Rolls Royce ultrasound at 6w5d

We were fit in today for an early morning ultrasound with a higher definition machine. Thankfully.

The resolution was so much better.

The OB radiologist said he saw what he would expect to see with a sac this size. He clearly visualized a yolk sac, and said the gestational sac is measuring about a week behind, but that this doesn't trouble him significantly because frozen transfers can be behind (not sure they can be a week behind, but I wasn't going to quibble with him).

6w5d ultrasound of uncertain viability-
The little speck in the middle is the top of the yolk sac,
which was clearly visualized but not showing up so great in this picture.

Looking at the picture, it's hard to believe that there's a yolk sac there, but two radiologists and an ultrasonographer concurred that it was definitely there, and obvious to them across multiple images. This particular area of the hospital doesn't have the monitors set up for patients to see (no extra monitors, no printing capability). so this is just an iphone image one of the doctors took for me of one of the images.

The OB radiologist said not to come back this Tuesday - that it is too early to see much change. So I am scheduled to return a week from Monday, on October 5th.

It seems a lifetime from now, but if there's going to be cardiac activity, we should see it by that point.

I was thrilled that there was a yolk sac. I thought we weren't even going to make it to that stage. I don't know what to make of the fact that everything is measuring small. But it's premature to call this over yet, and so we will wait.

I woke up at dawn this morning feeling very detached from my life, like I was at a great distance looking at my family, career, the whole of my existence. It wasn't unpleasant, more peaceful to see things from a remove. That sense has passed as I've gotten whipped into the various tasks of the day, but it was an interesting experience.

Not sure how I'll survive the long wait until October 5th. And I'm not feeling very hopeful, if I'm being honest. But I do like that either way, we'll have a better sense of where things stand by that next ultrasound.

For now, more waiting, as I attempt to hang onto my sanity.

Mo

PS - anyone ever seen a pregnancy this far off course successfully turn around? I would welcome ANY positive stories at this point. Thanks.

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Maybe, part 2

The ultrasound was inconclusive.

The RE couldn't see an embryo. He looked for a long time, he kept thinking maybe, but he ultimately decided that no, wasn't seeing anything that was for certain. He said the sac looked "good," "fine," although again he didn't measure it.

6w4d ultrasound

It is such a shame that the equipment at his office is so crappy.

Bad equipment or not, I am having a really bad feeling about this. It looks an awful lot to me like FET#1, from the low initial beta to the small indeterminate sac. And you remember how that turned out.

I really don't pray and am not religious at all, but I had asked God back at the time of the transfer to please have mercy on us and if the outcome wasn't going to be good, to just please not string us along. My faulty logic makes me hope then that maybe it will work out? I asked so earnestly not to be in the awfulness of pregnancy limbo and then left in grief again. Or maybe we don't get to make requests of God like that.

We are scheduled to see someone in OB imaging, who has a Rolls Royce version of an ultrasound, on Tuesday. I will be 7 weeks, 2 days at that point. Not sure if no heartbeat then is game over or not, but I think there should be a heartbeat by then if there's going to be.

Will is trying to see if maybe I could get seen earlier, earlier as in tomorrow. If we still can't see anything, it's not a definitive no go at that point, but I think he's hoping I'll get good news and not have to be tortured all weekend. It's a nice thought.

I asked the RE what the odds are given what we're seeing (and not seeing), and whether he'd say things look ominous.

"Not yet," he said. "I'd say it's 50/50."

I guess I'll take it, and hope for the best.

Mo

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5w5d ultrasound

So it is not much to look at, but there is a sac. My local RE's machines aren't that good, and this is an iphone photo of the scan, but there it is, in all its glory - a gestational sac. In the uterus, so that's good (as opposed to a fallopian tube). 

The sac is too small (and equipment too poor) to see if there's a yolk sac or fetal pole, but there could be. 

Quote from the RE: "You're still in the game."

I told him the initial beta had been low and the initial doubling slow.  "I know," he said. "I've been watching."

We talked for awhile about that initial slow doubling and the low beta and prognosis. 

