Been MIA

Wow, I've really dropped off the face of the blog earth! It hasn't been intentional...more that I'm not really sure what to say about things at this point. Thankfully everything has been going well and these days I am kind of on auto pilot. I am about 17 1/2 weeks and experiencing the "boring" pregnancy we were hoping and praying for after the ovarian torsion and emergency surgery eight weeks ago. The baby has looked good on ultrasound and is measuring where it should be. My ovary has also FINALLY gone back to a more human size. I was pretty miserable with morning sickness up until about 14 weeks so I am very much enjoying not feeling rotten all the time. Slowly we are starting the process of planning for actually having this little one in our lives. We've begun searching for child care as I will go back to work full time after 12 weeks of maternity leave. That has been an interesting and terrifying endeavor so far. It somehow seems wrong to be inquiring about care for a child that weighs maybe 1/2 pound right now and won't even be born for five more months. However, our friends with kids encouraged us to start looking sooner than later and we've encountered one or two places with waiting lists for November. We have started kicking around some ideas for names but haven't put any real effort or serious thought into it quite yet. At our 20 week u/s we will most likely find out the gender so I think we will bide our time until then. Part of me feels that after almost eight years trying to get to this point and all of the disappointments and lost chances there just isn't a name special or all-encompassing enough to fit our child. Clearly I'm putting too much pressure on myself. Husband is fond of vetoing but not of suggesting so I will be the one with the books and websites. I'm sensing some lists in our future. That's about all for now. It is gratifying to see a little more snow melting each day. Spring must be right around the corner. :)

This update is overdue

I had my post-op appointment on 1/24. Our doctor was able to pick up the baby’s heartbeat with the Doppler right away. Husband and I were both very relieved to hear the sound. I must say it is pretty incredible what you can hear so early on (just a little over ten weeks at the time). The heart rate was 176 which seemed high to me. Doctor said he was fine with it given that it is the first trimester. That is the highest it has been so far. Trying not to be concerned, but hoping it will be more in the “normal” range the next time we get to hear it. My stomach also got measured, which completely floored me! 10 cm so I guess it corresponds correctly. I lost a little weight from being in the hospital but I still considered my abdominal situation to be more about lack of sit ups (for several months!) than about baby growth or distended bowels as the case may be. I literally thought to myself “he’s measuring my fat!” Pretty surreal. Hopefully things will remain calm for a while now. We have another appointment on 2/8, with an ultrasound to check my ovary size and hopefully the baby, too. I still have to say I’m not sure I really believe that there is an honest to goodness baby in there. I just can’t get my head around it. Is anyone else looking forward to spring as much as I am? I was given a bulb garden as a “get well” gift and I have three yellow flowers blooming so far. It makes me look forward to warmer weather that much more!

Scary Weekend

Thought I would post an update on some recent events. I should start by saying that we believe the baby is fine. An appointment tomorrow with my OB will hopefully confirm this. Starting early Thursday morning I began having severe pain in my back/flank area. Pain to the point of nausea. The OB on call told me to go to the ER and by the time we got there the pain had subsided. The ER doctor ordered an ultrasound of the baby, my kidneys, gallbladder, etc. Baby looked fine and they didn't see anything out of the ordinary with the rest of my organs. Foremost in my mind was my greatly enlarged right ovary (from the IVF), which measured even a few cm larger on this ultrasound than it had before. There was some fluid in my abdomen, most likely from large cysts also on the ovary. I was sent home with Tylenol 3 and something for nausea. The pain came back that evening and husband and I were back in the ER a few hours later. This time it didn't quit and only increased in intensity. I was given IV narcotics, which didn't help much. They admitted me. When my OB saw me he immediately suspected an ovarian torsion. He ordered a doppler ultrasound, which showed blood flow and ruled out surgery. He didn't want to expose the baby to anesthesia, etc., when he wasn't sure he would find anything. After a sleepless and very painful night, my doctor decided he couldn't leave me the way I was and I was taken into surgery early Saturday afternoon. Sure enough, he found that my right ovary had twisted on itself. The blood flow they had seen on the ultrasound was either intermittent or just a little was making it through. He also drained the three largest cysts. I woke up infinitely more comfortable than I had been in days. I am still scared that this could happen again, but I am hoping that the cysts being gone will help stabilize the ovary. My doctor also said he has never had a torsion recur after surgery before. My fingers are crossed that this will hold for me. Today is my first day back at work. I am looking forward to my appointment tomorrow and hopefully hearing a strong heartbeat. I am 10 weeks, 1 day today, and this little one has been through a lot already. Life definitely can throw some curve balls.

