The End is in Sight

We had our last appointment with the perinatologist today. It went well, the babies looked fine. They measured Apple at 4 pounds 6 ounces and Banana at 5 pounds 1 ounce, so pretty close to what the OB's sonographer got on Monday. Fluid looked okay too. Apple is coming in at the 17th percentile (was 19% two weeks ago) and Banana at the 27th (was 40% two weeks ago). So Banana slipped down the curve a bit. But the peri said the growth curves are based on singleton averages and that it is common for twins to be behind the curve, so not concerning enough to do anything about it.

Because of where the babies are now (head down, stable and at a late enough gestational age) and because of this hellacious rash I have all over my body, her recommendation is to take me off the pro.cardia tomorrow (contractions be damned) and schedule an induction at 36 weeks (in about a week) if I don't go into labor first. She didn't bother with a cervical check today because it really doesn't matter at this point-if I go into labor, they will let me.

I have mixed feelings about induction, but I really think that my days as a stellar incubator are past. I'm not getting any decent sleep (maybe an average of 2 hours a night) and when I do sleep, I'm scratching myself in my sleep. My appetite is starting to wane. And frankly, I'm starting to lose my sanity. I'm usually in tears at some point every night because I just want the itch to stop. The rash keeps spreading and absolutely nothing is helping. I'm also appalled at the sight of it. I played around with the idea of taking some pictures to post, but I'm afraid I might lose all of you, my dear readers, for posting something so incredibly offensive. I guess one good point is that the itch pretty much takes my mind off of the pelvic pain and makes it less intense.

I can definitely tell that the babies are low now. Lots of pressure going on down there. It will be really interesting to see if anything happens spontaneously after stopping the medication tomorrow. It has been a long 6 weeks since I first went to the hospital and I'm proud of us for making it this far. My goal all along was to get each baby to 5 pounds and to go to 38 weeks. Those goals tend to slip as things start going wrong along the way. I am just relieve to be past the major developmental milestones for the babies and will just hope for the best at this point. I'm trying to get excited that we are so close to the end now, but to be honest, all I feel right now is relief. The itching will stop. It is all I can think about right now.

The Smell of Memory (and 24w2d)

You know how smell is so strongly linked to memory? A single whiff of a certain smell can bring back a day 10 years ago with such clarity you feel like you're there. I had one of those moments this morning. Although the memory isn't from nearly that long ago and it isn't one specific memory, but rather an entire section of time in my life.

I woke up this morning fresh from a dream of spotting. In my dream, I was spotting pink and waiting for a call back from the OB. I was worried, close to panic. I was also supposed to go perform a floor routine in a gymnastics meet and my old coach was annoyed with me for delaying. I could see the red starting to creep up his neck. I was trying to explain to him how NOT RIGHT spotting is at 24 weeks into a pregnancy. In the (no) logic of dreams, it didn't seem to matter that I was going to tumble while 24 weeks pregnant. Go figure.

When I woke up, I ran (okay, waddled) to the bathroom and was relieved to find NO spotting whatsoever. I went back to sleep for a couple of minutes and B woke me up with donuts and juice in bed. Do I have the best husband or what? This completely rid my mind of the lingering disturbance of my dream. I ate, showered and got dressed in the slow, clumsy fashion that is my reality these days.

As I put my watch and rings on, I casually grabbed a bottle of scented lotion on the dresser and rubbed the lotion on my hands. And immediately, it felt like I should be doing a shot of Me.nopur, or feeling the stick of a PIO shot. I guess I haven't opened that lotion in at least 4 or 5 months. The smell immediately brought back the FEELING and EMOTION of dealing with all of the shots and disappointments of the past 2.5 years. I looked down at my ever-expanding waistline and my brain tried to meld my realities together. The reality of the past pain and disappointment, the reality of my current fear and excitement, and the reality of these two lives that we are already so attached to and how close they are to joining our family. There must have been a crack in the space-time continuum (yes, I'm a child of the 80's).

Do you ever have a smell or an object bring a rush of memory to the surface? Does that memory linger with you or are you able to brush it off?

I think I'm going to go wash my hands.



*****************************************

Week 24 belly shots below. Sorry for the belly bra, but once it is on for the day, it doesn't come off until the evening.

Girl? Boy?

We've actually known for a week now, but I didn't want to post anything because my parents were out of town and we wanted to surprise them with some cool news. Because I tell my mom pretty much everything (and she tells my dad the salient points), she's known from the start when we were doing IUI's, IVF's, FET's and she always knew when we got bad news. She knew right away when we got pregnant too, so there just hasn't been an opportunity to surprise them without the expectation of some type of news.

After our ultrasound on Monday, I called my mom to tell her everything looked great. But I held back a bit. I didn't tell her that we were able to see Apple and Banana's genders with some level of certainty. Yes, I lied and said that they weren't able to tell yet. It was a long week waiting for my parents to get back into town. When they did, they found a little treasure hunt set up in their house.

When my parents opened their garage door upon returning from their trip, this is what they saw (if you can't read the signs, click to make the picture bigger):
















The rest of the signs led them through the house until the final surprise!











































































And behind the Baby A and Baby B signs was a little stuffed bear for each holding a little ultrasound picture:





























































The pictures have a bit of a glare and yes, they are pink because our printer ran out of black toner. So, the scanned versions of the actual photos are below. Apple was being a little shy, but the tech was about 70% sure it's a girl! Banana wasn't so shy and the tech was about 90% sure it's a boy! So, looks like it could be boy/girl twins for us-for now anyway-to be confirmed at the next scan hopefully. If you can't tell, the pictures below show a view as if the babies are sitting on the camera with their legs stretched out in front of them. You can see two legs and the little bums and a little something in between for Banana. We are beyond excited!

