9dp5dt – 2nd Beta 223

April 26, 2013

Great news ! 2nd Beta result today at 9dp5dt is 223 – almost 3 time larger than 2 days ago. The HCG level is definitely heading to the right direction. I finally felt a little bit relaxed now than 2 days ago. Next Beta will be on Monday April 29. Then first ultra-sound will be on May 15. I will see my doctor to schedule the first US.

7dp5dt HCG 81

April 24, 2013

The Beta report came in the late afternoon and my HCG level is 81 at 7dp5dt! I was thrilled. What a solid number to start with! I emailed the report to the clinic and Nina, lovely nurse congratulated me and said I am pregnant!

I have been waiting for this moment for a long time but when it really comes, it feels like not real. But I know, it is real.

I will repeat a few more Beta test in the next a couple of week to watch the growth. Next Beta will be Friday and then next Monday. Hope to see the HCG number is doubling everything 2-3 days. 🙂

7dp5dt – HPT ++

April 24, 2013

Our clinic told us that early HPT is “discouraged” since it might be inaccurate and cause misunderstanding. I understand that if we don’t see a line with early HPT we will feel frustrated and sad. However, the anxiety and the stress from waiting is not fun too. So we prepare 5 HPT sticks before the FET.

I started HPT 2 days ago, 5dp5dt, got a very faint line – I felt good about it since it might mean something; it also might be due to the hormone medications I am using. We just kept cautiously optimistic and hope the line will get darker day by day.

And luckily, the line did become darker yesterday – we felt better but still cautiously optimistic since it’s still only 6dp5pt.

This morning, I woke up at about 2:40am to go to bathroom. Again I did HPT and this time the line showed quicker and even darker. There was a dark “+” showing clearly on the stick!! I was more convinced that it is a real POSITIVE and I am pregnant !! I was a little bit exciting… I took a few photos of HPT with + just to keep the “evidence” since it will fade after a couple of hours. I want to show it to DH.  I could not fall asleep again, lying on bed turning and toasting. By about 4:30am I had to go to bathroom again and I did another HPT! It’s still BFP with a even darker “+”. I am totally convinced now! 🙂

HPT + BFP

This morning I went for an early Beta test to confirm the result. I should be able to get the result this evening. Hope it will be a nice solid HCG number! Fingers crossed!!!

Best wishes to all other moms and mom-to-be out there on the same boat with me!!!

5days past transfer

April 22, 2013

This morning when I woke up to pee, I pee on a stick! There was a very faint line showed up. It’s better than seeing nothing but it might be from all those hormones I have been using. After all the roller coaster journey, I just want to be cautiously optimistic . i will do home pregnancy test in the following 4 days until my first beta date Friday, April 26.

Fingers crossed. Hope to see the line darker tomorrow! 🙂

FET – 2dpt: Something wonderful is about to happen

April 19, 2013

Feeling better and stronger than last two days. I had a short walk with DH and out lovely dogs  at the park. I also did a little bit gardening at the backyard.

I truly believe that something wonderful is about to happen!

positive thinking

What’s Blastocyst and Blastocyst Quality Grading

April 18, 2013

In our previous IVF or FET cycles, we always used day 3 embryos. We used a different clinic this time and they suggested to transfer day 5 blastocyst to increase the chance of getting pregnant. We did a little bit more internet research about blastocyst and would like to share with people who might be interested.

What is a blastocyst?

A blastocyst describes an embryo stage reached usually after about five days of development post-fertilization. It has about 50-150 cells and has started to develop specific regions with different cellular destinies. The blastocyst is working hard; pumping fluids towards its center, creating a fluid-filled center and expanding like a water filled balloon. The inner cell mass is a clump of cells  protruding into  the middle of the fluid-filled cavity. This inner cell mass will continue to grow and ultimately will be the source for all the cells of the future baby.

The trophectoderm cells line the inner surface of the zona pellucida (the glycoprotein shell around the embryo) and play a supporting role, supplying cells to form the fetal part of the future placenta. So the grading system takes into account how much progress the embryo makes in hatching from the “shell” and also how richly endowed the inner cell mass and trophectoderm are in terms of cell number and quality. More expansion is better than less and more cells are better than fewer cells.

5-day-blastocyst-embryo
Above is a picture of a high quality expanded human blastocyst embryo 5 days after fertilization.
The clump of cells in the 10 to 12 o’clock area is the inner cell mass (ICM) which become the fetus
The trophectoderm cells (TE) that will form the placenta surround the fluid cavity.
The fluid-filled blastocoel cavity is in the center

A healthy blastocyst will implant within one to four days following a day 5 transfer, with invasion of the cells into the uterine lining occurring soon after blastocyst hatching.

Blastocyst Development and Blastocyst Quality Grading (or scoring)

  • There are 3 distinct parts to a blastocyst – the two cell types and the fluid cavity (see picture above)
  • As development of blastocysts progresses, cells in the 2 components divide and the fluid cavity enlarges
  • With continued blastocyst development the embryo expands, the shell thins, and it hatches from its shell
  • Blastocyst implantation into the lining of the uterus can then begin

Many IVF clinics that do blastocyst culture and transfer use a blastocyst scoring system originally developed and published by Dr. David Gardner in the late 1990’s. Dr. Gardner is well known for being first to develop a commercially available embryo culture media system that supported high rates of viable blastocyst development. There are other grading systems for blastocysts , but this one is most widely used.

