Sunday, March 14, 2010

In vitro maturation news...and what would you do?

More good news!!!

We received a surprise call from the embryology lab this morning. They've kept an eye on our five "immature" oocytes, hoping to mature them in the lab. Turns out three of them matured and when they attempted day 2 ICSI on those, all three fertilized!!!!

In vitro maturation is something our NYC lab doesn't offer and was one of many draws for trekking out to Colorado.

So the total yield stands as follows:

19 eggs retrieved
14 mature
13 fertilized with ICSI
3 more matured in vitro overnight
and all three of those fertilized with day 2 ICSI!
So the grand total is 16 embryos culturing at the Denver lab right now.


We are hoping hoping hoping that we'll get a good number of blastocysts out of this that can be biopsied using microarray and that maybe, just maybe there is at least one chromosomally normal one in there. Please!

Amidst this fantastic news, we are faced with one remaining decision, and it is a doozy.

We are trying to decide whether to send the frozen embryos we have in NYC to Denver to culture and biopsy as well. We have six embryos slow frozen at the 2pn stage (so very, very early Day 1 embryos). We have been strongly considering sending them to the Denver clinic, thawing, culturing to blast, and adding whatever we get to the blasts we have from this fresh IVF cycle for biopsy. That way, we will know if we have any normal embryos, rather than just taking the risk and transferring a bunch of unknowns.

Will is more in favor of sending the embryos to Denver than I am. I worry about the potential damage of transporting them, thawing and then culturing to blast and then biopsying and then refreezing (with vitrification) and thawing them again later (assuming there is a normal one or two). We could alternately just throw them all in in an FET in NYC in the future and see what happens. Will, justifiably so, doesn't want to sign up for any more miscarriages. I don't either, but am afraid of losing a normal embryo to attrition due to all this monkeying around. These embryos, by the way, are from IVF #2, when I was 36. Not that I had a great track record at that point either, but it's worth noting. We have to decide in the next day or so so that the NY six could join the Denver 16. If we do them separately, we'll owe an additional $6,000 for separate microarray and PGS. No thank you to that!

So the question of the day is, what would you do? A blind FET in NYC or sending the six to Denver to be added to the microarray pot?


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  1. I would thaw them, culture them, and biopsy them. There are many cases of thawing and refreezing and even biopsying more than once and embryos do very well, especially with vitrification. That's just my two cents. Having that many to possibly test just increases your odds of finding those normal ones--and there WILL BE normal ones! Hang in there, and congrats on such a great yield.

  2. *sigh* that's a tough one. I would probably just throw them in and see what happens. But then I have always been nervous of the chance of human error when labs are dealing with my embryos.

    Also, do you have to decide right now. You might feel differently based on the results of your fresh embryos.

  3. Send them to Denver - I'm with Will on this one :)

    And GREAT news on those other embryos!

  4. Fantastic news, indeed!

    And yeah, a doozy of a decision to have to make. If it were me, though, I'd send 'em for biopsy. I think (in my completely unscientific opinion) that the chances of a lab foul up - especially at CCRM - are smaller than the chances of finding THOSE PERFECT THREE EMBRYOS to transfer. Throw 'em all in the mix. CCRM has one of - if not THE - best labs in the world. I'd let 'em work their magic on as many as you can get hold of and see what you've got to work with.

    Whatever you decide to do - woohoo on getting three more embryos out of the game! (If your ovaries had hands I'd totally wanna shake 'em.)

    Take care, and again, congratulations!!!

  5. I am glad you stuck to your guns on them checking on those immature eggs. That is crazy that they thought you had enough. What if one of those 3 is your baby? I transferred 18 embryos and I don't know how many others were made (and arrested earlier) just to get one baby. Every egg counts. Perhaps they wouldn't be so flippant about eggs if they went through the shots and ERs and knew what it felt like!

    As for whether to send the others... what freezing technique do they use? I would be happier if all clinics used vitrification over the slow freeze. If they do that maybe it will be better? You can ask what the thaw statistics are if there is time.

  6. Given all the losses and non-normals you've had, and how fantastic your new lab is supposed to be, I'd probably also vote for bringing them out and culturing them to blast and biopsying. They may do a better job getting them to blast in Denver. Will it cost much more to add them into the mix?
    How insane that you have 16 embryos currently growing! So glad you pushed them to mature whatever else they could. I'll be on tenterhooks to find out what develops out of all those embryos. And I'm so glad it's not me sitting there waiting for the daily call! Good luck!

  7. IT's always hard to make these decisions, but seening as you;re asking for assvice, I would send them to denver and have them tested. But, that's just me, I'm with Will on this one!

  8. I'm with Will on this one, too. Send thm to Denver. I've heard the shipping, which is the only true concern (beyond money), is usually very dependable and safe for embryos. I would like the idea of having all of my embryos together with their brothers and sisters and finding out for sure which/how many are normal. I've lost 3 babies myself to chromosomal issues, so I know I'm not the most objective, but I would want to know everything I had on the table. Plus the Denver clinic just sounds like it's working for you more.

    Though I do have to gripe that they wouldn't have bothered to watch those extra eggs for in vitro maturation except that you begged them yesterday. Why don't they do this for everyone??

    Either way, fantastic news about the extra three!!

  9. After all you have been through, I would send them to Denver. I don't want you to go through the hope and pain of another possible miscarriage. Lots of luck to whatever you decide.

  10. I wouldn't worry about them being damaged in trasport--frozen sperm gets transported all teh time, and does just fine. I think I'd throw them all in--i'm with Will, no more miscarriages!

