Plan B and C and...

So today we are pregnant. At least a little bit pregnant. 4w4d, but who's counting? Only maybe pregnant, right? No beta has been drawn since Monday, so it could all be over by now. Maybe the IVIG killed the embryos. Hopefully not. Of course, I haven't felt anything cramps-wise in almost 12 hours, so you never know.  Ok, I do think I know sometimes. This never, ever works out for us. This is our seventh pregnancy in less than five years. Yowza. And last I checked, no live children. Still, it could work out, right? Maybe. But hard to tell. Hard to figure out anything, really.

That happiness I felt yesterday? Elusive, I tell you.

Ugh.

It is tough to believe in even the moment here sometimes. This all still doesn't feel very real most of the time. (I find myself weirdly experiencing the feeling of being over the moon and in simultaneous disbelief and denial.) And it feels very necessary to try to protect myself as much as possible. So that if everything falls apart (negative thought - when everything falls apart), we are ready to move forward toward having a child.

So we are moving ahead with our alternate plans - donor and gestational carrier - so we don't get left high and dry when this silly delusion I've been having that I'm pregnant reveals itself to be a fantasy.

So where are we at with our alternate plans?

There is a wonderful woman I've mentioned before who came to us and offered to be a carrier if we need it (unbelievable, really) - she has sent all of her medical records to the Denver clinic and they are reviewing them. She will be able to go for a one-day work up in May or June 2012...three months after she finishes breastfeeding her youngest daughter. We still have two euploid embryos and one no result embryo left, which we could potentially transfer to her. It's also possible I might do one final fresh IVF cycle to see if we could make anything more decent/higher quality for her to carry if I lose this pregnancy. So that's percolating.

We're also still in the process of screening potential agency egg donors...and this process continues to move at a glacial pace. We're pre-screening them ourselves rather than have another donor fail the stringent standards of the Denver clinic, because boy, that sucked.

Here's where things are at:

Donor #1 (E) - the twenty-three-year-old donor we loved with great AMH, 33 resting follicles, low E2 and FSH...but the inversion on chromosome 9 - we have asked a great clinic here in NYC if they would let us cycle with her and do CCS, eliminating of course all aneuploid embryos...They are thinking about it and talking to their geneticists and getting back to us.

Donor #2 (R) - a scary bright twenty-something physician - has a great AMH and is FINALLY expecting her period after going off the pill in December. So once that happens, we will get antral follicle count, FSH, E2 drawn. If that's all good...we'll go on to genetic testing. She's almost too good to be true on paper (dad's at NASA, sister's a Rhodes Scholar, etc...), so we're also seeking some confirmation of her narrative., just to make sure she really is who and what she says and not trumping some of this stuff up. To clarify on this, we'd be fine if half of the stuff wasn't true, but if she was being untruthful, THAT would be very concerning. We'd like to tell our child real things about their donor, not some made-up fantasy.

Donor #3 (K) - Has great AMH, good FSH and E2, good but not stellar AFC, is now undergoing genetic testing. This is a boatload of stuff because she is half-Jewish. Her personality and interests are also not so similar to mine (she's an aspiring actress. I'd rather hide in the closet than be the center of attention any day)...still trying to figure out if that matters.

Donor #4 - Seemed like a great match on paper for my personality and interests and she is super bright, and young, and is already a mom, so we know she is fertile. Her dad committed suicide, so that was a bit nervous-making, but there is no other psych history in the family, so we decided we could deal with it...Unfortunately, she has decided she is not interested in donating at this time, so she is out.

So those are the back-up plans, and the back-up plans to the back-up plans. Sigh. Probably seems really weird if you haven't had a ton of miscarriages, but, well, we are weird and we have had a ton of miscarriages. It's so strange and almost out-of-body all of this, both the being pregnant, and the being sure it can't last, and the trying to be ready to take big alternative steps if we need to to move forward.

