23dp5/6dt - Still Climbing

Today's labs showed that my HCG has risen to an impressive 39,071! Go, baby, go! Even more exciting is that tomorrow is the big day - our first ultrasound, our first real opportunity to take a peak and see what's going on in there. Although it's probably too early to see a heartbeat, I feel like actually seeing a pregnancy where it's supposed to be will help quell some of the anxiety I'm still wrestling with. I know it won't really go away, but I'd like to be able to breathe a little easier knowing things are progressing as they should be.

According to Betabase.info, if we've only got one little embie in there, they are still gunning for over achiever of the year award. We're still way ahead of average and my doubling time is only just slowing to 77 hours. If there's just the one, they mean business. I expect this kiddo to come out ready for college or at least ready for some serious nursing sessions.

If there are two, my anxiety is probably going to explode. I can only hope that both are strong enough to hang on, grow well, and not become a statistic. Our end goal is a healthy, living child and if we can get two out this experience, great. I just need them to stay off each others cords and do their best to grow and thrive.

Guess we (might) find out tomorrow! Of course there's always the possibility that it's too early, twins do have a knack for popping up in later scans, but we'll just have to wait and see. I'm hoping I can keep my coughing/hacking/snotting under control long enough to get some good photos.

22dp5/6dt - High Dose Hook Effect

Since my friend was kind enough to send me an entire box of pregnancy tests, I've been taking one every morning with FMU. I like seeing the two dark lines pop up as a sort of reassurance that everything is still okay in there since we haven't had an ultrasound yet.

The lines have always been nice, dark and reassuring until this morning. I actually slept in a bit later today and tested with a solid 8 hour hold. To my horror, the test line was lighter than the control line, lighter than the test the day before, OMGWTFAHHWHATWASGOINGON? I told myself the test was crappy, and it was, even the test line was lighter than normal, and resolved to test again after a 4 hour hold. Oh my god, holding your bladder and pregnancy do not go well together. I made it exactly 4 hours, rushed to the bathroom, and although the test was a little darker, it wasn't as dark as it should be. That's when it hit me right in the face, the high dose hook effect. Duh. I've experience it myself with ELISAs in the lab but I didn't think to apply it to a pregnancy test. Duh duh duh.

The high-dose hook effect is a well-known phenomenon in laboratory medicine, Dr. Gronowski says. It occurs when increasing concentrations of analyte lead to saturation of both the capture antibody and detection antibody, preventing formation of a complete antibody-antigen-antibody sandwich and leading to possibly false-negative results. She co-authored a study focusing on what she calls a “variant hook effect” that affects qualitative urine hCG tests. “The problem is an excess of one form of hCG. Part of the problem is that hCG comes in many different isoforms, and after five weeks of pregnancy, you get much more of one variant form called the β core fragment than you get of the hCG intact molecule. We demonstrated that if you add increasing concentrations of β core fragment to a urine sample that contains intact hCG, there is a dose-dependent inhibition of signal. This is similar to the standard hook effect, except that in many cases the devices don’t recognize β core fragment alone. In other words, the β core fragment only binds one of the two antibodies used in the assay, but it still has the same net effect and causes a false-negative result.”  (Check out the full article here)

And now it makes sense. At a day short of 6 weeks, I bet my β core fragment levels are much higher than my intact HCG. Obviously, I had to test this out by peeing on more sticks. 

And look at that! The solution diluted 50/50 with water has the darkest test line by far. Clearly, it looks like my stick peeing days have come to an end. There's no way I'm diluting cups of pee at 5 in the morning to get a satisfactorily dark line. I think I'm going to have to rely on blood tests and ultrasounds to reassure me from now on, as tough as that's going to be. The next blood test is tomorrow morning but my ultrasound won't be until Friday and after that, who knows. I hope my OB/GYN is open to frequent appointments to soothe my nerves :/

18dp5/6dt - Up, Up and Away!