He said he has unpublished data that FET betas and embryo development typically lag two days behind fresh transfers. And that he was just talking with a colleague who's a beta expert that betas and their rise don't matter as much as everyone tends to think, and that the true threshold is probably around 50% rise, not 66% (and mine was 70%, so above both those thresholds).

So maybe this could be ok. 

I am not going to get my hopes up, but I'm not throwing in the towel either. 

We will see what next week's scan brings. With any luck, there will be the tiny flickering of a little heart. 

Hoping. With everything I have.

Mo

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35.5 weeks update...with pics

Thanks for all of your thoughts about last names. Great food for thought. Will and I will continue to discuss and we'll let you know what we decide on : )

In other news, the most well-monitored fetus in NYC continues to do well. She passed this week's biophysical profile with flying colors and she did well at her non-stress test today as well.

I'm now on 7 units of insulin...an amount that seems to be steadily creeping upward as my pregnancy progresses. At some point (maybe soon?), I'm told my insulin needs will stabilize but so far, my fasting numbers look ok for a bit but then start rising again, necessitating another insulin increase.

I've been switched over to heparin from the lovenox I was previously taking. It was a bit of a fiasco - first because my doctor didn't specify a dose (the Rx read "take 1 dose twice a day"), and then because the pharmacy dispensed heparin preserved in benzyl alcohol. According to the FDA, this preservative is contraindicated in pregnancy as well as for infants and pediatric patients, something my OB says she had never heard of (Oops!). So this took some monkeying around, but I am now on a preservative-free version. The heparin is a lot of liquid volume - or feels like it anyway - compared to the lovenox, but the needle (an insulin needle) is smaller and easier to deal with, which is nice. The 12 hour administration schedule is a bit of a drag but no big deal really.

I saw the OB this week, and will do so weekly for the duration. She checked my cervix and said it is high and closed but softening. Baby has not yet descended. She will check me for Group B Strep next week, and in the meantime I'm on a garlic protocol that my doula says will make it less likely I'll test positive. Google it if you want...it's a bit gross to me, not to mention pungent, but hey, if it works... And this may not affect Group B Strep, but at the very least I'm assured I'll have no vaginal vampires : )

Still hanging in there else-wise. I am starting to really slowdown and my legs are really uncomfortable and crampy, it seems no matter what I do. I am supplementing with magnesium and calcium, getting massages from Will, and soaking them in a hot bath at night. This part of my body will so appreciate this child being born!

We are busy still trying to get Ms. Magpie's room all cleared out so that she can have her own furniture, clothes, and decorations. Five years of infertility have made what was once deemed the nursery quite the storage room. But we're getting there! And in the meantime getting the rest of the apartment super organized as well. When you live in a very small space, you have to be very thoughtful about how much to keep and where to put it!

Here is the babe this week, in 3-D. I wonder if seeing all these pics will help me recognize her better when she comes?

Magpie at 34 weeks 4 days, her hand up at her mouth

Mo

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Growth scan, BPP, and pic at 34 weeks

Magpie is now 34 weeks gestation (and change).

She is in the 35th%ile for weight - I think they said she weighs about five pounds, which my providers are very happy about, given the gestational diabetes.  And she passed yesterday's biophysical profile with flying colors - practicing breathing, kicking, having a good (but not too much) amount of amniotic fluid - another sign that the GD is not raging too much out of control).

That's my girl!

She is also kicking up a storm these days. Her head is down and her feet are up under the right side of my ribs now. She also seems to like to do what Will and I call "butt thrusts." Maybe it is the downward dog yoga position?

We also got another 3-D picture of her while we were at the growth scan. Magpie is looking very much like my husband Will. In fact, Will can do a Magpie impression by puffing his cheeks out that looks dramatically similar. It's quite something. My impressions only make me look silly, but don't resemble her in the least. Perhaps she will be a Daddy's Girl (not surprising. Moxie the Boxer is definitely also a Daddy's Girl).

Here she is, in all her glory...

