House Arrest

Apparently, this pregnancy isn't going to be normal.  Whatever normal is.

Last Tuesday, I was talking on the phone with my mother.  I had just scheduled my first appointment with my OB/GYN, and I was telling her everything that they had said.

I felt something wet in underwear and immediately thought-  Did I just wet myself?  I walked to the bathroom (phone still in hand) and pulled my underwear down.  Mr. Bossy followed me in. There were two large spots of blood.  As I wiped, there was lots more blood.  I remember being more calm than last time; I think I may have just been in shock.  I told my mom about the blood and her response was, "Don't freak out."  Easier said than done.

I got off of the phone and immediately phoned my nurse.  She was amazingly calm and didn't sound concerned at all.  She told me to put on a pad and assess the bleeding every 15 minutes.  If it didn't begin to taper off within the hour, then Mr

 Bossy would need to take me to the ER.  Her calmness is what kept me sane.  She said that I could have easily "overdone" it that day at work, or there may have been a blood pocket (I've since researched this).

I obediently returned to the bathroom every 15 minutes.  The bleeding began to quickly taper off and eventually became light spotting.  By the next morning, there was barely anything on the toilet paper.  I emailed my nurse to inform her of what had happened after we had spoken and to see what she and my RE recommended.  I was ready to leave work at any point to go in to my RE's office for a visit.  Surprisingly, she didn't want to see me.  She did; however, want to me take the next 10 days off from work and rest.

Here I am.  Day 4 of rest/relaxation and I'm bored out of my mind!  Mr. Bossy won't let me do a thing around the house, and I'm already tired of watching tv.  I'll do it though.  I'll sit here with a smile on my face if it means this baby is safe.

On a positive note, all of my symptoms have intensified.  I'm extremely exhausted, I have major food aversions, and the nausea is awful!  I've already lost my breakfast once this week.

Today, I am 8 weeks/2 days, and my next appointment is June 12th.  June 12th can't get here quick enough!


                                                             
      Bossy Bud

Scary Day Yesterday

Yesterday was the scariest day of this pregnancy. Started out normally (sick as usual). Before lunch, I went to the bathroom and just like I do every time I wipe, I looked at the TP. This time, unlike every other time, there was red blood. I didn't even know what to think. I was terrified, but told myself I had to hold it together and see what happened. So I gave myself an hour--ate lunch, drank some water, surfed the web, and promptly at the hour mark went back to the bathroom. I saw lots more red blood, went back to my office, and called the midwife. I don't know if it's a good thing that the nurse who answered remembered me from my last miscarriage, but she did, and she was able to schedule me for an appointment an hour later with one of the midwives. She also was able to send an asap ultrasound referral to the hospital, with the hope I'd get the call to schedule it while on the way to their office for my appointment.

Then I called Mr. Magnolia Bud, and just started sobbing on the phone. I think he only heard "blood" "appointment" "coming to get you." Looking back, I'm sure he was terrified getting that call from me. But he was great about everything. After I picked him up, we went to the birth center. On the way, we got a call from ultrasound scheduling, and we scheduled one for 8am today.

At the birth center, I had a couple vials of blood drawn, gave a urine sample, and then got called back to meet with the midwife. We talked for a little while about my history, and then she pulled out the doppler. We were a little surprised, since we're still considered borderline early for doppler, but went with it...and she surprised us again when she immediately was able to find a strong heartbeat at 160. We listened for a little while, and Mr. Magnolia Bud started to tear up. I was still in shock that there was an audible heartbeat! She did a quick pelvic, during which she didn't see the cause of the bleeding, and then we talked for a while longer. We talked about some homeopathic remedies for nausea and insomnia, including nux vomica (nausea), calms forte, coffea cruda, calcarea, passiflora, pulsatilla, and aconite (all for sleep). She gave me a sample of nux vomica and calms forte--I tried the nux yesterday, and it kept me nausea-free for a couple of hours, it was great!

Anyway, back to yesterday's tale. After she finished checking me out, she said she didn't see any reason to worry. She said it was up to us whether to keep the ultrasound appointment, and she told me that oftentimes, stress can cause obscure reactions in women--including bleeding. I told her what had been going on with my job (promotion, awkward work situation with the former director now working for me, etc), and she said to minimize my stress and delegate wherever I could.

