Ultrasound and fire truck update

Well, the spotting increased to full-on bleeding Wednesday afternoon, so C and I both canceled each of our evening plans and stayed home to mope. The bleeding slowed overnight, then started again Thursday afternoon, this time accompanied by cramping.

Ever the pragmatist, I emailed Dr. R before driving home from work:

“In the last hour I’ve started cramping and bleeding more heavily. Do you think I should still come in tomorrow if it continues/increases? Should I try to save any tissue for testing?”

She replied that I should still come in, and that I should save any tissue if I could.

Again the bleeding slowed that evening and overnight.

On Friday I got up and got ready for work. I taught my class (OChem II), replied to emails, prepped for Monday’s class, and represented my department at an event for prospective students. As I realized that it was time to leave, a feeling of dread settled into the pit of my stomach. I said a grim goodbye to my friend/department assistant (who is ‘in the know’ about everything going on), and drove home to meet C.

C and I drove to Kaiser, making small talk. I mentioned Dr. R’s email, and speculated that she might recommend a D&C so we could test the embryo and see if there was a genetic reason why things went wrong.

We arrived, checked in, and waited. A nurse took me back in to get my weight, blood pressure and urine sample, then brought me back to the waiting room because Dr. R was behind schedule and she thought I’d be more comfortable waiting there.

Eventually the nurse came back for us and as we walked down the long hallway to the very last exam room, I leaned over to C and told him it felt like we were walking to the firing squad. I undressed and sat on the exam table, feeling both literally and figuratively naked.

Dr. R came in and hugged us both. She said how nice it was to see us, that it had been too long. She asked if I felt pregnant, and I explained that the only pregnancy “symptoms” I had were feeling weepy and very tired…both of which could easily be attributed to depression over our apparently failing pregnancy.

Mercifully, she suggested that we postpone the usual prenatal visit stuff and skip straight to the cervical exam and ultrasound.

Dr. R did her thing as gently as humanly possible. She realized that the probe was disconnected from the ultrasound machine and had to start over. She tried again and focused in on the dark oval (the gestational sac) and said, matter of factly,

“I see a heartbeat!”

What?!

She carefully showed us – skeptical as we were – what she was looking at. She checked the rate and declared it to be a normal heartbeat, then she measured the embryo, twice, and showed us that it was measuring 6 weeks 5 days. (We were at 6w6d by my count.)

IMG_6576

Dr. R was so visibly happy; she just about started crying. Meanwhile, C and I displayed no emotion at all. We were (and still are) dumbfounded.

I had already been anticipating how I would tell my department chair that I needed to change my fall teaching schedule back to a normal schedule. (I had jumped the gun and moved some courses to accommodate a November due date, prior to student registration starting last week…) I had planned to console myself with a delicious cadillac margarita at the Mexican place behind our house, watch the depressing movie about stillbirth I’ve been wanting to see, and ugly cry on the couch by myself…

That I could still be pregnant was, and is, so unreal.

Of course, we know we’re not out of the woods – that we will never be out of the woods.

But that doesn’t stop this me from feeling like getting this far is a miracle.

Dr. R suggested I lay off the aspirin for a couple days and then start back on it again Monday and see how it goes. She said I could go to a ‘normal’ prenatal visit schedule and come back in a month…or that I could come back sooner if it would help me feel less stressed. C answered for me that of course I would want to come back. (He told her I’d just move in to the clinic if she’d let me!) So Dr. R set up an appointment for next Friday, and said we could “play it by ear” after that. It sounds like she plans to let me come in as often as I want!

We talked about other things, including how (and when) I should deliver, but it was pretty much consistent with what she had already recommended when we met back in September.

.

In other news, on Thursday I heard back from the sales rep for Kompan, the Danish company that we contracted to make Jane’s memorial fire truck. He said he had just confirmed that the pieces of the truck had arrived at our local Parks & Recreation office! We don’t know when they’ll get around to assembling it and removing the current fire truck, but this was unexpected good news!

He went on to say that while he didn’t know all the details, our story had touched the hearts of many of the people at Kompan who worked to make it happen. He shared that many years ago, he had lost an adult son (age 25), and that he was honored to be able to contribute to Jane’s memorial. ❤

Here were the plans for the memorial again. We can’t wait to see it in place at our local park!

