On Friendships

I have a friend (IRL) who also suffers from RPL. Though she didn't need IVF to conceive, we bonded over beta hcG's and progesterone levels and the devastation of early loss after early loss. She, like me, has suffered 3 miscarriages  - though all of hers were in the past year. I was over the moon to learn last week that she was expecting again, and had made it all the way to nine weeks! We were due within weeks of each other. I was left speechless when she told me yesterday that she was measuring three weeks behind, and that her baby had no heartbeat. Her last words to me as I hugged her neck yesterday were concern over me, and reassurance that she was continuing to keep everything crossed for my success. 

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I have another friend who conceived fairly easily. We bonded over her early days of TTC, and she did absolutely everything right when she got pregnant with her first. She bent over backwards to consider my feelings, never treating me awkwardly, just waiting for me to ask about the baby. She is pregnant again, without even trying, and due a month before me. She continues to be considerate and kind and oh-so-hopeful for me, without ever being preachy or a "know-it-all" about baby things that I have absolutely no idea about. 

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Mo's best friend and his wife have become our biggest cheerleaders in recent years. They conceived their two beautiful and brilliant children easily, though they suffered an early loss in between. They put us up whenever we roll into town for doctor's appointments, and lend us their children whenever we want. Their babies call us "Aunt Jo" and "Uncle Mo", even though we aren't related. They are our chosen family, and I feel so lucky to be a part of their lives. 

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My sister's route to parenthood wasn't easy. It took several years and some intervention before she was blessed with her two girls. My sister will always listen to me bitch about infertility, and has consistently supported me throughout the trials of trying to build our family. She refrains from judgement and is able to put her personal views aside in order to celebrate my happiness. She is an excellent mother, and a better friend than I ever imagined growing up. 

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Over the years, I've developed these unexpected friendships with (mostly) fertile women through no real effort on my part. I consider myself fortunate to have people who can overlook my jealousy, who have forgiven me time and again for being unable to celebrate their joyous news. They have treated me with kindness and compassion even when I have been unable to reciprocate. They have loved me through my pain, never ignoring it or brushing it aside, but acknowledging it and, eventually, helping me to heal. 

Online, I have a plethora of bloggy friends, with similar histories, and the connections I've made have quite literally saved my sanity over the years. But it's different IRL, where people don't know the lingo and are often thoughtless and/or careless with their words and actions. 

I am far from a perfect friend. Some days, I'm quite lousy. Infertility, and more specifically loss, has taught me a little bit about how to support others - but I'm not always able to do that in ways that they can understand.  I'm better with tragedy than I am when things go right. I am so very, very lucky that, in spite of that, I've managed to find a small group of souls whose brightness helps to lighten the darkness of this journey. 

Every infertile gal should be so lucky. 

Another Hurdle Cleared

Despite my frantic worrying and obsessive googling, today's ultrasound showed one beautiful baby growing right where he/she should. The CRL was 9.4 mm, which is spot on for almost 7 weeks, and the heartbeat was a-thumpin' at 148 bpm. 

We've got another peek planned for next week. I am trying -oh! how I am trying! - to believe that things will continue to progress as they should. 

I have wanted for so long to be pregnant that I feel guilty wishing the weeks away. But after so much loss and heartbreak, I just don't know when I will start feeling "safe." If I could fast-forward to March and have my baby in my arms, I would. Since I can't, we'll just take each day as it comes. 

Keep growing, little one! Momma loves you so much. 

3...2...1...

Three. More. Days. 

That's all I've got. Three more days until I can either breathe a sigh of relief (for now, anyway) or.....let's not even discuss  the alternative. 

Today was a bit better. I managed to keep myself distracted for most of the day. I ran some errands, worked on some stuff for school, cleaned the kitchen. Anything really to keep me from thinking too much about things I cannot control. 

Thank you for all of your supportive comments. I feel whiny and ungrateful when I express my anxiety, but getting all of my fears out in the open really seems to help.  As does going back and re-reading some of my posts from Pregnancy #2. (It's amazing what you can forget in three years.) Turns out I did have some ominous hints of what was to come -- there was spotting, and even some bleeding, that I had somehow  blocked completely from my memories. I've had none of that yet (knock on wood!) and that gives me some hope. 