We ended up keeping the ultrasound appointment for another fistful of reassurance. Bright and early this morning, we headed in to the hospital for our appointment. The tech was one of the ones I had had during my miscarriage, though she didn't remember us. She too was able to find a strong heartbeat right away at 174, and the baby was measuring 10w1d. The doctor said at this point, they'll keep my EDD the same, and my risk of miscarriage has dropped to minuscule percentages since we've seen the heartbeat twice and are able to hear it on the doppler. He didn't see anything that could explain the bleeding, so to be safe, put me on pelvic rest and gym restriction for a week after the bleeding stops. Since it's tapered off to brownish-red spotting, I'm hoping the restriction will be lifted at my appointment next Friday. So today, I remain at 9w3d, with an EDD of September 19.

I also got the bloodwork back--all normal, except I'm Vitamin D deficient. So as soon as I get home from my work trip tomorrow night, I'll be kicking back and relaxing at home for the weekend...with my new friends, Vitamin D supplements.

As a prize for reading the saga, here's a pretty picture of our little baby from today! (Head to the right, arm sticking up, legs toward the left):

Three Cheers for Progress!

39 weeks pregnant. Holy cheese and crackers.

I am without a doubt carrying differently this week, and rapidly running out of anything that could be considered "under my belly".

We had our 39 week appointment today, and I was terrified that if there were still no progress Dr Loh would bring up induction - not to schedule - but to start the conversation. Fortunately, it never got to that point... because we have progress!! 1cm, moving anterior and a dropping baby. YAY! I know it means nothing in the grand scheme of things, but it makes me feel a little better. And then after the appointment, I lost my mucous plug and had some bleeding.

I don't know if it's an infertility thing, but seeing bright red blood in the toilet FREAKED me out. My mind immediately went to a bad place. Even though i JUST saw the baby. I know I'm going to have palpitations for the rest of the day every time i go to the bathroom.

We also had a quickie ultrasound to check the fluid levels. Dr Loh said it's not uncommon for IVF pregnancies to have fluid issues towards the end - but my fluid pockets were all great. I may not be able to get pregnant, but my body loves BEING pregnant. Now if only I could get these contractions I've been having to actually stay regular instead of petering out all the time!

And even better than all of that news... i lost another pound. So, now it's 19 pounds for 39 weeks. THAT couldn't make me happier. I'm still well within my goal of 20 pounds for the pregnancy, and that thrills me. Dr Loh and Mr. DB are both really proud of me.

So - we're pretty much at the end. I'm ready. But as ready as I am, I can't help but think about after... i think i'm really going to miss being pregnant. I never thought I would love having a giant santa belly and watching it jiggle like the ocean. Yeah - i hate the back/hip/leg pain, and not being able to get up by myself, but I love this closeness and the feelings that only I can feel. In a couple of weeks this baby goes from being mine to being everybody's.

I can't believe how fast this has gone or how close I am.

The Sweetest Sound in the World

I really considered getting a doppler once I graduated from Dr Z, to sustain me during the long waits between OB appointments. (How anyone expects an infertility patient to be able to act like a "normal" pregnant woman is beyond me.) I did my research, found the best ones that could hear an early heartbeat that wouldn't completely break the bank, and started stalking ebay and craigslist (nationwide) so I didn't have to pay full price.

Then I started bleeding. Stupid subchorionic hematoma.

What a nightmare that was. Thankfully my doctor's office is wonderful (we love Dr Loh and nurse Maggie) and we were able to see that Smudge was okay right away... but now the anxiety level was even higher. How on earth was I supposed to handle the long wait between appointments now?! Bleeding, scared to death? That's conducive to relaxation. Sure.

So I made a plea to a group of women who know I how feel. Fellow infertiles, both pregnant and those who already have their take home baby/ies. And someone came through.

Thanks to the kindness of strangers, I now have a doppler I can call my own. I tried to pay for shipping, and I promised I would return it in 6 months, but she says no. She's 41 and she's done. It's mine.

And last night, for the first time, we heard Smudge's heartbeat. Not a ultrasound simulation in m-mode. Smudge's actual heartbeat.

Want to hear? It's music to my ears.

Monitoring update #2.1

So, i'm back from monitoring #1.

I have one measurable follicle on the left at 10x10mm with 6 small and on the right I have 12 small.