Halfway there

It’s funny, when you can’t get pregnant, it feels like all you do is wait – for test results, your period to come, the next treatment cycle, or the dreaded two week wait. Time crawls by, marked by morbid milestones like big birthdays (Hello, Advanced Maternal Age), would-be due dates, number of years spent trying to have a baby, and so on…

But ever since I’ve made it past the nail-biter of a first trimester, time has flown by. Suddenly I’m halfway through the pregnancy wondering where the last two months went!

After the third email from a bloggy friend checking whether everything is alright, I have no choice but to admit that it has been far too long since I’ve written. For that I am sorry. (As always, I have been reading – celebrating, mourning, and above-all praying – right along with each of you, bloggy friends!)

Rest assured, all is well with me and Baby.

The day after my last post, I went in for the nuchal translucency ultrasound (part II of the so-called California Prenatal Screen). Seeing our baby in high-def should have been extremely cool, except that:

1)      I hit unexpected traffic on the way there, which caused me to panic that I would lose the appointment. (If you’re late at all to the full-bladder appointments, you have to reschedule…and get your bladder uncomfortably full again.)

2)      Despite following instructions to the letter, my bladder wasn’t full when I got there (maybe the traffic stress slowed things down?), and the technician made me feel rotten about it.

By this point, I was so stressed out that when the baby appeared on the screen, I found myself asking whether the technician could tell us if it was alive. She gave me a weird look as the baby on the screen proceeded to wave its arms and swallow gulpfuls of amniotic fluid…

3)      Then, I outsmarted myself…or not. After writing my previous post, I was convinced that I knew what I should be looking for – namely a nuchal translucency that was around 2 millimeters (or less) in width. So far so good, except that the measurements the technician was making were in centimeters. Embarrassingly, when this so-called-scientist saw the numbers creeping up to 0.18, 0.19, 0.21 cm, I was convinced that this was the equivalent of 18-21 millimeters! (For those of you who aren’t up on your metric system, 0.20 cm is equal to 2.0 mm.) Worse, my husband – the pediatric dentist who works on millimeter scale every day (or did, prior to the accident) – didn’t catch my error.

It wasn’t until we were outside the hospital that we realized something had to be off with our calculation.

Think about it, how could a baby the size of a peach (~3 inches from crown to rump) have the skin on the back of his neck be 21 millimeters (nearly an inch) thick?!

About an hour and a half later, I got the call from Kaiser telling me that everything was totally normal. Based on the combination of the 1st trimester blood test and the ultrasound, they adjusted my probability of having a baby with Down syndrome (from my original age-based estimate of 1 in 296) to an adjusted estimate of 1 in 5,000; and the probability of a baby with Edwards syndrome (originally 1 in 1152) to 1 in 95,000.

Several days later, on Friday afternoon, I got the call with the results from the NIPT blood test. (This was the brand new, more-accurate, qPCR-based blood test that I described here.) The test revealed that we were having a chromosomally-normal boy!

Great news…which I again managed to mess up in translation. But first, some unsolicited advice:

Do not tell your husband the gender of your baby-to-be in a text message.

I should explain. After waiting impatiently for the results of the NIPT scan, I finally got the call on Friday afternoon – while in a one-on-one meeting with my boss. Unwilling to wait until Monday for the news, I apologized to my boss and quickly left to take the call. Then, after learning such amazing news, I wanted to tell C immediately. (Somehow me knowing for more than a few minutes longer than him seemed horribly unfair.) But, I also felt an urgent need to return to my boss to apologize and continue our meeting…

So I sent C a text message.

He will never let me live it down.

Anyway, that was all our test news. I’m sorry to leave you with a cliffhanger for the last 7 weeks!

