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    Switched at Conception

    'I question everything'

    Ripening, retrieving, fertilizing, implanting continued...

    About 12 days later, when the developing egg follicles (structures containing the egg and supportive fluid) reach a diameter of 17 millimeters or more, another drug is given to trigger the final stage of egg development. But before the follicles have a chance to release them, the doctor harvests the eggs with a laparoscope (a long tube with a camera and retrieving device on the end), which reaches the ovary by passing through the vagina, uterus, and fallopian tube on that side. Monitoring the laparoscope's journey by ultrasound, the doctor targets the maturing follicles, inserts a fine needle into them, and withdraws their contents. "We look to get at least four eggs, but 12 or more would not be bad either," Luciano says.

    The harvested material is then delivered to an embryologist, who isolates the eggs and places them individually into petri dishes. The partner's sperm is combined with the eggs, and if all goes well, fertilized embryos develop.

    Should that happen, the progress of the embryos is monitored for three to five days. Then the strongest two to four are transferred into the woman's uterus, where it is hoped they will implant. The rest are frozen for any future attempts. Hormones are given to inhibit menstruation, and a few weeks later, a pregnancy test confirms if the process was successful.

    After two attempts that failed to produce any harvestable eggs, Gora's ovaries produced 28 on the third try.

    Success rates tell the tale

    "You would think that under such controlled conditions, it would work 100% of the time," Luciano says. But the rate of success is somewhere between 25% and 35%. In young women like Gora, the rate may be as high as 50%; in women over 40, it can be as low as 15%. "If a woman does not get pregnant by the third try, there is no reason to believe further attempts will be successful," says Luciano.

    Indeed, Gora did not become pregnant, and decided to stop trying. "The doctors told me the success rates, but it didn't sink in," she says.

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