I wish I could tell you this all brought me peace, but it doesn't. I am a bundle of nerves right now. I am so trying not to get sucked into believing in this pregnancy and getting my heart stomped on again. Trying to not think about it, or not feel too much about it really. I just don't want to get burned again. I feel like with each loss I've lost a little piece of myself. I hope it's not permanent. I hope I don't have to lose any more. I hope that having back-up plans helps make things a little less risky. I don't know that it does, but I'm hoping.

Mo

Photo: Management Briefs

Click here to subscribe

HCG level 11dp5dt plus IVIG #2

Sorry to leave you hanging. I thought I'd be able to post during the IVIG infusion, but the nurse could only get an IV line into the crook of my right elbow, making my right arm fairly useless for typing (and I'm right-handed). Add to that hefty amounts of Benadryl and Tylenol, and I promptly fell into a Benadryl-induced coma for the night, slightly nauseated and head dully pounding. Which is how I feel today. Blech, blech, blech. I think I might puke.

We dutifully went in to the little country lab yesterday morning and got the blood work done. I was feeling somewhat less anxious than I thought I would because I had peed on a stick and the line looked nice and dark and, well, reassuring.

The numbers came back reassuring too.
Beta HCG = 445!!
P4 = 38.68

So things seem to be continuing well. Huge relief over here! I am happy, but also realize I keep waiting for the other shoe to drop, because, well, I am good at dropping shoes. I have a history of a bunch of dropping and dropped shoes trailing behind me where IVF and pregnancy are concerned.

But so far so good.

I had a brief thought of canceling the IVIG after we got that awesome beta, but then immediately thought, Everything is actually looking good right at this moment - why in the world would I ever mess with success? So we went ahead as planned. Really hoping this treatment was it for me, though. This stuff is tough. I feel yucky.

Physically, that is.

Emotionally? I couldn't be happier right now.

One moment at a time. Still pregnant over here at this moment, today. Can't believe it.

Mo

Click here to subscribe

2ww FET symptoms and pee stick comparisons

I didn't mean to scare anyone with the last post. Was trying to capture the anxiety I was feeling as I approached the official beta. Didn't mean to yank anyone's emotional chain. Thank you again for your encouragement and well wishes...I'm successfully staying in the moment so far today. Am just here, super early pregnant, enjoying this moment, hoping for the best; trying not to go to the bad places in my head. 

Life is ironic in so many ways. For instance, now that I have good beta doubling numbers from the lab yesterday and don't need visual reassurance, TODAY the line on my hpt finally looks darker!! Silly pee sticks trying to mess with my mind! (see progression below)

Pee sticks 6dpt (on far right) to 10dpt (on far left)

I warn you, this post is going to be somewhat boring, a documentation of the hpt lines and symptoms up to this point. Feel free to skip...this is just for future reference (or for other poor souls in the 2ww obsessively googling symptoms - look, I've been there!). FWIW,  here are my two week wait "symptoms" this FET...

6dpo (1dp5dt)	nothing, truly nothing
7dpo-9dpt (2dp5dt to 3dp5dt)	nothing. Maybe the slightest uterine twinge. For a moment. But only if really paying attention. And maybe not even then.
9dpo (4dp5dt)	very slight breast swelling, very slight bloating, increased heart rate
10dpo (5dp5dt)	high resting heart rate while trying to fall asleep (~95bpm), thirsty, bloated, mild L-sided pain in abdomen, mild shortness of breath
11dpo (6dp5dt)	spotting and increasing cramping after rushing around medical campus that continues even after lying down and drinking water
12dpo (7dp5dt)	insomnia, increased urinary frequency, bit of nausea using iPhone in taxi in AM?, significant cramping when walking briskly around NYC  (beta HCG comes back at 69.3)
13dpo (8dp5dt)	uterine fullness, severe "period-like" cramping while giving workshop talk, urinary frequency, "off" appetite
14dpo (9dp5dt)	nothing in AM, then as day goes on mild to moderate cramping, fatigue, L-sided pinching, occasional breast tenderness, light-headedness (beta HCG of 155)
15dpo (10dp5dt)	L-sided pinching, uterine fullness, fatigue, breast tenderness when Moxie slams herself lovingly against my chest

Per the Denver clinic's instructions, we will draw another beta hcg tomorrow at same country lab we used yesterday. Then we are headed back to the city where a private nurse is meeting us at our apartment to do IVIG infusion #2 tomorrow afternoon. Ugh. Hopefully no terrible headache this time. And hopefully it helps keep things going. We would do anything and everything to keep this pregnancy going. We are taking nothing for granted.

