That's a Wrap! And That's Where We Are.

The arrival of AF seems newsworthy enough for a post to mark the end of pregnancy #5 and miscarriage #4.

I'm doing fine. Friends are delivering and gestating babies #2 and #3 and I am not. I begrudgingly loaned my baby swing to one of these friends. She asked to borrow it the week of the miscarriage. That was hard. Maybe I will get to ask for it back, but probably not.

I am aware of my age more than ever (I am now in the last year of my 30s). I know the odds are not in my favor. But I couldn't get pregnant at 31, 32, and 33 with and without assistance so age feels meaningless in my experience anyway.

From 2011-2013, over the course of 2 IVF cycles and one FET, it took 26 eggs to make 5 embryos. Those embryos developed into 3 pregnancies (4 gestational sacs). And we are so lucky to have one healthy child.

When I think about the odds, my age, my recent miscarriages, and the years, trying for a natural pregnancy that doesn't end in miscarriage seems ludicrous, naive, and actually, pitiful. I imagine people saying, "Bless her heart."

I came across this a few weeks ago:








 

And that's where we are.

Faint Lines

The follow-up hpt at four weeks post miscarriage:

Second Line: Still there? I don't know! Infertility has trained my eyes to see lines that may or may not be there. But it doesn't matter because that means my hcg levels are non-detectable!

Have any of you used the new comfort grip or shape FRER sticks? WTF FRER?!

Weekly HPT Self-Monitoring: 3 weeks post-miscarriage

I'm in better spirits this week. Fall is here and I love the fall in this town. Baby G, who I guess I should now refer to as Toddler G, is a whirlwind of energy and emotion and is about all I can keep up with at the moment.

I left an hpt sitting next to the toilet last night so that I would see it first thing. Here is the result with first morning urine, 3 weeks after miscarriage:

I don't think it shows in the photo, but after 10 minutes I could see a very, very faint second line. Though for all purposes, a negative result. My 'experienced' guess is that my hcg levels are below 5. Yet, I still want to take another in a day or so just to verify a negative (Yes, I am a little obsessed about hcg levels).

I am sort of in disbelief at how quickly my levels have dropped compared to past experiences. I think 4 weeks is a standard, with 6 weeks being a standard for a return of AF. Things are looking good then. Fingers still crossed for a 'normal' recovery to continue.

Weekly HPT Self Monitoring: 2 Weeks Post Miscarriage

I saw those two lines on the hpt this morning and I felt such a sadness and grief because I'm going to watch those two lines fade and disappear into one. And there was this little voice in my head that said with such exactitude, "After this line fades, you will never see two lines again."

I try not to think too much about what comes next, to get too far ahead of the present task, which is for now, to get my cycle back. Based on that second line, my hcg is definitely dropping. I've decided to start taking weekly hpts. I planned on using first morning urine, but in my 6 am sleep zombie state, I forgot. So I will use s.m.u. instead and post weekly until...no more second line.



Thanks for reading. I'm reading you, too, just haven't gotten back into the groove of commenting. In many ways its so comforting to see these blogs again.

Final Follow-Up (hopefully).

I had another ultrasound today, four days after the second dose of misoprotol, to confirm that the miscarriage is complete. Everything looked clear. I've been bleeding pretty heavily all week. Yesterday I passed another large piece of tissue. The news that everything seems to have passed is a relief. I will self monitor with hpts rather than hcg blood panels for now. Hopefully my hormone levels will decrease quickly.

And then what? The midwife today asked me if I was seeing a fertility specialist or if we planned to. No. We don't really have a plan. We still know that we do not want to do treatments again. We know that we will not be using birth control. We also know that miscarriages are sad, painful, and difficult. I asked the midwife if she would ever tell a patient like me that enough is enough. She said no. I asked her if recurrent first trimester miscarriage posed any sort of health risk. She said not in my case so far. She did suggest that I continue taking my prenatal vitamin and add an extra folic acid supplement. Ok.

F and I talked about this for a little while tonight. We are happy as a family of three. We would also welcome a sibling for our son. But three is good, really good. If it happens, it happens. We'll try and see what happens, for how long, I'm not sure.

Misoprostol the Second Time Around

Because Misoprostol worked so well for Miscarriage #3 last year, I decided to go that route again for #4. There is something morbidly comforting about planning your miscarriage, making your little nesting spot for the next few hours, or day, with everything you may need.

The dosing/prescription was different this time. Actually, it was half of what I was prescribed last year. I don't know if the dosing was different because I am at a different practice, because this pregnancy ended earlier than the last one, or what. One CNM did say that there is not a standard protocol for administering misoprostol for missed miscarriage.  The instructions were also different. I was instructed to take one dose of 800 mg of misoprostol versus 400 mg every 4 hours.