Other highlights of the last two months:

  • I ‘popped’ during Thanksgiving dinner. Once I switched to maternity pants, there was no going back…
  • I felt the first fluttering of movement on Christmas morning. It felt kind of like an upset, rumbly stomach, except without any feelings of queasiness. Feelings increased over the last weeks, so that now it actually feels like something is lightly tapping on me from the inside. After so much uncertainty, it is the most reassuring, wonderful feeling to know that he is alive and kicking in there! His most active time is from ~5-7am each day. The last few mornings I swear he has been doing cartwheels in there…
  • The Board of Trustees approved my promotion to Associate Professor (starting in Summer 2014)!
  • Saturday we hit 20-weeks. Say what?!
  • C felt movement for the first time on Sunday morning (during one of Baby’s gymnastics sessions).
  • We celebrated our 2nd wedding anniversary on Tuesday. Thanks in large part to our struggles with infertility and C’s life-threatening traffic accident (10 months later, it’s still causing him considerable pain), we’ve never been closer. I’m so glad I get to spend the rest of my life with this man!
  • Yesterday was our 20-week high-resolution ultrasound. The ultrasound technician wasn’t allowed to make any evaluative comments, but she narrated as she went, so we were able to count: two arms, complete with hands and five fingers on each; two legs with two adorable feet and ten toes; one stomach; one, four-chambered heart; two kidneys; one placenta; one umbilical cord (with blood flowing to the placenta); one head with a two-hemisphere brain (measuring 20w6d); and – oh yeah – a penis. (No surprise there, given our NIPT result, but it was nice to see it nonetheless!)

That’s about it. Now that my belly is swelling and I can feel ‘Baby Lou’ doing gymnastics in there, I’m actually letting myself believe that this is going to happen (although that doesn’t prevent me from middle-of-the-night panic attacks that something is wrong, like yesterday at 4am…) I’ve even relaxed enough to allow myself the occasional half-glass of wine, coffee, or Diet Coke. (Before you sic the Pregnancy Police on me, read this, or, if you prefer, this.)

And now, I’ll leave you with a picture of the beautiful flowers C got me for our anniversary. I’m enjoying the soft scent of lilies as I type this. 🙂

Image

Advanced Maternal Age

One week ago I turned 35. In pregnancy terms, this makes me officially old.

Visit with the genetic counselor

On Thursday, to celebrate, I got to meet with a genetic counselor through Kaiser (a meeting recommended for AMA women like me). Here’s what I learned:

At 35, my risk for chromosomal abnormalities is much higher than it was at 25. (Okay, so I already knew that!) The counselor was kind enough to point out that – despite the medical community’s black-and-white labeling method – there is nothing magic about the age 35. My risk increased slightly every year, so that now my risk of conceiving a baby with:

  • Down Syndrome (aka Trisomy 21) is 1 in 296
  • Edwards Syndrome (aka Trisomy 18) is 1 in 1152
  • Any chromosomal disorder is 1 in 134

(When you think about the fact that a few months ago, I was looking at odds of successful IVF with my eggs as about 1 in 4, 133 in 134 odds of having a chromosomally-normal baby really don’t look all that bad…)

I also learned a bit about the different disorders. Down syndrome (a disorder arising from three copies of chromosome 21, hence the name trisomy 21) is the most common, but is actually somewhere in the middle of the spectrum in terms of severity and prognosis.

Trisomies 13 (Patau syndrome) and 18 (Edwards syndrome) are more serious. The vast majority of babies with these disorders don’t survive a year. Those that do have severe disabilities.

Then there are the ‘milder’ sex chromosome disorders, like Klinefelter syndrome (in which baby boy gets an extra X chromosome, to get XXY) and Turner syndrome (in which baby girl gets an extra X, to get XXX). These may lead to slight reductions in cognitive function, health problems (e.g. diabetes in the case of Turner syndrome), abnormal physical characteristics (e.g. webbed neck in the case of Turner syndrome, small testicles and man boobs in the case of Klinefelter syndrome) and infertility. (I have to admit to finding it perversely amusing to think about infertility as the most minor of possible birth defects.)

(In case you’re wondering, XYY is also a possibility, but one that apparently doesn’t lead to any noticeable difference in cognitive or other abilities…)

 

Prenatal Screening Tests

To find out my likelihood of having a baby with one of these disorders, I was offered a variety of screening options.

I. California Prenatal Screening Program (PNS)

The first was the California Prenatal Screening Program. The charge for this test is $160 (fully covered by my insurance), and I found it interesting that that the money from all the women who get screened gets thrown into a communal pot. Uninsured women who get a positive screening test are eligible to use funds from the pot to pay for follow-up tests (like amniocentesis), and further prenatal care. Kind of cool.