Who am I? -or- Me at 9 weeks, 1 day

So it has been a while since my last post. It's tough to know what to say at this stage of the game. Most days I find myself in a bit of a mental battle with myself over believing that we could have a good outcome with this pregnancy. When I get to feeling this way, I feel guilty about posting it here because I know I should simply conisder myself lucky to have made it this far. If this were my first pregnancy, that would probably be a lot easier to do. Instead my mind favors the "guilty until proven innocent" or "don't get your hopes up" approach. I don't want to out myself as a gloom and doom-er, but I guess I just did. I wonder when it will get easier. We had our first OB appointment last Friday and my wonderful doctor was very congratulatory. No u/s, but I guess everything "feels" as it should. The nurse asked me strange and, in my opinion, exceedingly premature questions such as: where are you planning to deliver? and will you breast or bottle feed? Huh? I am just trying to get from one day to the next and hopefully make it to the somewhat safe haven of the 12th week here. Delivery locations and feeding methods aren't even close to being on my radar screen yet. Since I didn't think "I'm infertile, back off" would be a welcome answer, I made up something more normal sounding, with the caveat of "although I haven't really thought about it" tacked on at the end. Up until a few days ago my stomach was feeling pretty rough. As much as I didn't enjoy feeling that way, I am a little uncertain about now feeling somewhat better. I'm even wrestling with calling my OB's office and pleading my case as a recurrent miscarry-er in the hopes that they will take pity and schedule me for an ultrasound. I think IVF pregnancies should automatically come with scans about every other week to soothe wraught nerves. If my minimal google searching can be believed, morning sickness does seem to come and go for a lot of women. No other signs of worry have presented themselves so the battle wages on. Things are fine...no they're not...YES they are. Time will tell, but in the meantime I will keep telling myself to breathe.

7 weeks, 3 or 4 days

Today was ultrasound day. When the picture first came up on the screen, both husband and I thought all hope was lost. We couldn't make out much. I don't know what we were expecting to see, exactly, but in my mind it wasn't so fuzzy. RE started pointing things out and we slowly began to realize that indeed, things looked fine. I even managed to see a tiny little wiggly heartbeat all on my own. Unbelievable. Despite the fuzzy image, we seem to have the right size gestational sac, yolk sac, and fetal pole, with aforementioned heartbeat at 159 bpm. The baby is measuring 7 weeks, 3 days and today I consider myself 7 weeks 4 days. I'm not sure which one to go by now. I've heard that the early ultrasounds are the most reliable way to date a pregnancy, but RE only measured once so I don't know about margin for error, etc. All in all we are very relieved and mostly in a state of disbelief. We know there is a LONG way to go. Our first OB appointment is a week from today. The other thing the u/s showed is that my right ovary is still in a scary size range. The left one has gone down, but the workhorse on the right is being stubborn. I am to avoid any and all activities that could "break" it so more laying low is in my future. I also learned that I am likely the highest E2 my RE has ever triggered. How I managed to avoid OHSS/symptoms is beyond any of us. I just got the call about my progesterone, which is still greater than 60. No more shots for us! Whew!

