Category Archives: Pre-implantation Genetic Screening (PGS)

Day 6 – part one (written 4th February 2015)

Transfer day! Eeeeee! I’ve slept surprisingly well (maybe it’s those herbs the acupuncturist gave me the other day) and wake up at a normal hour not buzzing with stress. Amazing. The lab have told us they’ll have the PGS report to us before 9:30am and it’s somewhat of a relief knowing I’ve just over an hour to wait tops.

In reality it’s only 45 minutes as the report shows up just before nine o’clock. We’re both excited but on edge as we open the email to view the findings from our embryo testing, and learn the fate of our remaining embryos. I’ve been warned to expect a 25% drop-off from PGS as usually around quarter of embryos are found to be abnormal, and that’s just what we have. Our PGS results are below:

  • 1 x Hatching Blastocyst: Fair/Fair (no result, this embryo will be re-biopsied and frozen today)
  • 4 x Hatched Blastocyst: Good/Good (normal, 2 of which are recommended for transfer today, the remainder will be frozen)
  • 1 x Hatching Blastocyst: Good/Good (normal, recommended for freezing today)
  • 1 x Hatched Blastocyst: Good/Fair (normal, recommended for freezing today)
  • 1 x Hatched Blastocyst: Fair/Fair (normal, recommended for freezing today)

Then, on top of those tested above, we have the remaining embryos which have not been pre-implantation genetically screened but could be today if we chose:

  • 1 Hatched Blastocyst Good/Good (eligible for biopsy and/or freezing today)
  • 1 Hatching Blastocyst Good/Good (eligible for biopsy and/or freezing today)
  • 2 Hatching Blastocysts Fair/Fair (eligible for biopsy and/or freezing today)

And these ones, which aren’t up to scratch, don’t meet freezing criteria, and will be discarded today:

  • 4 Early Blastocysts: Poor
  • 2 Compacting
  • 4 Multi-cells

Now the extra decision-making comes. We can have the other four eligible embryos tested for chromosomal normality if we want to but the lab needs to know by 11am – just two hours after we receive the results email. It’s a hard decision. Testing costs a fair bit of money (US$250 per embryo) but will we regret not testing them?

After we transfer two today, we’ll have three remaining good/good embryos that have tested normal and 2 (possibly 3) lesser quality ones, is that enough? It’s at this moment I desperately want a crystal ball. If this cycle works then yes, it’s plenty, but if it doesn’t and we have to come back for another shot then maybe it would be better to have more that have passed testing up our sleeve. Even if this does work we’d like to have a decent shot at a sibling sometime in the future.

It’s a hard call to make. The perfectionist in me wants to test all four as that would be ‘neater’, and we’d know the normality of all the frozen embryos. However, the realist in me knows this is excessive. Hubby’s gut feeling was initially not to test any more, but 30 minutes later he’s not so sure. With both of us coming from extremes we decide to comprise and get the remaining two good/good quality embies tested, leaving the two fair/fair to be frozen unexamined. I promptly email the lab before we can agonise over it any further.

And now we wait. Four and a half hours to embryo-transfer. I’m super excited. It’s our wedding anniversary back home (because of the time difference it’s not our anniversary date here until tomorrow, but as we got married back in NZ I’ll take the NZ date as fact) which seems to me an auspicious date for our babies to be transferred into their uterine home. I agonise over what to wear for a while, I mean what does one wear when meeting their babies for the first time? I want to be comfy but I can’t have our babies thinking I’m a complete slob; I want them to stick around! I finally opt for my favourite underwear, some comfy ¾ trousers and a green singlet purchased on one of our fantastic New York holidays. I’m ready.

It seems so weird to me that the team at the lab know the sex of our potential children but we don’t. There’s a tiny part of me that wants to yell “tell me, just tell me!” but luckily most of me doesn’t want to know, that wants a surprise sometime in the future. Hubs and I had always said we want to find out the sex of our children before they’re born but this feels just a little too early to me. In fact, after four years of trying to get pregnant, I’m not even sure I want to find out further down the track. There really aren’t enough surprises in life as an adult so maybe it’s better to wait until the birth and allow myself that “SURPRISE!” feeling. Who knows how I’ll feel about it all in the future, let’s just get pregnant first eh!