Anyway, the California Prenatal Screening includes up to three different elements:

A.  A first-trimester blood test that measures levels of two molecules:

  1. human chorionic gonadotropin (hCG) – the protein hormone that’s used to confirm pregnancy in both home pregnancy tests and blood pregnancy tests, and
  2. pregnancy-associated plasma protein A (PAPP-A) an enzyme that chops up other proteins

Image

First trimester hCG levels tend to be a bit higher in Down syndrome pregnancies than in normal pregnancies, while PAPP-A levels tend to be a bit lower in Down syndrome pregnancies than in normal ones. Here are some figures I found on the interwebs showing the rough trends. In one-dimension:

ImageSource

In two-dimensions (hCG is on the x-axis; PAPP-A is on the y-axis):

ImageSource

Notice that there is a large overlap between Down syndrome and normal pregnancies in each plot. The genetic counselor also assured me that the levels change significantly over the course of the pregnancy, so a correct pregnancy date is crucial for an accurate result. Ultimately, this one blood test alone is insufficient to reliably predict Down syndrome risk, which is why the CA screening folks won’t give a result until they have at least one other piece of data, such as the following:

B.  A high-resolution ultrasound called nuchal translucency (NT) ultrasound is used to measure the thickness of a fluid-filled ‘translucent’ layer in the baby’s neck. More fluid in the neck is correlated with higher risk of congenital heart defects, which in turn is correlated with Down syndrome.

Here’s a figure showing normal (right) and Down syndrome (left) NT scans:

ImageSource

As with the blood test, this is all based on correlations, and just gives probabilities. (We infertiles just love probabilities…) Anyway, it is far from diagnostic.

These first two tests are sometimes referred to as the first trimester screen.

C.  The final data point that can be used as part of the California screen is a blood test in the second trimester. This test is sometimes called the quadruple test or quad screen, as it measures the levels of four molecules:

  1. human chorionic gonadotropin (hCG, see above)
  2. α-fetoprotein (AFP) – the most abundant plasma protein in human fetuses; its function in humans is unknown; AFP levels are elevated in pregnancies of babies with certain birth defects, including Down syndrome and neural tube defects like spina bifida.
  3. unconjugated estriol (UE3) – a  steroid hormone produced in pregnancy; low levels of UE3 may indicate chromosomal abnormalities
  4. inhibin A – a protein that inhibits follicle-stimulating hormone (FSH) production; inhibin levels are especially high in cases of Down syndrome, and especially low in cases of Edwards syndrome

 

Image

Like with the first trimester screen, the specific levels of these molecules can either more closely resemble a ‘normal’ or a ‘Down syndrome’ (or other chromosomal abnormality) pregnancy.

Even with all three data points, the best the CA screen can do is give probabilities of an abnormality. A probability of 0.5% (1 in 200) or greater is considered a positive test. In other words, the vast majority of women who get a ‘positive’ screening result will go on to have normal babies.

 

II. Non-Invasive Prenatal Test (NIPT)

The genetic counselor informed me that I’m also eligible for a very new blood test called the Non-Invasive Prenatal Test (or NIPT). This test is so new that Kaiser just began routinely offering it to women over 35 in June (which may explain why my OB failed to mention it in our first prenatal visit…even after C and I had made it clear that we wanted every non-invasive test available…)

This test is also a blood test, but instead of measuring the levels of proteins and small molecules in my blood, the NIPT looks at fragments of DNA in my blood. This post is getting rather long, but I’ll try to give the basic gist.

Apparently if you looked at all the DNA in my blood right now, about 10% of it would actually be pieces of DNA from my baby’s blood. Unfortunately, there’s no easy way to recognize which DNA is from me and which is from baby.

It is, however, possible to extract the DNA soup (including mine and baby’s) from my blood, and then make copies of certain portions of DNA from certain chromosomes. (For any biology types, they use quantitative PCR for this.) To detect Down syndrome, they make copies of a piece of DNA that only appears on chromosome 21, along with copies specific to several other chromosomes. Then they compare the amount of chromosome 21-specific copied DNA to the amount of other chromosome-specific copied DNA.

