30w5d ultrasound and other notes

(x-post from my other blog, so if you read there, nothing new here)

I’m not used to being quite so nervous before what should be a routine ultrasound. As you know, I was a bit worried that they would tell us there was something else wrong with our little Truffle.

DH and I were both a bit concerned as the tech was doing the u/s; the cerebral ventricle she was measuring was at about 1.5cm (because Truffle is nicely head down, they couldn’t get a good shot of the other one), whereas they had told us before it was 1.2-1.3, so we were thinking that had maybe gotten worse. And there seemed to be a bit more fluid in the kidneys. But when the doc came in, she told us that the ventricle was measured at 1.5cm on the MRI, and the change in the kidneys was within measurement error, so all in all things seem to be stable.

Although going from 1.3 to 1.5 puts the ventriculomegaly into the ‘severe’ category rather than ‘moderate’. Choosing to ignore that particular fact at the moment.

And the best news – no additional findings. PHEW.

Truffle was measured (based on head diameter, 30w4d, belly size, 31w, and femur length 30w6d) at 3lb10oz. That’s a gain of a pound over the last three weeks, which is nice. Amniotic fluid was also at a good level, continuing to indicate that the kidneys are functioning reasonably well, and if there is an obstruction, it’s partial rather than complete (=bad).

His head was down, back along the left side of my uterus, with feet and hands over to the right. I find this interesting, because when I get a strong BH contraction, my uterus totally bunches up on the right hand side. I would have thought that was where most of the baby was! (Although I almost exclusively feel kicks from the middle to right of my belly).

Lots of other questions for my doc this time, mostly relating to what we can plan for and expect surrounding his birth.

The neurologist had said we should do another MRI post-birth. I was thinking this probably wasn’t necessary – we will deal with whatever may happen, and finding out there’s something else to worry about? well, I’d rather not. Dr. B said that she would defer to him, but her guess was that it would be to get a more accurate measurement of the ventricles to determine whether a shunt would need to be placed or not. I did not want to do it (because it requires sedation of my brand new munchkin) if it would not change anything, but if it could lead to a potentially helpful intervention I think it is a good idea.

As far as Truffle’s birth, there is no reason based on the kidney or brain findings at this point that we couldn’t have another vaginal, natural birth. I did promise we’d get to the hospital a little sooner this time (with T we arrived 30 min before he was born, and by the time I was on the triage table I needed to push, so especially as there was meconium that had come out when my water broke, things were a little hectic).

We should expect that the pediatric team would be on hand to do an immediate post-birth evaluation, but at this point there is no expectation that he would need to go into the NICU. She said perhaps one of the NICU step-down nurseries where the nurse to baby ratio is higher so they could keep a close eye on him – but hopefully he will be able to room with us right away.

He will have another ultrasound both of head and kidneys, and may need to take antibiotics prophylatically if the kidneys are still fluid filled, as that often leads to UTIs. I have found D-mannose quite helpful in fighting UTI’s, I wonder if there might be a way to use that instead. Will look into that.

He will also most likely have a test called a VCUG, something to do with the kidneys that I have not looked up yet.

So he will most likely be away from us more than we would like in the first few days, hopefully we can at least go with him to the tests/procedures so he’s not all on his own.

At least one procedure he will not be having is circumcision – we have been very happy with our decision not to have that done for A&T.

Two weeks later...

We're just going about our daily existence at the moment.  We have all the information we're going to get, nothing we can do but wait and see.

I have told a few people face to face, and as settled as I am with trusting that we will enjoy and love our little Truffle no matter what, saying that there's something missing out loud is still really hard.  I can't do it without crying.

I feel like I have so many other things I want to say but I'm afraid that they come out in ways I don't intend.  And sometimes I can't even find the words.

I want to talk about how I find myself wishing we never had that ultrasound.
But that it probably is good to have an inkling beforehand that things might not go as hoped.
I think it would be harder, if Truffle does have challenges that our other boys have not, if we were trying to figure out why that was.  Now we know.
I wonder if it is worth it to have another MRI after he is born.  We know what the possibilities are, do we want to subject him to that when he's just a few hours old?  What will it really get us?  It's not going to change anything.

I don't wonder at all whether we will love him.  I know the boys will do so unconditionally.  I hope that we all can find it in ourselves to do the same.  I hope that I don't find myself looking at other kids and thinking 'why didn't we get that?'.  I hope that I am able to enjoy Truffle for who he is and not worry about what he is or isn't doing.

