Red Carded

When a change in procedure is made before retrieval, my clinic uses a red form to alert the embryologist that a change has been made.  I filled one of these out with the nurse coordinator after my monitoring appointment yesterday even though I told her that the information MUST be in my chart because I've been telling my team all about our embryo number plan for CCS since we turned in our paperwork.  I'm pretty sure F and I even wrote our stipulations on the consent forms we gave them.  Yet somehow,  my RE says that he did not know of our wishes until yesterday when he saw the red card on my chart.

I feel like I've been red carded.  My RE called me today to tell me that if he had known of our cut-off number we would have had this discussion earlier.  And to explain (in a tone that sounded a bit too scolding) that based on my follicle count, we probably won't be doing CCS, but a fresh transfer. 

Oh, so many things.  So much biting of the tongue.  And blinking back tears.

I fucking know that already you smug asshole.

We asked about having a cutoff number at our WTF consultation with him.  We specifically asked about the benefits, in terms of cost and success, of testing four embryos versus transferring two fresh and freezing two for later.  We talked about an embryo cutoff number with the genetic counselor.  I told him about our embryo cut off number at my hysteroscopy post-op appointment.  I explained our logic in that choice.  I asked him about thawing the frozen blast we have for biopsy and the chances of it surviving re-freeze and re-thaw.  I've been reviewing with at least two different nurses instructions on how we will prepare for a transfer in case we don't meet our cutoff number.  I don't understand why this is suddenly a red card situation.  And why I am being made to feel like a naive patient who thinks she's stimulating so well that she's gonna get more than 4 embryos out of nine follicles.  I know this is going to be a close call.

And FINALLY I get a clear, intelligent answer about how my cycle is progressing!  I have 9 follicles greater than 10mm.  With IVF #1, at trigger I had 10 follicles greater than 10mm.  I am responding to stimulation in an average, normal way, not great, but not poorly.  I just can't expect to have more than 5 blasts on day 5, it could happen, but statistically it won't.

Thank you for actually giving me useful and specific information about my cycle!  But I do have to explain, AGAIN, that our cutoff includes the frozen blast.  Five embryos including the frozen blast.

If he has an issue with our cutoff number then he needs to convince us why we should do CCS with only 2-3 embryos.  Is this why he called?  Or did he call because he thinks we are delusional about the number of embryos we will produce this cycle and wanted to set us straight?  Based on the conversation we had, I think it is the latter.