IVF Diary Vol III: 20-24 Apr 16

Medication(s) administered and dosage(s). 8DP5DT (8 days past 5 Day Transfer)  PM Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2.

These injections do not get any easier!! Fortunately (for me) the past two evenings Chris has been doing the injecting part.  Kudos to him.  It doesn’t get any easier for him.  He had a nervous laughing fit the other night after he pierced my skin and was starting to inject, and I was trying hard not to laugh at him (I didn’t want my muscles to tense up or to shake the needle around as it was inside me!!!). Nope, it doesn’t get easier.

Medical procedures undertaken. Nil!

Any results?  Apart from finding out I needed to be taking iron supplements, I wrote a post about that and had a brief ‘freak out’ moment of feeling like maybe I had a chance to improve my egg quality.  But that was silly, and I realise that now.  I did go out and buy some iron supplements.  I bought it in liquid form because I find the majority of pills hard to stomach (there is something about the pill lining they use that makes me puke them back up).  Basically the supplement tastes like I am swallowing a tablespoon of blood. BLEUGHHHHHHH.

What are my symptoms?  Yesterday I struggled with my OHSS symptoms.  We had a nice day out watching a parade and going to a festival that celebrates NATO.  But it’s really the first time I have been out and about for a significant amount of time not sitting down.  We then went to the shops and after about an hour my stomach was in pain.  I just needed to sit!  I was also incredibly thirsty all day, nothing could quench my thirst!!!  Last night I got up to pee FIVE times!!!! I also found it hard to get in and out of bed each time because of my hugely bloated painful tummy.  I am a little worried that my OHSS has done a U turn and rather than getting better is now getting worse.  This could mean I am pregnant though because OHSS can get worse as my body starts to produce hCG after the embryo implants.  It’s something I’ve been told to watch out for….If things don’t subside today then tomorrow is my last chance to go in for an ultrasound before I am supposed to be back in DC – I don’t want to be getting worse whilst I am away from home!  I am going to take it easy today though, maybe I just over did it yesterday.

How do I feel today? It has been really hard not to pee on a stick the past few days.  Especially yesterday with my symptoms developing as they were I just felt like I might see a positive!  And so now I have my expectations set high, I’m terrified to be wrong and see a blank white space on that pregnancy test.  So I haven’t done it.  I looked back and compared my symptoms from cycle 1 (BFP – positive) to cycle 2 (BFN – negative) and actually I seemed to have experienced similar symptoms in both cycles.  I guess it is that damn progesterone and estrogen making me feel like this!

Chris told me that if this cycle fails he wants to wait several months before transferring our final frozen embryo.  Which I understand why he feels like that.  But I feel differently about it.  I said we should have this conversation later and not now.  I need to be positive, I need to be hopeful right now, I want this to work so so much I can’t even think beyond this.  Last cycle I was OK with thinking about the future and what’s next because I knew we could always give IVF another try.  This time for me is different.  I know there isn’t a next IVF.  I know this to me is all or nothing.

 What’s next? Friday is test time – in between all that I have a work trip to DC to occupy me and keep me busy!  This does mean I will be doing more injections on my own 😦 and Chris will be on his own in the house alone this week when perhaps we really need each other right now.

The Final Countdown!!! 

160424_IVF3_Calendar_Countdown.jpg

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal), 5mg Melatonin at bed time and CoQ10 200mg gummies, and  Pur-absorb iron supplements daily.  NSTR = Nothing Significant To Report.

I survived!

Of course I survived…no one dies from an HSG right?!?!

As I sat on my own in the procedure room waiting for the doctor I noticed just how dated everything in this room looked.  I also noticed two capsules stuck with cellotape onto the wall behind the head of the bed and the other on the needle disposal box.  I was intrigued because they said ‘amonia’ on them.  I wondered why these capsules were stuck there.  As more time passed I finally figured out what it was for – smelling salts for passed out patients! There was a piece of paper stuck on the wall that gave steps of what to do in an emergency – the kind of emergency when  patient passes out and you have no clue what is wrong with them.  The first step said: Keep calm! I found this quite amusing that a doctor/nurse needed to be reminded to keep calm first of all.  One of the other steps described how to use the ammonia capsule to see if the patient ids responsive. There was another sheet of paper stuck on the wall next to these emergency instructions, giving instructions for what to do if a patient was having an allergic reaction.  I suppose some poor people in the past have found out that they truly are allergic to shell fish or iodine as a result of this HSG procedure! So I guess you can die from an HSG afterall.

After waiting for 20 minutes ready to go, the doctor came in and introduced herself – as if I had never met her before.  She didn’t recognise me at all.  Even with my British accent she didn’t recognise me and proceeded to ask me questions as if I was a new patient.  Considering the number of times she has seen my vagina and cervix (I can count 8 monitoring appointments and 2 inseminations) I was a bit upset by this fact.

