Crashing down

By the time we went into our appointment with the obstetrician I think my hope was outweighed by my doubts. When the ob asked "how are you going?" I was very quick to reply that we weren't so great. I quickly explained the result of the ultrasound from the week before. The ob said it was probably best we get straight to having a look, rather than spend half an hour talking about pregnancy management, just to find out things aren't looking good. He also told us a story about a woman he'd seen whose first scan didn't look good, with the baby having a heartbeat of 78. He said when she came back he felt nervous about what the scan would show, but that everything was great, the baby had a heartbeat over 160 and had really grown.

A glimmer of hope just as we get on the bed for the scan. 

He starts with an external scan. By this time, 8 and a half weeks, the baby should be clearly visible from an external scan. By how hard the ultrasound thing was pushing on me I could tell it was hard for the ob to see the baby, and from what I could see on screen it didn't look good. He switched to an internal scan where he confirmed that things didn't look good. He said he was sorry, but from what he could see the baby didn't have a heartbeat and the size hadn't changed from our last scan. 

Procedure from this point is to have a high resolution/diagnostic scan. The portable scanners the obs have apparently can miss stuff, so they are reluctant to recommend the curette without the diagnostic scan. Our ob rings the women's diagnostic centre and gets us an appointment in a couple of hours. He asks if the result is as expected if we'd like to have the curette that night if they can get a theatre booking.

We head home for a couple of hours. Given we have the chance of having the operation in the evening I've got to eat something now, and then I'm on nil by mouth, just in case we can secure the evening theatre time. An hour before our appointment I drink the obligatory pre ultrasound water, knowing no matter how full my bladder is they will still need to do the internal scan. 

It's funny that it doesn't really matter that we already know that it is pretty much over, when the sonographer sympathetically tells us she can't find a heartbeat I still can't help but cry. She confirms the baby is still the same size it was a week and a half ago. She looks around to make sure the other embryo isn't tucked away somewhere it shouldn't be, but there is nothing else, just the one that is no longer a viable pregnancy. 

With our results in hand we head back over to the obstetrician's office where he quickly sees us between patients. He asks if we'd like to have the curette that night or tomorrow morning. I opt to have it done that night, so that way only one day revolves around the whole ordeal. 

We head home to pack 'a just in case' overnight bag and by 5pm we are back at the hospital being admitted. By 6.30pm I am wheeled down to pre-op and by 8pm I'm back in my room texting home. They keep me in for a few hours and then we are allowed to go home.

Despite having a body full of sleepy drugs I didn't sleep well. I couldn't get into a deep sleep. I don't cry, just toss and turn. 

Scanning

Well, I've been on holidays at the beach for the past 12 days. We holiday in a small beach side town each year. It is an incredibly beautiful part of the world. I had decided to take the risk and book in our first viability scan for the day we were leaving for holidays. I thought this showed great faith in that the pregnancy would be okay. If it wasn't okay, I planned to head to the beach anyway and drink myself into oblivion.

The scan was with our fertility specialist - the first viability scan. I've actually never managed to have a viability scan with him due to bad holiday timing over the past year. As it turned out, this time he was going on holidays for the same days as us, so we managed to squeeze the scan in.

I was a little disappointed with the scan. He showed us one baby, with a heart beat, right at the top of the uterus. He was pretty happy about it. He said "I'm not hearing any oohhhs and aaahhhhs". So he tried to hear the heartbeat. I tried explaining, it wasn't that we weren't pleased, it's just that we've seen a lot of tiny babies, that don't even look like babies, with heartbeats. He printed a picture for us.

I have grown to hate ultrasound images. I hate everybody's ultrasound images, not just my own. If a see a friend post their ultrasound image to facebook, I have to delete/hide the post. To me they just look freaky. So Matt took the picture. He thought his family might like to see it, I said "really, why would they want to see that?"

Due to my specialist usually being on holidays, our first scans have generally been with ultrasound clinics. These scans give you sooooooo much information. You get the crown to rump length, the heartbeat rate, the size of the gestational sack, the gestational age. So when the fertility specialist showed us a blob with a heartbeat and said it looked about the right size, I was underwhelmed.

As we were both about to head off on holidays the fertility specialist gave us a referal to get a diagnostic scan done, just in case anything went a miss during the week of holidays.

We packed the ultrasound referal in our gear and headed off on holidays hoping we wouldn't need it, but that wasn't to be the case. The very next day I had a pretty heavy bleed, dark red with little clots in it. I lost it. I was crying and crying. I just hate it. One day everything is 'fine' the next day, it seems like we are about to have another miscarriage.

The worst part is, there is nothing to do about it. You just have to go to sleep, get up the next day and somehow try to enjoy your holiday at the beach. The bleed was on a Saturday so we couldn't even go for the scan until Monday at the earliest.

So we soldier on. Force yourself to get outside and enjoy the beautiful place you are in. Try not to think about it all the time. Try not to let your bad mood spoil it for everyone else who is there.

