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Betas 3 and 4

I haven’t had much time to write. Thursday night we ended up in the ER (then admitted) because Riley had some trouble breathing (breathing fast, neck and sternum retracting, grunting on the exhale, a little wheezing) in the setting of a virus. She’s doing much better and we were discharged after less than 24 hours, which is awesome. But we’ve been a little under water over here.

Anyway, quick update re my ever perplexing betas.

Recap/update:

  • 11dp5dt (16dpo) – 78
  • 13dp5dt (18dpo) – 134
  • 15dp5dt (20dpo) – 239
  • 17dp5dt (22dpo) – 471

Those doubling times are slowish, but all technically within normal limits (less than 72 hrs), and have increased slightly each time (went from 61.5 hrs to 57.5 hrs to 50 hrs). That said, they’re all totally lower than what is normally expected.

Today, my nurse said that everything is still within normal but that they’re a little concerned about the lower numbers. The plan is for another blood test Tuesday, then ultrasound on Thursday or Friday.

My only “symptoms” thus far are sore boobs (obvi because progesterone to the max) and a decreased appetite. The appetite thing is significant enough to feel like a real symptom. I’ll keep updating here as the week progresses. For now, I’m going to play Mr. Potato Head with my kid. Happy Sunday 🙂

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Beta #2

My HCG today is 134. That’s a doubling time of 61 hours. Not exactly what I was hoping for but also not out of the game. I feel like I’m playing a borderline game over here … I’ve read a couple of studies that basically stated that 74 is the cut off for what you would want to see at 11 days past a frozen embryo transfer. Mine was 78. Also I know they are looking for the number to double every 31-72 hours but I also know that most people would see those numbers at least double in 48 hours. The nurses have reported my numbers in a positive way each time – saying it’s a good number or a good rise. Today when I probed further, she said it was okay and we’re just going to keep an eye on it. I guess it feels like just a slightly more fragile pregnancy.

Overall, my initial emotion when I got the phone call today was relief. I’m still in the game, the numbers aren’t trending downward (which I feared), and they are still “in normal limits.” I go back again on Friday, and I’m guessing they’ll keep having me come back every other day until I get to at least 1,000 so they can schedule an ultrasound.

I’m still hopeful and also still nervous – my anxiety of low-ish/lower than expected numbers is all mixed in with my anxiety about my last pregnancy and everything we went through with the miscarriage and weird betas. I’m still pregnant and still having a hard time being excited about it. That said, despite all of the mitigating circumstances, I am pretty sure I felt the exact same way the first time around during my perfectly normal pregnancy with Riley. I’ll just be here biting my fingernails until Friday. Here’s hoping for some better news 🙂

Beta HCG #1

I just got the phone call with my first hcg level for this pregnancy. The number is 78. I KNOW that that number indicates pregnancy, and I hate that my heart sank a little when I heard it. I am trying to not be such an anxious ball of human – whatever happens is going to happen – but my first beta with the pregnancy that is now my living child was 306. To be fair, I do think it was a day later (12dp5dt as opposed to today, which is 11dp5dt). I’m also comparing this to my most recent cycle/pregnancy that resulted in a miscarriage. At 12dp5dt, my beta was 127. You guys, I honestly know I need to quit it with the comparing. Why am I even doing that?!

Positive signs: I have not had any cramping or bleeding. I also have totally been noticing early pregnancy symptoms, which is probably weird/maybe I’m just seeing what I want to see … but my appetite is way down, I have zero desire to be anywhere near red meat, and I’ve been falling asleep much earlier than usual. I know it’s a little early to be feeling those things, but I felt them with this most recent pregnancy this early as well. Maybe it’s just how my body reacts to hcg? Possible negative signs: The number is a little low (but maybe it’s not and that’s just my perception – I’m not a doctor). Also, the progesterone support could be maintaining a pregnancy that may not have continued naturally in a different world where I didn’t do IVF.

So, for the next day and a half I will be twiddling my thumbs and trying not to be an anxious ball of human. I appreciate any good vibes y’all have to spare. And any stories from the trenches with similar beta hcg numbers! Happy Monday.