So we got down to the business….and the procedure hurt so much that I had tears in my eyes.  It was all over after only 5 minutes, but they were a painful 5 minutes.  I peeked at the video of the x-ray as she was cleaning me up.  I could see my upside down uterus and the dye free flowing through my tubes.  And then something weird happened – my uterus flipped upright at the end of the procedure!  I felt her do something weird, did she manipulate my uterus? Or was it just the xray moving to a different position?  Logically the latter doesn’t make much sense…but then again neither does the manipulation! I’ll know exactly what happened when I go for my baseline ultrasound in the new year.

Good news is that I passed the test!! IVF round 2 is on in the new year!!

After the procedure I went back to the waiting room to pick up Chris because he wasn’t allowed in with me.  And there sitting in the waiting room was someone I knew.  It was funny because Chris was sat with his back to them and he didn’t realise he knew them.  It was a bit of a bizarre moment because I guess we didn’t really know what to say to each other.  I don’t know why they were there specifically, but I feel a little sad that infertility affects so many of us around us we just don’t know about. Today was just another reminder of that fact.  Infertility – you truly are a sneaky bag of crap.

The healing power of Stockholm and my Nobel Prize

As I return from my work travels in Stockholm, I have some down time to reflect upon our recent failed first round of IVF.  I say ‘failed’…it’s actually quite difficult to say with any confidence that it was actually the IVF that failed us.  It is possible I suffered an ectopic pregnancy, but the doctors were unable to confirm it, although they treated me for it with methotrexate to terminate the pregnancy to be on the safe side.  Something was growing, they just could see it.  If my pregnancy was truly ectopic, then it wasn’t the IVF that caused the demise of my pregnancy….the IVF treatment managed to get me pregnant, but my body decided it wasn’t going to succeed; my body simply decided that this wasn’t my time to join the pudding club.

Or it could all simply be described as just terrible bad luck.  Sometimes, there is just no reason known to man why Mother Nature can be so cruel.

Of course, it is natural to blame oneself.  There are several potential causal links to an increased risk of ectopic pregnancy: tubal damage, smoking, age, IVF – all of these increase the risk: approximately 1-2% of pregnancies are ectopic.  But mostly there is just the plain and simple element of unfortunate luck.  You can find on the web doctors who speculate that the risks are higher with IVF because either:

  • a) With a 3-day transfer, the embryo that would ordinarily be in Fallopian tube at this stage, seeks out the more fluffy warm tubes because that is where it thinks it should be, then gets completely lost and doesn’t ask for directions.
  • Or b) the doctor who performs the embryo transfer procedure places the embryos too high up in the uterus; or they are transferred too quickly and end up in the wrong place.

However, my doctor explained to me that statistically speaking, the risk of ectopic pregnancy doubles with IVF because generally there are two embryos being transferred and so that risk doubles from 1% to 2%.    This makes a whole lot of sense to me.  I was just unlucky.

I am thinking through all of this right now because I need to take away something positive from this failed cycle.  I’ve got to get my cup half full again….and so the positive could be that we just needed that extra help from ICSI or the hormones, and I was just one of the really unlucky ones to not stay pregnant this time.  Next time might just be our time.  There is still no reason why it shouldn’t be.

I was feeling a little sorry for myself in my last post.  But the last couple of days have been an improvement, and it is starting to look like our path is finally beginning to flatten out, allowing us to take a breather.

Time to catch a breather before heading off on to the foggy path called infertility.

Time to catch a breather before heading off on to the foggy path called infertility.

I have been kept mentally busy with work, socialising and networking with my colleagues, so I have had little time to think emotionally about the failed round of treatment.  Physically, the pain has dissipated, the bleeding continues (seriously, where does it all come from?!!?), but it is a very small amount that it has barely bothered me.  I still feel exhausted, but jet lag most likely lays claim to the cause of that.  I miss my pre-natal multi-vitamins, I really hope to be allowed to take them again soon.  They help keep my bowels in shape and my energy up.

And I will grow back my positivity because over the next 3 months as we have a plan to get us to our next IVF cycle (hopefully if I get the all clear from my repeat HSG!!).  In short – we have our 2 week, 2000 miles, road trip starting from Las Vegas, visiting various amazing places like Grand Canyon, Zion national park, Bryce Canyon, Monument Valley, Santa Fe, Albuquerque, Petrified Forest, Painted Desert, Hoover Dam and a whole lot more.  I have another 3 work trips to Europe to fit in – Munich, Berlin and Brussels/Mons (I haven’t been to Berlin yet so that is exciting!).  We have a consult with our doctor scheduled for late October to discuss the plan for the next cycle.  I need to find some time to fit in a HSG once my period returns (seriously NOT looking forward to that).  I am hoping my body is going to play nice and we can get an IVF cycle in just before Christmas.  It’s also Chris’s Birthday soon and I want to organise a small party for him.  And amongst all that we are going to try and fit in a weekend away to Shenandoah National Park to see the beautiful colours of autumn.  No time for stopping over the next 3 months!!

