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Wishing you all the best in the coming days as you meet your baby. Congrats!

CrazySweetStrong:

3 days and I’ll be holding our baby.

Someone pinch me. Where did the time go?

Infertility can be such a bitch. Some days I think I don’t deserve this opportunity to be a mom again. There are so many women out there who have tried so long and it’s their turn. We’re lucky to have our #1 miracle boy. I cannot tell you how I feel about getting the chance to do it again…

But then I think about what we’ve gone through to get here. Over a year of ttc with no dr support.  A missed m/c. Clomid, bloodwork, multiple HSGs, sperm analysis, laparoscopy, fertility drugs out the crazy mo-fo ying-yang, thousands and thousands of dollars on treatments, hours and hours of travel to and from drs, having to stab myself with needles, having my uterus punctured to get to my ovaries for egg retrieval, another m/c, negative results enough to break hearts in a whole city and the stress and anxiety of going through this over thr course of years (started ttc in 2004). We deserve this baby. I hate to say it so selfishly but we earned this baby. Not that others haven’t earned their chance. …. but I refuse to feel guilty.

We’ve already had to start considering what we’ll do with our 2 left over frozen embryos. Right now we’ve paid to store them until summer. Then we’ll have to decide whether to store again (too soon to use), donate or destroy. It’s a big decision… when the time comes.

3 days. And I’ll be a mommy again. New baby smell. Tons of diapers, lack of sleep, sore nipples, and recovery from surgery. And I cannot wait.



ADOPTED EMBRYOS: Family Welcomes Triplets

  

This spring, four embryos arrived via FedEx.

On Tuesday, three babies were delivered by C-section. For 34 weeks, they went by Baby A, B, and C. Now they are Ezekiel, Malachi, Evangeline born healthy and in that order.

Parents Joni and Luke Timm count the newest additions to their family as a blessing.

Their story is different from most. The Timms adopted embryos from a couple in Alaska. 

http://whotv.com/2013/12/19/timm-triplets-family-welcomes-birth-of-adopted-embryos/

BACK TO BASICS!

    

EMBRYO DEVELOPMENT…

Let’s Look At What Happens Day 1 through Hatching.   

  

Conception/Fertilization

Conception happens when the sperm enters the egg, which usually takes place in the fallopian tubes. As soon as the sperm and egg unite, the gender, hair, skin and eye color of the new baby are already determined. Fertilization usually takes about 24 hours.

30 Hours After Conception

The new baby cells divide and subdivide as it is swept through the fallopian tube by cilia toward the uterus.

3-4 Days After Conception

3-4 days after conception the fertilized egg arrives at the uterus after a 4 inch journey through the fallopian tube. The cells look like a microscopic mulberry or raspberry and are called a morula. Once in the uterus it burrows itself into the endometrium, which is the lining of the uterus. The outside cells of the morula eventually grow to form the placenta. Baby begins to develop from the inner layer of cells.

6-7 Days After Conception

The morula, now dubbed a blastocyst because of various changes, begins to attach to the uterus. This is when some women report feeling implantation cramps that feel like mild menstrual cramps.

7-10 Days After Conception

Implantation may or may not be followed by implantation bleeding, which looks like light spotting. Once the blastocyst is implanted, baby is deriving nourishment from maternal tissues.

2 Weeks After Conception

This is the magic time when most women discovery they are pregnant via the results of a home urine pregnancy tests.  

http://fullmoonsdaughter.com/blog/2009/11/pregnancy-timeline-conception-through-first-2-weeks/   

#ivf #iui #fertility #infertility  

Embryo Freezing (Surviving the Thaw)

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Is it better to transfer a 2PN (aka two pronucleate) embryo, morula, or blastocyst?  Which would better survive the thaw?   Let’s talk!
  