Day 5 (written 3rd February 2015)

Today’s a better day. You know how you just have those down days where you know it’s completely irrational that you’re feeling down (I mean we’ve got some fabulous embryos for goodness sake!) but you just can’t help but feel a bit doom & gloom. I think for me it’s because we’ve tried so many different things over the last four years, have had so many failures, and it’s largely been my body’s fault. It’s sometimes hard to believe that, even with great embies, my body will actually behave and nourish those embies into viability.

But that was yesterday. Today I wake up determined to beat the blues. We decide to head north to the San Diego Zoo Safari Park. I absolutely LOVE tigers and, following the acupuncturist’s advice to find something that brings me real joy, the Safari Park Tiger Trail seems just the ticket. It’s fantastic, not just the tigers but the entire park. We spend a good four hours wandering around the beautifully laid out plains and exploring all the various areas the park has to offer. Of course the tigers are my favourite and a fair bit of time is spent in that area (don’t even ask how many photos I took!). I’m happy again.

We’re enjoying our time so much we completely forget about checking emails for the lab update. About halfway through our visit it suddenly dawns on me – our update! A quick check shows it’s sitting there waiting for us. And the news is still good!

By this stage (day 5) they’re expecting to see the embryos developing into blastocysts and they start to grade them on where they sit on the blastocyst scale. Firstly they evaluate their expansion (Early blastocyst, Expanding, Expanded, Fully expanded, or Hatching blastocyst). Next they give them grades for both the inner cell mass (which will form the foetal tissue) and the outer cell mass (which will form the placenta). These are marked as Good (G), Fair (F), or Poor (P).

Our top twelve embryos (the ones that will be biopsied for Pre-implantation Genetic Screening) are classified as:

  • 1 x Hatching blastocyst (1 x G/G)
  • 9 x Expanding blastocysts (5 x G/G, 4 x G/F, 1 x F/F)
  • 2 x Early blastocysts (1 x G/G, 1 x G/F)

Our remaining 14 embryos are:

  • 4 x Early blastocysts (potential for biopsy and/or freezing tomorrow)
  • 2 x Morula (potential for biopsy and/or freezing tomorrow)
  • 4 x Compacting (potential for biopsy and/or freezing tomorrow)
  • 4 x Multicells (probably won’t make blastocysts)

We’ve only paid for 12 to be tested so once we get the biopsy results tomorrow we’ll need to make a very quick call on whether we’re happy with what we have or whether we pay to get more tested. Even if we don’t get the remainder tested we’ll still be able to freeze any that are of acceptable cryopreservation quality.

At the bottom of the email is the timing and details for our embryo transfer tomorrow. We’re locked and loaded. Some last minute decisions to be made on which embies are going back in but by this time tomorrow I’ll be pregnant until proven otherwise (PUPO) and the two week wait will begin!

Day 4 (written 2nd February 2015)

It’s day four. A day when we should be seeing our embies compacting and forming morula (a compact ball of 8-16 cells). After the morula stage our embies will hopefully form into blastocysts which is what we want them to be for both testing and transfer into me.   Our wee Bumbles are doing well and we current have:

  • 2 x early blastocyst
  • 4 x morula
  • 12 x compacting
  • 6 x 8 cell
  • 2 x 6 cell

It’s great news. Our two 6-cell embies probably won’t make it but at least some of the 8-cell embryos will hopefully progress through to later stages.

Me on the other hand, today I’m not doing so well, and I don’t even know why. I had a great sleep but, after a few days of feeling positive, am all a bit doom and gloom again today. I’m not quite at the “this isn’t going to work” stage but I’m not as sure as was over the weekend that it will. I need to snap out of it.

I did manage to have some acupuncture today though which made the physical me feel better even if I couldn’t get a handle on the mental me. This acupuncturist was recommended (and booked) by a lovely friend, and was totally different to the acupuncture I get at home. My acupuncturist at home is much harsher, for want of a better word, using stronger needles and more manipulation, a very traditional Chinese style. Today’s session was much softer – more Japanese in style as my US acupuncturist said – and more relaxing.

I normally come out of acupuncture feeling physically good (although I have to admit it’s often painful and I don’t feel better until a few hours after the session) but somewhat drained. The intense needles and manipulation can hurt sometimes and it takes a lot out of you, but you do end up feeling better for it. Today’s session was almost the opposite. Softer needles, no manipulation, and I exited the appointment feeling almost dreamy. Totally relaxed, body feeling great, with a euphoric buzz. It was fantastic. Physically better without the pain or endurance factor. I only wish this acupuncturist could come back to New Zealand with me.