I also find myself hoping that I don't end up never being able to work again.  This part-time stay at home mom thing was never intended to be permanent, and I'm afraid that going back to work again might not be possible.  I often feel like I fall so far short of other stay at home moms in terms of the enrichment I offer my kids when I'm home with them, so many days feel like all I'm doing is whatever it takes to get through the day.  I don't know that I can live with feeling like that for the rest of my life.

Last appointment... so now we wait.

We saw the pediatric neurologist today.  He told us that they did not see anything additional on the MRI, which is excellent news as it means we are much more likely to be in the category with less dire outcomes. If you're interested, this paper provides a pretty good summary both of their own findings and the literature.  So at this point it's just a waiting game - we will do another MRI post-birth, and hope that they don't find anything additional on that either (the fetal MRI can be a bit of a guessing game b/c the fetus is moving around so it's hard to get perfect images). 


We have another u/s in 2.5 weeks to check on the status of the kidneys; the would consider early delivery if those progress, as fluid in the kidneys if it builds up too much can cause a dearth of amniotic fluid (which is essentially the baby's urine), and can also cause kidney damage. I am hoping that since truffle's kidney size was relatively stable between 18 and 28 weeks that it will remain that way - having to deliver him prematurely is definitely not ideal, I think that the extra cooking time is even more important for him than someone without brain abnormalities. I have a feeling that as long as the post-birth MRI comes back clear, we won't know for a long time what we're dealing with, as a lot of the issues that these kids have do not necessarily show up in the early days. 


One thing from the paper that I referenced that took us by surprise was that in the group with isolated agenesis, 60/87 chose to terminate, and in the group with additional brain abnormalities, 70/88 chose termination.

MRI confirmation and more thoughts.

The MRI today wasn't too bad.  I asked before the procedure if I could lie on my side and the nurse said she didn't think that would be possible as they need to get things in a certain plane.  So I started out lying on my back.  After a bit (there were no timepieces, so not sure how long, but Mark who was in the room with me guesstimated 10-15min) I started feeling lightheaded, a bit queasy and clammy as if i was going to faint, so I squeezed the emergency bladder they give you and got the heck out of there.  I couldn't do another half hour of that, so i told them I had to lie on my side - and turns out that was fine.  So they gave me a bunch of pillows, and I was comfortable enough that I actually fell asleep (I was practicing my Bradley relaxation - guess it worked!)

After we were all done, the doc came out and told us that on his preliminary look at the scans there was nothing additional to what we had been told yesterday, but those findings were confirmed.

We then went to see the doc who did yesterday's ultrasound, and talked to her for about 45 minutes.  She said that at the u/s she wasn't sure if the corpus callosum was partially there or not - turns out it is completely missing, and the ventriculomegaly was confirmed as well, but the two are intimately linked (in this case, there can be other causes of the ventriculomegaly).  The MRI doc looked specifically for some other brain defects that can be associated with the missing corpus callosum and didn't see any of those (although he said that he would need more time and a fine tooth comb to make sure that some of the finer details are as they should be, like the infolding on the surface of the brain).

So we are *really* hoping that there are no additional abnormalities that are discovered in the next few days.  Please.

Then we spent quite a bit of time talking about what we might expect.  She said that if the missing corpus callosum is an isolated finding, i.e. no other abnormalities, there is a 60% chance that Truffle could be totally normal, or have such mild deficiencies that one wouldn't notice without them being specifically pointed out.  40% chance of some kind of developmental delay.  If there is an additional finding that comes out from the MRI, and perhaps the fluid on the kidneys is such an additional finding - it is unclear if the two are linked or not, then the chance of delays goes up to 70%.  The reason it's unclear is that the missing corpus callosum is not typically seen with kidney fluid, or vice-versa.  So it's possible that there is some underlying genetic issue like a trisomy of some chromosome that is causing both of these, which would put us in the latter category, but if it's just two random occurrences, then there is a higher chance that we would have no issues.

They offered for us to meet with a neurologist once the MRI reading is complete, to get a better sense of what the range of outcomes would look like; as a physician who sees patients he could give us perhaps a more complete picture based on his experience.