T
here is some difference of opinion about whether it is better to transfer embryos on Day 3 (cleavage stage), or Day 5 (blastocysts)  The answer may be that it depends upon the protocols of your clinic.  Some clinics have not observed a significant difference in pregnancy rates between the two procedures, or speculate that embryos which do not survive to the blastocyst stage in the laboratory might have survived inside the body.  However, the argument for incubating embryos longer in the laboratory is twofold.  One, it delivers embryos to the uterus at the time they would normally arrive, avoiding exposure to potentially harmful amino acids and carbohydrates.  Improvements in culture mediums may provide a more hospitable environment in vitro. Two, it allows for the identification of the strongest, most resilient embryos in the batch, avoiding the possibility that the most viable embryo(s) might be lost during the freezing/thawing process rather than selected for the fresh transfer.  Transferring fewer, more robust embryos results in a lower risk of high-order multiple pregnancies (triplets, quadruplets, etc).  In many clinics, the transfer of blastocysts results in higher pregnancy rates per transfer, but it also increases the number of couples who do not have any viable embryos at the time of transfer.  On average, about 30% of embryos make it to the blastocyst stage, while about 70% stop growing.  It is unknown whether these embryos would have survived if transferred earlier, and therein lies the debate. (Actual rates vary between clinics and individual patients.  In general, fewer embryos made from the eggs of older patients, and more embryos made from the eggs of donors and younger patients, go on to develop into blastocysts.)  Often, clinics will choose extended incubation only when there are sufficient quantities of good quality embryos on Day 3 (8-10 or more) to assure the probability of an adequate number of Day 5 blastocysts for transfer.

Embryo freezing, or cryopreservation, adds an important dimension to assisted reproduction by:

  • Extending the possibility for pregnancy when fresh cycles fail or when couples want additional children after a successful embryo transfer.
  • Avoiding many ethical dilemmas by eliminating the need to dispose of embryos.
  • Offering an alternative to couples that might transfer too many embryos and risk a multiple gestation pregnancy.
  • Avoiding embryo wastage by freezing embryos individually for efficient use.
  • Increasing pregnancies per retrieval cycle with normal outcomes by 10-30% more. Many studies have evaluated the children born from frozen embryos. The result has uniformly been positive with no increase in birth defects or development abnormalities.

We define embryo survival based on the number of viable cells in an embryo after thawing. An embryo has “survived” if >50% of the cells are viable. We consider an embryo to “partially survive” if <50% of its cells are viable, and to be “atretic” if all the cells are dead at thaw. Approximately, 65-70% of embryos survive thaw, 10% partially survive, and 20-25% are atretic. Our data suggests that embryos with 100% cell survival are almost as good as embryos never frozen, but only about 30-35% survive in this fashion. 

Embryo morphology (appearance of the cells / percentage of fragmentation) is one of the most influential factors for embryo survival. Interestingly, embryos produced from intracytoplasmic sperm injection (ICSI) also seem to survive somewhat better than embryos produced from conventional insemination. The following graph illustrates these points. The embryo grade in the graph goes from worst (3.2) to best (1.0).

Embryos that are 2, 4, or 8 cells when frozen have about 5-10% greater survival than embryos with an odd number of cells. Donor egg embryos have a 2-5% greater survival rate than embryos from infertile women when compared by morphology score. 

Pregnancy rates are similarly affected by complex relationships and like embryo survival only 7-10% of the predictive value can be observed and measured. Age is not a significant factor with frozen embryos but fewer older women have frozen embryos. From the approximately 20 factors reviewed, the most important factors predicting pregnancy rates are the number of surviving embryos transferred, the number of 100% surviving embryos transferred, and the morphology scores of the transferred embryos. The delivered pregnancy rates ranged from 5% (a single poor quality embryo) to 36% (4 high quality embryos) when the cycles from 1987 to 2001 were combined.

Blastocysts (embryos cultured for 5 days rather than 2-3) are a special case. The embryos are much larger and have special needs with regard to freezing without damage. Many centers have had trouble with blastocyst cryo-survival and pregnancy rates. A new protocol developed in our laboratory and implemented in December 2000 led to a transfer rate of 62% and a 35% pregnancy rate per transfer. This important change now makes blastocyst transfer more appealing since excess blastocysts can be expected to yield pregnancy rates comparable to embryos frozen two to three days after retrieval. 

  

For more info please visit the GIVF Center website:  http://www.givf.com/fertility/embryofreezing.shtml and the Miracles Waiting website: http://www.miracleswaiting.org

Embryo Donation… a first thought.

So now that embryo donation/adoption is on the radar I decided to delve deeper into this little known area of ART.  And wow did I have to do some digging…  it is seldom spoken about in the blogs and forums, certainly when compared to topics such as IUI and IVF, and printed literature on the subject is about as rare as gold, but now after a week of digging the one thing I have come to realize is that there is A LOT more to think about.