6w3d

...and all seems well as far as we know. We are in a bit of a no man's land as far as this pregnancy goes. Our next ultrasound is one week from tomorrow and in the meantime it is what my RE called "auto pilot." I've never been on auto pilot before where a pregnancy was concerned. I have always been the blood draw/monitoring/scary spotting/impending doom type in the past. Not quite sure what to do with myself during the waiting other than to try to keep at bay thoughts of bad things. In my line of work I have access to ultrasound and I know a few techs who would be happy to take a look for me...as one was kind enough to do right before my last ectopic was diagnosed. It is difficult to sit quietly and not plead for a favor right now. However, I know the most prudent thing to do is wait (I hate the "w" word) until January 4th and let the RE see what he sees. Husband is adamant about this, too. At least the holidays have kept me somewhat occupied. We were with my family over Christmas, 16 of us in total, at my parents' house. Save my youngest sister, no one is any the wiser about our situation. I'm starting to feel rather yucky rather frequently, but thankfully nothing obvious while we were there. At my last appointment my acupuncturist told me that in her experience a high progesterone level tends to mask some of the early pg symptoms. I'm crossing my fingers that this is the case for me. I'm not a puker at all - it has been close to 13 years (I keep track) since I last threw up - so I'm also hoping this helps predispose me to NOT getting sick in that way. Food is a little iffy right now. Sugar doesn't appeal to me and I have a major sweet tooth. I passed on all manner of Christmas goodies. I guess these are the things in which I am strangely taking comfort in the absence of any concrete evidence that things are progressing as we hope they are. One day at a time. I hope everyone had a lovely holiday! Happy new year in advance!

A quick peek

Our first ultrasound appointment was yesterday. RE was very frank about the fact that we "wouldn't see much" this early (about 5 weeks 1 day). We were really just there to make sure our embryo hadn't gone for a swim up one of my tubes. Yes folks, IVF isn't a sure fire remedy to avoid ectopic pregnancy. Thankfully we saw a gestational sac right in the middle of my uterus. It apparently contained the beginnings of a yolk sac, etc. RE didn't spend too much time on it other than to measure it and tell us that it looks to be an appropriate size. He spent much more time on my ovaries which are still large - the size of cheap grapefruit or expensive oranges according to him - and some free fluid adjacent to one of them. We were told it could take another month for them to shrink down again. They drew a progesterone level and I am waiting to hear the results and further instructions for shots. RE thinks my ovaries are probably cranking out quite a bit of progesterone on their own so we may be getting a shot reprieve sooner than later. Our next ultrasound is scheduled for 1/4/08, which seems like a lifetime away. At that point if we are lucky enough to see a heartbeat we will be released to our OB. As of now I am feeling fine...maybe a little queasy here and there but nothing that really gets my attention. The staff at RE's office was smiley and congratulatory toward us and while we appreciated the sentiment, husband and I are realists and battle worn skeptics so we are uncomfortable with unbridled happiness or excitement at this point. I'm sure (if things continue to progress) it will take a good long while before we can let ourselves feel positive emotions about this pregnancy. However, we definitely feel fortunate to have gotten to this milestone, and more than a few sighs of relief were breathed and thankful prayers were said when our appointment was over.

