Tuesday, August 18, 2009

Results of our 20 week ultrasound

I am so excited to report that our 20 week ultrasound went GREAT!

When we first arrived the sonographer told me that she'd do 30-45 mins of measurements where she'd just be taking notes, but at that point we could look around for vanity's sake. She gelled me up and we jumped right in. It was last Monday and the weather was quite warm, so my clothes were thin and sparse but the AC was blazing. It wouldn't have been so chilly in there except that I had consumed 20 oz of ice cold water to fill my bladder just prior to the appointment (I don't believe in drinking an hour before hand - no pain for me, thank you!) ... so I was stretched out on the table, in summer clothes, with cold gel slathered all over me, AC blasting right on me, with cold liquid running through my body ... and I was shivering! Though I'm not entirely sure it was just the elements, I was quite scared too.

I finally asked the sonographer if she wouldn't mind confirming a heartbeat for me and she looked surprised. I told her this was our fifth pregnancy, but our first live child (that's how I answer people now-a-days when they ask me if this is my first) so she quickly confirmed the heartbeat and asked if I could feel the baby kicking on a regular basis. As you know, I can, but there's still a part of me that gets scared that somehow the baby might have died between the last kick and when the ultrasound wand was placed on my tummy :-(

As she took her million measurements she kept placing the wand quite high on my stomach, I finally asked her "is there uterus and baby up that high?" ... she told me that my uterus ended 1 1/2 inches above my belly button and I was SHOCKED! I had heard that at 20 weeks it should be AT your belly button ... but I guess the location of a belly button ... is relative ;-) While she glided the wand over my tummy I broke out in only a few chuckles - heck, I'm ticklish! Then she had me turn on my side and I'm not kidding you - my uterus is all the way on my SIDE! When I shared my surprised the sonographer laughed and said, "well what do you think is filling up this stomach of yours?" ... so I guess it's the uterus and the baby! While I was "quietly" waiting for her to complete her measurements I mentioned: "I know you're not supposed to give me the results, but can you just tell me if you will be looking into my cervical length, amniotic fluid level, number of umbilical cord arteries, and placental location?" ... she looked at me in shock again and asked how far along my previous losses were - she was concerned I had reason to worry about all of these things most pregnant women don't even know exist. I confirmed for her that they were all early first trimester losses - but you learn a lot of scary things the years you are waiting to successfully conceive. She let me know that she'd be taking down all that information. I was relieved. I guess I was so relieved that I relaxed a bit and fell asleep! That was nice.

When we were done taking the required medical measurements, I asked to go to the restroom and upon return we would look at the fun stuff!

The baby cooperated the entire time! The sonographer said that she got a clear shot of the goods and just when you'd think that we'd ask her if she saw the pork and the beans ... we told her that we aren't finding out gender until the delivery day! However, we did ask her to write the gender down for us, in a sealed envelope, so that we'd have it in case something were to come up before the baby is due. It's morbid, I know, but I think about a family member lying on their death bed, at least we'd be able to share the gender and the baby's name with them before they go ... I guess I've always been a planner. And you'd think, with the information in an envelope, right inside our house (!!) (no, I won't tell it's location!) that we'd be tempted to rip it open and find out ... but we are excited that we'll have EXTRA motivation for delivery day. Right now, the only people that know what gender our baby is are: the sonographer, the paper greeting card, and the good Lord Himself! (but it was never a surprise to Him! ;-)

Regardless of that anti-climactic decision ... we still got our chance to poke around and see the baby's head, heart, stomach, face ... you name it! Some of the cooler things were: watching the baby gulp and swallow! (the sonographer said that that shows great lung development - exactly what you want to see at this stage!) and we saw five fingers on each hand! We tried to look for five toes on each foot, but when she went down to get a picture of the cute little feetsies, the baby wouldn't stop kicking!! It was ... too cute. Flicker is just as stubborn as her mother ;-)

Without further adieu (for those of you still faithfully reading) the actual test results:

Cervical length: 5 cm with NO funneling ... WOO HOOO!!!
Placental location: Fundal ... YIPPEE!!!
Umbilical artery count: Three! .... PEFECT!!!
Amniotic fluid level: "grossly normal" ... DOES IT GET ANY BETTER???

