Tuesday, September 29, 2009

another sucky week in the offing

Our first ultrasound today was another exercise in frustration. We are technically 6 weeks 3 days pregnant (the convention is to count back to the start of your last period). This means that we should be able to see an amniotic sac, yolk sac, tiny embryo (fetal pole), and possibly a heartbeat by now. Well I have all the right sacs, but nothing else. It's too soon to officially throw in the towel, but it's definitely not encouraging. We go back in a week to see whether the embryo catches up in growth or whether it's just a dud.

In the insult-to-injury department, Dr. Snaggletooth advised me that I have a honkin' big hematoma (blood clot) in my uterus. It's even bigger than the amniotic sac itself. So I can expect to keep bleeding.. maybe a lot.. for a while.

So here's my plan for the week:
  • continue to inject progesterone in between the many welts on my ass.

  • bleeding and mildly cramping at all times.

  • wondering where the fuck my crystal ball is. If the embryo is genetically "off" then it was predetermined 4-1/2 weeks ago that the pregnancy would fail. The doctor quipped that we should pray this week. Screw that! The die is cast.. we're all just waiting to see how it plays out.

Thursday, September 24, 2009

3 facts that kept me sane last night

It's been a rough week. After the period-like bleeding I had Monday night, I proceeded to have even more on Tuesday night. That was the worst of it and now I'm back to constant red spotting. Another alarming thing is that I lost 3 lbs. since this weekend, which I figure is the loss of excess water weight. I started to get that "not so pregnant" feeling when I realized my body was dumping excess fluids. This couldn't be a good sign.

Last night I was tormenting myself with internet research about early pregnancy bleeding and miscarriage. I was bracing myself for the distinct possibility that my awesome week-long pregnancy had come to an end. You can find plenty of anecdotes about women who had first trimester bleeding and went on with a healthy pregnancy. Are they the exception or the rule?

Here are the three tidbits of wisdom that helped me sleep last night and braced me for repeat bloodwork this morning:

  • A 5-6 week embryo takes up a tiny space of the uterine wall. Most of the uterus is not "engaged" in supporting the early embryo. Your little embie can be snug as a bug in the East Wing of your womb while you're having total bloody chaos in the West Wing.
  • The risk of miscarriage is 10% during 5-8 weeks of pregnancy (3-6 wks after conception). Who knows how real this oft-quoted number is, but I like my odds.
  • When your hormone levels fluctuate, there can be a delayed effect. I figured this one out all by myself. When you take your last Pill, you don't get your period the next day - you get it 3-4 days later, right? Well my progesterone levels dropped Thurs/Friday last week and the delayed effect was a mini-period Monday-Tuesday. Tada!

Okay, on to the bloodwork results. It's all good. My HCG is way up to 5,300 (spot-on for 26 days past ovulation according to http://www.betabase.info/) and progesterone is back up at 20.

I have to run a very important meeting tomorrow morning at work, so I decided not to do my ultrasound tomorrow after all. I wouldn't want to get bad or ambiguous results and then be a pathetic wreck at the office. In fact, I think I'll put it off until Tuesday, when Dr. Snaggletooth is in the office and I can have my post-IVF meeting in the same visit. PUPO lives!

Tuesday, September 22, 2009

i will not panic, i will not panic

I have good news and bad news.

The good news is that I went with choice "D" from my previous post (self-prescribe an increase in progesterone dosage AND request follow-up bloodwork) with excellent results. I upped my progesterone to a modest 1.25cc and by Monday my blood level went up from 13.4 to 14.9. I did not confess this self-prescribed change to the nurse. (naughty patient!) She told me that Dr. Snaggletooth said I could go up to 1.5cc if it made me feel better. Okay! Also my HCG level went up to 2500 which is perfect.

The bad news is that a little spotting over the weekend became a menstrual-like flow last night. It's back to spotting today, so I'm no longer out on the ledge. I called the clinic today, begging for an early ultrasound, since Monday the 28th is ages away. I bargained my way up to Friday, but no sooner. They don't want me to go in too early and risk being freaked out when we don't see an embryo even though it's just too small to be seen yet. I'm also "allowed" to go in for another blood sample if I want to before then. Nice how they humor the crazy lady.

So I have to keep my shit together for a few more days. I know that early bleeding is very common and it's not necessarily a bad thing. I will not panic.