 

Cautious optimism

I’m definitely an awful blogger. Here’s a bulleted list of all of the things I should have blogged about between my previous post and now:

  • I went in every few days to test my estrogen levels leading up to transfer. At some point, they increased me from 4mg of estrogen per day (2 pills in the morning by mouth, 2 in the evening vaginally) up to 8mg per day (3 in the morning by mouth, 3 in the evening by mouth, 2 in the evening vaginally). That seemed to do the trick as my numbers didn’t raise any red flags.
  • I started on 1cc of progesterone in oil on the very first day (Friday May 25), then up to 2cc every night since then. I was visiting my family in Ohio that weekend without my wife, so my mom had to give me the shots, which was a little weird. Definitely not a bonding moment we’ve shared before. She was a champ about it though.
  • My progesterone level was tested on my transfer day (May 31), and was apparently fine. So that’s good.
  • Overall meds have been stable since the 25th: estrogen in the morning, Metformin, estrogen (vaginal), estrogen (oral), low dose Aspirin, and progesterone in oil (2cc) in the evening.
  • They transferred a 4BB embryo (frozen) on May 31st. I think the transfer overall went well. I wish the embryo was graded a little higher but I know that 4BB is totally acceptable. I’m an all-A’s kind of gal, so a B in any form has me worried lol.
  • Over the past 4-5 days or so, I’ve had increasing issues with the progesterone shots. I feel like the progesterone in ethyl oleate has been much more difficult for me overall – my injection sites have been much sorer the next day than I recall from when I did progesterone in sesame oil back in 2015. But also in the last few days, my left ass cheek has gotten a raised, swollen area that is like the size of my whole hand. I went to see one of the nurses in my RE’s office today – they’re having me stop the shots on the left side, and do tie right every other day. I’m doing 2x/day crinone on the off days (ugh). Also they sent me to Urgent Care to see if it’s cellulitis. The Urgent Care doctor basically said she can’t be sure if it is cellulitis vs. a local inflammatory response, so she put me on antibiotics. Cue the worry.

And … drumroll … the big news is that I took a home pregnancy test this morning and it was positive. I took it because I wanted to know if the hullabaloo about the progesterone injection site was worth it. I’m 7dp5dt, so essentially 12 dpo. I knew that it would probably be positive if it was going to be positive. My blood test isn’t until Monday, but I’m glad I took that test this morning. It means that the Urgent Care doc knew to prescribe me a safe for pregnancy antibiotic (it is Class B, but I think that’s the best I can hope for as far as antibiotics go). I’m on a shortened course of cephalexin. Has anyone taken it in early pregnancy? Can you help calm my nerves about it? I know that antibiotics are better than a full blown infection, but I’d much rather have neither if we’re being honest.

I kind of can’t believe I’m pregnant and kind of also have been expecting it all along. Now that I had the experience of a miscarriage, this part feels very different. I’ve always been anxious (and was certainly anxious for the whole first pregnancy), but that anxiety feels more real now, and more like fear. So here we are – back at the start. Fingers crossed that this one stays sticky. Also I’d appreciate good thoughts about my maybe cellulitis. Happy Pride y’all.

Onto the next

A quick update to share that I am finally heading toward my frozen transfer this month. Today is day 7. I’ve been taking estradiol (2mg orally in the AM and 2mg vaginally in the PM) and low dose aspirin since day 1. My estradiol protocol is a little weird because I have an adhesive allergy (discovered during my last FET cycle) so can’t do the patches. Despite the progesterone in oil shortage, I finally got my hands on some and have it ready to go for next week. FET is scheduled for 5/31!

On a separate note, I’m looking for a new prenatal vitamin. I read some new research that correlates unmetabolized folic acid at birth with development of food allergies (similar correlation with tongue ties – which my daughter also had at birth). This led me to a theory that perhaps my body doesn’t metabolize folic acid well. I know that correlation doesn’t equal causation, and that there’s no way to know what caused Riley’s allergies, but I figured this was something I could do to possibly help. And I can’t see how it would hurt. So anyway, I’m wondering if any of y’all out in the inter webs have a prenatal vitamin that either doesn’t have folic acid (and know of a separate natural folate supplement), or know of a prenatal with natural folate instead of folic acid? I asked my OB and the nurse replied saying that since the study was small and hasn’t been replicated they can’t change their recommendations 🙄 … I can’t see how taking methylfolate instead of folic acid is a total change in plan of care! But what do I know? Anyway if anyone knows of such a thing I’d appreciate suggestions. For now, I’m still taking my regular prenatal. Anyway, happy Thursday! And happy food allergy awareness week! If you haven’t thought about food allergies recently, I’d love to hear you thinking about it now. I’ve been trying to do a little social media education on my Facebook, asking folks to be thoughtful food allergy citizens by doing things like cleaning hands (and kids’ hands) after eating before touching public things like playgrounds, thinking about what kinds of snacks are brought to public places like playgrounds, etc. I hope it helps just one or two people make the world a little safer for folks with severe allergies!