  • If the amounts are the same, it suggests that there weren’t ‘extra’ copies of chromosome 21 floating around to begin with, and that my baby probably does not have Down syndrome.
  • If there is an excess of chromosome 21-specific DNA, it suggests there were extra copies of chromosome 21 in our combined blood. Since we are pretty sure I don’t have Down syndrome, the most likely explanation is that my baby does.

This test catches a higher percentage of Down syndrome cases than the California screen (99% versus 90-95% for the combined CA screen), and has a much lower false-positive rate. (The detection rate is a bit lower for some of the other chromosomal disorders, for reasons that I haven’t taken the time to investigate.) It doesn’t, however, give any information about neural tube defects (which the California screen does), and it still does not give a definitive yes or no answer. For that, one would have to do chorionic villus sampling (CVS) or amniocentesis, both of which actually look at the full set of chromosomes in baby’s cells.

 

What I did

So, if you’ve been reading this blog for long, you know that I’m a sucker for data, so perhaps it comes as little surprise that I requested both tests. I gave blood for part A of the California Prenatal Screening right after my first OB visit three weeks ago. No doubt my results are sitting on a computer somewhere, but they won’t release them until I’ve completed my nuchal translucency ultrasound (part B)…which I’ll do bright and early tomorrow morning.

Last Thursday, after my meeting with the genetic counselor, I gave a blood sample for the NIPT. I’m told the results of that test should come back to me within a week. (Oh, and did I mention, the NIPT will also tell us baby’s gender?!)

Given that the NIPT is so much more accurate than the California screen, one might argue (as the genetic counselor sort of did) that the NT ultrasound is a waste of time. For one thing, there’s a decent chance that the CA screen may indicate an abnormality, while the NIPT may come back normal. If that happens, it may indicate that baby has a chromosomal disorder but is in the very small percentage of cases that are missed by the NIPT. Or, it may mean that baby has no chromosomal disorder, but has an unrelated congenital heart defect (giving rise to the thicker-than-usual nuchal translucency). Or (most likely) it may mean that baby is fine and the CA screen gave a false positive.

The uncertainty could easily cause a lot of stress, which is why the genetic counselor was careful to make sure I didn’t choose it blindly. I’m probably being a bit naïve (or arrogant?), but I’d like to believe that I could think logically about the likelihood of each possibility and handle any ambiguity that might arise.

Also, I really want to see my baby in high resolution.

 

What if?

In all this talk about the science behind these screening tests, I’ve conveniently avoided the most important question that all this brings up.

Namely, what will we do if the screening tests (particularly the NIPT) show a chromosomal abnormality?

The short answer is, I don’t know.

After all that we’ve been through, it’s hard to imagine choosing to terminate this pregnancy under any circumstances. In particular, I don’t think I’d terminate if faced with any of the ‘mild’ abnormalities (Turner or Klinefelter Syndrome). I don’t even think I’d terminate in the case of Down syndrome. (The way I see it, this may be my only chance at genetic parenthood, and I’d rather be mom to a child with Down syndrome than to no child at all…)

The decision gets harder for the ‘severe’ chromosomal abnormalities – trisomy 13 or 18. Could I continue with all the emotional and physical pains of pregnancy and childbirth, knowing that my baby would in all likelihood not survive infancy?

On the other hand, could I choose to end a life – my baby’s life – even knowing that it wouldn’t live long anyway?

I just don’t know.

And then there’s the fact that this isn’t just my decision. This decision would affect C too, and we’d need to somehow arrive at a plan together.

It’s enough to make me think that the people who refuse to test are on to something. Perhaps mothers like me – who aren’t prepared to terminate yet do decide to test – are just betting on a negative test result so that we can enjoy rest of our pregnancies with one less thing to worry about…

Well, I’ve already placed my bet, so all I can do now is wait and hope that my big gamble pays off.

I’ll keep you posted.

