Pregnant, but not really …

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Yesterday was my first beta.  I got the call from the clinic a few hours after my blood draw to let me know that my hCG level was a 13.9 mIU/mL, which is low. Like, really low.  I know that <5 mIU/mL  is considered ‘not pregnant’ and anything above 25 mIU/mL is ‘pregnant’. Honestly, I’m not even sure why they are considering me pregnant as my hCG seems to be floating in an indeterminate stage, but the nurse said that they want me to continue taking my medicines (prednisone, baby aspirin, endometrin, estrace, and PIO shots) and will bring me back in two days for another blood draw to see if the numbers have gone up.  While Daddy Graham and I have not given up hope completely that we have a late implanting embryo, we are also realistic in that this is looking like a chemical pregnancy.

During the two week wait, I had a multitude of symptoms.  I felt the strangest tugging sensation behind my belly button that traveled down to the top of my pubic bone.  Cramps that were distinctly different from normal period cramps.  I knew something was going on, I just wasn’t sure what. In the days preceding the beta, I cop to taking some home pregnancy tests so that I could have some sense of where I stood.  Daddy Graham and I had a long discussion about how they were not the end-all-be-all of pregnancy indication, and I tried not to put too much stake in them. Faint positives each and every time, but the lines never grew darker as the days went by.

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Truthfully, while I am sad, I am also feeling alright about the situation.  We knew that this process was not going to be easy, and that odds aren’t necessarily in your favor with IVF and FET (though much greater than other infertility interventions).  We will not be deterred by an unsuccessful cycle, as we are committed to trying again.  Before Daddy Graham and I began this process, we both agreed that having a child would make our lives wonderful but we are not incomplete as a family without children.

We are now #PUPO!!

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Pregnant (until proven otherwise)!

Yesterday’s frozen embryo transfer (FET) went off without a hitch.  I arrived at the fertility clinic at around 9:30 for my first of two scheduled acupuncture appointments (before and after the FET).  The spa-like atmosphere was incredibly relaxing, as I was feeling jangly with nervous excitement.  Unbeknownst to me, I would be wearing the spa robe for the entirety of the day, so there was no need to wear a cute dress (a dress being my appointment attire of choice, as I just have to hitch it up and drop my undies for the table rather than dealing with pants or jeans, etc.).  I had never had acupuncture before, and I’m not sure exactly what my expectations were, but it neither over- or underwhelmed me.  No lightning bolts of pent up chi that were set free just a nice, calm room with a warm blanket for me to bliss out in before the procedure.  For the pre-FET treatment, I had a needle placed in my skull, one on my forehead, one on left hand between my thumb and forefinger, and the rest were centered around my belly button.  After all of the blood draws and self-administered needles, these I was completely oblivious to. I laid there with the needles in for a half hour before having the needles removed and taken to the FET room.

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I was given a lovely net bonnet and warm blanket, and Daddy Graham was brought in fully suited up in surgery scrubs.   Unfortunately, my veins were not complying with the blood draw, so after a few painful, digging attempts, it was decided that we would get my blood after the transfer.  The transfer itself was relatively quick and painless.  Daddy Graham and I were laughing afterwards at the fact that there was no need to be worried about him and an unsightly vantage point of my lady bits in full speculum-ed glory, as it would end up all hanging out in the open anyway.  You really lose any sense of modesty through this process. It didn’t really appear to faze Daddy Graham so, in turn, it didn’t faze me either.  The doctor came in and shared the first picture of Baby Graham with us, and told us that we were transferring a 5BB single embryo.  He reiterated not to get too hung up on the grading system, but that it looked lovely and was a strong candidate for a successful transfer.  We were also happy to find out that they only had to thaw out one for this transfer, and that we still have seven in reserve.

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Once the speculum was in place and the doctor was able to locate my uterus underneath my (very full) bladder using ultrasound, a catheter was thread through my vagina and cervix and into my uterus.  After the correct placement was determined, the embryo was brought in and verified from embryology, and into my uterus it went.  After the doctor removed the catheter, he froze the ultrasound screen and pointed out the little speck that was Baby Graham!  It is hard to fathom that it one split second I went from being not pregnant to, for all intents and purposes, pregnant.  Amazing.

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After I laid on my back for fifteen minutes and my blood was successfully drawn, I was taken back upstairs to the spa for my second acupuncture treatment.  This time, all of the needles were placed along the tops of my lower legs and my feet.  I once again was told to relax (which I tried to do, but I was too excited and overwhelmed with feelings of gratitude).  After the needles were removed, I was able to change into my regular clothes and head home.

I was given instructions to continue all of my prescription protocols (estradiol suppositories, progesterone suppositories, PIO shots, pre-natal vitamins, baby aspirin, prednisone, and tacrolimus) and that I come in for my first beta on August 18.  As it turns out, Daddy Graham and I are away that day, so we had to schedule the beta for August 21. I wonder if I will really be able to resist POAS for that long a time – we shall see.

I am definitely scrutinizing every little change I feel in my body, and trying to determine if the feeling is a pregnancy feeling or not.  I am trying to back off Google, as I know that it will only drive me crazy and that each woman’s pregnancy experience is different from the next. Before I left for the transfer, my mom gave me a huge hug and said something along the lines of “after today your life will never be the same”.  These words have been echoing in my head since yesterday – what a momentous and incredible opportunity to be fully present in the process of creating Baby Graham!

In the meantime, which us luck and sticky baby dust! Stick, Baby Graham, stick!