***update: my progesterone was greater than 60 so we are to cut back on the shots to every other day. Yay!

Thoughts of dropping shoes and other ramblings

One of the curses of the infertile, and certainly anyone who has experienced pregnancy loss too, is the inability to trust or believe that a pregnancy will ultimately work out. I am living this curse right now. I am so happy to have had a successful IVF cycle, and I have more reason to be optimistic about this pregnancy than I ever have in the past. We have a known good quality embryo, my numbers look good, and I haven’t had any spotting (I hesitate to even type this for fear of speaking too soon). These are all encouraging signs. At the same time, I am a six-times-bitten individual and when you have had the proverbial rug yanked out from under you that many times it takes the hugest leap of faith to even entertain the thought that we may have a healthy, lasting pregnancy this time. I consider myself a faithful person. I know God is the captain of this ship and the outcome of this is definitely not in my control. I am praying that things work out for this little one. One of my favorite movie quotes is from Rudy: “praying is something we do in our time…the answers come in God’s time.” I hope this is THE time. I have been experiencing cramping off and on. It seems to be more noticeable the last day or so. I don’t know what to make of it. I think cramping can be normal in early pregnancy as things get situated in there. I have also known cramping to be the beginning of the end for a few of my pregnancies. The fear of it makes me want to rest and not move. Then I tell myself that if this pregnancy is healthy and destined to continue, a walk through the skyway (Minnesota winter) to grab lunch isn’t going to be its undoing. I am finally getting over an eye virus, which at first appeared to be pink eye but was re-diagnosed by my ophthalmologist when it didn’t respond to the drops provided by my family practice doctor. We are going to visit husband’s family this weekend in the Milwaukee, WI area. If we are lucky and things continue to progress, we won’t be sharing our news with anyone until a lot further down the road. Our families and friends have been through too much heartbreak with us to make them sweat things out yet again. It would be so amazing to announce an impending grandchild/niece or nephew when we can be reasonably confident that it will come to fruition. Plus, it is easier to not have to talk about things now if we don’t want to. So this weekend we will be mum. We are having the traditional Italian Christmas Eve feast early, as we won’t be with them on the day, and I hope no eyebrows are raised when I politely decline any wine. Knowing me and our issues as many years as they have, though, I don’t believe they will go there. In closing, I will do my absolute best to stay calm and think positively for the next few days. I so badly want to make it to the ultrasound on Tuesday with hope intact. It would be a huge milestone for us.

Another step forward

We finally got the results of our second beta. Today we are at 353. Relieved and thrilled are both understatements. We know there is a LONG road ahead but we are happy to be on the journey. They aren't having me come back on Friday, for which I am thankful. In past pregnancies we have never had good news from a third beta. I am not superstitious, but I think I will do better to just relax and trust that things can be different this time instead of fretting over phone calls and numbers. There is nothing I can do about it anyway so in and out I breathe. Our ultrasound will be on Tuesday afternoon. I know there won't be a chance of seeing much, but something, anything in my uterus would be cause for happiness. And a milestone we haven't before reached.

Praise God!

I just received the call from my RE. I am officially pregnant, with a beta hCG of 157. The sound you are probably hearing right now is me exhaling. Try as I might to remain calm today, I have been on pins and needles since the band-aid went on my arm. We repeat the beta on Wednesday, with an ultrasound to follow next week because of my history of ectopics. My estrogen was on the high side so I am to discontinue my patches. My progesterone was also high so I had the choice to cut back on the injection amount or switch to suppositories. I opted to stick with the shots because if it ain't broke, don't fix it. Thanks to everyone for their comments and support. I so appreciate it! Now I'm off to repeat my latest mantra: "just relax, your body can do this."

A new day...

...and a new pee stick. I am amazed to be reporting that this one appears positive. The faint line of yesterday that I whole-heartedly discounted may have been something after all. Today's showed up more quickly and is definitely darker...visible without squinting or turning the test toward the gamma ray producing mega wattage bathroom light fixture bulbs. I am stunned. When I told husband he hit me with the classic Dumb and Dumber line "so you're saying there's a chance." I guess we do have a chance after all. A very long way to go, yes, but a glimmer of hope nonetheless.