This seems to be a whole new (somewhat misunderstood, somewhat undefined, certainly under-regulated) world. 

One of the more interesting (to me) strains of thought I have come across after having five (very different) conversations with potential embryo donors is the idea that some donors cannot bear the thought of their embryo (or potential future baby) being experimented on (I get that), or being born to another woman or family (not my way of thinking but I do understand it)….  So instead they decide to terminate those embryos instead.  

Hmmmm….   Am I missing something here?

You cannot fathom the thought of your “baby” being experimented on, or being born to anyone else except you (don’t worry, I get that), so you decide to destroy them instead (don’t get that) - by placing them to thaw in a container on your dresser, or have them be reintroduced into your uterus during your non-fertile phase, or pouring them into the ocean…

Okay, I am being very serious here.  And, I am in no way saying that this is an easy decision, or that everyone (or anyone) must choose to donate their embryos — I truly believe that people have a right to do whatever they want to do with their embryos - their body, their embryos, their choice…   BUT… saying that you care too much for your (potential) babies so you’d rather destroy them, to me, makes zero sense.   Sort of in the same way mercy killings make no sense to me.

So can someone please explain this…  seriously.  I promise I am very capable of processing another side of an argument - my IQ is actual quite high.   And please… no sarcasm, no inflection, no drama…  just bring it home with the basics.  How does this thinking work?    Is it that one feels they are choosing the lesser of two evils?   Or, does it even have to make sense to an outsider?  I mean, it’s their embryos, right?   They don’t need to justify anything to anyone…

Fertility Yoga… does it work? Let’s Talk!

The Secrets of Yoga for Fertility

Desperate Housewives actress and founder of Yoga4Fertility shares her top fertility yoga tips…  (www.babyzone.com)

Brenda Strong Dougle Pigeon Pose

Though you may know the voice of Brenda Strong from ABC’s Desperate Housewives, you may not know her as yoga instructor—specifically, one who specializes in yoga for fertility. Through her personal battle with infertility, and her work with other women, she developed a yoga curriculum, Strong Yoga4Fertiliy, that utilizes poses to nourish the reproductive organs, calm the nervous system, relax the mind and body, and to help boost fertility.

“One of the wonderful benefits of yoga is it teaches you to respect your journey,” says Strong. “It requires that you approach everything as a process.” And while there are many types of yoga to choose from, she says, not all types are ideal for fertility.

How Does Yoga Help with Fertility?

The research is clear—chronic stress can lead to a variety of health issues, both physical and psychological. And yoga has long been recognized as an effective way to reduce stress and anxiety. But in addition, says Strong, certain yoga poses can help to detoxify the body while relaxing tight muscles and connective tissue.

Yoga for fertility focuses on improving blood flow and circulation to the low back (sacral plexus), hips, groins, and pelvis, which can aid in healthier gynecological function. As the body relaxes, the mind calms. Focused breathing aids the nervous system and helps lower stress hormones like cortisol, which can impede reproductive hormone function.

There are emotional benefits as well. Learning to listen to the body’s natural rhythms through yoga and breathing can bring a deep sense of peace and connection to our own innate healing capacity, says Strong. A strong yoga practice can help women and couples feel more empowered on their journey toward conception.

The Best Fertility Poses

The yoga poses that best aid fertility have a few key things in common. The poses:

  • increase circulation to the reproductive organs
  • balance hormones
  • reduce stress

You may have already heard that inversions like headstands and shoulder stands are powerful fertility aids—recommended because they can aid in balancing hormones. But since inversions and other advanced yoga poses require supervision, they don’t make the top of Strong’s list.

The following five yoga poses can be done safely, in the privacy of your own home:

  • Reclining Bound Angle Pose (Supta Baddha Konasana)—a reclining pose that softens the internal organs, opens the pelvis, unburdens the heart, and calms the mind
  • Double Pigeon Pose (Dwi Pada Rajakapotasana)—a sitting pose that helps to release stored emotional trauma in the periformis muscle, which guards the gateway of energy in the hips
  • Reclining Half Pigeon (Thread the Needle)—a pose done on your back that helps relieve tightness in the body
  • Cobbler’s Pose (Baddha Konasana)—a sitting pose that helps to open the hips and increases circulation in the pelvis
  • Seated Angle Pose (Upavistha Konasana)—a sitting pose that stretches the hamstrings and helps the blood to circulate properly in the pelvic region                                            
  • Legs Up the Wall Pose (Viparita Karani)—a restorative pose that helps calm the nervous system and heart rate0

Yoga4Fertility

Brenda’s Strong Yoga4Fertility classes are unique because she offers participants expert instruction in yoga asanas (poses) and pranayama (breathing techniques) that nourish the reproductive organs, calm the nervous system, and relax the mind and body, helping to release accumulated anxiety and stress.