Magpie at 34 weeks, 2 days

Magpie in a hoodie. Thanks, Will!

Mo

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Be still my beating heart

Twenty-nine weeks, two days here and all is well.

We had a fetal echocardiogram today, and everything checked out normally. I guess the gestational diabetes can cause a thickening of the heart wall (ugh), but Magpie doesn't appear to have that at this point, which is great. I'd had some lingering fears too because of my high vitamin E intake in the first trimester and its association with congenital cardiac defects...but again...no evidence of anything wrong. Yay!

Nice to get her checked though in any case, since there is no risk to checking. I wish she knew we were peeking in. Hi Magpie!

There are a few minor things that the pediatric cardiologists can't check yet because they should change after birth, but we will only worry about these if a pediatrician tells us something is concerning in the future. And these unlikely issues all sound like they are problems that are eminently fixable, which are the kind of problems we like to have if we're going to have any.

Fetal echo with doppler showing chambers, valves, and blood flow.

In other news, there is no news. I am feeling well overall and am being told now by the general public that I am "looking good" and "carrying well." (What does that mean?). Trying my darndest to control my blood sugars, mostly successfully, with a few hair-raising surprises (so far, for example, I have learned that Ethiopian food, with its bready injera is fine, but a couple of small tortillas with shrimp fajitas sends me over the glycemic edge. A huge chipotle vegetarian burrito is fine but a small Amy's bean and cheese burrito on a bed of salad is not....it's a bit befuddling.)  I saw a nutritionist last week who was fairly useless, so am on the lookout for another one. I promise to update if I learn anything worth sharing. 

Mo

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Magpie at 28 weeks...in 3D

We had an ultrasound today to check on the location of the placenta and to see how the baby is growing.

All good news (phew!)

My placenta is now 4.5 cm away from my cervix, so no more previa issues, thankfully.

We also checked the cervical length - long and closed. Yay!

And Ms. Magpie is measuring in the 25th percentile...I think they estimated her weight as 2.3 pounds. So...so far, no macrosomic baby here!


Right now, baby is head down and facing to my right side, but they said she can still move around quite a bit.


We met briefly with a maternal fetal medicine specialist after the scan to go over the results. All looks good he said. Will asked if we can keep the baby from getting too big by carefully controlling my diet and blood sugar levels. The doctor said unfortunately no. That the diet/glucose are the two factors we can control, but that there is evidence that the diabetic state itself can cause large for gestational age infants. Boo! (He said something about hyperinsulinema and amino acid secretion...but I didn't catch all of the details).

It's not the greatest picture...hopefully she won't be this lumpy in real life...but here is our first 3D image of Ms. Magpie. Oh my, I can't even process this. There is a little person inside of me. How did that ever happen?

Mo

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OB appointment 17 weeks 4 days

My husband Will and I met with the OB today.

And wonderfully, amazingly, all still seems to be going well.

She did an ultrasound and I had my usual immediate thought that the baby had died, but she was fine. This week, we could see her swallowing fluid on the ultrasound. The OB said this is a sign of an intact neurological system. So Yay! My tiny daughter is a champ at drinking her own amniotic fluid!

My blood pressure and weight checked out fine. The OB also answered our questions about my continuing nausea, almost constant leg pain, and fatigue. (I know - can you believe that these are my current "serious" complaints?! I am so lucky). It looks like compression socks may be in my future. The nausea and vomiting are likely to get better in the next month, but may not resolve completely. All that is ok. I am thrilled to be pregnant. Thrilled to be at this place. Still incredulous.

We also would like to take a vacation at the end of June so we were asking the OB's opinion on the safest places to go. She said Europe or Hawaii are both fine, but in Europe, we have to watch the cheese, can't have proscuitto, etc. So that makes me think we might prefer it post-pregnancy. So it seems likely that we will head to Hawaii!! I think the flight will be a bit tough, but it will be a wonderful trip if we can do it.

For your viewing pleasure, here is the little one. To me, it looks like she finds her head intolerably weighty. Poor thing!! She's propping herself up on my placenta!

