6w5d and 7w3d Ultrasounds

I have actual photos of our little baby! Maybe he/she looks like a blob now, but I was assured that would change in just a matter days.

At our 6 week 5 day ultrasound lil' pumpkin had a heart beat of 137 and looked big for age (though the RE didn't measure at this scan).  We were able to see and hear the heartbeat on the scan and things looked perfect.

You can see the yolk sac on the bottom below the baby, it looks like a ring and the baby is the above it, closer to the uterine wall with the beginning of the placenta forming, creating an outline.

Here is baby at 7 weeks 3 days, looking quite a bit bigger, he/she measured 2 days ahead at 13.9mm (which is good news according to the perinatologist since that means there is no slowing of growth). The heartbeat was beating great at 155:

Above the word BABY you can see the actual umbilical cord arching above the baby and it is attached to the placenta. The tech thought I had an SCH/tiny bleed at the top of the placenta, but the doctor disagreed. The baby's head is on the left facing down and the feet are on the right facing upward. It looks like you can see tiny hand buds on either side of the body. I asked about the dark spot in the baby's head and was told it was a normal part of development and had a name, but I don't remember the term.

I started feeling really sick at the 6 week mark and that has continued. I feel that it's a good sign and it provides me reassurance, even though it is very difficult to function a lot of the time. I also continue with intralipids, Lovenox, baby aspirin, folate/B12, fish and krill oil, calcium, and prenatals.  I have a long way to go yet and my next scan is during week 9. It's hard to wait that long but if things still look good, I will have passed my previous loss anniversaries. Most of the time I try not to think too much about being pregnant, it helps me cope and makes the time go a little faster while I wait to get out of the danger zone.  Stick baby, please stick.   

1st Ultrasound 5w2d

My RE brought me in for an early ultrasound today at 5weeks 2days along. The pic above isn't mine, but this is what the screen looked like! Heh.  I was nervous but feeling ready for whatever the news would be.  As soon as the tech turned on the ultrasound screen, I could see one nicely sized gestational sac. So...my beta wonkiness and slow down must have been due to losing one of the embies early on. I did feel some sadness about that, and yet also real relief that one of the embies was pulling through.

As she focused in on the sac, we saw the yolk sac too. I asked about a fetal pole but it was too early to see it clearly. The RE assured me later that this was totally expected at this stage. The gestational sac itself was measuring ahead at 5w5d, so that was comforting. He also said the sac was placed ideally in my uterus.

I left feeling very happy because I have a rationale for the slowing beta finally. I also know the pregnancy is progressing with one embryo on target and that it is not an ectopic pregnancy, nor is it a blighted ovum (because there is a yolk sac present).

I go back for another ultrasound when I reach 6w5d, so I have a bit of a wait, but the wait will be a little more bearable now. I am so grateful for the compassion and understanding of my RE today.  

Progression Pics of Wondfo, FRER, and Dollar Tree Tests

I pee on a few sticks most days to check progression even though it is not an exact science by any means.  I have an endless supply of internet cheapies that will otherwise go to waste in my closet, so I've been using them up during this pregnancy, in addition to a few other sticks. It's been kind of fascinating to see the way different tests respond to HCG. For those searching for HPT progression pics, my POAS-aholism is for your viewing pleasure. ;)

The first set are my Dollar Tree tests. The interesting thing with them is that they have continued to get darker just up until about 19DPO (my beta was 1,555 that day) and then they look the same-with the control line just a hair darker than the test line.  This makes me think that they hit a threshold with the dye around a beta of 1,000 and that they won't get darker anymore. They get the prize for progression with changing dye the longest.

UPDATE: 11/12/12:  I continued to take the Dollar Tree tests and the test line finally became darker than the control line on 26 DPO (before that it was looking about the same darkness):

The second set are the cheap wondfo's from Amazon. You can see that by 14-15 DPO the test and control lines were equally dark and that they haven't changed since despite my HCG levels rising from 300 (13DPO) to over 1,000 by 19 DPO. Their threshold is less than Dollar Tree store tests and so while they pick up the earliest BFP's, I would say they stop showing progression with betas in the 500+ range.

