Week 36: False alarms, part 1

First, my sincere apologies for the long-delayed update. I can chalk it up to, primarily, two things — 1. Life has gotten a bit hectic and 2. While there have been things I may have wanted to share in the last few months, I think I’ve experienced a bit of the survivors guilt phenomenon. Coming from such a tumultuous place of infertility and failure, a part of me had/has a hard time accepting success and that I’ve had a rather uneventful pregnancy. It can all feel very complicated. Have you been in my shoes and experienced this, too?

I’m now 37 weeks in and officially full-term. I doubt I will ever completely wrap my head around that, given how I got here. But last week was especially crazy in both a hectic and mindf*ck sort of way.

Monday was the first false alarm. It’s first worth noting that I have an anterior placenta, and given that placement, I felt Little Wookiee move much later than expected (as in true movements, not just the “that could be something but…”). I was far into my second trimester before movement became regular and noticeable to me. In the last month or so, though, LW has been particularly active at night, usually around 8pm. At my last OB appointment we’d talked about kick counts and how I didn’t do them, really, because given the placenta placement there were only a handful of times per day that I could feel LW and I didn’t want to freak myself out. Well. Famous last words.

Monday night I settled into bed to read or watch TV for a bit before going to sleep, about 8:15, as is our usual. No doubt that might seem crazy early to most people but I rely on as much routine at home as possible, particularly since third trimester sleep has been spotty at best. Anyway, I expected to be feeling LW punch my bladder within a few minutes. Nope.

By 9:00 or so I’m poking around my belly trying to get a reaction. Nothing. I grab a lollipop. Sugar usually does it. Not this time. Around 10 my husband says, “stay calm, she’s just sleeping. You should try it, too.” Not interested. But he was, so I said sure, you go ahead, and I’ll try. By 10:45 or so I had sort of fallen asleep.

12:30am: My dog wakes me up to take him out. As I’m walking down and then back up our three flights of stairs I’m simultaneously willing LW to wake up and reassuring myself that everything is totally fine and I should just go back to sleep as quickly as possible.

3:00am: I’m wide awake and trying to determine the last time I felt movement. Was it just after dinner? No, that can’t be right… that’s like eight hours? I poke some more. I wait. And wait. I Google, but very carefully. Because there are really terrifying things on the internet at 3am when looking for solutions for “decreased fetal movement 36 weeks.” Bad. Things.

4:00am: The dark thoughts roll in. Dark. All logic is out the window. I want to call the doctor but the idea of confirming the dark thoughts is not something I’m able to fully grasp. I keep poking and waiting and worrying that my healthy Little Wookiee isn’t so anymore.

4:30am: I walk into the nursery, with a death grip on my phone, and make the call to the doctor’s answering service. I explain. I’m told I’ll receive a call back within 30 minutes. I hang up and pace.

4:35am: The on-call midwife calls. I explain. She tells me I did the right thing by calling. Suggests I drink a very large glass of ice water and wait a few minutes. If I still don’t feel 10 kicks in the next 30 minutes it’s time to go into the OBED for a non-stress test. I drink so much water. I wait.

4:45am: I got back upstairs, wake my husband and tell him we need to go to the hospital because I did all the things and nothing. I go back downstairs for more water. Drink. Back upstairs to get dressed.

4:50am: I feel something. And then another something. I tell my husband LW is on the move. There are tears behind my eyes but I can’t cry. Within another few minutes LW gets sassy and gives two very powerful kicks. I count 25 kicks in that 30 minutes since I spoke to the midwife. I’m breathing normally again.

5:00am: I call the midwife again to confirm I don’t need to go into the OBED. Thank her profusely for her patience.

Ice water is my best friend.

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Week 21: A bumpdate

Alternately titled: I outgrew my underwear but my maternity jeans don’t stay up

Here’s a statement that surely has never been uttered before: Pregnancy is so weird.

I’ve just passed the 21 week mark, and my body has entered that stage of looking pregnant with the bump shape (I’d consider myself Stage 3.25, according to Pregnant Chicken. Which is just about the realest pregnancy site ever and worth peeing yourself a little bit because it will make you laugh for sure). I’d transitioned to mostly maternity clothes (excluding a few tops from pre-weight loss) mid-week 19, with the hold out being one pair of jeans that still fit. Those no longer do as of last week.