On Monday we get the diagnostic scan. The baby is still there, but we are told it is only measuring 5 weeks and 6 days and the heartbeat is 96 beats per minute. Basically, the baby is more than a week smaller than it should be. The sonographer also told us that the heartbeat would preferably be over than 100. In closing, he said the pregnancy was viable at this time, but given the result no doubt another ultrasound will be needed in another week or two.

So the baby is small, with a slow heartbeat. The same sonographer gave us similar news last year with our heterotopic pregnancy, and that baby miscarried soon after. We don't leave with smiles on our faces. My husband says on the way to the car "We know how this played out last time, but I guess we just need to give the little trooper a chance."

We had a little more spotting over the next day, but for a week now I've had nothing. I've had not bleeding. I've also had no morning sickness or other symptoms that wouldn't be caused by the progesterone pessaries I have to use morning and night.

Our first appointment with the ob/gyn I chose for this pregnancy is coming up, so I haven't bothered following up with our fertility specialist about getting another scan. I have some hope - hey, maybe it will be fine - I really hope that it is. I also have some doubts.

All positives

My HCG blood test was positive, with my HCG coming in at 183. My second HCG blood test came back at 382. This is all positive. They are looking for the HCG to double at this early stage, and mine did that.

There is nothing extraordinary about these numbers, that is, they didn't say 'wow that's big, maybe it will be twins'.

Two week wait is officially over, however once you know you are pregnant it is just more weeks of waiting. I am again waiting for the first ultrasound. The ultrasound will confirm if obiwan and obitwo are both still hanging on. Waiting to find out if the pregnancy is viable at this time. Then, if the first ultrasound is good news, it is just more waiting, to find out if the pregnancy will last the next week, 2 weeks and so on.

Thankfully after our last pregnancy loss we sat down with our fertility specialist to discuss what was going on (here's my blog on that). He told us that despite having lost 5 babies in early pregnancy, that we really were just unlucky, versus there being something specific causing the problem. Four of the five pregnancy losses were completely random and could happen to anyone. The fact that they all happened to us is apparently just really bad luck.

Armed with this knowledge, I've created myself a new mantra or two during this pregnancy:

• Short mantra - there is no reason this pregnancy shouldn't work
• Long mantra - millions of other people find out they are pregnant and don't worry about losing it and there is no reason this pregnancy won't be like the ones all those other people have.

I wish I didn't need the mantras, but I do. I am occasionally overwhelmed with it all and not even the mantras help. I've downloaded an anxiety information sheet and read it when I'm feeling really anxious to try and help diffuse the feelings.

There is nothing more I can do about it I guess. I just have to wait it out.

Preparing to feed the test obsession

A week or so ago I decided I would prepare for my upcoming series of home pregnancy testing.

I had lunch with my sister, who happens to be studying pharmacy and enjoys any reason to visit a chemist, so I asked her if she wanted to come with me to carefully study the pregnancy tests and make a selection.

It turns out she needed a real education. She was such a novice. I had to show her to read the packets, looking for those with the earliest detection chance, lowest HCG test. Then she kept picking up packets with one test only - what was she thinking? I explained if the test doesn't come in a 2 or 3 pack, I'm not interested.

After much researching I decided on First Response in stream tests. A 3 pack of course.

Because pregnancy just can't be a straightforward thang for me, on the same day I picked up the tests I noticed a little bit of spotting started. Pinkish.

Now, every other pregnancy this early spotting filled my heart with dread, however this time it was so early, only 6 days after transfer, I felt confident if it was anything, it was implantation bleeding. To me implantation is good news, so I surprising tolerated a little spotting with very little anxiety.

When I got home I told my hubby I was sure I was pregnant, but, that I was certain because I had the little bleeding. I was armed with tests and would start testing tomorrow morning. To my surprise he said, 'why don't you do a test now?'

hmmmm.... Now, I've blogged before about my pregnancy testing rules, one of which is only test for first thing in the morning pee, but here is my husband tempting me to break one. So, within in seconds I was in the bathroom peeing on a stick. I left the stick and went to get changed out of my work gear. A few minutes later I returned to check on the test and found the faintest of faint positive results.

I'm excited by the positive result, but let's face it, it is soooooo early, not even 4 weeks. My husband isn't so excited. He almost immediate slips to worry mode.

Last month when we did transfer and got a negative result he said it was a relief it was over, and we didn't have to go through all the waiting and worrying etc. I told him that I was going to be excited and try to pretend like it was the first time and we don't know about everything going wrong. We have to get a positive to get to a 6 week ultrasound, to get to a first trimester, to get to having a baby! The positive result is the first and necessary step to getting the baby, so I'm smiling about it.

We're back on track to mission take off.

The low down and the down low

Damn you fertility treatment and your insidious infiltration of happiness and general well being!

This treatment cycle moved so quickly, I'm already on the 2-week wait roller-coaster and once again, it sucks.

