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 🙂

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!

Uncertainty sucks

So, it’s exactly 2 weeks since egg retrieval (9dp5dt), and I woke up this morning with a bit of brownish red spotting, so took another pregnancy test just to see. I knew it would probably still be positive given that my HCG was high enough yesterday, but it felt like something concrete I could do. Anyway, it was definitely positive. I know the darkness of the line doesn’t mean much, but it was way darker than yesterday’s, and almost as dark as the control line. Even so, my spotting turned into some red bleeding. Nothing needing more than a liner, but definitely beyond spotting. I called my RE’s office and spoke to the on call RE, who basically confirmed what I already knew – could be a chemical pregnancy, could be a non-viable pregnancy, could be normal bleeding, and there’s nothing I can do but watch and see what happens. I’ll keep taking the Crinone and go in for my blood test on Monday morning as planned. Those numbers will give us more info.

For now, it sucks to have the uncertainty. But I suppose it was uncertain anyway! I’m trying to stay positive. I know red blood is not a good thing, but I also know that it could just be a little bleeding that doesn’t progress. I also know I have 3 frozen embryos in the wings.

Just to make things extra fun, we are on a family trip in DC (doing a 5k in memory of my aunt who passed away from colon cancer). Traveling, especially on a plane, with a 16 month old is stressful. Throw in that she has a full blown cold … and you can see how things are feeling in my life right now.

Here’s today’s pregnancy test just for shits. Any and all good vibes appreciated. Happy St. Paddy’s Day!

Well damn

Not feeling super positive

Today is 7dp5dt (basically 12dpo). I’m not feeling any symptoms, which is fine. I’m also spotting a bit, which is less fine. It is honestly just a bit (once when I wiped but not since), but that paired with the brown tinged Crinone left overs (so gross, so sorry) has had me mostly counting this cycle out today. I’m also feeling a ton of anxiety this evening without a real discernible cause.

Anyway, I plan to test in the morning but I also plan to pack the menstrual cup for our weekend trip to DC. Blood test is on Monday (11dp5dt). Last ditch baby dust appreciated. Otherwise I’m guessing I’ll be back her waxing poetic about an FET cycle in May. Here goes nothing.

The State of my Uterus

I think it’s time to fill you in on our journey to conceive #2! I did update my timeline if you are inclined to just jump to the quick and dirty facts. If you like my prose, feel free to stick around.

Em and I like to make big life plans. And our big life plan has always included trying for #2 once Riley was about a year old. In Em’s head, that meant starting the week after her birthday haha. I was on a slightly longer trajectory because I knew it would take some time to wean. I know that some folks choose not to wean before doing IVF, but I needed to do a retrieval (which means lots of drugs), so was just not on board with that plan. It took a little over 2 months to totally wean, and we were done mid-January. Because I’m a procrastinator, I didn’t call my RE until that week, thinking I’d be able to get an appointment within a couple of weeks. Dumb assumption! When I called, they booked me for an appointment on April 28th.

I’m not really particularly good at waiting, so I directly e-mailed my doctor and came just short of begging for a sooner appointment. She wonderfully agreed, and squeezed me in the next week, AND agreed to have me do CD3 blood tests that day (I just happened to get in touch with her on CD3).

I know I mentioned it in my last post, but it bears repeating. This second time around has been so polar opposite to our first attempt to conceive. My day 3 labs all looked good and my RE booked me not only for a consult, but also for all of the other testing I would need to complete in order to submit for insurance approval. So on January 25 (CD11), I had an ultrasound, sonohysterogram (SHG), consultation with my RE, and meds teaching session with her nurse. The SHG was about a billion times more comfortable than the HSG thank goodness. All systems were a go for IVF, so my doctor submitted for insurance approval. If you recall (you probably don’t, so I’ll remind you), my insurance plan covers IVF and fertility related treatment once I prove a diagnosis of infertility. That meant I had to pay out of pocket for all of my treatments (IUI, meds, ultrasound monitoring, lab work) for 12 cycles, which I did. Thus, I qualify as “infertile” and now can have all of the things for free (except not for free because I have a deductible and co-insurance, but for cheap anyway). As you probably also know, insurance companies like to take their sweet ass time and make you sweat it out. I was fairly convinced that they would take about 30 days to respond, which would mean we could proceed with my cycle beginning in late March. But the TTC karma gods smiled on me and BCBS gave me the thumbs up a whole week before CD1 rolled around!

