ivf day 22: relentless attrition

while i was out on a hike today, i received quite a mixed bag of news from cny. the adventure continues!

(from left to right:)

embryo #1: while yesterday was indeed listed as the “biopsy and freeze day” in my health portal, only two of our sweet three stayed viable long enough for that to happen. our third little amigo, who was neither biopsied nor frozen, got to spend 6 rad days as a never-before-seen-in-this-reality genetic combination, and the universe got to experience itself as that little embryo for almost a week. it’s really kind of mind-blowing to think about. so long, little comrade, and may your cells go to good use and bless and enrich scientific discovery.

embryo #2: one of the two embryos that was biopsied and frozen received the lowest possible score from embryology, a “4CC” meaning it was behind in development and showed a low quantity of cells both in the trophoblast (the outer “beachball”) and the endoderm (the inside clump that will eventually become the fetus). this isn’t the end of the line for #2 quite yet, but it means a much larger likelihood that there’s a genetic issue. we’ll know that hopefully by the end of next week. also of note: embryo grading is incredibly subjective and not the final word on anything, but we’re prepping for #2 to be a loss.

embryo #3: lucky #3 received the highest possible grade for an embryo, 6AA, meaning it has already successfully “hatched” from its blastocyst shell called the “zone pelucida” (latin for “see-through girdle” HA!) and it shows a large and thriving quantity of cells both in the trophoblast and the endoderm. in the picture above, it’s the one that’s YUGE AND PERFECT. first school picture. it’s going on the fridge. but really though, the game changer here is that, although embryo grading is more art than science, one study found that 6AA embryos had a 65% pregnancy rate and a 50% live birth rate. that’s up from the 14% general statistic for random eggs at my age. no guarantees with a 6AA, but our odds of success just went up despite losing one and probably another. if the testing for #3 comes back normal (we’ll know in just over a week), our odds go up to 85% for a pregnancy that progresses to at least 24 weeks (that study didn’t include life birth rates. rude.)

all of this is technical data. labs. grading. odds. it’s worth noting though that none of this feels technical in my or stephen’s hearts and minds. this is all exciting and excruciating. it’s cringe and brace and hooray and crickets and tears and magic and horror. i’m amazed at what our bodies were able to do in marriage with science, and i’m devastated every time that number ticks down. i’m terrified of it hitting zero, and i know it won’t, but i worry that it will, and i know that it won’t–back and forth forever.

each piece of news from me is a text message that might make or totally derail stephen’s day. will it be yay! or will he need to drop everything and come home? how do you grieve at and with a person who is grieving for the same reason? how do you stay in a place of both hopeful joy and realistic authenticity in knowing the odds?

this experience has been all-consuming for me. i don’t have bandwidth for anything else or anyone else. i don’t answer emails. i’ve cancelled meetings. i don’t give two shits (temporarily, and not in a bad or scary way) about ordinary life things. i’m getting out for walks and hikes to pass time, but i have zero capacity for responsibility. i feel like it’s taking all i have to hold this…

…and i’ve drawn so much energy and stamina from all of you standing alongside us. thank you for being here for the joy and the horror that is in vitro fertilization.

yours truly,

a hopeful mama