blech

I keep meaning to post IVF # 4 – 6 and their stats, etc. You know, just in case someone really wants to hear about my ovarian response to gonadotropins. Actually I learned a lot from reading about other people’s cycles. I probably wouldn’t have my son had I not come across a blog back in 2006 where a woman had zero fertilization of 17 good looking eggs – thanks to her I made sure we did ICSI on each cycle and had good fertilization.

Unfortunately this blog is turning into one long moan and I am sorry to say that there isn’t much I can do about it. I’m not the kind of person who can wait and see. I need to know what I am facing.

So here I am facing a deep dark hole – I am 8 weeks today. Yesterday, at 7 weeks 6 days, the embryo measured 7 weeks exactly – 7.2 days if you use another measurement. I have earned my google MD….and over the past 24 hours I’ve become an expert on reading fetal ultrasounds prior to 9 weeks gestation. So the facts are that I measuring behind – to be precise, the embryo is measuring (the CROWN RUMP LENGTH or CRL) exactly 1cm. This corresponds to a gestational age of 7 weeks exactly (there is a plus or minus of 5 days but….I received this reading from two different techs so I’m going to trust it). Last week I measured 3 days behind and now the gap is widening. This could mean a number of things.

The Bad:

1. Abnormality. Triploidy/other chromosomal abnormality in the embryo seems like a reasonable diagnosis for slow fetal growth.

2. Sac size not growing fast enough to accommodate growing fetus. My sac is measuring 5 weeks 3 days (which translates to 2/3 days ahead of the embryo). I won’t bore you with the minutiae but basically this is a death sentence.
3. Blood flow problems. I have a blood clotting issue. I am on lovenox injections once per day to keep my blood clot free and flowing. Hopefully this is working because these shots are a mother. My legs are bruised and battered and quite frankly, I spend a good deal of my day dreading them. When my husband does the injection it definitely doesn’t hurt as much. I’m such a wimp that I SLOWLY stick the needle into my thigh and then even more slowly inject the fluid. I don’t think I’ll ever get used to giving myself injections.

The good (there are some glimmers of hope here):

1. The embryo is a girl. Read this: The longitudinally collected observations showed that CRL in female fetuses was significantly smaller compared with that in male fetuses
2. Late implanter. Could be – I did have lowish betas and who knows when I actually conceived on an IUI cycle (though I suspect it was within a 24 hour period of November 4th).
3. Tech error. Again, highly unlikely that two techs are going to come up with the same measurements.

So I guess I just have to wait until Monday’s ultrasound. I have to remain hopeful that growth will be consistent and that the heartbeat (154 bpm) will remain strong. The prognosis isn’t good though – from every story I have read of women in the same position…probably 80 percent resulted in miscarriage.

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Consult with Dr. Schoolcraft.

I seriously cannot say enough about this man. I really liked him for so many reason – he came across as not only knowledgeable but genuinely concerned.

Prior to the appointment I had to fill out about 20 pages worth of forms and compile my infertility novella (which is up to about 40 pages – my true file, if I had absolutely everything would probably be twice as large). I wrote him a concise chronological note so that he would not have to sift through all of it which I think he appreciated. He talked at length about his program and answered all of my questions. He told me that the new form of PGD that they are testing is getting unbelievable results. His pregnancy rates for women of all ages is around 70 percent. Even women who are coming to him with repeat miscarriages, horrible egg quality, previous chromosomal abnormal births – these women are having healthy babies! He attributes it to this procedure – they grow your embryos to blast, test them and then freeze them. The process takes a week and that is why the embryo has to be frozen. They test ALL 23 chromosomes – unlike the old PGD (which I had the pleasure of wasting a great deal of money on) which only tested 9 of the most common abnormalities. Once the embryos have been assessed the mother is given estrogen and progesterone to create a healthy environment for the embryo. He believes that this environment is more conducive to pregnancy than a fresh IVF cycle and that is another reason the success rate is so high. Apparently not one embryo has been lost after the freeze. So, I think any woman who wants a kid should just go to Colorado and cycle with CCRM. Their stats are just beyond compare and he gave me such hope. I was quite touched that he repeatedly wished me well on my current pregnancy and said, “we are here if you need us but I really hope we never speak again”. The next day his nurse followed up with a call giving me well wishes and reminded me that they were there for me if I needed them. It felt really wonderful to have this option in the back of my mind – nothing worse than grasping at straws after a failed cycle. I actually owe this current pregnancy to Schoolcraft – his writings (and he reiterated this during our conversation) convinced me to ditch the lupron and go for a low stim for better egg quality. So, thank you Dr. Schoolcraft for being indirectly responsible for what is going on in my uterus at the moment. I also have him to thank for reminding me that I should be on blood thinners (I have a blood clotting factor). I originally thought that baby aspirin would do the trick but, as he says, better safe than sorry. I’m taking lovenox and believe me when I say that this is one nasty drug. It hurts going in and each and ever shot makes a huge purple bruise.

So far so good – I’m feeling sick most of the day, breasts still massive with big blue horrible veins, belly big and bloated..and I’m tired.

Trying to find the energy to post about IVF#4 and IVF#5 – this weekend I must do that.

