Sunday, September 20, 2015

A digest of loss: the stories we tell ourselves

I'm sitting here today, exactly 6 weeks pregnant.

It is a great place to be. It is a terrifying place to be.

I'm on 20mg of prednisone, so I have moderate insomnia, giving lots of chances to think in the wee hours of the morning. And one of the things that I have thought about is our prior pregnancies and losses.

Here's the digest version:
  1. IVF fresh transfer pregnancy: Loss at 8.5 weeks after seeing heartbeat. Turned out to be trisomy 21 and monosomy x.
  2. Natural pregnancy: Loss at 7.5 weeks. No heartbeat. Dilated yolk sac and no fetal pole. Presumed chromosomal abnormality. Couldn't confirm, because lab erroneously discarded tissue from D&C without testing.
  3. Natural pregnancy: Chemical pregnancy
  4. IVF fresh transfer: Chemical pregnancy
  5. Natural pregnancy: Loss at 9.5 weeks after seeing heartbeat. Turned out to be triploidy xxx.
  6. FET #1 pregnancy: Loss at 7.5 weeks, no heartbeat found. Chromosomally normal boy.
  7. FET #2: Magpie!
  8. Natural pregnancy: Chemical pregnancy.
  9. FET #3: In progress!
When I try to make sense of this history, it seems we've had a lot of chromosomal loss, and probably also implantation issues (four out of five IVFs at my first clinic ended in no pregnancy or a chemical, despite transfering up to 5 embryos at a time).

I'm at peace with all that. Mostly. It's water under the bridge.

The pregnancy loss that keeps me up at night is pregnancy #6, our chromosomally normal little boy. This one looks a lot numbers-wise like the pregnancy I am carrying now, which scares me. The numbers are distinctly different (most noticably the low start) than Magpie's numbers were.

But pregnancy #6 was also the first loss that we know was chromosomally normal. I know a lot more than chromosomes go into making a living baby. but it's hard not to wonder.

During that pregnancy, at just about this time, I had to fly internationally, lift heavy luggage over my head into the overhead, and then give a keynote talk to a ballroom full of academics (yikes). Just after arriving at the conference, I started cramping and spotting. And when I got home, a small subchorionic hemmorage was found, but no heartbeat.  In the back of my mind, I've always wondered if the lifting I had to do at the airport, and on the plane, doomed the pregnancy. One wouldn't think that would cause a miscarriage, but I was on lovenox, and well, who knows.

Mostly I've told myself that it doesn't matter; what ever happened happened. But now I found myself with this doppelganger pregnancy. Our last chance.

This time I've tried to be especially careful not to lift anything. I've been mostly successful, with the one exception being when Magpie fell off our bed this week while Will was away (we co-slept, since I can't lift her into her crib). I awoke to a giant crash onto the hardwood floor, following by Magpie's howling piercing the darkness. And before I even knew what I was doing, I'd run to Will's side of the bed and hoisted her into my arms. I was back over on my side of the bed comforting her before it even dawned on me. . . I'd lifted her, all 27ish pounds of her.

Probably ok, but ugh. I spent the next couple of hours staring at the ceiling, worrying about it.

I've been wanting to fly to see my sister and her brand new baby. But I'm scared to fly and handle my luggage at this delicate time in the pregnancy. Then I get annoyed at myself because the most likely outcome it seems to me is that this is going to result in another miscarriage (that's what typically happens for me, isn't it?), so I shouldn't have to suffer that loss and also miss out on being a support my sister.

Just wishing we could either find out this is over or get onto more solid pregnancy ground.

These early pregnancy days are not for the fainthearted.


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  1. Re: #6: remember mosaicism. Just b/c he tested normal doesn't mean he mostly was--it's just luck whether the needle landed on a truly representative clump of cells.
    Is there any way you could pay someone to travel w/you to see your sister and niece, and take care of your luggage? It would be such a good distraction for you.

    Hoping so much this pregnancy goes the distance for you.

  2. Oh Mo. This one brought tears to my eyes. Instead of thinking of the similarities, try to think of the differences. Your dietary changes, the IVIG, most importantly - this is a different pregnancy with a different embryo. I know it's hard, but try to put lifting Magpie out of your mind.

    When will you have your ultrasound this week?

  3. Mo, I hear you. I really hear you.

    You didn't cause that miscarriage. And carrying Magpie will not doom this pregnancy.

    You're doing everything you can...mostly it's up to that embryo.

    I wish Thursday would come sooner...

    1. Yes, re the carrying. Will not doom/not your fault.

  4. Oh Mo, I feel you.
    Early on after my first IVF, the only one that got as far as a miscarriage at 8 weeks, my then 3 year old son happily jumped on my belly at one point...Every so often I am still haunted by the what ifs. The chemical and many bfn's since have reassured me in a way the pregnancy was doomed from the start, and while I continue each transfer to be careful about picking up and playing rough, I hate that my now 5 year old son has had to be careful with mommy off and on for half his life.
    When I read your summary, I too see the chromosomal issues as being different from this pregnancy, and the IVIG, which is no small thing. I understand the frustration at not being able to look after your sister right now, but it is beyond understandable that your need to look after yourself. And protect yourself from regret. You have done all you can.
    Thinking of you often, and praying for your healthy baby in 8 months or so.

