16 Weeks - Little Cutie

After several more unsuccessful house hunting ventures, I finally had my 16 week OB appointment yesterday. Although it's not usually an ultrasound appointment, I got to have a little peak at our baby anyway. They were so darn cute, kicking their legs and waving their arms.

Such a cutie already!

This was my first appointment with my awesome midwife S who I haven't seen in a few weeks since I stopped acupuncture. Although she prefers to use her hands and the doppler to check on baby, she hadn't seen our bean yet in person and knew I wanted to check on them so she obliged me with the ultrasound. I'm so glad she did, seeing their heart beating and legs kicking always makes me feel better. Overall I'm doing pretty well with the pregnancy too, no more morning sickness and I've come to accept that heartburn is clearly my new way of life. Considering that I'm a couple weeks into the second trimester now, I thought I would have gained a few pounds too but it looks like I'm still at 0. It's not a problem since I started off so chubby to begin with, thanks FXPOI and IVF, but I'm sure that will change over the next few weeks. 

That morning the traffic had been absolutely horrible, apparently Vice President Biden was in town blocking roads, so I'd ended up getting to my appointment at least 20 minutes late. S had been planning on putting in some needles for me but now we didn't have the time, which was a bummer. I think I'm going to schedule a regular acupuncture session at the center instead, certain points in my foot and on the inside of my knee are feeling kind of sore. Plus, I always feel better in general when I'm doing acupuncture. 

I also had a little bit of an upset tummy yesterday, something I ate the day before didn't agree with me. That coupled with skipping breakfast since I had to leave so early meant that I was super dehydrated by the time I got to Kaiser. I couldn't pee for them for over an hour, even chugging down water, and once I finally did, they weren't thrilled that my urine sample had some protein in it. I gave them a second one that looked much better that they had tested in the lab and thankfully it came back totally clear. No bladder infection, no protein, no sugar, nothing to suggest anything out of the ordinary. Basically, I have to be more careful about drinking even more water in this heat. Otherwise, everything looks nice and normal with little bean and I won't get to see them again until our anatomy scan at almost 20 weeks.  

12w4d - NT Scan

Today was our NT scan and I don't think I've ever enjoyed an ultrasound more. Little bean was much less bean and much more tiny, wiggly, stubborn person, I couldn't stop smiling and laughing watching them. I was holding my breath when the tech first put the wand on my belly but before I could ask if baby was okay and had a heartbeat, they started waving their arms around and squirming. They wiggled left, then right, arched their back and squirmed all around. It was beautiful.

Turning on their side, wiggling their little arms

We saw them swallowing big gulps of amniotic fluid and begin to suck their thumb. We got a peak at their brain, which is developing perfectly, and when we went to check out bean's organs, we caught them practice peeing! Their little bladder was full of amniotic fluid and they just happened to empty it right then. It was incredible to see them moving and dancing so much when they're still too small for me to feel. I can't wait to feel some of the acrobatics going on in there.

Baby on their side, showing off their tush

The whole point of this ultrasound was to perform an NT scan, a nuchal translucency scan. The NT scan measures the fluid in the tissue at the back of baby's neck to look for markers of chromosomal abnormalities. Babies with chromosomal problems often accumulate a build up of fluid in their neck which results in a larger fluid space and a bigger measurement.  To get a clear reading, the tech needed baby to look up so we could get good measurements of the back of their neck. It seems simple enough but little bean clearly had other ideas. Every time the tech got close to the right shot, baby would roll over onto their side and give the tech their butt. The tech would ask me to cough, which makes baby jump, but bean would just wiggle and squirm and show off their tush again and then I'd laugh which also makes baby jump.

Profile shot the tech was looking for

Eventually we were able to get a couple shots and baby's fluid is measuring a perfectly normal 1.3mm. Amazingly, although I'm only 12w4d today, baby is in the middle of a growth spurt and measured an impressive 7.08 cm which correlates to 13w2d! Clearly they're still an over achiever. Their heartbeat was also perfectly on track, 156 bpm. I wonder if this growth spurt is why my morning sickness came back, although they were measuring perfectly on target at my last appointment which was the day I started throwing up again.