Last week I went in for my first blood test on day 12 of my cycle. When I rang my fertility specialist to be told when I needed to do my next blood test I was surprised that I needed to go back the next day and go in for an ultrasound. I thought it must just suit the specialist to see me on that day for the ultrasound (which is to check that my uterus lining is looking like a nice soft cushion that little embryos would just love to snuggle into) and that he wanted the blood test result to check my hormone levels that corresponded with the ultrasound.

Once again the ultrasound is internal. To try to elevate some of the embarrassment about the whole situation my specialist starts a funny conversation about how his teenage son asked him what sort of deviate he was to decide to become a gynecologist. He assured me it wasn't because he wanted to look at girls private parts (phew).

Throughout the scan the fertility specialists say he thinks I ovulated the day before. What? Really? He needs to check the blood test result to be sure.

Once I'm re-dressed from the waist down I wander across to the doctor's consultation room. He is looking at my blood test results and confirms he thinks I've already ovulated (on day 12 of my cycle!). He confirms he is going to request my embryos are thawed that day and that transfer will be on 3 days time.

Crickey! I'm stunned by the speed of it. I usually get blood tests for a week and half, before we get to ovulation (which usually happens between day 18 and 21 of my cycle!).

I mention to the doctor I've had some spotting for the past few days. His face then looks perplexed. He explains while it can happen around ovulation, it is not ideal. He wants me to start progesterone medication immediately and to let him know if the bleed develops into a full blown period. If that happens, we will potentially have wasted the embryos that are being thawed.

Thankfully once on the progesterone the spotting disappears.

The thaw of 2 embryos for transfer results in 3 embryos being thawed, our last 3 embryos. One embryo didn't survive the thaw but the other kicked on, slowly at first, but by transfer day 1 is a blastocyst, the other still a morula. Both apparently look pretty good. I've nicked names these embryos obi wan and obi two, a tenuous link to Star Wars famous princess Leia plea - help me obi wan kenobi, you're my only hope.

I decided at the last minute to throw acupuncture in the mix again this time. I saw the acupuncturist just before transfer, that day after transfer and again 5 days post transfer.

And so, we wait. It sucks. Some days I think it has worked, other days I think it won't have worked. I really struggle at work at this time. I just don't cope well with the everyday frustrations and difficulties of the office. Everything that is crap about work is so amplified. All week I've been fighting with myself just to get to work. I get there every day and it isn't as bad as I've made it out to be in my mind.

Not long now before the home pregnancy test obsession will be let loose and we will see if obi wan and/or obi two have settled in.

Feeling futile

Before it was medically confirmed, I was pretty certain this transfer cycle hasn't worked. I did 3 home pregnancy tests and all were completely negative.

I blew off the blood test wait and went in a couple of days early to simply get the result confirmed. And it was - negative.

Did you hear the sound of the twist top wine bottle opening?

I've experienced anxiety throughout the wait and while I have definitely been frustated about a the cycle not working, I have already decided to head straight back into another cycle.

Logically I know I just have get ready to try again, but this failure has me asking questions about just how much more of it we can take. I resent the money we've spent on numerous treatments and treating lost pregnancies. Tens of thousands of dollars that is just running through our fingers like water. I also resent that my career is stalling. Spending more, earning the same, going nowhere, with nothing but pain, heartache, scars and sad feelings to show for it.

With failure after failure you have to ask, when do you stop? When do you decide to just simply get on with your life? While I don't know the answer to this question I do know, it is not yet.

Three frozen embryos are still waiting to be used, and I intend to burn through them, before ploughing straight on to make more embryos (presuming we are able to replicate another successful stimulated IVF cycle) unless by some miracle I actually manage to get pregnant, and have a baby.

Not pregnant (yet?)

As always, I cannot resist the urge of the early at home pregnancy test, and this time I'm not getting the result I want.

I tested 6 days after transfer, knowing it was really early, it was negative. I tested again the next day, 7 days after transfer, and still negative. Why test so early? Well, because we transfered 2 embryos, I think if they have both taken, it is likely I will get a positive early.

Last time we did transfer I got a positive at 7 days past my 5 day transfer of two embryos. By the time time we got to ultrasound there was only 1 baby, so I don't know if there were 2 at one point.

I am disappointed to not be getting a positive yet and beginning to think perhaps it hasn't taken this time. Not being one to give up, I'm waiting until 9 days post transfer to test again and if that one isn't positive, I will no doubt test again 11 days post transfer.

I think that what ever the result is on 9 days post transfer should be pretty accurate as 9 days post a 5 day embryo transfer is 14 days post ovulation, and when my period would be due if it weren't for the progesterone medications I'm on.

I've heard my friends still start their period, even when on the progesterone medications post transfer. Perhaps if I'm not pregnant this time, that will happen to me too?

My blood test will be 11 days past embryo transfer, and I guess if I haven't had a positive home pregnancy test by then, it will be settled once and for all with a blood test.