Unfortunately the acupuncture didn’t do anything to regenerate the “this is totally going to work” vibe. My body is dehydrated of electrolytes, there are issues with my ‘heart blood’ and my yin is down – not a good thing when this is supposedly what opens your uterus to embrace an embryo – and this news gets me down. I’m told to get some electrolytes into me, try a herbal supplement to help calm the mind, and to do some fun silly things that bring me true joy and open my heart up to get everything flowing again.

I’m trying my hardest but I just can’t seem to make that happen today. Hopefully tomorrow will bring a brighter me.

Day 2 (written 31st January 2015)

Today we get more good news. Two of the embryos that hadn’t fertilised yesterday have done so overnight and have caught up to the others in their developmental stage. Woohoo!

Today the embryo grading begins and I’m pleased to say that so far most of our fertilised embies pass the test, some with flying colours. As of 9am this morning (US Pacific time) we have:

  • 3 x Five cells (fair quality)
  • 5 x Four cells (good quality) – one of these is the first of our late-fertilising embies
  • 9 x Four cells (fair quality) – our other late-fertiliser falls into this category
  • 4 x Three cells (fair quality)
  • 3 x Two cells (fair quality)
  • 2 x One cell (ungraded as they’re only 1 cell)

At day 2 the embryos should be between 2 and 4 cells, so with all but two falling into this range, and with some even exceeding it, we’re really happy.

Now the difficult part comes. We’ve paid to have 8 embryos tested for chromosomal abnormalities but, with so many decent looking embryos, we may have the option to test more (for an additional fee of course). This causes a big dilemma for us. We want to do absolutely everything we can to help the process along and to ensure, if we are successful in achieving pregnancy, that we have sufficient frozen embryos to provide our child with a sibling or siblings. It’s possible that testing 8 will achieve this, but it’s also possible that those 8 won’t have enough normal embryos amongst them to allow us a decent number of frosties. It’s pretty much up to chance as to which way it could go. And what’s worse is we need to make a decision by tomorrow so that the lab can perform the necessary steps to allow for the embryo testing.

After much debate between ourselves, and consultation with others, we decide to add an additional four embryos to our testing selection. We may not have enough embryos at the right stage (blastocysts) to test this many but if we do then testing 12 should hopefully give us enough for a decent number or frosties. A very wise friend told me today that I should expect about 25% of those tested to be abnormal. That would take us to nine, which after having two transferred this cycle, leaves 7. Assuming those are all good to freeze that allows us enough for a sibling or two and a buffer should any not survive the thawing process. I email the lab with our request then hope like crazy we’re making the right decision. The exchange rate is not in our favour at the moment but hey, it’s only money right? Eek.

The Process (written 30th January 2015)

After a few random questions on what we’re going through this cycle I’ve decided to write a post on the different stages we’ve completed and what is yet to come. Assuming we’ve contacted the clinic, chosen our donor, passed all pre-work (which we have) this is what is happening from start to finish of our cycle. Here goes.

