One Year to Decide

Today marks one year since my IVF transfer in Jacksonville. It's not a particularly special moment, not like a due date or anything, but as this day has approached, I've been thinking a lot about next year. January 12, 2016 will mark two years since our first transfer, and more importantly two years since our remaining embryos were frozen for storage. FIRM, the clinic we used for IVF, requires an upfront payment as part of IVF for storage of any unused embryos or eggs. That payment covers two years, so you can see how this time next year becomes important... we're already halfway there (how can that be?!?). Essentially, we will need to either use our remaining embryos by this time next year, pay another storage fee, donate our embryos to another couple, or agree to discard our embryos.

Many couples face this decision at one time or another. It's often once a child (or more) comes home that the couple is faced with this decision. The decision is really personal, and as many posts have been written on this topic, I take it that it's a pretty hard decision for everyone. For us, the decision is already made (in part). We're using our embryos. We simply cannot discard them for moral and ethical reasons. And I also don't think we could donate our embryos, not because we are against embryos donation (we are strongly FOR), but because our embryos are of poor quality. I know if I was going through an organization like Snowflake Embryo Adoption and read our profile, I would scroll right past us. "Four embryos frozen on day 3, all grade 3, and 8, 6, 4, and 3 cells with no live births from the cycle" does not read like a winning profile. These embryos are our responsibility and we take that very seriously.

However, if I'm being honest, I don't really want to shell out another $800 to keep these embryos in storage, so I'm feeling the burden to transfer all of them before this time next year. For one, the embryos aren't a source of hope for me. For some, the thought of having embryos frozen is a source of hope either for another chance at the first bring home baby or a future sibling. But for me, these embryos feel more like a weight, like a duty, like something I have to get back to. And truthfully, the embryos don't feel like a real possibility of a child. I mean day 3, grade 3, and four cells??? That embryo is a full day behind in growth (embryos should reach four cells by day 2) and the cells are also unequal. If you google day 3 embryo grading, you'll find that, transfers are far more successful, no matter what the grade, if the embryo has between 6-10 cells at 72 hours after fertilization. I've got two that fall in that category (frozen in different groups), the other two are very, very, very unlikely to even make it to the blastocyst stage, let alone implant and become a viable pregnancy. But truthfully, none of them feel like a real shot because we've already transferred better embryos, both in grade and cell division, but all have (obviously) failed.

I say all of that to explain, paying for another year of storage doesn't really feel like a wise investment of money. Truthfully, it feels like delaying the inevitable. I'd really like to just bite the bullet and move forward with the FET(s) within the next 365 days. However, as always, finances play a big, big part in the decision making process. A single FET will cost approximately $1,500 not including medications or travel... so it's really more like $2,300. As I mentioned above, our two best chances (which still aren't great) are frozen in separate straws and there's no way to thaw one embryo within a straw... it's all or nothing.

In light of the odds, the costs, and the way in which our embryos are paired, I want to transfer all four at one time. I know that sounds scary, and maybe I'm crazy, but at this moment, it feels right. Dr. Duffy has agreed to it, mostly, I believe, because he's not really all that confident that the three cell embryo even fertilized correctly. He started yammering about meiosis and mitosis and lost me completely during that phone call (biology was so not my thing), but basically, he really feels like it would be a three embryo transfer, which he wanted to do on the original transfer. However, he also wants to do the Endometrial Function Test, before transferring the last of our embryos to ensure that we're providing the best possible environment for implantation. The test costs about $600 by itself, and then there are the additional costs of performing a mock cycle, the biopsy, and the overnight shipment of the sample. I'm guessing it'll round out at about $1,000. If I'm going to go through the expense and trouble of the EFT and the biopsy, I figure I might as well do the E-tegrity test (the one CCRM requires) at the same time if possible. That test is another $600, but if I could get the biopsy in the same cycle, I'd save some money in the long run.

I'll be honest and say I don't know exactly what the future holds for us in terms of family building (who's shocked?). If I had to make a plan today, I'd say that we'd complete this domestic adoption (please God), then we'd transfer our four embryos. If that fails, which it likely will (just being real), I think I'll be ready to jump back into TTC. I don't know which way we'll go though: IVF with my own eggs, IVF with donor eggs, or donor embryos. My hunch is that due to financial circumstances, we'll go the donor embryo route.

When I think about the expense of the tests in terms of the future, be that another round with my own eggs, donor eggs, or donor embryos, the tests don't seem to be so extreme. While I don't know that the outcome one way or another will change the chances for these four embryos, it will certainly be good information to have going forward... and I'm still confident that there will be a forward. I still believe that we will pursue a pregnancy in one way or another, even after adoption. And I imagine if we went the donor embryo route, the donors would probably be pleased to hear that my uterus is nice and cushy and full of the appropriate proteins. Maybe they'd be more likely to pick us and take a risk on us even though we haven't achieved a pregnancy.

All of that to say that, best case scenario appears to be that we complete one final Hail Mary transfer with our remaining embryos in Jacksonville before officially closing the door on that chapter forever. However, I'm completely stumped where the $4,000 will come from between now and then. I mean, it's not like we're shoveling all available money towards an adoption or anything like that, right? Oh well, I guess we've got a year to decide and figure it out.