Baby #6, Beta #2

Still pregnant. Our little embryo is clearly trying. Today's beta was 137.7. According to the Babymed calculator, given the 43.5 hour time lapse between the two, that's a doubling time of 42.15 hours.

Do I feel good about this? I feel ok, not great. Last time I went from 249 to 877 in roughly 24 hours. I'm clearly not doing as well this time, and my beta is still on the low side of normal, per beta-base (median hcg for 15 dpo is 194). If I'd never been through my last pregnancy, I'd probably be feeling much better about these numbers, but the comparison effect is hitting me hard, and I can't share my fears of aneuplodies or blighted ovums with these numbers.

Still, for today, I am pregnant. For today, I can assume that there's an embryo growing and trying in there. For today, I'm going to continue talking to it and telling it to be strong and healthy. For today, I'll continue with the progesterone and estrace and hope for the best.

I go in for my first ultrasound on 4/10. Here's hoping for darkening lines and no bleeding between now and then.

Baby #6, Beta #1

I got the phone call last night. Actually I got two - two nurses both rushed to be the first to call me, which was either genuinely sweet, or an indication of how bad my clinic's internal communications are.  (Side note: Let's just say that the people at the clinic are all absolutely sweet and compassionate, but no fewer than three people asked me if I was getting blood work done because I'd had a positive home test, despite me calling and saying "Hi, this is Me. I'm 15 days past trigger and got a positive home pregnancy test, so I'm calling to schedule blood work." Their internal communications are the pits.)

Anyhow, at 13 dpo, my hcg is 67. Pregnant. A bit less than the median hcg of 86 reported on betabase. Drastically lower than the 249 at this same dpo with the girls. Still undeniably pregnant.

So I return on Saturday to retest and we see if my hcg rises as it should. Doubling time should be approximately 48 hours, so we're hoping for a 140 or so. I'm not holding my breath, given my history and how this cycle has gone.

I am feeling so many emotions right now. None of them are good. Here's the thing: starting out TTC in October 2015, I was adamant about only wanting one child. I wasn't interested in the challenges, the costs, the physical demands, or the stress of two. I just wasn't. I am an only child, I liked that lifestyle, and I wanted that for DH and I. I truly, truly did not want two children.

Despite that, when I saw the girls' heartbeats for the first time, nothing has ever felt so right to me in my life. And when we found out both were healthy girls, I could not have been more overjoyed. I don't have words to explain how utterly perfect everything about that situation seemed. It was as if something I didn't even know I had dreamed of had come true. Despite the constant retching, I was so happy because my family felt "right" to me.

Today doesn't feel right. I have this awful feeling that if today's beta had come back strong, if I had the sense that this pregnancy was twins, I would feel so much better. Instead, I feel this sense of loss, knowing that this is, at best, a single baby. Knowing that at most there's one baby growing in me leaves me feeling like I've lost what my future was supposed to be - what the dream I didn't know I had until I had it was. I feel like I can't possibly love this one baby as much as I love the girls. And I feel so fucking guilty for feeling this way. It's unfair to that baby. It's horrific, when I interact with so many amazing ladies who would give anything to have a single baby. It's what my life would have been if my first, second, or third pregnancies had gone to term. It's what I wanted right up until that first ultrasound last August.  Why can't I be happy, that maybe we'll finally bring a child home with us, from the hospital? I don't know, but I'll hope that it resolves as time passes.

Again

Once again, I see two pink lines. Once again, they're faint. Once again, in these early days, they don't seem to be getting darker. Once again, I wonder if theses are my lines - the lines that will lead to a THB.

Things I know:
These lines are definitely lighter than the ones with Alexis and Zoe. No twins thsi time, for sure.

Wondfos are notoriously inaccurate in gauging hcg levels, but the presence of two lines indicates there is an embryo in there.

Blastocysts grown in vitro can produce hcg in concentrations > 5. Wondfos can pick up hcg at concentrations of 8 or greater (based on my past CPs, with hcg of 8 and 14, both of which produced two lines on a Wondfo).