Friday, September 18, 2009

a teeny update

My third beta today was a delightful 502. Always the science geek, I charted my three numbers, using a logarithmic scale, of course. The result was a perfect straight line. *sigh*

I'm kindof worried because my progesterone level dropped from 20-ish earlier in the week to 13.4 today. Dr Snaggletooth didn't think it was low enough to warrant increasing the dosage on my progesterone shots. The nurse relayed to me that they like it to be over 15, but my HCG is rising so well that the doctor didn't think there was a need to change dosage.

My first ultrasound isn't for 9 more days and I won't have any bloodwork done before then. What should I do?
A) Don't worry, keep the same dosage until your appt. on 9/28
B) Self-medicate: change progesterone shots from 1cc to 1.5cc
C) Request follow-up bloodwork early next week
D) Both B and C

I'm leaning toward D.

Wednesday, September 16, 2009

slacker embie now a frenzy of activity

I was very very happy to get the results of my second beta today. Our slacker embie is making up for lost time - the number jumped from 42 to 162. Yay!

When the doctor's office hadn't called yet by 3:00, I started losing my mind a little. I know they knock off at 3:30 and there was no way I could wait any longer, so I called them. This time the nurse was chipper and, compared with her cautious optimism on Monday, today I got a hearty congratulations. Yay again!

Now I'm feeling more confident about the next blood test Friday and then the first ultrasound in a couple weeks. But I'm still holding off on looking up a projected due date or thinking about finding an obstetrician. Wouldn't want to jinx it! Oh, I would be so happy to be done with infertility.. for a couple years, if not forever.

Thank you for checking in on me and sending good wishes!

Monday, September 14, 2009

embie implants, but fails to impress

My blood results are in. Drumroll, please..

We got a 42!

Yes, it's a positive. But it's pretty weak for 16 days past ovulation. A really solid pregnancy would have an HCG of 150-200 by now. We're keeping it "cautiously optimistic" until follow-up bloodwork on Wednesday and Friday. The number should double every 2-3 days, so as long as the 42 becomes an 84, which becomes a 168, things may turn out okay.

It looks like the embie that was all spunky and over-achieving in the petri dish is just scraping by now. I realize now that the spotting I had on Friday was probably implantation bleeding. The implantation "window" is between 6-12 days past ovulation. Friday was 13 dpo. Our slacker embie implanted at the latest possible moment!

It's going to be a nerve-wracking week. Let's hope the embie gains some confidence and goes for the gusto. Wish us luck!

Sunday, September 13, 2009

i love photoshop

I POAS again this morning and it seemed to be another negative. Then after staring and squinting at it for several minutes, I think maybe there was an extremely faint second line. Well, maybe I imagined it.. 'cause I was dropping acid at the time - hell, how else does one get through the 2ww?! Or maybe it was a very very faint positive. We'll get the blood test done Monday and all will be revealed.

So today I was amusing myself with a little Photoshop. I've been thinking back to how interesting my stomach looked a couple months after Waffle Girl was born. All the various lines and scars were like badges of honor, earned along the way to mommyhood. Below I offer you my artistic rendering.
Are my pubes really comprised of green squiggles? I'll never tell. But the "rock hard abs" two months after having a baby? Totally true. Anyhow, I hope to see this funky inverted T-shape on my stomach again someday. Approximately one year from now would be just perfect.

Saturday, September 12, 2009

thinkin' we may need those frosties..

I've been pleasantly busy during the 2 week wait. Work is already a madhouse and, on top of this, my boss assigned me to write a $100K research proposal. I'm the type of geeky scientist who can actually write in plain English and can make a project sound interesting and worth throwing money at.

On the PUPO front, there is the usual medicinal regime: a honkin' big shot (1-1/2-inch needle) of progesterone in the glutes every night, a baby aspirin, and these nifty little estrogen patches on my stomach. And no drinking, even though I really want some wine!

I'm at the point now, two days before my blood test, where one is inclined to take a home pregnancy test.. the ol' pee on a stick (POAS, of course.) This is a great way to drive yourself insane. If you test too early, you get a false negative (even if you're preggo) because your hormone levels aren't high enough to trigger it. But we all want an answer before we go in for the blood test, c'mon! Well, I took one yesterday and got a negative result. I know it's not definitive, but it seems late enough that I should have seen at least a faint line. I had a pretty solid BFP at this point when we got Waffle Girl.