Mo

Click here to subscribe

FET#2: 9dp5dt: preparing for the worst

So today was finally the official beta day for the Denver clinic. And we are up in the country far north of NYC. My husband Will arranged for me to get my levels drawn here locally, and we arrived up here yesterday evening after I successfully finished hosting a training seminar in my area of expertise.

I didn't realize how nervous I was to have to give a serious talk while pregnant until yesterday as I was doing it. It was with a clinical audience. And although it was only a 90-minute talk, it felt like a fairly big deal both because it was a fair jaunt away from NYC, and because it was with the same colleague I'd been with in 2010 when I spoke at a featured symposium internationally while pregnant (and while majorly cramping) and turned out to be losing pregnancy #6. So standing up there in front of an audience pregnant again yesterday, and finding myself significantly cramping again, and toward the end feeling fluid running out of me (that I was sure was blood), well, cue major internal freak out. I had to actively tell myself to try not to panic. And because that self-talk wasn't so effective, between the cramping and the fluid-feeling, I even left and ran to the bathroom before all the folks with questions coming up to us had gotten answers following the talk (and thankfully I quickly discovered that there was no blood, only my progesterone suppository and mucous). Phew! I then parked myself on a cushy chair for the next 2.5 hours, drinking water and not budging until Will could come get me and whisk me away to the country.

Since then, and into today, I have been exceedingly nervous about the beta. My anxiety was heightened by two other things:

(1) I worried - and my Denver nurse confirmed - that having my beta drawn at a different lab might mean we would get harder-to-interpret numbers. That if the numbers weren't doubling as expected, it might be because the pregnancy were failing, or it might just be the labs' differences in calculating.

and

(2) I have been faithfully POASing (although not posting many of the results), and damn ladies, but the line has not been getting darker. It has still been a weak positive, but I can't tell a whiff of difference between the stick from 7dp5dt and 9dp5dt. I've been trying to tell myself all kinds of reasons for that, from the fact that I just don't have great visual acuity, to the fact that the hcg would still be relatively low so maybe not a noticeable difference (haven't really believed that) to the possibility that I ruined myself when I tested with an hpt when my hcg was over 12,000, and so now everything else just looks like a weak positive to me (I could get myself to mildly endorse this possibility).

So I've been steeling myself for at least a non-confidence-inspiring number, and maybe a lower number than I got previously. Basically preparing myself to have to try not to be devastated.

We've had so much practice being devastated.

Anyway...we drove 40 minutes to the closest little municipality with a community hospital, got the blood drawn stat, and then went to the local Target to pick up toys and a new dog bed for Ms. Moxie (whose old dog bed is not so cushy anymore and is stinky no matter how much we wash it at this point), and then for a scrumptious gluten-free Indian buffet lunch.

I called for the results this afternoon and the lab refused to give them to me over the phone (arrgh!!!), so I then had my "doctor" call back 15 minutes later (Will, who had written the prescription). Felt mildly deceptive about this, but I guess in this case he was the doctor on record and I needed those results!!

And...
HCG = 155!!!
Progesterone = 31.16

So a doubling time of 42.19 hours, a 123.7% increase!!

Oh my gosh, what a relief!

I don't know why my hpts are so underwhelming-looking. This hcg level is one, though that I, and Will, and the Denver clinic, are very happy with. We will be up here until Monday morning, and Denver has asked us to test again at this lab so we have as much consistency as possible with the values.

So very good news over here, despite all my continued cramping, and despite my consierable trepidations! I still have a hard time believing any of this and am taking this one moment at a time.