Saturday was a busy day. At 4:00 pm, I pushed 4 little pills of misoprostol against my cervix, said a little prayer, and lay down.

Saturday
4:00pm: take 800 mg misoprostol (vaginally).
6:15pm: spotting pink
7:30pm: crampy. take 200mg ibuprofen
8:30pm: take another 200mg ibuprofen
9:00pm: period-like bleeding. cramps intensify. use heating pad until ibuprofen kicks in.
10pm: nothing much is happening. go to bed.

Sunday
4:30am: got up to use the bathroom. passed some clots. no cramping.
7:00am: wake. very light bleeding, no cramping. worried that one dose of 800mg was not enough. instructions say to give it 24 hours. Wait.
10:00am: clean the house.
4:00pm: 24 hours since dose. No progress. Spotting.

Monday
7:00am: very light flow with small brown stringy clots.
9:00 am: Go for a brisk 2 mile walk to see if things pick up.
11:00am: Spotting. Call ob office. Pick up another dose.
2:30pm: take second dose of 800mg vaginally.
6:30pm: passed more small clots. No cramping yet.
7:00pm: Period-like bleeding. Passed a large clot and...the pills! Attempt to put. them. back.
7:30pm: Cramping and heavy bleeding. Take 400 mg ibuprofen.
8:30pm: Felt a gush. passed something LARGE, most likely the sac and tissue.
9:30pm: another gush and large clot or tissue.
10:00pm: last large clot.
10:45pm: take 400mg of ibuprofen for cramping. Period-like bleeding. Go to bed.
Overnight: woke up every few hours to change my pad. Moderate-heavy bleeding.

Tuesday
Heavy bleeding all day. Off and on crampy feeling, mild enough not to need any pain reliever. Feels like there might still be a clot on my cervix. Call OB's office to check in. They want to see me on Friday.

Wednesday
Heavy Bleeding continues. Felt more confident to leave the house today.

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So. 800mg of misoprostol was definitely not enough, but with a second dose, hopefully everything has passed. Passing the sac and tissue is always jarring and disturbing, and I always wish our medical providers would accurately describe to us what we will see, what the tissue will look like and even feel like, so it is not quite so shocking. Yes they tell us we will not be able to see the embryo/fetus, but they do not tell us what the sac will look like. Maybe they just do not know. Maybe it is up to us to describe it to each other.

But I won't here. In case you don't want to read it in bloody detail. But if you happen to come across this post in search of details and wanting to know what to expect beyond the description of "heavy bleeding with clots and possibly tissue," let me know, and I will.

You can also read about my first experience with misoprostol here. Or click on the miscarriage tab for a summary of them all.

Another Year Goes By, Another Miscarriage.

A second natural pregnancy. And a fourth miscarriage. I'm sorry to pop in again with this sort of update, but I feel compelled to add this event to our story of infertility and loss. I'll summarize.

In the months after miscarriage #3, I had irregular bleeding and spotting off and on until my post-partum cycles regulated. I don't know what of this bleeding to attribute to the miscarriage, getting my period back after having baby, changes in breastfeeding, or all of the above. By December 2014, my cycle seemed to regulate and we were 'casually trying' for another pregnancy.

Then this summer I actually got pregnant from sex! I made an appointment for an early ultrasound. But right around 6 weeks I had some bleeding and went in for a scan. The Nurse Practitioner who performed the u/s had a hard time identifying a yolk sac. I thought I might have seen something but was convinced it was a blighted ovum. We also saw some blood in between the sac and my cervix. She was way more optimistic than I was and told me it was too early, I probably ovulated later, etc, etc. She didn't take any measurements. We made a follow up appointment for the following week.

I was 7 weeks, based on my LMP, when I had the second scan. There was actually growth. The CRL measured 6w5d. There was a heartbeat but it was low. As low as 80 bpm. Very low. This time I had a CNM doing the u/s. She told me to be cautiously optimistic, that maybe the heart just started beating, that she has seen this situation go either way. I was more pragmatic. I know what the fetal heart rate should be when the CRL measures 6w5d. But still, I was shocked that there was growth and even more that there was a heartbeat. Wait another week.

I started getting more pregnancy symptoms in the days following the 7 week ultrasound. I was starting to get hopeful. And then my symptoms disappeared. When I went in for my third ultrasound at 8 weeks, the image showed no growth at all since the last scan and no heartbeat.

That was yesterday. I've decided to take misoprostol again to induce the actual miscarriage. I was almost leaning towards d/c, but this practice of OBs and CNMs recommend medical management when the pregnancy measures 8 weeks or under.

I'll check back in after the miscarriage is complete. Thanks for reading.