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Archive for September, 2011

Clearly you guys know me by now and nothing can ever be fucking smooth sailing as far as this IF journey and pregnancy journey goes.  Remember the 8w2d u/s and how happy and giddy we all were?  Ya, well, fast forward to Sunday morning and we fell off of the Happy and Giddy Train and right into Holy Shit Am I About to Lose This Pregnancy-ville.

I woke up early in the morning on Sunday and I had mild to moderate bleeding.  I immediately called the OB’s office who paged the nurse on duty and she called me back quickly.  I explained the situation and she said that since there wasn’t cramping and it was mild to moderate, I should try and get some sleep and if it was still there or worse in the morning, to go to the ER.  Ya right – how could I sleep knowing there could be something wrong?  So, I got dressed (a.k.a put on a bra) and headed out to the ER and spent from 2:00am-11:00am there.

As luck would have it, the Doogie Houser, MD that was assigned to me was hot as hell.  Like, McSteamy hot.  And here he was looking at my vagina.  LOVELY.  The exam didn’t indicate “active” bleeding, but Doogie couldn’t say for sure it wasn’t something indicative of a problem or a miscarriage so I demanded an u/s.  And by “demanded” I mean I literally laid it all out on the line for him basically saying it has taken me two years to get here and I’m not leaving this goddamn hospital without an u/s.  So, he reconsidered (a.k.a. was scared of the crazy preggo) and said that if I waited until 8:00am when the u/s tech comes in, he would order it.  Since that was 3 hours away and I didn’t have anything better to do, I agreed.  See, Doogie – we can come to terms here.

So, I waited.  I dozed off a few times (oh because of course Chris was away at work and I went by myself) and was spooked awake each time a nurse came in to check my blood pressure.  No wonder it was high each time…  At around 8:15am, they came to wheel me down for the u/s.  The tech was super nice and even let me watch and see the babies.  Baby B even did a bit of a somersault while he / she was being measured.  I had to then wait over an hour for someone to read the results and give them to the new ER doc who was older and not nearly as handsome as Doogie. 

Come to find out, it’s a perigestational bleed – basically a bleed in the uterus between the gestational sacs. New ER doc said it should not negatively affect the babies and they looked good, measuring on target and their heartbeats were 175bpm.  It was very scary – I am happy that the bleeding has seemed to have stopped and the NP at my OB’s office met with me and Chris this afternoon and said it’s fairly common with pregnancies and all should be okay.  I’m just hoping we start to have some uneventful weeks ahead of us as I feel like I spend my life in doctor’s offices…  But, we’ve made it to 9 weeks.  They’re officially “fetuses” (or is it “feti?”) and they’re starting to look more and more like babies and less like gummy bears or shrimp.  As long as everything goes well (LORD WILLING!), I’ll see them again at my first trimester screening appointment on October 20th.  A little more than 3 weeks away…

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Septemeber is PCOS awareness month and I feel it is my duty to dedicate a blog entry to the very reason this blog exists.  I will discuss a little more detail about PCOS and then tell my story.  As always, you can find out more about PCOS and Infertility on my website:  https://projectpcosbaby.wordpress.com/about-pcos-and-infertility/

About PCOS

Polycystic Ovarian Syndrome (PCOS) affects up to 1 in 10 women in this world.  It is an endocrine disorder, not an ovary function disorder, and is represented by an imbalance in a female’s sex hormones including estrogen, progesterone, and androgens.  There are many symptoms, however the difficulty with PCOS is that it doesn’t present itself the same in every woman and can present itself in different ways.  To be thorough, though, I want to include some of the symptoms PCOS’ers may find and I’ve highlighted and added notes to the ones I have:

Changes in the menstrual cycle including:

  • Absent periods, usually with a history of having one or more normal menstrual periods during puberty   (If I am not on BCPs, I go months without a period)
  • Irregular menstrual periods, which may be more or less frequent, and may range from very light to very heavy 

