Feb 12, 2009

So your embryo stage must match if you have more than one donor. 2pn's to 2pns, and multi's to multis, and blast to blast. Only exception is that you may have a multi if your first choice is a 2pn. I think they must culture the 2pn's to multis, but I do not know this for a fact. But it would make sense. :)

http://www.miracleswaiting.org/factsembryos.html

What is the difference between an embryo and a pre-embryo?

Embryo and pre-embryo are both terms that are used broadly to refer to all the early stages of development of a fertilized egg. The word embryo is specifically used to refer to the stage of development between implantation in the uterus and the 8th week of gestation, so some IVF clinics use the term pre-embryo when describing pre-implantation embryos. However, both words are commonly used to refer to stages of development prior to transfer to the uterus.



What is a 2PN embryo?

Male and female gametes (eggs and sperm) each have a nucleus containing DNA. Within hours after penetration by the sperm, the egg jettisons half of its chromosomes in a process called meiosis. (Sperm complete meiosis much earlier, while still in the testes.) The remaining DNA packet from each gamete is called a pro-nucleus. For a period of time after the sperm penetrates the egg, the two pro-nuclei exist separately within the cytoplasm of the egg. Appropriately, this earliest stage of development is called the “two pro-nucleate” (or 2PN) stage. When embryos are being created in an IVF laboratory, the embryologist typically will be looking for proof of initial fertilization (2 pronuclei in close proximity to each other) about 16-18 hours after insemination.

http://www.miracleswaiting.org/factsembryos.html#top

What is a Zygote? What are Blastomeres?

Gradually, the two pro-nuclei gravitate toward each other, their cell walls dissolve, and they complete the process of fertilization by merging to form one nucleus. The fertilized egg is now called a “zygote.” The nucleus begins to duplicate itself by dividing into cells called blastomeres. This process is called mitosis. At first, the blastomeres are rather large, but each division produces smaller and smaller blastomeres. Normally, embryos reach the 2-4 cell stage about 24 hours after fertilization (two days after egg retrieval), and a day later, they will have about 8 cells. Here in the United States, Day 3 is the earliest stage at which embryos are routinely transferred to the uterus. In between fertilization and the point at which there are too many cells to count, they are called cleavage-stage embryos. They are also commonly referred to as 6-cells, 8-cells, etc., according to their stage of development.



What is a Morula?

When the embryo reaches about 16-32 cells, it is called a morula (mulberry shaped).

What is a Blastocyst?

As the morula continues to divide, it forms an outer shell of cells (the trophoblast) around a fluid-filled cavity (the blastocele) containing an inner cell mass (the embryoblast). At this point, the organism is called a blastocyst. An embryo usually reaches the blastocyst stage around Day 5, which is when it would normally be entering the uterus during a natural cycle. The trophoblast and embryoblast cells will continue to differentiate from one another as cell division continues within the blastocyst, laying the groundwork for the placenta to grow from the trophoblast, and the fetus to develop from the inner cell mass.

Feb 12, 2009

Hmm, I'm missing some steps, so let me back up a bit.

After our initial application to the NEDC, we were given a list of things we needed to have done:

1. two lab request forms, one for wife, one for husband
2. request for our medical records to be sent to Dr. Keenan
3. sign, notarize, and return the "Informed Consent for Receipt of Donated Embryos/Waiver of Liability" if you want open
4. Fill in the "Open Donation Agreement" with the amount of openness you feel comfortable with and return to the NEDC
5. If you are willing to adopt either way (open/anonymous) please attach a note stating this fact
6. send note with updated contact info
7. send note with who our SW at Bethany is. (if you do not already have an SW, they will send your info to Bethany Christian Services, and an SW will be contacting you to begin the homestudy at this time. However, we already had it done).
8. Family Info sheet
9. letter to donors
10. release of info form




If you chose open, then:
1. our profile sent to donors
2. if selected, we get to review their profiles.
3. then we say yes, and this is sent to Paula at Bethany to negotiate the open adoption agreements between the parties.



If anonymous, then:
1. you're sent a brief sheet with descriptions
2. you chose enough embryos for your initial choice and your back-up choice. (I believe that's true for open as well) as they like to see a minimum of about 6 embryos.
3. if the anonymous party has selected to have final say, they review your profile.
4. if everything is honky-dory, then you move forward.



