Things that go bump in the night

photo credit: tome chan

All is looking good. As good as good can be right now.

Our big hurdle - both real and psychological - is time. Just needing to get through the next few weeks or so - past the date of our latest loss, further into the pregnancy where things would be a bit safer. We're thinking that might make things start to seem more real, more likely to stick around.

And considering everything we've been through - the six losses, the five years getting to this point - I think we are holding up damn well. For the most part, I am not angst-ing too much or for too long.

There are some back-of-my-head worries, some middle-of-the-night worries, the type that you don't see so clearly, but maybe hear in the background sometimes, late at night bumping around in your head and your heart.

My main fear that I can pinpoint at this stage is a fear that this pregnancy is another triploidy. We've had beta numbers this high once before - during pregnancy number 5 - and it was a triploidy, 69 XXX. Actually, my beta numbers during that pregnancy were lower than my hcg numbers this pregnancy. Gulp. Which I'll be honest, does worry me some. (edited to add: I mean lower at the same day in time...much earlier than now - back in the beginning of a pregnancy when you usually get betas drawn....)

The embryos we transferred this time were tested ahead of time and were deemed normal by microarray analysis. Because the Denver clinic was worried about repeat triploidy in our case (usually a spontaneous, non-age related, not likely to repeat event), they also did FISH testing to specifically look for this. The FISH failed to work, however, on two of the three blasts we transferred this time. So we know there is no mismatch with the chromosomes - no trisomies - but there could be an entire extra set again, which is what triploidy is (microarray only looks for a mismatch between the chromosome numbers, not how many sets there are).

Cue the fear.

I talked to the OB about it last week and she reassured me some. She said that it's unlikely to be a triploidy, but that if it is, I'll miscarry in the next few weeks. If I don't miscarry in the next few weeks, and if the quad screen, nuchal, etc. comes back ok, we can pretty much rule that fear out.

May not sound like much reassurance, but it worked for me. Nothing I can do to change it if this is a triploidy, so it's a wait and see game at this point. OK. I can do that. I can wait and see.

I also contacted the genetic counselor in Denver, just to see if she could put my mind at ease at all. She also said triploidy is unlikely (which I know, but don't these folks realize that Mo and Will are especially prone to rare and unlikely events?). She affirmed what I thought, which is that because we did ICSI, we know only one sperm fertilized each egg, which is one way triploidy occurs. She also confirmed that the Denver clinic checks for the expulsion of the polar body from the egg, which is another way triploidy can occur (the egg doesn't shed its extra set of chromosomes, so you end up with 3 sets). I was also hoping to find out if the embryologists tried to visualize the 2PN stage that confirms fertilization (because I think in triploidy you'd have a 3PN, not a 2PN stage, but she didn't answer that part of my question...oh well).

So rationally, it seems unlikely this is another triploidy, except that my beta numbers are a little out of this world. And I realize to those without a crazy bad history, these thoughts and fears may seem crazy, or super negative or something. But I don't think so. I think this is what happens when you've rolled the dice as many times as we have and have come up wanting each time. It's hard to believe your luck may finally have changed. You keep looking for the catch. You keep looking for the asterisk. The "just kidding!" in small print at the bottom of the page.

Mostly I'm not thinking too much about this. Mostly I'm actually in the now...this fear is just a little niggling thought in the back of my mind sometimes. It helps so much to know that whatever is going on in there is out of my hands. I can't unmake a triploidy if that is what is growing. I also can't mess up a perfectly normal baby if that's what we're lucky enough to finally have.

It helps that I'm still feeling guarded, have not launched head over heels into this pregnancy with my heart wide open yet. I feel a little guilty about that, but am trying to be understanding of myself and Will. We are gun-shy. We are wounded. We are taking this a day at a time, and that's ok.

So these are some of the things that go bump in the night for us. If we can just get a bit farther along, these particular fears will be put to rest. And that will be a very good thing.

Mo

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