Sigh of Relief

Everything looked great at today's appointment! I don't know why I was so nervous, but I was. Both babies are looking great and I'm in pretty good shape too. Here are the highlights.

• Each baby has its own placenta
• Both placentas are in a good spot.  Baby A is on my left side and the placenta is attached at the front.  I think this explains why it has been harder to hear the heart beat on the doppler because the sound has to go through the placenta.  Baby B is on my right side and the placenta is attached at the back.  Although Baby A is called Baby A because it looks like this will be the first baby out, they told me today it is close.  Looks like they're going to compete for the first trip through the birth canal.
• Blood flow through both placentas and cords looks good and both cords appear to be placed appropriately (in the main part of the placenta and going into the belly).
• Both babies weigh about 5 ounces right now and are measuring about 3 days ahead of schedule.  This is really good news for twins.  They like to see them grow at the same rate.
• Both babies had a heart rate of 150.  Normal is 120-160.  We watched one of the babies have the hiccups or some kind of rhythmic jerking while listening to the heart beat.  This is quite common because their nervous systems are just forming.  You could see the movement along with the spike in the sound from the disturbance.  Pretty cool.
• We saw two hands and two feet on each baby.  Too soon to count fingers and toes because they generally are all curled up at this point (although you'll see from below, we did get one shot of a spread out hand on Baby A).
• We saw a nice nasal bone (the nose) in both babies.
• We saw stomachs and bladders full of fluid.  This is a good sign that the babies are swallowing amniotic fluid (as they are supposed to) and it is making it through their whole digestive system.  We also saw two kidneys in each baby.
• Nuchal folds were both within normal range for this time frame (<5).
• My cervix is nice and long (I think over 6?).
• I have two fibroids (an extra has grown since January), but they are small and shouldn't interfere with the babies at all.
• My blood pressure is still very low at 112/56.
• No protein in my urine.
• My uterus is now above my belly button and I'm measuring at 21 weeks.
• My weight is up to 129.5, so I gained 8 pounds since my last appointment (about 3.5-4 weeks ago).  I'm psyched about this.  It seems like it took forever to start gaining weight.  I'm officially the heaviest I've ever been in my life and couldn't be happier!  (I know 130 doesn't sound like much, but I'm only 5'1").

They sent us home with a bunch of pictures (some of which are below) and a dvd!  We were able to play the dvd in our dvd player, but I can't get it to play on our Macs.  There goes my idea of trying to post the video.  Oh well.

We did agree to draw blood for the quad screen today (tests for risk of Trisomy 13, 18 and Downs) since it was recommended (no particular reason) and insurance apparently pays for it.  Results should be back in about a week.

Next appointment and U/S in 4 weeks.  All in all, we couldn't have asked for a better appointment.  I still don't know quite how to react when everything goes perfectly!  Other than the perma-grin attached to my face, of course.  Just not used to that.

Here are three pictures for your viewing pleasure.  The first shows both Baby A (right) and Baby B (left).  Baby A looks like a freaky skeleton in this picture.  The shot is taken like the camera is right above Baby A looking straight down.  Baby B looks a little more normal and is shown looking towards the camera.  You can see the nose, mouth and one of the eye sockets.

The second picture shows Baby A stretching out the left hand.  You can count four fingers and a thumb in this picture.

The third picture is a 3D/4D picture of Baby B, which is why it looks different than the others.  Cool, huh?  They look better as you get further along and they have more flesh on their bones.  We cracked up when we saw this picture because it really looks like Baby B is flipping us the bird!

The Best Day Ever or the Worst Day Ever?

Two years ago, we were fairly early into our quest to become parents. I had been off the pill for a couple of months and we had just returned from a great vacation in Italy. This was back when we were still trying the old fashioned way (you mean, people actually get pregnant by having sex?). The vacation just happened to be timed perfectly over peak fertility that month and I was CERTAIN I was pregnant by the time we came home. I mean, a relaxing vacation with my man and KNOWING I was ovulating over that same time--that's how people get pregnant, right? By relaxing and going on vacation?

About a week or so after we got home, Mother's Day arrived and I got my period. That morning. On Mother's Day. We went to the museum and out to lunch that day with my parents and my grandma. I bitterly told my mom how ironic it was that I got my period on Mother's Day and I think she was probably surprised at how upset I was. We hadn't been trying that long, after all. Just a couple of months into the journey and I was already noticing just how many children and pregnant women there are in the world. They were swarming at that museum exhibit.

Fast forward two years and now I'm pregnant (oh, if only those two years had gone by as quickly as that sentence makes it seem). But this day is still difficult. I am still super aware of bumps and little kids everywhere-at the restaurant and on tv. And the advertising for Mother's Day just seems over the top. I have to keep reminding myself that I'm pregnant. I'm a mom. Even though they aren't in the outside world yet, I am caring for those little embryos inside me as we speak (as I type). I even had a little bit of lunch meat today and then realized "oops! I'm not supposed to eat that right now!" I keep thinking that at any moment I'm going to wake up in my bed and realize this was all just a dream. The pee sticks were negative, the beta was negative. I keep waiting to wake up, but so far it hasn't happened. I think this is going to take some getting used to.

Because I'm still obsessed with betas, I found a little program that made this chart:

















Isn't it pretty? Too bad I couldn't find something similar for twin pregnancies so I could visualize where I might fall on that chart.

