Average number of blastocysts per IVF cycle

It’s a really simple question – what is the average number of blastocysts per IVF cycle?  After our failed IVF cycle I posted a status update in my local resolve support group’s facebook page, I explained what had happened with our cycle: 14 eggs retrieved, 11 mature, 11 fertilised, 2x 5 Day blastocysts transferred (5BB & 5CC) on Day 5, 9 still alive on day 5, but 0 were of sufficient quality for cryopreservation.   Some ladies commented how they had similar results with 0 embryos making it to the freezer, and one lady posed the very good question how common is it to have 0 make it to the freezer? Perhaps it is more common than we think?  So it got me thinking…at no point has my doctor said what a typical number of eggs, embryos or blastocysts she would expect out of a cycle for us – the only stats we were ever told was all about our likelihood of a successful pregnancy from 1 cycle of IVF, and ultimately, a live birth.  And of course, that is the only statistic we only really care about, right?  This holds true, until you get a Big Fat Negative (BFN), then the other statistics start to matter and grind at you.

So I looked into it, and asked google – what is the average number of blastocysts per IVF cycle?  But I couldn’t find an easy answer, or at least one that I held great confidence in.  I’m the kind of person who needs to see the supporting evidence, and not just some seemingly arbitrary numbers some random person has posted on a website.  But although I didn’t find any national statistics per se, what I did find, made me feel a whole lot better about our last cycle.

The statistics that the Pacific Fertility Center in Canada are claiming are [1]:

11 – Average number of eggs retrieved

9 – Average number of mature eggs

7 – Average number of eggs that fertilise (approximately 80%)

7 – Average number of fertilised eggs that will form embryos (98%)

7 – Average number of embryos on Day 3 of culture

3.5 – Average number of blastocycts on Day 5/6 (50% of good quality day 3 embryos make it to blastocyst)

It was not clear if this was their clinic’s statistics or where the source of this data came from.  So my confidence is not high in it, I don’t know over how many cycles or patients this average is calculated.  But at least it gives you a flavour of what numbers to expect.  Note, it does not mention average number of blastocysts making it to cryopreservation!

Another clinic, Advanced Fertility Center of Chicago, provides a nice pretty chart of their own statistics, broken down by age for the period of 2003-2005.  First of all my first alarm bell is that is over 10 years old now!  Has anything changed in Assisted Reproductive Technologies in the last 10 years? Hmmmmm.  Anyway, here it is….

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Advanced Fertility Center of Chicago’s average number of eggs, mature eggs, fertilised eggs, 8 cell embryos and Day 5 blasts [2]

Their numbers are slightly lower than the Canadian clinic’s…but there could be many reasons for this because, again, there is no clue as to how many cycles/patients this average is calculated over.  This clinic does publish their statistic of how many blastocysts make it to cryopreservation.  And here is the money shot statistic people!!!!

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Advanced Fertility Center of Chicago’s average number of blastocysts frozen per cycle in 2010-2011 [3]

Just look at how low these numbers are! An average of 1.7 for women younger than 35 years old.  And this statistic is a little bit more up to date than the ones above – this was for cycles from 2010-2011.

So what is the point of this post?  The point is that we didn’t have any blastocysts that made it to cryopreservation, but we did have 2 blasts that were transferred and 1 that could have been frozen, but they decided it might not survive the thaw.  For our first cycle we had one blast make it to the freezer.  The point is, we had high expectations for more to make it to the freezer, when in actual fact the reality is, we were better than average to have so many good Day 3 embryos and we were typically average with transferring 2 on Day 5. Yes, IVF cycle 2 was a failure, but we were pretty average with our second cycle!!! This doesn’t mean we are less likely to succeed with cycle 3, rather the odds ARE in our favour.