The final set are the more expensive tests, the First Response Early Result (FRER).  They seemed to darken up until 16 DPO, which is when the test line became darker than the control line. I like that they have the kind of dye range, but they too seem to have a threshold in the 500  beta range- as if the dye has done all it can do and simply doesn't look any darker after that. 

UPDATE 11/12/12:  I continued taking FRER's every other day and found that by 25 DPO, the test line looked the same darkness but the control line faded and continued to fade on 27DPO. So, these do keep changing, it just took a long time:

Anyway, it's important to note that these tests do not continue to darken indefinitely if you're using them for progression purposes (at least not until much, much later on and even then they hit a threshold!). At this point, my tests can't give me a lot of new information and the one reason to keep testing would only be to catch dramatically falling hcg. Also, please note that some days the lines looked lighter, only to darken up again...that was due to my urine being more dilute or because the dye just seemed less in that particular HPT. One day of lighter tests doesn't mean anything....it's only if they continue to lighten that you need to consider things further. 

Happy stick peeing! 

Betas # 1, 2, and 3

Today I am 5 weeks pregnant.  My betas have been a bit wonky and I'm not sure what to think, but so far they are:

6dp5dt/11DPO: 96
8dp5dt/13DPO: 307 (28 hour double time)
14dp5dt/19DPO: 1,555 (60 hour double time)

The slowing doubling time is of concern, even if it is in the very slow end of "normal," but it could mean a variety of things-- it may be just a random slower beta and means nothing, or one of the embryos implanted but is now arresting, or the hcg is starting to decrease because the pregnancy isn't viable.  I won't know more until I either have another beta drawn or an ultrasound during the 6th week.

I'm staying very busy with family and church and reminding myself that it's not in my hands anyway...what will be, will be.  God alone knows. I feel at peace in general with the situation and we do have 2 more tries if this one fails (not that I'm particularly excited about going through this process again). But it is possible that this, our last effort to have a child together, will not work. If so, I will not have any regrets or wonder what more we could have done.  I will know that I did my best to give my DH the child he longs for and my DD a sibling-something they both want so very much.

I use this blog to express worries that I don't share anywhere else; it's a bit like a journal and has a similar therapeutic effect. Of course, it is pretty one sided, dealing only with the one topic of infertility and the attempt to have a baby, and so all the broader life stuff that happens in a day is missing...like my walk with DD today to pick Autumn leaves to decorate the table with or my time teaching a group of youth about prayer.  

Yet I also know, having been involved in the infertility and recurrent loss community for some time, that it is comforting to know you're not alone and that others struggle and have similar feelings.  I have found that no one understands or "gets it" outside of women who have had the same experiences.  So this blog is for those women, and selfishly, for myself -to have an outlet, since I refuse to burden my loved ones with the ins and outs of this whole process. I know there are plenty of like minded women out there who understand exactly what this is like.

BFP at 4dp5dt!!

I got a faint but very much there BFP on 9DPO/4dp5dt.  I actually had a maybe something there line on 8DPO, but it was way too faint to call it. It has been an intense emotional rollercoaster ever since. In fact, the day of my BFP I felt completely unexcited, just totally pessimistic, bracing myself for anoher loss because I have had almost nothing in the way of symptoms. In fact, this has been completely different from any pregnancy I've ever had in terms of symptoms (or lack thereof).  I don't know if the reason is that my hormones are not being produced by my own body (estrogen and progesterone)  or if it is different simply because it is a donor egg/embryo.  But I have become accustomed to knowing when I am pregnant because I have so many predictable symptoms. I do have a few, but they are very mild and minor...fatigue, tightness in the abdomen, and some round ligament pains. I have had some nausea, but not much.

