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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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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.

53%

I went in for my second beta this morning, and fully expected the numbers to be dropping given how much heavy bleeding I’ve been experiencing. In fact, the number increased, albeit slower than is typical for a normal pregnancy (which makes sense, given how unlikely a normal pregnancy is at this point). They reminded me that my Monday beta was 127. Today’s was 199. That’s a 53% increase in 48 hours. I’m pretty sure the guideline is for doubling every 48-72 hours, with at least a 60% increase over 48 hours. Basically it’s more uncertainty (with a healthy dose of nope). In the meantime, I’ve been bleeding since Saturday, and bleeding heavily since Monday. Today is less heavy, but Monday and Tuesday were VERY heavy, and it’s been dark red bleeding with clots the whole time (sorry for the TMI). All of that said, I am still getting the fun early pregnancy side effects like heightened sense of smell, very minor nausea (the thought of beef made me retch today), and major exhaustion.

So I’m just hanging out, continuing to consider this a miscarriage/chemical pregnancy, and waiting for the numbers to drop so that I can move onto the next. I’m not doing anything to sabotage the outside chance that things may turn around and this may become a viable pregnancy, though the chances are so so low. I’m honestly not feeling as awful about this as I thought I would. Disappointed perhaps, but in the same vein of the disappointment I felt each time an IUI or that first IVF didn’t work. I haven’t cried. I AM frustrated at the not knowing, and anxious to be able to get to the next steps (which I can’t do until my HCG is below 5).

Blah! OK to end on a positive note – Riley started a new daycare on Monday and seems to really like it. At her old daycare, she came home every single day with a rash and “allergy shiners.” So far this week she has looked awesome, which just reinforces my perception that she was just a little allergic to her old daycare (detergent, pets, mold … something like that). Our doggo came through surgery well, though we are waiting to hear on the biopsy still. But she’s finally seeming more like her self (barking at the mailman and all those good things). Also, I love my kid so much I can’t even handle it sometimes. The biggest difference between TTC the first time vs. this time around is that I have my beautiful bundle of awesome that I can go home and snuggle. It makes it easier to not fixate on all of this and keeps the bigger picture in perspective. I know that I couldn’t have had that perspective the first time around, and am grateful to have it now.

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!

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!

TWW fun stuff: 2 and 3dp5dt

Well, I broke my streak. Ah well, life goes on.

That doesn’t mean there was nothing fun about yesterday though! Yesterday was 2dp5dt, and we had good friends over for dinner, which was really nice. It’s also why I didn’t blog. Em made a delicious veal and mushroom sauce over pasta and our friends brought homemade swiss rolls. Delish.

Other news from yesterday – my best friend is pregnant. There are definitely mixed emotions there. She started trying about 6 or 7 months after us, but her insurance is better than ours in that they started paying for treatment after 6 failed IUIs. She has gone through a lot – 6 natural IUIs, 2 medicated IUIs, and now IVF. Our retrievals were within a week of each other back in December. They didn’t do a fresh transfer because they were doing genetic screening. Her frozen transfer was just over a week before ours this month. And it worked! I’m so happy for them. The twinge of jealousy is there, but I keep trying to remember that I’m “pregnant until proven otherwise” at the moment as well. I definitely feel like this might make it harder than it already would have been if this FET doesn’t work for us. But I’m staying optimistic. I hope that we get to make that same phone call to them next weekend. 🙂

My fun stuff for today: pineapple. I’m sure you’ve all read about pineapple (specifically pineapple core) and how it can help with implantation. The above mentioned friend ate pineapple I think every day after her transfer for a week or so. I was not planning on it, but maybe felt a little peer pressure via pregnancy-announcement-phone-call last night, so I had Em buy me a pineapple this morning. Pineapple core is gross/feels like chewing wood, so I decided to make a smoothie.

IMG_7714

I had Em cut up the pineapple for me, including the core, because I suck at such things. She did a lovely job. I got bananas, frozen strawberries, frozen mango, plain yogurt, and (not pictured) milk.

IMG_7715

I threw the following into the blender:

  • 1/2-2/3 cup frozen mango
  • 3/4-1 cup chopped pineapple (including the core)
  • 1 banana
  • 2 spoonfuls plain yogurt

IMG_7716

Voila! It was pretty delicious. It could probably have used a splash of milk to thin it out but I forgot to put it in so I drank it as is. Our blender did a pretty good job with the pineapple core. There were maybe 1 or 2 little pieces of core that I felt but it was generally smooth. And delish.

Have y’all tried pineapple core? As I was drinking my smoothie I did some internet research as to why people say to eat pineapple core. The source that I found reported that it is because pineapples (especially the core, but also the whole fruit) are a good source of an enzyme called bromelain, which acts like a natural aspirin (anti-inflammatory, blood thinner). So it may help with implantation by helping with inflammation and encouraging increased blood flow to the uterus. BUT that’s also why I’m taking baby aspirin so now I’m worried that I shouldn’t be doubling up. Always something to worry about, right? Jury is out on whether I will put the core into my smoothie tomorrow, but now that I have all of the stuff I’ll definitely be having smoothies with breakfast for the next week or so. 🙂

Plus they’re delicious.

I have been making a conscious effort to improve my healthy eating habits now that I am hopefully hosting a little growing human life. Honestly, Em and I eat fairly healthy in general. Em does all of the cooking (I know, I’m spoiled) – because she loves it and is good at it and we’ve been together since I was 20 so I never really learned. Anyway, we don’t eat out more than once, maybe twice, per week. The meals she cooks are usually made up of whole foods – nothing too processed, fresh proteins and produce, etc. Because of this, my lunches and dinners are well balanced, relatively healthy, and super delicious (I take dinner leftovers for lunch the next day).

My breakfast habits, on the other hand, leave something to be desired. I used to skip it altogether almost every day. Mainly because I am not a morning person and am late to work every day even without stopping to make/eat breakfast in my morning routine. For the past few months I’ve been taking a prenatal that upsets my stomach if I don’t eat right after taking it though, so I have been eating breakfast. The problem is that breakfast ends up being a very unhealthy meal for me. I’ve mostly been eating cereal (and not the whole grain kind) or like coffee cake or something equally terrible for me. This week I’ve been making myself eggs and fruit in the morning. Miraculously (lol, obviously not a miracle, just regular science), I feel fuller longer and have more energy in the mornings. Plus I feel better and I’m not snacking as much during the day (the other eating habit that I am trying to squash).

My new breakfast plan has been: 2 eggs, scrambled, with salt and pepper AND with 1/2 of a chicken apple sausage and a sprinkle of shredded cheese, and a little bit of fruit on the side (a few raspberries or an apple). I’ve also been packing extra fruit as snacks so I’m not tempted to go to the vending machine and buy cheez-its (my guilty pleasure snack) or chips or something. So far so good! I’m going through fruit a little faster than I’d like, but I’m hoping that the good things I’m putting in my body will translate to my body thanking me by holding on to that little embryo in there.

Happy weekend!

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