February 20, 2018 was CD1. By then, I had approval for treatment, all of my meds were in the cabinet/fridge, and our sperm was at the clinic. On CD2 I had a baseline ultrasound and got the go ahead to start the IVF stim meds. My protocol this cycle was:

• Gonal-F 300IU in the evening starting CD2
• Menopur 150IU in the evening starting CD2 (this was a change from last time – I believe I did Menopur 150IU but I didn’t start until day 4 or 5)
• Ganirelix pre-filled syringe in the morning starting about a week in (I responded well early, so they had me add in Ganirelix after about 4 or 5 days of stims)
• • My LH started rising earlier than expected, so I added an extra Ganirelx twice during the cycle. Once on the day I ended up triggering – they were worried that I was already starting to surge and wanted me to do the extra dose “as soon as I had access to it” (they assumed I was at work – I was actually home so did it right then). Thus leading me to an all-consuming obsession with the worry I would ovulate early and there wouldn’t be any eggs in there at retrieval.
• HCG and Lupron trigger (last time I just did one trigger with Novarel. This time they wanted to add Lupron – my RE said that it would help release any less mature follicles and thus decrease my chance of ovarian hyper stimulation syndrome?)
• • When the time came, I ended up just triggering with HCG as they were worried that the Lupron would actually over-do it and make me ovulate too soon.
• Crinone 8% in the morning starting after retrieval

After only 9 days of stims (I think), I had 11 follicles on the left and 13 follicles on the right over 12mm (AKA measurable). There was a good mix of sizes – the biggest were 20 and 21. Because many of them were over 16-17mm, they had me trigger that night on March 1st (which I believe was 2 or 3 days sooner than my original calendar had predicted). I had my egg retrieval on Saturday March 3 (which was also Em’s 33rd birthday. My gift to her was having to get up at the crack of dawn to get to the clinic and then let her take care of me all day). I was so epically disproportionally worried that I had already ovulated and was going to have no eggs at all. My brain latched onto the fact that my LH was high during my last 2 tests and added that to the fact that my cervical fluid had gone from OMG super fertile too much EWCM to pretty much dry once I triggered. Also I was super anxious because I had a REALLY tough recovery last time. Like, weeks of pain and limping. In the end, it went great! My recovery has gone so well. I have no pain at all now, less than a week out. And they got 23 eggs! 23! The nurse whispered it because she didn’t want to upset anyone else in the recovery area. I know not all of the 23 would be mature enough to fertilize but I was really happy with that outcome. Last time I got 12 eggs (from 20 follicles) so I was expecting about the same. We did “natural” fertilization (no ICSI) and ended up with 10 embryos from those 23 eggs. After 5 days, 5 were still contenders. They transferred the best one yesterday (grade 4AB), and ended up being able to freeze 3 others. It’s less than I initially expected but I’m not at all disappointed. I’m happy to have what will hopefully be the option for 2 more pregnancies.

So that’s where we’re at! The state of my uterus is … pregnant until proven otherwise. Official blood test day is March 19 (because 2 weeks from retrieval falls on a weekend). I’ll probably take a home test on Friday March 16. Anyone else on a similar timeline?

I’ll leave you with a pic of the little guy who’s in there now!

9 weeks

Oops … I forgot to do my Friday update. And by “forgot” I of course mean “decided to sleep instead.”

I’m super happy to report that we had our second ultrasound last week and it went really well. The baby is still growing on schedule, and its little heart was beating 176 beats per minute! We even got to see him/her wiggling their little arms and legs. It was super cool and, as each passing blood test/ultrasound has done, it boosted my confidence in the fact that I’m actually pregnant. I still spend a lot of time worrying and anxious, but I think it’s getting a little easier to believe/trust.

The circular thing on the right is the yolk sac. The rest is the little one, with its head on the right. You can kind of see its little limbs even!

It’s crazy how much it changed in just 2 weeks. It looks much more human now.

How far along? 9 weeks 3 days

Baby is the size of: a medium green olive? (I don’t eat olives so this helps me not at all) a southern pecan? (also allergic to nuts so … again … not very helpful)

Total weight gain/loss: Still sitting pretty at 0

Maternity clothes: Permanently in the land of stretchy waistbands because holy comfort, Batman. When I say permanently, I mean that I started before I got pregnant and never plan to stop.

Coming out of the baby closet status: So I have both good and bad “coming out” stories this week. I say I start with the bad and graduate to the good – do you agree?

