My Friend Flicker

The ultrasound technician in my OB's office (my RE is on vacation) actually offered to go on my trip with me, and I said yes. I think she might have been joking, but I was absolutely serious. Of course, she'd have to bring her machine along with her...

Things are still looking like they may actually work out. At 6w4d we saw an embryo measuring 6w5d, and a flicker of a heartbeat at 129 bpm. So far, so good. But it's a hollow kind of reassurance. I used to think that those of us who have gone through losses really had to get past the point of the loss before we could begin to relax and believe things might work out. But now I'm not sure even that will be enough for me - I can't imagine losing this feeling of "maybe" and "we'll see". My OB was so excited for me, hugging and kissing me and almost literally jumping up and down. It just seemed like too much, too soon.

The nurses offered me their pre-natal welcome package, which includes lots of samples of vitamins, a copy of WTEWYE, coupons for pregnancy yoga and massages and gift certificates to maternity stores. I got the same package last fall, so I still had most of the things in my big box of IVF leftovers. I just said thanks, I have everything I need. But I was shocked by how naive it seemed - not even 7 weeks and they are already assuming I'm going to need this stuff? Don't they of all people know that these things are not guaranteed?

I'm going to be out of the country for almost a month - my OB said I could come in the day after I get back, but the ultrasound lady suggested I wait just four more days and then we can do the nuchal translucency scan at the same time. So, okay - but my RE will be back by then, and you can bet I'm going to try to get in there for a scan as soon as my plane lands. I guess it's just going to be a tentative time for me, and I'll have to figure out how to be okay with that.

If anyone has a sister (cousin, friend-of-a-friend, etc.) who's an ultrasound tech in London, let me know!

Six Weeks Exactly

Because my retrieval was on a Monday, we are measuring weeks and days starting on Mondays - which is very convenient. Of course, it doesn't make time go any faster, but it's easy to keep track of as it goes creeping by.

At 6w0d, I feel tired. No nausea, no sore boobs. Maybe my boobs have been pregnant too many times (this is #7, including the probable early miscarriages before I knew enough to recognize that my period wasn't just oddly two weeks late). Maybe they've been plumped up and stretched out enough that it doesn't really matter any more? They seem a teensy bit firmer, but alas, not really anything more in terms of cleavage.

I think my daughter suspects. She hasn't said anything outright, and I'm not going to bring it up, but she has remarked, at separate times, that I'm not drinking coffee, that my clothes are all really floppy, that I'm going to a lot of acupuncture and doctors appointments. It was only five months ago that I was fully pregnant, that all those things were completely well-known to be related to that, and that she was asking a million questions about everything.

When we were in Yosemite in December and had to run from the bear (I know you're not supposed to run from a bear, but it's impossible not to) I had grabbed her hand and pulled her through the woods. Afterwards, she said it was fun and I told her that I wasn't supposed to run so fast, so haphazardly, because of the baby. (Yes, I've wondered if that could have been a factor in the demise - I wonder about everything.) And today when we were taking a walk in the hills, she started running down a grassy slope and calling for me to come after her. I told her that I can't run right now. She turned and looked me in the eye and said "Like that time with the bear?"

The problem with high-IQ kids is, well, they can figure things out for themselves. If it weren't summer, if my husband weren't out of town, if her camp hadn't ended last week, then maybe she wouldn't have noticed? But now, after only a few weeks, I know she knows. There is some unspoken agreement that we aren't really saying it out loud, but I think she's just waiting for me to say something first. I've been weighing the options - being openly truthful, ignoring the topic completely, waiting for her to bring it up - but I have no idea what to do. I know she probably just wants reassurance - I do too! - but I'm not sure I can give her much at this point. What would you do?

Teeny Tiny Someone

So, one gestational sac with a yolk sac. (It's too early for cardiac activity, but I have an appointment for next week and we should be able to see something then.)

All I could think of was that if there were two I would have had a back-up. It is just such a measure of how much loss and failure and disappointment come into play with infertility treatments that I couldn't even muster up some genuine enthusiasm for what is actually normal. And the crazy thing is, I quite emphatically don't want twins. I can understand why it's so appealing after IVF - two for the price of one! - to get even more of what you were hoping for. But the possibility of added complications, especially at my "advanced" age, seriously frightens me.