She teaches the Four Fields of Fertility©, which enables students to understand the innate connection between the mind and body as they learn specific techniques that will help them shift away from fear based anxiety to empowered presence and the ability to embrace their inherent ability to receive Life in all its forms of fertility. She also has developed specific breathing and visualization techniques specifically for fertility.

To learn more about the classes, her new Fertility Ball™, and yoga DVDs, visitwww.yoga4fertility.com.

Lets Talk EMBRYO DONATION! I think it’s time…

I stumbled upon this awesome blog post by Jess from the blog A Greater Yes about her Embryo Donation journey.   I think it’s a great post to get the conversation started…  so Let’s Talk!

   

The How and Why of Embryo Donation/Adoption

I have been asked on several occasions about our EA journey and have responded individually to each one. Instead of continuing to do that I am going to post it here for everyone. Though EA has been around for years many people are unfamiliar with the process. First I will discuss the options available and then explain how we arrived where we are today. My research was done over a year ago so some it may have changed (prices at clinics, wait times, etc). AVAILABLE OPTIONS:
 
NEDC: Donor couple: can choose an open or closed donation. (open-they can know the recipient family and have contact, see photos, etc/closed-little or no info).
Recipient couple: must have home study, can choose open or closed depending on what type of relationship that they want to have with the donor family.

The NEDC does that actual FET there. Couple have to travel to them 2 times, one for a consult, one for the actual FET.
 
Snowflakes: Same as above except the embryos are shipped to the clinic of your choosing for the FET.
 
Miracle’s Waiting: MW is unique in that it is just a way for donor and recipient couples to meet. You each can post a profile and if you find one that interests you, you send an email and take it from there. If a “match” is made (both couples agree) then a legal document is made for the “transfer of property” and the embryos are shipped to the recipient’s clinic. MW is popular for several reasons: usually a shorter wait time, donor and recipients can develop a relationship before decision is made, much less expensive. The negative is that you do the leg work yourself and do not have a facilitator.
 
There are a few other places that act as a facilitator between donor and recipient couples. Embryo’s Alive and Adoption From The Heart are two of them. They require home studies and offer open and closed donations/adoptions.
 
The last option is going through your local clinic which only provide anonymous donations and the information offered to donor families is nothing and varies for recipient families. My clinic gave us a complete health history as well as a description of the donor couple, though no identifying information of the donor couple. Some clinics only tell you the hair and eye color of the donor couple.
We took time to look into each option and originally chose the Miracle’s Waiting route. We really wanted a relationship with the donor family and MW was the most affordable way to do this. There is no cost to the donor family on any of these options, but they vary greatly for the recipients. The NEDC starts at $8000 plus $2500 for the home study. The cost is higher if you want an open donation. Snowflakes is similar in costs, though it can be less expensive depending on your clinic fees for the FET. MW is the cost of the FET (varies by clinic) and meds and shipping of embryos and any legal fees. The shipping is about $300 and legal fees $200. For us it would have totaled $4500, much less than the NEDC. We joined MW and while waiting for a match I scheduled consultations with the two local clinics that would use donated embryos. During one of the consultations the RE told me that they had available embryos if we wanted to use them and we prayed about it and decided to go this route. It was $4000 and the wait was about 1 month. I would have preferred to have a relationship with my child’s biological family, but felt that God had opened this door and He wanted us to give these embryos a chance at life. The couple had 6 embryos and 2 were thawed for our FET. Sadly, one did not survive the thaw so another one was thawed. These two were transferred and one is now our little bambino!
I hope that this helps some of you understand it better as well as help you to make a decision in your own journey. If anyone has any questions please feel free to ask!
http://agreateryes.blogspot.com/2010/03/how-and-why-of-embryo-adoption.html 
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