Stockholm has done me a lot of good (despite the jet lag), I’m feeling mentally refreshed and excited to be moving forward.  However, I was very disappointed to discover that my invitation to pick up my Nobel Prize must have got lost in the post.

No Nobel Prize for me.....But it was beautiful!

No Nobel Prize for me…..But it was beautiful!

But I did get a chance to scope out the building they award them in, the museum my name would be listed in, and the best restaurants to celebrate at….May be someday I’ll be back 😉 bahahahahaha – Keep dreaming Dani!

The Nobel Museum, Stockholm

The Nobel Museum, Stockholm – Something to reach high for 🙂

Is the pain in my mind?

I have had a very specific pain around my right ovary for the past four days. The pain worsened in the evenings, I slept it off after getting to sleep with the aid of the pain killers and my sheer exhaustion.  It felt like something was pushing inside, wanting to pass.  The acetaminophen & codeine-3 was barely hitting this very specific pain.

Late last night I considering going to the Emergency Room.  I knew that my doctor had said I shouldn’t travel to Europe if I was having pain.  Well I was in pain, the drugs weren’t stopping it, but I wasn’t doubled over with the pain, I was getting waves of pain, increasing intensity and then becoming dull but it was in this one particular spot.  I couldn’t ‘touch’ the pain, when I pushed down it didn’t hurt more or less.  Was I being stubborn or just simply stupid for ignoring this?  I read stories of women whose fallopian tubes had ruptured weeks after taking the methotrexate.  Surely this was a very rare event, it can’t be happening to me?  I cried a lot in my indecisiveness.  Chris even cried with me because he didn’t know how to help me – it was my decision to make whether or not to go to A&E – he felt helpless.  I didn’t want to go to hospital to spend a fortune for me to be sent home again – or worse – they wouldn’t be able see anything again on the ultrasound and end up opening me up. Chris asked me a very good question – was the pain in my mind?  Was I making it out to be worse than it was because I didn’t want to travel to Europe?  It was a harrowing question to think about.  It was definitely a possibility.  The mind can play cruel tricks.  But I eventually decided that in the morning if I still had that specific pain we would call my clinic or go to ER.  That was my line.

I woke up this morning PAIN FREE!!!! It was an amazing relief.  I was exhausted and felt like I had been out on the town all night, waking up with a hangover.  Oh how I wish that were the case!  But I felt free.  That was for about 3 hours….then the heavy bleeding and passing of clots continued along with all that type of associated pain.  But this pain I could deal with compared to the specific pain I was having the past four days.  Such a relief.

So here I am waiting for my flight to Europe.  After connecting flight #1 I have discovered that flying whilst still miscarrying is not the greatest idea I’ve ever had.  I could feel I was about to pass something, then of course there was turbulence and the seat belt sign came on.  The flight attendant barked at a little old lady to sit back down!  So I sat there in my seat hoping I would not leak everywhere (sorry – I know this is probably way too much information!!!).  20 minutes later I couldn’t sit still anymore, so I got up despite the turbulence and dashed to the toilet.  I sat on the toilet thinking how ridiculous this whole situation was and sobbed.  I am so glad I didn’t wear mascara today, in fact, mascara has not been part of my make-up regime for several weeks now.  I thought about all the things I would shout at the flight attendant if she gave me grief about getting up from my seat! Fortunately she was too busy to bark at me.

I just have a 9hr flight to London, followed by 2hr flight to Stockholm to survive this mess!  Wish me luck!!!

10 days of eughhh

It’s been 10 days since I started to miscarry and I am just exhausted from all the emotions and the physical madness that is going on with my body.

My 7 day post-methotrexate injection hCG blood test went very well today.  My levels have almost exactly halved since monday, from 2696 to 1358, and dropped 58% overall since the injection was administered.  This bodes well for successful treatment. I am even allowed to travel to Stockholm – as long as I am not having any pain.  I am not going to hide it, I have been suffering with pain for past two evenings now (weird how it is mostly in the evening).  Last night I struggled to sleep because of it.  The 500mg extra strength acetaminophen doesn’t seem to cut the mustard, but the acetaminophen with codeine #3 I was prescribed for pain relief after my egg retrieval seems to work a bit better.