I keep telling myself that THIS pregnancy is different. That we are doing / have done everything we can to give this embryo the best shot possible. That THIS time, I'm going to make it through the first trimester and, eventually, bring my baby home. 

And for a few brief snippets of time, I almost believe it. 

Anxious Isn't The Word

*Warning: This post may contain material offensive to those still in the trenches. If you don't want to read an infertile crazy-person bitch about pregnancy, feel free to skip this post and come back later. No hard feelings, I promise. 

Pregnancy after IF is hard. Pregnancy after IF and RPL is ridiculously hard. And yes, I'm well aware that I am still "barely" pregnant, and that the hard stuff is yet to come. But seriously, I think I'm losing my fucking mind. 

I am so, so anxious. And scared. Scared doesn't even begin to encompass how I feel. I am terrified. I wake up worried, and go to sleep exhausted from fear. I can put it off intermittently throughout the day, but since my days right now consist of naps, blogs, Candy Crush, and Google -- well, you do the math. I'm so ready to go back to school (two more weeks!) just to have something else to occupy my thoughts during the day. 

I'm just over six weeks, which is an accomplishment in itself. My first and third pregnancies were over by now. So, in theory, I should be breathing a sigh of relief, right? I'm not bleeding, or cramping, and I still have some, albeit mild, symptoms. I should be able to assume that good things are happening. It's that second pregnancy, that missed miscarriage that I never saw coming, that continues to fuck with me three goddamn years later. 

I had no signs that one had ended. A tiny amount of spotting, then nothing. No cramps, no bleeding. The nausea continued full-force, up to and including the day that I learned that my baby no longer had a heartbeat, and had died weeks --WEEKS-- earlier. 

How do I know that this one is any different? I don't, and that's why I'm so freaked out. I don't trust my body to do what it should, whether that's in regards to maintaining a pregnancy, or recognizing that it's over. 

I've tried so hard to maintain positive thoughts. I've visualized a successful ultrasound a thousand times. I've imagined bringing my baby home in the spring. I've started researching baby wearing and co-sleeping and trying to decide what we might need to purchase in the coming months. I'm TRYING, really and truly I am. But I just can't shake the fear. 

I had a pink tinge the other day - very, very, light, and just once. It hasn't recurred, despite excessive TP checks and way too thorough analysis of my nether-regions. It is probably nothing more than my cervix being irritated by the progesterone suppositories. It's likely FINE, but it's amazing how quickly my brain just goes, "Okay, that's it. It's over." And then I spend HOURS looking for reassurance, which absolutely no one can give me. Because it's either going to be fine, or it's not. And no one, no expert or anecdote, can tell me which one it's going to be. I simply have to wait and see, and that my friends, feels like pure torture. A torture that is guaranteed to last at least six more weeks, if not longer. 

(And I know you mean well, but please don't suggest an early ultrasound. At this point, a heartbeat may or may not be detectable, a gray area that I don't want to subject myself to if I don't have to. I'd rather wait a few more days until we can be sure of what we should be seeing.) 

Even as I write this, I debate whether or not to post it. No one wants to hear a preggo complain, least of all those of you still struggling so hard to get here. And while I don't believe in a higher power directing this pregnancy, there's a primal, superstitious part of me that doesn't want to jinx things by making my fears concrete, by giving them more footing than they deserve. I WANT to relax, and I want to enjoy this time. I really, honestly do. 

I just don't know how to make that happen. 

I told my sister today that if I lose this pregnancy too, I will positively lose my shit. 

What I didn't tell her is that I feel like I already have. 

Fine, Fine

Everything is fine. Thank you for the reassurance yesterday. I did call the clinic, and my nurse called me back to reassure me that everything is fine. She even ran it by Dr. Expert and he wasn't concerned. She didn't give a very clear explanation, just that levels are very inflated after retrieval and tend to level out over time. (I did find out that the check progesterone at transfer to make sure it's high enough to support implantation). Oh, and I found a fascinating study that showed a higher progesterone level at transfer leads to higher pregnancy success. Interestingly, high progesterone prior to transfer has the opposite effect, so much so that some RE's will cancel your cycle if your progesterone is too high (over 2) at retrieval. I assume mine was fine, and can only hope that the "leveling out" of my p4 doesn't mean that miscarriage is imminent. So, in short, I'm as fine as I can be while alternating between gleefully reminding Mo that We Are Pregnant! and becoming convinced that Doom is lurking just around the corner. 

