IVF #2, Stim Day 1

IVF #2 is really under way now. As of today, suppression is over and stims begin. I had a consult with Dr. Peppy on Monday, to discuss our last IVF cycle and the current one. Other than the ultimate failure of that cycle, she was very pleased with how everything went. I respond well to the medications, with 18 eggs retrieved and 13 of those being mature. The 100% fertilization rate was impressive, and our embryos were of good quality. Of the two embryos we transferred, one was a Grade 1 (the best possible on a scale of 1-4) and one was a Grade 3 (it would have been a Grade 2, but because an odd number of cells on transfer day means a score no higher than 3). So we're going to follow essentially the same protocol* - Follistim & Lupron for approximately 10 days, ICSI four eggs after retrieval, most likely a day-3 transfer. Dr. Peppy really wants us to attempt to fertilize more eggs, but she also wants to comply with our convictions against freezing embryos. Since we ended up with exactly what we hoped last time - two embryos to transfer - we want to stick with the same plan of fertilizing four.

For this IVF, Dr. Peppy gave us the option of telling the lab we want to do a day-5 transfer. I feel torn about this option. On one hand, we risk having nothing to transfer if none of the embryos survive until day 5. But, if one or two did make it to day 5, then we would have a better chance of success with a blastocyst transfer. I'm inclined to be conservative and stick with the day-3 transfer. Any opinions out there?

I start Follistim tonight. I'll be on a slightly lower dose than the last IVF (175 IU rather than 200). I have to go into the city on Sunday for an ultrasound and bloodwork, and I'm hoping that I can get an early appointment so I don't end up missing church three Sundays in a row!

*One new element in the protocol will be estrogen patches starting 6 days after retrieval, to support the uterine lining. It's a new standard at my clinic. Has anyone else done this?