I had horrific night sweats Tuesday night. Soaked through the bed and needed to chnage clothes twice. This typically happens to me during the follicular phase. I can't recall if it happened during early pregnancy.

My BBT has not shifted up yet, although it didn't with the girls, either.

I felt lightly sick - sore throat and stuffy nose all weekend.

We'll see what the next few days bring. I'm much more zen about things this time. I'm ready to get on to the next cycle, as I never expected this one ot work, but I'm also talking ot the little embryo daily, telling it ot hang on and grow up healthy and strong.

Here's to the mind fuck that is pregnancy after many losses.

Knot Now

The last fifteen months have been hard on me, physically. Let's recap:

Jan 2016 - Missed miscarriage discovered, d&c.
March 2016 - Natural miscarriage
April 2016 - Natural miscarriage
May 2016 - Saline sonogram reveals scar tissue and thin lining
May 2016 - Operative hysteroscopy to remove scar tissue
June 2016 - HSG with catastrophic reaction & results
July 2016 - Stims for first injectible cycle
August - October 2016 - Morning sickness, lost 6% of body weight by the end of the first trimester
October 2016 - Pprom. Severe damage to digestive system. Constant pain.
November 2016 - Pain. Bedrest. Infection. 26 hours of labor. 2 emergency surgeries. Antibiotics.
December - January 2017 - Pain. Ulcers throughout digestive system. Saline sonogram reveals major scar tissue.
February 2017 - Pain. Operative hysteroscopy, balloon stent, estrogen. FemVue procedure. Ear infection, virus, fever.
March 2017 - Stims for second injectible cycle.

When I was a kid, my mom had this picture of a kitten hanging onto a rope. The words on the picture read "When you get to the end of your rope, tie a knot and hang on." I was hopeful that once the ulcers healed and I wasn't in constant pain, things would be better. Back to normal, whatever that was. That hope -the hope of 'back to normal' - was the knot I was holding onto, as I hung at the end of  my rope.

It's really coming unraveled. I noticed during the last few ultrasounds and the TI that the parts of my anatomy involved felt unusually uncomfortable. They were raw, which I remembered from my last time on Estrace, but everything also started to feel a bit swollen. As it turns out, 'a bit' is a dramatic understatement. Everything south of the border is swollen to proportions identical to those seen at my two week post-partum visit. And at that visit, my doctor's exact words were "You poor thing, you're so swollen." You know when an OB feels the need to tell you you look bad post-partum, you look bad.

I don't know what's causing this. The Estrace? Maybe, it's got a ton of dye in it, and I know I'm sensitive to that. The feminine hygiene products I've used to keep the Estrace from staining my clothes? Maybe. The soap DH and I have used to clean up before and after TI? That's a good candidate, and would explain a lot. All I can tell you is that I hurt, it hurts to wear clothing, but I'm now on estrace and prometrium, so going commando is 100% not an option. Plus, it's 15 degrees outside. Brrr!

That would have been enough to start my knot unraveling, but no. There's more. I also have a UTI. Bad enough to come with a fever and constant pain, plus burning. I've been started on Macrobid, and taken a day's worth of Azo to try to manage the pain. Which is, of course, just what I want to be doing when there's hopefully a little embryo trying to grow and settle in. Yep, adding more medications sounds great. I also have a history of chronic UTI's that I finally shook 6 years ago when a urologist put me on 6 months of low dose marcocrystal. The thought of going back into that constant UTI cycle, after everything else, is pretty close to doing me in.

Finish Line

Well, we made it to the injection finish line. At my ultrasound on the 8th, after 11 days of stims, the last four of them at 300 iU, I had one follicle at 20.8 and one at 14. My lining had dropped from 7.9 to 7.0, but I was told it looked great and was trilaminar.

