Muddle Through Somehow

A thousand thoughts are running through my head about what to say and how to say it, so I’ll just pick up where I left off.  First, a quick recap – We had a single embryo transfer on November 15th.  Our 10-day post transfer test showed a positive but with a low hCG number of 17.  My hCG continued to rise at a slow rate and finally surpassed 100 a week later.  At that point, we were told to wait another couple weeks for an ultrasound on December 14th.  We’ll begin here.

The ride to Memphis didn’t consist of any hCG talk.  We knew all we could know at that point, so it seemed silly and exhausting to continue rehashing all the details of my low, slow-rising hCG and what it could mean for this pregnancy. As soon as we arrived at the clinic Wednesday morning, they took me back for an ultrasound.  This is what we saw….

6-5-weeks

A tiny gestational sac with an even tinier yolk sac – a speck.  Brennen said, “Wow that’s it!” We had never seen anything on a scan of my uterus except a “fluffy” lining, so this was a special moment for us, despite not seeing a fetal pole.  Then we met with the doctor who laid it all out for us.  Here’s what we knew after our discussion:

  1. The embryo did not implant in my tubes. It implanted in the uterus right where it was supposed to, and it implanted well.  This was great news for us – our first implantation!
  2. Based on the timing of my transfer, I should have been at 6 ½ weeks.  However, based on the measurements of the sac, it looked like I was closer to 5 ½ weeks.  In “normal” conception, some doctors chalk this up to ovulating later than you think you did.  However with IVF, conception and implantation is more controlled.  Implantation can take longer to occur after the transfer, but a week late is pretty uncommon.
  3. Being that I was measuring at 5 ½ weeks, it could explain why we didn’t see a fetal pole; therefore, another ultrasound was scheduled a week later.
  4. My lagging measurements coupled with the low, slow-rising hCG indicated that the pregnancy may not be viable, as it was not advancing at it should. The doctor gave us a 20% chance.

That’s a lot of information packed into 4 bullet points! We were thrilled to hear that the embryo had implanted where it was supposed to.  Until that point, we had never made it as far as implantation.  So although this news was coupled with our poor 20% chance, we were thankful to have made it that far.

For the next few days, I continued my medications (Estradiol and Progesterone) and hung on to that 20% chance.  Still, I didn’t feel connected to the pregnancy.  Partly because I was guarding myself against that other 80%.  Plus, I hadn’t developed any symptoms other than cramps, which were attributed to an expanding uterus.  On top of that, it just felt odd saying the word “pregnant.”  To me, this was a pregnancy, but I didn’t feel pregnant.  I talked to a few of my friends who are mothers, and they all said it takes some big moment to feel connected sometimes – like hearing the heartbeat or feeling movement.  So I guess I just needed that moment, and maybe, I thought, it would be December 20th when I heard a heartbeat, or hoped to.

The week between my two ultrasounds flew by thanks to a trip to New Orleans for the Southern Miss bowl game and, of course, Christmas preparations.  Monday night after work, I was wrapping the last few presents when suddenly I began cramping.  It felt like menstrual cramps, but I can’t say it was much worse than the cramps I’d been having over the past couple weeks.  I took a break from wrapping to sit on the couch and watch Mickey’s Christmas Carol.  When Brennen walked through the door at 7:30 with our Mexican takeout, I stood up to greet him (and get my food).  That’s when I felt it, and my heart sank.  I looked at Brennen and said, “I’m bleeding.” “Bad?” he asked.  “Like a period.” The next words out of his mouth were, “Oh my God.”  I can’t begin to explain or mimic the tone in his voice, but I can replay it in my head.  With those three words, I could hear him letting go of our 20% chance.

(This next paragraph gets a little graphic so skip ahead if you’re not up for it.)

I rushed to the bathroom and experienced what I had never experienced with any period in my 16 years of “womanhood.”  After a minute or so, we decided to call the nurse.  I told Brennen to go to the other side of the house to call her.  I didn’t want to hear him tell her what was happening. Living it was one thing, hearing it was another.  While he was on the phone, I sat there alone in our guest bathroom, bleeding.  I looked around – stared at our hand-wash-only clothes hung across the shower curtain rod, at the succulent that I had somehow managed to kill, at my stained pajama pants gathered at my knees, then finally into the toilet.  There was that moment – the moment I felt pregnant.  Only….I didn’t feel pregnant until I knew I wouldn’t be much longer.

Brennen returned, not grossed out by any part of the female reproductive cycle anymore, with instructions on how to monitor the bleeding.  He also brought with him two Tylenol for the cramping and a Benadryl to take before bed.  After an hour or so, the bleeding had slacked off significantly.  “What do I do now?” I asked.  I honestly didn’t know what the proper protocol was.  I needed to eat.  I needed to take a bath.  But I almost felt guilty going on with my normal routine.  “First, you’re eating,” Brennen said.  So I ate.  Then, I took the rest of the night one step at a time, just like we tackle this whole process.  I took a bath, called my mom, took what was perhaps the most difficult progesterone shot ever, downed my Benedryl, set the alarm for 8:30 when my OB’s clinic opened, said my prayers, and drifted into a medicated sleep.

The next morning, I called the clinic, and the nurse told me to come in right away. By 9:30 we were in the waiting room. The ultrasound showed a smaller gestational sac, an abnormal yolk sac, no fetal pole, and a bleed.  My OB’s prediction – this was not a viable pregnancy.  But she did say that although there was little to no hope in this pregnancy, it still brought hope with it.  My thoughts exactly, doc.

My next appointment is Tuesday after Christmas.  My OB expects the process to have completed itself by then. If not, a D&C may be in order.  My reproductive endocrinologist (fertility doctor) in Memphis called this morning and instructed me to stop all my medications.  So now we’re just waiting….waiting to miscarry.

We appreciate everyone’s thoughts and prayers during our “space between,” and we ask that you continue to keep us in your prayers over the holidays.  This will most likely be our last post until the new year when we’ll tackle the why’s and plan for the next transfer.  But for now, we’ll enjoy the time we have together with our friends and families over the holidays. It seems like life hasn’t been fair to us when it comes to fertility, but we’ve been more than blessed in so many other ways.  And ‘tis the season to remember that!

We hope you all have a very Merry Christmas and a blessed New Year.  It’s going to be a good one! I can feel it!

Someday soon, we all will be together,

If the fates allow.

Until then, we’ll have to muddle through somehow

So have yourself a merry little Christmas now.

Judy Garland, “Have Yourself a Merry Little Christmas”

hancock-christmas

Merry Christmas! (Photo Credit: My best friend Lauren!)

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