Development of male sex characteristics:

  • Decreased breast size  (HAHA – those that know me know this is absolutely not the case here)
  • Deepening of the voice
  • Enlargement of the clitoris
  • Increased body hair on the chest, abdomen, and face, as well as around the nipples
  • Thinning of the hair on the head, called male-pattern baldness

Other skin changes:

  • Acne that gets worse  (This was the second most notable sign after going off of BCPs)
  • Dark or thick skin markings and creases around the armpits, groin, neck, and breasts due to insulin sensitivity

Other common symptoms include:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Weight gain  (Another struggle that became worse after going of BCPs)
  • Obesity

There are no “tests” for PCOS that conclude you have it.  Instead, a battery of testing and procedures are done to put together a story that would indicate that PCOS is the diagnosis.  Often, your OB/GYN can assist with the diagnosis, however it is my personal opinion that you are better off being seen by a Reproductive Endrocrinologist even if you’re not actively TTC in order to have them conduct the testing and review the results.  REs are typically more educated in endocrine disorders than OB/GYNs and are able to offer treatment suggestions that fit in line with your lab results.

My Story

In 1999 I was a sophomore in college and had stopped using BCPs as I wasn’t sexually involved with anyone at the time.  About three months had passed and I finally realized I hadn’t had a period, which I thought was weird but wasn’t concerned about since I wasn’t having sex.  I made an appointment for the next time I was home to visit my OB/GYN and find out what was going on.

The appointment with the OB/GYN was quick – we discussed what had happened and she basically told me that my ovaries were “farting”.  When I laughed and asked her REALLY what was happening she said that if she told me the real thing it wouldn’t make sense so that was essentially what was going on.  Okay, I thought – and she prescribed BCPs and I was sent on my merry way…for over 10 years.

I always questioned whether I would have a difficult time getting pregnant, but not because of my ovaries and their apparent gas issue.  It was more because of my mother’s history with cervical cancer and endometriosis that had me concerned.  About a year or so after I got married, so in 2008ish, I went to my PCP to have a physical and to talk about this weight gain I seem to be struggling with.  I never really had weight issues growing up and even into my 20s, but it seemed to happen quickly.  She did a blood panel on me and told me my thyroid function was fine and that it was probably “marriage” weight I was gaining.  Yep – basically I needed to get my lazy married ass up and get back to working out!  Well, okay then…

I went off of BCPs in mid-July 2009 to give my body the 90 day cleanse it needed before we could start actively TTC.  I essentially ran out of excuses to give Chris for not TTC, so August was his last and final date and I agreed and there we go.  Except – no period.  For three months.  In the meantime, I started breaking out in terrible acne on my chest, back, and along my jawline.  I went to my dermotologist and she asked if I had been diagnosed with PCOS?  So yes, it was my dermotologist of all people that first suggested PCOS to me!  I told her no but that we were TTC and so she prescribed me topical solutions and sent me on my merry way. 

In October 2009, I finally went to my OB/GYN to discuss this lack of period thing and beginning to TTC and that is when she suggested that I likely have PCOS.  She wrote it down for me on a piece of paper and told me to look it up online, but that I need to TTC naturally for about a year before a referral would be made.  She prescribed Provera for me and told me to take a HPT every 35 days and if it’s negative, use the Provera for 5 days to bring down a period.  She suggested I pick up some OPKs and track my ovulation and time the intercourse appropriately.  So, me being by the book, this is exactly what I did for a year.  And during that year I peed on a stick every day of every month (and spent TONS of money) and never got a smiley face.  I took them with me on business trips, I didn’t miss a beat.  Never once got a positive.  In the meantime, Chris had an SA done and got a glowing report card so we knew that all of this was on yours truly…

In November 2010, Chris and I both went back to my OB/GYN for a meeting.  As I am telling her about my lack of smiley faced on the OPK, I burst into tears as I think it was right then that I realized this was serious.  She immediately gave me the referral to an RE and handed me information on three different fertility centers in our area.

