Now That’s a Big Dumplin’! And DW’s Transfer Date!

  
(Photo from: http://www.boozyburbs.com/2012/10/18/brand-new-mandu-factory-northvale-nj/)

Today we went downtown for our 28 week biophysical profile ultrasound at Mt. Sinai. I’m only 27 weeks 5 days, but close enough. Not everyone has this ultrasound, but after our scary NT scare at 12 weeks (thank goodness everything turned out okay), we get all sorts of fun precautionary appointments. Seriously though, we love the extra opportunities to see Dumplin’, and what he’s up to in there. The reassurance that all is good is also very nice. And like I’ve mentioned before, the peeps over at Mt. Sinai are da bomb and might be getting an Edible Arrangement from us. 

The ultrasound itself was actually really short in duration. Previous ultrasounds at 14 weeks and 18 weeks were about 45 minutes, we saw lots of stuff, and were given a pretty good commentary by the ultrasound tech. Today however, it was 8 minutes, and the guy doing it barely said two words. I guess he’s not a morning person? 

Pro Tip: Bring a hand mirror to your ultrasound appointments- so you can watch and see baby as they’re doing the scan! This is what we’ve been doing.

We got to see Dumplin’s positioning- he is already head down, right by my cervix, which is 3.4 cm right now. His face is looking at the left side of my back, and his legs are tucked near my far right ribs. Which is exactly the position that I predicted! When I feel movement, it’s usually strong kicks near my right ribs, and punches near the bottom of my left belly. Sometimes I feel both at the same time. I also rarely feel what feels like bubbles or popcorn popping near my cervix. I’m guessing that that might be hiccups?

Anyway the specialist said that at this point, there’s less space so Dumplin’ is unlikely to change position. So I’m really happy that he’s already setting himself up in a good birth position.

Functionally, he scored an 8/8 on his Biophysical tests- amniotic fluid, fetal movement, fetal tone, fetal breathing. Mommies are very happy about this!

The blood pressure in his umbilical artery is perfect, and my placental integrity is a grade 1 (best).

Size-wise, little Dumplin’ ain’t so little. His head is measuring 30 weeks, his legs are measuring 29 weeks, and overall, he’s measuring 1 week and 1 day ahead. He weighs 1260 grams = 2lbs 13oz, which puts him at the 80th percentile for his gestational age. 

I’m sorry if I’m boasting too much. We’re just so relieved that all is good with our little man. Ultrasounds have been kind of traumatic for us after all of the fertility treatments, sad miscarriages, and horrific NT scans. To have a “perfectly normal” scan is something to be celebrated!

So yeah, that’s one big Dumplin’!

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In other news, DW’s started her daily regime of 27 pills (13 different drugs/vitamins) + 1 injection, and FRIDAY IS TRANSFER DAY!!! We are nervous and excited about it, and I’ve been giving her “spa” treatments everyday- massages and acupuncture on alternating days. We are begging the universe for some good vibes.

Pregnancy update to follow in a few days… 

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Embryo Transfer #6: Frustrations

So DW is on cycle day 9 today of her FET cycle. So far, she’s had blood work and ultrasounds done during her previous cycle, and during this treatment cycle on day 3, and her next will be on day 12 (Friday). We have been with this clinic since 2012, and it really hasn’t been feasible for us to change clinics because of all the monitoring that needs to be done before work. This clinic has 4 locations, which makes them fairly convenient for us, since we work in two different cities. However, our relationship with them isn’t without significant frustration…. 

I’ve had time to cool off about it, so I will just casually list off the ridiculousness and incompetences that we’ve had to deal with:

1. Nonsense: When DW went in for her monitoring last cycle, they kept insisting that I had to come in to update my bloodwork since she hadn’t been active for almost a year. I suspect that this must be protocol for heterosexual couples, but we’re a same-sex couple, and my blood work has nothing to do with DW’s FET or the status of our embryos. Plus, the nurses know who I am (I mean, 3 years, 4IUI’s, 2IVF’s, 5 transfers, and 50 grand later, they better know who we are!), so logically, why do they need my blood? We argued with them for a while, and all they said was that they needed updated bloodwork because the embryos came from me (still doesn’t make sense!). Anyways, we just keep ignoring their requests because I ain’t getting poked to satisfy their stupidity and inability to critically think.

2. Inconsistencies: So on her last cycle and during this cycle, DW had elevated prolactin on her both of her day 3 blood draws. They told her that anything over 30 (don’t remember the units) was elevated and then made her repeat her prolactin bloodwork the next day while fasting (in fact her day 3s were also done fasting coincidentally), and her repeat levels were normal (29) for her monitoring cycle and 39 for her treatment cycle. They then said that the normal range was 40 or less, and that her prolactin values were fine. WTF? How did the normal range change from 30 to 40? This nurse has made major mistakes in the past and I’ve argued incessantly with her but it just makes her even more unwilling to check her facts. Also, I know that high prolactin can affect implantation, and have read that other RE’s consider normal as 25 or less, and ladies with anything higher are put on bromocriptine or Dostinex to bring it down before transfer. Sadly, there’s nothing we can do about this because this nurse is not very open to other opinions and the RE is very uninvolved in checking levels it seems. 