However, when my test darkened up on the afternoon of 10DPO, I felt hopeful again because the line was so much darker than the day before. But on 11DPO, my morning Wondfo test looked the same, if not lighter than previously and I was down all day, fighting tears. I decided to get my beta done early then, feeling like I couldn't be in limbo any longer. I was shocked when that evening, at 5:30pm, the clinic called to tell me and that my beta hcg was 96! I had to make them repeat it several times because I was in disbelief. Never have my initial betas been that high. 

So, tomorrow I'll have my second beta drawn. This will be very telling...if it doubles, I will draw a deep breath. With so many losses under my belt, it's hard to believe I could get good news, but things have been going well so far. I may not know until Monday what the results are...it's so hard to wait. Eeeeeps.

The Embryo Transfer

We had our embryo transfer last Friday and it was quite an emotional experience, but all went well. For those who are interested in what to expect, I'll lay out the details.

First, 2 things to keep in mind before you arrive for a transfer:

First, it is important to shower and ensure you have nothing scented (including deodorant)  on you. So forget styling products for your hair or scented lotion, etc. I did purchase unscented deodorant because I was worried about going without it on the big day.  But it's important for the embryos not to be exposed to any kind of harsh foreign particles that can be in the air from scented items.  The same goes for anyone who goes with you to the transfer. I personally was alone at the transfer to save money on airfare.

Second, bring a bottle of water with you and drink plenty. They want your bladder to be very full because the transfer will be guided by abdominal ultrasound and a full bladder effectively presses down on the uterus, making it more visible on an ultrasound, which means they can see what they're doing much better.

Here's how my transfer played out...

I arrived at 9am and did not have to wait more than a minute. The nurse, who was serendipitously named Mary, helped me into the transfer room to check my bladder on the ultrasound and make sure that it was full or filling enough.

She then went through the actual procedure of the day and covered the post-transfer do's and don'ts which included:

-no sexual intercourse until after the second beta
-no caffeine
-no simple sugars, avoid simple carbs as well
-no exercise or stress or anything that will raise the heart rate
-no smoking and avoid all second hand smoke (run from it in fact)

I signed off on the information given to me. She left the room and I texted DH, only to see that he had texted me saying, "I'm right there with you, Baby Love...dreaming of our future together. I love you sooooooo much! xoxoxox. " It seriously melted my heart. I texted him that I was about to see the pics of our embies!He texted back, "Exciting! I'm right there holding your hand."  I responded, "I love you so much honey, I can feel you here!" He wrote, "Holding your hand and running my fingers through your wondrous hair, kissing the back of your neck."  It really helped me feel relaxed and happy, like he was right there with me in those moments.

Next the embryologist came in. This was a great time because she had photos of our beautiful embryos.

Seeing these little embryos made tears come to my eyes and I was filled with emotion, knowing that one or both of these could be our future child(ren). She explained that they are 5 day "Expanded Blastocysts" and were rated as Grade 2, which is very good quality, though not perfect, which very few embryos make (Grade 1).  She also re-confirmed our profile and the numbers assigned to us, which I had to sign off on, stating that these 2 embryos were in fact ours and from the profile we picked.

I was undecided about whether to transfer 1 or 2 embryos when I walked into the office, but I have to say, seeing both of them on the photos really had me hooked...my heart practically leapt out of my chest. I had been praying daily for the donor, for the eggs, and then as soon as I knew the eggs had been retrieved and fertilized, I began praying for God's presence, love, and light to be with all the embryos.  I sent DH the pic and told him that they recommend transferring both. He wrote, "You are wondrous beyond words. The most beautiful person I will ever know." And then, "They're beautiful Honey!"  We texted back and forth and decided on going with the embryologist's recommendation of transferring both.

After the embryologist left, the nurse came back in to reconfirm that my bladder was ready and then called in the RE. The doctor came in and I had a chance to ask him about his recommendation for transfer as well. He too recommended transferring both, and said he did not feel that a twin pregnancy was a big risk, that it was safe, and that our chances of twins was only 10-15% and that pregnancy was 65-70% when transferring both. At one point he said reassuringly, "You will get pregnant." I texted DH  the news and he wrote back, "Love you forever" and I wrote, "Let's do this! Love you!"

