Round 4

Medicine

300 Folistim nightly

1 Menopure nightly

Clomid: 5 pills a day (2 in the morning, 1 midday, 2 at night)

Letrizole: 2 pills a day (1 in the morning, 1 at night)

ICSI v. Natural/Standard Fertilization

I talk to the clinic about ICSI v. natural/standard fertilization. ICSI is when the lab cracks the shell of the egg and manually injects a single good looking sperm from the male's semen sample. Natural/standard is when the lab adds a drop of semen to the egg and allows fertilization to happen on its own. ICSI is the go-to when there are male fertility issues (slow or misformed sperm, for example).

There are pros and cons of the ICSI approach. The con, and what concerns me and prompts me to discuss with the clinic, is the cracking of the shell. Once the shell is cracked for ICSI the egg maturation is arrested. This means if the egg isn't fully mature at the time of retrieval it is game over for any potential embryo development. Conversely, with natural/standard fertilization even if the egg isn't fully mature its shell, left in place, provides additional time to grow and can still become a viable embryo. Almost like it gets a second chance.

In our case, male fertility isn't a major factor. Round 1 Chris's morphology (shape) was a little below standard so the lab opted for ICSI. Round 3 his morphology was borderline and they said they could have gotten away with either method but chose ICSI. Round 2 however there were no issues yet they used ICSI. So my request to the lab for this round was to please default to natural/standard unless there are clear morphology issues.

Final Follow-Up Appointment Stats

Lining: 7.9

Right: 18, 10

Left: 15, 13, 10, 10, 9, 4

Retrieval

Dr. retrieves 5 eggs.

Day 1 Update

3 have fertilized.

Day 3 Update

One embryo is dividing nicely and is where they want to see it at this stage. The second embryo is lagging behind. The third has more fragmentation than they'd like to see at this stage but is dividing on time. So sounds like maybe 1 and 2 maybes!!

I ask the embyologist how many they like to see banked before testing and she says, "Six is the sweet spot" but really it is a financial decision. Six? At the rate I'm going I'll hit monopause before I get to six.

Day 5/6 Update

One didn't make it. The other two were kept incubated and checked again on Day 6 but were still not formed enough for biopsy.

The clinic is closed in June (closes twice a year for cleaning and inspection-June and December) so I will have a forced month off.

Maybe take a little getaway....