And the pregnancy is at 20 weeks and 3 days, with the baby measuring 21 weeks! The OB has yet to modify the due date ... so we'll hang off on changing that. The baby was measuring big on all fronts: femur, cranial, abdominal, etc. One measurement even came out at nearly 23 weeks! Hmmmm ... Berilac is 6'3'' and I weighed 9 1/2 lbs at birth ... should I start to worry yet about having a large baby? ... I'm actually quite enjoying our good news ... so I won't worry ... just yet.

And lastly, here's an adorable picture of our 6 1/2 inch Flicker:

We are praising the Lord for this healthy baby!

Tuesday, August 11, 2009

CCRM Regroup: Dumbfounded

If you remember from a previous post, I dreamt that I couldn't dial my husband's cell phone number while I had Dr. Schoolcraft holding on the other line. That today, was not my problem.

In preparation for the call, I wrote out a ton of questions to pose to Dr. Schoolcraft and prior to the call reviewed them with Berilac:
  1. We transferred 3 embryos, what was the quality/grade of the remaining 7?
  2. What was the quality/grading of the remaining 7 on day 5/6?
  3. What was the overall quality of our eggs/embryos (anything look off/odd/weird)?
  4. The previous diagnosis you gave us was "egg quality," after completing a cycle with us, is it the same?
  5. This was my first fresh cycle, and it was successful, are we really a "tough case"?
  6. Yes we have a child that has made it this far into pregnancy, but some RE's don't consider that a successful cycle, was this a successful stimulation and cycle to you?
  7. What would you change about our protocol?
  8. My mom had early menopause at age 36, we don't feel like we should wait to TTC#2, how soon after giving birth can we take CD3 blood work to see where my AMH and FSH are at?
  9. How soon after birth can we cycle? How do we take breastfeeding weaning into consideration for the timing?
  10. How soon after a miscarriage can we cycle?
I felt very prepared. I felt like I was getting the entire rest of the story from our April cycle.

Then the call came, and like I said, I nervously dialed Berilac. I successfully got both men on the line and thanked Schooly for his involvement in our successful cycle, but that, before we forget, we wanted to know how he thought the cycle went down.

So I started with my first question:
  1. We transferred 3 embryos, what was the quality/grade of the remaining 7?

And I was SHOCKED at the result:

  • 1. 8-cell, grade 4 (transferred)
  • 2. 8-cell, grade 3 (transferred)
  • 3. 6-cell, grade 3+ (transferred)
  • 4. 5-cell ... poor fragmentation
  • 5. 2-cell
  • 6. 4-cell
  • 7. 4-cell
  • 8. 2-cell
  • 9. 4-cell
  • 10. 2-cell

I am shocked because the remaining 7 embryos ... were such bad quality, they weren't even graded on quality ... they were developmentally too far behind to get a grading (or he didn't tell us what they were) ... he did mention that the 5-cell had a lot of fragmentation :-( ... with each cell count he told us about I felt the breath go out of my chest. The feeling reminded me of infertility's heart ache and isolation.

At that point, a couple of my other questions went out the window ... did I need to ask what our overall embryo quality was at this point? No. Was this considered a successful cycle? I'd surely say No. So I modified the questions a bit, and below, I'll provide his answers:

2. What was the quality/grading of the remaining 7 on day 5/6?

None of the 7 remaining embryos made it to day 5 or day 6 - they ALL arrested prior to day 5, which is what he would have expected on day 3 ... hence the day 3 transfer. Ouch.

3. What was the overall quality of our eggs? (anything look off/odd/weird)? I didn't ask about the embryo quality b/c I thought that was obvious.