****************************************************

I haven't always been the best daughter. When I was little, I must have driven my mom crazy by hanging onto her leg shyly whenever there were other people were around. She literally had to drag me with her when she walked. She got used to this that at some point when stepping on the scale at the doctor's office, she couldn't believe how much weight she gained. Until she realized I was still hanging onto her leg. There was the time I decided to decorate the fancy bathroom wallpaper and my hair with a jar of vaseline (what, isn't shiny hair pretty? You didn't want to wash my hair 50 times to get it out?). There was that horrible Mother's Day trip to Alabama for a gymnastics meet where I was the most rotten kid in the world. The times I snuck out of the house. The times I disappointed her with things I knew I shouldn't have done. I could go on and on with this list.

And through it all, my mom loved and supported me, taught me lessons and helped me grow into someone who is ready to be a mom herself. She has put almost as much time, energy, shopping, thoughts, hope and emotion into our IF treatments as we have. She deserves for me to be pregnant just as much as I do. And I'm not sure I could have made it to this point without her.

Thanks Mom. Happy Mother's Day. I love you!

Beta #2

Second beta came in at 941. Phew!!! First beta was 445, so this is an increase of 111% and a doubling time of 1.85 days.

Our nurse told us they like to see it rise by 66% in 48 hours, but every thing I read talks about it doubling (100% increase) in 48 hours. Either way, we made the grade! There are some sites out there that talk about it doubling in 48-72 hours (which if it doubled in 72 hours, that would be equivalent to a 66% increase in 48 hours, right?). I need my 10-key (no, accountants don't do math in their heads-at least not this one).

Does anyone know if be*tabase is down for good? I haven't been able to get on since Thursday and it is driving me crazy.

Anyway, this is very good news. It means that so far things are progressing as they should. I go back in for another blood draw on Thursday, but they will only check estrogen and progesterone levels to see if my meds need to be adjusted. I'm really, really hoping my body kicks into gear and starts pumping out tons of progesterone on its own because these suppositories are driving me crazy. It is too soon to tell if the switch over the en.dometrin is helping (I just started it last night), but (HUGE TMI warning) my crotch feels like its on fire it is so irritated. Ick.

I think I will go in for my first ultrasound about a week after the next blood draw, but no one has given me an exact date. When I asked the nurse this afternoon if I could schedule it now, she said just to wait until I go in on Thursday. I think it is because they are working with a skeleton crew this weekend. The palace was completely deserted this morning.

So now we exhale just a little bit more and wait until ultrasound. Can't I just take a really long nap and wake up in a couple of weeks?

Lend Me Your Creativity

I need a name to start calling the embryos as I can't keep calling them that and I am feeling very uncreative at the moment. One name that is plural would work best since we don't know how many there are right now. Please, provide as many suggestions as you can think of.

I also added a new poll to the top right sidebar, so go vote on how many you think I have in there. I've also added one of those baby widgets that show how many days until my due date (sorry, Nancy, I know you think they're creepy). I know it is early, but I want to take advantage of all that is out there because for the first time, I can.

One of the best things about coming clean with my post yesterday was all of the comments I received. Each one made me smile, or tear up, and I just feel so loved by people I know and so many people I've never met. Even people who delurked and left a comment for the first time. It's an amazing feeling. I feel surrounded by joy for the first time in so, so long.

I'm particularly grateful for my blogging buddies who are still waiting, struggling through their current cycles, or dealing with recent disappointments. I know how hard it is to watch others around you get pregnant when you are still in the thick of it. And I know how hard it is to keep reading as they go through their pregnancy. This is all very new to me and all of the sudden I find myself on the other side of that line drawn in the sand. Except that I don't feel any different. I still feel like the same old infertile me. I most certainly intend to keep supporting you ladies as much as I can and I hope you won't abandon this blog. But if it is too hard, I will certainly understand. I just wanted to mention this because it has been on my mind and (as I'm sure you would expect) I'm sure I'll be spewing lots of pregnancy-related posts in the coming months.

Okay, with that out of the way, I am still trying to digest the news and it doesn't quite feel real yet. I'm guessing it won't fully sink in until that first ultrasound in a couple of weeks. It can't come soon enough. The other thing that can't come soon enough is B's hernia surgery. It is scheduled for Wednesday and I can tell he is getting more uncomfortable by the day. I think we will both be able to relax a little more once that is out of the way.

I have been noticing a few pregnancy symptoms. Let me first make a disclaimer that these are NOT complaints. I welcome any signs that the __________(s) are still growing inside me.

First to make an appearance was the nausea. It started Tuesday night with a particularly bad bout. Wednesday was a little bit better, but still rough. I had to force myself to eat. Yesterday was even a bit better and today I feel pretty darn good and my appetite seems to be returning. There is still an undercurrent there that I only notice if my mind isn't occupied by other things. The one thing I'm finding alarming is that chicken has thus far been completely unappetizing to me. I usually eat a LOT of chicken, so I hope this one goes away.

Second, my boobs are sore. I know this could be from the progesterone, but they also seem to be slightly larger today (yippee!) and they weren't sore at all last time I was on pro.metrium. As a side note, I am switching over to end.ometrin tonight to see if it is less irritating. I honestly can't remember how much the pro.metrium was, but the end.ometrin is pretty pricy ($120 for a week's supply). I'm hopeful that they will start weaning me off of the supplements in the next week or so, but I could be on them through the whole first trimester.

