Empty

Sac. An Empty Sac.

6w3d.

A Gestational Sac measuring 5w5d. A Yolk Sac barely visible. No Fetal Pole.

That's it.

My options:

1. Continue progesterone and estrogen and return for another u/s next week, with a 1%-3% chance that something will change.
2. Stop progesterone and estrogen and wait for natural miscarriage.
3. Take the drug, misoprostol, to induce miscarriage.
4. Schedule a D&C.
5. Schedule a D&C and have genetic testing done on the tissue.

We drove the 6 hours home yesterday in mostly silence interrupted by my occasional sobs. When I spilled the coffee, when my mom texted me, when I thought about how I had been losing symptoms over the last few days, when I thought about how completely unfair infertility is or that tomorrow will be 2012. I thought about many things on the way home.

I stopped the progesterone and estrogen and aspirin. This morning I stayed in bed wondering if I made the right decision. If I should have scheduled a second u/s. If a miracle could happen. Yet knowing that I am no longer pregnant.

6 weeks

I feel like I've passed some sort of milestone by making it to 6 weeks. At the same time, it feels like nothing. I am so far from being out of the woods.

There are a few more symptoms, but still not much to speak of. Still no nausea. And that is okay.

My primary fear is that we will see and hear nothing at the ultrasound on Friday. Yes Friday. I just can't wait, yet if it means that this is over, I never want it to arrive.

Don't Get me Wrong; I Do Have Moments of Pure Joy and Excitement

This post on the heels of my hard times. I want you all to know that while I am terrified of losing this, I am overjoyed that this really may be happening. My excitement is quiet and reserved, but it is still there.

F and I are taking one day at a time. Which makes waiting for the ultrasound excruciating.

Thank you for your patience and support.

Hello? Embryo? Are You Still There?

It seems that around 10am all sensations of pregnancy disappear. I feel thinner. My breasts aren't sore AT ALL. I just don't feel pregnant anymore.

This morning I just couldn't let go of that heavy feeling of discouragement and pessimism. I wanted to cry. I convinced myself that the embryo was no longer growing, that I was not really pregnant.

It is 10am. F persuaded me to go out and get another pregnancy test. Which I did. And was terrified.

Thankfully it was still positive. The darkest line yet. But the test only confirmed the the thing that is making this wait so long and difficult. We won't really know anything until we can see with our eyes that the embryo is doing okay. That won't be until next Friday.

Deep Breaths.

5 weeks

I am 5 weeks pregnant today. Of course I have no idea what is actually going on in my uterus, with the embryo, with this pregnancy. My fears speak loudly. I try to quiet and distract them.

I focus on symptoms. Last night I read through all the IF blogs I subscribe to searching for the early symptoms of others, or lack thereof. Mine:

1. Swollen breasts, hot to the touch at night. Though sometimes even this symptom is completely absent, usually during mid morning when I have a freak out of negative thoughts.

2. Maybe slight dizzyness, what I describe more as loopyness or feeling woozy when I'm out walking my dog (not to be confused with nausea, because I have not been graced with that symptom, though I long for it).

Umm....that is all. That is it.

Am I still pregnant? I really have no idea. I hope so.

Beta #2

Today has been excruciating. I arrived at my local small town medical center at 7:30 this morning to ensure that there would be time today to send the labs out and get the result to my clinic so that they can get the result to ME the same day. Only to find that the medical center doesn't open until 8 am.

My phone has been in my hand all day long. Even when I fell asleep at lunch.

When the nurse finally called, I could tell by her voice that she did not have bad news.

Beta #2 is 263. We have doubling! A doubling time of 44 hours.

This may be for real, folks.

Beta #1

My first Bhcg was yesterday.

I got the call from the nurse that afternoon. Because I cheated, I already knew what the answer (pregnant, not pregnant or maybe) was. I knew I was pregnant, just not how pregnant. More than anything I did not want her to say, "For now, let's just be cautiously optimistic." So when she said, "Congratulations, you're pregnant." I quickly said, "What is the number?" In my mind it went, WHAT IS THE NUMBER, JUST TELL ME THE NUMBER!!

I didn't tell them that I cheated and already knew.

My hcg level was 124. They want to see over 50 at the first beta, 9dp5dt.

Of course, I am still cautiously optimistic. My hcg levels still have to double. The embryo still has to grow. And stay put. And have a beating heart. Whew, I will try to take this one day at a time.

We talked about my horrible breakout, which may or may not be caused by high levels of estrogen. They decreased my dose of estrace to 2mg once a day. I hope that helps.

As for symptoms, I am experiencing some cramping on and off. Some moments I don't feel pregnant at all. My boobs aren't sore. At night they feel full and hard, but not sore. Yesterday I was tired. What I mean is, I really don't have any symptoms.

