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Showing posts with label Dr. Anjali. Show all posts
Showing posts with label Dr. Anjali. Show all posts

Tuesday, September 9, 2014

The much awaited fertilization report




Blastocysts which were frozen on day 6

Growth arrested embryos

This post is going to be easy for me. I will just copy and paste Dr. Sai’s emails.

On day 1, I had 15 embryos. I guess one egg matured in the lab, so there were totally 15 mature eggs out of 19 retrieved, and all were in the 2 PN stage on day 1. This means all ICSIed eggs fertilized, a 100% fertilization rate! This is just awesome and clearly shows the technical expertise of Dr. Sai.

The Day 2 gradings of your embryos are as follows:
2x 5-cell grade A
4x 3-Cell Grade A
6x 2-Cell Grade A
3 Embryos got arrested at 2pn Stage.

There are total 8 Top Quality Embryos on day 3.
Day 3 Grading is as follows:
5 x 8-cell grade A
3x 7-Cell Grade A
1x 6-Cell Grade A
1x 5-cell Grade A
3x 4-Cell Grade A

Day 4 Grading of your Embryos as follows:
3x MORULA
6X 8-CELL Grade A (COMPACTION OF CELLS SEEN)
.
2X 6-CELL Grade A
1X 4-CELL Grade C

Day 5 Grading of your embryos as follows:
1x blastocyst grade 1AA
1X EARLY BLASTOCYST
6X MORULA
2X 8-CELL Grade A 
1X 6-CELL Grade A
1X 4-CELL Grade C

Day 6 (One must keep in mind that, on day 1, fertilization of eggs were done during late evening!)

We are Freezing Total 6 Blastocysts today on day 6.

All morulae Stage Embryos have Become Blastocysts.

Although Exp Blastocyst in image Cap1020 doesn't have great Trophectoderm (the last blastocyst in the above collage) we are freezing it becauze it has got a good Inner Cell Mass.

Altogether I got 7 blastocysts out of 12 cleaving embryos, this means 50% blastocyst formation rate. This is  a great result ! Normally women below 35 years old can expect a blastocyst formation rate of 40%
I am already getting queries regarding how it was possible to get so many eggs. I have no clue too. My AMH was infact low but my AFC count was high. Honestly, I didn’t expect such a good outcome. But, I had lots of faith in Dr. Malpani’s team. Dr. Malpani designed the protocol, Dr. Anjali monitored me very closely and decided when to give the trigger shot, ofcourse, as always, she did a great job during egg retrieval, Dr. Sai was excellent in doing his part of the job and my ovaries cooperated too well! I didn’t take any supplements. Two and a half years ago, when I had my first IVF cycle with Dr. Malpani’s clinic I took DHEA 75mg for 6-7 months and I thought might be DHEA helped me to get many eggs. But this time I took nothing and I do understand now that DHEA might  not have contributed to the improved outcome previous cycle. My first five cycles which I had in Germany were terrible (http://myselfishgenes.blogspot.in/2012/05/my-ivf-journey-timeline.html). I was much younger at that time, had great AMH value, yet, I had only very few eggs to work with.In short, I am very thankful to God and to everyone who helped me to get 7 blastocysts. In the beginning, prognosis of this cycle looked very bleak, but it ended up much pleasant and successful than expected.
There were 6 blasts frozen on day 6. What happened to the remaining one? :) Was it transferred to Rita and what happened thereafter? Keep reading ! :)
Dr. Sai was kind enough to provide the pictures of embryos which got arrested during its development. I have given the pictures of blastocysts frozen on day 6 and the ones which stopped growing in the above collage.

Tuesday, September 2, 2014

Egg retrieval and Rajender’s sperms



I am sure Rajender will not be so happy to read the title :) Anyhow, let me keep this one, it sounds interesting. On the day of egg retrieval I was so happy for no reason. I was not even a bit worried, might be all the good hormones were at play! I went to the clinic, the nurses started to prepare me for the retrieval. In Malpani clinic they have a gown; you need to wear it when you go for egg retrieval and during embryo transfer. I have gone there four times and not even a single time I tied the gown correctly. Rajender couldn’t succeed too in helping me! If someone of you who go to Malpani clinic, wear that gown and tie it properly, I would easily agree that you are one of the intelligent person in this universe, a genius :) This time I and Rajender wanted to do our best to tie it correctly. We tied it; Rajender did it actually and gave me a very proud smile. I looked at him with great admiration until sister Lizzy came, looked at me, removed the knots and retied it properly :) When sister Lizzy entered the room she told Rajender that Dr. Sai was looking for him. So he left the room. I was wondering what for Dr. Sai called! Usually the sperm collection cup is brought to the room where we are. During our first IVF, in Malpani Infertility Clinic, a nurse came with a big cardboard box into the room where I and Rajender were. I was wondering what it was! She looked at us both, smiled coyly and kept that box in the table, left quickly with a much shyer body language. I was amused by her behavior and when we opened the box there was a sperm collection cup. I still remember that smile and I guess she was new there at that time. Her shy, naughty smile did make that room very romantic ;) 