Happy dance Dani!!!

stay the path

[1] Source: http://www.pacificfertility.ca/our-resources/guide-to-ivf-lab-results/

[2] Source: http://www.advancedfertility.com/ivf.htm

[3] Source: http://www.advancedfertility.com/cryo.htm

 

 

IVF Diary Vol II: Our Failed Cycle

I had been eagerly waiting for Chris to finish work on Thursday, I had been off work ill with this cold so was getting impatient.  As soon as we were  both ready, I went to pee on that stick.  I watched as the wet line slowly crept up the test window…it went straight past the result line to the control line without even a vague faint line.  It was so white and empty.  At 12DP5DT I should be seeing that line.  It was all over.  I cried.  I came out of the toilet and just hugged Chris and told him “It didn’t work, I’m so sorry”.

So many things were running through my head.  Bitter sadness at our situation.  No halloween baby this year for us.  No frozen embryos from this cycle despite our great fertilisation success rate.  These embies were not meant to be.  Anger.  The anger at our failure and hopelessness.  The anger at not knowing why.

Of course, there is always a chance the pregnancy test could be wrong, but the odds at this stage were not in my favour, I’m not that naive.

Thursday night I woke up every hour with our negative result on my mind, and finally at 5AM I woke after a dream about being stuck on a sinking nuclear weapon ship that I helped to destroy by providing intelligence about it (I was a spy in my dream!).  And as the ship started to sink, one small rescue boat was filling up quickly with other people, there was no room for me on it, I shouted out, “please save my frozen embryos. Please, all I want is for you to make sure they are born and grow up knowing that I was their mother, and I loved them.”  I woke up in a cold sweat with tears streaming down my face.

For all our failed IUIs, the clinic never made me go in to have a beta blood test if I got a negative.  For IVF, everyone has to have a blood test.  I now know what it feels like to go to that blood test with a heavy heart, knowing it is pointless.  The idea of not testing and waiting to get the results by phone whilst at work horrifies me, so I am glad I tested the night before to prepare me for the worst, and be with Chris at the same time.  I am not brave enough for that.

Today when I went in for my blood test I got the new nurse.  I knew she was new because she was literally shaking as she took the blood from me, and then afterwards proceeded to spill my blood from the end of needle all over the table.  She also asked me some very awkward questions, in a sweet naive way, so I could tell she was a newbie around here!   But I wasn’t in the mood for being polite and quaint, so I cursed myself as I left, telling myself it was typical for that to happen to me of all days!!!

I got THE phone call from my doctor not long after lunch when she confirmed what I already suspected.  A negative result.  She basically ran through what happened during my cycle – 14 eggs collected 11 mature, 11 made it to Day 5, 2 reasonable blastocysts transferred on Day 5, and then none made it to the freezer.  She said that my egg quality was not looking good and we can talk about it some more at a later date when I am ready.  I thanked her, put the phone down and immediately picked up the phone again and called the clinic to schedule a consult with her for next week.

What next?  Chris and I talked about possible next steps, but it was foggy.  I looked at my calendar and figured out if we did another IVF cycle when it might be.  The thought of going through all of this again to end up with nothing seems terrifying.  They say you should try at least three complete rounds of IVF before considering to changing tactics.  In the UK, depending on where you live, you may only get 2 rounds of IVF with the NHS, but there is lots of research that suggests 3 rounds is the magic number.  My bets are on. We don’t seem to be able get enough embryos to freeze so there will be no point in trying for genetic testing, I am betting my doctor will suggest donor eggs.  This is a path we are unlikely to go down (which I will expand upon for another time).  Or donor embryos, which we know little about.  But before we even consider any of that we still have one frozen blastocyst from our first cycle, so we also need to think about that too.

It’s devastating to get this far to have nothing to show for it.  I hope that at the least we will learn something more about our infertility.

At least you know you can get pregnant

I think I’m quite a tough lady when it comes to receiving mis-informed and unintentionally hurtful infertility advice from the more fertile.  I experience it frequently because I am open about our infertility journey.  I forgive them because I know they don’t understand infertility as a disease and they only mean the best for me.  And I also know they couldn’t possibly truly understand how I feel because it has never happened to them.  Similarly like to people who have suffered from other diseases such as anorexia or depression or cancer, I don’t know what it is like or how it feels…I would never offer my uninformed opinion about treatment options or ways to overcome the symptoms of these diseases.  I won’t offer consolation that attempts to make them feel better about their disease.  Rather, I will offer my ear and my hand.