We could also do an amnio to find out whether there is an underlying karyotype issue that is causing these findings, but both my OB and the u/s doc said that if termination is off the table (which it is for me as I mentioned yesterday), they would recommend strongly against an amnio at this point because it could cause preterm labor - and in a baby with a brain abnormality, the last thing you want is additional stress and issues from prematurity.  So that, for me, is also out at the moment.  I don't see the need to have that information before he is born; perhaps afterwards as it might help us have a better idea of what to expect, but I don't think things will change much for a newborn so I don't think we need to know before that.

Mark's parents also know two people who had the same abnormality discovered via ultrasound, and both are completely healthy, functioning individuals.

So I think that overall, despite the confirmation of the missing corpus callosum, the information we received today (and what I found in some googling I did yesterday) is overall not as bad as I initially feared, when I heard, "an important part of your baby's brain is probably missing".

I'm fully prepared for us to have some struggles, it would be nice if everything worked out happy clappy, but I'm not going to bank on that, and I know that no matter what Truffle will be loved.  It seems to me that severe issues are unlikely (will get more info from the neurologist on what the "worst case" scenario would look like), and we will be okay.

Thank you SO much for all your thoughts, comments, and prayers - means so much to me to know we have so many people on our side.  xoxo.

27w4d and not so good news...

Bit of backstory first.  We did the Early Risk Assessment at 11w4d.  Bloodwork came back normal (risk of Down's syndrom in the 1:1000 range, trisomy 13/18 in the 1:3000 range), NT measurement was good, but they couldn't visualize the nasal bone, which is a soft marker for Down's.  So we had another scan 10 days later, at which everything fortunately looked good, and so our risk of Down's decreased to 1:3200 and 13/18 to 1:5000-ish.  So it was a little worrisome, but everything seemed to turn out okay.  This was the point at which we decided to share our news with the boys and the world.

Fast forward to our anatomy scan at 17w4d... we found out we're having another boy, and that he, at the time, had excess fluid in his kidneys (Hydronephrosis).  The doc told us that this is fairly common, particularly in boys, usually resolves itself, but if not just bears watching over time to ensure that it's not affecting amniotic fluid or anything else in the pregnancy.  Also that it is a soft marker for Down's, but given that everything else looked great, it only increased our risk to 1:1600 - so pretty much not even on the radar screen for me.  But we were scheduled for another ultrasound for 10w later to monitor the kidneys = today.

I was honestly pretty unconcerned about all this.  DH was debating about coming to the u/s, saying, "well, what if we get some bad news like the baby does have Down's, I wouldn't want you to be alone for that" (as I was at our 10wk appointment when I found out Schweffel had no heartbeat).  I told him that if it worked out with his schedule at work he should come, but no need to jump through any hoops.  I was expecting that just like in the cases of many of my friends who have had various soft markers on ultrasounds, like spots in the brain or whatever, that the excess fluid would be gone by now, and we'd get the all clear.

Well, not so much.  Not only was the fluid in the kidneys still there, when they scanned the rest of Truffle's anatomy, they found that he now has a buildup of fluid in the ventricles in his brain, a condition called "ventriculomegaly" which can be associated with anything from completely normal outcome (which is what the article from Children's suggests as the most likely) to mild developmental delays to severe retardation, mostly depending on the cause.  The doc looked around at the rest of the brain, and apparently one potential cause of the ventriculomegaly is that the corpus callosum, which is the structure that connects the two halves of the brain, can be missing (agenesis) - and she couldn't find it on the ultrasound, or maybe only part of it (and I'm not sure if she was just saying that to avoid giving us all the bad news at once).  So we're going for an MRI tomorrow for a more detailed look.   The range of outcomes if the CC is in fact missing is much less likely to include "normal".  It sounded like they are more of the opinion that this is some kind of chromosomal problem given that we now have two abnormal findings; the kidneys which have not resolved (although not gotten worse either, which I suppose is good), and the potential malformation in the brain.

Obviously, not what we wanted to hear.  For me what made it even harder was that each person we spoke to about it (the radiologist, my OB, and the genetic counselor) made sure to mention that although termination is not an option in this state, they could refer me out of state if that was what our decision was, if the additional testing confirmed abnormalities.  I couldn't even begin to think about it without sobbing.  I had held myself together pretty well up until that was mentioned, but that's what necessitated tissues.  (I honestly can't imagine terminating at this point unless Truffle wasn't going to be able to survive, and even then I'm not sure I could willfully end his life).