I’ve tried on (at home because I don’t do fitting rooms or even much shopping outside the internet) at least ten pairs of maternity jeans to find one pair that met my criteria: 1. comfortable but structured (jeggings aren’t flattering for a woman of my ample booty and thighs), 2. still in my pre-pregnancy style (I like me a good skinny jean, but I am short and generally unwilling to have things hemmed because I am also lazy) and 3. cost less than my mortgage payment. I tried side panel, demi-panel, full panel… all of ’em. They. Don’t. Stay. Up. I even tried several with the belly band as an added makeshift belt. Nope. I’m apparently too early in the bump stage before my belly actually holds up my jeans, but still big enough that I’ve outgrown my underwear. It is a physically strange place to live in maternity wear.

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Note: Standard preggo wear of leggings and a dolman tunic will make you look deceptively more pregnant.

34 Farm-fresh eggs

I am, once again, a human farm animal. Such is #IVFlife.

And as I suspected, each stim cycle is a little bit different.  To recap: During my first, in June 2016, the doctors retrieved 23 mature eggs, which resulted in six embryos making it to blastocyst stage. While the meds no doubt kicked my ass then, the much more (physically) unpleasant experience came following my egg retrieval.

I’ll get to the good stuff straight-away, I know that’s what you’re here for… Somehow my doctor managed to find 34 eggs in my swollen stomach. As I was coming out of my anesthesia following the procedure, the greatest nurse on the planet popped her head in to say, “34,” with her big, bright smile. If I didn’t actually ask her at the time, I certainly wanted to say, geez, are you sure they were all mine? They claim they are. Thirty-four was more than my brain could actually process in the moment. Then she said something that I will stick with me, and will be a key piece of the story I tell my daughter or son about how they came into our family…

“One of those eggs is your baby.”

She said it with such hope and conviction that my heart swelled to match my enormous ovaries and I felt so strongly that she was going to be right.

“One of those eggs is your baby.”

To every woman who has felt beaten and broken by infertility, I wish you a moment just like this. I felt renewed and ready. I’ve been so careful not to ever really let myself believe this could still be possible in case it wasn’t. In that moment I let go of so much negativity, and let those words sink in.

Of those 34 eggs retrieved, 21 were mature. I did find it pretty surprising (and encouraging) that it was only two fewer than my first cycle, when I was the better part of two years younger. Physically the process of stimming felt much more intense this time than I remembered, and I again went for the full 12 nights. Perhaps it was because I knew this would be my last time, but I was feeling SO done before I’d even gotten to the trigger shot. The bloat and the fatigue felt especially powerful in the last few days of injections. And I was a straight-up nightmare emotionally-speaking.

Despite the more intense stim (guess that meant it I was firing on all cylinders?), the retrieval recovery was a breeze compared to my Dark Willow situation last time.

When the lab reported that 21 eggs were mature, they relayed that 14 of those had fertilized. This was virtually the same ratio as my previous IVF cycle, and I felt fine with that and eager to see how many of those would progress.

On day three, I waited for news from the lab. And it was good… ALL 14 embryos were developing! I read the message a few times, and then squealed and cried. Things hadn’t gone down this way before. To still have all of them thriving on day three? It was the injection (ha!) of encouragement we needed.

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I agree, Ron. Stay tuned…

Wounds of war

The scary thing isn’t the bruises of IVF, it’s sharing a photo of your far from flat, stretch mark-filled tummy on the Internet.

Yes, the bruising and soreness and feeling crappy 110% of the time sucks. But such is stimming. I leave this here for posterity, to say these bruises may be the wounds of war necessary to finally get a baby.

Good luck, IVF sisters. I’m with ya.

Stim Part Deux: Electric Boogaloo

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Friends, the day has arrived (finally): Day one of my stim cycle. Let’s grow some follicles and make some good quality eggs, shall we?