  • Suppressing my cycle. Just after the period I have following my evaluation cycle, I start on birth control pills (seems totally contrary to what we’re trying to achieve right?!?). Just over a month later, on the 5th of January, I inject myself with Lucrin (known as Lupron in other parts of the world), another drug designed to suppress my cycle. I’ve previously nicknamed this drug “Lucky Dip Lucrin” as when taking the daily injections in my 2nd IVF cycle it was a lucky dip as to what side effects I’d have each day. Luckily this is the monthly dose, which I don’t seem to have as much of a problem with.
  • Supplements: I begin (or in some cases continue) a range of supplements, which assist my body get into the best shape possible for our cycle. These include a pre-natal multivitamin (exceedingly hard to find in New Zealand so I have to opt for a ‘pregnancy & breast-feeding’ one, and boy do I feel like a fraud taking that!), folic acid, iodine, and a low-dose aspirin.
  • Blood test and ultrasound #1: This is a baseline scan that essentially checks the starting point for our cycle. They measure the thickness of my uterine lining and make sure my ovaries have been suppressed by the last few weeks of drugs so that they aren’t producing any egg-containing follicles. For us this occurs on January 12th.
  • Estrogen substitutes: I start taking Progynova (estradiol valerate) on the 13th of January and will continue taking this (hopefully) until my 12th week of pregnancy. Beginning with a low dose (one pill in the evening) I slowly build up my dosage until I am taking five tablets a day. This drug helps to grow my uterine lining to a decent thickness (anything greater than 8mm) so that it is ready to receive our embryos when we get to that point.
  • Donor scan and meds: Our donor has her own baseline scan and blood-work done in San Diego on the 15th of January and is all set to start her medication on Saturday January 17th. We’re not informed of what drugs she’ll be taking but assume that it will be similar to the ones I’ve taken in previous cycles – some kind of follicle stimulation drug (Gonal-F or Follistim for example) to encourage her ovaries to produce a multitude of egg-bearing follicles; and not long after, a lutenizing hormone antagonist (e.g. Cetrotide) to stop her body from ovulating before we need it to.
  • Blood test and ultrasound #2: Another blood test and internal ultrasound to make sure my uterine lining is developing and that everything is on track for our cycle. Both bloods/ultrasound #1 and #2 occur at our clinic in New Zealand. #2 occurs for us on the 20th of January.
  • 23rd of January: We head to The States! I inject Clexane, an anticoagulant, three hours before we fly, to help prevent blood clotting issues such as deep vein thrombosis. Not only does flying increase the risk of such problems but the estrogen substitute I’ve been taking also adds to the chance of such issues arising.
  • Final blood test and ultrasound: A final set of bloods are done and yet another date with ‘dildocam’, this time at the clinic in San Diego ensure that my lining has reached an acceptable thickness (it needs to be 8mm and mine is 7.6mm, but not to worry, they round it up to 8mm, phew!). 27th of January and we’re good to go! Our donor also has an ultrasound today and from this the clinic determine the dates for egg retrieval and embryo transfer. At the point in time of this ultrasound our donor is showing between 35 and 40 follicles, which will hopefully result in anywhere between 24 and 32 eggs (they expect to retrieve eggs from 70-80% of follicles).
  • Donor trigger: Once the clinic has assessed our donors scan results they decide that egg retrieval will occur on Thursday 29th In order for this to happen our donor needs to ‘trigger’. This mean she injects herself with a human chorionic gonadotropin (hCG) product (e.g. Ovidrel) to instruct her body to put the finishing touches to the maturation of the eggs, and to begin the process of ovulation. Our donor won’t actually ovulate normally as the clinic will extract the eggs before this can occur. However, by setting ovulation in motion, it becomes easier for the clinic to retrieve our donor’s eggs and allows for their final maturation process.
  • Egg retrieval: Just what it says. Our donor heads into the clinic and the docs there remove all the lovely eggs she’s been growing for us. As mentioned above, this happens for us on the 29th of January.
  • Sperm collection: At the same time our donor is having her eggs collected, my husband drops his sperm sample at the clinic so that it can be ‘washed’ and ready for the fertilisation process.
  • The first set of numbers: Later on the day of egg retrieval the clinic contacts us to let us know the number of eggs collected during the morning procedure. This is our first anxious wait, hoping for the best result possible. It’s good, we have 27 eggs collected and of those 26 are mature (able to be fertilised) with the final one having the potential to mature in the couple of hours before insemination.