I like to think I'll feel better after our ultrasound in a few weeks, but the truth of the matter is that I don't know if I will be able to breathe until the end of the first trimester, at least. And even then, there are no guarantees. 

Yet another thing that infertility and loss has stolen from me: the ability to assume that everything is fine until proven otherwise. 

In fact, for me, it seems as though it's quite the opposite. 

Too Much Information?

So, I called Dr. expert's office today, just to make sure they got my progesterone results over the weekend and to move back my ultrasound date by a few days (Mo is unexpectedly leaving town that weekend and is coming home Monday, making it difficult for him to be there). I got a quick call back from the scheduler who easily moved my appointment and said that yes, my results were in, and my progesterone was a 48 so all was good (my clinic wants to see them at least at 25). 

Hold up, what? 

For the record, my progesterone the day of embryo transfer (the last time we checked) was 151. 

WTF? 

I asked Miss Scheduler if that kind of drop was normal, and she just kind of hemmed and hawed and said it was fine. And I was kind of shocked, but at the time told myself to relax and stop over analyzing things.  If they weren't worried, why should I be? (I am currently on 1cc of PIO and 2 vaginal suppositories of 100mg each daily). 

Breathe. 

Google. I'm sure this has happened to someone before, right? 

Only, not according to Google. I can't find any evidence of 1) anyone even checking progesterone pre-transfer on a fresh cycle, or 2) anyone ever having a drop of 100 points. Ever. Regardless of outcome. There are a zillion posts about minuscule drops of less than 10 points, and five zillion more about low progesterone, but none that I could fine where a persons levels fluctuated THIS MUCH. 

I am a medical freak. 

(I did find one website somewhere that showed the conversions between nmol/l and ng/mol, and I am wondering now if that's all this is. I did have two different labs runs the bloodwork (though both Lab.corp), so perhaps they used different units? In which case my p4 is holding steady and right in range.)

I've decided to go ahead and be That Patient and am calling the clinic back in the morning. I want to talk to my regular nurse and have her explain how in the hell my numbers could drop so drastically when we've actually ADDED progesterone suppositories since beta. (And yes, I know that the supps don't show up in bloodwork. But, my PIO has remained the same and my levels should not have dropped so significantly.) And I want to know how often they have seen this, what it means, and what our outlook is. I know that low progesterone is an easy problem to fix, but mine isn't exactly low.  But what, I mean really WHAT could cause such a huge drop? And am I just fooling myself thinking that things could possibly still be okay? 

Has anyone else ever seen or heard of anything like this?

Cue: The Panic

I have no real reason to suspect that my super-early pregnancy has gone belly-up, other than, of course, the fact that all three of my previous pregnancies went belly-up, so why would this one be any different?

I wake up every morning and have to remind myself that This Pregnancy Is Not Doomed.  It's harder than it looks, though, friends.  If I have cramping (and I've had some pretty wicked cramping), then obviously it's because I am about to miscarry.  If the cramping eases up (as it has these last few days), then obviously my baby has died.  I feel slightly nauseous most of the day -- but I had morning sickness the day of my ultrasound that revealed I had been toting around a dead fetus for upwards of two weeks already.  I am dead tired and my boobs feel like bricks, but both of those are side effects of the ridiculous amount of progesterone coursing through my body.  The mindfuckery is endless, I tell you.  Endless and monotonous and dark.  

In short, I want to believe that This Time It Will Work.  I want to be happy and positive and start thinking about names and nursery colors and how this time next year I'll be joyously posting pictures all over FB of my adorable newborn. Unfortunately, my experience thus far has been fleeting joy over positive pee sticks / rising betas followed by bleeding/crappy ultrasounds.  And, much like I find it nearly impossible to believe that people actually make babies by having sex (it sounds odd, doesn't it? they swear its true), I am also finding it nearly impossible to believe that we are actually going to get a baby out of this.

I want rainbows and unicorns and birds singing about the miracle of life.  Instead I get hourly TP checks and symptom over-analysis and way, way, too much Dr. Google.

I know practically everything there is to know about getting pregnant.  I just wish I knew how to stay that way.

The Result

I am pregnant. 

Again. 

Beta #1 (at 8dp5dt) was a 71. This doubled nicely to 187 at 10dp5dt. (That's roughly a 34 hour doubling time. Woohoo!) 