1. (This is probably going to be an unnecessarily long story … #sorrynotsorry) I am a speech-language pathologist at a Children’s Hospital. Most of my job is evaluations, and we have a waiting list that is about 6 months long. This means that my schedule books out around 6 months most of the time. This is annoying because I have to plan vacations in mega-advance. It is also annoying because, right at this moment, I am already booked through the end of October. We are down 1.5 clinicians and the rest of us have had to absorb those caseloads which (obviously) make ours bigger. Anyway, I did NOT want to have to reveal my pregnancy at work yet, but I also did not want to be responsible for having to call and reschedule a billion patients once they started booking into November. So last week, I told our admin that I’m pregnant and had her block my schedule from the beginning of November (I want to have a couple of weeks of flexibility before I leave) through mid-February. Of course, this immediately caused a ruckus with the front desk ladies (who may as well have the additional title of “gossip mongers”) when one of my patients tried to schedule a follow up, so I ended up feeling forced to tell one of them as well. I’m basically assuming that the front desk ladies have, at this point, talked amongst themselves and I am no longer having an easy time making eye contact with them. The thing that really bums me out is that I didn’t feel at all in control of the information. And I like to be in control. But I’m going to have a child soon so I should probably just let it go, eh? Sigh.
2. In the good news column, however … we told my siblings yesterday! I am the oldest of 4 and the whole family tries to video chat about twice a month or so on Sundays. I’ve been really looking forward to telling the sibs but wanted to wait until after the most recent ultrasound, so I decided our “Sunday Funday” Google Hangout would be a great time. It was a bitch and a half to schedule the hangout because my parents are in San Fransisco this weekend (3 hours earlier in terms of time zones) and my youngest sister is currently living in Prague for a few months for work (6 hours later). It somehow all worked out though, and they are all really excited. My brother cried, which was very sweet, and both of my sisters did a lot of squealing and jumping. They’re all going to be excellent aunts and uncles, and this is the first grand baby, so there were lots of positive vibes and excitement.

Have you started to show yet? Just a bloat baby. But no worries, dress pant yoga pants to the rescue 🙂

Sleep: I. Am. So. Tired. All. The. Time. Still hitting the hay between 8:30 and 9pm, which is a little rough on my relationship with Em because I essentially come home from work, eat dinner (sort of – see things making me sick below), make her give me my progesterone shot, then fall asleep.

Best moment this week: The ultrasound was really great! It was awesome to see the little one wiggling around and watch its little heart beat like crazy. We also officially “graduated” from the Reproductive Endocrinologist to a regular old OB/GYN! My RE did some blood work to check on my hormone levels and was able to give me a weaning schedule for all of the fertility meds. I actually feel like I’m weaning sooner than most people I’ve read about?? My RE said that the placenta has taken over at least 80% at this point, and should be producing 100% of the hormones I need by week 10, so she was comfortable weaning right away. I weaned off of Estradiol within 3 days of the appointment (so was off it right around the 9 week mark), and I decreased my Progesterone to 1cc/night. I’ll be off the Progesterone entirely once I hit 10 weeks. They told me to stop the Aspirin (actually they didn’t mention it and I asked), but I didn’t. I don’t know why I didn’t listen to that particular advice but I just felt like stopping everything at once sounded scary and I’m a little concerned because my circulation has always been not the best (I’m that girl whose nose and fingers are always freezing). I’m going to call and ask about it this week, and express my concerns re: circulation. I just don’t want to invite trouble that may have been preventable – especially since most people I read about are staying on all of these drugs through the first trimester.

Miss Anything? Being able to stay awake and interact with my wife on weekdays (also sex. Because tired.)

Movement: nope

Food cravings: Not really. I am having LOTS of what I’d call “food apathy” – and the only thing that I’m really willing to eat during those moments seems to be soft pretzels with mustard. So maybe that? Though it doesn’t really feel like a craving per se.

Anything making you queasy or sick? I’ve been having very apathetic feelings towards all food, especially at lunch and dinner. Nothing sounds good to me except for soft pretzels. I try to have green smoothies with breakfast to load myself up with some nutrients, but even those are just not interesting to me right now. It’s not that I’m not hungry – and most of the time I will eventually settle on something to eat out of “not getting nauseous” necessity, but I just don’t want anything and sometimes the idea of eating makes me queasy.

Symptoms: The nausea has ramped up a bit this past week, but is still really mild compared to what I’ve heard from other people. It’s just kind of a queasy feeling that usually lasts from like 10am til whenever (sometimes just til after lunch, sometimes the rest of the day). It’s definitely worse when my stomach is empty. Also the fatigue is for serious. I guess this baby wants me to save up on sleep so I’m ready when (s)he comes out and never lets me sleep again. I’m also having some dry skin, and am currently slightly concerned that I may be developing a yeast infection (ugh).

Purchases: Nope.