Anyway, even though I never wanted two take-home babies, I did like the idea of a spare in there, just in case. Which is horrible, because it assumes that the odds are so bad that one by itself doesn't have much of a chance, that something drastic will happen. And I know (really, I do) that it's enough that there is one, that it seems to be doing well so far, that hoping for a back-up is ridiculous when there is still every reason to just go ahead and hope for one that's successful. As long as I'm just hoping, might as well hope for what I really want, right?

If I weren't so nervewracked by by infertility I would be amazed that I have seen my child at such an early stage. I wish I could blithely assume that this is my baby, that in March I'll get to meet this little whitish circle. Shouldn't it feel incredible to be able to watch these earliest moments of your own child's life, to see and know and verify such a teeny tiny existence?

Instead, I'm bracing myself for the next scan, hoping for a good heartbeat and the idea that this one might actually make it.

Limbo

My first meeting with the maternal-fetal medicine specialist (which is maybe just the new-fangled thing to call a perinatologist?) was mostly just that - a meeting, in which we met. We chit-chatted about my history and what her general recommendations would be, with a lot of "if and when", since it's obviously so early. I appreciated that she didn't try to placate me with a lot of reassurance.

She reviewed my protein-S deficiencly results and thought we should retest and look at uterine blood-flow doppler before assuming that I need to switch to lovenox. My hematologist has me on low-dose aspirin until 9 weeks, then lovenox and monitoring. I know that he feels it's better to be on the lovenox just in case, and at this point I am leaning that way, too. So, I have a few weeks to think about it, and maybe the next round of bloodwork will reveal something new, but in general I am willing to err on the side of "don't #2@*% this up."

Other than that, I have nothing. I have no symptoms, no hunches, no news - just me waiting for that first ultrasound. The one good thing I found out from the MFM is that I can still go on my August trip, so at least I don't have to cancel our vacation. I do have to wear compression stockings on the plane, but I should probably do that anyway for my spider veins.

I have been tired, but I don't even have the sore progesterone boobs that I usually get regardless of the outcome of a cycle. I have no nausea, no headaches, no vivid dreams. No overwhelming sensitivity to smell, no cravings. My bras still fit, my pants aren't too tight. Although, to be honest, I'm only wearing the "IVF pants" now - regular pants have been at the far end of the closet rod for a loooooong time.

My OB wants to see me on Friday, but I think that will still be too early for any kind of scan. Done with betas and not ready for ultrasounds. Early limbo.

Second Beta

I'm still not sure how beta numbers really work when multiple embryos are transferred. It seems like any combination of thriving and failing can produce a vast array of results. But, that said, my numbers more than doubled, to 756. Here's the chart:


So, who knows? But for now, things are good and I suddenly have a slew of appointments with a new MFM, my hematologist, my acupuncturist and - of course - a mani/pedi just to celebrate!

Believe me, I of all people KNOW that this is just the beginning. I'm not telling anyone but my husband (and you!) for a good long while. But it's something, and for now I'm so grateful.

Inbox

It's easy to love your clinic after a positive HPT. But can I just say that they have been so kind to me, so helpful and so understanding. After my late loss a few months ago the RE called me several times in the evenings to discuss my case and gave me great referrals to specialists. The coordinator checks and replies to emails even on the weekends, and has always given me a few samples of Follistim to offset the costs of my heavy-duty stim cycles.

And now, this email from her:

Hi!

I’m not really supposed to give you the final call until we see your second beta level….which is why I’m emailing and not calling (things echo in here so much….).

I was excited for you though…your first beta is 329. So far, so good! Continue your medications and I will call you on Thursday to let you know how things are looking.

Congratulations and I’m sorry about being impersonal with the email!

Sweet, right? Waiting until Thursday would have been torture.

In any case, 329. Which is high, even taking into account the fact that I tested a day late since I was out of town. Not that I'm questioning my decision to transfer three embryos - yet, anyway. There are so many hurdles between now and the possibility of then that I'm not even going to think about any of it yet. First things first - or, in this case, second things (next beta) first.

Thanks for all of your lovely comments, too - it meant so, so much to me. Of course, after my laptop died my dad had offered the use of his computer, but I was too nervous to use it while everyone was around. I would wait until they were all asleep and sneak back into the family room to check my reader. It was so wonderful to feel cheered on and congratulated in the wee small hours!

Shhh

Am visiting parents, laptop crashed, have no privacy, pee stick postive.

Lab tests Tuesday and Thursday.

Yikes!

Chill, Baby

Two of my embryos made it to freeze. I have to say, it never occurred to me that I would have anything left over.

