Sunday, February 17, 2013


We were supposed to hear from SCI today, but this is the first time they have not emailed on the expected date.  With the 11.5 hour time difference between New Delhi and Dallas, the clinic is presently closed.  So we have to wait and keep our minds from racing.

It's hard not to dwell on the history of prior failures and speculate about the worst.  We received an email from SCI last week that made us realize we are actually on our fourth attempt.  You see, last month we started all over with a new donor, but when the eggs were collected and fertilized, the surrogate was not deemed suitable for transfer, so the cycle was cancelled.  There were no surrogates for back-up that could take her place, which was what had happened in the past.  So no 2WW, no pregnancy test with a BFN (big fat no), just upfront failure

Margarida, one of the excellent SCI case managers, explained that this happens in a few rare cases, and that had the transfer gone ahead, our chances of success would have been very poor.  We trust Dr. Shivani's judgment, and on the positive side, we did not lose our best quality embyos in the attempt.  But we were crushed that we did not get an attempt with a fresh cycle, since your odds are higher when the embryos do not have to undergo cyropreservation.  Unfortunately, all of our embryos had to be frozen and we would have to wait to try again.

So while we wait for news on this recent attempt, I figured we would share our embryology report.  Perhaps it will help other IP (intended parents) know what to expect.  Our 2WW is somewhat shorter, since this attempt was an FET (Frozen Embryo Transfer) where the previously frozen embryos were thawed and cultured to 5 days (counted from the time of fertilization), versus the usual 3 days for a fresh cycle.  Allowing the embryos to grow to this more advanced "blastocyst" stage can aid in selecting the best/strongest embryos for transfer.  However, when we were in New Delhi and asked her, Dr. Shivani was very clear that the best environment for the embryos was the womb, which makes perfect sense, so it's a risk to freeze and then culture to 5 days, since some of the embryos will not survive the thaw or will just fail to mature outside.   In our case, four embryos were thawed, and four (in various stages of development) were transferred.

The report uses the Gardner blastocyst grading system, which assigns 3 separate quality scores to each embryo:
     1. Blastocyst development stage - expansion and hatching status
     2. Inner cell mass (ICM) score, or quality
     3. Trophectoderm (TE) score, or quality

Pictures and information taken from the following website:

The inner cell mass (ICM) will become the fetus
The trophectoderm cells (TE) will form the placenta
So the embryo is given a number grade (1-6), followed by a letter grade for the inner cell mass and then the trophectoderm (A,B or C).

The expansion grade scale ranges from 1 (least expanded) to 6 (completely hatched).
     Grade 1: The fluid-filled cavity takes up less than half the space of the embryo.
     Grade 2: The fluid-filled cavity takes up more than half the space of the embryo.
     Grade 3: The blastocyst cavity has expanded into the entire volume of the embryo,
     pressing the trophectoderm cells up tightly against the inside of the zona.
     Grade 4: Expanded blastocyst, where the blastocyst has increased beyond the
     original volume and caused the zona pellucida “shell” to become super thin.
     Grade 5: Embryo has breached the zona and is hatching out of its shell
     Grade 6: Embryo is completely hatched.

For the inner cell mass:
     A: Many cells, tightly packed
     B: Several cells, loosely packed
     C: Very few cells

The trophectoderm grading goes like this:
     A: Many cells, forming a cohesive layer
     B: Few cells, forming a loose layer
     C: Very few large cells.

As noted in the report, laser assisted hatching was performed.  The zona pellucida "shell" surrounds embryos and the embryo must escape or "hatch" in order to implant in the wall of the uterus. Some embryos in which the shell is thickened or hardened make it difficult or impossible for the embryo to implant.  Assisted laser hatching uses a laser to create a hole in the shell to aid the embryo in the hatching process.  Apparently this is a safe procedure, and if it helps increase our chances, I'm all for it!

The report notes that our pregnancy (bHCG) test was to be performed today, 2/17/13.  Looking at the treatment summary, I'm worried that we only had two blastocysts.  The other two were slower developmentally, so I'm not hopeful they will grow/implant.  I know, everyone always says "you only need one!"  And I would prefer not to have to undergo a selective reduction for multiples, but in this case, isn't it better to have too many than not enough (or any at all)?

I hope the delay isn't an omen or due to an issue.  Realizing this is our fourth attempt and we are three-time losers, I'm much less optimistic than when I thought we were on our third try (three strikes and you're out).  Crossing our fingers anyway.


  1. Things happen so dont worry, I got one of mine a day late. Remeber they have at one time prolly 150 surrogates and its also India. so just wait till tomorrow, e-mail the clinic and hope all is well


  2. Hi Ben,
    Really sad to read about the failed attempts, It must be so heart breaking. What most foreign IPs don't realise is that they are not in control of the situation on the ground when it comes to surrogacy in India, when it should be just that, through a legal representative who ensures that everything goes smoothly for you, who gives you clear picure of how your money is being spent, how the surrogate is being cared for. But many unscrupulous 'doctors' will not allow any legal reps to look into how they operate because they want to mislead you and make more money out of you. Those doctors who are genuine will of course allow your representative to work alongside so that you can cut your costs down and at the same time get true copies of all monies spent towards the entire process. Also, by squeezing so many IPs like this with false reports, this is how many clinics in India make money through giving them nothing but negatives, by squeezing them out of their hard earned cash and getting away with giving them false information. You should be asking your clinic or speak directly to your doctor to give you a free cycle with fresh donor with nothing to pay at all and just to pay for the later stages during pregnancy. At the same time look for a legal representative in India and find out if your doctor will allow transparency into the way her clinic works. If she is genuine, she will of course allow this. It should be you the parent who should be in control and not the doctor. After all it is you who is spending so many dollars on this process while keeping the clinic going on your funds.

  3. Ben and Travis,
    I hope you guys get good news today. I kindly disagree with "Anonymous". If SCI had anything to hide, why be so transparent and connect their clients' blogs?

  4. The gutless anonymous is schilling for clients. Nearly 500 babies gone home with SCI, I don't think SCI has anything to hide, and what could a lawyer do anyway, come in and tell SCi how to do business? All the lawyers do is hit you up with huge fees and do nothing!!! Beware the lawyers!!! The report was late as 17th was a Sunday, and tests aren't done on Sundays, everything is closed. We will have the lab be more careful with beta dates. Meg