Third, my abdomen is sore. When I stretch in bed, it feels tight and almost like I did some new type of ab workout that works muscles I didn't know I had. I'm also getting little sharp jabs and pinches every once in awhile. I've been told this is probably round ligament pain as the ligaments that support the uterus stretch to accommodate the growing uterus. It is amazing to think that I would notice such a thing so early when the __________(s) are still so tiny.

The one notable early pregnancy symptom that I'm lacking is fatigue. I keep wondering why I'm not falling asleep standing up (well, I'm not actually standing up much these days) or watching tv. I guess I should enjoy the energy I have while I still have it.

It's Officially Official (P Word Mentioned)

I'm PREGNANT!!!!!

And in shock. Someone pinch me.

First beta HCG today at 14dpo was a whopping 445! They like it to be over 50. Progesterone should be over 20 and mine is at 60. These little embryos (I need to think of something else to call them-suggestions are welcome) are definitely over-achievers right now! I hope this gives the other U.O.D. (uterus of doom) ladies with thin linings some hope as my lining never got above 7 this cycle. Don't ever let an RE tell you 7 is too thin if it looks consistent and has a triple pattern!

It is still very early (I am considered 4 weeks pregnant today). Anything can still happen, so we are celebrating quietly and humbly.

We were originally going to wait until the 2nd blood test to tell people, but we just couldn't wait. I feel like shouting out from a rooftop "I'M PREGNANT, WORLD!" You see, I've been hiding something from you, dear readers. Tuesday morning, I gave in to impulse and, well, for the FIRST TIME EVER ladies and gentlemen, 2 gorgeous pink lines! See...
















And then I started spotting again Tuesday night. So I HAD to POAS again on Wednesday morning. See...

















And of course, I was still spotting and the line didn't get darker and I was sure it was ever so slightly lighter than Tuesday and that is when I officially started obsessing thinking just my luck, I'm going to miscarry my very first pregnancy ever really early. So this morning...

















The line is DEFINITELY darker. Here is a picture of all three sticks together.
















Enough pictures of pee sticks for you?

So, the next step is a second blood test on Saturday. We have a target HCG number of 739 (66% increase from today's number). Although, if the number doesn't quite rise that much, we shouldn't be TOO concerned as it is possible that there are currently two growing inside me and one may not make it to Saturday. We'll take one. Or two. Either way. I just can't believe I'm finally pregnant. Have I mentioned that yet? I'm pregnant. I don't think it has quite sunk in yet.

In going through this journey, there have been many losses to mourn. The loss of our ability to conceive on our own, the loss of expectations, the loss of an expected timeline, loss of control. The list goes on and on. One of the losses that was most difficult to swallow was being able to surprise our families and friends with news of a pregnancy. To be able to impart the news and get shocked, happy faces/voices in return. To find some creative way to tell our families. To be the source of happy tears and celebrations instead of worry, depression and pain.

Turns out, we didn't really have to mourn this particular loss at all. Telling our friends and families today has been the most rewarding, fun experience. In some ways, I think it is even better than it would have been had we conceived naturally right away because everyone is just so darn excited! And this excitement is so contagious. We are trying to keep it under control because, again, it is very early. No person in their right mind would ever tell their family and friends about a pregnancy that was only 4 weeks along. But our family and friends have been following every step for months or years.

We are taking a bit of a risk here in sharing this amazing news right now, but it is something we knew we'd have to do once we gave people my blog address. Frankly, it is a risk I am so happy we took because no matter what happens, at least we get to spread some great joy for now. I wouldn't want to miss that for the world.

Crikey

I sure am getting my money's worth out of the nurses this cycle. I spoke with a nurse for about 30 minutes today. The bleeding could be a number of things:

1. Implantation bleeding-yes, it is possible for implantation to occur this late, or for the embryo(s) to just be burrowing in further. The process apparently takes weeks. Who knew? Plus, the nurse said that because we get hormones in spurts from the estrogen and progesterone support (rather than the constant supply that would occur in a natural pregnancy), it tends to make the uterine lining a bit less stable than it normally would be.
2. Impending period trying to break through even with the progesterone support
3. Irritation of the vaginal wall from the prom.etrium. If pregnancy is confirmed, they suggested switching me to endo.metrin which may not be as irritating.
4. Small, or beginning of, a subchorionic bleed (separation of lining from uterine wall). This can be diagnosed through ultrasound, but they don't see the point of doing this until a pregnancy is confirmed and the recommendation is always bed rest on hope it heals on its own. It can't be fixed.

The nurse said that if I was really worried, they could have me come in for blood test today, but it is still a bit early so she recommends we wait until scheduled blood test. I didn't push it.

Because of the possibility of number 4, I've been ordered back to bed rest through the weekend. Not as strict as post transfer, but lay down as much as possible and no vacuuming, laundry, etc. So I packed up some work to take with me and now I'm hanging out at home trying to get some work done and hoping with all my might that number 1 is true.

On the plus side, the spotting appears to have subsided. At least for now.

Spot Check 2008

Still no sign the of the evil spotting. Yay! And in even better news, Spicy Sister got some amazing news today! This is definitely the start of something good.

Long Week

Just a quick note as I won't be home until late tonight because of a work dinner. Just wanted to let everyone know that I've had NO spotting/bleeding today. None. And simply by typing that, I fully expect it to start again. But seriously, it seems to be done and I'm relieved. I'm still afraid to hope that it was implantation bleeding, but at least I don't have to deal with the evidence anymore if it wasn't. This is going to be a L.O.N.G. week.