After Rajender left, Sister Lizzy gave me enema (how much I hate that!) and I was lying down. Few minutes later Rajender entered the room and looked at me as if he would burn me to ashes. I asked him what happened. He burst out – ‘what do you think of yourself? Is it very important to see the sperms?’ I was totally clueless for a moment and then I understood what happened. Actually, I was the one who mailed Dr that I would love to watch the sperms live under the microscope. He must have told Dr.Sai. Sister Lizzy instead of sending me, sent Rajender. I was excited. I asked Rajender whether he saw the sperms. He said with a very rough look, ‘no, I didn’t’. I asked, ‘why?’ He said, Dr. Sai asked me whether I wanted to have a look but I said no. That appeared very ridiculous to me. They were kind enough to let him into the embryology lab inspite of their busy schedule; they were ready to show him the sperms and why should someone be angry for that! Rajender continued to talk, actually he spitted out. He said, I went to Dr. Sai and he asked me whether I want to see the sperms. I said no and came out. Shonali came and she asked the same question to me. Everyone sitting there was watching me (the patients probably!). When I was about to come out, another Sister came and she asked me the same question. I felt very embarrassed, and it is all because of you. This blaming got me too irritated. Instead of seeing the sperms, what for he is coming and shouting at me! I couldn’t really understand at that moment about how he felt, and the reason for his anger, but now I could. He was already too tensed about the sperm giving part. He prepared himself for that five minute job for days (abstinence, healthy food). When Dr. Sai called, he must have gone thinking that he must give sperms and all the little drama that happened there made him very irritated; especially, he couldn’t tolerate the fact that everyone was watching him when he was being asked whether he wanted to see the sperms. Whenever I think of this incident I smile, a happy memory! I dare not talk to him about that incident after that.


When this fight was going on between us, Dr entered the room. I had no clue that he would come. He smiled and asked ‘are you ready to give lots of eggs’. I said, ‘I hope so’. Before I could start the next conversation, he wished us good luck and he was gone. Dr. Malpani talks so fast, and if there is a Guiness record challenge about who speaks the maximum words per minute, I am sure he will easily win! :)  I needed some time to talk to him, I had some questions in mind and more importantly I had something with me to show to him. He just came like a lightening and left. All I could think thereafter was, 'I need to talk to him!'


After sometime, they called me for egg retrieval. I went, and there stood the anesthesiologist. He asked me whether I was afraid and I replied very happily that I love anesthesia and I am not a bit afraid. He again asked whether I am nervous about injections. I said, ‘I have gone through 7 IVFs (as if it was the most proud happening in my life!), I am not afraid of needles’. I saw Dr. Anjali sitting there. As soon as the needle entered my vein I lost consciousness. Someone woke me up, don't know after how long! I felt I am being disturbed from the most happy, peaceful sleep. I said, ‘I had beautiful dreams’. The next question I heard was, 'do you remember them’. I said, ‘no’. Then I asked them, 'please give me more anesthesia, I want to sleep' :) I wish death is similar to going under anesthesia - a long, deep, peaceful sleep. If it is so, I am sure death will be an amazing experience! Then I remember someone asking, most probably Dr. Anjali - 'do you know how many eggs you got?' I kept quiet. Dr. Anjali said 19 eggs. I couldn’t open my eyes but I thanked her and said, ‘ma’m you have the luckiest  pair of hands’. Then I said, ‘I want to talk to Dr’. Someone asked me which Dr. I was angry, I thought very hard (it was very difficult to use my brain!) and said ‘big Dr’:)  I could feel that I was back to my bed, heard Rajender’s voice, said to him that they retrieved 19 eggs and again repeated ‘I want to talk to Dr’, I dozed off. I heard Dr. Anjali’s voice, Rajender’s voice and then after one or two hours I woke up. I could see my husband’s face eagerly looking at me. Obviously it must have been boring and he was waiting for me to get up so that we can go to our hotel room. Happiness is waking up from anesthesia to see the love of your life waiting anxiously for you! I smiled at him and said, ‘I am very hungry’. 


After getting dressed up, I said to Rajender, ‘just wait for a moment; I will be back in few minutes’. I told Sister Mary that I want to see Dr. Sai. I was still in half-sleeping mode. I held my forehead with my hands and sat in the waiting room until Dr. Sai came out. I asked him, ‘can I see the sperms?’ He said, ‘wait a moment’, he went inside the lab and called me after some time. He asked, ‘do you want to see your husband’s sperm?’ I said any sperm sample would be fine. He took a sample from Rajender’s sperm, mounted them on a slide and showed those little swimmers. I was so happy to see them live. They are like tadpoles and were moving constantly, at least most of them were. I thought, if Rajender could see this too it would be wonderful, but, I had no guts to start the sperm topic again to him :) I looked around the embryology lab; Dr. Sai must have been busy working there. In the music system, which he had in that room, devotional songs about Sai Baba was oozing out making that place much more peaceful and desirable. I did feel comfortable that Dr. Sai will be handling our eggs and sperms and creating our embryos. He actually does the most important job, the job of Lord Brahma – the creator!


Yes, I got 19 eggs. I learned soon after that, 14 out of 19 eggs were mature. I and Rajender were happy. We have crossed one hurdle successfully! Will I get enough embryos on day 5 so that we could do ateast 2-3 transfers to Rita; this was the nagging question in my mind! I thought, I will be very happy to transfer my embies to Rita. We met her during one of our follicle growth scan and we liked her instantly. More on that soon!
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