Thursday, March 24, 2005

Counting my eggs before they're ICSI'd

In the spring, at Easter time, a middle-aged woman's fancy lightly turns to thoughts of...eggs.

What, you thought I was going to say love? In hopes that Lord Tennyson will pardon my paraphrase, I've got to go with Tina Turner on this one: What's love got to do with it? I won't even be in the building when my husband's bashful sperm are introduced (via ICSI) to my donor's pretty eggs, sometime next week.

Today I went to my RE's office for an ultrasound of my uterine lining and some bloodwork. They had to stick me twice to get my blood because I'm dehydrated, having been a victim of the flu recently. This was not so good, as I loathe needles. Later, the RE made up for it in giggles by making ballpoint-pen x's on my butt, in his earnest efforts to convey to my husband where he is to inject the progesterone-in-oil to get it into the muscle. I'm laughing all over again thinking about tonight: "Honey, I want you to look at my butt. No, really."

I took the opportunity to ask how our donor is doing. She was in this past Tuesday and has 11 follicles, all about the same size. This is a good thing, so that none are underdone or overcooked when she takes her trigger HCG shot. She will be checked again tomorrow. Then we'll know the exact dates of egg retrieval and transfer.

I must admit, although I would never wish either discomfort or the danger of overstimulation on our kind donor, that I had hoped for a few more follicles. My RE says that, as a grossly generalized rule of thumb, 50% are lost at every stage of the game. So, if we have 11, just 5-6 will be retrieved, and of those, 2.5-3 will fertilize and grow; if 2 are transferred to me, one may survive and grow into a baby. To the doctor, by those rules, 11 follicles is the perfect number, since a healthy singleton pregnancy is his ultimate goal.

But me, I'm both greedy and broke. I was hoping that we'd have enough embryos from this cycle to have two children, whether that's twins or by freezing embryos we don't use this time around. I plan to tell my child(ren) about their donor egg origins, and there's no way to know how they will feel about it. It could be important to them to have a full sibling. It will be years before we can afford to do this again, win or lose.

Oh well. Note to self: Self, stop the insanity. Don't worry about what you can't control, and by the way, how about a little gratitude for what you have? (Self's answer: "Shut. Up.")

My lining, by the way, was plush like a velvet Elvis picture: 12mm. The RE said they look for anything over 6mm. Padded walls for the embryos' playroom, I guess is the idea. The better for implantation, and making themselves to home.

Is it my fault I'm the type of woman who, when confronted with such good fortune, immediately wonders, "Is it too thick?"

Quite obviously, I'm the one who needs the padded walls. Infertility in general -- and donor egg in particular -- is crazy-making. It can create a schizofrenic where none was before. You think things like, "I'm so happy...in about a week I might be pregnant...Oh God I'm so scared, in a week I might be pregnant!" I long for the days when getting pregnant was a simple concept.

Doing donor egg is like standing in line all day at an amusement park, waiting to board the big rollercoaster. You shelled out big bucks just to get into the park. You're hot and impatient and bored while you wait. You mutter complaints to your husband about how long this is taking and wonder aloud whether it'll be worth it. You stand on your tiptoes to peer ahead at the front of the line, longing to be where those people are. You think you'll never get there, and then you do. At last.

But once you are actually on the ride, chugging up the hill toward that first big drop, your thoughts are more like this: "I'm so scared I'm so scared I'm so scared omigod why did I want to do this I'm so scared...!" Then you drop. You're falling. And you scream, in exhilaration and fear, all mixed up with total delight. That's what donor egg feels like to me.

So far, so good. Waiting to fall.

11 comments:

Andi said...

Bee, I hope your RE is just trying not to get your expectations too high. They do that sometimes. At my current clinic, I have always gotten more eggs at retrieval than the RE claimed he expected to get. They'd see 2 or 3 on one side and 3 or 4 on the other side, and they'd be all over the map on size, and the RE would say, "You might get 3 or 4 mature eggs at retrieval." And then I'd be thrilled when I got 7 or 8. And many of the women I cycled with had similar experiences. So, don't count your (donor's) eggs before they're ICSIed, but don't undercount them either. You just might be happily surprised.

Pam said...

That roller coaster analogy is perfect! I'm chugchugchuging up the hill with you. I'm expecting to retrieve and transfer on the same days you are. Had my lining checked on Monday and it was already 10--RE said it will be 12 or more by transfer. I too immediately worried that it was too thick! I was assured that thick is good and told not to worry. RE also said I was doing great and already "good to go" on Monday. But instead of being reassured I worried that my if my lining was ready now, would it be stale or something by 4/1? Well the answer was, "No, that's not how it works you needn't worry about that either." Crazy.