Confirmed

My hcg came back 74 on Friday morning. That’s quite a drop from 1200! It certainly confirms that what I experienced on Wednesday afternoon was indeed a miscarriage. I feel weird for feeling relieved about it. It obviously comes from a place of not wanting to have to have a D&E or experience a miscarriage further into the pregnancy … but still is a weird emotion to be feeling about a miscarriage.

So this pregnancy ended at 5 weeks 3 days. I feel fortunate to have gotten pregnant on the first try (second time around), and to have felt supported and mostly at peace through this process. I’m disappointed that this attempt didn’t result in a take home baby, and that we have more hoops to jump through. It sucks to be back at the start. I’m going to try to enjoy my “time off” with the breastfeeding/pregnancy no-nos that I’ve been avoiding for like 2 years. A little drinking, a lot of sushi (ok I haven’t been avoiding that one for 2 years but I have for the past few weeks!), etc.

The plan moving forward? I’m getting my hcg checked again in a week (honestly it feels like it’ll probably be “negative” for pregnancy in sooner than a week? But whatever). Once it’s negative (below 5 I think), they can submit to my insurance for the frozen embryo transfer (FET) cycle. They want to do another SHG to make sure my uterus still looks good and nothing sticks around from this pregnancy. That means a cycle “off” before trying again. I also have no idea when to expect my next period – what was the timeline for those of you who’ve gone through this? While it doesn’t make sense that I’d be having a period right now (2 days after a miscarriage), I did start bleeding in a period-like fashion last night. I do find it odd that the initial bleed from the miscarriage only lasted a couple of hours, but I suppose that my lining wasn’t as thick as it should be given that I essentially had a full heavy period before the miscarriage itself. This shit is weird and I hate not knowing what to expect.

In happier, non-TTC/miscarriage/IVF news, we are excited for what I think is our first holiday not spent with extended family tomorrow. We usually go to my MIL’s for Easter, but just decided not to this year. We’re not religious, though our families are (my parents are very catholic as is Em’s Mom, and her dad is Jewish), but are excited to celebrate Easter from a cultural and “making traditions” kind of place. We got Riley a cute little basket and non-edible surprises (eggs filled with finger puppets and tiny train cars and stickers), and are gearing up for an it’s-finally-warm-outside Easter egg hunt in the yard.

Speaking of Easter eggs – Riley’s daycare had a little egg hunt. It looked super cute, but this was my first hair pulling experience as a mom to a kid with severe food allergies. I can’t remember what I’ve said here but she’s in a new daycare as of last Monday, which has been SO awesome about her allergies (refresher: peanuts, tree nuts, sesame, gluten, dairy, egg). They are also already peanut, tree nut, and egg free, and all families provide their own food. Great. Perfect. Until Thursday. They had the egg hunt and encouraged families to bring in nut free candies to fill the eggs. We expressed concern that Riley would accidentally ingest or touch (even her milk allergy is contact, so she would likely get awful hives just from touching milk chocolate). They assured Em (who does drop off and pick up) that she would just be picking up the eggs and putting them in a basket and that none of the kids would be opening eggs or eating the treats at school. Okay. I still don’t love it because it’s putting allergens into her little hands, but I trust them and know that they’re super conscientious and on top of the allergies thing so I let it happen. And you know what? She was fine. This time. No accidents happened, and the staff was appropriately attentive and watchful. But accidents happen sooo easily. Next year I think it’ll be harder to keep her from eating things that are already literally in her hands, so I’ll do some education and push for non-edible treats for everyone. BUT this was the thing that really made me pull my hair out: they sent her home with a little Easter bag with a stuffed bunny and a plastic octopus and 6 eggs … all FILLED WITH CANDY SHE’S ALLERGIC TO. Like, how hard would it have been to set aside a few eggs with just stickers inside and stick those eggs in her bag? Also, what toddlers eat M&Ms and chocolate eggs? They hardly have sufficient teeth for those things! I can’t imagine any of her classmates were enjoying the treats. She couldn’t even play with the eggs. I mean, it was nice that I got to eat some chocolate but we had to throw out the eggs because they had chocolate all up in them, so it was just a waste for her. Sigh.