Our next peak at baby won't be until the end of July, another long stretch without getting to see our little bean. They already look like such a perfect little person now, I can't wait to see how they've grown at 16 weeks. If anything funny shows up in my blood tests, they'll call at the end of this week but since we added on PGS and know baby has normal chromosomes, I don't anticipate any problems. Baby just needs to keep doing what they're doing and grow, grow, grow.

11w5d - The Pukes Have Returned!

Oh man. I haven't had a single incidence of morning sickness for several weeks now. I thought I was in the clear, almost 12 weeks, it should be gone. But no.

Yesterday, E bought me donuts, because he is wonderful. I was rushing this morning to make it to work for a meeting and I swallowed my prenatal vitamin, grabbed an old fashioned and jumped in the car. I was about halfway there, and 95% finished with my donut when I started to get that "feeling". For a few seconds I thought it might pass but when it didn't I decided to pull over and get the ziplock out of my purse just in case. I pulled down a side street that had no parking, so I pulled into the first driveway I could find, reached for the bag in my purse that was allll the way at the bottom, and promptly vomited all over myself before I could get the bag into place.

This was me before the puke. BWHAHAHAHA

It was disgusting. The first one got my shirt, pants and the seat, and then I threw up 6 or 7 more times, thankfully into the bag. I was now halfway to work, late, covered in puke, holding a bag of puke with no paper towels in the car. Ugh. I had wanted to wait until 20 weeks to tell my boss about the baby, but we had a conference call meeting in 20 minutes, she knew I was already on my way, I very clearly needed to go home and change and this is one I couldn't explain away. I shot her a quick text explaining the news and the puke, turned around and went home for new clothes.

Thankfully, she was very pleased for us and had horrible morning sickness with her pregnancy so she had many vomit in the car stories to share. I was able to conference into my meeting from the car on drive to work attempt #2 and everything else went okay.

Late afternoon, I had some tax things to go over with our tax guy and then FINALLY, our OB appointment. I had eaten a grilled cheese for lunch, which is my morning sickness go to food, but it turned on me and I had to throw up again on the way to the OB. Double ugh. This time I was ready and did not have a disastrous mess but I'm pretty disappointed in my stomach.

However, and most importantly, our little bean is OKAY. I've been having major anxiety leading up to this appointment but there they were on the screen, little arms raised up over their face, with their tiny heart beating away. It's such a huge relief to see them alive and well despite all my fears.  They measured exactly on track, 11w5d and looked so much bigger than last time, even though the ultrasound photo kind of sucks. The OB and I talked through our screening options and agreed that we should go ahead and skip CVS since we're not comfortable with the risk. The CA screening panel we did will look at some of the PGS stuff, down syndrome etc, and if we want to later we can get the amnio.

E had to miss this appointment which really sucked, but we're having our nuchal translucency ultrasound next week and he will be able to come to that one. Maybe baby will put their arms down and let us have a peak at their face for that one.

11 Weeks - Progesterone Freak Out

Ugh. I'm having a bit of a freak out over progesterone. As I've mentioned, I had a natural FET with this baby. This means no estrogen priming, so no hyperovulaton to leave behind lots of corpus luteum cysts to produce progesterone.  Just one, naturally ovulated egg. I also skipped progesterone in oil, which is easily measured in the blood stream and greatly increases progesterone levels. For me, it's been just Endometrin suppositories which don’t show up in your labs since it's absorbed directly by the uterus.

My progesterone has been increasing pretty consistently at a "low normal level" as my pregnancy progresses, which the RE has been happy with since the transfer was natural. With PIO, they'd be looking for levels over 20 early on and a big jump when the placenta takes over. As you can see, the biggest bump I've had was 16.6 a couple hours after I'd put my progesterone in.

I am supposed to be weaning off the Endometrin since I'm 11 weeks today but my labs at 10w5d showed my progesterone was only 15.4. I would have thought that my placenta would have taken over and be producing progesterone on it’s own by now, but it’s not making the jump. The RE isn’t super concerned since this is still technically the lowest side of normal and my estrogen is increasing, but I am freaking out. There's all sorts of studies suggesting that "91% of pregnancies with progesterone lower than 15 ng/ml will end in miscarriage" (source) and "Average progesterone in pregnancies that miscarry is 14 ng/ml; in healthy pregnancy: 32 ng/ml" (source). I'm terrified that my levels are low enough to endanger our otherwise perfectly healthy baby.

