2ww Obsessing: 5-6 DPO Symptoms

Okay, having been preggers three times in the last 2 years means I am REALLY aware of pregnancy symptoms. It's still very early but I am having TONS of symptoms already, starting a bit at 3DPO and then really getting intense on 5 DPO. I researched and found that there are hormone changes and elevations pre-implantation (so it is possible to have symptoms before 7-10 DPO). I think they are primarily related to Progesterone jumps.
http://humrep.oxfordjournals.org/content/12/12/2607.full.pdf

I want to record them because they're either just crazy hormonal symptoms this month and I should disregard these in the future, or they're actual pregnancy symptoms.

Implantation could not have occurred yet, so there is still the possibility it won't happen (even if conception did) and then my symptoms would just fade into regular PMS symptoms.

Here is the loooong list, taken from the Countdown to Pregnancy site I'm using in addition to my own notes. This is the most symptoms I've ever had in any cycle (BFP or BFN) but I tend to have more symptoms on BFP cycles.

Spacey/lapses in brain function!
Vivid Dreaming
Sharp Round Ligament pain when stretching upon waking
Shortness of Breath (when singing)
Abdomen: Feels like a "lump" in my stomach
Abdomen: Bloating- abs are really swollen tonight
Abdomen: Gas/Flatulence- crazy gassy since like 2DPO
Abdomen: Heaviness/Fullness
Abdomen: Mild/Dull Cramps/Pressure
Abdomen: Pulling/Pinching
Abdomen: Twinges
Abdomen: UTI or Feels Like
Back & Legs: Achy Legs or Hips- leg muscles feel soooo sore in pm
Back & Legs: Backache
Chest: Breasts Feel Heavy or Full
Chest: Heartburn
Chest: Increased Breast Size
Chest: Sore/Sensitive Nipples
Chest: Tender Breasts, esp in the pm
Emotional: "I Just Feel Pregnant"
Emotional: Crankiness/Irritability
Emotional: Depressed
Emotional: Weepy
Head: Dizziness or Light Headed
Head: Dry Mouth/Increased Thirst
Head: Headache -very off and on
Head: Increased Sense of Smell - neighbor's cooking, herbs, vitamins
Head: Sore Throat
Head: Strange/Metallic Taste in Mouth
Head: Stuffy Nose
Overall: Sleeplessness
Pelvis: Diarrhea
Pelvis: Increased Cervical Fluid
Stomach: Nausea-waves in the morning, queezy until eating breakfast

Pregnancy Fertility Prayer

I decided to compose a prayer for the new year related to our infertility and recurrent loss...praying in faith to God!

Dear Gracious Creator Lord: You created everything that is and all of life is yours. You give life and you take it away. Your ways are inscrutable and your ways are not our ways, but your ways are always true and just. In our human frailty, we call out to you in prayer and ask you to hear us. We come boldy to your throne in Your Son Jesus' name, knowing that you ARE a loving God and Father who cares "for the least of these." We know that with you "ALL things are possible": You are the God that created the world, spoke through a burning bush, freed the Israelites from bondage, broke down the walls of Jericho, raised up prophets and kings, brought victory when victory was otherwise impossible, and you deigned to come to earth, God in human form in the guise of a little baby, in order to rescue us from sin and death. You have conquered evil in Jesus through the cross and the resurrection and you have redeemed humanity in your faithful love and mercy. You are ALMIGHTY GOD. Your miracles are too many to number! You have blessed older, barren women with babies, women like Sarah and Elizabeth, and then you blessed a virgin to become the mother of the Son of God. Nothing is too great for you!

And so I pray on behalf of all women suffering with infertility and pregnancy loss and ask you to grant us, as is Your will, healthy children. And Lord, this year I ask that you give my husand and I health of body and mind and that you please bless me and my family with a healthy baby, that we may rejoice and give you praise, because you are a God who turns weeping into joy and mourning into dancing. We pray earnestly for the joy, the blessing, and the miracle of a healthy baby in 2011. We ask not because we are worthy or because we deserve it, we ask because you are merciful and gracious, abounding in steadfast love, and able to do all things. O God, our strength, our hope, and our redeemer, our hope is in you and you alone. Thank you Lord. In Jesus' Holy Name I pray. AMEN.