I'm trying really hard at the moment not to drive myself crazy with what-ifs and to wait until tomorrow when we will have more information (they were able to schedule the MRI for tomorrow afternoon).  I know that we will all love Truffle regardless but at the same time this may mean a very different future, particularly for me, than I had envisioned.  Mostly I'm managing, aside from not being able to write this news to anyone without sobbing.  And forget talking about it.  I'm sure as things settle in and I'm used to our new normal it will be okay, but having to adjust that normal is hard.

So please, think good thoughts for us, and hope that we don't get worse news tomorrow.

More updates

i've posted some new updates over at my other site if you're interested.  If you need the password, let me know.  :)

What a tease!!!

Yesterday, my spotting was negligible, and I was so stoked.

I also felt Pswyfl flip over, I'm almost positive.

Then I woke up this morning to my lightdays liner being almost totally filled with lovely, red blood.  ARGH!

I checked for a heartbeat with the doppler and was able to find it, so that set my mind somewhat at ease.

Called the doc and the nurse called back pretty quickly.  Offered another ultrasound.  But when I asked if there was anything that could be done, for, say, a placental tear (which is what I'm guessing it is, re-aggravated by the flippage), she said no.  So I didn't really see the point.

Either the baby is going to be okay or he's not, and unfortunately it seems like there's not much I can do about it.  Except hope like the dickens.  And wait.

Not too much bleeding since this morning, and back to old brown gook.

But really, can we just be done with this already???

Updates

posted at http://phredfwedschweffel.wordpress.com.  let me know if you need the password (comment if you have emailing enabled, or email me at my gmail account, noperiodbaby).

Beautiful beautiful sound.

Blah blah blah spoke with the nurse, went through history blah blah blah

She *finally* got the doppler out, and despite my fears we could hear the h/b as soon as she put it on my belly. Nice and loud (I know that's only b/c the volume was turned up, but still).  180 bpm.

Next hurdle is the NT scan, 10/3.  I'm not particularly concerned about that (yet, talk to me in ten days or so) but I am more so than for any of our previous pregnancies given that I'm now 37.  But it's SO good to get past this appointment with good news instead of bad!

Practicing deep breathing

My first OB appointment for this pregnancy is tomorrow.  I am nervous as all get out.  My nausea has all but disappeared, and I have zero other symptoms, so I'm worried.  Really worried.  Symptoms aren't supposed to abate this early, and this is exactly what happened last time - all of a sudden, 3-4 days before my appointment, I felt completely fine.  And then, we discovered that was right around the time Schweffel had stopped growing. I do not like that this is following exactly the same path.  Fortunately we had a really busy weekend so I haven't been able to think about it much, and now I'm about to go to bed.  Then I only have to make it through about eight hours tomorrow before we know.  Please think good thoughts for us!

Pg notes

My last two pregnancies I've written "diaries" at somewhat regular intervals to track how I'm feeling, what I'm thinking, that kind of thing.  I think that despite the fact that I'm feeling nowhere near convinced that this pregnancy will end in a RLB, it's also kinda unfair to future RLB if s/he should come to pass not to have the same care taken to notate my pregnancy with him/her as with my previous ones.  So I'm going to dive in, over on my other blog.  If you're interested, great, come on over, link is http://phredfwedschweffel.wordpress.com, let me know if you need the password (comment or email).  If you're not in a place where you feel like reading about kids or pregnancy I completely understand and will not be in the least offended if you don't follow me over there.

Another step in the right direction

I've started feeling queasy just about every day, starting right after lunch.  Makes me feel like things are okay in there.  Three days before the fateful appointment with my last pregnancy, the very very mild queasiness I had disappeared entirely.  So it is definitely reassuring that I'm feeling this now, and nice that I'm actually feeling more queasy than I have for previous pregnancies.  I will take it!

So that was reassuring me, but I was still nervous about today's u/s appointment, and more so as it got closer and closer.  Didn't help that they were running half an hour behind, and had me sitting in the exam room with my feet up in stirrups for at least 20 min of that!

Anyway, when the doc finally came in, he popped the wand in and went first to look at my ovaries.  (WHY do they do that FIRST?  Why not go to the important part first???  He did pop by the uterus and I saw a nice black spot with junk inside.

When he focused on that briefly, I could have sworn that I saw a little flicker!