Pending the results of this morning’s progesterone check, I begin Lupron injections this evening. Here’s a fun refresher on the types of side effects I may experience during this phase of the cycle: fatigue, increased sweating, headaches, acne, trouble sleeping… Oh boy! During my first cycle nearly two years ago, I wrote about the frequent urination hitting me hard by day 8. Guaranteed that one pops up again.

Knowing what to expect physically and emotionally during a stimulation doesn’t make me excited to start injecting myself with hormones every night, but it does give me some comfort. One of the most difficult mental hurdles last time I did this was overcoming the fear of the unknown. Perhaps no two cycles are alike, though?

Mentally, where am I? That is, of course, more complicated. Knowing that I can get through to the egg retrieval is one thing. I can handle tired, peeing a lot and crying at the drop of a hat. After the retrieval, though, the next six days are out of my hands. I’ll wait to hear how many eggs fertilize and grow to blastocyst stage. Then the embryos are biopsied and shipped for PGS and I’ll wait some more. That wait, though… that’s going to be the toughest one. It determines our next few months, our entire path for moving forward. Will there be any normal embryos? If so, how many? If not, how will I feel? Will I want to move right into adoption, or will I need to grieve the loss of my fertility?

None of these questions will have answers for at least the next month. As we get dangerously close to April, no less. The worst month of the year.

So stay tuned for some fun!

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(I really love Happy Endings. Can you tell?)

Understanding PGS: Why we’re doing it

PGS (pre-implantation genetic screening) is a complicated topic. While I knew we would opt to use PGS during our upcoming stim cycle prior to a transfer very early on, I didn’t know much about it. I’d watched an animated video on the website of the laboratory that my clinic uses for PGS, and it felt a bit Schoolhouse Rock-esque, without the clever puns and music. This video could have used those. I felt like I knew the basics of what happens to the embryo/blastocyst during the PGS testing, the lab counts chromosomes, … blah, blah blah… and then following testing my husband and I would see a report on our embyros each characterized into two neat little columns — normal or abnormal.

At least some of that was correct.

I’ll say before I move on that I am not usually one of those infertiles that spends hours in the middle of the night on message boards comparing IVF stories with other women. I’m not passing judgement on the women that do that, mind you. For me, and my mental health, I have to sometimes turn down the fire hose of infertility information. I very much pick and choose when I consult Dr. Google or the message boards because when I know too much, my anxiety hits dangerous (read: 1947-era padded room, straight jacket) levels. Too much research can cripple me. I try to be well-informed about my treatment options and protocols, and I think I am, but I know my limits. I’m good without knowing that Jane Doe in Oregon also had a Lupron-down protocol resulting in 20 eggs at her retrieval and then experienced this freak thing… yeah. I, personally, don’t need to know. I advocate for myself but I also trust my doctor and the greatest nurse on the planet.

So while I knew I’d move forward with PGS almost regardless of my research, I still wanted to learn more about it. If anything, I wanted to confirm that I was making the right call about doing it, and gain confidence that we’d have some clear answers after the tests were complete.

Where did I land? Well, I will say that PGS is (still) the absolute right step for us at this point (more on that in a bit). But, dayum, I got schooled.

First, all hail FertilityIQ. Their online course on PGS is the absolute best, most comprehensive resource on the subject I’ve found. If you’re considering this as part of your treatment plan, take 30 minutes to watch their helpful videos and read through their detailed written material. Deborah and Jake, the founders of the site, host the videos and I’d like to be friends with them. They’re clearly knowledgeable (fertility clinic vets so they totally get it), but they also include interviews with doctors on both sides of the aisle in this PGS debate. The course has easy to understand patient examples, visuals and just a ton of great information. Honestly, it’s not only worth your time, but in my opinion you owe it to yourself to understand the intricacies of such a complex fertility topic.

This post isn’t sponsored by the site, nor do I have any relationship to it, I am just a big fan. Also, I probably don’t need to mention this but I am NOT. A. DOCTOR. I am a fellow infertile sharing her experience. 

