My Cousinless Nephew

Last year I blogged here and here about struggling with my brother and sister-in-law’s pregnancy during our miscarriage. Can I just say that—nearly a year later—it still hurts, it’s still raw, and I’m still having a tough time dealing?

The short recap is that my brother has had two surprise babies conceived and born in the time I’ve been desperately trying for just one. My family pretty much wrote the book on non-communication and how to sweep things under the rug, so infertility is a secret that I guard closely from them. Family dynamics and all…it’s complicated.

My brother and sister-in-law were already well into their pregnancy with baby #2 (I’ll call him Baby) when I found out that we were pregnant from IVF. Our children would’ve been only 6 months apart. During the early weeks of my pregnancy, I could barely contain my excitement to announce to them that Baby had a cousin on the way. I never got that chance, though.  In fact, I received an invitation to Baby’s shower on the same day I found out that my own baby had died inside of me. Then, almost immediately after my second miscarriage, Baby was born.

The whole situation was just textbook terrible. Especially challenging was genuinely sharing in the joy of Baby’s birth so fresh after our loss. So I spent the next little while (okay, 10 months) avoiding my brother and—by association—avoiding Baby. It was surprisingly easy: though they all live close by, my family doesn’t spend much time together.

That is, except for our four get-togethers every year for each of the four major holidays: you know, Thanksgiving, Christmas, Easter, and Camping. What can I say? We’re seriously into travel trailer camping… it’s like our very own made up holiday.

On Thanksgiving I ditched my family and went to the beach instead, as the miscarriage had literally just happened and I was still in tons of physical pain. I begrudgingly attended Christmas, where I drank too much wine and ignored Baby’s presence by hanging in the kitchen all night. For Easter, I purposefully sat at the opposite end of the table from Baby and spent the meal talking only with those around me, then made a quick exit. Check, check, and check. That only left one more family get together: camping.

Our annual camping trip was recently. It was the first time I’d seen Baby since Easter, and this time avoiding him was trickier, as campers are not known for their spaciousness. Leading up to camping, I was tripping about whether anyone in my family would comment on my childlessness if I were to go near Baby. Fortunately, no one said anything about it this time, though they have made such comments in the past that hurt very much. Having Baby camping, seeing my family dote on him and make him the focal point of the weekend was… for lack of a better word, rough. Emotionally, it brought everything home that I’ve so successfully psychologically avoided until now.

It’s not Baby’s fault. From the few times I’ve been around him, he’s adorably, preciously, perfectly wonderful. His laugh could melt a heart of steel. His face wears a constant look of wonder and amusement. He rarely cries. He’s insanely awesome. Yet every time I look at him, I have to quickly look away. Because just his being here, so alive and so beautiful, is a sharp, painful reminder that my baby is not here. It reminds me that he’ll never grow up and be in school with his cousin, or become best friends with him/her, or go on family trips together. It’s a taunting reminder of failure that revives my grief as if I were reliving the miscarriage again and again and again.

Let me be clear that it’s not bitterness I’m struggling with here. Not at all. In fact, I’m very happy for my brother to finally have a son after having had three daughters first. To be bitter would be the easiest, most natural response in the world. But, through the grace of God, I’ve learned not to fall victim to every whim of emotion that tries to creep its way inside of me and bitterness hasn’t taken root. His grace has truly gotten me through. No, it is not bitterness. It’s just straight up pain… and heartache. I want to be free of it, but I don’t know how.

Because how can I watch Baby grow up and not feel this constant, underlying current of pain and grief? How will I ever look at him and not fixate instead on the invisible space where his cousin, my own baby, should also be? Will I subconsciously treat him differently than my other nieces and nephews? Or do I instead lavish extra love on him in some convoluted way of paying homage to my own never born baby? 

I don’t know the answers.

Readers, have any of you struggled with a niece’s or nephew’s birth soon after your own loss? Did you have similar issues interacting with their babies? And, perhaps most importantly, does it eventually get easier?