My favourite nurse drew my blood today, she asked how I was doing.  I just replied ‘eughhh’.  She understood and nothing more was said.

Here are two photos of my cat Diesel….sympathising with my ‘eughhh’ feeling.  Chris managed to take these beauties yesterday evening in an impromptu photo shoot…..

Chris captured Diesel in  beautiful way yesterday evening

Chris captured Diesel in beautiful way yesterday evening

Chris captured Diesel in  beautiful way yesterday evening

Chris captured Diesel in beautiful way yesterday evening

What would we do without our fur babies to keep us sane?

Compared to this, the 2 week wait will feel like a breeze

Warning – grumpy Dani on the loose!!!

  1.  We turn up to my ‘monitoring’ appointment this morning, sign my waiver which only has a beta blood test and no ultrasound listed.  I point this out to the receptionist…she checks my notes, apparently in my notes my doctor said only for a beta because it was too early to see anything on the ultrasound.  Hmmmm, this is not what my doctor said on the phone on Thursday!!  She said now that my hCG levels were over a 1000 perhaps we would find Waldo this time!  Receptionist talks to doctor and adds the ultrasound to the waiver form.
  2. A nurse I have never met before takes my blood…after making me almost pass out.  She jabbed hard with the needle, Chris was watching, I wasn’t but it was REALLY painful.  He was pulling faces at me from across the room because he could see that the nurse did not have control over the needle – even with a butterfly clip the needle apparently flipped 180 degrees.  She was not apologetic and had not appreciation for the pain on my face or that she had even done anything wrong.  The other day when a nurse hit a valve she was so apologetic, but it barely hurt so I told her not to worry.  The nurse today – I give her a big fat Freddie F for FAIL.
  3. We waited an hour after my blood draw for the ultrasound.
  4. Once we are in the ultrasound room, lucky me – I get two different doctors again, one I have never met before – my doctor was not working Saturday.  Fair enough, everyone needs a break!!! No Waldo found today.  BUT both Chris and I noticed that my uterus looked different from the previous 2 ultrasounds, I think this is one of the downsides of having different doctors monitoring me.  Basically, the doctor sent me to have more blood drawn in preparation to take the methotrexate if my beta hCG levels are still rising.  They even discussed whether the labs would be able to get the results today stat and could get a prescription in at the campus hospital for them to administer tomorrow (Sunday).  They thought it would be possible.  We sat there nodding our heads.
  5. Chris asked if a different nurse could draw my blood as he explained the ineptitude of the earlier nurse.  I will admit that I was annoyed that Chris asked this because I would have preferred not to have caused a fuss, and being a reserved Brit, probably would have told the nurse that she had really hurt me earlier and shown her the bruises she left – then at least get an apology from her.  Anyway, the doctor kindly arranged for me to have a different nurse draw my blood from the other arm.   Blood drawn – nurse hits a valve – may be my body is telling the nurses it is done with blood draws.
  6. We wait for results all day.  It is now 9PM and I have not had a phone call today.  In the UK, if the doctor doesn’t call it’s a good thing.  I’m not sure that’s how it works here?  Chris thinks it’s a good thing.  I think the tests were not done ‘stat’ and there were simply no results today – usually the nurse would call to update me, but because it is a Saturday and we seemed to have got one nurse into trouble, no one has updated us.
  7. I am still pregnant unknown location (PUL) – i.e. rising hCG levels and no visible sign of pregnancy on ultrasound.

I have been concerned today that the on-call doctor wanted me to take the methotrexate tomorrow – but I realised after the appointment that my doctor had said she thought that as long as I have no symptoms and there is no pregnancy on the ultrasound she would keep monitoring me until I am 7 weeks pregnant (3 days time).  So I wondered how that would work – if the on-call doctor had a different opinion to my doctor, would my doctor be pissed.  I was planning on talking to the on-call doctor about this when I got my results, but this seems to be a moot point now she hasn’t called today.

I’ve done a bit of research into my situation of possible ectopic pregnancy and there is quite a bit about misdiagnosis of ectopic pregnancy.  Basically, doctors prefer to diagnose ectopic early to avoid rupture of the fallopian tube.  This makes a lot of sense….except there are many cases where doctors have been too early in their diagnosis and effectively terminated a healthy uterine pregnancy mistaking it for ectopic.  The most up to date information I found on PUL, ectopic pregnancies and methotrexate was discovered from an article: “Tragically Wrong: When Good Early Pregnancies Are Misdiagnosed As Bad“.  The author of the article is interviewing a Dr Peter Doubilet, one of the authors of a well written research paper: “Diagnostic criteria for nonviable pregnancy early in the first trimester

I am literally copying the introduction to the article, written by Carey Goldberg, because I thought it was worth sharing, but the full article can be found here:  http://commonhealth.wbur.org/2013/10/ectopic-pregnancy-misdiagnosed-methotrexate

A beautiful, supremely talented young friend of our family recently fell victim to a terrible medical mistake. Newly married, she was having some pelvic pain and bleeding, and the doctor who saw her diagnosed a probable ectopic pregnancy — an embryo that develops outside the womb. Concerned that such pregnancies can turn life-threatening, the doctor prescribed the standard treatment: methotrexate, a drug used for chemotherapy and to help induce abortions.