So why is infertility any different to any of these other diseases in how we talk to other people about them?  Why do so many bloggers end up writing about this struggle?  Is lack of education really the cause of this? May be other disease sufferers experience similar unhelpful comments too.  I really don’t know.

Have you seen that film about depression where friends and family offer their advice about depression, but the recipient of the advice is portrayed as a cancer sufferer?  The point of the video is that you wouldn’t say these things to someone who has cancer, so why would you say these things to people who have depression?  I think it is a great educational video (it’s at the end of this blog post if you want to see it).  Ultimately, I think there needs to be a film in a similar light about infertility.  I know there has been outrage on some forums of comparing infertility to cancer.  I understand that it is outrageous because people generally won’t die from infertility.  Comparing depression to cancer may also outrage many people as well…but depression can lead to suicide, it can kill too, but it is not a well understood.  So what is my point?  My point is that there are helpful things you can say to someone with infertility, and then there are unhelpful, even hurtful, things you can say to someone with infertility.

I have written about things that hurt, what to say, what not to say to someone with infertility many times before (ignorance is bliss, a voice of the child free family, Grow some thicker skin, you are so lucky you don’t have kids, Understanding: #YouAreNotAlone, Reblog from Que Milagro: Pardon Me While I burst into flames).  Today’s post adds to this list.  Today I am writing about one particular comment I have received multiple times since our loss from IVF cycle 1 from both fertile and infertile people:

“At least you know you can get pregnant”

I’m just going to put it out there straight away.  There is nothing consoling about this.

I get that there are many women who have never seen those two pink lines, me being one of them until our fist IVF cycle.  So I understand how hard it is to get negative after negative 25 times in a row.  But being pregnant  and losing a pregnancy is not consoling, knowing that I ‘did get pregnant’. I didn’t stay pregnant.  Maybe they would say “But it’s one step in the right direction”, yes perhaps, but it was then like ten steps back after our loss.

Would you say this to someone after they lost their baby during childbirth?  No.  Would you say this to someone who lost their baby in their third trimester? I doubt it.  Would you say this to someone who has suffered from recurrent pregnancy loss and miscarried 6 times? Definitely not. Would you say it to someone with secondary infertility? For goodness sake, NO.  So why does this need to ever be said at all?  It makes absolutely no sense at all and simply reminds me that we simply FAILED.

I am due to have my first beta test on Friday and in some ways, I am afraid of a positive than a negative.  Don’t get me wrong, I WANT A POSITIVE MORE THAN ANYTHING.  But I am afraid of when the positive comes, I know that even if this is my one successful pregnancy, my journey through the first trimester is going to be a psychological challenge.  If we ended up in a similar position to last time with a slow rising beta levels, pregnancy of unknown location suspected ectopic, yes it will be easier knowing the process the second time around, but it will be bloody damn hard to go through it all again.  And that is why I cannot accept the statement  “At least you know you can get pregnant” as consoling.

exhausted

IVF Diary Vol 2: 2-8 Feb 2016

Medication(s) administered and dosage(s). Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2.  I have failed to pierce the skin myself yet, I am so close, but I have managed to do everything else, including doing the actual injecting part…I had a couple of mis-haps, including one evening as I removed the needle, blood gushed from the injection site.  The blood poured down my leg and I just managed to catch it before it landed on the nice white hotel towels.  I have no idea why it happened, I guess it’s going to happen once in a while.  The injection site was sore for a couple of days after that 😦

minions.jpg

I had to put a plaster (aka band-aid) on this one after the blood gushed from this injection site!  Minions to the rescue!