  • Insemination: Once both the eggs and sperm have been washed (cleared of any excess debris not actually related to the sperm or egg). The lab fertilise our donor’s eggs with the sperm my hubby has provided. There are different ways to do this. The simplest and possibly most common way is to introduce multiple sperm into the petri dish the egg is contained in and let them fight it out, much as they would if the embryo was conceived ‘normally’. For our cycle we’re doing things a bit differently and are using a process called intra-cytoplasmic sperm injection or ICSI. In this process a single sperm is selected and manually inserted into the egg. This of course has its pros and cons. It makes the fertilisation rate much higher but it also increases the risk of the embryo or child having something wrong with it as it’s not necessarily the strongest sperm making it to the egg. The increase is very small though, so in the interests of getting the best possible result overall we’ve agreed to go with this option. The day of egg retrieval/insemination is known as ‘Day 0’.
  • Fertilisation report: The day after egg retrieval/insemination (January 30th for us) we receive a fertilisation report from the lab to let us know how many of our eggs have fertilised into embryos. For me this was one of the most harrowing times of the process so far, I think perhaps because this is where everything has gone wrong in our other cycles. The news this time is good and 24 out of the 27 (yes our last little egg that was lagging behind in maturity caught up) have fertilised. At this stage, day 1, the embryos are only a single cell. Tomorrow they will start to divide and we will begin to see differences in their development and quality.
  • The daily updates (this is currently the stage we are up to as I write this): From now until transfer day we will receive daily updates as to how our embryos are doing. On day 2, the second day after egg retrieval/insemination the embryologists begin grading our wee embryos. They look at the number of cells each embryo has, the quality of the embryo (poor, fair, or good – a call dependant on various factors such as the graininess/transparency of the embryo, the symmetry etc.), and finally the amount of fragmentation the embryo has (this is the amount of excess waste generated by the dividing embryo. A heavily fragmented embryo, much like our embie in our first IVF cycle, will have a lot of this waste trapped within the embryo itself rather than excreted and expelled).
  • Pre-implantation genetic screening (PGS): Most normal IVF couples would proceed with the daily updates until it was decided the embryo/s were ready for transfer. Again, we’re doing things slightly differently and have elected to pay extra to get pre-implantation genetic screening, or PGS, done on our embryos. This is more insurance for us, having travelled so far, that the embryos we implant are chromosomally correct. This will hopefully reduce the chance of miscarriage further down the track should we be lucky enough to fall pregnant. The testing, which for us will occur on day 5 (the 3rd of February), involves taking a few cells from each of the embryos chosen for assessment. These cells are then examined under a microscope to determine whether they have the correct number and arrangement of chromosomes, and any abnormal embryos are discounted. Abnormal embryos might result in a pregnancy (although pregnancy is less likely) but are far more prone to miscarry before full term. The standard number of embryos tested is 8 but, due to the number of embryos we currently have at day 2 we’ve decided to pay to get a further 4 examined. We’re not going to get this chance again and figure it will give us peace of mind that any embryos we’re able to freeze for future use will be chromosomally normal.  It’s also at this stage that you can find out the sex of your embryos and can choose whether you want girls/boys/one-of-each transferred into you.  We’re opting to go for the two best-looking/highest quality embryos and leave they sex of them to chance, we want that to be a surprise further down the track.
  • Egg transfer: This is it, day 6 (4th February). Decisions are made on the best quality embryos and we head into the clinic for egg transfer. Finally I get to play my part in this process. Because we’ve selected the success guarantee program (essentially, “we guarantee you a baby or your money back”) I am to have two embryos transferred into me.   Basically I rock on up to the clinic, pop my legs in the stirrups and have two little embryos inserted into my uterus via a catheter. Having been at this stage twice before (with less than ideal embryos) I have some idea what to expect. Every clinic is different though so there may be some slight disparities in what I expect and what will actually occur. I know of one already. Back home in New Zealand, our clinic performs this transfer with a full bladder. I consume 750ml-1 litre of water an hour before transfer so that by the time I get in there I’m desperate for a pee. It’s horrendous for the patient but helps the doctor with both ultrasound visibility and with the uterus’ position. Thankfully our San Diego clinic is able to perform the egg transfer without the exceptionally uncomfortable full bladder, so I am one happy camper!
  • Home time: A couple of days of relaxation then it’s time to head home. On the 6th of February we’ll drive back to LA and hop on a plane bound for New Zealand, hopefully with two very precious cargo still on board. Another shot of Clexane 3 hours before the flight and away we go!
  • Test time: The nerve-wracking two-week-wait (2ww) and pregnancy test. A couple of weeks after we arrive home I’ll have a blood test to determine whether all this has worked or not. It’s an excruciating wait, not helped by the fact that our test day will be delayed due to the San Diego/New Zealand time difference, and clinic hours. I hope the wait will be worth it. Wish us luck!