I am still cramping up a storm and fairly fatigued, so have spent a few hours flat on my back. My amazing husband Will is working on making us a gluten-free/egg-free pizza crust with organic goat cheese, asparagus, and basil toppings for dinner (I'm having a little tomato sauce tonight, despite my supposed "sensitivity" to it. Yum!! And Moxie is snoozing happily (oblivious to all going on her family) in her new bed from Target.

Thank you all for your many comments and thoughts and support. Trying to wrap my head - and my heart - around this good news. We are so, so grateful to be just a little bit pregnant.

Mo

Click here to subscribe

Anti-inflammatory Mo

Prior to this FET, I gave you guys a bullet-point list of all the things we did this cycle in the name of regret management...from IVIG (which I guess I need to sign up for treatment #2 of), to lovenox, to acupuncture.

Something I didn't mention because I hadn't decided what to do about it yet was diet changes.

This January, for my fortieth birthday, Will took me to a health spa in Miami Beach. We are far too plain and no frills to be spa-type people, and the whole experience was nice enough, but really surreal. One of the things I did that weekend was see a nutritionist, which I have never done before. I was completely honest with her about both my diet and about the very real practical limitations to fixing it, such as me often not making it home from the hospital until after 9pm at night. And cooking after that? Ain't going to happen. She was great and had lots of helpful tips on how to improve things, what frozen meals are healthy (think Amy's or Kashi), what snack items would be good for me and easy enough to actually have happen (like peanut butter on rice crackers, or lentil chips with hummus, or sardines with baby carrots).

One of the other things the nutritionist had me do was a bunch of blood work to look at food sensitivities. I don't have any food allergies, but she gave me a test that was supposed to see if my blood serum reacted with approximately 150 different food items. The results give you a list of foods you reacted to, with 4 being the worst reaction and 1 the most minor (0 if no reaction at all).

And lo and behold, I came up positive on over 20 food items. No 4s on anything, thankfully, but a couple of 3s (Filbert nuts - who even knows what that is?! brazil nuts, and eggs - which is a major bummer), several 2s (brewer's yeast, alfafa, oysters, tomatoes), and a bunch of 1s (including bakers yeast, lemons and limes, navy beans, yellow wax beans, cranberries, kidney beans, mushrooms, almonds, vanilla, and wheat). The nutritionist also had my blood tested for gluten sensitivity, which I tested in the intermediate range for at 27 (above 20 is positive and above 30 is moderate to strong positive). The results were mailed to me about two weeks ago.

And at first, I was like - you've got to be kidding me - I can't cut out wheat and gluten and eggs and tomatoes. What is left?! I tried to dismiss the whole thing in my mind. I've been eating these foods all my life and am not aware of any reactions whatsoever! What a bunch of hooey!

And then I thought...upcoming FET...possibly your last...regret management...remember regret management?! Ugh. So the day before the transfer, I cut all of these foods out of my diet. I have not been 100% perfect - there have been a couple of things that I started noshing on before I realized eggs were an ingredient, and I did have one rice-crust pizza that had tomato sauce on it.... But I've been probably 98% adherent. It is tough. Especially because I don't really believe in it whatsoever.

But I'm thinking that if there's anything I can do to reduce inflammation in my body, anything that might stimulate an inflammatory response that could adversely affect the pregnancy, I'm going to give it a try. At least until the pregnancy gets a little more established. Or, really, let's be honest. At least for today. Because it has been hard to eat following this, and so many of the things I like are now off the list of possibilities. And I still don't get home until 9pm many nights.

So a little crazy, I think, and probably doesn't matter. But in the spirit of wanting to have done everything in my power to give this pregnancy a chance, I am sticking with it for now. This plus the boatload of drugs I am on (aspirin, claritin, prednisone, pepcid, lovenox, vitamin D, supplemental folate, multivitamin, fish oil, progesterone, estrogen). Phew.

These are the kind of crazyish behaviors that have evolved in me after 6 failed pregnancies and 7 IVFs. I chuckle at myself, and I remain a total skeptic about much of this.

And then I dip another rice cracker in my tub of organic lemon-free hummus.

Mo

Click here to subscribe