 

Medical procedures undertaken. Nil

What are my symptoms?  I have had a few sharp pains and cramps here and there.  All good signs I guess.  I have also managed to catch a cold and sore throat. WHYYYYYYYYY??!!?!!  Now the wisdom of the internet says this is an early pregnancy symptom. Well, it is the runny nose/cold part which is the symptom that can be explained by the extra estrogen caused by the pregnancy, apparently that creates a stuffy nose.  Well, I have a sore throat and that can’t really be explained by that theory.  Some argue that your immune system drops after implantation.  Well in my case, this cold was inevitable because it was going around at work.  I was the last person to catch it because it was going around mostly when I was out of office for the stimulation/egg retrieval part of the IVF.  There were some remnants of the cold hanging around the office when I returned.  It was bound to happen.  Also, this happened to me the exact same time last year during my second IUI, excitedly thinking it was an early pregnancy symptom, I was wrong.  SO I am not taking this cold as a sign of anything except for being a pain in the butt.

The night sweats.  It’s gross and I hate it.

The cats have been on my lap again (two nights in a row)…I have already written about this (Can your cat tell if you are pregnant before you do) and whether it could be an early pregnancy sign.  I think they can detect a change in something, whether it is pregnancy or just a change in your body temperature, I don’t know.  One thing I do know, they can’t tell if the pregnancy is going to stick around or not 😦

cats.jpg

Sushi sitting on my lap and tolerating Diesel laying next to her, it’s not a common sight

Having said all that, today I do feel a little nauseous and I couldn’t bare to eat my chicken sandwich.  So who knows?  May be I am pregnant!  I don’t know because I haven’t tested yet!!!  Yup, today I am 9DP5DT (9 Days Past 5 Day Transfer) and I haven’t pee-ed on a stick yet. I am impressed with myself! I’d like to thank a very lovely lady who I met at my local Resolve Support Group who is IVF cycling with me…she encouraged me not to do the test it out thing, and to wait it out with her!!  Last time around I tested 12DP3DT (i.e. what would be tomorrow, when my period would ordinarily be due).  But this time I am not testing until the evening before my Beta test (which is scheduled for Friday).

How do I feel today? You may have noticed my absence for the past week.  Well I took my ‘Must keep busy during the 2 week wait’ a little too literally!  Although I have been hampered a little bit as a result of work.  Last week I got home in the evenings with my brain frazzled – I wasn’t doing overly long hours, just lots of hard thinking and writing.  The thought of updating my blog was too much for my poor brain, so I did mindless (mindful) things such as knitting, TV watching and colouring in.  I even taught Chris how to knit 🙂

knitting project

My IVF knitting project 2/3 complete!

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Chris learning how to knit!

We also went away on a mini road trip/city break to Charlotte, North Carolina to see the Charlotte Hornets v Washington Wizards (Basketball).  My first NBA game, it was my birthday present from back in December.  I had a fantastic time, I really enjoyed the experience and appreciate the very talented athletes.  I think it might be my favourite American sport so far!  Along the road trip we visited some random places, like a Lemur conservation, the world’s biggest chest of drawers, and a mountain that was only 350ft tall (it was a slightly misleading name of a state park!!!!).  Planning a city break in this 2 week wait was perfect! (Except for the catching a cold part).

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Our first NBA game!

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The World’s Largest Chest of Drawers – It’s in a town called High Point in North Carolina!

Any results?  Not much longer to go now!

What’s next? Beta HcG test will be 4 days from now :-s

Weight. NSTR.

Waist. NSTR.

Boobs. So, so sore and sensitive!

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF Diary Vol II: 31 Jan – 1 Feb 16

Medication(s) administered and dosage(s). Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2.  I still have not mastered injecting this thing myself, but getting used to seeing the needle going in and injecting the oil myself.

Medical procedures undertaken. Nil

What are my symptoms?  I have had some aches and pains around my ovaries.  I am also quite tired, mostly because I have not been sleeping overly well since starting the progesterone.

How do I feel today? A little stressed with work situation at the moment.  At work as we were trying to sort some issues out amongst the team, and I was sat there consciously trying to remain calm, breathing through my nose and exhaling through my mouth slowly and consciously.  That worked for the morning, the afternoon I was just plain sad about work.  Someone who I barely know came to find me after a meeting and asked if I was OK, I seemed a bit sad and not my cheery self.