Eleven follicles is good! Quality is the most important thing. My clinic shoots for 10-15. My donor was showing 20 follicles on Tuesday, and I'm glad...but am also worried about hyperstim. Nurse said donor was doing fine and feeling fine and that RE does not feel hyperstim is a risk. So, good. I'll try and let that one go. Donor will be checked again on Friday and that's when we'll get our exact dates too.

Best of luck to you Bee--please keep us posted! Pam

Millie said...

So glad to hear you're feeling better!! Sounds to me like your donor cycle is going fab. I know you're going to worry but DON'T. Remember, it's quality over quantity.

I was just at a mutual friend's (who knew!) house today and her twins are GORGEOUS. Yup. She only got 8 follies (South Africa, very big on quality down there) and you know the rest!

I, too, loved the roller coaster analogy. So true!

Wishing the very, very best of luck to you (and Pam too)!

wessel said...

Your RE is exaggerating the 50% piece--any time retrieval only yields half the number of eggs for follicles, there's something more going on! I've usually gotten one or two less eggs than I had follicles, and that seems to be pretty standard.

I think one RE I had told me the attrition rate at each stage of the process was about 25%, which is a bit more realistic. But when you have fewer follicles that are all mature, I think your egg yield is closer to the total # of follicles. (As opposed to having 30 follicles, and only getting 18 eggs, for example, which is more common because lots of follicles often translates into lots more immature ones).

I'm going to bet that you end up with 2 to transfer and 4 to freeze. Care to make it interesting, anyone? :-)

tee said...

Hi there Bee!
I'm a firm believer in the "less is more" philosophy. I willing to bet that you get 9 eggs and 7 fertilize. In my book, that is plenty. Also, don't worry about your lining being to thick. Mine was at 13 mm 3 days before transfer and it was obviously not a problem.

Are you going to transfer 2 or 3? I just had two friends do DE cycles. One only got 3 eggs and they all fertilized. She transfered 3 and is preg w/ a singleton. The other had a zillion eggs, transfered 3 and is preg with...you got it, triplets!

Rooting for you!

xo tee

p.s. Love Milly...known her for years now!

Bee said...

Hey Tee,

Small world with you and Millie knowing each other offline too. :D :D

I'm not sure how many I'll transfer. My donor coordinator said that the doctor will let me do either 2 or 3, but he'll sit me down and argue heartily against 3 because of the risks associated with a triplet pregnancy. I'd probably go with 2 if I felt I had enough embryos to give me a shot at a frozen cycle later. I dunno, maybe I'll post that over on the board and see what people say.

How are the little guys? Talk to you soon,

Bee

Anonymous said...

Thinking of you Bee and wishing you lots and lots of luck.

xxoo,
Emily

Anonymous said...

Wish you well Bee, you are almost at the front of the line now. There's still quite a few ups and downs, but just hold on tight.
As I already mentioned on the DE board, we got 11 follicles and ended up with 10 Grade A embryos. You never know. Nature has a way of doing what she pleases and not fitting in to statistics if she doesn't feel like it.
It is very difficult, but try to stop analyzing (:)). As you said, unfortunately, we have no control over this situation. Just go with the flow. That's all you can do.
Best of luck. Keeping my fingers and toes crossed for you.
Kat.

Enough Already said...

Just a note on something to consider on fertilization. My doctor's practice is to ICSI half and use natural fertilization for the other half in case something fucks up with one or the other. In my case, ALL of the ICSI did not fertilize. I have my suspicion as to why (operator error perhaps?), but the long and short of it is, it may be wise to cover your basis w/this unless there is some reason that natural fertilization should not be considered in your case.

Bee said...

Hi Everyone,

Thanks for the kind thoughts, Em! And Kat, you're right that I need to just let go of what I can't control. I tried to do that a bit this weekend. Lots of distractions, Easter with the family and so forth, so that helped!

Enough, I'll ask at my clinic but they've told us that we have to use ICSI because my husband's sperm morphology was at 1%, and they like to see 4% or higher to use natural fertilization. You are right though that we're at the mercy of the lab.... Anyway, thanks for sharing that information. Interesting how all of this varies so much from one clinic to the other.

Bee

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