The Next Strategy: Improving Sperm Morphology & Damage

On December 20th we had "THE TALK." I have been holding off for months because DH has been closed to the idea of TTC (trying to concieve again) after so much loss and frustration and I wasn't sure what approach to take after our sad news and multiple miscarriages. But on December 10th, which was Avery's due date, I visited the grave site and realized I still desperately wanted a baby, was feeling stronger again, and was even willing to go through more tragedy and loss just to try again...hoping against hope. I was also encouraged because several times I came across information that pine bark extract could actually improve sperm morphology, along with vitamins and minerals like C, E, B complex, zinc, grapeseed extract and iron. Antioxidants seem to be the key to correcting sperm damage.


I ordered DH an amazing multi-vitamin called Opti-Men (with an amino blend, excess amounts of vitamins A, C, E, D, B complex, and zinc, and Folic acid...much more than found in Fertile Aid or Fertile Blend for men), an iron supplement, and a supplement called Super OPC Plus. OPC has in each serving (2 capsules): Grape Seed Extract...500mg, Red Wine Extract.....200mg, and Pine Bark Extract....200mg. He began taking the supplements on December 21st and it takes sperm 72 days to be produced (from start to finish), so we should be seeing improvements some time after that. I realize now that we did not have enough time for his sperm to improve when he was off of his meds (~60 days) the last time we conceived and subsequently miscarried.


I was also given hope about pine bark extract after reading this study on Pycnogenol (200 mg of pine bark extract): http://circles.fertilityfriend.com/Circles/c.php?u=http://www.chiroonline.net/_fileCabinet/pycnog_pub.pdf .


I have just gone off of Birth Control pills and will begin basic charting, checking CM and using OPK's (not temping or obsessing however). The idea would be to prevent naturally for 2 months and then try again in earnest in March. The feeling that the biological clock is ticking for my eggs does engender feelings of panic within me, but I am trying to trust and pray for the future.


If I do get pregnant, I will have to take a different approach...I just cannot jump into doctor's appointments and ultrasounds, etc. until much later. They just bring me too much anxiety and ulimately false hope because my last two pregnancies looked so "good" up through week 8. I hope to wait till 12 weeks before I am seen. Easier said than done I know, but by then I would feel like we will have more accurate information (for us anyway) because the early "good" ultrasounds have meant nothing in the past and only made the heartbreak that much worse. I know there are still possibilities of birth defects beyond that of course, and we're never "out of the woods," not with what we're up against. But at this point I don't see any other options for us...DH is not open to adoption.


So...prayers now for healthy eggs and sperm and that they find each other at the right time. Feels like Russian Roulette but I'm willing to take the risk even given our odds, and I feel that it is worth it in case we get a miracle baby.

FSH and SA/SCSA Results

I am kicking myself for never recording the last of our tests with the RE, especially since I lost the hard copies during our move in October. I believe I remember correctly and found a few notes, so here's the best I can put together.

Results:

-Day 3 FSH (Follicle Stimulating Hormone): 8.75

That's mostly good news, as anything under 9 is considered 'normal' but it's worrisome because it's on the line, (9 - 11 is considered only "fair") and my estradiol was elevated slightly (I think it was 93). They prefer it to be under 80. This means that the estradiol could be falsely lowering my FSH.

The biggest problem was my husband's Sperm Analysis (SA).
-Count/Concentration: +50 million (good)
-Motility +60% motile (good)
-Morphology: Only 2% normal (devastating)

He also had "fair" DNA damage with the SCSA (Sperm Chromatin Structure Assay), which can be related to poor morphology. I believe it was 23% DFI. So, that's concerning though not as alarming as the morphology.

Regarding the SCSA:
Greater than 30% DFI (% sperm with damaged DNA) is viewed as a significant lack of fertility potential, 15-30% DFI as a reasonable potential and less than 15% DFI as high fertility potential.

And the new World Health Organization standards for SA's:

Concentration: the median was 73 million but anything over 15 million was considered normal
Motility: the median was 61%, anything over 40% being normal
Morphology: the median was 15%, anything over 3% was deemed normal

Hysteroscopy / Mock Transfer Today and Testing Underway

We called my RE at the beginning of July to see what type of testing we should be doing so that we can find answers related to our recurrent losses. We really can't afford IVF, but we want as much information as we can get and we know we need a lot of tests done.

Last February my OBGYN had me go in for a slew of blood tests that are standard for Recurrent Pregnancy Loss (RPL) and everything came back normal...no mutations or thrombophilias, etc. So that's good.