He indicated that look of the egg - graininess or darkness, really doesn't tell much about quality, he's had some weird looking eggs make beautiful embryos and vice versa.

4. The previous diagnosis you gave us was "egg quality issues," after completing a cycle with us, is our diagnosis the same?

Yes, he'd agree that it's the same, but we can't lose sight of the Sperm DNA fragmentation issues. But he believes that the overall problem is with the eggs. He would generically classify us as having an "egg issue."

5. This was my first fresh cycle, and it was successful, are we really a "tough case"?

I reminded him that this was my first real fresh cycle, so were we really "tough" enough to require cycling at CCRM? ... Basically I was asking him if I could cycle locally next time. I truly wondered if I brought out too big of guns by using CCRM and their lab and he said we are a tough case (even in his experience) and we are very fortunate that the cycle was successful.

I think this is where I was really shocked. After 4 miscarriages ... I could (even then) still tell myself that perhaps those 4 miscarriages were flukes ... and perhaps the monkey clinic in Sacramento caused the problems from the first two retrievals and the CGH vitrified oocytes transfer back in January ... but the results of the remaining 7 embryos and Schooly's affirmation that we ARE a tough case really threw me in a tailspin. I guess I was hopeful that somehow we'd been living in a nightmare these past 3 years and that we'd learn today that it was all just a bad dream ... but no, we really DO have fertility problems. I know, I know, many of you are like DUH POLLY ... but I've had ladies who have said to me, they just think I've been unlucky and that really I'm a better case than we think (because we've gotten pregnant so many times on our own) ... but really, this paints a picture of poor fertility - no matter how you dice it. Given that there is a baby in my belly, I really was optimistic that things would look different. This was just so unexpected.

6. Yes we have a child that has made it this far into pregnancy, but some RE's don't consider that a successful cycle, was this a successful stimulation and cycle to you?

I didn't even bother with this question ... for obvious reasons.

7. What would you change about our protocol?

Dr. Schoolcraft said that since I got about 5 eggs from each of my previous retrievals, and was able to generate 14 eggs with CCRM's EPP/Antagonist protocol ... he didn't think there was anything he would change about that.

8. My mom stopped having menses at age 36, we don't feel like we should wait to TTC#2, how soon after giving birth can we take CD3 blood work to see where my AMH and FSH are at?

He indicated that six months after birth is when the mom's hormones get back to normal.

9. How soon after birth can we cycle? How do we take breastfeeding weaning into consideration for the timing?

He indicated that six months would be the earliest time to cycle again and that we'd want to wean from breastfeeding at four months and then take two months off before starting a cycle at the six month point.

10. How soon after a miscarriage can we cycle?

I told him that we'd been considering possibly trying naturally one time before considering treatments again to TTC#2 and I indicated that there is a high likelihood that it will be another miscarriage, I asked him how long we'd have to wait after a miscarriage to cycle again, and the answer is two months.

So there you have it. All the details from the call. Where does this leave me? Incredibly grateful for the 'one little engine that could' in my belly. Grateful that I waited until after the first trimester, the genetic screening ultrasound and blood work, and after the 20 week level II ultrasound ... before hearing this news.

You are probably wondering if we're really considering treatments for #2 when we're only 1/2 way pregnant with #1 ... and the answer is yes. We're not getting serious about anything, but we do want to know our options.

I'm glad we had the call. I'm just not happy to hear the results.

Friday, August 7, 2009

HALF WAY ... ah, the belly

I can't believe we are half way through our pregnancy. I would say half way to baby, but this dream of ours started over three years ago ... so we're getting close, much closer than we were, that's for sure.