When our friend returned to be checked a few days later, the imaging revealed that in fact, the pregnancy had not been ectopic; it was in place, in her uterus. But because she had taken the methotrexate, a known cause of birth defects, her pregnancy was doomed.  She soon miscarried. What may have been a perfectly healthy pregnancy had been ended by well-meant medical treatment.

I assumed her horrifying case was an exceedingly rare medical fluke — until now. A paper just out in the prestigious New England Journal of Medicine shows that such misdiagnosed pregnancies are part of a pattern — a pattern that needs to be changed. “Considerable evidence suggests that mistakes such as these are far from rare,” it says.

When I told our friend’s story to the paper’s lead author, Dr. Peter Doubilet, he responded that he knows of “dozens and dozens and dozens of similar cases that have come to lawsuits, and that’s probably the tip of the iceberg.” There is even a Facebook group, Misdiagnosed Ectopic, Given Methotrexate, run by a mother given methotrexate whose daughter was born with major birth defects.

The New England Journal of Medicine paper stems from a panel of international experts who resolved to change medical practice to stop such misdiagnoses.

When I read the research paper the most interesting take away for me was:

  • Women with a pregnancy of unknown location (PUL) and hCG levels of 2000 to 3000, the likelihood of ectopic pregnancy is 32.7%, the likelihood of nonviable intrauterine pregnancy is 65.5% and 1.7% for a viable intrauterine pregnancy.
  • Women with a PUL and hCG levels of 3000 or more, the likelihood of ectopic pregnancy is 33.2%, the likelihood of nonviable intrauterine pregnancy is 66.4% and 0.5% for a viable intrauterine pregnancy.

The authors recognise that these likelihoods are not highly precise, and there are some limitations to their data, but they argue that this does not matter, it purely demonstrates that ectopic pregnancy is not the likely outcome in PUL.  However, they point out that this is only true of the woman is hemodynamically stable and not presenting with abdominal pain. The one thing that was comforting to see was that there is limited risk in taking a few extra days to make a definitive diagnosis in a woman with PUL.

There is also one other interesting thing I discovered after looking up the facebook group  “Misdiagnosed Ectopic,Given Methotrexate”.  PUL is very common in women with a tipped (retroverted) uterus.  Why?  Because it can be harder to see an early intrauterine pregnancy on transvaginal ultrasound and may not be seen up to week 8.  A lady who created the website misdiagnosed miscarriage says that no research has been done on the relationship with retroverted uterus and misdiganosis of miscarriage.

What is my conclusion?  Keep going to the monitoring appointments, if I have pain – take myself to ER straight away, wait until my hCG levels rise enough to see something on the ultrasound- then we can make an informed decision on which drug to take to aid my miscarriage. – Or best of all situations, I just miscarry naturally.  Really, the next 2 week wait is going to seem like a breeze compared to this.

Nothing….

There was nothing there on the ultrasound screen, just my beautiful uterus – empty.  There was the teeniest tiniest black spot that may have been the beginning of a sac, but it was so small my Doctor was not certain.  She didn’t need to say anything for me to quickly realise that I was not one of the lucky 1%.  My doctor checked my ovaries: my right one is still hyperstimulated from the IVF and I had some VERY big follicles/cysts (but this is normal for after IVF and of no concern, but may explain any pain I may have here), my left ovary too was swollen, but not as bad as my right one.

What does this mean?  It was difficult for my doctor to say without knowing what my beta test results are.  If my hCG levels are continuing to rise, it is likely that I have a tubal pregnancy (ectopic pregnancy – a pregnancy that grows outside of the uterus).  If my hCG levels are falling, then it will be safe to assume that I have a chemical pregnancy* and the little black spot on the screen was indeed huckleberry.

My symptoms have been spotting dark brown blood since Friday, general abdominal pains all day Monday, my spotting surprisingly stopped today (Tuesday).  I have had some pains specifically on my left side, although not overly sharp pains, and I pointed out to the doctor (doctors – there were 2 others in the room with her) where this was….yeh, about where my ovary/fallopian tubes are.