F-Day (written 30th January 2015)

D-day yet again…or should I say F-day as it’s the day we get our fertilisation report. I’m awake early, unable to sleep in anticipation of the news we are yet to receive. I try to keep busy, making tea and coffee and breakfast but even still I’m checking my emails every few minutes for an update.

By 10:30am we decide we need to get out of the house, we’re both going crazy with the stress of waiting for an update. We opt to head back to the Gaslamp Quarter as I’ve got my heart set of some yellow (bumble coloured) slippers to ward off the cold of these tile floors. Just as we’re about to hop into the car a text from a DEIVF-experienced friend arrives hoping we’ve received good news this morning. It’s just before 11am, should we have received news by now? Thinking back to our other cycles it’s seems that we should have, that can only mean bad news right? Or maybe not because we received early news in our other cycles and THEY were bad. My panic shifts into overdrive. Emails are checked nearly every minute as we cruise down the freeway. Why aren’t they emailing us?!? Should I have opted for a phone call? Do they prioritise the calls first then get to those who have selected to receive their news via email?

I think I’m officially nuts, but looking over at my husband I see the stress written all over his face too. It’s a quiet car ride, no talking, no music, neither of us can bear it. We clutch each other’s hands and steal frantic yet supportive glances at each other. Then we reach our destination. I check emails again but the number in my inbox hasn’t increased. “Refresh! Refresh!” says hubs urgently…and there it is. ‘Day 1 update.’ My stomach drops out as I open the email, I think I am going to be sick. “Yesterday we retrieved 27 eggs. Of those, 27 eggs were mature” (YES! Our little eggy lagging behind caught up!)…yada yada yada…..”We inseminated 27 mature eggs yesterday and today 24 have fertilised”

Twenty-four! Oh my god, that’s amazing! That’s an 88% fertilisation rate. I’m stunned. WE’RE stunned. I feel a sense of relief. I’m smiling yet kind of numb. Then a minute or so later it actually sinks in. We have 24 embryos. I feel the tears start to stream down my face and look over at my husband to see the tears in his eyes too. A text to our friend in San Diego who had messaged earlier and soon she has tears welling in her eyes also. We’re both shaking and I feel some of the stress leave my body. There’s still a fair bit of tension there, we’ve still a long way to go, but we’ve crossed a major hurdle. Now to hope that our potential little Bumbles develop normally, survive their PGS testing, and make it to transfer/cryopreservation.

May the odds be ever in our favour (written 15th November 2014)

Two and a half weeks on and I’ve just had the second scan in my evaluation cycle. The cycle is designed to test my body to make sure it can do everything it’s supposed to in order to receive the donated-egg embryos we hope to have once we commence our proper cycle. Amazingly my body has behaved and my endometrial lining is at 10.6mm after only a week of minimal drugs – much more than the 8mm required to pass my mock cycle. I suppose I shouldn’t really be surprised, my body has always been pretty good at this part of the process, it just can’t do the one piece that makes this part worthwhile – grow a decent egg. Nevertheless I’m pretty pleased and am anxiously awaiting an email from San Diego to say we’ve passed and I can stop the drugs….or more to the point, move onto the next ones.

As far as I know our blood tests have come back normal (yay!) and we also ticked off our counselling session, if you can call it that, last week. It’s the third time I’ve seen the counsellor we saw (my fourth counselling session at the clinic) and, having just seen her for our local donor cycle, this one was more of a formality than anything else. Once again we’d already spoken about most of the stuff she bought up and knew exactly how we felt about it. We’re generally a pretty laid back couple so her ‘curveballs’ (“what if your donor had donated to someone else here locally and you ran into the children from that donation”) were kind of like water off a ducks back. We’re prepared for that and will deal with it if it arises, we’d like to think that would be a positive thing rather than something to worry about. What worries me more is the extra risks we’re choosing in the hope of having a child.

We’ve decided to go with the clinic’s ‘Success Guarantee’ which basically means, if we’re accepted into the program, our cycle/s will result in a baby or we get most of our money back. If our first cycle doesn’t work we go back for a cycle or cycles using (should we be lucky enough to have them) our frozen embryos (AKA FET) until those frosties are used up or until we have a baby. If no baby results from this process, refund. The catch with this – other than having to qualify for the program – is that they transfer two embryos each time. Yep, there’s a possibility (although isn’t there always) of us having twins, a thought that both terrifies and excites me.

There’s roughly a 40% chance of our cycle resulting in twins and, should that happen, the risks for both mother and babies go up dramatically. There are higher risks of premature birth, low birth-weight, preeclampsia, gestational diabetes, and complications and/or issues both as newborns and later in life. I’m not going to lie, all of that absolute petrifies me. What if the decision we’re making now severely impacts on the future lives of our children. What if by implanting two we’re effectively issuing them with a life sentence? So why have we made the decision we have?