I know some women just have lower progesterone but I don’t feel ready to stop the Endometrin without a real increase.  I only have 1 day of Endometrin left and I just don't feel good about stopping. 

Pregnancy Symptom Round Up

I used to watch those "I didn't know I was pregnant" shows and think okay, I guess it could happen. Maybe she was a little chubby to begin with, had irregular periods, thought she had the flu, there's a lot of excuses. But now, I think I have to call bullshit.

I have had so much funky stuff going on in just the first trimester that I'd have to be living under a rock to not suspect something. I haven't even felt the baby move yet

4 - 6 weeks - crazy sore boobs, pokey nipples, lots heartburn, twinges and cramps, bloating, peeing all the time, hungry

7 - 9 weeks - all day morning sickness, sore boobs, nipples still pokey, occasional round ligament pain, major bloating, peeing all the time, sick if I don't eat frequently

10 - 11 weeks - heartburn is back with a vengeance, nausea thankfully ebbing, sore boobs, round ligament pain, still bloated, still peeing all the time, stomach and organs squashed, sick if I don't eat frequently

Now that the nausea is mostly gone, the heartburn is probably the most noticeable symptom because I have it all day long. Eating, not eating, standing, sitting, it's pretty constant. My acupuncturist and midwife S said in addition to the bloating, my middle is already so large because my organs are being pretty well squished upwards by my uterus so I'm sure that doesn't help either. I'm probably going to bring it up at my next appointment

I've also had some weird cravings for things I don't normally eat. It was meat the first few weeks, but after that it's been chocolate covered almonds, pomegranate juice,  salty chips and most recently cheetos which I don't think I've eaten in the past decade. I also briefly wanted something sweet like a donut, though that craving passed pretty quickly, and I've wanted nothing to do with my favorite vegetables. I couldn't even bring myself to eat my favorite veggie pizza, I took one bite and it was so unappealing I had to put it down. Why doesn't baby want nice, healthy foods full of vitamins? What nutritional value could there possibly be in crunchy cheetos? 

10 Weeks - Bumpin'

I know some women get through early pregnancy without showing, but apparently I am not one of them. I don't know how much of it is Endometrin bloating, or normal pregnancy bloating, all my organs being squished upwards, or just my body being thrilled to finally be pregnant. Either way, my belly has just exploded.

Bam! Baby Bump :)

Granted, I was pretty bloated from the Endometrin before the transfer, and as you can also see, I've put on some major poundage since starting the whole infertility process. But I can't suck this in and I'm pretty sure that bloating is supposed to change day by day and morning to evening, mine doesn't go down, just consistently gets bigger. This baby clearly doesn't want to stay incognito.

Our plan was to wait until after the anatomy scan to begin announcing our pregnancy but with my belly this big at only 10 weeks, who knows what I'll look like at 20 weeks. E is convinced I'm going to be the size of a house and I think he might be right. I don't mind being big already, I love having visual proof that baby is doing what they're supposed to in there, but it is making for some awkward looks from people. Everyone has been too polite to ask anything outright but this little bean is pretty noticable.

As far as the rest of pregnancy is going, my nausea is letting up a bit for which I am so, so grateful. I haven't thrown up in a week now and the constant queasy feeling is ebbing. Unfortunately, in it's place, the heartburn is coming back with a vengeance so tums are my permanent best friend.

Our next opportunity to check in on bean isn't until just before 12 weeks, so in the meantime I'm trying to remind myself that everything is okay, my belly is clearly growing so bean must be growing, even if I can't see them on ultrasound every week.

Grumpy Cat

Since getting our positive, I've noticed some changes in our wonderful pets behavior. Some things are mild and innocuous but others might potentially be cause for concern.

Our boy kitties are solid. They're in a serious bromance and usually don't pay too much attention to the humans since they're too busy grooming and cuddling. Since our positive, they're a little more cuddly, they want to sit on my belly and get pets whenever I'm sitting down in one of their spaces and will seek me out a little more often for attention. Aside from that, they're not concerned with change as long as their meals keep coming on schedule.