Yes! I successfully had my labs run at Kaiser this morning and it didn't cost me $300! I'm so glad we were able to get them ordered in time, although it turns out they accidentally got put in as routine instead of STAT. The lab was able to get the HCG back today since they run that on location, but my estrogen and progesterone had to be sent out to their main lab about 30 min away. Considering that they don't do pick up until 12:30 and tomorrow is a Sunday, I think it's unlikely that we'll have those numbers before Monday. I'm not super concerned about it since those hormones are pretty much set by the 4mg Estradiol and 200mg Endometrin I'm taking each day.


 So, at 18dpt or 23dpo my HCG is an impressive 13,024! Going back to betabase.info:

For a singleton pregnancy, we're still on the chart but getting even higher. Only 5.3% of singleton pregnancies reported have an HCG about equal or higher to mine at 23dpo. 

For a twin pregnancy, we're in the high average. 34.6% of twin pregnancies have an HCG about equal or higher. We're actually at the high end of the average group too, another 700 points and and we'd be in the 9.8% of reported twin pregnancies with betas over 13,723 today. That's really only the difference between a morning and afternoon beta.

My doubling time is also still really fast. Usually things have started to slow down just a little bit by 5 weeks but my body clearly didn't get the memo.

At 40 hours, only 14% of reported single pregnancies have a doubling time equal or faster while 52% of reported twin pregnancies have an equal or faster rate.

I know it's entirely pointless to speculate about 1 or 2 at this point, but our ultrasound isn't for another 9 or 10 days and that's a long time to be left wondering. We put in one embryo with the hope that we'd get one baby, the idea that there could potentially be two in there has got us all thrown off. E has always teased me that the only way we'd have three children would be if we had one set of twins. I had thought that option was lost to us, at least without another round of IVF  and assuming we could have any at all, and the idea that the universe might be orchestrating some twins for us after all is wonderful.

17dp5/6dt - OB Labs

As I mentioned in my previous post, once we got our first positive beta we officially completed the protocol for our frozen embryo transfer. This is pretty standard protocol, I knew that our FET fee wouldn't cover our ultrasounds but somehow I got my wires crossed and thought that it would cover all our betas and hormone tests. That was a $450 surprise and both the clinic and I were hoping to avoid more expenses like that if possible.

Since E and I have Kaiser, our insurance should cover all prenatal care - labs, ultrasounds and appointments. However, since our plan is an HMO, they won't cover any outside care that isn't an emergency even when it's prenatal. Darn. The ultrasounds we can't get around because Dr. D has to check up on our little embie himself, but any lab can run blood tests. So, today Dr. D's nurse sent over a lab order and I had the pleasure of figuring out how to translate that order into the Kaiser system.

I think at a regular lab, I'd just hand this slip over. Not so at Kaiser :/

Unfortunately, my first and second choices for getting the labs ordered were unavailable. Both my acupuncturist (and Kaiser nurse midwife) and OB/GYN were out of the office today and wouldn't be back until Monday. My labs needed to be drawn on Saturday so that wouldn't work. My next option was to leave a message for the on call OB, which I did, but didn't feel particularly confident about it since I don't know them. After waiting a couple hours and not hearing back from them, I went for the last resource I could think of, the Kaiser infertility department.

Unlike most departments of Kaiser that prefer you contact them through the general number, the infertility department gives patients a direct line. While I was doing my IUIs with them, I never had to fuss with an automated system or tell the general system receptionist what I was trying to do. There was always a nurse or assistant on the other end of the line and there was one there today when I called almost a year to the day after my first IUI baseline appointment. I explained everything to them, that I had done IUIs there a year ago, moved on to IVF and now that I had a positive beta I was looking everywhere for someone to order tests for me. They were predictably awesome.

Two minutes on hold, during which two other nurses picked up to see if I was a new caller who needed something, and my labs were ordered. Thanks Kaiser Infertility. I should have called you guys straight away, IUI might not have worked for me but you've been awesome from the very beginning.

I hope these lovely dark lines translate into a super high beta tomorrow. I think we're shooting for something around 6,000 but I'm not completely sure. I think doubling times are supposed to slow to 72-96 hours from 48-72 hours between 5 and 6 weeks. 