I went home crushed.  And with a lot of work to do.  I immediately began researching the various centers and making calls to get personal references – eventually ending up at Boston IVF with Dr. Zimon.  And the blog takes over from there…

I wanted to tell my story not only to support the awareness of PCOS, but to summarize my journey and my learnings along the way.  Things I would do differently if I knew then what I know now:

  • When I was first told about the ovary “farts”, I should have inquired more about what it was and what it could lead to so I could educate myself further and get control of it as soon as possible
  • I shouldn’t have waited over 2 years after getting married to TTC
  • After 6 months of no ovulation, I should have went back to my OB/GYN and demanded a referral to the RE

Hindsight is always 20/20 and I feel that things do, in fact, happen for a reason.  But I will be honest and say, just because you get pregnant does not mean the stress and worry goes way.  If anything, it increases.  I am very lucky that after about 6 months of being treated by an RE I find myself 8w4d pregnant, but the pain and struggle of PCOS and IF won’t go away until I hold a beautiful baby (or two!) in my hands.  Then, I believe, I will come to peace with the process and know that it was all worth it.  For now, I walk around in constant fear that I will lose what I worked so hard to get. 

In the end, I will come out of this process with an in depth knowledge of my body, of PCOS, and what I need to do to fight it for the rest of my life.  Because, it doesn’t go away and will never go away.  But I can fight it through efforts to better my health – and we can all fight it through awareness.

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Much better news yesterday!!!  I went for the follow-up “viability” u/s and it was such a great experience!  The technician was awesome and you can watch everything that she did on a screen in front of you (unlike with Boston IVF where you couldn’t see what they were doing).  She explained everything, from checking each heart rate and doing the measurements.  She was absolutely amazing – it was great!  Their heart rates were 165bpm and 162bpm which is perfect.  They are now measuring a little ahead (and it appears a lot of growth has occurred since Friday!) as they are measuring at 8w3d and 8w4d now.  There was no issue with the yolk sac on either one and the technician said that now that we’re into the 8th week they are using the placenta more than the yolk sac so we are just fine.
 
I feel like a million bucks – OH OH and the best part!  While she was checking out Baby B something moved and I was like “wait, what was that?!” and she said, “it’s your lucky day – this is a bonus.  That wasn’t me – that was the baby moving!  They don’t usually move a lot at 8 weeks so that is a real treat you got to see that.”  He / she basically turned and faced the screen.  I about died – how unbelieveable!    She pointed out their little arm and leg buds – it’s just simply unreal. 
 
I got cleared to travel, which is good.  Just have to move around a lot on the plane and keep well hydrated.  I also was cleared to return to the gym to do cardio and pilates and yoga, so once I can muster the energy to renew my membership, we’ll be back at that.  I’m hoping next week. 
 
I’ll end my much happier note by including three pics – I swear I won’t send out u/s pics as our Christmas card but I do like to share these with everyone.  There is one of Baby A (lying on his/her belly), one of Baby B (sitting up), and one of both.

Baby A

 

 

 

 

 

 

Baby B

 

 

 

Still Twins!

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I’ve been severely neglecting the updates here and I sincerely apologize.  Last Friday’s u/s was not all that glamorous and between being worried about that and dealing with a busy life in general, it’s been brutal.  But, let’s share, shall we?

7w4d U/S with Dr. Zimon and Boston IVF & Potential Yolk Sac Issue

Both babies were measuring a bit behind at 7w1d, but I was told their heartbeats were in the 150s (come to find out after a call with Nurse Karen, only one baby’s heartrate was measured and it was 153 but it was noted the heartbeat did exist on the other baby and we did see both on the screen).  The babies looked like gummy bears!  The u/s technician noted that it appears one of the yolk sacs is a bit misshapen – specifically “possible irregular yolk sac”.  Dr. Zimon basically brushed everything off (the measurement and potential misshapen sac) and said that she thinks this was an overall great report.  She even graduated me to my OB.