Your belly is my new favorite bed

Milou, our soon to be big sister, is a little more protective. She's fine with other people around, loves children, but she's really not loving other dogs in my space. My mother's dog is particularly upsetting for her, she doesn't want him near our "personal" space - my bedroom, her bed, her crate. On Saturday in her agility class, the instructors dominant male dog tried to lean into my side for butt scratches and Milou basically draped herself across my legs and laid in my lap. She usually backs off from him since she's on the submissive side but it was pretty clear she would not be doing so this time. Her mama is off limits. I'm not really concerned about this behavior, it's normal for dogs to get a little more protective when their people are pregnant and she's still perfectly happy with people, both adults, kiddos, and littles.

I might be smiling but I'm not happy about this

I think the wild card here is probably going to be our girl kitty, Button. She's a 100% mamas girl, shy and scared of other people, and she's making it pretty clear that she is Pissed. We've always known she wasn't a huge fan of change, but in the past she's done really well moving houses, accepting new pets, making things work as long as she had her mama. Now, she's quite literally lashing out. For the past few weeks, she's been reaching out with a paw whenever I stop petting her to grab me. Today, I was walking by her cat tree on my way to put away laundry and stopped to pet her. I only gave her quick pets since I had clothes in my hands and on my way back past her tree she reached out and whacked me right in the face. She actually gave me two teensy scratches and I can't remember her ever intentionally scratching me before in the 10 years I've had her. I gave her a stern talking to and she wouldn't even look at me, she is not a happy camper.

Don't let my big eyes fool you, I'm really grumpy right now

I'm not really concerned about Button with a baby, she's an under the bed, in the closet cat who has her little space that she doesn't leave.  I'm fairly sure she's going to keep as far away from baby as possible. But in the meantime, I need to find some way to make her feel secure and loved so she knows these changes are good ones. I can't have her taking swipes at me every time I go by and I don't want her feeling upset and stressed for the rest of the year. 

8 Weeks - Heard Bean's Heartbeat!

This morning we had the absolutely exquisit pleasure of hearing little bean's heartbeat for the first time. It was such a beautiful sound, thumping away, beatbeatbeatbeatbeat like a strong, steady drum. I can't stop listening to it, I need to take a longer video of it next time so I can listen on repeat.

8 week little bean! Not a great photo but still adorable

The downside of the appointment is that we really didn't love the doctor we met with. She's not on my schedule for any other appointments so I'm hoping she was just the ultrasound dating person and not one we're going to have to see again. She argued with me about how far along I am, didn't seem to understand basic post IVF medication (estrogen and progesterone are pretty much standard), wasn't going to look for my SCH even though I told her I had one and more importantly didn't seem to understand PGD/PGS. I introduced myself, explained that this was an IVF/PGD/PGS pregnancy, these are the medications I'm on etc. And she's like oh....I see here you're a FX carrier? You know you could pass that on to boys....and E and I looked at each other like WTF? Is this lady for real? I explained again that yes, I knew I was a carrier since I JUST said we did PGD/PGS and that I was aware my mutation could be passed on to both boys AND girls HENCE THE PGD. Then she asked if I had seen the genetic counselor to talk about passing on my mutation. OMFG.

She was nice and thorough otherwise, I just don't think she has any idea what PGD/PGS is or she wasn't listening when I tried to explain what we'd done. It was disconcerting and we definitely don't want to see her again. We worked way too hard to get this baby to continue care with someone who doesn't understand everything involved.

6 weeks 4 days - Morning Sickness

It has begun! I've been feeling queasy for a couple of days but today was the first day I actually threw up. I woke up feeling nauseous and was just getting out the crackers to see if nibbling helped when I had to run for the bathroom. It seemed to be entirely bile but my big worry is the medication - I take my estradiol, aspirin, prenatal, and probiotic first thing since the Estradiol is time sensitive and taken every 12 hours. If I throw up the medication, which I'm not even sure how I'd track since it dissolves so quickly, do I need to repeat the dose?

(Source)

I called the nurse to ask and she said I'd need to repeat my lab work at the end of the week to see if my numbers are falling. It's not helpful if I throw up 15 minutes after taking my pills but we don't want to overdose since estrogen is a powerful hormone. I know 80% of women get morning sickness but my clinic seems to be a bit fussier about it. They asked me to try preggie pops and call back in 48 hours to report on the puking, which I hopefully will not be repeating.

Still, it's a small, welcome price to pay to have this little embie on board :) Anything for this little bean!

Over Achiever on Board!