Beginning the FET Protocol

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After the egg retrieval procedure, I was given the instruction to phone the office and set up an appointment after the first day of my period so as to begin the next phase on our journey to becoming parents.  As it would happen, my period started on the last day of a mini vacation Daddy Graham and I took to the Adirondacks – and this one has been a doozy.  I can say without hyperbole that this has been the. worst. period. ever. I won’t go into the icky details, but suffice it to say acetaminophen and a heating pad have been my best friends (and Daddy Graham’s back rubs).

Yesterday’s appointment brought the welcome news that I am on track for an estimated frozen embryo transfer (FET) date of August 9.  During the ultrasound, the nurse mentioned that my right ovary was still swollen from the egg retrieval procedure two weeks ago.  She wanted to see the results from my blood panel (Progesterone, TSH, Estradiol, FSH, LH) before giving me a definitive timeline, and if my Progesterone or Estrogen were off then this month’s transfer was in danger of being cancelled.  Thankfully, the numbers came back within the normal range and I will return to the office in a week’s time.

In the interim, I’ve started the FET protocol which entails:

  • Estradiol tablets (2x day), inserted vaginally (to help grow my endometrium lining and keep it thick)
  • Z pak antiobiotics for five days (preventative antibiotic administered anytime they do a procedure with the uterus)
  • Prednisone (2x day) (low dose steroid to help combat inflammation, which is detrimental to implantation)
  • low dose aspirin (1x day) (to help improve blood flow)
  • pre-natal vitamins (which has been on-going since we started this process)

My next appointment will bring another ultrasound and blood panel to see how my lining is progressing.  At that point, I’ll get the next protocol round which will entail progesterone oil shots.  I was also given three optional ‘procedures’ that are all aimed at helping with embryo implantation (text is from my fertility clinic‘s Reproductive Immunology pamphlet):

  1. HCG: HCG uterine wash. The corpus luteum provides the main source of progesterone support. The corpus luteum maintains its activity for 14 days. If an embryo fails to implant and HCG is not secreted, the activity of the corpus luteum will decline. The normal development of pregnancy depends on proper corpus luteum activity. Providing HCG, along with Progesterone, supports the luteal phase in infertility treatments.
  2. Intralipids: Intralipids are a liquid emulsion of fat. It is mainly composed of soybean oil and egg fats. It is similar in effectiveness to IVIG but significantly more affordable for couples who are seeking success after multiple miscarriages. Researchers believe it acts to suppress the body’s natural killer cells and prevent embryo rejection. This is an IV infusion that is performed in our office and generally takes approximately 20-30 minutes. The recommendation is to infuse intralipids before IUI/Egg Retrieval/Embryo Transfer and weekly thereafter to 12-14 weeks gestation.
  3. Acupuncture: My fertility clinic, in it’s east meets west medical philosophy, highly encourages acupuncture for blood flow and fertility before and after the FET procedure.

I know for sure that I want to partake in the acupuncture treatments (and look forward to it!).  The other two Daddy Graham and I are doing more research on, and looking into whether or not insurance will cover them.  In the interim, I am trying to get a lot of rest and eating well.

On a (strange) side note, out of curiosity I slotted my FET date of August 9th into a pregnancy calculator.  As it turns out, the due date if we were to be blessed with a singleton Baby Graham would be April 27 – Daddy Graham’s birthday.  And, if we were to be blessed with twin Baby Grahams, the due date would be April 6 – my birthday.  What are the odds?!?

TTC, WTF?

IMG_4565New to the whole world of trying to conceive, I was utterly confused at first by the language that kept cropping up in online forums and message boards.  I work in a field that is acronym heavy (educational policy at the state level), but it was still a challenge decoding some of the terminology as some of the acronyms have other, more commonly used meanings (see AF, below). I found myself Googling quite a bit, and wondering at times why we should need a glossary to describe one of the most fundamental aspects of biology or why we can’t just write what we want to say instead of abbreviating.  It should come as no surprise that I am the kind of texter that writes in long form.

At any rate, I thought I’d share some of the common acronyms floating about:

2WW/TWW The two week wait (otherwise known as the luteal phase or ~14 days after ovulation).
AF “Aunt Flo”.  I hadn’t heard this term since junior high.  Also not to be confused with its more common usage “as f*ck”, as in “I’m tired AF right now”.  Why can’t we just say period, ladies?
Baby Dust What well-meaning fellow message board-ers will offer to sprinkle on you for good luck.
BD Baby dance (sex).  Is this cutesy acronym in play so that message board content doesn’t get flagged as inappropriate?
BFN Big Fat Negative

Big Fat Positive

The pregnancy test results.  You’ll see these a lot.
BFP
CD Cycle Day … usually followed by a number
DB Darling boyfriend

Darling daughter

Darling fiancé

Darling husband

Darling son

The darling monikers.  I’ve seen the “D” also stand for ‘dear’.
DD
DF
DH
DS
DPO Days past ovulation
FRER First Response, Early Response pregnancy test.
FX Fingers crossed.  Usually used in conjunction with baby dust.  The best part of the message boards is the common rally call and support you receive.  Everyone is rooting for you!
HPT Home pregnancy test
IUI Intrauterine insemination
IVF In vitro fertilization
LH Luteinizing hormone (detected in ovulation predictor kits)
OPK Ovulation prediction kit
POAS Pee on a stick (Home pregnancy test). No DYSIP, though (dip your stick in pee) … yet.
SA Semen analysis
TTC Trying to conceive
VFL Very faint line – with regard to pregnancy tests.  Chances are you’ll also see VVVVFL, as well as other iterations that vary the frequency of the ‘v’.

Any others that I’ve left off?