If I Were Having Identical Twins

They'd be DupliKate and BiforKate!

And I am having twins because we saw the heartbeats. Both of them.

But they're fraternal.

One Heir, One Spare

Yes, that's right. Twins.

So, the 5 week ultrasound looked good. Two little bean like things. I'll have HCG & Progesterone numbers later today, but the Reproductive Endocrinologist thinks it's looking good.

UPDATED:

HCG -- 4,984
Progesterone 40+

WackJob...

So, I've been obsessing.

As you may recall, I've done this twice before, both times we miscarried.

The first miscarriage we went in for the 6 week ultrasound at week 7 (Christmas was the week before and we were in D.C. for the holiday) and discovered that there was no heartbeat and that the fetus had likely died at about 5.5 weeks given the size.

The second miscarriage we went into our six week ultrasound and saw a heartbeat. At the time I thought that the doctor doing the ultrasound was not as positive as I would have thought and I felt like something was up. When we did a seven week ultrasound the fetus had only grown another millimeter and we were told that even though there was a heartbeat and a fetal pole, the fetus would likely die. By the eighth week it was dead.

But I have always been sure that the doctor knew at six weeks that there was something wrong and didn't tell me. As it turns out, I was right.

I have a five week ultrasound scheduled for Thursday. Knowing that, and knowing what I wouldn't see (heartbeat, fetal pole, etc.) I was curious to know what I would see. So I went to the all powerful, all knowing Internets. Where I found this article on five week ultrasounds.

And here is the passage I found interesting.

in the fifth week of gestation: a circular chorionic sac, typically 5-8 mm wide.

When I had the second pregnancy, the one which allowed us to see the heartbeat the chrionic sac was 4.3MM wide at six weeks. He did know something was wrong and he didn't tell me.

Having read this I am now totally paranoid that the fetus inside of me will be tiny. That we won't be able to see it. That there is something terribly, terribly wrong.

I was really happy when they told me to no longer come in for HCG tests because I was doing so well, but now I have this awful feeling that things aren't rising properly. I don't feel particularly pregnant (as opposed to the last two times). I'm a little more fatigued, but not to the extent I was. There's the hunger issue, but I'm not peeing as much as I did the first two times.

And I know I have to calm the fuck down. But I am not sure I can.

What The Heck Am I Putting In My Body?

Breakfast -- Toast with butter, 2 slices (7:30am)
Early lunch -- Leftover Mac n' Cheese (11:30pm)
Snack -- can of stringbeans (3:00pm)
Another snack -- Cookies, six of them (3:30pm)

UPDATED:
Dinner is going to be really late so Chris made me a snack:
Pre-dinner snack -- Nan bread with swiss cheese and procuitto melted on top (1/2, Chris ate the other half) (6:30pm)
Dinner -- Pulled pork sandwich on a kaiser roll with cole slaw and a pickle (9:30pm)

So Hungry

I normally eat two meals a day.

I skip breakfast because I'm never hungry for breakfast.

I have an early lunch.

I eat a late dinner.

I'm chubby because I eat more than I need.

In the past two weeks I have been eating the most rediculous amount of food. I had toast this morning at 9am. If I had done that two weeks ago I wouldn't start feeling hungry again until about 3 or 4 in the afternoon.

Today I'm so hungry I am about to gnaw off my own arm.

Should I get the spicy chicken sandwich downstairs or the burger down the block?

St. Valentine's Day WTF

I had to get my levels tested again today. For reference:

Pregnancy One: First bHCG -- 65, Second bHCG -- 118, Third bHCG -- 176.
Pregnancy Two: First bHCG -- 63.6, Second bHCG -- 190 (four days later -- so it was the equivalent of the Third bHCG in pregnancy one).

Pregnancy Three: First bHCG -- slightly under 200, Second bHCG -- 460.

They've told me not to bother coming in until next Thursday when they're going to do an ultrasound in order to determine what the hell I've got in there.

Officially Official

I have a bHCG level of slightly under 200. Previous bHCG levels at this point were 65 and 63.

I'm really really pregnant.

More info to follow as it comes in.

POAS -- I Did It For Angela

So I peed on a stick this morning -- a home pregnancy test. I generally do one the day before the real test anyway, just to see. It lets me go into the actual test with some semblance of knowing what the result will be.

I wasn't planning on doing it this time. Kind of didn't want to bother. But Angela is off to India today and so she could quite possibily have no way to find out what the status of stuff was for a week or more, so I figured I'd do one this morning. I got the cheapest test I could find. I woke up at 4:45 this morning and went to the bathroom, opened the test and peed.

