard to wait the two weeks to find out if the IVF procedure was successful. Doctors ask their patients to wait the full two weeks before testing at the doctor's office to avoid false negatives which can be disappointing.
There was still a week and a half to go before the final test by the doctor. Jenny and Erin decided not to stress out. Another test might have a better result. There was always tomorrow.
Thursday, May 24, 2007
THE FIRST CYCLE
After their embryo transfer, our recipients, Jenny and Erin, stayed in a hotel near the clinic. To give themselves the best chance of the procedure working, Erin was on bed rest for a couple of days until it was time to fly home.
Now began the two week wait. Until the pregnancy test two weeks after the transfer, there is no indication whether or not a woman who has completed an embryo transfer is actually pregnant. This is a nail-bitingly stressful time. The intended mothers would be cataloguing each twinge, wondering if a bit of spotting was a sign that the embryo was implanting in the womb, or being rejected, and generally on pins and needles.
Many women can't wait the full two weeks and use early home pregnancy tests to try and get an indication of whether or not the transfer worked. Jenny and Erin were no exception.
The problem with these tests is they are not certain. It is hard to tell exactly when the developing early pregnancy might produce enough hormones to register on the test. In other cases, a "chemical pregnancy" produced by the drugs one takes to do the IVF cycle could indicate a pregnancy where none exists.
With all of this in mind, I waited to hear what Jenny and Erin's early tests were revealing.
Now began the two week wait. Until the pregnancy test two weeks after the transfer, there is no indication whether or not a woman who has completed an embryo transfer is actually pregnant. This is a nail-bitingly stressful time. The intended mothers would be cataloguing each twinge, wondering if a bit of spotting was a sign that the embryo was implanting in the womb, or being rejected, and generally on pins and needles.
Many women can't wait the full two weeks and use early home pregnancy tests to try and get an indication of whether or not the transfer worked. Jenny and Erin were no exception.
The problem with these tests is they are not certain. It is hard to tell exactly when the developing early pregnancy might produce enough hormones to register on the test. In other cases, a "chemical pregnancy" produced by the drugs one takes to do the IVF cycle could indicate a pregnancy where none exists.
With all of this in mind, I waited to hear what Jenny and Erin's early tests were revealing.
Tuesday, March 27, 2007
THE EMBRYO
From Jenny and Erin's perspective, the cycle was on. They had the medications they needed, plane tickets to get to the clinic for the transfer, hotel reservations and positive signs from the blood work and tests the clinic conducts before each cycle to make sure the body is ready to become pregnant.
The last piece of the puzzle was the embryo itself. I had three embryos left over from my own in vitro fertilization cycles. That gave Jenny and Erin up to three chances to become pregnant. But they might have no chance, if the embryos did not survive the thaw or grow properly.
Our contract stated that Jenny and Erin's clinic would thaw just one embryo at a time. If the first embryo thawed did not grow they could thaw another one until they got a viable embryo. The embryologist could tell right away if the fertilized egg would grow. If it didn't look good she would thaw another embryo right away. That way the cycle could continue even if the first embryo did not begin to divide.
After beginning the final medications to prepare her body for the embryo, Erin and her partner Jenny still had a tense four days ahead of them while they waited to see if the embryo that might become their child would take the first step.
The last piece of the puzzle was the embryo itself. I had three embryos left over from my own in vitro fertilization cycles. That gave Jenny and Erin up to three chances to become pregnant. But they might have no chance, if the embryos did not survive the thaw or grow properly.
Our contract stated that Jenny and Erin's clinic would thaw just one embryo at a time. If the first embryo thawed did not grow they could thaw another one until they got a viable embryo. The embryologist could tell right away if the fertilized egg would grow. If it didn't look good she would thaw another embryo right away. That way the cycle could continue even if the first embryo did not begin to divide.
After beginning the final medications to prepare her body for the embryo, Erin and her partner Jenny still had a tense four days ahead of them while they waited to see if the embryo that might become their child would take the first step.
Subscribe to:
Posts (Atom)