 

 

Starting Back at One: Transfer Day

This morning our only frozen embryo, a grade 5BB hatching day-5 blastocyst, was thawed from its lonely chamber of cryopreservation. The thaw process only takes about an hour, a timeframe that is completely amazing to me. At some point during that one hour, our hatching blast became a fully hatched blast! Transfer day at my clinic becomes Day 1 all over again, so a new countdown now begins.

 

5bb blast
The pic came out a bit wavy since my husband folded (!) the paper it’s printed on. But I still think s/he’s a beaut, crease marks and all!

Between the unscented soap and all-natural crystal deodorant I insisted Jake and I wear, we were both completely sans scent. I even had us brush our teeth with plain baking soda this morning because, you know, just in case. I’m a fortunate girl that he didn’t complain about any of my many restrictions. It might have been unnecessary, but I went a step above and wore no makeup or styling products in my hair just to keep out any unnatural chemicals or subtle scents. I have reallllllly curly hair, so I ended up looking like a small porcupine took up residence on my head without my products, but pssssh, whatevs. Totally worth the outcome. I wanted us to smell like nothing, and I got my wish. Always Be Prepared, right? I would’ve made a phenomenal Boy Scout.

Anyway, Jake* and I were scheduled for a 9:15 a.m. transfer. Being overly prepared for a big day like this (see above), we got to the clinic fifteen minutes early. I had the obligatory “uncomfortably full” bladder as per the  clinic’s verbatim instructions, my squeezy stress ball ready for the blood draw (I keep one in my purse to whip out specifically for blood work), plus comfy clothes and a pillow to sit on for the car ride home. All in all, I’d say we were ready.

And once we got to the clinic? We waited. Boy, did we wait! And holy canolis did I have to pee! We waited well over an hour while I squirmed in my seat trying to find a comfortable position before it was finally our turn.

Normally the surgical clinic has extremely short wait times, and I’ve rarely gone in for a procedure and seen anyone else waiting. Not today though: this morning was apparently Day 1 for everyone else in southeastern PA, and the waiting room was packed. It seemed every female patient there had her husband and her mother with her, which opens up a whole other realm of psychological crap on my end that I’ll spare you all the deets on. I just couldn’t help but notice it, cause all these chicks with their mothers’ support  suddenly made me feel very alone, like a spotlight shining down on an always-empty place in my life. It’s moments like this that I feel that void the most. But let’s keep it happy here today. I’ll stop digressing.

I knew in advance that Dr. Goodman would be doing my transfer (f/k/a “Dr. G,” but in keeping in line with pseudonyms I want her to have a more “real” fake name if you follow me). This was totally okay by me because I really love Dr. Goodman. She’s my second-fave RE in the practice and has a warm and genuine and relaxing presence. She’s performed my first h/s and first ET, so she knows my uterus well. I never imagined another woman could know my uterus so well. Or that I’d ever type a sentence like that with a completely straight face.

In a twist of non-ironic irony, it turns out I had too full a bladder for transfer. Dr. Goodman took one look at my bladder on the u/s screen before she had me hop off the table. She handed me a cup and instructed me to fill it three times before coming back to try again. If I hadn’t had to pee so badly I almost would’ve laughed. Almost. But I was too busy running down the hall clutching my pee cup to care.

The actual transfer went off without a hitch. I’m a bit crampy from the procedure and sore from the PIO injections, but otherwise I feel fantastic.

I’ve spent the day hanging in my bedroom with Puppy and our new cat  Rocky f/k/a/ Tugg (I absolutely had to change his name. I felt like an idiot calling, “Here, Tugg!” across the room. Like a five-year-old). It’s election day here in my state, and while walking the two blocks to my polling center doesn’t sound undoable, in the name of cautiousness I’ll be negligent in my patriotic duties today and skip on casting my vote. I don’t want to look back at anything I did or didn’t do today and have a regret. But still, I’m sorta bummed that I’ll miss out on voting.

