Quincy and I got our day 3 report card back yesterday from the lab. Before I go into that, I want to explain a few things the best way I can:
After the retrieval, the eggs are put in an incubator for a few hours before they are checked for maturation. This is where they discovered that out of the 12 retrieved, only 6 of mine were mature…which was kind of a letdown.
Once they identify the mature eggs, they try to fertilize them by either putting them in a dish with sperm (to allow it to happen “naturally”) or with ICSI, where they literally inject one sperm directly into the egg using a tiny needle. Quincy and I had our eggs undergo ICSI, and it went as well as could be expected – all six eggs fertilized. Woohoo!
Once they are fertilized, the newly-created embryos are placed back in the incubator to, well, incubate. They are left alone to do their thing and are checked again on day 3. Here’s where the fun begins.
The grading is based on the number of cells that make up the embryo, the amount of fragmentation seen, and the symmetry of each cell. They are assigned a number and a letter grade.
The number is easy – it represents the number of cells that make up the embryo. On day 3, an embryo should be between 6-10 cells. The “ideal” embryo is an 8-cell, whereas any embryos with six cells are fewer are far less likely to continue to develop. 6-cells are borderline – they may or may not continue to develop, but an embryo with fewer with six cells usually start deteriorating as the other ones thrive.
So, on to the letter grade. Embryos are giving a letter grade just like in school – A, B, or C. That’s based on fragmentation and symmetry. Symmetry is easy – it’s how closely the cells are in size. The closer they are – the more symmetrical – the better. Cells that vary greatly in size are a bad thing and are rated lower. Fragmentation is a little tricky but from what I understand, when the cells are dividing sometimes little chunks of cytoplasm break off and create little globs that aren’t cells – they contain no nuclei – but they are floating around in there. Also, any fragmentation takes cytoplasm away from the actual cells, which isn’t good. The actual cells are missing that information. Embryos with high rates of fragmentation rarely develop into blastocysts.
So. That’s the long and short of it. Now we understand what the following numbers mean.
I had six eggs fertilize. On day 3, they were graded as follows:
8-cell, grade B
6-cell, grade B
6-cell, grade C
6-cell, grade C
4-cell, grade C
4-cell, grade C
So, yeah. Obviously not ideal. Dr Landay says the 4-cell, grade C embryos are done. That leaves four. The 6-cell, grade C guys are iffy – we have to wait and see. They could improve…or not. We won’t know for a couple of days. The 6-cell and 8-cell grade Bs…those are promising. The 8-cell one is ideal, the 6-cell is more of a “looks good, but we’ll have to see” scenario than anything else.
I think this is actually worse than your average two week wait. They’re right there. They’ve been fertilized. They were inside my body right now, they’d be preparing for implantation. I’d technically be pregnant. But they’re not. And if I were pregnant…two would have already died, even before trying to implant. Now I have to wait until tomorrow for our day 5 report, just to see if any have even survived to biopsied for defects. Then, after that, the REAL two-week-wait begins. We won’t know how the biopsied, frozen embryos are for another two weeks. So, we’ll have a good Thanksgiving…or we won’t.
My Stork Got Lost 