48 Hours

It has now been 48 hours and I'm still bleeding. A bit lighter than yesterday, but still persistent. I'm so annoyed. I've been robbed of the anticipation of this 2ww and I can feel my hope for this cycle slowly draining away with the blood.

Still in the Darkness

This morning, the bleeding is a touch heavier and bright red. And I'm still crampy.

I called the clinic. Again. Yes, I'm the pathetic panicking patient who knows full well it could be implantation bleeding, but is still convinced she's having a period. Oh well, figure I should get my money's worth, right?

The nurse said it could be one of two things. It could be implantation. Or it could be my stupid body trying to have a period. She did try to reassure me by saying that plenty of patients call right around this time with the same complaints and 75% of the time there is a positive outcome. She said bright red can still be implantation bleeding. As long as it isn't full flow. She did admit, however, that it is possible to have a period while on progesterone. It isn't common, but it isn't unheard of either.

I was told to make sure I'm hydrated as being dehydrated can cause cramping. That is definitely not my problem with all the vitamin water and water I've been drinking. I just want this to go away. Now. It's kind of funny actually. In all my past cycles I've hoped for some type of early sign of a positive. I always thought implantation bleeding would be the best because all other symptoms can be blamed on the progesterone. Now, I'm just freaked out.

Darkness

Why is it that things always seem worse at night? In the dark. Darkness has a way of making the most uneventful thing seem meaningful. As kids we are afraid of the dark because we can't see what might be lurking there. In the closet. Under the bed. Maybe this irrational fear lingers in our adult selves in a different way. Bad things always seem to happen at night. Problems seem worse at night. Sickness feels worse. Doubts feel heavier.

Late this afternoon I noticed some spotting. Red. Just a little bit. Accompanied by lower back ache eerily similar to AF cramping. I spoke with the nurse, knowing that it was probably not a big concern and could even be a (good sign-shhhh). The nurse confirmed my initial reaction and said that red, pink, brown, it was okay and nothing to worry about at this point unless it got to the point where I felt like I needed a pad. I wasn't even going to post about it because, honestly, I didn't want to jinx anything in case it was a sign of implantation. There. I've let the cat out of the bag.

But as I've sat on the couch all evening, feeling the cramping still lingering and religiously checking the toilet paper every time I pee (and I pee a lot from drinking so much these days), I'm feeling the panic start to rise. The red turned to pink, but there is definitely more of it. Not enough to require a full pad, but definitely enough to warrant a panty liner. How much is too much to be considered implantation bleeding?

I'm not asking this to get superficial reassurances, I really want to know. What else could it be? Would it even be possible to be starting a period this soon after transfer (3dp5dt) while on 3 prom.etrium per day? I know I'm just freaking out because the darkness has settled in for the night. But it is truly disconcerting. I just want it to go away. Make the scary monster go away.

BFN and Hope, You Bitch

Unfortunately this is NOT a picture of what I wish I COULD have. Because, well, it is what I DID have with dinner and what I'm HAVING a second glass of right now. The doc snuck in an HCG test with my blood work today and it was a BFN. My E2 and P4 had tanked to 123 and 4. Apparently because implantation did not occur, my ovaries (the corpus luteum) knew to stop producing estrogen and progesterone on their own. AF has been held at bay simply because of hormone supplements I've been on. So the patches have been removed, I won't take any more pro.metrium and she should arrive in the next couple of days. The doc was hoping that if there was a small amount of HCG in my system (indicating implantation), and my E2 and P4 were low, we could add additional supplement and try to salvage the pregnancy.

To be honest, loyal readers, I've been hiding something from you. I started testing at home on Sunday. I wanted to make sure the trigger shot was fully out of my system so that I could test the morning before beta (Friday) and be comfortable with the result. But once I started, I couldn't stop. I tested Sunday morning, Monday morning and this morning. For some reason, after the stark whiteness of the stick this morning, I was convinced this cycle hadn't worked. I dragged myself to the clinic for blood draw this morning thinking "what's the point?" I got to work and had a mini break down. I cried for a bit, pulled myself together and went on with my day (with the help of some encouraging words from Melanie). And then I got the call.

The nurse called to give me the results and to give me Dr. S's cell phone number. Yes, his cell phone number. To call him. Tonight. While he's on spring break vacation with his kids. Did I mention he's on vacation? With his kids?

So we talked for a bit tonight and I actually feel a whole lot better now than I did this morning. Even though this morning, that bitch hope was still hanging on for dear life in the background. Even though she has now been banished to the closet until next time (although I can see the bright beams of sunshine pulsing behind the closet door). Because what I got out of the conversation with Dr. S is that next time, we will get things right. We will NOT hyper stimulate, we will have a great lining, and we will make it to transfer with a positive outcome.

I only hope he hasn't given me unreasonable expectations.

My lining with my last fresh cycle looked good (as good as it finally looked with this past FET). But because it only got to 8, which really is the minimum thickness they like to see (8-12), the lining is still in the running for being the culprit here. The other culprit is simply the freezing and thawing process. While FET's can work, Dr. S said frozen/thawed embryos are never as good as fresh. He does feel that we have proven that we make good quality embryos since we were able to thaw some that then grew to blast. So whether the problem this time was my lining, or using frozen/thawed embryos, or a combination of both, Dr. S feels a fresh cycle will do the trick for us if we pull back on the stim meds and start slower.

Dr. S said he feels very frustrated for us, that we've done everything right and he would not be encouraging us to move forward with another fresh cycle if he didn't truly believe it would work. He wants us to get pregnant and he is convinced we can and we will. He is determined to make this work for us.

