Spilled Milk

At what point do you mourn the loss of a....

Wait.   

First we have to define what '____' is!  So let's give you some background.

So septomom is no more.  The embryologist advised the seven well-performing embryos are now down to six.  Six went on to the next stage -- blastocysts, and one's cell stopped dividing at around 5pm.  The cells of an embryo will stop dividing (growing into specialized cells which eventually develop into human parts) for a number of reasons, the main one being that something went wrong with its chromosomes.  Nature will find a way to self-abort (if it can), rather than perpetuate or introduce a potentially detrimental defect into the gene pool.

(I paraphrase)

"We lost one", he said.
"WHAT?  HOW?  I worked really hard to produce that egg!"

"It happens....part of life.  Can't cry over spilled milk.  Let's focus on cryopreserving the best performing embryos"

"....did you just call my dead embryo spilled milk???"

"hmmm.....I see you need some time alone.  Let's ...uhmmm.... I ....have a ....uhmmm....thing to do....uhmmm"

"....Have a good evening!"

Reminds me of some of those very heated debates I used to find myself in....about 'when life begins' and whether abortions should be considered murder.  

So what do you do when a 4-day old embryo stops dividing?  Cry?  Mourn?  Plan a funeral service?  Clean up spilled milk??? 

Septomom!

superstar embryo with 8+ cells

Yep!  3-days after fertilization 7 out of 8 eggs made it to the next phase.
7 embryos....dividing wonderfully.   Six of them have 8 cells and one embryo already has more than 8 cells (like any other living organism, if all goes well, they'll continue dividing into millions of cells that will eventually become specialized over the months, some of those cells forming the heart, others forming toes, some the elbow, and so forth).  If for some reason, something goes wrong in the growth phase of each of these embryos, the cells will receive a chemical signal to stop dividing, and that would be the end of life for that embryo.  It's kind of up to God at this point...science can only take you but so far.

The next stage in this IVF process is to determine what day to transfer the embryo(s) back into the womb and 'how many'.  The most advanced fertility centers are generally very conservative in their approach.

The first goal is to select the best-performing embryo as it will have the best chance at leading to pregnancy.  The second goal is to prevent multiple births as much as possible -- so transfer the least number of embryos possible.  Having unexpected twins/triplets/quads, etc comes with its set of medical, financial, and psychological burdens on families.

When embryos are transferred on Day 2 or 3, it's tough to select the best embryo as they may all be dividing at the same rate.  On Day 5, they would have reached the blastocyst stage and would already begin to differentiate between placental and fetal tissue --- then it's easier to tell the superstars from average 'embies'.

Shots, Shots, Shots!

Remember back in the "I'm Huge" post, where I broke down what happens to non-dominant follicles that don't go on to ovulation, but instead disintegrate and produce necessary hormones in a woman's body... mainly progesterone?

Hold that thought!

So because all the eggs I produced grew to a considerable size -- essentially no particular one was dominant -- they were all harvested from my body leaving nothing behind to disintegrate and produce progesterone.  It's a hormone that gives support to the lining of the uterus and is needed to maintain an early pregnancy.  At around 12 weeks, the placenta starts producing its own progesterone and can sustain itself.

Sooooo....what does that have to do with the gigantic 22 gauge needle pictured above?  THAT bad boy goes in my ass every night....(too graphic for ya??? put yourself in my shoes!).  I get a shot of progesterone every night until the medical team says stop!  The ENTIRE needle must go in as it needs to penetrate into the muscle.  [He] gets to do the honors.  I get to numb the area an hour before the shot with Lidocaine, but funny enough, on days when I've managed to get on every one of his last nerves, I seem to feel the pain of the needle.  Somehow the numbing cream doesn't work when he's mad at me....

Coincidence?

*disclaimer:  I'd recommend taking a break from reading this blog for anyone with delicate sensibilities, an inability to cope with death, in-vitro abortions, miscarriages, and the likes.  As these tend to be the realities of many (not all) infertility treatments, many may find it difficult to keep up with future posts. I'll try to keep it light, however keep in mind this is just one person's experience and perspective*