Not even a question. Positive. Normally you need to wait up to 2 minutes for results. My results were up in 10 seconds. Sometimes the line is very faint. Not so in this case, the line was there and clear and unmistakeable.

Now if I can just get through the next 9 weeks more without miscarrying, I'll be pretty happy.

My Regularly Scheduled Freak Out.

My this time I should have some pretty definitive symptoms but I feel like I don't. My mother has pointed out that all the little symptoms, taken together, could easily be signs of pregnancy, but I feel like they're not.

I have been sleeping more than usual and going to bed earlier than usual (11 hours on Saturday night, 9 hours last night...and only because I had to get up for work) but that could just because I have had less sleep than usual (due to bad dreams and surgical pain) and I could be wrong, it's just me playing catch-up.

My boobs were sore, because of the hormones I am taking, but they're getting less sore. Last time I was pregnant, they got more sore. I don't know what to think about that.

I am peeing more, but I am drinking more water. I have not been waking up in the middle of the night to pee. On the other hand Chris woke me up and 11:30pm so I peed then and then I woke me up and about6:50 needing to pee, and then I didn't because I knew the Dog would jump on me in 30 minutes and I wanted another 1/2 hour of sleep.

I'm hungry more. But is it just because I totally quit smoking and cigarettes are an appetite suppressant? Sometimes I just get a normal appetite. Could that be it?

I am getting headaches, which I never used to get before, but that could just be dehydrated/tired.

Also, could just be stress.

Who the hell knows.

Awful Statistics*

*I don't mean the statistics themselves are awful, I mean that statistics, in a general sense, is awful.

So I wanted to figure out what the chance was that I would get pregnant with the current round of IVF. I haven't taken a probability/statistics course in 20 years and I didn't pay much attention when I did. So I sent out the following question to some of my more mathematically minded friends.

A has a 58% chance of happening.
B has a 58% chance of happening.
(Two of my blastocysts were 4BB grade or better meaning that, in general, they had a 58% implantation rate)
C has a 33% chance of happening.
D has a 33% chance of happening.
(The other two blastocysts had not developed far enough to grade. Therefore I am assuming, for the sake of the stats, that they are low-grade).

None have any relation to each other.

Given the above:
1) What is the likelihood that at least one of those things will happen?
2) What is the likelihood that at least two of those things will happen?
3) What is the likelihood that at least three of those things will happen?
4) What is the likelihood that all of those things will happen?

The answers are:

1) What is the likelihood that at least one of those things will happen? 92%
2) What is the likelihood that at least two of those things will happen? 62.5%
3) What is the likelihood that at least three of those things will happen? 23%
4) What is the likelihood that all of those things will happen? 3.7%

I like those numbers. Is it Thursday yet?

Progesterone Level Check

It's at 21, which is, apparently, good.

One week until test time.

Feeling Positive

The new reproductive endocrinologist has a much shorter time between when you get you're eggs put in you and when you get your pregnancy test. I don't know why. At Columbia it was 14 days from implantation of a day three embryo, 12 days from implantation with a day 5 embryo. At RMA (where I am going now) it's 10 days from the day 5 embryo.

They also want me to come in for "morning monitoring" to make sure my progesterone levels are okay tomorrow. So I have to schlep into the office and get blood drawn before work. But it also means that tomorrow should be when I have my week-before freak-out...or not.

But I'm feeling so generally positive, so much like something must have taken, that I probably won't have it. We implanted four day-5 blastocysts. Each of which as a 50/50 chance of implanting. That means there is a 1/16 chance of me NOT getting pregnant. I like those odds.

On the other hand, next week I'll probably be freaking out and crying.

Four In...

They did the transfer today. Four blastocyst went in. We still have two in a petri dish. Well see if they're good enough to freeze in the next day or so. No real news until 2/12 but I'll keep you updated on symptoms or lack thereof.

Bad Dreams

I sleep like a log. On normal occasions I go to bed at about 11:30pm and wake up at about 7:30am. I don't wake up to go to the bathroom. I don't remember my dreams. I don't even recall waking up to turn over. I have been known to fall asleep in one position and wake up 8 hours later in the same position. Chris has had conversations with me when I was actually asleep. The dog has learned not to even bother jumping on me for a walk in the morning until the second snooze-alarm goes off. I am a very, very sound sleeper.

Except during IVF time.

Even before I get implanted I start having trouble sleeping. Part of this is because the egg retrieval process is a somewhat painful one and, therefore when my bladder gets full it presses against my ovaries and they hurt and I wake up. So I've been waking up to go to the bathroom one or two times a night which is unusual for me and then I have trouble falling back to sleep.

