We are pleased to announce our annual Reproductive Care Center Patient party, which will be held on Saturday May, 22 from 2-4 PM. RSVP by May 17. (See Page 2)

The day patients receive negative pregnancy results can be one of the most challenging faced by infertility patients.  Feelings of guilt, anger, grief and hopelessness are common.

Zygote, cleavage, embryo, blastocyst…at times these can be confusing terms that may leave you wondering how your embryos are developing in culture.  Briefly, a zygote is a fertilized egg that is yet to undergo the first cleavage (cell division).  At this point, both components of a normal fertilization event are visible inside the egg:  the male and female pronucleus.

Following the first cell division of the zygote, the resulting embryo will undergo several more rounds of cell division until it reaches the 8-cell stage on Day 3.  The timeline is established from the day of your egg retrieval (Day 0).  On Day 3, your embryos should contain 8 individual cells of similar size.  The overall size of your embryo has not changed at this point; it has merely undergone cell division to increase the number of cells contained within.

The decision to transfer your embryos now on Day 3 or at a later stage of development will be made on Day 3.  Generally, if you have more than a few embryos in culture on the morning of Day 3 we will encourage you to wait until the embryos have developed further, to the blastocysts stage, typically on Day 5.

At the blastocyst stage the embryo has expanded considerably and formed a large, fluid filled cavity and has differentiated into two distinct cell types: the inner cell mass and the trophectoderm cells. 

The Advantages of Waiting to Transfer Embryos on Day 5
By culturing embryos until Day 5, the embryologist has a much better chance of selecting those embryos(s) suitable for transfer.  The increase in embryo size and the differentiation of the inner cell mass along with the trophectoderm cells are all powerful indicators of embryo viability.  Although selecting embryos for transfer on Day 3 can be a successful strategy, it is more advantageous to transfer embryos that have already shown developmental competence by achieving the blastocyst stage.  Attempting to select the best embryos for transfer on Day 3 with limited morphological data is at best a guessing-game in certain situations, such as when most of the embryos are fair or poor grade. 

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Many patients dread the day of the pregnancy test feeling almost unable to answer the phone when we call with results.  While some patients are able to process the bad news and move on quickly, most feel an overwhelming surge of difficult emotions like sorrow, depression and anger. 

Another common response is to question “What did I do to make my cycle unsuccessful?”  “Should I have remained on strict bed rest?”  “Should I have taken more medication?”  “I was so stressed out – I know that’s why I didn’t conceive.”
In reality, elimination of all stress just isn’t possible and bed rest has not been shown to improve pregnancy rates.  It is important to remember that patients who are following the protocol set out by their physician are doing everything they can to work towards a successful outcome. 

So your news was bad what’s next?
Give yourself permission to grieve in your own way.  Everyone transitions through the grieving process in unique ways.  Some find talking helpful – others do not.   Activities they previously enjoyed may be a welcome distraction for some while others cannot imagine doing things that seemed fun in happier times.

Seek support.  Some patients mistakenly assume that once they are not pregnant the clinical staff is no longer interested in them or willing to help them.  This could not be farther from the truth.  The nurses and physicians at Reproductive Care Center realize that often after disappointing news we are needed more then than ever.  Spending time with our patients on their journey, we become very attached to them and truly share not only their joy but their disappointment when the results we were all hoping for are not achieved.  At Reproductive Care Center we are here to provide emotional support to our patients through all phases of their treatment.  Many patients find comfort in friends and family but for some this is a source of additional pain.  Surrounding yourself with only those people who are supportive and understanding may be possible at least in the short term.  Remember that it is okay to excuse yourself from activities such as baby showers or family gatherings where pregnancies are announced when it is more than you can handle.  Seeking professional help with a caring therapist can also provide an excellent outlet for working through the challenging issues that accompany fertility treatment.  At Reproductive Care Center we are happy to provide referrals for counseling at any stage of therapy.

Share with your spouse.  Remember to keep communicating with your spouse but allow each other the freedom to grieve individually.  Men and women often respond to emotional issues in very different ways.  Women may want to talk extensively about their experience while men may not want to discuss things as much, preferring to move on more quickly.  (Continued, Page 2)