I'll probably POAS again Sunday - this will be closer to the "real" result. My blood test is scheduled for Monday. I can handle a negative - a BFN, as we say. I'm psyched about having so many "frosties" to work with - I don't really need to get pregnant this month. Part of me actually wants to get a negative result, because what the hell am I going to do with those frozen embies? If we have our second baby and still have frosties, I swear I'll be tempted to try for #3.. just because they're there! I know there are other options: you can donate to another IF couple, donate to research, or just "discard" them. All of these are reasonable, good options for a rational grown-up.. but infertility makes you look at things in a crazy way sometimes. I want my embies and I want them now!! **holds breath and stomps feet**

I hear Waffle Girl chatting in her crib. We're going to a picnic this afternoon. More fun distractions! Yay.

Friday, September 4, 2009

SET, PUPO, and other pertinent acronyms

Those of you who know the lingo will see SET (single embryo transfer) and think to yourself, "Oh, too bad the infertile breeder's embryos petered out and she only has 1 good one to transfer." I would appreciate your sympathy, but the real story is way more cheerful!

Mr. Foxy and I went in for our procedure yesterday, expecting that the clinic would pick the best 2 embies for transfer, as is standard for us 35+ ladies. We were surprised to learn that we had 2 blastocysts that were at the top of the scoring system (AA's). They were so good that the doctor gently tried to steer us toward a single-blast transfer to reduce the risks of multiples. I should mention that Dr. Snaggletooth wasn't in the office yesterday, so we had one of the other senior docs, let's call him Dr. Koop. Unlike Dr. Snaggletooth, Dr. Koop has a warm bedside manner and spent a lot of time talking us through the issues. And it took us a long time! Here's what our decision came down to:

1) If we transfer just 1 blast, it will have a good chance of implanting, due to its high quality and my previous success. Even if it doesn't "stick", though, we haven't hurt our overall chances. The other grade-AA embie will be saved, so we can do a frozen embryo transfer in another month. There's no risk to us in this scenario, only some potential delay.

2) If we transfer 2 top-quality blasts, though, there is a strong chance that both will implant and we'll have twins. This isn't a bad scenario, in and of itself, however the risk of triplets (which is much more dangerous than twins) becomes a possibility. Each of the two embryos have a 1% likelihood of splitting into a twin. Dr. Koop noted that we would be taking on an unnecessary risk if we took this route.

After a lot of discussion, we started leaning toward the SET, even though it seems so crazy for a 39-year old! In the end, Mr. Foxy asked the doctor what he personally would do. Dr. Koop says to me, "If you were my daughter, I'd tell you to transfer 1." Having lost my own father 9 years ago, I was a total sucker for this logic.

We transferred one embryo, froze the second one, plus several others will be frozen (maybe today?) after the embryologists decide which ones are "keepers". We are now, as they say, pregnant until proven otherwise (PUPO). Hee hee.

My biggest challenge in the 2 week wait (2WW) is to avoid picking up Waffle Girl. I mean, she's a skinny girl, but my lifting restriction is just 10lbs! My mom was a big help yesterday and this afternoon we have the girl's beloved auntie coming over. Yay!

Our pregnancy test will be on Monday, Sept. 14th. Ideas for fun distractions in the meantime are most appreciated!

Tuesday, September 1, 2009

i love me some 5-day transfer

I was kindof surprised to learn that the 12 embies we had on Sunday were all still rockin' on Monday (Day 2) when the nurse called. My memory is a little hazy on this, but I could swear I had a couple casualties between Days 1 and 2 the last time around. Woo-hoo! Score another one for the 39-year-old lady.

Dr. Snaggletooth has a preference for 5-day transfers, so they told me I will be scheduled for Thursday. It looks like we may even have back-up embies this time around. Yay, frosties!

I'll get a call Wednesday telling me what time to show up on Thursday. So today is a blissful day with no blood draws, no phallic ultrasound probes, and no sitting around staring at my cell phone all afternoon, hoping they remember to call me before closing time! My little embies should go from 4-cells yesterday, to 8-10 today, and then "esplode!" into 100-cell blastocysts by Thursday morning. Well, some of them at least. Think happy thoughts about our little embies this week!