Of course, I went home and discussed it with Dr. Google and it appears that misshapen yolk sacs are an omnious sign for the pregnancy and lead to miscarriage.  That lead immediately to tears and complete devastation and confusion around why my RE would be so dismissive of it when it could be a huge issue?  I called Nurse Karen and left her a sobbing message asking her to call me as I had additional questions.  She called around 5:00pm and had spoken with Dr. Zimon and essentially, they’re unsure of the clinical significance of the issue with the sac and what could happen to the baby.  Essentially, if there is a 5% chance of miscarriage for me right now – this baby would fall into the higher end of the range.  Nurse Karen didn’t know if it would or could negatively impact the other baby, so that was a question on the list for my OB.  Both babies did measure at 7w1d (and I was 7w4d), which is a good sign and she said that the measurements can sway 2-3 days either way. 

I called my OB and they squeezed me in for Monday (yesterday) with another OB in the practice, Dr. McNulty.  It was the longest weekend of my life.   I had a really tough time sleeping on Saturday night.  I just couldn’t shut my brain off.  I know there’s nothing that can be done to prevent a miscarriage, but it’s so hard to already have an issue this early. 

8 Week First OB Appointment and Follow-up U/S Scheduled

Yesterday was more like a first OB appointment with family history, urine sample, bloodwork, pap smear, exam, etc…  I did get to discuss the potential yolk sac issue with the OB and she’s going with the fact that my RE wasn’t really all that worried and the report being so vague that if there was something truly significant, it would have been noted.  All the report said was “possible irregular yolk sac” and they didn’t measure the heartrate on that baby (which was something that could have been useful for my OB to see – stupid u/s tech!).  My OB’s office wants to see it for themselves, so I’m going tomorrow (Wednesday) for an u/s and then meeting with my actual OB after to discuss the results.  And, in the end, there is nothing that can be done so it’s very much a waiting game.  I was comforted a bit by knowing that it shouldn’t affect the other baby if something does happen.  I can’t imagine losing both.
 
Hopefully tomorrow shows them both measuring closer to 8w2d and normal yolk sacs (whatever that means or looks like).  I swear, this is more stressful than the damn fertility treatments!  So, not a lot of answers but a little bit of comfort – and I just have to find peace in the process and that I have little control.  It will be nice to see them again on the screen and I hope it looks good.  After this I won’t have another u/s (unless there is an issue) until 12-13 weeks.

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Who’s your daddy?

As kids conceived with donated sperm grow up, life may get complicated for donors

http://www.boston.com/lifestyle/family/articles/2011/09/15/sperm_donor_has_75_kids_and_counting/?page=full

Wow.  I read through this and simply didn’t know what to think, but knew I had to post it in my blog so I could remember it and try and work through my thoughts overall.  The whole concept of donor egg and donor sperm is so important to the world of IF, but the truth of it can truly become eye opening.  Such as, ya know, having 70+ children running around the US before you’ve even been married to try and procreate your “own”.  It can be very real for those of us who were lucky not to have to use donor eggs or donor sperm as if you are undergoing IVF, you have to sign paperwork and make a very similar decision – what do you do with the frozen embryos?  Keep and use them all (which is an interesting concept if you’re those high producing women with 20 frozen embryos!), discard them, donate them to research, or…donate them to a couple in need?  Same thing for some people not undergoing IVF but that have frozen sperm for IUI cycles – what do you do with the remaining vials? 

Our personal decision was to donate the embryos to research (when we’re ready – those suckers aren’t going anywhere yet) and discard Chris’s spermcicles (again, when we’re ready).  I personally couldn’t get over the thought of another couple becoming pregnant with my embryo(s) or Chris’s sperm and bringing what is essentially our child into this world.  But, contrary to where the now lawyer was coming from, this is a very real process to me, to us.  I became attached to the two little things growing inside me as soon as the embryologist gave me that picture.  I am much too attached to the whole process and simply couldn’t live knowing that there was the potential for our kids to be in someone else’s family.