In June, after our third miscarriage, the OB had us get our karyotypes done, and everything came back chromosomally normal for us. Also very good.

After consulting the RE, he lined us up for a bunch of tests and had us do all the bloodwork for a "Fertility Panel." Everything came back fine...so again, very good.

Then today I had a hysteroscopy, ultrasound, and a mock transfer. I had no idea they were going to do a mock transfer, so that put me on edge, but in retrospect I'm glad they did it because I think it gave me the first glimmer of hope since we lost our twins in May.

I was also terribly nervous about possibly having Asherman's Syndrome (uterine scarring) following the last D & C to remove the placental tissue because I have had such scant periods since then (which is a symptom of Asherman's). I feared the worst, but thanks be to God my uterus looked fine. The RE saw no signs of scarring anywhere.

The RE removed the camera and did the mock transfer immediately afterward and it went very smoothly and quickly. I had some cramping right afterward and throughout the day, along with spotting, but it has been primarily uncomfortable, not painful. My understanding is that the mock transfer basically measures the uterus so that they know what tools to use and where to place the embryos in the future (should we ever get to that point).

They also did an ultrasound and measured my uterine lining and it looked "fine" for Cycle Day 12 at 9mm. My right ovary had 2 follicles measuring 16 & 17 mm, so I should be ovulating in the next few days. I'm very pleased that the lining looked good since he seemed to indicate that was essential.

The next test on my list is to get my Day 3 FSH and estradiol checked during my next cycle. My husband needs to get his sperm analyzed with a basic SA and have the DNA fragmentation checked with a SCSA. Our insurance covers basic diagnostics but nothing else fertility related, so it is adding up quickly, even in this preliminary phase of seeking answers.

All in all, everything has checked out great/ideal so far. We do not have any definite answers yet, but I think the next 2 tests will be telling. At least we are getting more information and ruling out possible causes for our losses, and that feels good. Knowledge is power.

The Burial

Since we lost twin babies, we went ahead and made a burial box for both of them, even though we only had the body of one of the twins to bury. Our other little one was too tiny to identify because he/she died so early on. My husband and I decided to do this ceremony by ourselves and picked a beautiful Maple tree in the canyon near our home for the burial site. We walked to site, dug a small hole, blessed it with prayers, laid the burial box inside, took some photos, and then prayed through a wonderful liturgy (miscarriage memorial) produced by the Episcopal Church. The text of that service can be found here: http://www.episcopalchicago.org/about/about-admin/documents/HannahsHopesRachelsTears.pdf .

Here's a prayer from it:
We commend to your mercy, O God, our child N., that death may be for her the gate of life and peace with you. At your heavenly banquet, may we rejoice with her and all your saints to see you face to face, one holy and undivided Trinity in glory everlasting. Amen.

We cried quite a lot and hugged. Finally we placed the soil over our little one's box and placed flowers and rocks (a Jewish tradition) on the burial site, one rock for each living family member (3). It gave me a sense of having honored my babies the best way that I could with a sacred rite.

Now I blow a kiss and remind my little ones how much I love and miss them every time I walk past that precious burial site. Tears often flow, bidden or unbidden.

D & C Following Misoprostol

By way of update, the Misoprostol failed to evacuate all of the fetal tissue after my miscarriage. This was discovered at my 12 day post-treatment ultrasound when most of the placenta was found. It is my OBGYN and RE's opinion that Misoprostol works well for very early miscarriages or chemical pregnancies, but for later or "bigger" pregnancies (6 weeks and over), it is not as effective. I should have been close to 9 weeks along by the time we discovered the fetal heart beat had stopped. Sadly, I had to schedule yet another D & C to evacuate my uterus because leaving the left over tissue could lead to a serious internal infection. In fact, I was still losing portions of the placenta several days after the D & C.

Unfortunately, I have been having symptoms of Asherman's Syndrome (scarring of the uterus) since the D & C and am very concerned that this last D & C has done damage which can impair fertility. This is more common than people realize after a D & C because the uterus is so fragile during and immediately after pregnancy. Often the scarring is caused by the tissue tearing away from the lining of the uterus and nothing more. My symptoms have included extremely scant bleeding/periods (especially in comparison to my normally very heavy periods) and uterine pain. I will be getting a hysteroscopy to have this checked into.