We have blast off!

Get it?!  "Blast" off?!

This is an IVF blog, so I am of course referring to our blastocysts which resulted from my egg retrieval and fertilization last week.

On Day 5 after egg retrieval, we started getting a different kind of report.  No more information on the cells and the grade, but instead since the embryos were becoming blastocysts, we were getting information on where they were in their overall development and expansion:

• 1 - Blastocoel cavity less than half the volume of the embryo
• 2 - Blastocoel cavity more than half the volume of the embryo
• 3 - Full blastocyst, cavity completely filling the embryo
• 4 - Expanded blastocyst, cavity larger than the embryo, with thinning of the shell
• 5 - Hatching out of the shell
• 6 - Hatched out of the shell

and then scores on the Inner Cell Mass which is the part of the blast that becomes the fetus:

• A - Many cells, tightly packed
• B - Several cells, loosely grouped
• C - Very few cells

and finally, scores on the Trophectoderm which is the part of the blast that becomes the placenta:

• A - Many cells, forming a cohesive layer
• B - Few cells, forming a loose epithelium
• C - Very few large cells

This is called the Gardner blastocyst grading system.  Here's a great page to help explain better.  So at this stage we started seeing embryos/blastocysts being labeled things like 2BC and 4AB and 5AA, following the grading you see above.

Early yesterday morning I got an email from Dr. A who sounded so hesitantly excited (yes, my RE gets excited for us - LOVE THAT!)  She gave me the extremely awesome news that our 5 embryos had all turned into "beautiful blastocysts" which could ALL meet biopsy criteria.  Meeting biopsy criteria basically means that they grow to expansion grade 2 or higher.  They can be biopsied for the PGS testing we're doing at this stage!  That means they're all totally viable blasts!!  OMG my nerves (which were so stressed all weekend knowing this was likely the last IVF round we could do at this time) could finally relax!

Whew!

The report you see below, for Day 5 was the stage they were at very early in the morning yesterday.

Day 5 (1/21) - early morning

Tracking 5 embryos!

Embryo Count	Blast Expansion Grade	Inner Cell Mass Score	Trophectoderm Score
1	2 (5)	B	B
1	1	A	A
2	1	A	B
1	1	B	B
1	1	0	C

The numbers don't look incredibly impressive (1's & 2's) but they were expanding rapidly at this point.  The 2(5) meant that it was currently an expansion grade 2, but with assisted hatching (which is done as part of the PGS process) was starting to expand and hatch to a 5.  By the afternoon, a total of 4 had reached blastocyst stage, which meant they were biopsied and frozen on Day 5! (you can see their gradings in the Day 6 table, below).  Remember in my Day 3 update we had 5 potentially promising embryos, but Dr. A had given 3 of them only a 25% chance of becoming blasts.  25% chance and we got blasts out of all of them?  I mean - maybe we should get some lottery tickets up in here?!

Day 6 (1/22)

Tracking 5 embryos!

Embryo Count	Blast Expansion Grade	Inner Cell Mass Score	Trophectoderm Score	Freeze/ Biopsy Day
1	5	A	A	5
1	3	A	B	5
1	2	A	A	5
1	2	B	B	5
1	6	B	B	6

Blown away.  I mean seriously?!  We had 7 eggs fertilize successfully and we ended up with 5 viable blastocysts?!  We totally beat those 50% odds!  ESPECIALLY me with my elevated FSH levels!  Now the whole way through this process I've been very understated in my celebrating.  The true celebration is only when we're holding a live baby in our arms... But IVF is such a roller coaster and there are so many steps and hurdles along the way that even though we're not at the end of the journey yet - this is definitely cause for a mini celebration.  :)  Even Dr. A can't quite believe it.  She said she doesn't even see that level of blast development with her egg donors!  Woohoo I beat you this round, you 22 year-old egg donors!!  :P

We're not quite sure what happened, either.  Just a lucky cycle?  The growth hormone I took (which I also took in cycle 1...)?  Doubling my meds?  The fact that I gave the "kids" a pep talk every time I happened to pass the fertility clinic?  The blowing on dandelions, fertility dances, crossing our fingers and throwing coins in fountains?  Maybe all of the above...

But we're not done yet.  We now have to wait for the PGS results to come back, hopefully by early next week.  That will truly tell us where we are and how many embryos we have to work with.  And then we can start planning for a transfer and hope that our selected blast will implant.

I'm not totally sure how robust the blasts with Expansion grade 2 are, plus there's a note from the embryologist that our 6BB is "very small" so perhaps it won't perform.  But man - this is all such great news, overall.  Having 5 to sort through and send for PGS = amazingly better than having 2!

I'll be back shortly with our PGS results, but after that I'm not sure how long a break I'll be taking from the blog.  We haven't yet decided on when to attempt our first transfer.  There's some travel we may want to fit in along with trying to avoid having a "Holidays Baby" (Thanksgiving through New Years).  So there may be very little to update on - but I'll definitely keep you all posted as and when things happen!