Overall, I felt much more confident this time around because I knew exactly what to expect. The whole time the intake nurse was reading off instructions to me on how to change into the garb and how the process was going to go down, I gave her my attention in only a cursory polite way. While she spoke I began wondering about many of you fellow bloggers who’ve been down this road many more times than I have. I wondered if eventually the nurses reach a point where they’re like, “Just go ahead in. You know the drill. Let’s save all our time here and just do this thing.” I don’t want to ever find out.

Lastly, I had this really great post in mind that I wanted to do about TWW stuff. I’m so overly prepared for the TWW that it’s kind of frightening. Most likely I’ll still post it later, but not so late that it’s irrelevant.

It’s not even a true TWW. More like a 10-day wait. Totally doable. You’ll be hearing from me between now and then. No doubt about it.

*Since I began this blog I’ve referred to my husband as “DH,” which is the go-to acronym in the land of infertility message boards. But really, it’s just starting to sound so… blah… like he’s just an extra in a movie instead of the leading man. In the interest of preserving privacy because I will continue to blog anonymously for the foreseeable future, it only seemed right to give him a name. Even if it’s a fake one.

 

“Possibly Ectopic,” or Otherwise Known as The Worst Day of My Life

Guys… I don’t even…. how do I…..?  It’s only 3:00 in the afternoon, but I’ve been through the full gamut of emotional wringers today. I’ve finally reached a place of subdued shock , which apparently means I’m coherent enough to write this and not fry my laptop with a torrential downpour of tears.

In case you missed my post from two days ago, I had to have a follow up RE visit today to recheck embie’s position in my uterus. The other day Dr. C was all types of concerned both that the embryo had implanted off center and that the yolk sac wasn’t visible. He might have been worried, but I actually wasn’t overly concerned myself. I know it’s still so early to be able to see a yolk sac, and a slightly off centered embryo didn’t sound like the worst thing in the world. So I popped into my follow up appointment this morning ready to just have a quick peek and be on my way. Yeahhhh….  but no. There were far more sinister plans in store for yours truly today.

During the ultrasound Dr. C grew very grave very quickly. He informed me that the embryo has implanted into the uterine wall right where the fallopian tube meets the uterus. You follow me? Not quite in the tube, but also not quite in the uterus either; just somewhere along that curve. I don’t remember 100% verbatim, but he said, “I’m sorry, but I don’t think this pregnancy can continue. It looks ectopic on all the images I’ve taken. These things don’t happen often, but they can happen more frequently in IVF pregnancies. I really feel the embryo is in a dangerous place in your uterus and the pregnancy will likely have to be terminated. I’m going to refer you to a fetal development specialist today just to confirm things.”

He did not just say that. Surely I’m having my deepest, darkest nightmare right now and this isn’t happening. I sat sobbing on the exam table. Dr. C awkwardly patted my shoulder. The nurse gave me a side hug and told me to take as long as I needed to get dressed. I managed to dress myself, and after leaving the room, had blood work drawn. It’s kinda a blur right now, but I do remember all the staff and a couple of patients looking at me sympathetically (and probably in secret relief that it was my bad day and not theirs) as I cried and covered my face and refused to meet anyone’s eye while my blood was drawn. I then booked it outta there. Like, literally ran to my car.

I sat sobbing hysterically in the parking lot of a nearby mall and called DH to tell him. I called Boss to let him know there was no chance I’d be in work today. I called my best friend. Then, just as I got myself together enough to drive and was nearing home, I received a call from Dr. C letting me know the high risk specialist person would see me in slightly over an hour.

The specialist’s office was nowhere near my house. Long story short, I arranged to meet DH near his job so we could travel to the specialist together. Which meant I drove this morning: A LOT. I hit two traffic jams, construction, pedestrians, a downed traffic light, three bicyclists, got stuck behind mass transit buses and tractor trailers, and basically encountered any traffic obstacle one could possibly imagine. And I sobbed my way right through them all, screaming and cursing at other drivers and not quite believing today had taken such a turn. So if anyone was driving in or around Philly today and looked over to see a hysterical bawling chick in an SUV plowing down other drivers, then hello.

