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. 

16dp5/6dt - Mourning for a Friend

Today, I am mourning for a friend. In an incredibly cruel twist of fate, one of my best friends lost her seemingly healthy baby at almost 14 weeks. With 12 weeks usually regarded as the safe zone, it caught everyone completely off guard. Her previous pregnancies were healthy, all previous appointments had been fine, there was no warning or reasoning - just a fluke occurrence that no one could have prevented. 

Growing new life is such a fragile thing. An incredibly complex process where so many things can go wrong, it's amazing that any of us are here. Even when development looks smooth, one foot can slide out of place and the entire dance is lost. Her loss is a sobering reminder that anything can happen. I hope she and her family are able to get some answers, grieve and heal. 

E and I are still so early in our process that it's difficult to accept it and believe that everything is alright. I look at the birth boards and groups I should be joining for January babies and it looks like a different world - a place were people get pregnant easily, where genetic carriers and IVF/PGD don't exist, where all pregnancies yield a healthy baby.  I don't belong there. I still expect to walk into the ultrasound and see empty sacs or have someone jump out and say "just kidding!".  

The anxiety has been tough lately, throwing me off because I'm not usually an anxious person, and I know I need to work harder on living "today". Anything can happen tomorrow, we could have a healthy baby or babies, empty sacs, a miscarriage at 14 weeks - but today I AM pregnant. Two lines keep showing up every morning, even when the test is a crappy one (I'm looking at you 15dp6dt test - damn your crappy dye lot!). 

Today I am exactly 5 weeks pregnant. According to the www.ivf.ca calculator, cardiac contractions should have begun yesterday in our teeny tiny embryo(s). As long as everything is going okay in there, we should be able to see a heart beat around the 18th. I can't wait to see that tiny flicker. 

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.

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.