I Cheated. I Tested Before the Beta.

7dp5dt.

It was positive.

8dp5dt.

It is still positive.

We are still not celebrating yet. Beta tomorrow.

5dp5dt (and a non-post about eSET)

Five days past five day transfer. 4 days to go.

I wanted to do a post about Elective Single Embryo Transfer, something about how the few studies that have been done, mostly in Europe, show no significant difference in success rates when compared to transferring 2 embryos on day 5, or, how at my clinic, they know that 50% of those who achieve pregnancy (after transferring 2) have twin pregnancies, but that they don't have a whole lot of data about eSETs because so few of their patients choose that option. It was an option for us, we knew we would choose that option if it was available, and so on Sunday after a good discussion with the embryologist, that is what we did. It wasn't easy when it came down to the moment.

I know that many patients are not good candidates for eSET, I do know this. I also know that many of my favorite bloggers are having multiples and I think that is wonderful! Maybe that is partly why writing a post about eSET seems so difficult. There are many issues involved that complicate the decision, the cost of a fresh IVF cycle being just one, and so I don't mean to simplify in this post/non-post about eSET.

Maybe someday I will write the post I want. For now, I just want to acknowledge Elective Single Embryo Transfer. Because I really hope it worked for us.

-------------------

Now, back to 5dp5dt. And the worst part of IVF so far.

The worst part of IVF so far is the horrible breakout of tiny pimples, almost like a rash, extending from my jaw line down to my chest, and down my back. It looks like baby acne in the way it is clustered and size of the pimples. It looks like the measles when I stand in front of the mirror.

I am. hideous.

Please someone tell me you have experienced something similar? I can handle a zit or two, or few, but this? I better be pregnant.

Also tell me your thoughts on Elective Single Embryo Transfer. Would you choose it? If you could have but didn't, why?

OK TRANSFER!

Every time the phone rang in the days leading up to day 5 my first thought was, "Oh no, it's the clinic calling to tell me that all the embryos died!" It never was. Thankfully.

We still weren't entirely convinced we would have any to transfer as we made the drive to Portland the day before the transfer. I was awake at 6am with a crampy feeling that convinced me that my uterus was not going to accept any embryos anyway.

We had an appointment with the embryologist and the RE at 9:15 to talk about our embryos. We got up, showered (this would be my last shower for the next 48 hours. I suddenly became more worried about the mess made by the endometrin and instantly mortified at the thought that Dr H would see it. Later I will realize that he will also "flush" the area to clean said mess, or maybe just my cervix), and headed for the clinic early so that we could take our dog (who is always along for IF travels) for a good walk around the Nob Hill neighborhood. It was good to walk before the transfer. Also my last walk for a few days.

Ok, are you dying to hear the number of embryos we had on day 5?

We had 3 high quality blastocysts and one slightly behind. We talked to the embryologist about the number to transfer. F and I had been talking about the number to transfer for days and we really wanted to be able to do a single embryo transfer.

And that is what we did. We transferred one blast. It was a scary and difficult decision but it was what is best for us.

To our surprise on day 6, we had four embryos suitable for freezing. This means that out of 10 eggs retrieved, 9 fertilized and half of them made it to blastocysts.

One super blast is inside my uterus, hopefully implanting as I type this. Implantation should begin to happen within 48 hours of the transfer. I am staying in bed for an extra day, not caring if I am being overly cautious or that my back is starting to hurt.

I should probably take a shower.

How do people maintain bed rest for weeks and not get an unbearably sore and stiff back?

Fertilization Report

Out of 10 eggs retrieved, 9 fertilized.

As of yesterday we have 9 fertilized eggs (eek!).

Some clinics keep you updated on the fate of your eggs--how many make it to the embryo stage on day 3, how they are graded and growing and the number of cells. Not our clinic.

"You will not receive a report today."

We won't know how many embryos we have or what our options are until the day of transfer. Additionally, under our IVF refund plan, we can only do 5 day transfers (but I think most transfers they do at this clinic are 5 day, at least that is what it sounded like at the IVF orientation, as they did not even go over 3 day transfers).

At first the idea of no embryo updates was disappointing. But then I started thinking about the stress involved in daily or every other day reports. How important is it to hear that half of the eggs did not divide properly? Or that the embryos we do have are growing slowly. Of course, if none make it to embryo stage then they will obviously call us to cancel the transfer, but this way, we plan for the transfer, keep our fingers crossed that we have 1-2 good blasts to transfer (and more to freeze) on Sunday and let the next 3 days go by quickly.

3 days is not so bad. And since we have a day of travel (again, ugh!), it will be like we only have 2 days to wait, today and tomorrow.

5 day transfer is scheduled for Sunday at 9:15 am!