13dp5/6dt - Woah Beta!

This mornings beta looked just fabulous! I was hoping for at least 800 with an optimistic 1200 but my HCG is officially 1642! Go little over achiever, go! My hormone levels looked good too, estrogen is 247 and progesterone is 24, and that's with just Endometrin, no progesterone in oil. Not bad for a natural transfer with no PIO!

I will never tire of peeing on these sticks #newhobby

The next check in is Saturday when they'll do another set of labs. The only bummer is that we've now officially completed our FET cycle so everything is charged by appointment again. Today's labs ran me $450 for HCG, progesterone and estrogen from today, and the Estrogen and Progesterone they added on to my last beta and forgot to charge me for. Going forward, that makes a regular appointment with labs and an ultrasound about $610 EACH time. Ouch. Still though, it's a really good problem to have. I'm going to see if I can have my labs run at Kaiser instead of the clinic since they'll cover 100% of them as part of my prenatal care.

As far as our ultrasound, it looks like we're going to have to wait a bit longer to take a peak at our embie baby. I had originally been told by a tech that we'd have one ultrasound at 5 weeks to confirm an intrauterine pregnancy and another between 6-7 weeks to measure the fetal pole, check out the yolk sac and maybe even see a heartbeat. Today the nurse said I'd have just the labs at the end of this week and then an ultrasound at around 6 weeks so it looks like we're skipping the 5 week one. I know it saves us a little money but it's a whooooole week longer I have to wait to lay eyes on this bub. It's crazy how we've been waiting so long for this and now 2 weeks seems like a lifetime away!

12dp5/6dt - Early Pregnancy Symptoms

Our trip to San Diego is winding down and I'm chilling in the hotel lobby since we had to check out of our room for the next guest. I was walking around the Gaslamp district, window shopping and sampling delicious snacks when the exhaustion hit and my body decided it's time for a nap.

I know I'm only like 2 seconds along but I have to say the pregnancy symptoms are real. Early first trimester ladies, I believe you.  Whatever combination of HCG, progesterone and estrogen that is currently marinating my brain is enough to make a noticeable difference in daily life. Far from finding it annoying, I'm actually relishing each little symptom that reminds me we really have a little embryo in there. They're real :)

Now since I've never been pregnant naturally, I don't know how much of the noticeable stuff is due to the embryo and HCG and how much is a side effect of the progesterone. 

The biggie for me is fatigue. After walking around or doing anything, I need a nap. I'm peeing all the time, which isn't too far out of the norm, and I'm noticing a little queasiness, heartburn and some burpy-ness when I wait too long to eat. I'm also crazy hungry, especially in the mornings when I don't usually like to eat.  My belly is still massive, but that's definitely the progesterone since our embie is still tucked behind my pubic bone. The weirdest is probably a little pregnancy brain. This one I really didn't believe, but I'm having little moments where I forget something stupid that I'd never forget. Those are the most obnoxious because I'm not a forgetful person and I really don't want to be. 

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As it turns out, I was too tired to actually post this earlier, oops. Now we're back home, safe and sound, and I'll admit that the first thing I did when I walked through the door was pee on a stick.

Thank goodness it's still positive. I didn't have any tests with me in San Diego and it was killing me to not know what was going on in there and if my HCG is still going up. Tomorrow morning is our second beta and with that line getting darker, I have my hopes up that our number will be good. Betas double ever 48-72 hours so our number should come back at least 800.  I hope our little over achiever is doing their stuff!

10dp5/6dt - First Beta!

E and I went in for our first beta this morning! It was really quick, although it's usually busy on Fridays, the place was practically empty and there was no line for labs. We hopped on the road shortly thereafter and headed for San Diego with our nurse's promise that we'd get called with the beta results by the afternoon.

We were waiting and waiting and it was sometime after I'd made E stop so I could pee that we finally got the call.

Our first beta is positive! My HCG is 400!