  11. Knowledge is power, right? I know with myself that if I can feel more in control, I do a lot better. So I'd send them to Denver. I can't imagine CCRM would be willing to accept them and biopsy if they thought the refreeze would hurt them.

  12. First of all, good for you for making sure they followed the 5 immature ones... kudos:).

    Ooooooo. This is a hard one. I see pretty much all of your commenters say add the NYC ones to the Denver 16. And I agree that being able to test them may save you much grief. And you have a fabulous lab there.

    My only hesitation is purely a result of my own experience. The only protocol that worked for me was when we froze the embryos as 2pns then thawed to blast and transferred (without PGD). Having said that, I totally understand Will's point that such untested embryos have only lead to miscarriages in the past for the two of you. So I think if it was me.... I would probably choose to throw the NYC ones in the pot with the Denver 16 (although I would have the same concerns that you are having).

    *Sigh* Not an easy question. And I know this wasn't helpful. The unknown is a killer.

    Good luck on your decision.

  13. I would send them to Denver. This way you save the money for later on, can remove the what if factor of throwing them all in an unknown FET, and they are all together in one place.

    Great news on the extra three from IVM!

  14. Yeah for the 3 little eggs that could! I am glad that they were able to mature enough to be fertilized and added to the rest. Awesome news!

    I think I would send your frosties to Denver if I were in your place.

  15. I'd send them to Denver for thaw, culture, biopsy and vitrify. In fact, I did just that! Granted, mine was at blast stage, but it was slow-frozen at the old clinic. It thawed perfectly at CCRM, was biopsied, then vitrified. It turned out to be a "normal" blast! And if you are going to pay for doing the MA, might as well only do it once!

    And yay for those Day 2s fertilizing. I know I was a bit of a negative nelly in my last comment about those. I hope I was wrong about them.

  16. congrats on the extra 3 eggies maturing and fertilizing!! all 9 of my eggs were immature at retrieval, and then my clinic in nyc did ivm on them and they ALL matured and then they ALL fertilized. i was really relieved to hear you asked for them to do ivm on your immatures ones and that it worked for you!

    this is a tough one, but if the clinic in ny feels confidently about their transporting techniques and the denver clinic agrees, sounds like it's worth a shot!?

    *goodluck to you**!!

  17. Send them to Denver and give yourselves the piece of mind that a blind FET will not. It's a lot of money, but can you really risk the emotional toll?

    16 is awesome --

    Good luck and hoping that the universe is with you this time.

  18. WOW- guess I need to check up on you more often (wink!) CONGRATS on such an amazing yield, plus the wisdom to request the remaining ones be watched for fert!!
    As far as IMO--I'm with Will-- I would send them out to Denver...There is a reason why CCRM is so highly regarded, I doubt they make an error and then you would KNOW for sure what embryos you are working with...
    Keep us posted- can not wait to read about your transfer and the BFP to follow!!

  19. I'd go for it, too. I'm glad things are looking so good so far!

  20. Awesome news on the 3 news ones! As for the NY ones, send them West! Denver seems to know what they are doing. Congrats!!!

  21. Another vote for Denver. Remember my donated day 3 embies were shipped from kooky, freeze everything, won't treat singles clinic in MI to Canada, where we had a 100% thaw rate. Let the CCRM lab work their magic. Time to shoot the wad, so to speak.

  22. i was seriously thinking.. this is a no- brainer. send them to Denver. And wow it seems many of your readers agree, too. better to test them all at the same time. I really hope you don't lose any in the monkey business.. but even if you lost 1 you still have 5 - and you will have great information abotu the 5 or whatever. I am so so so excited for this cycle and have a very good feeling.

    i know you are not one for thinking positive makes a difference (and you are right scientifically) and with all you have been through.. i'm sure it's very hard to think positively.. but you are doing something different now.. you are with the king of fertility kings, the magic lab of labs.. and they will assist your body to do what it's supposed to do! accept an embryo and make you and will a baby! i just know it!

  23. I'm with everyone else, I would bring them to Denver.

    Looking good! Good luck Mo & Will!

  24. I'd go with Denver as well. I think the more information you can get at this point, the better off you will be...and they've come so far with the freeze/thaw process that there is much less danger than there would have been even a few years ago.

    So happy for your great numbers so far, awesome on the IVM report too! (something that also wouldn't have been possible just a few years ago).

  25. I'd have to go with Denver. They have the technology and they've done everything right so far. More importantly, it seems to me that the cost to you of one of those embryos implanting and then your having another loss due to aneuploidy would be higher than the cost of even both of them not being viable for transfer when you potentially have 16 more that will.

    News from this cycle keeps getting better and better. Hooray!

  26. wow, great news. Sounds like the consensus is in on sending them to Denver. Personally, I'd have waited(b/c you have so many already there) but I am a frugal fanny, and IVF isn't always the best time to be that way.
    I am so hoping you get some great news!!!

  27. HOLY CRAP! 3 MORE! they rock! (ccrm and your eggs)--
    so that is great great great news.

    I hate the idea of loss- so I get Will's point, but I hate the idea of attrition, so I get yours.
    But since you have this amazing technology at your disposal, in some ways I say go for it.
    that is so easy to say from here.
    Can you do half of them? or 4?


  28. Oh, that's a toughie. I would have your same concerns- but Denver seems to be way ahead on the technology game. I think I might be leaning towards sending them to Denver.

    But a tough, tough call nevertheless.

    I hope this works out to be your Denver miracle...

  29. Ohhh, what a hard decision. I'll be praying for you guys. I am hoping you get a few normal embryos. How exciting!!! Thinking of you guys!


  30. Gawd, I have no idea, but am sooooo hoping for you that this all keeps going well:-)


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