Step away from the ledge

Yesterday husband had to talk me down. I was driving home from work and I casually mentioned that I was planning to make a stop at Target for some essentials...shampoo, deodorant, HPTs. He immediately and strenuously objected, much to my suprise. I am 5dp5dt today, or 10 dpo. If there was something to see, I think I could have seen it this morning. He was having none of it. He wants to wait until Saturday. Now I'm not a pee stick freak. I have had my fair share of run-ins with them, but in all the time that we have been trying and with our multiple losses, it has been inevitable. So here I sit, 3 1/2 days away from my beta (I would say 4 days but it is early on Monday morning ;)and I am itching to know. That is the type of person I am. Be it good news or bad, I like to be let off the hook. Husband admitted that he, on the other hand, prefers the ignorant "bliss" of not knowing for as long as possible. How or why he thinks this is pleasant I don't know. He is so NOT ready to know, in fact, that he volunteered to make my Target run for me. He even bought me the mascara I needed (with cell phone guidance provided by me, of course). I am currently bargaining with him that since I wanted to test today and he wants to test on Saturday, that tomorrow is a perfect compromise. He said we'll talk about it tonight. :) I have acupuncture after work so I will most likely be in a very zen and "come what may" mindset for at least a few hours. Then the battle of wills will likely be on again.

2dp5dt

OHSS symptoms thankfully did not make an appearance and we were able to transfer on Saturday morning. One blastocyst was transferred and according to the RE who did the procedure, all went as planned. Having never done this before, we were in awe of the whole process. I am fairly convinced that my valium was a placebo as I swear I felt no different on it than I normally do. I may have been a TAD more relaxed but nothing notable. I admit I was sort of looking forward to a nice hazy calm settling over me during the procedure and for several hours after. No dice. We drove home in the first stage of a pretty big snowstorm. It was a good thing we got out of there when we did. As it was, we saw some cars in the ditch. I took up residence on the couch and let husband bring me food and beverages. My 48 hours of "bed rest" is officially up so I am catching up on a few things. I feel like I've been out of commission forever because I have been laying low since the retrieval. It feels nice to be up and around and at least visualizing being productive. As for frozen embryos, at the time of tranfer there were four other blastocysts that they were planning to freeze. They were going to look again on Sunday and freeze any additional blasts. We haven't heard the final number yet. I've been kind of crampy both yesterday and today which is most likely a side effect of the progesterone. The shots are going amazingly well for how unfamiliar with and nervous about the whole process husband was. So we wait. I still need to schedule my beta, which will be on 12/10. If I know me, I will probably sneak a HPT on Friday or Saturday. Until then, just feeling fortunate that we have made it this far.

Fertilization report

Husband got the call today. The lab called my work number first but moved on to his cell phone when I wasn't there to answer. So things look like this: out of 23 eggs retrieved (one more than we thought) 16 were mature. Out of the mature eggs, 13 fertilized. We should get another update on Friday, along with a transfer time for Saturday provided that I have been able to fend off OHSS until then. They also mentioned transferring on Sunday depending on how things look. Husband and I don't know what to think. Part of that whole "hoping for quality not quantity" was about not having so many embryos...not more than we could ultimately use. Granted, with no idea as to what their quality would be or currently is, it is hard to say how things will look in another few days. Six previous losses means something is wrong but is it the embryos, my body, both? We realize that putting back a good embryo is no guarantee of a healthy pregnancy. So we will wait and see and I will continue to rest and not worry about what I can't control. Thanks to everyone for their well wishes and encouragement. They are greatly appreciated!

What a difference a day makes

When I last checked in, things were looking the way we wanted them to look. My body wasn't going crazy, we had follicles but a modest number, we were almost there and I was happy. Saturday brought another monitoring appointment. Follicles had increased to about 12 - 13 mature. I returned home and eagerly awaited the phone call that would give me my trigger shot and retrieval instructions. The phone rang, but instead it was my RE calling to explain that my E2 level had unexpectedly jumped from the day before and was now in an uncomfortable 4000+ range. Our options, he expained, were as follows.

1) To cancel the cycle completely - no trigger shot - and let my body simmer down. However, as we had been conservative and hadn't pushed too hard with stimulation he couldn't guarantee that the same thing wouldn't happen on a subsequent cycle.

2) Trigger as planned and retrieve the eggs, watch me closely for symptoms of OHSS and if they are mild or if none develop, transfer one embryo.