Any results?  At 5pm my phone rang with the clinic’s number, I couldn’t think why they were calling me.  The nurse answered the other line in a somber voice.  She had bad news.  Our 9 embies didn’t make it to cryopreservation.  So, no frosties this time around.  I tried hard not to cry on the phone, and burst into tears at my work desk as soon as I got off.  I cried in the car on the way home from work, trying not crash through the blubbering tears and snot.  We are gutted.  I am grateful we managed to transfer two at least.

What’s next? Beta HcG test will be 12 days from now :-s

Weight. NSTR.

Waist. NSTR.

Boobs. NSTR.

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF Diary Vol II: 29 Dec 15 – 3 Jan 16

Medication(s) administered and dosage(s). Ovulation Control Pill (OCP) Reclipsen 0.15MG-30MCG x 1 per day

Medical procedures undertaken. Nil

What are my symptoms? As per last time I took the Birth Control Pills, my period lasted a few days longer and I am still spotting.  It’s no biggy.  Especially as I know now that this is exactly what happened last time.  I also appreciate what some women go through who have more than 3 or 4 days of menstrual bleeding…I feel bad for you ladies!  I consider myself lucky that I don’t bleed for 7 days normally.  Today I had quite a heavy ‘spotting’ and had some sharp pains around my right ovary that I would ordinarily feel around ovulation time.  But a hot water bottle fixed that pain and now all is back to normal.

How do I feel today?  Chilled and relaxed.  That could be something to do with the fact that I have been off work for over a week!  With no travels this festive period, it had been true relaxation, probably more laziness more than anything.  But it’s back to work tomorrow, and despite the unknowns about what the year ahead will look like for me, I feel a bit excited to be starting with a fresh mind, ready for the start of my stim injections 15th Jan!  I am also really pleased I kept a diary from my first cycle….I can look back and read what happened so I have some kind of ‘objective’ truth to what happened.  I think it’s useful because it removes some of my anxieties about what to expect next!

My medication arrived on time…I decided to see how high I could stack up the boxes for this photograph 😉  It looks like a terrifying amount of medication!

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My meds for IVF cycle 2: Gonal-F, menopur, cetrotide, Ovidrel, progesterone in oil (generic), doxycycline

There are a couple more boxes extra compared to last time because they plan on upping the dosages a little.  It was interesting to see the differences in prices in the medication.  Not much, but some of them have gone up a few cents.  And every penny counts.  The lady at Freedom Fertility Pharmacy was very kind to ask if I needed to split my order or wait to the new year for my insurance in case it changed or I had reached my limit.  Fortunately, my insurance limit is ‘lifetime’ rather than a fixed time like every calendar year so it makes things very simple.    (I have also updated my ‘The $$ Lowdown’ page. – counting my blessings I have great insurance coverage for all of this)

Any results? NSTR*.

What’s next? Another week of Birth Control Pills, first baseline appointment is 14th Jan, so it’s all quiet until then.

Weight. I am 10lbs heavier than when I started my first IVF cycle.  Most of that extra weight is from after my miscarriage and Christmas.  I am going to be doing some more exercise, I am not getting too het up about it, I can still fit into my clothes, there are perhaps a few pairs of trousers I won’t be able to wear when it comes to the stimulation phase of IVF!  I will start tracking my weight like last time, but I haven’t bothered with a baseline weight prior to birth control pill.

Waist.  NSTR

Boobs. NSTR

Hours of Sunshine 🙂 For my first IVF cycle I recorded the amount of sunshine I soaked up.  It was summer.  This time, it is the deepest darkest time of winter, so getting sunshine is pretty difficult!  Having said that, we did get out onto the water to see some humpback whales.  The sunshine was glorious although the photo below you can’t quite tell how blue the sky was!

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

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A humpback whale blowing – at the mouth of the Chesapeake Bay