It certainly hasn’t been made lightly, and I wonder every day if we’re doing the right thing.  It’s partially a question of money – the success guarantee option is roughly only $5,000 more than a one-off, one time only, single-embryo transfer – and that’s clinic fees only. If a single-embryo transfer wasn’t successful we’d not only have to fork out another nearly US$20k, we’d also have to cover the costs of getting to San Diego and staying there again. Admittedly we’d have to cover travel costs under the Success Guarantee cycle too, but at least we wouldn’t be paying the clinic fees again.

Another part of it is that after three failed IVF cycles here (and countless other treatments) it just doesn’t feel like the odds are in our favour. It honestly doesn’t feel like it could work. I know that may seem stupid (especially given we’re using the eggs from a donor in her twenties) but after nearly four years of failure it’s extremely difficult to believe that things could go right. We’ve been conditioned to think negatively and now feel the need to give ourselves the best chance of success.

To further increase our chance of success we’re also opting to pay extra for Pre-implantation Genetic Screening (PGS) where a selection of our embryos are tested pre-transfer (usually around day 5) for any chromosomal abnormalities and the best (or most normal) embryos are selected for transfer. This testing will hopefully reduce our risk of miscarriage further down the track. It’s also possible to test for gender at this time and we’ve been told we have the option of choosing the sex of our child/children before the embryos are transferred into me. WOAH! Hold up there, what?!? Yep, we could potentially choose whether we have boys, girls, or one of each (assuming the embryos stick and make it to full-term). This world is starting to sound a bit Gattaca. Scary. Still, not ones to leave an issue unexplored, it prompts a lengthy discussion about the pros and cons of this.

The idea of twin boys freaks me out, we both (pre-fertility issues) always wanted a girl first, but if we were having twins then maybe one of each would be nice, or maybe twin girls would be better. In the end boils down to this: all we want is a healthy child (or children!), whether it’s a male or female, two of one or one of the other doesn’t matter to us, and so the choice of sex pre-transfer is irrelevant. All that matters is that the baby is healthy and is ours. End of discussion.

It seems we’re not the only ones freaked out by twins as, although our donor had initially said she’d be happy with an open donation, with her previous cycle resulting in twins, she’s become a bit freaked out about the whole thing and now wants to remain anonymous. However all is not lost. She’s agreed to register with the Donor Sibling Registry so, while we still won’t know who she is, we’ll be able to contact her anonymously to ask questions and share information. That’s enough for us! Our main concern was essentially ‘losing her forever’, having her disappear into the woodwork with no way to ever contact her with questions, and our child or children losing the only connection they have with one half of their genes. Who knows, even our donor herself has admitted that, at some stage in the future, her feelings on contact may change and we may have a more open relationship.

And that’s pretty much where we’re at. We paid San Diego for our donor’s medication today (eek!) so once the last little bits and pieces of our pre-testing are ticked off we’re good to go. Assuming I pass my evaluation cycle, SDFC will soon be providing us with our timeline, we’ll know our rough dates, and the die is cast. May the odds be ever in our favour.


The highs and lows of a child psychologist dealing with infertility.


Misadventures in recurrent pregnany loss & reproductive immunology


A blog full of humorous and poignant observations.

Today I hope

Ups and downs in a long and winding road to parenthood


A topnotch site

Room to Grow

Re-foresting a small piece of New Zealand

Infertility What ??

Journey to a family : IVF / FET

A Calm Persistence

A Journey Through Recurrent Pregnancy Loss

Starting Our Family

The reality of infertility, IVF and donor eggs

A Morning Grouch

Mama. Writer. Runner. Doodler. Yogi. Wine lover. Poor sleeper. Coffee consumer. Depression fighter. Gratitude practicer.

Just Stop Trying and It Will Happen...

Barren and blogging about it. Don't be jealous.


random acts of kindness, senseless acts of beauty


The trials and tribulations of a girl TTC

Schrodinger's Catbox

All the things they don't tell you about making babies. And not making them.

Under The Paw

The quest to expand our family

Waiting Mama

A Trying to Conceive Story

Diary of a Yummy Mummy in Waiting

The quest to expand our family


For every girl who's ever had questions but no answers

Two Good Eggs

Two cracked eggs find the sunnyside (and funny side) of trying to conceive

Bringing Up Bumble

The quest to expand our family