Remember when I said that I thought after PGS all of our created embryos (and Kristoff) would be put into two nice little black and white buckets? Nooope. Because mosaic embryos are a thing. As a woman lumped into the unexplained infertility category I’ll say they are a potentially confusing, frustrating thing. I don’t need more unexplained science, world! I need answers. The FertilityIQ videos and text were extremely helpful in explaining not only what mosaicism is, but that there are questions I need to ask my clinic about their policies on identifying these gray area embryos. (Aside: And because I now knew to ask this question I got an answer about my clinic’s policy! #winning)

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What this all comes down to is that I’m glad I did the research on PGS. While the idea of mosaic embryos does kinda make me want to cry in the corner, simply because it’s just more uncertainty when I’ve had my fill of that, I’m glad I’m armed with this information to better advocate for myself and my future blastocysts. I can ask the questions of my clinic, talk to a genetic counselor if I’m in a position where we only have mosaic embryos available, and then decide what’s right for us. If any of that happens.

Here’s why PGS is right for us at this moment in time: I’m 36. I’ve had two miscarriages, a chemical pregnancy and three failed embryo transfers (with a total of five embryos). Other than chronic endometritis, three years of infertility treatments and countless tests have not brought us any closer to a baby. This road is ending for us soon, with or without a biological child. I’m tired. We’ve reached our debt ceiling. PGS will allow us the best possible opportunity to have that baby. We will carry more debt with us because of it, but we’re going for broke this time (perhaps literally as well as figuratively). This is it.

If there’s one thing I feel really positive about heading into this last stim cycle, it’s the decision to have our embryos tested. And honestly, I really need that sliver of hope.

Infertility is really just a crap-ton of waiting

I’m a few days from starting my period. While nothing tops the two-week wait (TWW) on the anxiety scale, the time waiting to start your next IVF cycle is also stressful. In early January my husband and I repeated our lab work, and I had my 8,000th mock transfer and saline ultrasound to ensure all systems were go to start my last stim cycle. Other than a high TSH (thyroid) level, I’m all set. I wasn’t that surprised that my thyroid check was elevated since I’d been off my hypothyroidism meds for about 10 weeks because it conflicted with the prescribed appetite suppressant I was on for weight loss.

[Quick update on the weight loss: Somehow I’ve managed to quell my emotional eating inner demons, and am down 29.5 pounds! I picked up good habits and flipped that elusive switch that allowed me to rethink how I approach food. Particularly sugar. Perhaps the only person more surprised with my progress than me is my husband who knew all too well how unlikely I was to follow-through with this. It certainly has been challenging, but it’s pretty nice to feel like I am crushing. it. in just this one aspect of my life. Having said that, I’m about to stim again with hormones aplenty, so we’ll see what I’m made of over the next few weeks.]

It feels like there’s nothing but waiting. It’s often infuriating. Particularly in those rare time frames when I actually feel physically and emotionally ready to go down the IVF rabbit hole again. Like, ya know, now.

The downtime between completing one cycle and starting another always varies wildly. In my case, it’s almost always been months when it comes to IVF. I did my first stim (and fresh transfer) in June 2016. In fertility terms, that’s probably 25 potentially good eggs ago. Who knows if it was one of those “wasted” eggs that was the golden one?

Then we did our first FET in November 2016. Bust. The second FET didn’t happen for another ten months. Then I got a little bit pregnant. While money was probably the most significant factor in that span of time, getting answers to why three perfectly normal-looking embryos in an otherwise healthy woman simply didn’t stick (spoiler alert: it was endometritis) was also on the list. Not to mention my emotional health.

Moving into this last cycle, we’re already several months removed from the chemical pregnancy, and we’ve decided to leave our last frozen embryo from our OG stim cycle in the freezer (we’ll test Kristoff with his future embryo sibs). Which, another aside: If Kristoff is the ONE embryo that turns out to be genetically normal after PGS I think my brain may actually explode.

While the Clomid made me insane and pack on the pounds, at least IUIs keep the pace moving. I knocked a bunch of those out in a couple of months.

So we’re into another year of this waiting. Year five. We’ve reached the five-year milestone in infertility even before we did in our marriage. How’s that irony. Just delightful.

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