The Transfer Itself

Part of the embryo transfer protocol is a valium administered about an hour before the transfer itself.  Technically it helps to relax the uterine muscles.  But there's that ancillary benefit too, taking the edge off any nervousness or anxiety that might be felt.

Yesterday was the first time the nurse had ever made it sound like the valium was optional.  She knocked on the door and asked, "Would you like a valium?"

"Oh, yes, please!" I responded, my words practically running together in my eagerness. 

As she smiled and left the room to retrieve my dose, I asked Bryan, "Do you think I should have hesitated before answering?  Was I too eager?"

He just snickered at me.

I can say that between the valium and all the myriad of prayers that have been said (and are continuing), my nervous energy subsided.



I'd like to introduce you to "Dash" and "Violet". 

Dash and Violet were created in 2008 and vitrified five days after fertilization.  (And, if you're new to our story, we adopted them this past spring.)  These are blastocysts, and this picture was taken shortly after the thawing process.  These two were vitrified and stored in separate straws and thus thawed separately. The one on the right was thawed first and is a teeny bit more re-expanded/re-hydrated than the one on the left due to that approximate fifteen to thirty minute head start.

The embryologist was very patient with my myriad of questions.  Both of these embryos look great, with no noticeable cell loss.  It takes about fifteen minutes or so to thaw a vitrified embryo.  After the thawing process, each embryo "rests" for a few hours in a solution. 

The outside rim of each embryo is called the zona pellucida.  This is basically like a shell on an egg.  Through time, embryologists have learned that frozen embryos have a tougher than normal zona pellucida.  To help encourage embryos to hatch (a necessary step that must occur before the embryo can implant on the uterine wall), embryologist nowadays use a technique called "assisted hatching".  See that notch in the zona pellucida of the embryo on the right?  That's what the embryologist did to assist the embryo in its future attempt at hatching.  Both embryos had this done (it's actually standard practice at our clinic on all frozen embryos).  The left embryo had rotated since the assisted hatching was completed - the notch was there, we just couldn't see it.

You can just sort of make out an outer layer of cells, just inside the zona pellucida.  If I remember correctly, this layer is the trophoblast and will become the placenta.

The embryo on the right is a little clearer to see due, perhaps, to its short headstart from thawing first.  At any rate, you'll notice inside the outer rings are two masses, one a cell mass in the left center, and the other a clearer area in the right center.  The cell mass is what will grow into the baby and is called the "embryoblast".  I didn't think to ask what the clearer section becomes but it is called the "blastocoel".

Here's an color picture I found online that labels the blast components (this embryo is further along developmentally than Dash and Violet as pictured above).

 

 



 

Our clinic here in Texas has a big screen tv in the operating room.  We are able to see the embryos right before the transfer and watch as the embryologist sucks them into the catheter and brings them into the operating room.  There is probably a technical term for "the act of sucking into a catheter" but I do not know what it is.  ;-)

You want to know something truly amazing? The embryos had both noticeably grown in the short time since the first picture was taken. I don't know exactly how much time had lapsed between the first picture and the transfer itself, but it could not have been more than a few hours.  And both embryos had visibly grown - it was incredible!

The blastocoel (the clearer inner mass) had grown considerably on both embryos.  One embryo was more than two thirds filled with blastocoel, the other about half filled.  And, one embryo was already hatching, almost like the random internet picture below.  The embryo was just starting to hatch, though not near as far along as the one pictured below.

I didn't really notice the moods of the crowd in the OR (and there was a crowd: techs, doctor, intern, embryologist, plus me and Bryan).  But Bryan said everyone seemed very upbeat and encouraging about Dash and Violet and their growth.

Our clinic had recently changed their post-transfer procedures, so we didn't have to rest for any requisite amount of time.  Just transfer, bathroom (as procedure is done with a full bladder you cannot underestimate the necessity of this step), change back into civilian clothes, and then we were released. 

We then had some of the best burgers in our life at Hopdoddy's.  I had the Greek burger and it was AMAZING.  Perhaps I was still on a bit of a valium high and riding the good vibes from the transfer, but that was one good lunch.

We then wandered a unique toy store (Terra Toys, if you're ever in the area) and then headed back home.

I slept wonderfully last night and my nervous energy is mostly gone today.  This is due in part to the encouraging-looking embryos but most of all due to your prayers.  I am so very thankful for the family, friends, and even relative strangers offering up a few words on our behalf.



I do not know what the future will bring.  However, I know that today I am pregnant. Today, I have both Dash and Violet on board.  I am choosing to live in the moment and embrace it.  And pray without ceasing.