Moved over to the other ovary.  Then back to the uterus.  When he zoomed in I could see the yolk sac and baby, but no flicker... but then he changed planes by a little and there it was!  Measured it at a very nice 126bpm, which I think is just about perfect for this gestational age.  Measured the CRL and GS and all, everything right on target.

So.

Good news, but we're definitely not out of the woods yet.  I did make my first OB apt for 9/19, which will be just shy of 10 weeks, and hopefully will not go like my last 10wk OB appointment.

My gut says that the last pregnancy failed because something went wrong in the transition from the baby getting its nutrients from the yolk sac to placenta.  I hope that this little one (whom we will nickname Pswyfl, pronounced Shweffel, going with another creative spelling) will manage to get that step right.

All still well. Supposedly.

Had my first ultrasound yesterday.

Immediately saw a big black blob in my uterus = good.

Doc then went to check my ovaries - still somewhat enlarged, but not bad, and a nice corpus luteum on each side.

Back to big black blob. Only one = good.

My heart sank though, because that was all I saw so i thought it was a blighted ovum or something.

But, when doc zoomed in, he claimed he could see the yolk sac and fetal pole, and even measure the crown-rump length which was 5w5d, so right where it should be (theoretically 5w6d according to ER date).

I saw some white shmutz, but I guess if he says it was a yolk sac and fetal pole I should probably believe him.

No hb. I *know* it's early. But we did see one at 5w6d with A, so in my heart of hearts I was expecting to see it, despite telling everyone (and trying to tell myself) that I had no expectations going in.

It totally makes sense that we didn't see a hb - with my betas running three days behind where they were with A, I should really consider that I was 5w3d yesterday, which is WAAAAAY too early.

So theoretically everything is chugging along as it should be. And I started feeling a little queasy today, 6w exactly, which is right on schedule.

And in a way I think it's better that we didn't see a hb because if we don't when i go back next Thursday it won't be quite the same shock as if we did see one today and then it stopped.

so.

Trying to be zen. I know there is nothing that I can do to affect whatever the outcome will be so trying to just focus on other things and hope the time passes quickly.

All is well. And yet...

First beta 354. Second beta 850-something. I was so excited to hear that it more than doubled that I didn't even remember the exact number which is totally unlike me. Doubling time of 38-ish hours.

I also got to switch from PIO to endometrin. Yucky as that is (entire suppositories coming out in my pad on occasion), still WAAAAAAAAAAAAAAAAAAAAY better than the PIO. I've still got bruises from that!

First u/s scheduled for 8/23 at 3:30.

As my last m/c was discovered at 9.5 weeks, with the baby's growth stopped at about 8.5 weeks I find myself not terribly worried about next weeks' ultrasound or even the one two weeks after that (perhaps I should be!) but I won't be able to believe there's even a chance this is going to work out until we get past the 10-ish week mark.

It's odd. I'm pregnant, they tell me, yet I feel no different, and it's as if i've put that knowledge in some other part of my brain to think about later. I was going to tell my mom when she came over yesterday, but couldn't get the words out. Surreal.

Beta = 354

17dpo. Not bad, but not great in comparison to my previous pg which were ~350 at 14dpo and ~850 at 16dpo, and ~500 at 15dpo. I am hoping it's just because IVF pg tend to have lower betas than natural, and I believe I found a scientific paper to that effect when I was researching why my betas were so much higher than those most people were posting.

Going back on Monday for a repeat. Not so worried about that, more about what happens in a few weeks, but I think that's only natural based on my m/c being at 8.5 weeks. I imagine i will need a lot more hand holding as / if we get closer to that.

Updated: I get to change to endometrin instead of PIO. Whoop whoop!

NOT proven otherwise yet...

Beta tomorrow. I figured I'd call the "cycle nurse" and ask two questions. One, if I am in fact pregnant, could I change to a different type of progesterone (answer: can be discussed, they do let some people change, although they are not going to test my progesterone level), and two, if I am not pregnant, would the plan be to start bcp immediately upon AF's arrival for another cycle (answer: no, I would have to have an apt with the doc first). This totally threw me for a loop - I just feel like it would be a totally wasted month, given that of our 8 mature eggs only 1 ended up being any good - chances of a natural cycle being any good are somewhat slim and getting slimmer.