We triggered that night with Pregnyl. I started prometrium on Saturday and stay on estrace. RE's office tells me I should test on Wednesday the 22nd. I'll probably test out trigger again this time, but with the way the cycle has gone, I'm not anticipating seeing two lines once that trigger is out. Last time it was pretty much gone at 10 days post trigger, and I got a bfp at 12 days post trigger, but last time it was twins and I had really strong betas. My luteal phase has dropped since losing the girls, I"m now at 9 days. The prometrium should hold that off, but if it doesn't, CD1 will actually come before it's time to test. Awesome.

I need to email my RE's office and ask about meds for next cycle, so I have time to order them. With everything going on, I'm finding it tough to motivate myself. While I don't think this cycle is likely to be successful, it also feels like I"m giving up if I admit defeat already, 4 days post trigger. But there are other issues that I'll save for a future post.

Not There Yet

I wish I had some great update, but I don't. Or perhaps I should say that my great update is that we haven't been cancelled! Here are the latest numbers, with the best comparison to last cycle I can give:

Last cycle:
CD11, after 8 nights of Gonal F 150 iU, 1200 total iU
Right = 22, 18, 7, 4
Left = 18, 16, 10, 8
LH = 0.76 miu
P4 = 2.59
E2 = 1690

This cycle:
CD11, after 4 nights of Follistim 150 iU, 3 nights of 225 iU, and 2 nights of 300 iU, 1875 total. 
Right = 16.5
Left = 11
LH = 1.37 mIU/mL
P4 = 0.12 ng/mL
E2 = 1027 pg/mL
Lining = 7.9 mm

So, two more nights at 300, and I go back. Hopefully I can get at least one mature follicle and keep my lining decent. 

Getting Worse

Saturday morning was my second follicle check. I was hoping that with the increased dosage of Follistim, I'd see some good progress and my estrogen would be up. Instead, my estrogen has dropped and I still only have one follicle in contention. I'm upping my Follistim dosage to 300 iU a night and I go back again on Monday. The nursing staff warned me that unless there's improvement, my cycle will be cancelled.

It makes no sense, but I've got this thought that keeps running through my mind: Maybe Alexis and Zoe were the babies we were meant to have. Maybe they're the only babies we were meant to have, so there will be no more. I love them so much, and I'd give just about anything to have them arriving, safe this month as originally planned, but I hope they are not the only children we'll be parents to.

Here are the numbers this cycle vs. last:

Last cycle:
CD10, after 7 nights of Gonal F 150 iU
Right = 19, 13.6, 7
Left = 16.5, 15, 10, 8
LH = 1.03 miu
P4 = 1.66
E2 = 1294

This cycle:
CD9, after 4 nights of Follistim 150 iU and 3 nights of 225 iU
Right = 14.5
Left = 9.5
LH = 1.15 mIU/mL
P4 = <0.05 ng/mL
E2 = 432.4 pg/mL

On the Coaster

At the start of this cycle, I reminded myself that every ART cycle is a roller coaster. You get good news and are feeling good, and then you get crap news and are sure you're out. Rinse and repeat until the end of the cycle. That definitely happened last time, and I knew it would happen this time.

Last appointment: Uterus looks good, both tubes are open, ovaries look great. Great news! Thrilled and expecting good outcomes from cycle.

Today's appointment: First monitoring appointment of this cycle. Compared to last time, it's looking pretty terrible, and I could tell the nurse was disappointed. I only have one follicle in contention, compared to 6 last time. Out of 6 last time, we got 4 mature eggs and two healthy embryos. This time . . .? Let's just say I'm feeling like we're out, and it's only the 5th day of stims.

Numbers are below.

Last cycle:
AFC = 9
CD7, after 4 nights of Gonal F
Right = 11, 9, 8.5
Left = 12.5, 8, 8
LH = 8.24 miu
P4 = 2.68
E2 = 803

Today:
AFC = 4
CD6, after 4 nights of Follistim
Right 9.8
Left 6.5
LH =
P4 = 
E2 = 
Lining 5.9 mm

I increase my Follistim dose to 225 iu/night, and return on Saturday for another look.