We had our wonderful ultrasound yesterday and we officially have one over achiever on board! And a tired, slightly nauseous mama lol. Our little bean is growing right on time, they correctly measured 6 weeks 1 day yesterday which is fabulous and much to my amazed surprise, we actually saw a tiny heart beating away!

Everything looked good, the sac, yolk sac, fetal pole and tiny flickering heart. Now that we've seen a heart beat, even though it's only 6 weeks, Dr. D says that our miscarriage risk has dropped to 5%. It felt great to hear him say that but the anxiety is still there. Our next check in will probably be next week and I think I'm going to ask E to video the screen so I can peak back at that heartbeat whenever I want to.

Hi little bean :)

I hope one little bean means an easy, healthy pregnancy. I'm feeling a good deal of queasiness but haven't thrown up so I consider that a win. The bloating is also getting even more noticeable, even from last week to this week. Our embie is still tucked way behind my pubic bone but with all the progesterone I'm shoving up my girly bits, my stomach is huuuuuuge. I'm already getting looks from people side-eying my belly but my lips are sealed, we're planning to keep things under wraps for quite some time. I don't think we'll be announcing even a hint until after all our genetic testing and our anatomy scan at 20 weeks.

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 :/

21dp5/6dt - Cold

Hack. Cough. Snot. Sneeze.

This pregnancy cold is kicking my ass. I had an acupuncture session yesterday and was warned that it would make things worse before they got better but wow did they get bad. Itchy, sore throat, running and stuffy nose, headache from sinus pressure, sneezing and coughing from post nasal drip. It was miserable. Although I should change my official title to snot factory, I am doing a lot better today and I'm hoping that acupuncture at least helped shorten the duration of the cold. S told me that pregnancy colds can last twice as long and when Dr. D called to discuss our next appointment, he cheerfully apologized and told me that viruses love pregnant women!

Your immune system changes while pregnant to prevent your body from attacking the embryo, technically a foreign "other" hanging out in your uterus. This might as well paint a great big target on your back for even the weakest and most punny viruses to come have a go. I'm not even sure where I picked up the virus, as everyone I spend time with is still perfectly healthy. No, this virus is allllll for me.

Since I'm officially preggo and in the most delicate time period, I'm not allowed to take anything for a cold. To try and make things less miserable, I've been breaking out every pregnancy safe natural remedy I can think of to reduce symptoms.

• Gargling - This is pretty much the most effective thing you can do for a sore throat. Mine is both itchy and sore and I've been alternating gargling hot water mixed with a splash of sea salt or apple cider vinegar. The vinegar is particularly unsavory, especially if you're already sensitive to odors, but it does help. I do this as needed, depending on how bad it is the gargling usually relieves symptoms for a couple of hours and I have to do it before bed or the itching keeps me up.
• Neti Pot - Now that my nose is a constant plugged/leaking faucet, this thing has been a lifesaver. It washes so much crap out of my nose that it's unbelievable and really helps me breathe. I've been using it a few times a day and especially before bed so I can get to sleep.
• Cough drops - S is really strict about medications including cough drops but she did say I could suck on pure menthol ones when my throat gets really bad. I definitely needed them yesterday when my throat was at its itchiest and I just wanted to stick a fork down there.
• Humidifier - I didn't use one the first day and sincerely regretted it when I couldn't get to sleep until after 3am because my throat was so sore and itchy. Since then I've had it running constantly with some menthol vapor that really soothes my nose and throat. I'm keeping it handy from now on, no going back into storage. 
• Tea and Soup - pretty much the only things that don't feel awful to swallow are tea and soup. E has kept me going with a constant supply of hot herbal tea and matzo ball soup and I am so, so grateful. Add a splash of lemon to the tea to cut the mucous and a little bit of honey to coat your throat and that's pretty much the best you can do. 

I'm crossing everything that this cold moves on swiftly and doesn't come back anytime soon. I really don't want my body under any stress while our little embie's organs are vulnerable and developing. I'm also coming up on the time when morning sickness usually starts and I can't imagine barfing with my throat already this sore. Hopefully any future illnesses can hold off until at least the second trimester when our little one is more developed.

19dp5/6dt - Happy Mother's Day

(source)

 Happy Mother's Day to all the mamas, soon to be mamas, pet mamas and future will be mamas!