I remember before our first pregnancy three years ago, Berilac and I were playing a board game with my in laws and a question was posed "what is your worst feature," it wasn't my question, but I knew immediately what my answer would be: my stomach. I've got a life long best friend whose tummy is flat as a board and I always wished mine were like that, it's not large by any means, but it's got an 'extra layer' let's say. I remember thinking about my answer to that game question days later when I learned that I was pregnant ... and how ironic it was that I was grumbling about a stomach that, at the time, had a teeny tiny baby developing inside - how could I not appreciate that stomach?!

Fast forward to this past March/April. My weight was a tad high with all of the medications and lack of being able to exercise, my stomach was used like a pin cushion as I plunged (for the third cycle) endless needles into my "extra layer" on my tummy. At this point, I was VERY grateful that I could pinch an inch there!

Once we learned that we were pregnant, I started sleepwalking through the pregnancy. Just living in a state of denial as each day passed ... grateful, but still detached, about our pregnancy status. At nearly 10 weeks pregnant my belly couldn't take it anymore; but this time, the difficulty was in the form of food aversions - I was having food aversions like nobodies business. I would go from desiring a certain type of food, then taking the time to prepare it, and by the time the plate was sitting in front of me - I couldn't stomach it anymore. I was scared that I wasn't able to eat enough to provide sustenance for the baby, (though I know that's not true! I was being irrational ok?)

Near the 14th or 15th week, I started to need to support my belly as I rolled over in bed. I thought for sure I was exaggerating needing to prop up my belly with a pillow as I laid on my side, but each night I had to continue to prop, and each week it got worse.

In my 16th week I started to feel what I liken to gas movement inside my belly. I am so aware of my body that I noticed this when it was just slightly present. I'd feel some "gas" processing, really down low in my abdomen and wait to fart ... the fart never came. But when this kept happening, and people started asking me if I'd started to feel the baby move I said "I'll let you know in two weeks" ... as I thought, if this feeling maintains - then I'll really know that it's baby! Well, it kept recurring and I was grateful to feel baby kicks so early.

As you saw in a previous post, my belly was nearly un-hideable at 16 1/2 weeks. It was at about that time that my stomach felt like it was bursting to pop. I swear, I'm not sure how many times I asked doctors/specialists/BTDT moms/etc if popping was a potential scenario! I wasn't afraid of popping at 16/17/18 weeks ... I was worried that my belly wouldn't stretch far enough to make it to the end of pregnancy! I was told by a doula at 17 weeks that my stomach hadn't "popped" yet (meaning that the uterus hadn't fallen forward yet) but when it did, I'd be more comfortable and have more room for food.

Well, I'm not sure if I've popped yet (by definition of my uterus "falling" forward) but my belly has definitely grown since you've seen it last. At last week's appointment my OB told me that my stomach is large and will continue to get very large given my body type (short torso). I have been measuring my waist ... you know like, 36-24-36 OW!!! and my waist is now up to par with Berilac's. Yes, the man who is almost one foot taller than me and double my weight. I have gained 10 inches around my mid section and I'm only half way!!! I am large and in charge baby!

So I will leave you now with the belly that I am so proud of!

Thank you God for the incredible stomach you have given me and the fact that it's been able to protect and take care of our little one these past 20 weeks.

Thursday, August 6, 2009

Obsessed with CCRM

I regularly get emails from women who are curious about our take on CCRM and whether or not they should consider using them. And everytime, I can tell you for certain, that I sing the praises of CCRM ... and not just because they knocked me up good and strong on the first shot. No, I recommend CCRM because of the research that they do, their cutting edge technology, their staff, and their professionalism. If I had to guess I would bet many fellow CCRM infertiles (those that were successful and those that heartbreakingly weren't) would agree with me. After working with three other previous clinics and RE's ... it was easy to see just how superior CCRM really is. One of my favorite things to relay is that I feel like my CCRM IVF nurse knew more than most of my previous doctors!

During this successful pregnancy, since many folks in real life have known about our struggles, reasonably, they ask if it was a treatment cycle that worked ... and I'm grateful to be able to tell them that we were fortunate enough to be able to cycle at the best clinic in the country.