I was hoping for/expecting a positive beta given our home tests, but 400 completely blew me away. So many of my fellow IVF/FET ladies have numbers around 100-200 so I was definitely not expecting 400. Wow, we clearly have a little over achiever nice and cozy in there.

Our next beta is Monday since we'll still be out of town on Sunday. Dr. D wasn't concerned about the extra day, he said they often worry when a first beta comes in at 20 or 30, but at 400 he expects things to progress well. We'll confirm doubling time on Monday and then, fingers crossed, have our first ultrasound two weeks later. Each step is like a weight off my shoulders, another positive sign that our little embie is sticking things out. And as a bonus, if all looks good and my estrogen and progesterone are holding up well at our ultrasound, they can start weaning me off the Estrace and Endometrin early!

Now that it's evening and the positive is soaking in, E has gone off to work the game and I'm settled comfortably into our hotel. They upgraded us from a standard room to a one bedroom suite so I have my pick of the bed, two arm chairs or a large, squishy couch. It's a good thing too, I haven't done much today but I think I could use a nap.

View from the couch :)

And before I forget, I gave the CozyFolk liner a try today and it is so, so comfortable. I don't know how the edges would hold up to blood, but they're so soft and just blend right in to your undies. Definite thumbs up.

9dp5/6dt - Still two lines!

I tested again this morning with another crappy old cheapie since the tests that bestie mailed still haven't arrived. One package has literally been sitting and collecting dust in my local FedEx office but they won't let me go pick it up. Super annoyed with FedEx right now. Even though yesterdays tests were positive, I think I held my breath from the appearance of the control line to the moment the second line popped up. It still feels surreal, though I'm doing my best to enjoy it in the here and now.

The lines look purple because I took the photo after the tests were dry. I think the lines are getting darker!

I also received my cloth pad order from Cozy Folk! I took a chance and ordered a couple postpartum/overnight sized pads along with my liners, telling myself that I could always use them just as overnight pads. If all continues to go well, I'll actually get to use them postpartum :) I bought two 14" heavies and two 12" moderates. The colors and patterns are super bright and adorable but her design is something I've never seen before!

Two 14" on the left, two 12" on the right

I'm not sure if you can tell because I snapped these photos quickly but her pads are backed in Wind Pro fleece with a raw edge. The backing extends past the core as it does in most pads, but instead of continuing the absorbent top material to the edge, she finishes the top fabric edges a couple cms in from the backing edges. I think this is done to prevent leaking off the edge, the backing fabric is water resistant so it won't absorb any liquid, although the single layer around the edges feels somewhat flimsy and floppy compared to the double layers on other pads. In theory, I think liquid will bead and head towards the core and the soft edges will probably be pretty comfortable.

For liners, I decided to try minky, which is especially stain resistant, because I ordered them before I started the Endometrin. I think they'll be just fine and comfy but my plain cotton topped liners have actually been the best for Endometrin thus far. As it dissolves, the pill comes out as a sort of chalky, powdery paste that gets caught in the fibers of longer fabrics but rinses easily off plain, flat cotton. I actually prefer the flannel for my period, but thus far the smooth cotton fabrics win for suppositories. I'll have to see how the minky does tomorrow.

Sorry for the crappy photo!

More importantly, tomorrow is my first official beta! I've been trying to keep my mind off of it so I stay relaxed but it's much easier said than done. I'm not really nervous, but I feel like I'm filled with restless energy. I keep sitting down and then popping back up and I can't seem to settle down.  Unfortunately, walking around a lot seems to give me more little cramps so I feel reluctant to get it out by taking the dog for a walk or something similar.  I might try packing since E and I are heading to San Diego for a couple days for E's work. I'm hoping relaxing in the hotel will be a nice distraction to waiting for my levels to rise for the next anticipated beta on Monday. Or I could end up pacing the room, sitting down and popping back up just like I'm doing here. When does it stop? When my betas rise correctly? When we see a heartbeat? When we get to 12 weeks? When do I relax, or do you never really relax after IVF?