The Gardner blastocyst grading system assigns 3 separate quality scores to each blastocyst embryo:

  1. Blastocyst development stage – expansion and hatching status
  2. Inner cell mass (ICM) score, or quality
  3. Trophectoderm (TE) score, or quality
Expansion
grade
Blastocyst development and stage status
1

Blastocoel cavity less than half the volume of the embryo

2

Blastocoel cavity more than half the volume of the embryo

3

Full blastocyst, cavity completely filling the embryo

4

Expanded blastocyst, cavity larger than the embryo, with thinning of the shell

5 Hatching out of the shell
6 Hatched out of the shell

 

ICM grade

Inner cell mass quality

A

Many cells, tightly packed

B

Several cells, loosely grouped

C

Very few cells

 

TE grade

Trophectoderm quality

A

Many cells, forming a cohesive layer

B

Few cells, forming a loose epithelium

C Very few large cells

Blastocysts are given a quality grade for each of the 3 components and the score is expressed with the expansion grade listed first, the inner cell mass grade listed second and the trophectoderm grade third.

For example, a blastocyst quality grade of 4AB means that the blastocyst is expanded (grade 4), has many tightly packed cells in the inner cell mass (grade A), and has a trophectoderm with few cells forming a loose epithelium (grade B). See the examples of blastocyst grading pictures below.

hatchingblastocyst

The IVF blastocyst picture above shows hatching out from the shell – at lower right of photo
This blastocyst is grade 5AA.
After hatching, the embryo can invade and begin implantation in the uterine lining
This picture was taken a few minutes prior to embryo transfer.

** Please note, most of above information regarding blastocyst are from Richard Sherbahn MD from Advanced Fertility Center of Chicago. It’s very informative and easy to understand.

Before the transfer, our embryologist showed us the picture of our lovely blastocyst. It looks very similar to the the above blastocyst graded 5AA. 🙂

When will a Day-5 Blastocyst Implant?

April 18, 2013

When will a Day-5 Blastocyst Implant? This is very important since it will determine when HCG level can be detected – when can we start doing HPT!

As usual, we Googled and Below is the research result.

Timing of embryo implantation in humans

A good study of implantation was published in 1992 by Bergh & Navot. They studied 33 pregnancies from egg donation or frozen-thawed cycles (FET) with serial blood HCG levels on the mothers to find the time of the “first embryonic signal”. The HCG assay used could detect very low levels of HCG – the pregnancy hormone.

  • Average first detection of HCG was at an embryonic age of 7.1 days
  • The range of first detection was 6.6 to 7.4 days

Human blastocysts should hatch from the shell and begin to implant 1-2 days after day 5 IVF blastocyst transfer.

Therefore, the first a few days after blastocyst transfer are the most important days!

FET Today!

April 17, 2013

After almost one year break, we continue our journey again. Today we transfer a 5-day beautiful blastocyst. The grade of our blastocyst is AA.  Everything went smoothly today. I had a full bladder right before the transfer – perfect timing!

To help myself better understand when to do HPT, Below is the development of  a 5-day embryo.

For 5-Day Embryo Transfer:
-1dpt … embryo is growing and developing
0dpt … Embryo is now a blastocyst
1dpt … Blastocyst hatches out of shell on this day
2dpt … Blastocyst attaches to a site on the uterine lining
3dpt … Implantation begins,as the blastocyst begins to bury in the lining
4dpt … Implantation process continues and morula buries deeper in the lining
5dpt … Morula is completely inmplanted in the lining and has placenta cells & fetal cells
6dpt … Placenta cells begin to secret HCG in the blood
7dpt … More HCG is produced as fetus develops
8dpt … More HCG is produced as fetus develops
9dpt … HCG levels are now high enough to be immediately detected on HPT

We have 5 Home Pregnancy test sticks available at home. Based on the development stage above, it looks like we can do the HPT as early as 6days after transfer. I know someone did HPT as early as 5dpt. Maybe I will do it on day 5, which is next Monday!

Fingers are crossing for our lovely embryo! Grow grow grow!!! 🙂

30dpt – 6Weeks 3days – Beta HCG 11749

November 24, 2010

Today is 30dpt, 6weeks 3days of pregnancy. I did another Beta to check HCG level – result is 11749, which is right on track. In the report, there is a range of HCG level based on time after last menstrual period.

Time after LMP        Expected Range

Non-Pregnant           (Less than 10)
3rd Week                    (6 – 71)
4th Week                    (10 – 750)
5th Week                    (217 – 7138)
6th Week                    (158 – 31795)
7th Week                   (3697 – 163563)
8&9th Week              (32065 – 151410)
10th Week                 (46509 – 186977)
12th Week                 (27832 – 210612)
14th Week                 (13950 – 62530)
15th Week                 (12039 – 70971)
16th Week                 (9040 – 56451)
17&18th Week         (8175 – 58176)

My first ultra-sound is on Nov 29, 2010, next Monday. I can’t wait to head the heart beat of my baby! 🙂

23dpt – Beta HCG 4083

November 17, 2010

We did the 4th blood test today to check Beta HCG level. I requested my family doctor to do this. My clinic won’t give me referral since they don’t think it is necessary and it is obviously an extra work for them. The first U/S has been scheduled on Nov 30, 2010.

There is about 2 weeks waiting time when we have no idea what is going on in my body. This extra HCG can give me reassurance and a peace of mind.

The result came back nice and strong – 23dpt Beta HCG 4083, which is almost 3 times than 17dpt HCG 1371.

I will do another blood test on Nov 24, 2010. I am still cautiously optimistic. 🙂

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