I wish I could say I refrained from the pee-stick madness, but you all know me better than that. I started testing at 3dp5dt, hoping to establish a negative so that I could test for real at 7dp5dt. Only the FRER didn't cooperate and remained positive. As did the Internet cheapies I dug out from under my sink the next day, and the FRER again the day after that. The lines kept getting darker (after sending Mo out to buy more sticks, of course), but somehow I managed to hold out until beta before busting out the CBE digital. 

My first u/s is scheduled for July 29th, and I am anxious to see what's going on in there.  Right now I am most worried about my TSH level, which was 3.7 two days ago. I had already increased my levithyroxine (from 75 mcg to 100 mcg) at embryo transfer, so my RE says not to worry and they will check it again in a few weeks. Still, I am anxious, as I attribute some of the reason behind Miscarriage #2 to not increasing my dose early enough. There are conflicting stories in the interwebz, so any reassurance will be most welcome. 

I am trying to put some stock into the fact that these are the best numbers we've had yet, and that I am doing everything possible to make this successful. There are just so many hurdles to be crossed, and it seems like each time there is something new to worry about.  So much for The Zen, right? 

Please stick around, bab(ies). You are much-longed for and already so, so loved.

The Stats

IVF#3

15 eggs retrieved

13 mature

11 fertilized via ICSI

6 made it to blast (holy shit!!!) 

2 transferred

4 frozen 

Transfer was smooth as could be, and I loved the way Dr. Expert told me as he finished, "You are now 2 1/2 weeks pregnant. On (beta day), you will be four weeks pregnant." That positivity, that thisisgoingtowork mentality, is exactly what I needed to hear. I don't know how much positive thinking really influences the outcome at all, but I am resigned to the fact that I cannot prepare enough for this NOT to work. I will be crushed, no doubts about it.  And so I am going to enjoy it in the meantime, as much as I can. And right now, with nothing but hope and possibilities before us, that's easy. I am brimming with optimism and the SIX freaking blasts we got out of this cycle. I am under no illusions that my positivity will waver, but for now I am the most relaxed and confident I've been in a long time. I'm taking it easy, enjoying Mo's pampering and extra puppy snuggles. 

My sister put together a goody-bag for me with small gifts for each day from transfer to beta. Something to remind me that I'm not in this alone, to lift my spirits and keep me distracted. Which is beyond awesome, and makes me smile every time I look at it. I open each gift with great ceremony, and look forward to the next day's surprise. This feels good, and I am in no hurry for it to end. And so I've (mostly) stayed away from Google, and far from those wretched pee-sticks.  They can't tell me what I want to know anyway, which is whether or not my beautiful blastocysts are snuggling in for the long haul. Only Time will tell me that, and she's not in any particular hurry, it seems. 

And so we wait. 

And we hope. 

Again. 

I'm Not Obsessing

Really, I'm not. I prefer to call it "analyzing." Predicting, even. But obsessing? 

Just because I like to know my numbers --all of them--and I like to compare them to previous cycles doesn't mean I'm obsessing. 

Just because I google "follicle counts during IVF stim day 7" or "endometrial growth per day" or "success rates third time IVF" after every appointment just means I like to have information--the more, the better. 

I tried explaining this to Mo yesterday. I know that I can't control the outcome of this cycle. I can't control how many follicles grow, or how thick my lining gets.  I can't control how many eggs get retrieved, how many fertilize, or whether or not they implant. But, somehow, knowing what's going on gives me a sense of control -- even if it's a total illusion. Knowing my numbers doesn't stress me out -- it's not knowing that makes me crazy. Even when things aren't progressing like I wish they would (just 9 follies? Lining at 7.7 mm?), KNOWING is better than not knowing. 

We've had several minor non-events this cycle, including a cyst at baseline that had to be aspirated, missing e2 levels from a local Labcorp, slow-to-respond ovaries, and running out of meds while out-of-town. I have tried --oh, how I have tried! -- to roll with the punches and not to freak-out. But, I will admit, this IVF is consuming a little more head-space than I wanted it to.  I am 95% certain that tomorrow's appt. will be our last before trigger, and I am incredibly nervous. I know exactly what to expect, and I know exactly how little control I really have. 

And so I google, and I analyze, and I hope for the best. 

Obsessed? 

What IVF patient isn't?