(more coming)

Feb 12, 2009

* 10/07 mock transfer/initial appointment

We arrived in TN the night before the appointment. The morning of, we ate lightly and I drank my water. We drove over to the NEDC, pretty much first thing in the morning (9am). We did not wait very long in the waiting room at all. We did talk to a couple people in the waiting room who were doing other fertility treatments. Everyone was very friendly.

Things we did at the initial appointment:

Met a lot of the staff. The embryologist, the nurses, the doctor, etc.

Did an ultrasound (external). Then you're allowed to pee and they do the internal, including the mock transfer, where they go through the motions of a transfer to measure your uterus depth etc so they don't make a mistake and place the instruments too far back or too near. So they know if they have to curve it because your uterus is tipped etc.

Dr. Keenan will go over your medical history with you. It is helpful for you to bring your own "cheat sheet" as he will ask you tons of questions. Mind you, if you're like me and your file is about 2 to 3 inches thick of material sent over, it is a lot easier if you just have answers ready.

Some of the questions included how many cycles of what all did we try and what were the results? Did we do any sperm testing? How did each IVF go? # eggs retrieved, how many fertilized, what all happened, etc.

If you're overweight he will go over diet and exercise with you. He may put you on Metformin (he did put me back on it).


We were given a lot of instructions for what will happen with the FET, what all to expect. Things to do to prepare. A prescription to be filled as soon as possible for all the meds needed for the FET.

He did give a prescription we took straight to Walgreens because you need it immediately: Prometrium

Instructions for Prometrium: You will continue to take the Estrace as you have been taking it for the next five days. You will also begin to take Prometrium twice a day for the next 5 days. You will insert the prometrium into the vagina. You will have a cycle within a few days of stopping the medications.

They gave us instructions how to find the Walgreens. So we drove there, picked up the prometrium and some maxipads.

We had lunch at Subway, and continued on our way home.

(more coming)

Feb 12, 2009

Where should I begin? :D


Hmm . . .

How about a walk-through? :D

Ok, so . . .

* 07/15 Bethany Christian Services approved our homestudy for embryo adoption

* 08/06 received email from NEDC with available dates for our initial appointment/mock transfer. We could have chosen from:

Well, it’s time to schedule your initial appointment. This appointment takes about 2-3 hours and is an extensive consultation with Dr. Keenan for both of you. A trial transfer will also be done as well as an ultrasound. Jenny, the IVF nurse will work with you on your medication protocol for your “mock cycle”. The appointment needs to be within day 14-20 of your cycle (first day being first full day of flow).

Available dates are:

Tuesday September 9

Thursday October 2

Tuesday October 7

Tuesday October 14

Thursday October 16

Tuesday October 21

Tuesday October 28

Thursday October 30

Appointments are usually at 9AM.

Please let me know if any of those dates would work for you.

So, we couldn't do that first day, due to my cycles being messed up. They put me on birth control and we had then an appointment of 10/7.


* 09/18 took last birth control pill

* 09/21 cycle started

* cd 1-9 take 2 estrace per day
* cd 10 to transfer take 3 estrace per day

Instructions: please come with a full bladder, and take 600mg Ibuprofen 30 minutes before appointment.


* 10/07 Initial appointment/mock transfer

(going to break this up into a couple posts)

Our Embryo Adoption Journey to date . . .

I'll be updating the blog with posts I posted to Hannah's Prayer, about what we've gone through with our embryo adoption, along with costs.

We're still waiting on embryo adoption and domestic infant adoption. But I really want to put this out here somewhere so others have an idea of what to expect. :)

Interview in The Tennessean

Ok, so we were matched in Embryo adoption. We did a transfer, but it didn't work.

So we're back on the waiting list for domestic infant and embryo adoption. Will likely do a transfer in July or September again.

We were interviewed for the Tennessean while we were down there. There's also video on the site:

http://www.tennessean.com/article/20090405/NEWS06/904050394

Continuing to praise God in the midst of my storms . . .

May you all have a very blessed Easter!

Love,
Julie

Why doesn't it work?

Trying 1 more time. I just don't get it. It's way past those "6 hours" it's supposed to take to change it. So why does the embed code show the wrong picture?