I'm also not sure how I feel about it - two lesser-quality embryos sitting there, waiting. If this cycle doesn't work, I would prefer to do another (pre-paid) fresh one than rely on two slow-poke leftovers. I'll have to go back and read my plan to see if I am required to use the frozens first. If so, I am screwed out of another fresh cycle, since my plan runs out in September.

But, at the same time, in researching CGH I learned all too well that the best-looking embryos are not always the normal ones. In fact, it seems more often than not that the normals are the medium=good ones. Of course, there are a million reasons that this is not statistically reliable outside of that particular testing. For one thing, many people who choose CGH already have a history of abnormalities.

I would have loved to know for sure that I had a genetically normal embryo. And if I go through this again, I may opt for the testing after all. But there seems to be a lot of stress attached to the process, in terms of the additional wait, the high instance of "no result" reports, surviving the thaw, worrying about mosaicism. We decided to just cross our fingers and hope for the best - not very scientific, but since I still have to worry about whatever it is that happened in my last second trimester, we figured we'd save the money for all the fancy specialists that our insurance won't completely cover.

For now I know that if I DO get pregnant, I am going to do amnio as soon as possible. Once upon a time I was so low-intervention that I didn't even take tylenol unless something drastic happened. Now, just get me as much information as possible. If things go awry, I want answers.

In the meanwhile, I'll be traveling at the end of the week, so I'll have to bring my pee-sticks with me. Do you think anyone has ever POAS in one of those little airplane bathrooms?

0 to 100

So, this is my 100th post. Which may a cause for celebration, but I have some better 100s today.

100% of my embryos made it to day 5. When the doctor came in to talk about how many to put back he was so excited for the good quality that I actually felt a little zip of hope run through my veins. I asked him if he could surgically remove it, but he seemed to think it was a good thing.

We put back the 3 best ones. The whole time we were deliberating on the number to transfer, I was thinking of Sky and Wombded, the opposite ends of the transfer spectrum. Both made really well-considered choices about the number to transfer for their own circumstances, and I am just hoping that it works out as well for me. It's always scary to think about having a pile of babies, but it's also a matter of being realistic about the chances of even getting pregnant. The doctor and I talked a lot about success rates, twins, and SR. With three embryos, my chances of triplets are about 1.5% and my chances of just one are only about 30%.

Still, the fact is, embryo quality has a lot to do with success. Many clinics use an embryo-rating system of an overall number grade followed by two letters. The number describes the outer shell, cavitation and expansion. The letters describe the inner cell mass (the baby) and the outer cells (the placenta). Which makes it easy to see why a "A" baby cells and "D" placenta cells would be bad.

Of course, my clinic has their own special system which involves an overall number rating (1-6) and a 1-100 score that includes inner and outer cells, some kind of enzyme released into the culture medium and a lot of visual assessments by the embryologist. Anything under 70 doesn't really have a chance. We looked at the low-res images of the embryos and they showed me the blob of inner cells and the rings of outer cells. These weren't nice clear pictures like the ones from IVF websites - they were sort of like security-video images.

Anyway, we put back an 87, a 95 and - believe it or not, from these old-lady ovaries - a 100. Now, how am I supposed to keep from thinking this has a chance?

Hope - 0 to 100, just like that.

Day 3 Update

First of all, I have been on the "comment-combo" protein/gatorade/bed-rest regime and I feel much better. Thank you all for being my de facto medical advisors. So, maybe some mild OHSS plus the fact that my eggs were all crammed together so there was apparently a lot of maneuvering around in there. The phrase "foot-long needle" was used, and then I pretty much blocked everything else out. I think she said something about a bruised bladder.

In any case, I have been waiting all morning to find out the status of my six "beautifully fertilized" embryos. I know it's usually a numbers game, so I've been trying to calculate my odds of being mildly surprised or at least reasonably resigned to whatever news the lab has for me. I am still strangely removed from the process - I am very curious about the information in a science-project kind of way, but even when I try I cannot bring myself to be hopeful. Experimentally, I wondered how I would feel if it turned out that all six embryos were doing well and things looked great. But it's so hard to make yourself have a meaningful reaction to a theoretical possibility.

But then, I got this email:

You have some beautiful embryos! Even the embryologist says so. All 6 are still growing strong. We’ll see how they look on the day of your transfer and the doctor will discuss it with you then.

See you Saturday!


So, do you think I might break down soon and start to think, just maybe, there's a chance?