And even though all of our testing expired back in March, he won't make us redo any of the testing because he is now convinced that we make good embryos and I respond well (too well) to the medications. So that is good news. The only exception might be the communicable disease testing. I think this must be required in order to freeze embryos.

So, the good news is:
1. We make good embryos
2. We think my lining can do what it's supposed to
3. We don't have to redo all of the tests
4. We can start a fresh cycle off of this period if we want to
5. I can drink wine again for a little while, stop taking the patches and supps, and get back on my elliptical
6. We have an excellent doctor who is very invested in getting us pregnant
7. I was told that I will speak with my assigned nurse (Jennifer) every visit (except Mondays when she is off) this time to avoid conflicting information (which happened constantly). This makes me feel good. I love Jen.
8. I now have time to digest this recent loss before our company arrives (more below).

The bad news is:
1. I'm not pregnant.

Yet. Damn, Sage would be so proud. Look at me looking at the positives, along with the negatives.

Tomorrow is Friday for us. My brother, SIL and 4-month old niece come into town to stay with us until Sunday. We will be going to the NCAA tournament Thursday and Saturday. On Friday, my parents and my grandma will come over to the house to hang out. My beta was supposed to be Friday. I had all kinds of nightmarish visions of getting a BFN with my family at my house. While this could have been a good scenario (celebration or support if needed), I was just anxious about dealing with that kind of news around people. Last time I wanted to be around no one other than B. No one. Even though they are my family. I was worried about wanting to lock myself in our bedroom alone for hours on Friday.

On Saturday, we are going to visit G&K to meet their infant twins (although technically, B and I did meet them briefly when they were in the NICU). I was also worried that with a fresh, raw, open wound of a new BFN, I would be in tears the whole day Saturday and would maybe not be up to this visit. I still don't know how I will feel by then. But at least there is a chance now that I will be okay with the visit and even enjoy it. Tonight I feel strong. I feel good and hopeful. But I am fresh off a great conversation with my RE and two glasses of really good wine.

So I need to apologize in advance to my family and G&K. I'm sorry if I break down at random times over the next few days. I'm sorry if I'm not a ball of sunshine to be around. I will try, really. But I can't make any promises. Please know that if a break down does occur, it has nothing to do with you or your babies. It is just my sadness bubbling back up to the surface. Because it is still there. Raw and searing as ever. It is just balanced by hope at the moment. And I hope I can maintain that balance.

Au Naturale

We've gotten the go ahead from Dr. S to move forward with this cycle. Our nurse sent us a copy of a sample schedule and it is possible we could get to transfer as early as March 2nd. Of course, I have absolutely no idea what my body will do this cycle. The first step is to go in a week from today for an ultrasound so they can check for a dominant follicle. Assuming there is one, the size will give us some idea of how close I am to ovulating. I'm hoping that they'll be able to tell something about my lining at that point as well, but it may be too early.

If they see a dominant follicle, we will begin watching for LH surge. I can either do this with home OPK's (ovulation predictor kits) or I can go in for daily blood draws. I used OPK's in the past along with my CBEFM and they always SEEMED to work, but how do I know for sure? We were never successful with timed intercourse or with IUI's, so I just don't know for sure. This makes me lean towards daily blood draws. Except that driving to my clinic every day is somewhat inconvenient during the week because it is in almost the opposite direction of my work and will either require me to get up quite a bit earlier in the morning or show up to work late. Factor in the fact that it's winter and a couple inches of snow could make this even more inconvenient. I'm just not sure at this point which option will cause less stress. What would you do?

My comment the other day about a shot-free cycle was not completely true because they do like to do a trigger shot for natural cycles. Once we detect a surge, we will do an HCG trigger shot to ensure ovulation (even if I'm ovulating on my own). I think this is meant to ensure that my body will start producing progesterone on its own. The day after trigger I would go in for a blood draw to check progesterone level and the day after that begin progesterone and estrogen support. The schedule shows a standard "natural" FET protocol of using 2 Viv.elle patches in addition to 3 progesterone suppositories a day. I'm a little confused because Dr. S didn't mention anything about estrogen support.

Assuming we detect LH surge on February 26th (which is a complete guess at this point), my schedule would look like this:

February 26th: Trigger shot
February 27th: Blood draw (progesterone level)
February 28th: Begin progesterone and estrogen support
February 29th: Begin Tetra.cycline & Med.rol; Blood draw (estrogen and progesterone level)
March 2nd: Transfer; Blood draw (estrogen and progesterone level)
March 2nd & 3rd: Bed rest

Of course the above schedule will move depending on when I surge.

The nurse said she still needed to talk to Dr. S about timing for when they would thaw the embryos. And Dr. S is recommending we thaw ALL 14 of them to grow the to blasts. They said they have no reason to believe a lot of them won't survive to the blast stage, but I don't know. The only one we've had a chance to try that with didn't make it, so I don't have a lot of confidence.

Overall, I'm a little excited because we are already moving into another cycle already. But I'm a bit apprehensive about all the variables that could go wrong. I'm trying to keep my expectations low for this cycle and expect my cycle to be all screwy, my lining to be anorexic, to miss ovulation, etc. I guess I am going into this expecting to get cancelled and if we do make it to transfer, it will be icing on the cake. I'm not sure anymore what the right attitude is to have towards cycling. I'm tired of being disappointed. So I'm going to tell my old friend Hope to go hide in the closet for awhile and not show her face. I know she's there, but I don't want to look at her.

How do you balance hope with managing your expectations?