I also start having very vivid dreams and I start waking up at odd times for no reason. I woke up at 5:30am today and finally got up at 6:15 because, hell, why not, I was awake. This was after several bad dreams (not nightmares exactly, just bad dreams). One involved someone from the clinic calling me and informing me that while I had 7 great blastocysts ready for a day 5 transfer they found something in my blood which meant that they were just going to throw the eggs out because they would never implant. I tried to argue with them to freeze the eggs so I could get a surrogate but it was difficult because I was on a cell phone in a Turkish fabric market talking to a very important guy who I though could get me a really awesome job. The guy was my height and wore horn-rim glasses.

Dream number 2 I only remember that the doctor called me and told me that none of the eggs had made it to day 5 and the doctor told me that this is what I get for listening to him instead of going with my gut.

Two days ago I had a dream where the doctor invited me into the inner workings of the clinic which included a vast escalator that led to the huge billing department and then we took a walk through the fairgrounds. Yes, fairgrounds. There was a tent, and carnival like rides and there was a huge, grossly obese man who was suspended from the top of the carnival tent by his nipples swinging in the breeze. The Doctor told me that he paid them a lot of money to be allowed to do that.

I don't do dream analysis, partly because I don't have enough dreams that I remember to make it worth my while and partly because I think it's dumb. But I just thought I'd share.

I Hate This Time...

I really do hate the period of time between the retrieval of the eggs and the transfer of the embryos back into my cooter. Most women hate the 2WW as it is referred to in the infertility world...the two week wait in other words. But I view that 2WW is part of a longer wait, as someone who has had 2 miscarriages it's part of the longer nine month wait, which will be coupled with the interminable wait until the baby smiles, makes eye-contact, giggles, sits-up, stands, crawls, walks, talks, reads, makes jokes, dates, goes to college, etc. I dislike this 3-5 day period where some combination of my genetic materials and Chris' genetic materials are sitting in a dish somewhere across town slowly percolating...with some (in many cases most) not making it out the other end.

Now I've done better on this cycle, by some significant milestones, than I have on other cycles, so I'm hopeful. But the last time I had a little petrie dish full of happy little embryos floating about there were 9 of them on day 3 that looked awesome and by day 5 there was one. And it was pretty shitty.

Now this doctor seems to think that his lab is AWESOME and there won't be such a steep decline, but I wonder whether the lab is truly the bestest place in the universe(TM) or whether this is a case of a father thinking his children are the prettiest.

But I digress.

I don't mind as much once the embryo(s) are in me. I have some control. Nothing's going to happen if the wrong person sneezes on a dish or something. And, truth be told, I can tell whether it's working pretty early. Once they're in it takes less than a week for me to know whether I'm pregnant (starting with the crying jag that I am not pregnant, generally the day before I start eating my body weight in Cheetos, my breasts grow to the size of small nation-states, and I start falling asleep in mid-sentence. This past spring I fell asleep on the dog. She was not amused) or not (see the entry from November 8).

We'll find out how many survived the death-march to becoming a blastocyst tomorrow.

IVF Time #4 (last covered by insurance)

Chris and I have been doing another IVF trial. This is the last one covered by insurance. I feel like I've aged a decade in the year and a half we've been doing this. I've certainly gained weight. The recovery time, every time, has been longer.

We switched doctors this round. The clinic has a better reputation, better stats (and is much more expensive). The clinic itself I don't actually like. The location isn't as good. With the exception of my doctor and a couple other doctors I find the physicians quite rude and impersonal. There seems to be this sort of arbitrary 'well, we do it this way' mentality you, as a patient, has to constantly fight against. If I end up going for a fifth round, unless this guy can convince me he's worth it, I'm tempted to go back to the old clinic.

Right now, they've taken the eggs out of me and they're currently in a petrie dish turning into blastocysts. The first couple times we did this I was awed by the idea that genetic material that was a mix of both Chris and myself was in a little dish across town. I am no longer excited or awed by the process.

We'll find out today whether we implant them today, on "day 3" when the embryos are little 8 celled things, having not yet turned into blastocysts, or whether we'll wait until day 5 when they are hundreds of cells (8 celled embryos have about a 1/3 chance of sticking. Blastocysts have about at 50/50 chance). And I'll keep you updated on that. Figure I'll know around February 16 or so whether I'm preggers or not. I can probably do a home pregnancy test on Valentine's day.

But that's not why I'm actually writing right now.