My worst fear

Okay, so that’s probably an unnecessarily alarming way for an infertile pregnant woman to title a post. Rest assured, all is fine with the baby, as far as we know.  (Why do I always feel the need to add that qualifier?!) We had our first OB appointment last Tuesday. Aside from being super nervous, cranky, and cold, (Seriously, why would you keep an office in which your client is always naked at 60 freakin’ degrees?!)  the appointment was good. We heard the heartbeat (holy miracle moment!), saw actual toes, and as a bonus, we found out our obstetrician has a master’s degree in chemistry. 🙂

Since becoming spontaneously pregnant two weeks before my one-day-workup at CCRM, my “worst fear” (you know, aside from something awful happening to baby), is that people who hear my infertility story will try to use me as an example to support their bad advice. I just imagine well-meaning friends “comforting” their other infertile friend with the story of the girl-they-know who had abysmal AMH, who was counseled by three different doctors to consider donor eggs, and then spontaneously conceived once she “finally relaxed/stopped trying/[insert insensitive cliché here]”…

Last weekend, that fear came true.

I went to Palm Springs for my friend R’s bachelorette party extravaganza, and, as happens all too often with me, the subject of infertility & IVF came up. (It’s amazing to me how many infertiles come out of the woodwork whenever I open up about it!) One girl, who is currently struggling with secondary infertility, listened intently while I told our story. Then, as I finished, she declared triumphantly,

“I’ve heard so many stories like that. As soon as you relax and decide to leave things up to the experts, you get pregnant!”

Yes, because traveling across the country two days before the fall semester starts is so relaxing…

And what exactly what was I doing during the two IUI cycles, and IVF cycle? Apparently not “relaxing and leaving things up to the experts”…

In this situation, my post on infertility math came in handy, as I tried to explain why a natural conception after three failed ART cycles was evidence of nothing except that we had a helluva lot more months of trying ‘the old-fashioned way’ than anything else. (Believe me, I have the FertilityFriend chart – complete with BBT, EWCM, OPK and CBFM data – to prove that I was still trying damn hard!)

This challenge to the authenticity of my infertility made me want to whip out this little beauty:

Image

In her defense, I’m sure that the woman who said this desperately wants to believe that just relaxing might work. She’s been struggling for two years to get pregnant with her second child, and mentioned that her husband is opposed to both IUI and IVF (because they’re “not natural”).

I sincerely hope that putting her fertility in the (somewhat tied) hands of her reproductive endocrinologist is all it takes for her to have a spontaneous pregnancy!

But in the mean time, please DON’T use my story as evidence of anything other than that sometimes weird shit happens!

Lastly, as my contribution to the onslaught of cute Halloween costume pics, here are my two “babies” in their costumes:

Image

Graduated, and a touch neurotic

Sorry it’s been so long. Once again I want to reassure you all that I have been reading your blogs…on my iPhone (which is my lame excuse for not commenting). I’ve also been keeping you all in my thoughts and nightly prayers. On nights when I’m totally exhausted, the prayer goes something like “God bless all my infertile bloggy friends and local Resolve group members”. When I’m a little less sleepy, I try to mention you each by screen name and by situation – stims/egg retrieval/transfer/TWW, etc. I know many of you aren’t religious, but given the lengths we all go to, I figure it can’t hurt!

So, two weeks ago, we had our third and final ultrasound with Dr. Y. The ultrasound looked great. Although we were at 7w5d by my count, baby measured 8w0d and we could see a nice big noggin, along with spinal cord, booty, and a limb (not sure if it was an arm or a leg at that point). I’d share the video, but C’s iPhone video technique has improved significantly, and in the later videos my full name and clinic location are crystal clear on the screen. (I’m not quite ready to dispense with the last semblance of anonymity here…)

After the ultrasound, Dr. Y gave me some instructions regarding the baby aspirin and progesterone suppositories (Yee haw! No more suspicious bruises or greasy cooch!)

Then Dr. Y put his arms out to the side…

In retrospect, I think it was a gesture of “well, I guess that’s it!”, but at the time, I was convinced he was reaching out for a bear hug, and – without thinking – I went for it.

Which was weird, given that my lady bits were covered by a thin paper sheet, which kind of raised up during the hug…

 Like Lentil, we brought cookies to say Thank You to Dr. Y and his staff (but waited to give them to him until after the ultrasound and awkward hug). And with that, we graduated from the RE’s office.

