CD 18 - Transfer Day?

Oh my, my.

What a life we lead....to give an update from yesterday, our clinic knew we were not satisfied with the information we've been given thus far, and had their embrylogist call us so we can talk apples to apples.

While the discussion was informative, we're still in a place where we don't know what to decide. Dr. W said that sperm aspirated embryos tend not to do as well as ejaculated sperm created embryos. He said that the embryo would be better "housed" in my uterus than in a petri dish.

While I've heard that aspirated sperm doesn't freeze well, and often times has a lower fertilization rate, I've yet to come across anything that says that embryos from aspirated sperm don't often make it as long as embryos from ejaculated sperm.

So, the question is now: Do we transfer today or wait until Monday?

What I've read:
-Day 5 blasts give everyone a better idea on the "surviving/thriving" embryos
-Day 3 embryos placed back into the uterus, aren't really in their 'natural environment' because in a natural cycle, the embryo is still hanging out in the fallopian tubes at Day 3, not a uterus.
-It is possible for NO embryos to reach Day 5, there is controversy around whether or not this is because they would have died anyway, or if they would have done better in a more natural environment.

I unfortuantely (or fortunately) ran across this transcript online: http://www.sharedjourney.com/articles/3vs5.html

With the way this doctor talks, anything less than a 5 day transfer of one embryo and you're basically asking for a failure. Here are a couple of quotes:

"The primary reason embryos do not make it to the blastocyst stage is because they do not possess the necessary genetic instructions for continued growth. No one can change or improve the genetics of an embryo. Assuming the lab is competent (and most are), there is no "risk" associated with continuing to culture the embryos to the blastocyst stage."

"There are numerous reasons for continuing to perform day three transfers: its cheaper, its less work for the lab, lower liability because the lab has the embryos for a shorter period of time, everybody makes it to transfer, if the cycle doesn't result in a pregnancy, the program can still look good, etc. You'll notice I didn't say anything about a day 3 transfer improving your chances of getting pregnant - it doesn't. The reason programs continue to transfer day 3 embryos is because its more convenient for the lab and the docs."

This information conflicts with much of of what I've read, but it does seem to make the most logical sense. I mean if the embryo doesn't implant until Day 5 or 6, then what the hell do they do in there for 2 or 3 days? And how do you know you transferred one of the ones that would have eventually made it to a Day 5 blast?

This is all even more anxiety provoking when you're in the boat with us, and only want one baby. This wouldn't be such a tough decision if we were transferring many, but because we only want one, the decision of 3 day or 5 day is a significant one. My gut tells me 5 day, but if I stretch it out to 5 days and none of them survive, I will have gone through all of this for NOTHING. But does this mean that none of my embryos would have made it to the blast stage anyway? "The point of growing embryos to the blastocyst stage in the laboratory is to deliberately weed out the embryos that do not have the genetic potential for continued growth. The "risk" you speak of doesn't really exist. If they're gonna make it, they do. If they don't, they don't."

There's no data out there that will tell me one way or another.

So here I am, up early in the morning, on what could be my transfer day, and I'm surfing the thousands of websites for any tid bits of information that will give me better information to make this decision.

My clinic is good, but I cannot say they have OUR best interests in minds. Only we do.

At 11am today, the embryologist is calling back to discuss what the status of our remaining six embryos are. He indicated he thinks only 4 will make the cut, and then it's about seeing if we want to transfer one today or stretch it out to Monday.

He also seemed to infer transferring two on Day 3 would be a good idea, but this holds the same >55% twin rate as when I started this journey. I'm just not sure if I do a 3 day transfer, if I should do 1 or 2.

Why am I so scared of twins? Do I really need to have a reason? Why does this have to be beggars can't be choosers?

Another update when the decision has been made for today.

Wish us luck.