Looking forward to: My first appointment at my OB’s office. The way my office works is that I will work with my OB as well as a midwife throughout the pregnancy. The midwives are all CNMs (certified nurse midwives – so they are registered nurses with additional midwife schooling and licensure), and will be my first point of contact for non-emergencies throughout the pregnancy. During my third trimester, I can choose who I want to deliver the baby (midwife vs. OB). All new patients meet with the midwife for the first appointment, and then with the OB 4 weeks later (and I’ll see the OB every 4 weeks throughout the pregnancy until things ramp up at the end I guess). So I have an appointment with the midwife on Thursday! I’ll be 9 weeks 6 days. I assume that they’ll try to hear the heartbeat via doppler – does that sound like a reasonable expectation? I have no idea what to expect. I presume that the focus will be going over my medical history and this pregnancy so far, medications, weight, etc. I was told to expect this to be about a half hour, and the appointments with the OB to be about 15 minutes each. I’m excited to get started down the “normal” pregnancy path and meet the midwife.

 

Things that make this feel real

So I’ve been having a hard time with this pregnancy-after-infertility thing. It is really hard to just happily accept that I’m pregnant without constantly looking over my shoulder for someone who is going to run up and shout “April fools!” or something awful like that.

BUT I am really working on it and, little by little, I’m actually starting to feel like this might be real. God I hope it stays real.

Things that have made me feel that feeling in the last couple of days:

• Today’s beta showing a normal doubling time.
• Telling my mom and dad via FaceTime last night (man, that was really awesome. They are so happy)
• Telling our best friends, who made that same phone call to us only a week ago.
• Thinking about experiencing each stage of pregnancy with my best friend. And maternity leave!
• Talking about money and daycare and nursery things with Em, and freaking out a little but also feeling excited.
• Having 2 colleagues announce their pregnancies this week and not feeling that awful sinking feeling that I’ve become accustomed to over the past 2 years, instead feeling excited for them and excited for me.

I’m still kind of waiting for the other shoe to drop, but those feelings are happening less frequently, and I’m spending a lot of time smiling to myself at my desk or in the car, just thinking about how, at least right this second, I am pregnant.

Beta #2

I woke up early and trudged into the lab to wait in line with the old people this morning again for HCG beta #2. A nurse just called with my results and the number is … (drumroll) … 622.

Beta #1 was 306
Beta #2 is 622

That’s a doubling time (according to the internet) of 46.9 hours.

My initial reaction was that it seemed a little slow, but most places I’ve looked online (ugh, get off Google, Katie) say that under 1200, betas typically double every 31-72 hours. So I guess it’s good!

One more test on Friday and then I get a whole week “off” before my ultrasound/RE appointment on 3/21.

Beta is in

My first beta is officially in: 306. I actually can’t remember if she said 306 or 307 but obviously that’s neither here nor there.

Our nurse (Tracy) called with the news and said that the numbers were “really good,” though when I’ve looked it up it looks solidly average/a tad below average because I’m technically 12dp5dt today, which makes me around 17dpo.

Regardless, I’m totally nitpicking and I am trying to let it sink in that I’m pregnant. 306 is a solidly pregnant HCG level.

They didn’t check my progesterone and I asked why not/if they were going to. My nurse said she’d ask my RE but that they usually don’t test progesterone until the first visit with the doc, which is going to be between 6 and 7 weeks. I’m wondering if I should push to have my progesterone drawn on Wednesday when I go back for a repeat HCG beta. She said that when they test progesterone that they’d “just be seeing what they’ve prescribed,” but my concern would be that it’s not all absorbing? I don’t know, obviously it’s not my specialty to know these things, but if I was on PIO before and my numbers came in a little low I guess it just makes sense to me that they would repeat the test after upping the dose. Plus I know that women with PCOS can have low progesterone which leads to an increase in miscarriages. I logically know that the fact that I’m on a relatively high dose of progesterone via injection should cover me there. So I guess I’m not really anxious about it, just confused about when they choose to check levels and why.

The office just called and scheduled my first ultrasound and consult with the RE for 3/21, at which point I believe I will be 6 weeks 3 days (by my calculations/given the date of transfer – obviously that could be off if it implanted late or something). That early should I expect to be able to see a heartbeat?

I realized I have no idea what to expect moving forward – how often I will get ultrasounds with the RE, when they will likely “graduate” me to my OB, whether I’m considered high risk because of IVF, what type of testing to expect … So many changes. And right when I was getting into the swing of things with the TTC process…

Obviously I’m happy to roll with these particular changes. I’m excited to see what comes even though I’m currently in full-on denial/self preservation mode. I’m trying really hard to let that go (which is so much harder than I thought it would be) and just be excited that I’m pregnant. I’m trying to remind myself that being pessimistic now will not make it any easier down the line if something happens. As I’m sure most of you know/can guess, transitioning from infertility to pregnancy is really difficult. After so many negatives, so many calls telling me that I’m not pregnant, it’s just kind of hard to believe. I mourn a little for the loss of what would likely have been total innocence/excitement had I gotten pregnant without going through everything we’ve been through. But that is not my story and was never my journey.

Anyway, that was a long post to just say that my beta came back and is 306ish at 12dp5dt.