  5. I am feeling for you and sending much care. I can imagine how hard this waiting is. I resonate with what K said above re doing all you can and protecting yourself from regret. The IVIG (and diet to lesser degree) seem like significant differences with this pregnancy. I feel like along the way, you've tested and addressed more factors. Everything crossed for you.

  6. Dear Mo, so many precious women suffer the loss of perfectly normal, healthy babies. It's just nature. Heartbreaking nature. And they, too never know why. At least not on this side of Heaven. And also, some women lay on their left side on total bedrest only to rupture membranes at 26 weeks, while others continue labor intensive careers and have to be induced at 41 weeks. There's just NO telling. Which is probably why it's so damn hard. Praying for peace.

  7. Thinking of you, Mo. This early time of uncertainty is so hard especially with all that you've been through. I can't wait to see you on the more solid pregnancy ground. Hang in there. You are doing all the right things,no regrets. Hugs :)

  8. I totally get the crazy I wonders. I've have a list of about 5 things, most crazy, that I think about causing my pre-term labor: yoga class, a really hot day where I didn't leave my non-airconditioned bungalow, etc.

    I think it's impossible to turn off, but I s also extremely unlikely.

    thinking of you often!

  9. Fingers crossed everything continues to be as perfect as it has been so far.

  10. Those thoughts are heartbreaking, I've had the same especially with what I think was my 4th mc. It's so so hard to not know the future. Even when there's a hb there's sorry about x, y, then z. Would be much easier in black and white... but everything RE, IF, pregnancy and parenting is shades of grey at least in my experience(s).
    Wishing you strength and hope.

  11. As with most things IF, especially after recurrent losses, it is about regret management. Living with the coulda, shouldas is a hard thing to do after a loss. I tend to believe that these early days of ART conceived pregnancies are fragile and we do our best to give ourselves a chance of seeing them through. You have to live your life, but you also have to keep your sanity in the process. Everything in moderation.

  12. Mo - sending you so many hugs and good thoughts. It has been a bit hard for me to keep up with my IF blogs since my failed eSET in Denver in late July, but even though we've never met, I keep coming back here and wish you all the best and hope hope hope this one goes the Magpie route. I agree with everyone who has said that your lifting and comforting her that one time is fine, but I totally relate to the hope and terror. Such a tough tough road this is. Please know you've truly done everything you can to give that embie a warm, welcoming womb.

    1. Nina

      I'm so sorry for your failed eSET. Thank you so much for stopping by despite your own loss, and thank you so much for your words.

  13. Thinking of you, and going to bluebird it here and remind you that the lovenox/prednisone/IVIG you're on now is a different combo than with #6. Chromosomally normal losses are hardest--damn, do I know that. But for we lucky ones who seem to have a few issues going on, I honestly believe it's the lovenox/prednisone magic combo that helps keep them where they should be until everything gets big enough to hold its own in there. And you were on a different protocol with him.

    And you DID have a stressful thing going on--I'm more inclined to worry about stress than lifting, to be honest. And while there's no getting away from chronic pregnancy stress, it's very different from 'giving a big presentation' & 'travel' stress/dehydration, etc. I know your sister understands you sticking close to home right now, and there will be lots of time in your new (niece's?nephew's?) life to be there for them both.

    Now is the time to take care of yourself, and your real-Magpie, and your possible-baby. You're doing everything right, (even & especially lifting Magpie back into bed!) and all you can do is keep doing what you're doing. Keeping you in my thoughts. So hoping for a great outcome for you. Hope to see you soon.

  14. I agree with Jodi about looking at the differences. The first time you did IVIG was with Magpie, right? I know IVIG is not the magic solution for everyone, but in your case it may be one of the keys that makes the difference between success and loss.

    Also, I know it's hard not to think that the travel played a role in the loss, but it's very likely that traveling during that pregnancy had nothing at all to do with it. When I was pregnant with Baby Z, the department I work in was having a rare in-person department meeting that would have required me to take a 3-hour flight at 6w0d. I opted not to go, which was a very tough decision because it wasn't one my VP was happy with, but 6w1d has historically not been a good day for me. I woke up on 6w1d at 5 a.m., went to the bathroom, everything was fine - no spotting at all. I went to the bathroom again at 8:30 a.m., and there was a lot of bright red blood. It was a large SCH, and the peri gave us only a 50/50 chance of the pregnancy continuing. I kept thinking how glad I was to be at home, because I wouldn't want to be going through that 2,000 miles away without R, and I would have blamed myself thinking that it happened because I traveled. But the reality was that I didn't travel, I stayed at home (didn't even get in a car to drive to work, since I work from home), and it happened. Even with the IVIG, Lovenox, and everything else. These things still happen.

    All of that said, for the sake of regret management, if I were in your shoes, I'd probably err on the side of doing a lot of Skyping with your sister and her baby for now, and wait at least until you feel like you're on much more solid footing with this pregnancy before traveling to see them.


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