So, despite having pretty much vowed not to test before the b/w tomorrow (I figured PIO would be way harder tonight if I knew I was not pregnant), I threw that out the window. If I *knew* the blood test would be negative I could demand to speak to a nurse in person when I went for the draw tomorrow am and see if I could convince them not to make me wait another month.

I immediately went out to Walgreens and picked up a test. (I always go for the cheap ones, crazy?). Then I went next door to Starbucks, ordered a mocha coconut frappuc.ino in which to drown my sorrows, and proceeded on into the bathroom to take the test. (how many pg tests do you think have been taken at starbucks??)

So I peed, and I watched. And watched... saw the liquid line going up, nothing showing up in the test window. Eh, just what I expected. But wait! the control line was coming up and maybe something else? Holy.EFFING.SH*%&#$%^T! NOT NEGATIVE. I looked again to make sure. Definitely two lines.

Grabbed my now celebratory frappucino and headed right to the car where I had left the test box to make sure that the two lines actually meant what I thought they did, it wasn't that I was supposed to see a plus sign or anything like that. And sure enough, two lines means no longer PUPO, just P!

Called DH right away because I figured if I knew he should too. Then my sis. At least I got the order right this time!

So damn, I was wrong. Things seem to have worked! (so far anyway. I know there's a long way to go before I can truly breath easy. But at least this is a start!)

PIO update

Went to see the nurse this morning. Apparently we have been doing the shots in completely the wrong place, and in the wrong way. HA.

The day I took my trigger shot, I spoke to the nurse after my u/s and she gave me a general idea of where to do the shots, but we both thought I would be there the following day for another one, so she just gave me a general idea of where to do it, but didn't draw circles or anything.

So when I did do the trigger shot that night, we watched the Village pharmacy tutorial, and picked the locations for the shots based on that and what the nurse had said (about where your thumb goes when you're putting hands on hips).

Well, today's nurse drew circles further down and further outside, much more on the fleshy part of my bum. She also said that rather than stretching the skin out, which is what the VP tutorial had said, that DH should pinch a sizeable amount (of blubber) and then do the shot into that.

So, we'll see how that goes.

And, I totally chickened out of asking for an early beta since the conversation with the nurse was so short and to the point. So three more sleeps 'til that.

PI-OUCH!

So, Just had the WORST PIO experience. When DH tried the first time it felt like he hit the same nerve he'd gotten the first time we did PIO on my right side / hit a knot in a muscle, and he said that the needle wouldn't go all the way in, it felt like it was hitting something hard like bone. So we tried again. And again. And again. then switched to the other side, and same damn thing. I told him to just push the PIO in anyway - well, it started spurting back out again! I almost fainted, darkness was closing in on me, barely made it to our bed.

So I think I'm going to go in to the clinic in the am and just ask if one of the nurses can do it and show me if we've been doing it in the wrong spot. DH said usually it's just like going into butter, but this time it was "crunchy" as if he was hitting something hard. I'm wondering if it's either muscle knots or just the oil that's just kinda hanging out there. Regardless, not fun for either of us (and I actually think less fun for him than me). We went through seven needles (including going in to get more PIO out b/c I squirted it when trying to get the bubble out from the new needle.)

LOL and ARGH at the same time.

Oh, and I figure if I'm in there anyway I might just ask for a beta (tomorrow will be 14dpo, currently scheduled for beta at 17dpo :) Also progesterone, and if it's high enough I'll see if they'll let me switch to vaginal. b/c I think the next shot is going to be HARD!

pupo*

Today is 3dp5dt (3 days past 5 day transfer for those not versed in IVF lingo). I feel nothing. I was hoping that I might feel a bit crampy, or SOMETHING people, but nope.

Backing up a few days, starting Sunday night I found I was feeling the most nervous I think I have ever been for anything. which is weird, right? I think there was a butterfly mosh pit or something going on in there. Not because of the transfer procedure; that's fairly straightforward, I think just not knowing how many embryos were still growing, and of course, the eventual outcome.

Monday morning, more of the same. I could barely eat, which trust me, NEVER happens. I managed to force down some cereal as the only thing that seemed remotely appetizing. I had had doubts, when I read through my med protocol, about the vali.um they had prescribed to be taken an hour and again 15 min before transfer - by Monday morning I was counting down the minutes until I could pop one of those suckers!

When I finally did, it really did help, I felt much more zen within 15 min or so which was great. Took the second when we arrived at the clinic, as instructed. Had full bladder as instructed.