Both DH and my BFF went with me to the specialist. Their presence made all the difference to my sanity; we sat in a waiting room full of obviously pregnant women and my peeps had my back the whole time. At one point, a very pregnant patient entered the waiting room fresh from her u/s. She waved her u/s images around and complained to the woman who accompanied her to the appointment that her baby was already six whole pounds and she still had four long weeks to go and, oh, whatever would she do?! I may or may not have nastily said out loud that if that was her problem for the day then I’d gladly change places with her. I then chose to finish the remainder of my wait out in the hallway where I could cry in private, far away from women rubbing their bumps and bemoaning nonexistent problems.

Finally, it was my turn. At first, the u/s tech tried giving me an abdominal ultrasound, which seemed pretty ridiculous for being so early in a pregnancy. An abdominal u/s must be able to scan through abdominal fat (of which I may have a teensy amount) and scar tissue (of which I have a ton), all in order to see something the size of an orange seed. After a few minutes of this nonsense, the tech decided the images weren’t clear enough and that we’d next go the transvaginal u/s route. Shocking, I know.

The specialist doctor (Dr. L, who shall now be added to the ever-growing cast of characters) personally stayed in the room during the trans u/s to monitor things. The end result is that, yes, the embryo is implanted dangerously close to the opening to my fallopian tube. To ignore this issue and stop monitoring things opens me up to the fun-filled options of: a) having my tube burst and undergoing emergency abdominal surgery, or b) death.

BUT, thank the Lord there’s a “but” here, Dr. L took one last look at the images and has hope: his hope leans more toward a likely good outcome than bad.  Dr. L believes the embie is implanted closer to the endometrium (read: center of uterus, ie. a good thing) than originally thought. He suspects that embie is growing toward the center of my uterus—which is away from the fallopian tube opening and therefore a good thing—than not. This means I have a very good chance that everything will turn out okay.

Believe this drama?!

The only thing to do right now is for me to return to Dr. L in 48 hours—and 48 hours after that, and so on—to see which way my embie grows. So as it stands right now, yes, I am very possibly experiencing an ectopic pregnancy and will have to terminate what I’ve fought so long and hard to achieve. But that could change yet. No one really knows.

Please know that I am very well aware how snarky and detached this post reads. Please also know that I am truly neither of those things; rather I’m hurting tremendously right now and this is my way of coping. Truth is, I’m pretty well terrified right now. I only wish this was a bad dream and someone would wake me up soon.

Left of Center

First off, I just want to say how much I love you guys and that you all seriously rock! I had  some questionable feelings last week about this whole IVF thang. But within mere minutes of my Debbie-downer post, you guys sent so much encouragement my way—from across the city, across the country, and even across the pond! I haven’t personally responded to your many awesome comments, but please know they meant the world to me and lifted my spirit. I think I’m in a better place this week.

One thing I didn’t mention in my last post was the intense left-sided pubic/groin pain I’ve regularly had since my transfer. Dr. C was concerned enough about it last week that I ended up with an unexpected pelvic exam and ultrasound, which—much like planets orbit a sun—showed seven nasty looking cysts surrounding my ovary. Even crazier, the formation of the cysts on the u/s screen looked just like those Scream masks you can purchase at any Halloween costume store:

screammask

I couldn’t make this stuff up if I tried.

While having functional cysts after stimming isn’t that uncommon (or so I found out the hard way. Note to new IVF-ers: no one warns you of this), having so many of them apparently is. Who knew that one could fit seven cysts in her pelvic area?! The lowdown is that a growing uterus coupled with multiple cysts take up a lot of space, all in an area where everything’s pretty condensed to begin with. Since there’s no room for everyone to fit nicely and get along, the cysts are pushing down onto my groin/pubic area. Combined with the vaginal area pain that Crinone can cause, it’s become the perfect cystic cocktail. Cheers!