If this is a chemical pregnancy then the doctor will prescribe me some medication (a vaginal pessary, I cannot remember the name of it) to help my body along with expelling the uterine pregnancy.  If this medication doesn’t work, or my hCG levels come back higher with a likelihood of a tubal pregnancy, then I will be prescribed Methotrexate (an intramuscular injection – YEY another injection, of course!!!).  I want to avoid taking this drug because it will mean we are not allowed to conceive for at least another 3 months because the chemical can stay in the body and harm a developing embryo.  But at the same time, we don’t want to wait and see for too long because there is a chance my tube could rupture and I would lose a fallopian tube.  I have read that even after being given the shot their tube still ruptured because it was left too late.

So I was asking you to hope with me that I didn’t bleed, but now I want to bleed….please, please body, just bleed!!!  I think this will be one of those times when I cry tears of happiness when I start to bleed full flow!  I know it will also be sad at the same time….choo choo, all aboard the emotional train wreck!!!

I mentioned that there were two other doctors in the room, one was ‘shadowing’, the other was a fellow (no not a chappie you silly Brits!!!).  The fellow interjected and answered some of our questions, he was clearly very knowledgeable, but there was a lot of bouncing around between them.  Chris was getting frustrated with the information we were receiving, they were talking to us as if we were medical professionals.  It took 5 minutes of Chris’s continued questioning to get the doctors to say that despite the miscarriage being bad (and sad), what we were seeing was ‘normal’ or ‘common’.  What they really needed to start out with was – don’t worry, there is nothing seriously wrong with you, chemical pregnancies happen frequently with IVF (because they are transferring 2 embryos).  I think I had a bit more knowledge than Chris and didn’t feel quite as frustrated because I had googled a lot on miscarriage, chemical pregnancy, blighted ovum and have read forums/blogs etc.  So my lesson here is to share more of my ‘google expert medical opinion’ knowledge with Chris before these types of appointments.

We also discussed my hCG levels (49, 110 and 345) and my doctor did admit that my first hCG result of 49 was borderline low- to non viable.  So why, oh why, did the other doctor (who did my IUIs) seem so happy and chirpy on the phone, proceed to tell me my progesterone and estrogen levels were excellent but fail to tell me my hCG level.  All it required was this:  “Congratulations Ms Dani, you are pregnant, but your levels were a little lower than average, we would like to see you again in 5 days just to make sure you levels are doubling nicely.  Your estrogen & progesterone levels are excellent, so this is a good thing.”  Expectation management is not a bad thing.

So – we have one big question answered, I feel a relief, albeit a sad relief – there is no viable pregnancy.  The next big question we wait for an answer is – is this a chemical pregnancy or a tubal pregnancy?

*A chemical pregnancy is a clinical term for a very early miscarriage. It happens before an ultrasound could even detect a heartbeat (before the 5th week of gestation). This occurs when an egg is fertilized but it does not implant on the uterine wall. Chemical pregnancies are actually quite common, occurring in 50 – 60% of first pregnancies.  There are many possible causes of chemical pregnancy – inadequate uterine lining, low hormone levels, luteal phase defect, infection, or other unknown reasons. The most common assumption is that they are due to chromosomal problems in the developing foetus. This can result from poor sperm or egg quality, genetic abnormalities from either mother or father, or abnormal cell division of the foetus.

On being PUPO at P-1 Day (Prove Day)

I officially have the status of being Pregnant Until Proven Otherwise (PUPO).  I can ‘enjoy’ this status for about 24hrs longer because tomorrow morning I have my first ever beta pregnancy blood test.  What is a beta pregnancy blood test?  This is a blood test that will reveal ‘quantitatively’ the amount of hCG (Human Chorionic Gonadatropin) in my blood (hCG is the hormone that is produced when a woman is pregnant).

The last 24 hours have been interesting.  Yesterday I thought my period was about to happen.  I discovered a bit of dark brown spotting….I freaked out.  Then I thought perhaps implantation bleeding?  But surely this is way too late for implantation bleeding and unlikely to be possible??!  (Remember I have an upside down uterus so perhaps the blood from the implantation has taken a while to ‘gravitationallly’ find its way out! Perhaps it is not impossible?!?!)  But then I had horrible aches that felt like a period for several hours afterwards.  I felt that it was all over.  I went to bed last night pretty much expecting to wake up to my period flowing.  I even got upset when Chris told me I should go to bed with a pad and knickers on.  I shall not surrender!!!! But no!!! Cruel Aunt Flow teases me!!! Nothing has shown itself since.

Last night I had a weird dream.  I basically took three different home pregnancy tests.  The first was positive, because I couldn’t believe my eyes, I took a different brand…and it came back positive.  So Chris made me take this crazy test.  The results were really hard to interpret.  The lines looked like inter-twinned ladders and required knowledge of matrix calculus to understand it, and so we argued over whether it was positive or negative.  It was positive.