Looking Back and Looking Forward

Where to start? First of all, thanks to everyone for your kind comments, emails, voicemails, and text messages. I cried hearing/reading every single one of them. This process really is gut wrenching and B and I are lucky to have so much support both from our family and friends and from this online community.

Sunday was devastating. I took Monday to grieve and stayed home from work by myself. B had to go to work and he took the dogs to daycare, so I had the house to myself which is rare. I sat in the front living room (which I never do) on the couch in the sun for most of the day reading, crying, staring out the window. I went back to work on Tuesday and actually had a decent day. I was able to distract myself with work for minutes at a time which was nice.

And then Jen got some truly horrible news and it was all I could think about. At least it kept my thoughts off myself for awhile. If you have a minute, please stop over and grieve with her.

Today was a different story for me. I had trouble focusing. I got frustrated easily, angry easily and teared up at the drop of a hat. One thing that is making this week more difficult than it need be is that a project has come up that is requiring me to work much more closely with one of the pregnant ladies in our department. In the 2+ years we've worked in the same department, we've never really worked together. All of the sudden, I have to delegate to her, review her work, rely on her to get tasks done. I have to check in with her frequently, answer her questions. This is no reflection whatsoever on her personally or professionally, but she is possibly the last person I want constant interaction with this week. Such is life I guess. And I'm starting to realize that the grieving process for this will take awhile. Even if I feel great one day, I might feel completely horrible and down again the next.

Off and on over the past two years I've thought about going to therapy to talk to someone about what we are going through. I kept putting it off thinking the next cycle would be it and all our problems would go away. This time I'm biting the bullet and moving forward with it. At the very least I need someone to convince me that I'm not crazy and obsessive (even though I am). Our clinic has a counselor on staff and we have an appointment set for next Tuesday. I don't know if we'll go just the one time, or if it will become more of a regular thing, but I'm ready to give it a try and luckily, so is B. I know he's not looking forward to it (not that I am either), but he is willing to do this for me and that means the world and makes it so much easier. I likely won't write too much here about our session Tuesday or going forward if we stick with it simply because it just feels too private. But I will let everyone know if I think it is beneficial.

Okay, now to the looking forward. We're getting back in the game-immediately if we can. AF showed up today, so I'm officially on cycle day 1 and I'm waiting to hear back from Dr. S to see if he's okay with us moving forward this cycle or if we need to wait a month or so. Dr. S did call me on Monday to check in and see how we were doing. He apologized and was pretty sympathetic. He said he isn't sure whether my lining was the problem or if there was something wrong with the embryos.

One way to get a better idea of the quality of the embryos next time is to let them grow out longer to the blast stage (5-6 day embryos instead of 2-3 day). The standard FET protocol at our clinic for embryos frozen at the 2pn stage (the day after retrieval), is to transfer them the day after thaw. I'm not sure, but I think that would make them day 2 embryos. At that stage, you can't tell too much about quality which has a huge effect on whether or not they will result in a viable pregnancy. In a fresh cycle at our clinic, the transfer would either happen three days after retrieval, or five days after retrieval at the blast stage. The standard protocol is to try to get them to blast for a 5 day transfer and 3 day transfers only happen if the embryos maybe aren't doing so well or if the embryologist thinks the embryos would do better in their natural environment (in the uterus). Whether to transfer sooner or later is still somewhat controversial, but our clinic generally believes in trying for day 5 transfers instead of day 3 transfers.

The scary thing about trying to grow embryos to blast after a thaw is that they would want to start with as many as possible and, therefore, would thaw all 14 of our totsicles at one time. Assuming most of them survive the thaw, I would expect many of them to not make it to the blast stage and would hope that at least 2 did make it. But they could all stop growing prior to that and the transfer would be cancelled. Then we would be back to square one having to start over with another fresh cycle (stim and retrieval included along with risk of another bout with OHSS-hopefully avoiding the emergency room). However, if this gives them the best shot at picking the two best embryos, maybe it's worth it to risk all of them. If we ended up with more blasts than we were willing to transfer, they could refreeze the rest. So this is a decision we will have to make in the near future.

Dr. S was receptive to trying a natural FET this go round. He agreed that it is possible that my body just doesn't like the extra hormones and it is possible my lining might do better on its own, although we don't know until we try. There are risks to doing a natural cycle-mainly that I could ovulate through and would have to cancel the transfer. What is sounding really attractive about going this route though is that I wouldn't have to take the Lu.pron shots or the estrogen patches/suppositories AT ALL. And rather than doing the PIO shots, if we made it to transfer, we would just supplement my natural progesterone production with progesterone suppositories. That's right ladies and gents, a shot-free cycle!

I have to go into this natural FET knowing full well that there is a chance it could get cancelled either because I've ovulated unexpectedly or because my lining didn't cooperate. And regardless of how prepared I am for that possibility, I'm sure I will be just as upset if it doesn't work out. But since this whole process is one huge scientific experiment anyway, I figure it can't hurt to try something new if Dr. S supports it. Yes, I'm feeling rational today.

So now we just wait for word on whether we can try a natural FET this cycle, or if we need to wait. We then have to decide if we want to go the standard thaw/transfer route, or if we want them to thaw all 14 embryos and grow them to blast before transfer. I also still need to decide whether I want to continue with regular acupuncture or with the electro-acupuncture. Dr. S was pretty indifferent about this. A lot of decisions to make in the next couple of weeks. Feel free to spew advice (or assvice) in the comment section here if you have any thoughts on any of these alternatives.