3. Incompetences: so my endocrinologist (who is awesome, and I trust very much) says that TSH should be less than 2 preconception, and when I was trying to get pregnant, she vigilantly had my blood TSH, T3 and T4 levels checked monthly to keep me under 2. Last cycle, DW’s TSH was 3.8, and the damn fertility clinic seemed to think this was fine. I argued with them about it, and apparently my RE seems to believe that a TSH under 4 is acceptable. I’m so upset about this because for our 4IUI’s with me, my TSH was around 3.9 and my endocrinologist (looking back at old bloodwork print offs that I demanded from the fertility clinic) thought it was unacceptably high. I’m frustrated that the fertility clinic doesn’t seem to prioritize optimal hormonal levels, but instead is just happy with us trying under suboptimal conditions, wasting sperm, wasting embryos, wasting time and money. I feel so strongly about this that after her day 3 bloodwork last cycle, we “unofficially” started DW on 25mcg of Synthroid from my stash. In one month, that brought her TSH down from 3.8 to 2.8, so we added another 12.5mcg daily = 27.5 mcg daily to hopefully bring it down a touch more. Frustratingly, the fertility clinic only checks her TSH once in a cycle, so we have to just keep our fingers crossed that her levels are hovering around 2 or less. I’m also a big stressed because I’m still taking Synthroid and my stash of pills isn’t large enough to be supplying both of us until my next refill is eligible. But my priority is giving her body enough thyroid hormone to support a pregnancy. It just sucks to have to be so clandestine about it. We’re also doing the same thing with her and prednisone. 

I know I’m a bit over analytical about all of this baby-making, but DW has suffered 2 miscarriages of 4 of our best day 5 blastocysts. Despite their “investigations” the clinic has not been able to identify any reason for her losses. They have demonstrated inconsistencies, incompetencies, and don’t seem to critically think about our unique circumstances, but rather treat everyone with the same “cookie cutter” approach. Changing clinics at this point is pointless, since most clinics around here function very similarly (what’s the incentive in improving when you’ve got a 3-6 month wait list of patients?). So basically, our approach is to just go ahead with the transfer, hoping that by lowering her TSH her prolactin might balance out too, and that the autoimmune meds help deal with the unexplained RPL. As I mentioned before, this is DW’s last go at it. She took a year off after her last loss to be ready to face this juncture again. We hope that it works, because I can’t even imagine the heartbreak if it doesn’t. 

If you have any experience with prolactin or TSH levels, I’d love to hear from you. 

As usual, your support is invaluable to us. 

Cent Cinquante Neuf

All-day pregnancy sickness has kicked me in the ass this week. I’m basically doing the bare minimum in terms of daily tasks (feed self, feed dogs, bathroom tasks), and then trying to sleep away the nausea in between. When I am awake, I feel like I’ve got the worst hangover of my life- nausea, headache, flu-like symptoms. My food aversions are terrible too- all foods are grossing me out. I had a bottle of Diclectin (Diclegis) leftover from last pregnancy, and finally decided that it was time to take it. I started it last night, and so far, it hasn’t kicked in yet (heard it can take several days to work) and makes me feel super groggy. I’ve never responded well to Unisom or Benedryl as a sleep aid- it keeps me drowsy but unable to sleep, contrary to what many other people experience (Diclectin as a wonderful sleep aid). 

This morning I dry heaved several times because I didn’t get my oatmeal in my tummy fast enough. However, I was able to finish an entire lunch and had a snack this afternoon. That’s progress!

So today was my viability ultrasound. 

And I have good news….

We have a heartbeat!

Dumplin’ is measuring 6 weeks 6 days (a little short of the 7 weeks 3 days that is based on my IVF dates), and has a heartbeat of 159!

There was also another empty sac measuring 0.6cmx0.4cmx0.3cm that could either be a subchorionic hemorrhage or a second gestational sac. Judging by the shape of it (sphere-like vs. crescent-like), RIP Dumplin’s Vanishing Twin.

So I’m not sure if we’ve graduated from the fertility clinic, but given the congratulations!, random loot bag they gave me, plus the requisition for my OB or midwife to sign off on (for me to do a 12 week screening ultrasound there), I’m guessing we did!



Loot bag (with a post-it note that says ” For OB patients only”)

What was inside the loot bag.

So yeah! They want me to start tapering off my prednisone in two weeks, but after consulting with some other RPL friends as well as investigating other protocols for NK cytokine activity, I’ve decided to go rogue and start tapering at 15 weeks instead. 

The progesterones and Fragmin they want me to stop abruptly at 12 weeks.

The aspirin I continue until 32 weeks. 

The synthroid I will continue as per my endocrinologist’s recommendations.

This week I will have my last intralipid infusion as well.

We are very happy to have viability. Given our losses, it’s difficult to be as bright-eyed and bushy tailed about it, as we know anything can happen. But we are taking it day by day, and are grateful that this little soul chose us.