I kind of wish he had kept us for another week. Our first prenatal appointment was originally scheduled for October 22nd (hence the timing of our RE graduation). But during that last appointment, Dr. Y asked us which OB we had chosen, and when I told him that we had an appointment with one of the Kaiser nurse midwives, he hemmed and hawed and said “Well, that should be fine. Technically, you’re not high risk, so you don’t need to see an obstetrician…” Which of course led C to insist that we cancel our appointment with the midwife and make one with an OB. And that’s how our first appointment ended up scheduled for a week later, on October 29 (this coming Tuesday).

 So we haven’t seen our little prune in two weeks. I actually was fine with it, until my acupuncture appointment yesterday. My acupuncturist said my pulse was “fine” when I asked her, but then when I was leaving, she said, “Fingers crossed for your ultrasound!” And her assistant asked if I wanted to schedule my next acupuncture appointment then, or wait for the results of my ultrasound.

 Um. What does that mean?!

 So, naturally, I’ve been running through the list of pregnancy symptoms.

 Still here:

  • Unsettled tummy in the morning, and inability to eat a large meal in one sitting
  • Sore boobs
  • Tummy pooch
  • Constipation

Absent the last few days:

  • Exhaustion
  • Crazy acne
  • Waking up starving in the middle of the night to eat my night peanuts

 Image

Needless to say, the next four days can’t go fast enough.

Fortunately, I have a ridiculous pile of grading and course prep to keep me busy…

which I should probably get back to now…

Tired

Thank you all so much for your kind response to my news. I’m sorry it’s taken me so long to provide an update. Lest you think ‘No news is bad news’, I’ll spoil the punchline by telling you that all is well (as far as we know).

I hate to use a lame pregnancy excuse, but I am so tired that I can barely keep up with my work responsibilities, which is why working on a blog post has been out-of-the-question…

Suffice it to say that I am having some pregnancy symptoms:

  • Extreme exhaustion (coupled with difficulty sleeping…awesome!)
  • Moodiness (poor C has been dealing with some serious crankiness, punctuated by tearing up every morning during some story on the Today show…)
  • Acne (enormous, sore, pressurized zits…possibly worse than when I was a teenager)
  • Constipation (‘nuff said)
  • Unsettled stomach (I wouldn’t call it nausea per se, but more an uncomfortable feeling and general lack of enthusiasm for food)

As those of you who have miscarried can appreciate, I’m actually grateful for every symptom. (I had very few and very mild symptoms last time…) But nonetheless, it feels like all I do is work, sleep, and go to appointments (acupuncture or RE’s office)…

Here are some pictures to fill out this post:

ImagePhoto from the black-tie wedding in Chicago where we made a baby! (Well, an embryo anyway. Doesn’t C look handsome in a tux?)

ImageEating a Chicago Dog at Wrigley Field with my buddy R. (Meanwhile, my little embryo was on its way to becoming a blastocyst…)

Image“Umm. Wake up, C! Wanna hear something weird?!…”

ImageWhen my temperature didn’t drop by 10,11,12 dpo, I thought something was up. Then when it did drop at 15 dpo, I. FREAKED. OUT!

ImageBut I kept going in for blood tests, and my betas looked good…

ImageWhen I got to work the day of the ultrasound, I found these from my thoughtful colleague K! Notice the graduated cylinder ‘vase’.

ImagePrayed a lot to St. Gerard, and wore my lucky socks to the first ultrasound appointment. By my estimate, baby should be ~ 5 weeks 5 days old…

C and I were blown away to see this. “Baby Lou” (as my mom has taken to calling it in her nightly prayers) measured 5 weeks 6 days, with a steady heartbeat! (You can see the yolk sac ~6 seconds.)

This was HUGE news for us. Last time, we learned at our 8 week ultrasound that the baby was only measuring 5 weeks 5 days (no heartbeat). I miscarried naturally about a week later. That one extra day means that we’ve at least made it farther than last time.

And we’ve got a heartbeat.

We know that we are still so far from out of the woods, but we’ve decided to be hopeful. I even went out and bought another copy of The Belly Book to stick our ultrasound pics in.

And now, we wait.

Fortunately, a ‘perk’ of being an IF patient with Kaiser is that I get weekly ultrasounds until I ‘graduate’ to the OB (~9 weeks). So we’ll do it again on Friday (6w6d)…