But, the path the now lawyer took is one I heard of when I was in college as well.  Trust me, when you’re getting those tuition bills (or heck, if you want to take that Spring Break trip to Cancun), you’ll consider doing a lot to make a buck.  I knew of girls who donated platelets, marrow, and yes, even eggs just to make some money for school.  I’m sure there were a handful of guys who may have even done the same at a sperm bank – but you’re not thinking at the time what that means.  And, I honestly think that most outside of the IF world wouldn’t necessarily put so much thought into what it means either – we see things differently because we’re so intimately involved in our reproductive lives, the technology that surrounds it, and it changes our perspective on what an egg is or what sperm are.  I do, however, think it’s a shame that the lawyer’s fiance is in a bit of a tizzy about it – especially since he told her about it from the beginning.  If she knew how much time, energy, and money it took these women and these families to invest in their children – she would know that there isn’t going to be hundreds of kids knocking down their door for a handout.  Yes, because of modern technology and the good old internets, being an anonymous donor isn’t so anonymous anymore.  But HE chose to list himself on the website and it truly seems as though he’s interested in meeting these kids and at least having casual contact with them.  For those who may come into health issues in the future, having this contact may even save one of their lives. 

It is a sticky situation (no pun intended – okay, maybe a little) but one that I hope doesn’t reduce the number of sperm or egg donors available to those who need it.  These individuals deserve a chance at having a family and if you’re removed enough from the situation, it can be a rewarding thing for you to do.  But, it is all very personal and a lot of thought should go into the process on either side.  In the end, he helped bless the lives of 70+ children that may not have been able to be a part of this world.  And he’s brought happiness and joy to many families that are the true “mom” and “dad”. 

 

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So…I’m pregnant…with twins!!!  It’s all so overwhelming, so let me start from the beginning.

My mom couldn’t go (we couldn’t make it work), so I decided to go to the u/s appointment alone.  I was okay with it and actually preferred it because I was convinced something was going to be wrong and I wanted to deal with it on my own terms.  When they finally called me in for the u/s, I was literally shaking like a leaf.  I told the u/s tech that and she told me not to worry and that in the beginning she wouldn’t be speaking much and there are other things she’s looking for and measuring, but she will show me everything when she is able.  She first started off that I have a retroverted uterus.  I immediately go, “IS THAT BAD?!” and she said no, it just makes it a bit more difficult to see things.  Well that explains some of the terrible u/s experiences I’ve had in the last year.  Like 4-6 minutes goes by and nothing.  Then another few minutes and I’m like WTF?!  She told me there was a lot of gas in the way (oops) so she was having a hard time getting the clear pics she needed.  She said in a few minutes she would show me everything and that it “wasn’t bad news”.  WTF DOES THAT MEAN?!  “NOT BAD NEWS”?!  So I sat there for another 5 minutes or so and she turns the screen and goes, “there are two in there – you’re having twins!”  I about shit myself.  I think my reaction was “WHOA”.  I asked if they were measuring okay and she said yes, but that one was a bit more difficult to see.  She said it was the gas and everything going on – not to be worried.  She then showed me both of the heartbeats which flickered on the screen – I immediately burst into tears and it was truly amazing.  She said I am measuring right on target and everything looked good and that the Physician’s Assistant (PA) would tell me all the specifics.

I texted Chris first and his response was “gulp”.  Ya, well, it was YOUR idea to put two back in there, buddy… 😉  I then sent a group text out to a group of my friends and our immediate family to let them know.  I met with the PA and she was really nice – a very brief visit where she checked my heart, lungs, and thyroid.  She then did a pelvic exam (and the whole time I’m thinking to myself, “hey be careful in there – precious cargo are on board!” but clearly she knows what she’s doing).  We discussed the babies and they are measuring on target and their heartbeats were 113 and 112 each.  Anything over 100 at this point is good, so I was pleased with that.  I will have another u/s in 1-2 weeks (just scheduled it for Friday, 9/16 so Chris could go) and if everything looks good, I’ll be graduated to my OB!