IVF #3 – a conclusion of sorts

Monday, May 29 was a Memorial Day.  C and I returned to NYC that evening.  The week ahead was sure to be rough – we were putting our cat to sleep that week and I was going to get the final word from the doctor that my HGC level had indeed, like the month previous, fallen.

I had one more HPT test left in my medicine cabinet in the apartment.  When I told C that I might as well use it up – he said, “why do you keep torturing yourself”.  He was right but an HPT in my hands is like a pipe full of crack to a crack addict.  I peed on it.  Quickly the line second line indicating pregnancy became very, very dark.  What in the hell as going on here!?  Neither C nor I could believe our eyes.  Could it be?  Once again our hopes were raised.  I was kicking myself – what about all that wine and the sleeping pill!  

My hopes were quickly dashed the following morning when my period began.  I went to the RE’s office around 8am, gave blood and waited for their phone call.  It finally came at 1pm – my husband was also on the line.  I had stopped taking phone calls from the doctor at work.  C and I decided that he should learn the news first and then inform me.  I heard the voice of the nurse..and stopped her in her tracks.  “I’ve started my period, so I know what you are going to say” I informed her.  “Well, that isn’t your period – your levels went up to 51”.  I couldn’t believe it.  

I quickly learned that a level of 51 at 15dpo was certainly within range for normal betas but it became clear that this was on the low side of normal.  Only 60% (or something like that) of pregnancies with a beta such as mine went on to become normal pregnancies.  Certainly this would be a singleton pregnancy – twins would probably be a much higher level…but every two days they checked my levels and every 48 hours my beta doubled.  I was given three  IVIG transfusions -there was a theory that my immune system was causing early miscarriages and this would help calm it down.  I was also placed on blood thinners for the remainder of my pregnancy.  One shot of lovenox and one shot of progesterone until week 12.  

When my beta level reached 5000 they stopped testing me every other day and I went in for a sonogram to check for a heartbeat.  I remember I was due to attend an offsite work presentation and had to arrive late.  When I walked in they were already in progress….everyone turned, looked and me and cheered when I told them there was one strong heartbeat place in the right spot in my uterus.  When I told C the news he said, “but what happened to the other ones??”.  That made me laugh – for the first time “be thankful for what you have” became something I could not only understand but live by!

During one of my many visits to the RE for a sonogram and bloodwork I passed a short woman wearing huge black sunglasses.  Instantly I knew who she was…and so do you.  I can’t ethically post her identity here but let’s just say she is a huge star married to a very famous actor.  A few days later while giving more blood I saw her husband (my childhood crush) enter the “wank room” as my husband calls it.  A number of weeks later I saw them both pass me while giving blood – clearly they had come for a conversation after a failed cycle.   She was around 40/41 (approximately) at the time and to my knowledge has never been pregnant again.  At that moment it occurred to me that infertility can happen to anyone to everyone – money certainly helps buy more cycles but can’t make your ovaries work or make that embryo a healthy one or solve implantation failure.  

I certainly digressed…the weeks went on and on – and nervously we waited for magical #12.  We had chosen the most conservative doctor in Manhattan (by ALL accounts) and she did a wonderful job of worrying about me and testing me – so much that I felt that I could finally relax.  We had our nuchal scan (where they measure the back of the neck to check for aneuploidy) at week 11 and all looked fine.  The blood work came back normal…but my doctor was urging me to have an amnio at 18 weeks.  She told us horror story after horror story about women who had great first and second trimester results delivering downs and trisomy babies.  But I couldn’t do it.  I’d come so far and was just not willing to take the 1 in 300 risk of miscarriage that might be the result of an amnio.  When I spoke to the radiologist he told me that results like mine had never – in his 20 plus years of experience – resulted in anything other than a normal child, my decision was made.  My doctor wasn’t pleased but I didn’t care.  I couldn’t take the risk.

In my 20th week they discovered that I had placenta previa – being on blood thinners and having your placenta cover your cervix was not a good combination.  I was put on modified bed rest and allowed to get up four hours a week (which I used stupidly used to go to work!).  On December 7, when I was 31 weeks pregnant, C lost his job – on December 8 my doctor, during a routine examination, found that I had dilated to 1 centimeter, my cervix had shortened considerably and I was contracting fairly regularly.  I was put in the hospital for four days on a magnesium sulfate drip.  That was the most miserable drug I’ve ever been given – it made you feel like you had a horrible case of the flu and every muscle in my body was weak and ached.  I was only allowed to get up once a day to use the toilet.  They gave me steroid shots to help develop the baby’s lungs should it arrive early.  On day 4 I had stabilized, was no longer contracting and  allowed to go home.  I stayed on the couch and in bed for a month and half.  I ventured out for a small walk at 35 weeks and had a massive contraction which sent me hobbling back to the apartment in pain with a very angry husband…and an even angrier OB on the telephone.  When she asked me why I went for a walk I told her the truth – I was bored.  “well the NICU is very exciting” she told me, referring to the Neonatal intensive care unit…my doula called and told me that I should have a small glass of whiskey to stop the contractions.  She urged me not to tell my doctor…and I didn’t.

At 38 weeks I was induced because of my blood clotting problem.  But first, to prove my child had well developed lungs, they made me do an amnio – which I did without hesitation.  I was feeling miserable and wanted desperately not to be pregnant anymore….