Size wise that's about par from where I was last cycle at this time, but i have more follicles this time.

Other monitoring news is that my lining is 5mm, but it IS trilaminar, which helps me hope that my estrogen is a little higher than it was last time at this point of my cycle, since last time I didn't get trilaminar until stims day 9.

The bad: i mentioned that I had bright red spotting last night - and when vagivision started up, Dr B (Dr Z's associate) saw blood in my uterus.

He said it's probably from the BCPs still, and that he has seen this plenty of times before... it will most likely resolve and not cause a problem. Worst case, they would take me to ER and freeze, because they wouldn't be able to transfer if I'm still bleeding.

Except - the odds of me having embryos with enough quality to make it to freeze is slim to none.

So, now i'm scared again. I'm responding to the meds - YAY ... but what the heck should I make of this freakin bleeding.

I feel like my body is doing everything it can to NOT get pregnant. All I know is I can't take much more of this.

And I'm SO tired of bleeding.

Starting from the finish line

When Dr Z says we're not starting slow, he means we're NOT starting slow.

I just got home from my suppression check where I had my first official cycle vagcam/follicle check and blood draw. I also got my medication instructions for the next 4 days.

Vagcam/Follicle Check: All is well at this point. Lining is 6mm, homozygous and I have 12 antral follicles. Thats up from 10-11 at my vagcam 2 weeks ago, so I'll take it. Also, the bleeding has S-L-O-W-E-D down... it's still red, but I'm barely spotting at this point, so that makes me happy. If today is my last spotting day, i'll be thrilled. That would make 34 days bleeding all together. I'll be happy to stow the tampax - finally.

Blood draw: shockingly, they're checking my beta level. I laughed when Dr S (the embryologist that drew my blood this AM) told me that they were checking that in addition to my E2 level. Can you imagine if I were pregnant? Ridiculous thinking. But, they have to make sure. I know.

Instructions for the next 4 days: HOLY MEDICATION BATMAN. Dr Z warned me we were starting strong. I'm at maximum doses... for now. That's 2 vials of menopur (which burns like a bitch) and 300 units of gonal-f every day. Tonight the gonal will be in all one dose. Starting tomorrow, the gonal will be in 2 injections daily. We'll see where things are on tuesday. When my follicles hit 14-15mm, they'll add in ganirelex, which will prevent my ovaries from ovulating on their own.

Anyway - there's my update for now. We're starting from the top.... but we're on our way.

IVF #2 starts now.

There, but for the grace of Tampax, go I.

Ah, to be in the house of Dandelion.

I'd love to say that the road to IVF #2 is fraught with blood, sweat and tears - but mostly, it's just blood.

I've been on my favorite devil pills for 6 weeks now. I just started pack number 3 of the desogen. At least I know I only have to take 5 pills from this pack - because my last devil pill will be this friday. Usually, after you stop taking the devil pills, you expect a period. However, i've already been bleeding for almost 3 weeks. Isn't it just fantastic? Usually, the ONLY benefit to BCPs is NOT bleeding. Not in Dandelion land... not this time, anyway. The good news, is that my IVF nurse says I might not bleed like I did last time i came off the devil pills, since i've been bleeding for so long. But I've been through almost 5 boxes of tampons. So, enough is seriously enough already.

photo credit

I had my baseline ultrasound this past wednesday. The good news: my antral follicle count is 11. So - that's not great - but it certainly doesn't suck. Our only question is how many of those eggs aren't geriatric. I guess time will tell. I found this chart (below) online... explains a little bit more about AFCs. I think my AFC last time was 14 or 15.

