Secondary IF
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Embies update & WWYD?

For those who missed it last week, I had my retrieval last Monday. 11 follicles were retrieved, 7 mature, and 5 fertilized. The plan was to do a day 6 fresh transfer. My clinic only transfers blastocysts, so if they're not blasts by day 5, they do a freeze all and a FET the following month. They told me that few actually make it to blasts by day 5, so there was a good chance that we'd be moving to a FET.

I knew that with 5 fertilized, there was a good chance I's only end up with a couple, which I was not happy about. Since my Dx is "unexplained" and my FSH and AMH are within normal range, my nurse led me to believe there was some concern I could overstimulate, so they were going to be very careful with my protocol. Throughout my monitoring, I was concerned because my follicles seemed to be small, but I just trusted in the process. The day before my retrieval I had an u/s and my doctor listed 14 follicle sizes ranging from 17-20 and finally said, "I'm not going to count them all. They are just a lot." So I thought I was going to have at least 15. When I got the initial fertilization report, I was disappointed and felt like maybe I was under-medicated. I started to stress about what I'd have left at the end of the week. I was thinking if there are only 1 or 2 left, I might want to do another retrieval so that I'd have more chances banked. We're doing PGD, so the number that survived the week, might be further reduced by the results. The clinic can offer me a "PGD package" where the PGD from a second retrieval is discounted, but only if I do the retrievals back to back. If I have a transfer, I lose the discount (which is about $2000 off).

This brings me to my dilemma...2 of my 5 embryos made it to blasts, but not in time for the fresh transfer. Since it will be a FET, they do not rush the PGD results and I won't learn whether or not they are genetically normal for 14 days. The grades of the 2 survivors are 6AA and 6BB, so they appear to be high quality, but that doesn't mean they are genetically normal. I've asked my clinic to put me on BCPs to put me in a holding pattern to wait until we get the PGD results. If I only have 1 genetically normal embryo, I'll definitely do another retrieval. However, if I have 2 good embryos I'm not sure I'll do another one. Since I have less than 3 embryos, my insurance will cover another retrieval, so I don't have to worry about that cost. But, if both are normal and I do 2 transfers and neither takes, I'd have to do another retrieval, I lose the PGD discount. Given I conceived my first 2 pregnancies so easily, I have no experience here. I don't know the heartbreak of a BFN after going to such lengths to conceive. What would you do? Any advice or perspective here would be helpful. Thanks!

Sorry this is so long!  
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Re: Embies update & WWYD?

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    It seems like you have a pretty solid plan. Wait and see what happens with your frosties and go from there. If I was in your shoes, I'd do exactly what you are doing. If the report on your embies comes back good, then definitely go for the FET and hope for the best. If it doesn't come back so good, then consider a fresh cycle, but I would not consider a fresh cycle until I knew for sure it was the best option, and right now there is a still a good chance you have 2 awesome embies, right? 

    Good luck with your frosties! 






    Spontaneous pregnancy #1
    DD1 July 31, 2011

    Trying for #2 since Oct 11
    732973 Clomid Cycles
    2 IUIs 
    3 Fresh IVFs= 1 Ectopic treated with MTX
    Spontaneous pregnancy #2= Ectopic #2= lost left tube
    Spontaneous pregnancy #3= DD2 January 29, 2016
    Spontaneous pregnancy #4= Ectopic #3
    Spontaneous pregnancy #5= Baby #3 is a BOY!!! 



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    *ticker warning*

    It doesn't sound like you were under-medicated; 11 eggs is a lot. My RE was very careful to warn me that not all follicles will contain an egg, so even though they count them before retrieval you can never be sure how many you will get. They also told me that the average they get is 6 eggs, so I think 11 is a fantastic number.

    And all you need is one good embie! If both survive and are genetically normal, would you transfer both, or just one?

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    After 3 failed Clomid+TI cycles, DD was conceived with IUI#1

    TTC #2

    Clomid 50 mg + IUI#1  = BFP, m/c and D&C at 7w1d

    Clomid 50mg + IUI#2 = BFN

    Clomid 100mg + IUI#3 = BFN

    Lupron + Follistim + IVF#1 = 11ER, 10M, 10F, ET of 1 expanded BBA 5-day blast, 2 Frosties. BFP! Beta 10/13 = 264! Beta 10/15 = 702! EDD 6/21/14

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    @gmc222 - I will only transfer 1. We only want one more child. I think I'm so anxious over this because it seems like since our loss last November, nothing has worked out. This process has been delayed needlessly several months for various issues (insurance changes, stupid CMV delays, etc...) and I'm at my wits end. I'm super optimistic by nature, but this process is challenging that. I'm so worried that I'm lucky enough to have 2 genetically normal embryos, that neither will take (2 separate transfers) and then I'm back to square one and will have the full burden of the cost of PGD again ($4500).
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