Ultrasounds!

So I'm finally out of beta purgatory! But it has been a rather rocky road getting there. I had a very, very brief in & out type of ultrasound at the RE's office last Wednesday at 6 weeks 5 days along. Basically, he quickly slipped the transvaginal ultrasound in, made sure there was a fetal pole and heart beat and was done. He took no measurements and said he was only interested in whether anything was happening in there or not. I was happy about the heart beat but worried because he said it looked like I was not as far along as I knew I was. He also said the heartbeat looked "pretty slow" which is not what I wanted to hear. The husband and I left the office feeling ambivalent. Then they took my progesterone levels and it had DROPPED from 23.6 to 16.7. That's when I started freaking out. They put me on vaginal progesterone suppositories (eww...losts of white powder) and I think that has helped, but again, this was not a good sign in my eyes. (And don't even ask me how long it took me to figure out how to use the applicator to insert the dang things!)

And then I woke up the next morning and ALL of my terrible nausea and constipation was completely gone. So I completely lost my mind. I panicked and cried all the way to the office. I know that feeling "not pregnant" and "fine" at about 7 weeks is a very, very bad sign. When I went to see my spiritual director later that day I even told her point blank that I was miscarrying. I had no doubt whatsoever. I was sure of this fact for a 3 full days and I continued to feel completely normal and not pregnant. It was so depressing and I felt like I was postponing the inevitable.

And then suddenly on Sunday morning I felt nauseated again...terribly. I was elated!! I was so beyond thrilled to be sick and it gave me a tiny ounce of hope again. I called the OB after the weekend and she wanted to do yet another beta given my disappearing symptoms. The results came back on Tuesday and it was all the way up to 60,812. Wow. I was hoping for just over 30,000, so my hope continued to rise. (Apparently my numbers are the average for a 9 week, not 7 week pregnancy.)

But the true test would be the second ultrasound and I knew it. The OB had me come in today for a "viability scan" (don't you love that clinical term?) where they basically do all the measurements of everything imagineable of the uterus, ovaries, sac, and baby. It was not until that moment that I felt the shackles of beta purgatory start to loosen. As she focused on the gestational sac we saw right there our tiny little baby bean with a very clear heart just beating away beautifully!! I squeezed my husband's shoulder tightly. It was better than I had hoped.

She checked the heart rate and it was a very strong 159 beats per minute. Little one is measuring only 2 days behind now as 7 weeks 3 days (I think I'm 7 weeks 5 days) but that's okay. The Crown-Rump length (CRL) was nearly 12 millimeters and that's right about average for this week.

Afterwards we met with the OBGYN and she let me know that they found a second gestational sac. (I wondered what that was on the screen.) Sadly, it is most likely the result of a twin that didn't make it...so a fraternal twin since it had its' own sac, which is the result of 2 different eggs being fertilized. She said that probably explained my big jump in symptoms that was followed by the big decrease. "Vanishing twin" she called it.

I realize now that I really had miscarried, so it was not all in my mind. It's just that we had 2 in there and we didn't know it. I feel melancholy about this news, but then again I'm so thrilled that one of the little ones made it and is doing well right now. I am just going to count my blessings and thank God for the good news. Now, for the first time, I really -feel- emotionally pregnant, like there's truly 2 of us...and it feels so good for the time being. I know we're not out of the woods, but we have passed a major milestone today.

Beta Purgatory

Okay, this stage of pregnancy feels like purgatory to me. The image at the left is a painting of souls trapped in purgatory from Notre Dame. I'm pregnant at the moment, now just over 5 weeks along, so I'm certainly not in hell, but I'm far from being in heaven because I'm so fearful of another loss and I'm just waiting and hoping that all will be well.

I had my beta's done (blood work to check how much HCG-human chorionic gonadotropin or 'pregnancy hormone' is being produced). These numbers cannot guarantee any particular outcome, but they do provide a glimpse into the potential viability of the pregnancy. They are apart of my purgatory torture. My beta's with my last pregnancy started out quite low, and having researched this a lot since then, I now see that things were not going well from the beginning. However, my doubling time was excellent, so my low numbers at the beginning were overlooked.

Here are my beta's from my last pregnancy and miscarriage:

16 DPO: 63

18 DPO: 440

Here are my beta's from my current pregnancy:

12 DPO: 40

14 DPO: 122

17 DPO: 453

As you can see, my early beta's were are a lot higher this time around, and based on my doubling time, my day 16 beta would be about 300...quite a lot more than 63. This brings me some comfort, although I can't help wishing they were even higher just to give me some extra assurance. For now I can only hope and pray, because again, nothing is certain.

Here is a study I came across and saved the last time I was pregnant...it freaked me out at the time, and now I see it was predictive of my sad outcome.

16 DPO Beta Study...What your Beta may mean:

From: http://www.squidoo.com/16dpo

25 - 50 hCG at 16dpo -- Four women in this study had hCG levels below 50 at this stage. The researchers concluded that with these levels less than 25% would continue on with their pregnancy with more than 75% miscarrying.

50 - 100 hCG at 16dpo -- Of 16 women, 25% continued on with their pregnancies.

100 - 199 hCG at 16dpo -- Of 27 women with these levels, 73% continued on with their pregnancies.

200 - 299 hCG at 16dpo -- Of 48 women, 96% continued on with their pregnancies

Over 300 hCG -- All 105 women continued on with their pregnancies.

And another study I found from OBGYN News:

http://findarticles.com/p/articles/mi_m0CYD/is_11_40/ai_n16599521/

A quote:

"The investigators reviewed all IVF pregnancies at the New Jersey center from June 1998 to March 2004. A total of 53 patients did not have a fetal heartbeat at the end of the first trimester. Their mean [beta]-HCG levels were 56 mIU/mL on day 16, and 115 mIU/mL on day 18, with an average slope of 24 mIU/mL.

Levels and slopes were much higher for the remaining 269 women with viable pregnancies with mean levels of 216 mIU/mL on day 16 and 505 mIU/mL on day 18, with an average slope of 140 mIU/mL.

Most of the women, 180, had singleton pregnancies. Their average [beta]-HCG levels were 169 mIU/mL on day 16 and 401 mIU/mL on day 18. The researchers noted that the average slope of 111 mIU/mL was 4.62 times higher than in the pregnancies that were not viable."

I know women who have had great outcomes with low betas, but I was not one of them. I also know of women who had losses even with high betas. For now I will continue to place myself and my little one in God's hands, knowing anything may happen. And I am grateful that I am pregnant at this moment: thank you God. Of course, I don't know when I'll be out of this purgatory...perhaps not until (and unless) I deliver a healthy baby. Give me strength.