Today, I have been aching like my period is about to arrive, however, I have been experiencing those sharp pains again like in many of my other previous 2 week waits.

The problem with being PUPO is that the progesterone injections and estrogen patches I am being ‘topped up with’ each day to help make a cosy and attractive womb to Huckleberry and Huckleberina are probably causing all of these symptoms.  So I am not going to think too much about it all….I remain as I mentioned in my previous post – indifferent.

Lots of people have been sending their love and support over the last few days, and for this we are truly appreciative for the kind thoughts.

So….all that is left to do now is…Prove!  I’m excited, nervous and scared all in one breath…or maybe it’s just the drugs!!! Who knows?!?!

Ohhhh just one last thing I will levae you with to make you smile….here is the spectacular bio-luminescent plankton we observed on Sunday.  Chris did a great job of the pics! I hope we didn’t use up all our luck this epic weekend of fun!

the bio-luminescent plankton

the bio-luminescent plankton

bio1

IVF DIARY VOL I: 15-17 Aug 2015

IVF_Diary_Vol1cMedication(s) administered and dosage(s).  Progesterone 1ml, vivelle dot estrogen patches 0.1mg x2.

Medical procedures undertaken. Nothing!!!

How do I feel today? I am 11 days past my 3 day transfer.  I am very close to ‘prove’ time…I am feeling sadly indifferent about being ‘PUPO – Pregnant Until Proven Otherwise’.

Time has flown by this weekend – it was quite an epic weekend.  First of all it kicked off with a games night with friends – we played Risk – I didn’t win 😦  But it was still fun (Did I mention I hate losing??)!!! Saturday day time we took a trip to the ‘not so Dismal’ Dismal Swamp.  The conditions were glorious.

Dismal_Swamp_AUG

Dismal Swamp – How did it get it’s name???!!!

Saturday evening we went to see Cirque Du Soleil’s Kooza.  I AM SO LUCKY!!!  You may recall that I originally booked front row tickets for my Mum as a Birthday present for the 6th August – which ended up being the same day as my 3 Day Embryo Transfer.  Because I was on doctors orders for 24 hour bed rest I was unable to go 😦  But then an amazing act of mother nature cancelled this show because of a lightening storm.  Thank you mother nature!!!  So we re-booked our tickets for this Saturday….and it was AMAZING!!!!  Any other circus will never be the same again….these people are just so talented – the story, choreography and music FABULOUS!

Cirque Du Soleil

Chris doesn’t like ‘Selfies’ (It’s not a selfie, but a groupie!!!)

But the amazing weekend didn’t end there!  Sunday we headed to Back Bay Wildlife Refuge and False Cape State Park for a bike ride where we saw mother nature in her awesomeness again.  Afterwards we had a dinner sunset picnic on the beach, followed by a hunt for bioluminescent Plankton.  The plankton was lighting up the dark skies of Sandbridge beach’s ocean water in an amazing luminous green colour.  As you walked on the wet sand the ground lit up with luminous green beneath you (A bit like in Avatar!!)  I wish I could show you some pictures, but there would be no justice in the photo, you just had to see it with your own eyes to appreciate what an amazing phenomena this is!

I also completed my 4 week online course on Data Visualisation…it kept me a little distracted, but honestly it was a mistake to sign up for it with everything going on over the last 4 weeks.  If it had started 3 weeks later it would have been good to keep me distracted in the 2 week wait rather than working when I was struggling to recover from the egg retrieval!!

We bumped into a friend at the supermarket on Sunday who has previously sent us a private message of encouragement after our facebook announcement of our Embryo Transfer.  I nearly burst into tears as she gave me a big hug and wished me lots of sticky vibes.  So lovely.

As you can see I spent a lot of time having fun this weekend, but I was not distracted from the fact that I was sad at times for absolutely no reason at all, I cried over the smallest things, and I argued with Chris over the smallest things.  DAMN DRUGS messing with my emotions!!!

What are my symptoms? The sharp pains have subsided over the last few days, which makes me think waaay too much that this IVF hasn’t worked.  Apart from the growing boobs and the emotional schizophrenic Dani, I have no other symptoms.

How does Chris feel today?  Chris has put up with a lot of my random outbursts of tears and overly aggressive and defensive approach to every day occurrences.  He has been worried about me, of course.  He is very hopeful and talks to huck and huck, telling them to bury deep and grow strong.  He helps keep me mostly sane about all this.

Any results? No.

What’s next?  Test time!  I will do a home pregnancy test at some point before my blood test on Wednesday.  I know they are not wholly reliable after IVF but I want to have some kind of expectation before hearing the results over the phone.

Weight. NSTR

Waist.  Still not quite back to my normal waist size 😐

Boobs. NSTR.