And of course, we celebrated with some awesome authentic Chinese food for lunch! 



Tomorrow, we meet with our midwives for the first time! 

Thank you everyone for keeping us in your thoughts. Please continue to, as the next five weeks will be difficult as well. 


4w5d: Still Bleeding

I think I’ve exhausted all of the forums online that come up when you google “red bleeding but high HCG”. 

Thank you everyone for your support during all of this. I am grateful for each and every one of your comments. 

I’m still bleeding, but it has slowed down a bit. Instead of changing pads every hour, I’m changing pads 4 times a day. The colour changes- it goes from red, to red/orange, to brown, and then back to red and cycles through again.

From everything I’ve read, the bleeding could either be from:

– a subchorionic bleed (too early for that though- the gestational sac hasn’t really even formed yet)

– cervical irritation (probably not, as I’ve been on Endometrin twice before, with no symptoms like this. Plus, I’m only putting the tablet in half way to avoid injury to my cervix.)

– a polyp or some cervical abnormality (I’ve had enough people in my vagina [for fertility reasons, ahem] to know that I do not have any polyps)

– implantation bleeding (too late for that to be red right now)

And the most likely scenario:

– miscarriage of one embryo (as my HCG continued to increase yesterday from 643 on Monday to 897 on Tuesday, but the doubling rate has decreased by exactly half)

It’s interesting to read the gamut of information on bleeding during pregnancy- most official pregnancy websites claim that 20% of normal pregnancies experience bleeding, yet a lot of advice websites say if you have bleeding not spotting, to see your doctor ASAP or go to the emergency room. 

I’m also thinking that the bleeding might be worse because I’m on the blood thinners- 81mg ASA, 5000IU Fragmin, and about 1500mg omega 3’s. 

My approach to all of this is that I’ll just keep monitoring my bleeding, and if I get super freaked out, I’ll ask for another beta. Then the big reveal in 12 days at my 6w3d ultrasound, where we get to see what’s going on.

In terms of symptoms, I still have none besides being tired enough in the afternoons for a nap. Even the hot flashes have stopped. Those of you who got nausea- when did that start?

4 Weeks 4 Days: Bleeding *Updated*

So I’m hooked up to an IV of intralipids right now, typing on my iPhone with my left hand. The cannula is in my right hand and the expensive mayonnaise is cold as in enters my veins.

Last night my spotting turned into a gush of blood, then stopped overnight. In the morning, I saw some red/brown spotting again, took the dog for a hike in the woods, and then noticed that I had soaked a pad with bright red blood when I got home. I changed my pad, drove to the clinic for my intralipid infusion, and noticed that in the 30 minutes it took to drive there, I soaked a second pad with bright red blood.

I told them about my bleeding, and they took some blood to check my HCG levels again. We should find out the results either later today or tomorrow.

I’m totally freaked out now, as I’m having full on bleeding now, but I’m trying to take things in stride.

Why can’t I just have a drama-free pregnancy??? Universe, why can’t you just cut me a fucking break???

*Update*

So my beta HCG came back at 897. Yesterday it was 643. That’s a doubling time of 60 hours. The doubling time just ONE DAY ago was 32 hours.

My guess is that I may have miscarried a twin, hence the doubled doubling time. We’ll see what happens in the next couple of days. My file has been flagged for the RE to review, but I doubt that there’s anything he can do right now.

I don’t know what to think… I feel like I will be walking on eggshells until we see what’s going on in there (13 days).

This sucks.

IVF#2: 10DP5DT: Beta HCG

Just a quickie right now to fill y’all in. We drove to the clinic in a near snowstorm this morning, but we had the awesomeness of each other’s company, and good tunes. I fell asleep in the car on the way home, and have been on the edge of a nap ever since.

Finally, a few minutes ago, we got the call. I know that in this process there are many permutations of “the call”- “the call” to let you know you’ve been cleared to start a cycle, to tell you it’s time to trigger, to tell you when you will be egg collecting or embryo transferring, to tell you how many embryos survived to day ____. But today’s call is the one that has had me glued to my phone. Good thing we don’t live in the 80’s or at a time without call waiting.

So here we are, 10 days post embryo transfer, and my beta HCG level is….

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Thank you for your continued support, especially those of you who are also waiting for “the call” that brings good news- at whatever stage you are at. I know how hard it can be. These are exciting yet scary times for us, as you can probably imagine. But right now, in this moment, I am PREGNANT.

IVF#2: 7DP5DT We Couldn’t Wait

So last night DW and I were grocery shopping and bought a box of First Response Early Result tests.

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Luckily, I’ve been busy all day today, so I wasn’t home for the little FRERs to call to me like My Precious and Gollum from Lord of the Rings.

But this evening, they called to me. Their cries got louder and louder.

So we caved.

And I peed.

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Today is 7DP5DT, and it is POSITIVE!

We’re going to test again on Friday, to see that it gets darker (for peace of mind).

Beta is on Saturday, and I’ve got my fingers and toes crossed that we get a good HCG level.

But for now, we are pregnant!