Unfortunately for me, I started off my first soon to be mamas day with what is probably a cold. I can't figure out whether it's a regular cold (pregnancy suppresses the immune system) or just pregnancy expanding all my vessels which produces more mucous. I've got a killer sore throat so I'm thinking I might have some sort of post nasal drip thing going on and irritating it. Instead of going out to dinner tonight like we'd planned, E picked up some Matzo Ball soup for me which I ate before falling asleep on his arm and stomach. I'm pretty sure I drooled all over him, my nose started to plug up and I was sleeping with my mouth open, but he didn't move and let me sleep for a good two hours. I seriously love that man.

Since I'm pregnant I can't take anything for a cold. It's not fun, but honestly this is one cold I'm more than happy to just suffer through, I'm not willing to do anything that might damage our fragile embryo during such an important part of development. I can get some decent relief gargling hot water with a little apple cider vinegar but I made the last batch too strong and ended up gagging which was no fun. It works pretty well for at least an hour but I'm not sure I can pull it off with a more sensitive palate. 

In better news, I got a voice mail from the clinic confirming that they want to do my ultrasound at 6 weeks. I was thinking they'd wait for 6 weeks and a few days since we're more likely to see a heartbeat on the 18th at 6 weeks and 4 days but their message said 6 weeks exactly. I'm planning on giving them a call tomorrow and see if I can't get an appointment date so we have something concrete to wait for.

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. 

14dp5/6dt - Tricky Baby?

The more I look at my beta numbers, the more I wonder if we don't have a little tricky baby in there. My beta started off high but this last one has gone way up and now I'm giving serious thought to the possibility that there could be two in there - identical twins.

We transferred a Blastocyst so if we had twins, they would have split after day 6

In general, HCG numbers in PGD pregnancies tend to be on the lower side. It's most likely due to the biopsy of the embryo since they're removing cells that would otherwise be producing HCG in early pregnancy. When you remove those cells, the embryo takes a bit longer to bounce back and regrow enough cells to produce high numbers of HCG. It could also be the result of late implantation too, for the same reason really, the embryo needs to bounce back a little before it can successfully implant. Clearly, this hasn't been the case for me. Even my doubling time seems to be ahead of schedule, normal is 48-72 hours and thus far mine has been 35.34 hours.

Betabase.info Doubling calculator

With a beta number of 1642 at 13dp5dt or 18dpo, this puts us in the above, above average category for a singleton pregnancy. With 192 ladies sharing the same range, it's not unheard of but it is significantly higher than average. Only 229/2751 singleton pregnancies had numbers as high as mine or higher, that's only 8.3%.  Again, not impossible, but certainly not common.

If there's only one in there, they sure are an over achiever!

Although the percentage is small, it's believed that biopsying an embryo slightly increases the odds that it will split into monozygotic or identical twins. The theory is that by manipulating the embryo via cell removal and piercing the shell, you're making it more likely for the zygote to split clean in half and develop into two separate babies - either Mono/Di or Mono/Mono twins. Mono/Di twins have their own amniotic sacs but share the same placenta, while Mono/Mono twins share the same amniotic sac and placenta. You can also have Di/Di identical twins when the embryo splits early on, at the morula stage. Those babies actually have their own placentas since they split before they implanted. Mono/Mono twins carry a great number of risks, it's a lot to ask one amniotic sac to hold two babies plus the increased likelihood twin to twin transfusion syndrome (TTTS), cord problems and circulatory problems. Luckily, Mono/Mono twins usually only account for 3% of identical twins. Mono/Di twins are also at risk for TTTS but having their own amniotic sacs offers some protection. Mono/Di babies are often misdiagnosed as Mono/Mono early in the pregnancy because the dividing membrane can be tough to see until later on.

My beta seems a lot more at home in this chart

Looking at the twins beta chart, my numbers are a much better fit within the normal averages. 410/1442  twin mamas had numbers as high as or higher than mine which is 28%, a number that makes a lot more sense than 8%. If we'd transferred two embryos there'd be no doubt in my mind that there's two in there, but with identicals still being such a small percentage, I think it could go either way. Honestly, we'd be happy either way, with an over achieving singleton or a tricky baby that got bored and decided to split. I just want a nice, healthy, normal and boring pregnancy.

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.