Mo

My head is sooooo heavy!

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17 week anatomy scan results and picture

Sorry for the delayed post. I know I made at least a few of you nervous. I was totally wiped out yesterday and had to also prepare a talk for today. This morning, I spoke to 400 military service members for three hours. Yowza. Ex-haus-ting. It went well, but I am glad to have the talk behind me.

So...on to the anatomy scan. Yesterday, at 16 weeks, 6 days, I had my first anatomy scan. I thought I would need to drink a bunch of water, but turns out, that was not needed. Will and I were nervous. Me especially. I worried that the baby had died (I hadn't used the doppler in the past several days to reduce the baby's exposure time, since I knew this scan would be long, but of course that left me extra antsy). I was also nervous specifically about heart defects. They seem relatively common, so just at baseline I was worried about it, and then I came across information in the past week that high vitamin E intake in pregnancy is associated with congenital heart defects. I haven't been trying to supplement with vitamin E, but I've been taking high doses of fish oil (10 capsules a day per one of my doctor's instructions)...and it turned out when I checked the bottle that it contained vitamin E also...so inadvertently, I was supplementing this. Once I did the math, I started to seriously panic. I was way above the dosages associated with heart defects in this study. I've been trying without much success to calm myself since then.

So needless to say, a nervous-at-baseline Mo was especially nervous about this anatomy scan. 

Luckily, everything looks good so far. The center I went to has you meet with a high risk OB right when you do the scan, so we were able to get our results and have all of our questions answered. He said that all looked good. There were a few things we couldn't see yet, re: the heart (can't yet rule out a ventricular septal defect), at least one thing we couldn't see yet re: the brain (the corpus collosum), and the OB also said that later on the kidneys could turn out to be polycystic. But we saw what we should see at this stage. A four-chambered heart, a closed abdominal wall, a cute button nose, lips! (with no cleft), two kidneys with good blood flow, the stomach, all the bones where they should be. The OB said we could see 90-95% of what we need to see and that I should come back at 20 weeks, when they will be able to see the rest. 

They also checked my cervix, and although they didn't give me the measurement, it looked nice and closed, even to nervous me. 

The baby, they said, weighs about 6 ounces now (my little petite filet!).

And, they said that they are 99% sure that it is a girl.

Wow. A baby girl! That is just amazing. This whole experience continues to be so completely mindblowing. We haven't been hoping too strongly one way or the other - we just want a healthy, living baby. But a girl is extra special. In Will's family, there are 9 sons between all of his siblings. There are 0 daughters. In my family, 2 stepsons among my siblings, 0 daughters. So this little girl is going to get doted on, I do think.

So without further ado, here she is!

Mo

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OB visit 15 weeks 5 days

My husband Will and I went to the OB this morning. She looked like she was planning to use a doppler for the first time this time, but when she saw Will she said we would do an ultrasound (Phew! Glad he was able to come!).

Baby was very quiet when she started the ultrasound, which got me scared - but the OB showed me the heart beating right away to let me know all was well. Nothing majorly new to report. You could see the brain and more mineralization of the bones. Will hasn't seen an ultrasound for a couple of weeks, so he was pretty floored. Then the OB asked if we wanted to know the gender, and we said Sure!!

She looked and looked and looked and thought she saw the three lines that would indicate a labia (so girl!), but she wasn't sure. The picture wasn't great quality, and the baby wasn't completely cooperating with his/her positioning. So we will have to wait. It will be nice to know, but honestly, we just want a healthy baby. 

She checked my cervix, which was long and closed (triple phew!). Said we'll keep an eye on it to help me stay calm.

We asked the OB when the anatomy scan would be and she said at our hospital it's done at 20 weeks, but at another hospital further uptown, their high risk group does one at 16 and one at 20. She suggested we go to their practice for the early scan, given our anxiety level due to my history.

So assuming I can get it scheduled, anatomy scan will be next week - wowza!!

Now off to the basal cell Mohs removal. I'll update later if I can.

Mo

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