Total number of antral follicles	Expected response to injectable stimulating drugs and chances for IVF success
Less than 4	Extremely low count, very poor (or no) response to stimulation and a cancelled cycle expected. Should consider not attempting IVF at all. Rare pregnancies if IVF attempted.
4-7	Low count, we are concerned about a possible/probable poor response to the stimulation drugs. Likely to need high doses of FSH product to stimulate ovaries adequately. Higher than average rate of IVF cycle cancellation. Lower than average pregnancy rates for those cases that make it to egg retrieval. The reduction in success rates is more pronounced beyond age 35.
8-10	Reduced count. Higher than average rate of IVF cycle cancellation. Slightly reduced chances for pregnancy success as a group.
11-14	Normal (but intermediate) count, the response to drug stimulation is sometimes low, but usually adequate. Slight increased risk for IVF cycle cancellation. Pregnancy rates as a group slightly reduced compared to the "best" group.
15-30	Normal (good) antral count, should have an excellent response to ovarian stimulation. Likely to respond well to low doses of FSH product. Very low risk for IVF cycle cancellation. Some risk for ovarian overstimulation. Best pregnancy rates overall as a group.
Over 30	High count, watch for polycystic ovary type of ovarian response. Likely to have a high response to low doses of FSH product. Higher than average risk for overstimulation. Very good pregnancy rate overall as a group, but some cases in the group may have egg quality issues and somewhat lower chances for pregnancy.

photo credit

Okay - so the question on everyone's mind... what the heck is causing the bleeding? .... what about the fibroid? Here are the answers to those questions....

The bleeding, as far as they're concerned is just an unfortunate and messy side effect of the BCPs. They are 100% sure that it is NOT from the fibroid, because the fibroid "has not deviated the uterine cavity". In other words, my lining appears on the ultrasound as a straight line. If the lining were interrupted, because a fibroid had broken through into the uterus, the line would be separated, interrupted or deviated in some way. It is not. So, Dr Z is NOT concerned at all. Therefore, I am not concerned at all. However, there isn't just 1 fibroid anymore. Now there are 3. Nevertheless, as long as they all stay outside of my uterus, where they are now, Dr Z could care less, and isn't even considering taking them out. Totally works for me.

I also discussed another concern with him. It seems that the majority of girls I talk to have an ultrasound guided embryo transfer and all have had a mock embryo transfer prior to their cycle. I hadn't had either - and I was curious as to why. Mr DB told me just to ask, so at my appointment i said, "Dr Z, i'm in a support group (he doesn't like that I go online all the time, so i figured he'd take it better if I told him this all came from a support group), and some of the girls were talking about their transfer experiences. I was wondering why it seems that some doctors do mock transfers and u/s guided transfers, and some don't?" He was SO awesome with his answer. First of all, I DID have a mock transfer... it's just that mine happened during my retrieval while I was unconscious. That works for me! Then we talked about the u/s guided transfers.

Apparently, they did do them for about 4-6 months when they first came in vogue. However, their pregnancy rates dropped by almost 15% during that time. Dr Z said that it is a matter of learning new technique and personal preference. He said that in his experience, you can focus too much on the picture, and even a minor movement can cause you to lose embryos. Furthermore, he felt t he full bladder was very uncomfortable for patients. He said as soon as he stopped doing the u/s guided transfers, his pregnancy rates went right back up, so unless he has a patient with a particularly difficult mock transfer, he prefers to NOT do them.

As his pregnancy rates are already above the national average, without u/s guided transfers, I say, "if it ain't broke, don't fix it".

What 8 grand worth of meds looks like

So, where we are now:

• Last devil pill will be this friday
• Suppression check Friday, March 5th
• Stims start, at max dosages, Friday, March 5th
• 1st monitoring appointment Tuesday, March 9th
• ER/ET will be the week of March 14th

This time it is going to work - POF be damned.

Purgatory

In the past week I have found that I really am dealing much better with things, and in the last couple of days, I have actually found myself thinking that our next IVF might actually work.

Then I catch myself. Because I thought that last time too.

It's so weird. I don't know how I'm supposed to feel - but even though I'm gearing up for IVF #2, I still find myself just in this purgatory between IVF failure and IVF possibility.

It's even harder now knowing that this is all my fault. I can't blame the sperm anymore. We bypass the sperm problem by doing the IVF with ICSI. If the IVF fails, i have no one to blame but my shitty eggs. That's a tough pill to swallow.

And to add insult to injury, i'm just going to bitch about the BCPs, AKA devil pills, for a minute. I've been on them for 5 weeks, and I have 2 1/2 more to go. Last week I started spotting, and this week, i'm full on bleeding. Bright red, clots, fun fun fun. It's not heavy - but I have to use a tampon. It was too heavy for a liner. My nurse says it's okay - just keep taking the active pills.

Great - i'm doing IVF, I have shitty eggs, I have to be on BCPs for almost 2 1/2 months and i get to bleed for 4 weeks.

Ain't life grand?