You are 2 Weeks and 3 Days 263 days to go…

Vital cell divisions are now taking place as the fertilized egg begins its journey toward implantation.

What’s happening inside

When the two nuclei have pooled their genetic material to create a cell containing its full complement of 46 chromosomes—23 each from the mother and father—the cell can start dividing, shown here at the first division creating a two-celled body.

The chromosomes from the sperm and egg joined over 24 hours ago. It takes around 30 hours for the resulting zygote to complete its first cell division. The zygote, at only 0.1 mm in diameter goes on to divide into 16 cells, forming a compact ball.

Cell division is such that the ball of cells is hardly any larger than the original zygote. The ball of 16 cells, now known as a “morula” (as it resembles a mulberry), travels toward the uterus, entering on day three after fertilization. Every cell within the morula is totipotent, meaning it is able to form any type of cell. From this point onward the cells will lose this function as they start to specialize.

From eggs to embryos

Egg collection will be scheduled (see image), following the first stage of IVF. Not all follicles that were stimulated will contain eggs. Two days after egg retrieval, you will be given progesterone to thicken the uterus lining. Two to five days after fertilization, the most promising embryos are chosen to be transferred.

If you’re under 40, you’ll have one or two embryos transferred. If you’re over 40, you may have up to three or more transferred. The goal is to achieve a pregnancy, yet limit the risks of a multiple pregnancy. Any leftover embryos can be frozen for future treatment cycles. Recent research suggests that frozen embryos are better than fresh ones—this may be because only the best embryos are selected for freezing and survive the freezing and thawing process.

The outcome of IVF depends to a great extent on the woman’s age, but on average each cycle has a 20 percent success rate.

… Doctor
Q: I’ve been doing ovulation tests. I’ve now ovulated so do my partner and I need to keep having sex to make sure I conceive?
A: You can’t be sure that you’ve conceived already, so the usual advice would be to continue lovemaking. Even if you’ve been tracking your ovulation by monitoring your temperature or cervical mucus, or by using an ovulation kit (see Are you ovulating?), you can’t be sure exactly when it occurred. It won’t be possible for you to pinpoint the exact time of ovulation.

Since the fertile window is several days, you may as well continue having sex for at least a couple of days after what you think is your most fertile time.

Furthermore, since sex says “I love you” more strongly than most other means of communication, it’s good for both you and your partner to stay intimate at times you’re not trying to conceive.

Remember also that abstention doesn’t usually have the hoped-for effect of banking up and improving the quantity and quality of sperm. In fact, the opposite may happen (see This is Day 13 of your Menstrual Cycle).

You are 2 Weeks and 4 Days 262 days to go…

Significant changes are taking place daily within your uterus and within just 72 hours from now, the fertilized egg will implant.

What’s happening inside

This is an embryo at the 16-cell stage, when it has changed from a zygote into a morula. It is in the process of dividing into a hollow ball of cells—the blastocyst—which will eventually implant in the lining of the uterus.

Around four days following fertilization, fluid begins to collect within the morula (see You are 2 Weeks and 3 Days). This creates a separate outer cell layer, one cell thick that encapsulates an inner mass of cells. The inner layer will become the embryo, and the outer layer the placenta (see You are 4 Weeks and 6 Days). The whole structure now consists of approximately 58 cells and is termed the “blastocyst.”

The blastocyst spends several days within the cavity of the uterus before implanting. The morula had an impenetrable outer surface as it traveled, but this disappears as the blastocyst prepares for implantation.

… Mom
Q: Why are people so interested in whether I’ve conceived?
A: I certainly found that once I’d told people I was trying to have a baby, they were inordinately interested in the process. It was difficult, especially in the week when I was waiting to find out if I’d conceived. The best way to deal with it is to respond by saying that you’ll let people know if there’s news. If you’re struggling to conceive, telling people you’re having difficulties should help stop them from asking.
… Health
Fertility: The alternative approach

It’s not as clear whether acupuncture can improve fertility in couples not undergoing treatment, but it is thought to improve male fertility by improving sperm health and reducing stress, a factor that can impede the chances of conception.

  • If you’re having difficulty conceiving, or just want to improve your chances, consider using a complementary therapy. Always inform the practitioner that you might be pregnant.

  • Reflexology works by manipulating pressure points in the feet to improve energy flow to specific parts of the body. While there is plenty of anecdotal evidence that reflexology helps conception, this isn’t currently backed up by scientific research. However, it may help relieve stress, which can be a factor in couples who have problems conceiving.

  • Acupuncture (see image) works on the principle that problems such as infertility are caused by blockages in the body’s energy flow or “qi.” By inserting tiny needles into energy points that are linked to the reproductive organs, the flow is restored. In 2008, after reviewing seven studies of more than 1,300 women having fertility treatment, researchers concluded that acupuncture given around the time of embryo transfer increases the chances of pregnancy.

You are 2 Weeks and 5 Days 261 days to go…

While playing the waiting game, you may want to consider how you’d feel if there are two fertilized embryos waiting to implant!

What’s happening inside

This is an embryo at the blastocyst stage, five days after fertilization. It is seen hatching from the shell that originally surrounded the unfertilized egg. At this stage, the blastocyst has moved into the uterus and is preparing to implant.

Have you conceived, and might it be twins? Twins can be nonidentical or identical and each type of twins is conceived differently.

Nonidentical (dizygotic) twins are the result of two separate eggs being fertilized by separate sperm. They may also occur as a result of IVF if two embryos are placed in the uterus.

Identical (monozygotic) twins occur when a single egg is fertilized by a single sperm and divides into two embryos. This split can occur at any stage up to nine days after fertilization and its timing is critical to the way the placenta(s) and amniotic sac(s) are formed. If the zygote (see You are 2 Weeks and 3 Days) splits within the first three days, two separate placentas and amniotic sacs develop. If the split occurs at blastocyst stage (see image), four to nine days after fertilization, the fetuses will share a placenta but have separate sacs; when the split occurs after day nine, the fetuses will share a placenta and a sac.

Having nonidentical (fraternal) twins, which come from two separate fertilized eggs, depends a lot on family history. It’s often said that twins skip a generation, which isn’t quite true. In fact, your chances of having twins are simply higher if you have a close relative with twins, but twins never become inevitable, however many members of your family have them.

Family history is most relevant with nonidentical twins, and when the twins are on the mother’s side. This makes sense because this kind of twin relies on a woman releasing two eggs in any one cycle (see as a matter of fact), which may be hereditary. However, for reasons that aren’t clear, a family history of twins on the father’s side can be important too. It may be that the male of the species can carry a gene which makes his daughter release more than one egg at a time when she ovulates.

The lining of the uterus, when fertilization occurs, becomes secretory to nourish an embryo. The lining prepares itself in the same way, no matter how many embryos implant.

The lost twin

Twin conceptions may be more common than they appear. Without knowing it, some women miscarry one twin in early pregnancy. It is sometimes possible to have symptoms of a miscarriage, yet, confusingly, the pregnancy then appears to continue until term, culminating in the birth of a completely normal singleton baby.

Nobody is quite sure how often this happens, or why. While one in every 31 births in the US today is a twin birth, research using scans in very early pregnancy suggests that at conception the figure is much higher. Some experts believe that 15 percent of all births may start off as twins. Their loss could simply be nature’s way of dealing with imperfections.

The odds of having identical twins are about 3.5 in 1000.

Some estimate that the chances of having twins after fertility-enhancing treatment is as high as 1 in 38.

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