Commented to the nurse after they had me change into the hospital gowns in a ROOM WITH A TOILET that that was really mean! ;)

So we both got gowned up, then headed in to the transfer. They told us that of our seven embryos, one was a good looking blast (no score, but the pic looks to me like a 4AB from the advanced fertility website), and the other was not so hot (maybe a 2BB?), probably wouldn't make it to freeze, so they were recommending we transfer both.

I had prepped DH with my arguments against transferring two, in case the V made me so loopy I was unable to marshall them myself, but I was fully capable when it came down to it. A) we don't want twins. B) I have three natural pg under my belt (would that be a chastity belt?) C) This is our first IVF cycle, D) would rather not be pregnant than have twins. They did try and push us a bit further, by showing us a document they had typed up with their recommendations on eSET (only for women under 35 with at least one freezable blast in addition), which isn't really much of an argument, we stayed firm, and they relented. Perhaps if we get further down this road we will change our mind, but not now.

The transfer was u/s guided, and they used some weird-assed stirrups that held my whole legs up, and also tilted the table backwards so I felt like I was at maybe a 30 degree angle. I guess that helps with getting the catheter into the cervix? I tried as best I could to just relax, but I found myself tensing my legs as if to hold them up myself. It was definitely odd. Basically all I could think about though was how my bladder felt like it was going to explode every time the doc pressed on the ultrasound thingy. A friend who experienced this the week before did not have val.ium, and said that she felt horribly embarrassed basically having her entire ass hanging out in front of the doc. I guess another + for drugs! They did it first with just the catheter, then got the embryo, claimed they could see a little flash on the u/s as it was deposited (I could see where the catheter was but did not see the "flash"), checked that the catheter was empty, and then we were done.

Stayed at the clinic for another 15 min or so in quite a comfortable chair/bed (ched?), then got up, PEED!, and went home. NOW I was feeling loopy, and when we got into the car to drive home, asked DH if we had paid for the parking. He assured me that we had, but I could find no recollection of it anywhere.

Almost as soon as we got home I headed to bed, NOT feeling like myself, and slept for the next FOUR hours. I would have slept longer, too, except that the phone rang and woke me up.

Still didn't feel like myself, could barely eat dinner (again, NOT normal), so went back to bed again until about 10pm (not sleeping this time, just didn't feel like doing anything). At that point I finally did feel back to myself except FREEZING. Put on a sweater then within a few minutes I was drenched in sweat. Temp was 99.8. Ugh. I was then imagining that the fact that I had mistakenly skipped on of my doxycyline doses meant I had a raging uterine infection that was going to ruin this whole thing, so I actually called the clinic. Doc I spoke to was really nice, said they don't worry unless fever is >100.4, take some Tylenol (which I already had) and for sure come in the next day if my fever went any higher. Fortunately, next morning I felt my usual chipper self, so that crisis was averted.

So now I'm PUPO, but as I said not feeling terribly hopeful as I'm feeling nothing (aside from an inordinate number of hiccups** yesterday, but that was isolated). I don't even feel any of the normal PIO symptoms, just feel pretty much normal.

Found out today that the other embyro did not make it to freeze. In a way, the fact that only potentially one of our seven embryos made it past day 5 almost makes me feel better about our chances - we have NOT been making good embryos all along, so maybe, hopefully, my uterus is just fine?

*Pregnant Until Proven Otherwise; Anyone know who coined the term? was it Julie / A little pregnant?

** I have hiccupped every day for the past 23 years. At first it was on the order of 100's of times a day, it's dwindled down to about a dozen and I barely notice them anymore. Except yesterday when I probably hiccupped around 100 times. (Guinness record is 63 years so I hope not to make that!)

HFS!!!

The nurse called this morning and said we would be doing a day 5 transfer, on Monday. Someone else would call later on to let me know what time. I almost let her hang up, but then thought to ask how the embryos were doing.

Well. She counted, and said that all seven are still growing! Six are 8-cell, and one is a 10-cell.

So, we're scheduled for 11am on Monday.

Only thing is, the fact that ALL the embryos are still growing makes me think that producing embryos has not been the problem for the last year, rather getting them to hang around. I've been nervous ever since the D&C's that there's something wrong now such that embryos are not able to implant, and certainly this makes me feel even more that is the case. HOPEFULLY I am wrong and one of those embryos will snuggle in nicely just a few days from now.