Today’s u/s scan showed the same face-shaped cysts, albeit smaller. Dr. C assures me that the cysts will take “awhile” to disappear completely, but they WILL eventually go away on their own.

Today I had my third beta. My hcg level has jumped in one week from 214 to 2,102. I also has an ultrasound to see where things stand. I could see the black spec of the gestational sac on the u/s screen and it was all very exciting to me. Dr. C kept measuring and re-measuring one particular area though. He’s concerned that the embryo has implanted “very slightly off center” (his words). He wants to keep an eye on this. He also couldn’t see the yolk sac within the gestational sac. The sac itself measured at the size of a 5w1d sac; I’m currently 5w4d. Unfortunately I have to return in two days for follow up u/s. When my nurse called to give me the stats for today, I grilled the poor girl about the meaning of all these things for a good ten minutes. She assured me that a lot can change in two days. It’s still so early, sometimes I think they shouldn’t even be doing ultrasounds this early in.

One step forward, two steps back.

Beta Day

2poshptdigThe results are in! Beta #1 was this morning—BFP! Booya! My hcg level was 58.4. Currently I’m 9dp5dt (or, on a natural cycle, 14dpo). I return to the clinic on 13dp5dt for my second beta. Various online forums assure me that the results of a second beta are even more important than the first beta.

Confession time: I already knew.

Yeah, yeah, I know I said before that I wouldn’t test early or symptom count. And honestly, I did NOT symptom count. But therein lies the problem: I had no symptoms (thank you, Crinone). With no symptoms to obsess over, well, life became boring and the wait seemed so eternal, and well….

I caved.

On 5dp5dt, I tested: BFN. On 6dp5dt, I tested again: another BFN. Seeing those single lines were a bummer, but I knew it was still very early. At best, it proved no false positives from a leftover trigger shot hcg.

All this changed on the morning of 7dp5dt though. Because that test? It had a faint line! So, since I clearly had nothing better to do with my time, I dutifully drove like a wildwoman to Walmart and bought four more brands of tests just to be sure, and saw even more faint lines the same morning.  (*Incidental side note: The chick at the register who rang up my multiple boxes of HPTs was very visibly pregnant herself. I didn’t realize this when I initially got in her line. She finished ringing me up and, as I was leaving, smiled and said, “Good luck! I wish you lots of baby dust.” Ahh, a fellow TTC-er! Because, seriously, who in real life uses the term “baby dust” like it’s a totally normal thing to say? She completely made my day.*)   In the p.m. I got a stronger line on the FRER and a “positive” on the Clearblue. Rinse and repeat, you get the idea…. I’ve taken no less than twelve HPTs in the last 48 hours and every single one of them has been a BFP.

When my nurse asked me at this morning’s beta whether I had tested at home, I casually replied, “Nope. I held out.”

I’m not sure why I lied. Maybe I was expecting a lecture. Maybe I still wanted to keep this thrilling secret something that was all mine. Maybe I wanted her to feel like she would be giving me genuinely unexpected good news when she called me with the results. Who knows.

Happy news. Terrifying news. In 4 years of TTC and 12 years of marriage and 33 years of life I have never seen before seen two lines. Ever. Not even on my m/c because I didn’t even know when it happened that I was preggers. There’s a small army of used HPTs under our bathroom cabinet that I can’t bear to throw away.

As my new Walmart friend says, “Baby dust to you all.”

The Lowdown

b

Yes, that is a bona fide pic of our embryo! We did transfer yesterday. At the last minute DH and I decided to forgo PGD. We didn’t feel it was necessary in our circumstances. Because we made this decision we were given a 5-day transfer instead of a 6-day.

We got to the clinic bright and early at 7:15 a.m. I had blood work drawn and then we were escorted to the surgical area to change. DH got a smock, hairnet, and shoe covers; I got the standard too-short gown, slipper socks, and a hairnet. We looked so hot in our getup. I gotta say, it was comforting to have company for once. I had showered the evening before and put on no lotions, creams, etc. whose scents might interfere with the transfer. In fact, I went sans deodorant too just to be super safe (I just bought a new deodorant that I haven’t gone nose blind to yet). So yeah, like I said, hot stuff.

