And again, we lay tensely in bed at eight o’clock in the morning, on Day 5 of our embryos’ existences, waiting for Riverside Clinic to call and let us know how many we still had, and if they could be tested after all. Again, after a long, hot, muggy, sleepless night (we’re having a heat wave here in Blighty. No, stop laughing, I’m serious. 35 C and no air conditioning. Part of the M25 motorway melted earlier this week).
So, we had had six, three in good nick and three looking a little shabbier, that on Day 3 they thought worth doing assisted hatching on and culturing to Day 5.
And now we had, well, one that looked ‘good’, and had hatched; one average, that was hatching, and could be tested, one that was a bit slow but possibly thinking about hatching; and two that were holding up little signs saying ‘I aten’t dead’, but were otherwise massively unbothered by this growth and development nonsense.
The embryologist politely got off the phone for 15 minutes so we could discuss our options.
- Put the best-looking one back in this afternoon regardless, because there was no guarantee we could get enough cells to test from the others. This would mean getting absolutely no answers as to the genetic viability of any of them, but we would at least get a transfer out of it. And, if I were to miscarry, another completely unexplained loss. Which seemed, after the clutch-at-the-heartness of it all, a bit fucking pointless.
- Test the good one and possibly the mediocre one, culture the rest until tomorrow, and freeze any viable-looking ones. Transfer tomorrow. We could always test the others tomorrow, before freezing, but we’d be charged a whole ‘nother set of lab fees to do so.
- Take a wee leap of faith, wait another couple of hours to give the rest a chance to get their act together, test the good one and anything else that had hatched, in the understanding the others were not going to get their acts together for the mere asking, and we could still end up with the one embryo. And might miss the transfer window for this cycle.
It didn’t take us long to decide on option three. Option one, like I said, was just daft after we particularly decided to do IVF with Riverside because they offered rapid CGH array testing. It still stung a little to say goodbye to a guaranteed transfer. Option two was ‘safest’ in terms of not missing the transfer window, but it also limited the amount of knowledge gained, and then there’s the second lab fee… I know, I know, we would do anything for our children, but frankly that includes feeding them should they ever get here. So we asked them to wait, and test what they could test in one go. And they said they’d call us back mid-afternoon, when it was all over, and the samples had been couriered to the UltraLab 60 miles away.
[Recap. By Day 5 an embryo (now blastocyst) has gone from an undifferentiated mass of cells to a bobble that should become a foetus one day, and a ring of cells preparing to become placenta, cord, gestational sac, play-pen, crib and miniature internal ocean. When hatching, a clump of cells breaks through the egg ‘shell’ and, on contact with endometrium, will dig in and make placental noises. You can cut this extrusion off (carefully, with a laser) without hurting the embryo, as it’ll just grew some more. And this little clump of cells can be tested. Assisted hatching on Day 3 (basically, they gently poke a hole in the shell) speeds this up a little and increases the chance of an extrusion by Day 5.]
Oh, Christ, the angst. It was the right decision (‘For the Science!’). It might pay off. It might bite us on the bum in spectacular fashion. The courier might get stuck in molten Tarmac and our samples melt. *Chews nails*
I came away from the conversation with the distinct impression we were pretty much down to one embryo, as the embryologist was unsure she’d be able to biopsy the second one, it being a bit underachievey, and the third hadn’t actually caught up (and the slackers were, eh, slack, and really possibly only being kept in culture as a courtesy). It has all felt like sending a nice little platoon of chin-fluffed soldiers on a long, slow walk across No-Man’s-Land, in bright daylight, straight into enemy machine-gun fire, dressed in hot pink tunics and carrying a bayonet and a feathered hat each.
And then the embryologist called back.
It would seem my embryos take after their Ma, who thrives on lie-ins and a surprise dead-line extension (see my entire academic career from ages 18 to 33). Good embryo was good. Middling embryo was fine, and gave good biopsy. Underachieving embryo had caught up and also gave good biopsy (‘That one was much easier than I thought it would be!’ said the embryologist). And one of the wee slackers had also taken a Great Leap Forward and popped out a wee cell of its own to be taken away and tested. Four! Four biopsied! Admittedly, Wee Fourth’s sample was one cell big, so we’re not that likely to get a result off it, but four! OK, three and a hiccough!
UltraLab will call Riverside at midday. And then Riverside call us. If any of them are normal, we rush to Riverside for transfer ASAP. (It’s all gone a bit Secret Squirrel. The hen has been seen crossing the river! Emergency rendezvous at thirteen hundred!)
We’re going to the cinema his evening, because air conditioning, and distraction. For surely are we not both driven distracted already?