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 :/

15dp5/6dt - Am I Pregnant Today?

This morning, I slept in an extra hour and 45 minutes. I took a test, because I do every morning now, and the test line had somewhat crappy dye uptake. I ate left overs for breakfast, ate a real lunch and tried to snack all day long. I still had heartburn, I don't think I can do anything else about that, but I wasn't starving and I didn't get super exhausted.

Most people would say that's an improvement, a good day because I stayed ahead of things and felt pretty good. For me, with infertility PTSD, my first instinct is to assume there's something wrong.

What if my pregnancy is a chemical?

What if there were two and I'm losing one?

What if my HCG is too high and it's a molar pregnancy? 

What if I'm not pregnant anymore?

After everything we've been through, even with no real supportive evidence, I can't help but assume that something is/will go wrong. I don't know how to relax or how to believe that I'm really pregnant and this worked. How to accept that crappy dye uptake on a STILL POSITIVE pregnancy test could mean anything other than the test is cheap. What kind of crazy person assumes that they've lost a pregnancy because they're not super exhausted that day? It couldn't possibly be the almost 2 extra hours of sleep I got, nooooo. There must be something wrong.

I don't know when this anxiety goes away. When we make it past 12 weeks? When we make it to viability? When I actually have them safely in my arms? Will it ever go away or will it follow me into motherhood, sneaking up in the middle of the night, telling me to check my child(ren)'s breathing? Infertility has been our reality for so long, it colors everything I do.

I'm trying to take things one day at a time. I wish I could look through a peep hole into my uterus to to make sure everything is okay in there. I don't think I can wait 2 more weeks for an ultrasound to see if there are actually bab(ies) in there or if this has all been some sort of cruel joke.

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!

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?

8dp5/6dt - I DID A THING

AHHHHH!!  Do you see it?? These tests are super expired, and it's really, really early, today would only be 3 weeks 6 days, but I see a line on all three tests! We have to keep our cool, it's so early and my betas aren't until Friday and Monday so we won't even know if my HCG levels are high enough to be a viable baby. I've just never had a positive pregnancy test before!

I know at this point that it could be a chemical or an ectopic or any number of other things but for right now, in this moment, I think I'm pregnant! And if that wasn't enough, the doorbell rang and it was a gorgeous bouquet of red roses from one of my besties who knew I was having trouble getting through the two week wait. 

She included a really sweet card and that just about did me in, my hormones can't take this kind of sweetness when I'm this full of emotion already. I couldn't even call her to say thank you, by the time I got my myself together I was at Milou's class where no one knows what we're doing, so I had to text her. She also put some pregnancy tests in the mail for me and they will hopefully arrive tomorrow. That way I have more sticks to pee on before the beta so I can make myself wonderfully crazy over how dark the line is. In the meantime I'm both elated and exhausted, with a healthy dose of sharp little cramps thrown in to remind me that my embie baby is in there doing stuff. 

I can't believe this is really happening. After everything, our embryo is actually sticking!

TWW: Happy 4th of July! Too Chicken to Test

After we did our IUI this cycle, I felt SO confident. There was no way we weren't pregnant with 7 eggs split between both tubes and 148 million sperm, it was practically impossible. But as time wore on, I've gone from "We're totally pregnant!" to "Well...what if we aren't??" to ""Oh nooo, I just know it didn't work!". I'm feeling pretty lame about it right now and I've been too chicken to test today. 10 DPO is still pretty early, and I think staring at yet another negative stick would be so depressing. Trying to convince myself that there might be the shadow of a line on a stark white pregnancy test is not an enjoyable experience.

I'm over-thinking every twinge, every symptom, or the lack of symptoms like a crazy person. Last cycle the progesterone made my boobs hurt SO BAD. This cycle they're only mildly uncomfortable. Does that mean something? Last cycle I had a lot of cramping at this point, it was probably my period trying to break through the progesterone. This cycle I have had very mild cramping overall and almost no cramping now. But then yesterday I felt some pulling twinges on my left side, could those be my period? Does that mean anything? And Wednesday night my cat Button, who usually sleeps on my head or chest, planted herself firmly over my uterus and slept there instead. What does she know??? Last night my other cat Cillian did the same thing, he normally sleeps on my feet but instead slept right on my lower stomach, much to the dismay of Button who had wanted to sleep there again. Does he know something too??? I don't know! It's impossible to not notice this crap even though the knowledge does nothing to help and I can't answer any of my own questions.

This would be awesome. No squinting necessary!

I'm also nervous because if this didn't work, I think the road ahead is going to get much more complicated. While we had initially planned on doing 4 IUIs, we weren't expecting to have to spend SO much on medication for each cycle. I was also unaware of the boost you can get from the medication still in your system from the previous months attempt. Last cycle we spent about $3,000 on meds and got one egg. This cycle we spent around $4,000 on meds but got 7 eggs, probably from a combination of the medication still in my system, the birth control suppression, the higher dose of medication, the acupuncture, and the acupuncture herbs. That's $7,000 on two unsuccessful cycles that we could have put towards IVF and I don't think it would pay to spend another $4,000 - $5,000 on IUI.

If this cycle didn't work, I wouldn't want to lose the boost from this cycle by taking time off. With the higher dose of medication floating around in my system,  I would have a better chance of getting a decent amount of eggs than if I took a cycle off. It would also take forever to build the probe for PGD and we'd have to go through the PGD approval process at Kaiser. The idea of waiting so many more months to get pregnant is just awful. What I'd need to find out is whether it's possible to freeze biopsy samples in preparation for PGD, since people usually build the probe before doing the IVF cycle. It's so much to consider. 

Milou is not glad it's 4th of July

Hopefully I'm already pregnant and we won't need to go there. The blood test is Sunday and I think I need to know before that, which leaves tomorrow as the day to test. That gives me about 13 hours to work up the nerve to squint at yet another stick. Oh boy.