It took some time to get a good view of the uterus on the ultrasound because my uterus hangs so far to the right side of my body. Once they had a good view (meanwhile the ultrasound was pressing deep into the abdomen/full bladder!), they used the very uncomfortable tongs that they use in pap smears to get a good view of the cervix. They cleaned the cervix and also inserted a medium into it that is conducive to the embryos. Next they placed an outer catheter up through my cervix and into the uterus and you could see the tiny catheter on the screen.

Only after everything was in place did they call the embryologist to come out of the lab with our embryos.  They reconfirmed my identity and our assigned number and I then thought, "Wow, I sure hope they have the right embryos!"  She came right in, so as not to expose the embryos to the air for more than a few seconds. The embryos were inside a tinier pipette that both the embryologist and the RE put into place and inserted into the outer catheter. The embryos, which are in a medium themselves, were essentially flushed gently out of the pipette and into my uterus. It was then that the RE said, "there they are!" as he pointed to the screen. You could see them there, a tiny dot of white light. (You can see them because they're inside a protective air bubble.)

I asked for a photo and they took one while we waited for the embryologist to return to the lab and confirm that the embryos were both out of the pipette. She called back and I heard her say, "It's all clear!" At that point they were able to remove the catheter and tongs.  It felt so good because all the equipment was quite uncomfortable (though not what I would call painful). I will say, the only time I've been that "exposed" before was during labor!

Both the nurse and the doctor shook my hand and told me to get up and get dressed so that I could use the bathroom. You don't need to lay down because the embryos are placed in the lining, which is akin to placing 2 grains of salt on to a peanut butter sandwich. While the medium may flow out later, the embryos themselves aren't going to fall out. :)

After the much needed bathroom break, I was escorted out and wished good luck. I left feeling truly high and so very happy. I called DH and told him the good news of a successful, uneventful transfer.  Really, it wasn't a big deal, and from start to finish the transfer itself only took about 15 minutes.

So, now we wait. My beta isn't scheduled until another week from now...which is way too long to wait! Of course, I will be POAS before that. Come on embies...stick baby stick!!

Close Call! Breakthrough Bleeding Before Lining Check

I failed my lining check on Monday (cue complete freak out noises). I have been a basket case.

My uterine lining needed to be close to 8mm for the big lining check and it was only 5.9mm. I knew there was big trouble when I started having break through bleeding on Saturday...it continued through Tuesday, easing up to spotting yesterday (Wed). My RE looked at the ultrasound during the check and announced, "You're not ready!"  I had to fight tears.

So what happened?  Basically, my RE explained that not every woman metabolizes estrogen supplementation the same and the Vivelle patches were not enough to keep my estrogen levels up and so I began having withdrawal bleeding.  I was a complete disaster on the flight out to CA...during my layover in Chicago I locked myself in a bathroom stall to sob for 20 minutes and looked red and puffy all day (prompting a flight attendant to ask if I was sick).  I was certain my cycle would be canceled with all the bleeding I experienced.  And I cannot express how hard it is to get THAT close to a transfer and then believe it's going to be taken away.

As soon as the bleeding started I began taking estradiol, 6mg orally (2mg morning, noon, and night) and 800mg of ibuprofren. Amazingly, this did the trick and rebuilt my lining just enough to pass my recheck today.  Less than 72 hours from my failed check, my lining was up to 7.87mm...putting me close enough to the 8mm's to move forward with the cycle! I am elated and even the nurses were cheering for me when I walked out of the ultrasound room.

The clinic coordinator called me later today to tell me that I am to stop Lupron on Sunday morning, begin Progesterone (PIO) that night, continue estradiol until Saturday, and continue the Vivelle patches indefinitely...my transfer is scheduled for October 19th and I just bought my tickets!

This coming week is my 40th birthday and sincerely, this is the best birthday gift I could ever imagine. I am so thankful for this amazing answer to prayer. I can't get these DEmbies into mah' belly soon enough! ;-)