I'm a little behind on my blog reading, so I don't want you all to think I've forgotten about you. I'll catch up this weekend if I don't get a chance during the week. And for the ColoBloggers, I'll see most of you on Saturday. This meet up is coming at a great time-I could use some advice and company.

1 Day to Beta-Plan B

I am trying to prepare myself for a negative. I know some people would say I should be thinking nothing but positive thoughts, what you receive is the energy you put out into the universe, blah, blah, blah. I just want to have plan B (well, we're really on around plan Q by now) in place in case. Something to focus on if this cycle ends up like every other cycle so far-in the trash. And I am thinking about this now so that I won't have to tomorrow. Tomorrow will be for grieving if that's what the universe has in store.

So here's my plan. For the next FET, I'm thinking of asking Dr. S if it makes sense to try a natural cycle. No Lu.pron suppression, which would mean the actual transfer date would depend on when I naturally ovulate. This protocol has some risk to it because if you miss ovulation (about 10% chance according to Dr. S) the transfer is cancelled because they don't know when you started producing progesterone on your own and, therefore, don't know when to do the transfer. It also makes it more difficult to schedule the transfer date (and give work notice to take a couple of days off for bed rest).

This would also mean going back to using ovulation predictor kits ("OPK") and dusting off my Clear Blue Easy Fertility Monitor ("CBEFM"). This would feel a bit like taking steps backward because these are the tools we used for timed intercourse before getting into ART. But, it would mean no Lu.pron which is definitely a positive.

My reasoning for wanting to try a natural cycle is to see what my lining does naturally on its own. If this FET fails, I will blame it completely on my lining. My retarded, anorexic, uncooperative lining (of course, I reserve the right to take back all of this name calling should this FET turn out successful). Back in the day before we saw an RE and I was going through testing with my OB, I had a great lining, cycle after cycle, until we introduced Clo.mid into the mix. It just seems that my lining doesn't like artificial hormones and medications. I must have a hippie lining-all natural, all organic, all the time.

Dr. S doesn't actually believe my lining can get thicker than an 8 on its own because this is the thickest measurement in my chart. I tried to tell him during FET #1 (which was cancelled) that I had documentation of thicker linings in cycles past where I was unmedicated. He scoffed at this idea because those measurements were done by my OB's office. He doesn't trust any measurements or tests performed by anyone other than his own U/S or lab technicians. While this is incredibly arrogant and self-important of him, it is also a trait that I think is good to have in an RE. I want my RE to have full confidence in his staff and to believe their training is the best. But with my experience a couple of weeks ago, I'm not so convinced the measurements by his U/S technicians are all that accurate either.

Anyway, I would be curious to see what actually happens with my lining when left to its own devices. The thing is, there are different protocols that go along with natural FET's that span all ends of the spectrum. From absolutely no hormones or medications, to everything except the Lu.pron (still doing the estrogen patches, PIO, baby aspiring, etc.). So again, there would be more decisions to make that likely requires yet another regroup appointment with Dr. S. I hate those regroup appointments. The inevitable "no, we don't know what happened." They never know.

So now you know what's going through my head today. Of course I'm still hoping that none of the above will come into play (at least not for another year or so) and I can move forward blissfully ignorant of natural FET cycles because my fully medicated FET cycle did the trick.

6 Days to Beta-Torn

If you haven't noticed, the POAS poll is neck and neck (and at the moment is tied) between the yes's and no's. Funny thing is, it reflects exactly how I feel. I desperately want to POAS and see those two lines, no matter how faint the second line might be. Even if it is too early or if it really is negative, I still want to POAS just so I would KNOW (even though I know it wouldn't necessarily be accurate).

And I equally desperately want to wait until beta on Sunday. I don't want to see the stark whiteness of the strip (for the thousandth time). I don't want to lose any hope. I want to hang onto this feeling of "maybe I'm pregnant!" forever because this is the closest we've ever come (as far as I know). I'm hating the PIO shots and what gets me through them is believing it isn't all for nothing. If I were to POAS and see a negative, it could crush that belief.

So you see, I am torn. For those of you who voted, please comment and let me know your vote and why you chose to vote that way. I need to see all viewpoints of this. Even if it is just gives me something to think about for the next 6 days!

7 Days To Beta-The Lone Embryo

We have not yet received a call from the lab to let us know whether the 3rd embryo made it back to freeze. I'm expecting a call today and I will call them if I haven't heard from them by tomorrow. I know we have 14 others still on ice, so I won't be devastated if this one embryo doesn't make it to freeze. However, I feel like it might give me some clue as to what is (or isn't) happening inside my uterus right now.

Here's my thinking. If this lone embryo developed into a blast and was growing enough to make it to freeze, that means the two they transferred should be doing the same inside me. Assuming my lining was sufficient (eh, not sure about that one), they should be burrowing in nicely by now. I know that each embryo is different, but these were from the same fresh cycle, went through the same freeze process at the same time, and went through the same thaw process at the same time as the lone embryo. Might be flawed logic on my part, but that's what I'm thinking.

If however, the embryo didn't make it to blast, I will stick with the theory that they transferred the best 2 out of the 3 and that what happened with the lone embryo has no bearing on what the other 2 are doing inside me. See, nothing but positivity oozing out of my pores today. Or maybe that's the oil from the PIO shots.

I initially thought it was a good sign that the lab hasn't called yet because if the lone embryo had already arrested (stopped growing), they would have called to let me know it didn't make it to freeze. However, I think it is more likely that they would wait to even check on it until the day they would refreeze it (today?). So if it had arrested, they wouldn't even know until they went to freeze it.

This is driving me crazy.