3) Same as option 2 but if symptoms are moderate or severe, freeze all embryos and do a frozen embryo transfer at a later date when I am back to normal.

After some careful thought we decided to go ahead and trigger, with the understanding that we would take all preventative measures possible to mitigate OHSS: rest, fluids, protein, and something in my IV during retrieval to start the protein/fluids situation moving in the right direction. Retrieval was yesterday at 8:30AM. Everything went well. I was, however, shocked to learned that they got 22 eggs. We don't yet know how many of them were mature...I'm guessing that several probably weren't but I also know that my guesses really mean nothing when it comes to this process. We will hear tomorrow from the emryology lab to see how things are going. I have been a good little patient and have camped out on the couch drinking protein shakes and "resting my pelvis." I was told the less friction the better. I'm not sure exactly what causes friction but I am limiting any and all movement just in case. It wasn't in my plan to take several days off of work after retrieval, but I am more than determined to stay feeling good if at all possible. Our RE has recommended a day 5 transfer from the beginning due to our recurrent losses and this is still the plan if we end up transferring at all. By Friday we will guage how I'm doing and make a decision. I guess we could call this a detour on our route but still with the hope that we will eventually reach our final destination.

...It's The Destination

“Serenity is not freedom from the storm, but peace amid the storm” -Unknown

Still moving forward and taking things one day at a time. My wish for this cycle was to be conservative and aim for quality over quantity. Since at least part of our problem has been ectopic pregnancies, we have no idea what to expect if we actually get a healthy embryo in the place where it belongs. That, coupled with my tendency to respond with gusto, has made my RE treat me with kid gloves. Thankfully it looks like we are getting results that we are both happy with. As of this morning's ultrasound it looks like I will do my evening meds tonight, my morning meds tomorrow, and trigger sometime tomorrow. Retrieval will be on Monday. This is pending today's E2 results, but as long as it hasn't taken a drastic jump we should stick to this schedule. I have another ultrasound appointment tomorrow morning, too. I feel like we can see the station up ahead...just a few more stops now. I keep reminding myself that ultimately this isn't in my control. I read Randine Lewis' "Letting Go" meditation last night before bed and it helped reaffirm my understanding that I have done all I can do by following my doctor's instructions and doing my injections faithfully. Beyond that what will be will be.

Chugging Along...(updated)

Live in the present. Do the things that need to be done. Do all the good you can each day. The future will unfold. -Peace Pilgrim

I thought the above quote was fitting for today. It is day 5 of stims and so far I think we are on track (trying to see just how far I can take this train metaphor. :) I had my first ultrasound to check follicles this morning. Don't remember the exact counts and sizes but I know I had six measurable ones on the right, with about 10 small ones. One of the measurables was pretty large and it will probably end up being the odd one out as we wait for the others to catch up. I think there were about three measurables on the left with about 15 small ones. My lining was at 7.3. I haven't been asking my E2 numbers because I think less knowledge is sometimes better with me. The less I know the less I can drive myself crazy analyzing. I do know that My E2 on Sunday was in the 300 range. My RE dropped my follistim dose to less than half of what it had been, which seems to have been his plan all along. I am waiting to hear from my clinic to find out the plan for my next u/s. As it stands now I would go in on Thursday/Thanksgiving. There was some hemming and hawing about this between the nurse and front desk staff so I will get the final word later today. It's possible they will have me come tomorrow and Friday instead, but ultimately it is my RE's call. So I'm chugging along...feeling pretty good and managing not to obsess about the details so far. Due to the aforementioned appointment schedule we will be spending a quiet holiday at home, just me, husband, and stepson. Much easier than traveling to any of our families' homes and trying to juggle schedules, injections, and excuses as nobody is aware of our current situation. We're keeping it simple. Wishing all of you and yours a happy Thanksgiving!

Today's estradiol is 853. Not really sure what that means but I guess they are happy with it.