Sunday, 4 September 2011

Just another day in the office

Picture the scene: You’re working on a Saturday. It is ten to one. Your office shuts in ten minutes, and it is a beautiful day outside, you just need to make a couple of calls and you are free for the rest of the day.

I’m guessing that this was in the forefront on the embryologists mind when he called the wombmate yesterday. She is in the midst of her second round of IVF (you can read about her first attempt here and here).

On Friday she had nine eggs retrieved. Only three were mature. This morning she found out only two had fertilised. The embryologist rang her up and asked if she “wanted both the embryos put back in on Monday [day 3] or wait until they (hopefully) reach blastocyst stage on day five.” Her husband asked if they could have half an hour to think about it. They were told ‘No’ because they were about to close up.

Eventually they negotiated a reprieve and agreed to call back with a response on Sunday morning.

This might not seem like a big question to ask. But it is.

The wombmate has been consistently told by her clinic that her Health Authority only fund single embryo transfer for a woman of her age (35). They have stressed to her the negative health impact of twins on both the babies and mother.

Equally blastocyst transfer has been held up as the holy grail of IVF - the one thing that she should be aiming for.

To be fair I have no idea if the embryologist was keen to nip out into the sunshine. But I do know that he expected a quick, un-thought-through answer to a question that could have the longest-term of implications.

To him this was just another collection of eggs and a numbers game. “Not many fertilised = get them both in before either stop developing”.

To my sister this is a decision that she wants to think about, discuss with her husband, feel confident in.

In the end, she has decided, to go with a two-embryo transfer on Monday as suggested.

I think this is the right decision - I checked back to see how my embryos faired between day three and five. In round one I went down from 8 viable embryos (initially 12 fertilised) to just two on day five. During my second round on day three there were 13 embryos but again, by day five again only two were left. On both occasions two were put back in, and far from having to contend with twins I don’t have anything to show from either.

But she is disappointed at the way this was handled. And I’m not surprised. To the medical practitioners this might be just another day in the office, but to us it is, literally, about life or not decisions.



11 comments:

  1. I agree with the two on Monday. 'Typically' 20% will make it to day 5; with the $$ and emotions involved I would want to put the 2 back as well. I understand they don't want to spend their Saturday in a clinic, just as much as we dont, but it is there job. Time management would then indicate to make the calls earlier! Best of luck.

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  2. I've been thinking of that lovely wombmate of yours and wishing for good news. I wish the embryologist had handled things much more sensitively, a really difficult decision for them to make, seems like one the experts should be making or at least providing lots of information about so that they can at least make an informed decision. Thinking about those embryos tonight. They'll be where they were made to be tomorrow. Lots of love to you all xxxx

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  3. That is awful. In careers that handle people's hopes and dreams, a special sensitivity should be required.

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  4. Lots of luck to Iz xxx

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  5. I think I can understand a bit. Those medical professions may have removed themselves from all the emotions that their patients go through. To them it might be a scientific experiment but to use IVF patients it's more than a roller-coaster ride. I work in a trust department and I have clients who pass away almost every month. We help them process papers. I try to be more sympathetic but I have coworkers who act as if it is just work. Very weird world - all the hats that people wear. Sending you and your womb mate lots of support! :)

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  6. It's all so matter of fact with them isn't it. They have no emotional connection or concept that you are playing with peoples futures and from what you have said, it was an total inconvenience to be held up for a few minutes while someone makes a life changing decision. A bit of empathy wouldn't go astray!

    All the best for your wombmate :)

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  7. I can empathize with the embryologist - I work in a profession where personal empathy detracts from professionalism and it is not helpful to get emotionally invested. It does sound like there's a bit of a disconnect between the lab and the doctor's office - I can only think the embryologist assumes that this is a situation that has been discussed and decisions were made beforehand. Regardless, once informed that some thought needed to be put into the decision, the embryologist should have quickly regrouped...or perhaps called the wombmate earlier.

    Much luck to your sister - hoping those two embryos settle in nicely. Or one of them - whatever she's looking for.

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  8. Hear hear. These type of decisions we have to make are so angst inducing as it's so hard to know what's going to give the best outcome. A bit of sensitivity from the clinic would have gone a long way to alleviating this. My fingers are crossed for you sis on Monday...

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  9. That IS bad. Letter-worthy bad, I would have thought.

    Fingers crossed for Wombmate.

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  10. Yeah, some sensitivity would have been helpful there!! Wishing the Wombmate luck!

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  11. My embryologist only did 3-day transfers on me. He said that when you have older women with fewer embryos...it is best to get them back to the natural environment as fast as possible....he said there are actually studies showing better success rates for 3-day embryos for older women (35+) than trying to get some to blast...because you then run the risk NONE will get to blast. I hope all went well for your sister. I hate that you are both in this fertility roller coaster.

    Kd

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