Happy Easter and a solemn and respectful Passover to all who celebrate/observe. And for those who don’t – happy spring. Here’s to new beginnings and edible-free celebrations.

In the uterus, however briefly

Well, the “a little bit pregnant” saga continues. Yesterday, I went in for blood work, and got a call late morning with my updated HCG levels. 1200. That’s a 77% rise in 48 hours, which again is within normal limits. The overall number is generally lower than expected for being 5 weeks 3 days (my RE said she’d like to see numbers “2 or 3 times higher than that”).

Given this rise (and probably just the fact that it went over 1000), they wanted me to come in right away for an ultrasound to rule out an ectopic pregnancy. I ended up literally rushing over to their office immediately, because it was 11:15 and I had patients scheduled all afternoon (1-4:30). It’s such a hassle to cancel/reschedule patients, so I’m glad they were able to see me right away, but it also definitely got my blood pressure up for the whole situation.

They did an ultrasound – both abdominal and transvaginal. My RE was in the room for the ultrasound, which was good (no waiting around for results). They pretty immediately saw that there was a “small sac” in the uterus, and were able to confirm that it was not an ectopic pregnancy (thank goodness). And there was indeed a pregnancy to be seen in my uterus – right in the center. At 5 weeks 3 days, they saw a sac and a faint yolk, and mentioned a couple of times that it was small. At the end I asked the actual size of the sac, and the ultrasound tech said she thought around 3mm, though she didn’t have the numbers in front of her. (I’ve read that 5mm or greater would be “normal”)

Before we even started, my RE said that she wasn’t going to “do anything until nature decides what’s what.” I took that to mean she would recommend a chemical abortion or D&E unless it was a clearly nonviable pregnancy. At that point, she felt like it was likely not viable, but that I was “still in the ballgame.” So honestly, at this point, I was feeling about the same as I was previously. I knew that it wasn’t ectopic and really wasn’t worried about that, because I hadn’t had a single twinge of anything on one side or another that would indicate a possible ectopic. My RE also mentioned that she was worried it could have possibly implanted in my C-section scar and been just as bad, which was something I hadn’t considered at all.

My sense after leaving the ultrasound was that I’m still likely to be having a non-viable pregnancy, but that there’s a tiny chance it’ll pull through. The follow up plan was to return for another ultrasound in 2 weeks. My RE said that she could have me back in 1 week, but that we would possibly see a fetal pole and low heartbeat, and then return a week later to have no heartbeat, which she feels is probably more devastating. I think it’s weird that she shared that, but also tend to agree.

Within about 15 minutes of leaving the ultrasound, I felt a gush. I assumed it was the ultrasound goo, but after feeling 1 or 2 more gushes I hit the restroom as soon as I got back to work. Turns out I was bleeding – bright red blood and at a pretty good clip. I put a pad on and ate my lunch while feeling a couple more gushes. By the end of lunch, I had confided the whole sordid tale to 3 of my colleagues/friends. I went to the bathroom again and felt myself pass what felt like a large clot (my only comparison for this sensation was the clots I passed post-birth in the first handful of days). I came back into the office we were eating in and said, “I think it might have just happened?” Of course this is all happening at 10 minutes to 1, and my 1:00 patient (a new evaluation) was already in the waiting room. One of my colleagues was so wonderful and offered to take that patient for me as she had the early afternoon spot open for writing, and they all encouraged me to go home. I was able to quickly cancel the rest of my day and head home. I got home around 1:30 or so, and when I went to the bathroom again had the same “clot passing” feeling. Oddly, after that the bleeding totally stopped. I had minimal spotting for a couple of hours but only when I wiped. I think I probably bled for a total of 1.5-2 hours? And there was minimal mild cramping.

Soooo I am guessing that that was the miscarriage I’ve been kind of waiting to happen. To be honest, if it was, I’m pretty relieved that it means I won’t have to make a decision about a D&E or Methotrexate. I know that there’s always the chance that the bleeding (and even clots) were just the result of the ultrasound kind of “shaking loose” blood that was pooling somewhere up there. But given all of the information, I’m thinking that’s not too likely. I messaged my RE because there’s no way in hell I’m waiting 2 weeks to find out if that was “it,” and they put in orders for me to have blood work again tomorrow to see if my HCG starts to drop. After all of that, we’re still in a very “wait and see” place. I’ll be back tomorrow to report what happened to my HCG.

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