The real reason I don't like this clinic is what happened to me when they removed my eggs. It's a much more elegant clinic, as I've said. At the old clinic the system was like this:

They called you to the back (and Chris goes somewhere separate to provide a "sample").
You changed
You waiting on a little chair until they were ready to take out your eggs. (the longest I ever waited was 5 minutes because why would they have called you back if they weren't close to ready).
You went in to the room.
They talked to you for a minute...how ya doin', confirm your name and social security number.
The anesthesiologist introduced himself, confirmed you were who you said you were.
The nurse talked to you a little
The doctor said "hi"
The embryologist opened up his little window, said who he was, confirmed you were who you said you were
then the anesthesiologist says, "I'm putting in the medication now"
You were out.
They took the eggs out, got you into recovery, and that was that.

Not so at the new place.
They took me in the back and had me get changed.
Then I was brought to an exam room where they had me sit around with Chris for a while. They took my blood pressure and asked me my weight twice (once the nurse did and then the anesthesiologist did).
They took Chris away to provide the "sample"
And I waited.
And waited.
And waited.
To give you an idea how long, we were asked to be at the clinic at 8:30 in the morning. We got there at 8:20. I was asked to change at about 8:35. I did not go into the surgical room until 9:57.
After about 30 minutes a nurse kept coming by telling me it would just be five minutes more. She told me this four times.
By the fourth time I told her I didn't believe her. She got indignant. "well, I just checked and they really are just leaving now..."

I suspect that's why I got to the procedure room when I did. I think the nurse was so offended with my response to her "just 5 more minutes"ing that she put me in the room before they were in any way ready for me. Which now sucked even harder.

So off I went to the procedure room where I was ushered in by the anesthesiologist. Two women and a man were huddled around a computer. They did not acknowledge my presence.

The anesthesiologist asked me to hop on the table (at the old clinic, the table moved up and down. I have no idea whether this table moved up and down, but if it did they didn't want to bother with it). that was at 9:57. The anesthesiologist put an IV into my hand.

The anesthesiologist started talking to the guy about his...very pregnant wife. (Although it didn't actually bother me, I found it, given the circumstance, to be somewhat insensitive). The nurses started to chat amongst themselves. I lay there, and IV going into the vein in my hand, unable to move for the next 8 minutes. I know this because there was a clock on the wall.

One of the nurses came up to me and told me they weren't ignoring me, that the embryologist was still working on the previous case. I told her that was fine, but that they were ignoring me. She seemed surprised and said they were not. I said that clearly they were. She and her nurse buddy hadn't introduced themselves and were having a private conversation as if I wasn't in the room. The guy (who turned out to be the doctor, whom I had met once, extremely briefly), who had left the room, hadn't introduced himself and had been having a private conversation with the anesthesiologist without introducing himself to me. That seemed like ignoring to me, what was her definition of ignoring?

She apologized. The anesthesiologist ran out to get the doctor (realizing I was right). Then she started to make small talk. The doctor came in and introduced himself, apologizing half-heartedly that he hadn't introduced himself when I was taken into the room, and informed me that we had met that Saturday when he did my ultrasound. I told him we hadn't actually met then either, since he raced into the room, did the ultrasound, told me everything looked fine and then tried to leave the room quickly. When I had asked him for information about where I was he got indignant and told me almost no information before leaving as quickly as possible. He never introduced himself and never made any effort to look me in the eye.

Around the 20 minute mark I announced that I had been in the procedure room for 20 minutes. They seemed unhappy, I said I wanted to mark the time for posterity. About three minutes later the embryologist came in, asked my name, and the anesthesiologist, without warning, put the drugs into the IV bag. I looked at her and said, did you just give me the anesthesia? She said yes. I may have said "you could have warned me" but I may have just passed out.

At 11am I woke up in the recovery area, in quite a bit of pain and Chris at my side. They had taken 22 eggs (a record). They gave me some Fentenol (sp?), which is very nice stuff (Angela tells me it's the drug of choice for anesthesiologists) and I went home.

But it's three days later and I'm still pissed. Seriously, what the fuck?

of those 22 eggs, 14 fertilized (this is on par with previous fertilization's, #1 -- 12, #2 -- 13, #3 -- 12). I'll keep you updated.

UPDATE: Got the call from my doctor, of the 14 that fertilized, 12 are still going strong and more than half of those look very good. He wanted to wait for a day five transfer so we'll wait and transfer any embryos on Tuesday. I am very concerned about doing this since the last time I did this I had 9 good eggs on day 3 and by day 5 I had one crappy egg. He knows this and is willing to put his reputation on the line. We shall see.