Hours of Sunshine 🙂 The sun has just not stopped shining this weekend…if sunlight is as important as they say they are for egg development then my eggs are getting BAKED!!!

150817_IVF1_Stats

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF DIARY VOL I: 11-14 Aug 2015

IVF_Diary_Vol1b.pngMedication(s) administered and dosage(s).  Progesterone 1ml, vivelle dot estrogen patches 0.1mg x2.

We hit a blood vessel with the progesterone needle!!! Well mum did the check once the needle was in, drew back a little bit and she saw blood, she coped with it calmly and I told her it was OK we just change the needle and try the other side of my buttock.  I explained to her it was just one of those things that happens occasionally and that is why we check.  She was so worried she hurt me.  Poor mum.  She did well not to pass out because I think I would have done if I saw that!! It didn’t actually hurt, but I did get some tingling, numbing sensations running down my leg!!!  Then it bruised a little but afterwards, but no different to any of the other injections.

I think I have finally sussed out the Estrogen patches (vivelle dots – which by the way are nothing like a ‘dot’).  Sticking them oblong ways round and peeling them off from outwards to inwards towards the belly button is the easiest and least painful way to pull them off…I’ve tried every way round!!!  I still haven’t quite found a good way to remove the sticky residue.

2 patches - change every two days

2 patches – change every two days

Medical procedures undertaken. Nothing!!! But I returned to work yesterday to find lots of emails – from my medical insurance company notifying me of all the claims that had been submitted by the fertility clinic for all the medical procedures over the last IVF cycle!!! Every single ultrasound, blood test etc has an individual claim number…this is going to be a pain to track as soon as the bills start arriving through the door – time for a spreadsheet!!!

How do I feel today? I am 8 days past my 3 day transfer and honestly – I am not feeling positive anymore.  A few nights ago I woke up with horrific pain in my abdominal region.  I can’t pinpoint where it was exactly.  I cried as I curled up and thought I was going to have to take myself to hospital (I was in a hotel with my mum at the time), but after 15 minutes the pain subdued.  The next day I felt the residual pain, which I can only describe it to be like what you might experience after you have cramp in your leg after the cramp goes away, but the muscles ache from the cramp and is on tenterhooks for cramping again if you move too fast.  I have not experienced any more of this type of pain since.  I wondered if it was implantation cramping, but it was so painful, could it really be that?

The day after this night of pain I was due to do some guest lecturing at an offsite location near DC…let’s just say my office messed up and I was unable to access the site I was visiting because someone decided to handover their work and something fell through the gap.  Cue RAGING DANI…..8 hrs of driving and a night in a hotel wasted because someone didn’t properly do their handover when they were leaving.  So I called my boss, told him the situation and asked for the rest of the afternoon off – he pointed out that I needn’t have asked – he was actually more worried when I left a message for him to call me back that there was something more serious wrong (i.e. with my health!).  So I went shopping with my mum.  I will save the details of this for another post dedicated to shopping, but this is when I really started to feel more negative about everything and I have not been able to shake it off since.

What are my symptoms? I I have had lots of mini sharp pains and some dull aches like I have experienced in two of my previous IUI cycles.  My boobs are growing fast with much sensitivity!  I ache, like having a period time type ache all over my body.  The injections are not so bad, but they kind of rule your life a little bit.  It know it will be worth it if I do end up successfully carrying huckleberry and huckleberina to term, so it’s something to just live with.  (By the way, this is for Chris mostly, and anyone who has missed my previous blog post – we will NOT be naming these poor babies huckleberry or huckleberina, they are just affectionate names whilst they are inside me 🙂 )

How does Chris feel today?  Chris had a weird dream last night about using blown up balloons as a rope to do some climbing – he used about 30 balloons, then they burst.  I thought it might have been some kind of dream about how he felt about IVF, that we had put all this effort into getting so far, climbing up the mountain and it was all for nothing – a blow out.  He said I was being silly, and perhaps I am, but I dream a lot so I always try to think about why I dream certain things.

Any results? No.

What’s next?  Enjoy the rest of the time my mum is visiting – we have quite a fun packed weekend planned!

Weight. Fortunately my weight loss was only temporary, I am getting away from the danger zone of being underweight.  I have enjoyed plenty of eating out over the last few days of my trip to DC!!!

Waist.  Slowly the bloat is disappearing, but not quite back to my normal waist size.

Boobs. Woah they have grown massive!  Chris can look, but not touch – they are way too sensitive :-p I’m going to have to change the scale on my chart at this rate!!!

Hours of Sunshine 🙂 Sooooo much lovely sun.  What an amazing summer we have had compared to the Augusts of the previous two years.

150814_IVF1_Stats

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.