Before transfer, the embryologist met with us about the results of our embies. She came armed with a printout of the embryo that’d be transferred momentarily. Truly this was a perfect, beautiful, hatching, grade 5AA embryo. The embryologist—a sweet woman who spoke in lots of scientific terms—espoused the virtues of our transferee by showing us spots and specks and curves on the printed picture that DH and I didn’t understand, but her excitement was so sweet that we truly did try to process it all. I really appreciated her enthusiasm.

Then she dropped the bomb that only one embryo—a grade 5BB—was leftover to go in the freezer. Technically, there were two embryos to potentially freeze, but the embryologist wasn’t holding out for both of them to make it. (I found out this morning that indeed the second lil fighter did not make it, and ended its life as a 5-celled grade 3DE. Or maybe DF. I forget.)

So, 1 frozen embryo + 1 fresh embryo = 2. Out of 9. Mathematically, only 22% of our embryos survived. The lab thought we’d get at least 40% to survive. And out of the 13 eggs retrieved, only 15% made it to viable embryos. Those are not the kinds of numbers anyone wants to hear.   Then again…. we could’ve ended up with none to freeze at all. The two that made it are so special to me and I thank God for providing them. Yet I can’t help being sad and upset about the seven we lost. I of course started crying the minute the embryologist left DH and I alone behind our curtained area. And this morning after receiving the news that only one was left to freeze, I began crying again on my drive to work, ruining my perfectly good eye makeup. I hope this sadness gets better with time.

I truly struggled with this outcome. Part of me is of course undeniably grateful for our two embryos that did make it, grateful for this opportunity, grateful that it wasn’t worse. Yet another part of me is heartbroken for the seven embryos that didn’t make it. I don’t know how to feel. I go back and forth, up and down, left and right. If I start getting sad or worried then I kick myself, because surely those emotions are sending bad/draining/negative bodily vibes through to my lil blastocyst and maybe that will affect its implantation. So, what, am I not supposed to feel any amount of sadness because of this possibility? It’s a vicious cycle. Being on estrogen is not helping matters, since it seems to affect my emotional state the worst of any of the hormones I’ve stuffed into my body lately.

The transfer itself went smoothly. I had creepy Nurse Pam hovering over me again, but her chilling presence was buffeted by the return of Dr. G, who had performed my hysto and mock transfer! Aside from my regular RE, Dr. G is my fave doctor in the whole group. I was super happy to know she’d be doing our transfer. The lab is adjacent to the surgery room, so a door was opened up between the rooms so DH and I could see everything that was happening. The lab seemed like a happy place—it was brightly lit and they had music going. What a cool place that must be to work at.

DH and I got to watch on a TV screen as the embryologist in the lab took the embryo from its petri dish and basically sucked it into a catheter. She then carried it through the doorway into the surgery room. At this point I was already on the table with the speculum in. The catheter was inserted to the very tip of my uterus and the blastocyst placed. Quick. Easy. I laid there for less than ten minutes before they discharged us to leave. I spent the remainder of the day on bedrest, only getting up to use the bathroom or get something to eat. Today I am back to work.

Since we did a day-5 transfer, our TWW is actually a 9-day wait. October 1 I will have a blood pregnancy test done at the clinic. I’m so grateful we don’t have to wait an extra five days to find out the results. I really don’t see myself POAS between now and then. Among the lovely side effects of the Crinone that I’ve been taking for the last six days, constant cramping and ridiculous boob pain/swelling/lumpiness (They lie and call it mere “breast tenderness” on the informational insert from the pharmacy. Not.even.close) have been plaguing me on a daily basis. Because of that, there’s little else to “look for” as far as possible pregnancy symptoms go. Symptom counting has never been my thing anyway. Just gotta ride this thing out.

Peace 🙂