There's one more reason CCRM has been on my mind lately ... I remember when we were going back and forth with Schoolie as to whether or not doing a fresh cycle or doing a PBB CGH frozen FET would be our best bet and he said "Sure, we can get you pregnant on a fresh cycle, but I'm pretty sure you'll just miscarry again" ... well, we prayed about it and felt like trying the fresh cycle was the way to go. When Schoolie said those words to me I thought 'man, I hope we can prove you wrong!'

On 3 days past transfer, when we got the call that 'today will be the transfer day' I asked many a question about embryo quality, but my questions went unanswered. I have to think that things weren't going as well as they'd like (hence the day 3 transfer) and so in an effort to keep me optimistic they didn't share the information. Looking back, I'm grateful for that too! You see, I waited to schedule this regroup with Schoolie until AFTER the making it out of the first trimester, until AFTER getting good genetic screening results, until AFTER the big 20 week ultrasound ... so that I could feel confident about this pregnancy and not get discouraged if he were to tell me that my embryo quality was crap ... I think that if he said that, it might make me insecure about the health of the baby growing inside of me. And so we've waited.

So now, here we sit, 5 days away from our regroup call with Dr. Schoolcraft and our opportunity to say 'told you so!' (not really ;-)). Actually, I am hoping to find out what happened with our other 8 embryos, what stage/quality they were at on our day of transfer and how they developed up to day 5 and/or day 6. I'm wondering what he thought of our egg quality and embryo quality. I'm wondering if he'd change our diagnosis after seeing us through an entire cycle. I'm wondering what he would suggest for us in a future cycle ... or would he recommend we not 'fix what ain't broken'. Really, the data is a 'nice to know' but my heart lies in finding out what happened to our little embryos that didn't make it ... even being in the middle of a successful pregnancy, my heart breaks for what we lost.

Two nights ago I guess I couldn't get Schoolie off the brain. I had a nightmare about our call. It just had to do with having him on the line and then my 45 minutes of unsuccessful attempts to conference call Berilac into the conversation. It was less about being unable to correctly dial my husband's number (for 45 minutes ... according to my phone display in my dream) and more about feeling stressed that the doctors are superior and I can't even dial a phone ... I think this concern stems from just wondering if they discarded our embryos because maybe they didn't meet their "standard" ... when I would have frozen everything. Although I know that only 25% of couples make anything to freeze on a given cycle, it was heartbreaking to land in the 75%. And I guess, if the dream tells anything, I feel out of control about that.

I'm hoping and praying that Tuesday's call will bring me some peace about how the cycle actually went down.


On another note, yesterday, for the first time ... I felt the baby kicking my bladder! One second I don't have to go pee, then the next, I was shocked that I did ... then the pressure went away ... it was AWESOME!

Monday, August 3, 2009


Our second trimester blood work came back and our risk for Down's, Trisomy 18, and Neural Tube Defect have been identified:

Down's: 1:34,000
T18: 1:100,000
NTD: Negative

We drew another sigh of relief at last Friday's 19 week appointment. We are feeling so incredibly grateful to be able to sit here, nearly half way through our pregnancy, still pregnant, with a healthy baby.

To be honest with you: I didn't know pregnancy could ever result in a healthy live baby for me. I remember after our third miscarriage when I would come in contact with newborns, I would smell them, I would look at them closely - examining their elbows, their eyelashes, their blinking eyes ... and I would gaze in awe. How in the world could God use pregnancy to create a human being that actually survived. With so many losses, to me ... pregnancy = abnormal baby = miscarriage. Many times, I would grab my own arm and think to myself ... if I made it through gestation and birth then surely I can have a baby that can?

Now, there are no promises that our blood work guarantees a healthy baby - but things are looking awfully good.

In other news, at the appointment, I've learned that in 19 weeks I've gained 5 pounds and blood pressure and urine litmus look good.

One week from today ... we are highly anticipating our big 20 week ultrasound!!!