This is all so crazy and surreal.  I talked with my mother briefly and also with my dad (he’s so socially inept with this) and then spent some time on the phone with the All Knowing Julie and Heather.  I am still super nervous, but I feel good after seeing the heartbeats and knowing there really is something, TWO little somethings, growing inside me!!

Please keep the prayers and positive thoughts coming – we still have quite a long road ahead of us.  But holy shit, I’m pregnant with TWINS!

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DISCLAIMER:  If you don’t want to read brutal honesty about things coming out of a pregnant vagina (other than a baby at 40 weeks), skip this post…

One thing I’ve learned since my BFP was that being pregnant comes with a lot of yuck, in addition to fear.  You see – you go from having lots of things shoved into your vagina (u/s probes, speculums, catheters, washed sperm, real sperm, tampons, etc…) to having things trickle out of your vagina.  Yes, you read that correctly – things come out of your vagina.  And this typically happens, you know, while sitting at your desk working and when you least expect it.  Let’s discuss in more detail, shall we?

Crinone

Crinone is progesterone suppositories that most women who go through IVF are put on the day after egg retrieval.  Other women with IF are put on them if they tend to have low P4 counts.  If you’re lucky enough to get a BFP, many REs continue the Crinone for 3-4 weeks post BFP.  It’s pretty easy to do – similar to a tampon you put the plastic thing in (another thing going in!) and squish the air-filled pocket at the end to push the Crinone out and into your vagina.  This is done each morning and is a pretty non-event.  Well, until it starts to clump out.  Yes OUT.  On the toilet paper when you wipe, in your unsuspecting undies, etc…  Oh and it doesn’t come out in the form that it went in.  Oh no.  It somehow changes form to that equivalent to cottage cheese when it comes out.  And it’s sticky as glue – actually, Nurse Karen equated it to cement.  It’s fucking gross.  The sweeping method that Nurse Karen suggested in the morning has helped with the build up – but it still comes out.  Gross.  And the All Knowing Julie (this is her new nickname now since I have what appears to be a standing daily call with her to discuss my lack of symptoms and my overall lack of knowledge on being pregnant) says that this can come out WEEKS after you stop the Crinone.  Seriously, they have to come up with something different…we MUST have the technology available.

Snail’s Trail

Yet another thing answered on one of my calls with the All Knowing Julie.  In addition to the Crinone, this week started something new.  I’d be sitting at my desk or watching TV on the couch or driving in my car and all of a sudden I’d feel something leak out – almost like I peed my pants.  Of course, I immediately think the worst and assume it’s blood and OMG.  So I run to the bathroom and look and it’s this clear liquid, about the size / quantity of a half dollar.  What the hell?  I ignore it for a day or so and realize it’s happening more and more often.  So, that’s when I called the All Knowing Julie and she laughed and told me to Google “snail’s trail”.  Dr. Google informed me that this was a term frequently used by Jenny McCarthy in her books and it’s completely normal.  Normal – okay.  Gross – hell YES.  I still don’t have a clear understanding of what it is (aside from vaginal fluid) and what it’s purpose is (aside from being fucking gross and scaring the shit out of me), but I did have to laugh at the name. 

In the end – I’ll take whatever leaking out of my vajajay to hold a healthy baby in the next 9 months or so.

Well, that’s this week’s little education from me.  I am nervous and excited for my u/s on Wednesday – I will be 6w2d then, so I’m hoping to see a heartbeat and that all looks good.  And yes, I’ll probably pass out if there are two sacs, two fetal poles, and two heartbeats…

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