A Few Follow Up Questions on the Previous Post

There were a few more questions that came up from yesterday's post. note: I am not a doctor, but I did do a lot of research when I was pregnant with the boys. What I am writing here is my take on what I found out...

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From what I understand, choroid plexus cysts are actually fluid filled pockets of space within the part of the brain, the choroid plexus, that makes cerebrospinal fluid for the brain. They usually appear in the second trimester (most people find them during their 18 week scans) and are often gone by the third trimester. These cysts are found on anywhere from 1-3% of all babies and do not affect the baby's brain's function or the baby's personality.

There is quite the debate over these cysts. For some time, these cysts were associated with a higher than average risk of Trisomy 18 (I think the highest I saw was an increased risk of 1:300, although that was from dated data). But, with no other abnormalities to indicate Trisomy 18, many doctors now believe that the risk of miscarriage from an amnio is higher than the risk of a genetic disease. Often, the only recourse needed is to do a thorough ultrasound to check all major organs, etc. and wait/watch. An amnio would come in to play if the detailed ultrasound showed some other abnormality.

I believe that Dr. Doom was under the old school belief that the risk was elevated for Trisomy 18. Then when he couldn't rule out the clubbed foot problem for one of the babies, and I was nearing the 35 age mark, he pushed the amnios.

Had Is.aac and I been the patients we are today (and more prone to research the hell out of EVERYTHING before we agree to a doctor's suggestion), we would have came home and likely not had the amnios done. Besides, by the time we went back for the next ultrasound, the cysts were gone, so the point would have been a non issue then anyway.

As for the guilt, I don't know why I continue to hold on to that. I guess it is my attempt to have a reason...a cause...something...anything to blame the whole clusterfuck that was that pregnancy. Yes, I know the doctor recommended the amnios. Yes, he did tell us the risks. Yes, he was the one in the know and we do have to trust the doctor's expertise to some extent. But, we ultimately made the decision to do it. I end up blaming myself because...at least there is a reason then.

Do I carry that guilt with me at a conscious level on a day to day basis? No.

Do I wish that everything went a completely different way and I had the voice to say no to that amnio that I wish I had? Yes.

Does the guilt still shows up on occasion to say hello? Yes.

I KNOW that I made the best decisions I could make at the time. I really do.

I KNOW I tried everything in my power to keep those boys in me as long as possible.

My heart still struggles there, though. Sigh.

I suppose it is a way to continue to punish myself for my heart's belief that my body failed.

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There hasn't been any conclusive reason to why my membranes ruptured. There are a couple of possibilities: 1) incompetent cervix in itself runs the risk of premature rupture, 2) the emergent cerclage also had the risk of premature rupture (infection was also a possibility, and we were all sick at the end. Don't know if the infection was there to begin with.), and 3) contractions that I didn't feel (I didn't really ever feel them even at the end before I delivered) that led to the rupture. Like I said, I had to have terb several times over that first day I was in the hospital for the rupture. Whether the rupture or the contractions came first is up in the air.

My OB was equally confused as to why Doom was saying to send me home. It makes me think all over again that he had really written that pregnancy off as unsaveable.

Sadly, I would have went home, too, had the OB not fought to keep me there. Thank goodness for him...he saved the boys with that call. I believe that with all of my heart.

This time, I will have the first course of steroids at 24 weeks as a precaution, with another series later in the pregnancy.

We're pulling out all the stops.

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I have a hard time with the memory of Doom's continued comments on whether the boys were genetically normal. I do think it directly affected how he dealt with my pregnancy the entire time. I strongly believe that he would not have "helped" us had one of the boys been genetically abnormal. Is.aac feels that way, too.

I don't get that feeling from him this time, though...his office hasn't even bothered to call me about the results from the screenings. I have to ask. It's almost like they don't even care what the results are now. (although I am sure that the results are there for them to check before we speak to anyone) It's strange. It doesn't make me trust him any more than I would have otherwise, though.

I feel he is one of those "fair weather friends" who is wonderful as long as all is going well. As soon as a complication starts to brew, I am sure he will be completely different. Sigh.

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Thank you for asking the questions. This really helps me clarify some things in my own mind, too.

The "punishing myself" part was an eye-opener...maybe just realizing that will help me combat those thoughts?

The Recap of the Boys' Pregnancy for Those Interested

or alternately titled "Why I Am So Damn Paranoid This Time Around..."

I had a question about my last pregnancy in the comments of my last post. I started to address the question there, but it turned out to be a lot longer than I expected! I figured it deserved a post all its own. (plus it gives me something to write about tonight) I hope when I write it all out, it will actually make sense.

Here is the comment from Roccie:

Hey Stacie. I want to ask you some questions that might be painful to relive. Can you help me understand what the challenges were for the twins that started at 20 wks? Was it the level II ultrasound?Are there posts you can direct me to so I can build an understanding?If I am overstepping my bounds, please let me know. I just think we are so alike,that sharing the information might feel like healing. When I can offer my experiences with severe genetic anomalies, it helps.

You are by no means overstepping any bounds here. Actually it is a good question. I am sure there a lot of people who have no idea why I am so freaked out by things this time.

Here is the drama in a nutshell:

I was referred to Dr. Doom, the perinatologist, by my RE because I was on the cusp of AMA and a twin pregnancy. My first scan with Doom was at 12 weeks. At that point, other than thinking the guy was incredibly strange it went okay. (As an aside, Doom had crazy hair. You know the kind--hair that doesn't seem controlled and sticks out all over the place. It's the kind of hair you see on the mass murderers mug shots on television. I told Is.aac that Doom's crazy hair made me worry about him. I should pay attention to those kinds of feelings! I could have saved myself from a bunch of worry.)

At my 16 week scan, Doom found that both boys each had two choroid plexus cysts on their brains, each boy had one in each hemisphere. The cysts were rather large, and let's face it, no one wants to see big black holes in what you know is your babies' brains. He led us to believe that this is a huge marker for Downs (although I have since found that it is a soft marker that is greatly disputed). One of the babies (Ja.son) also had what was believed to be at least one clubbed foot. It wasn't clear because of how he was holding his foot, though. While we went into that appointment with no desire to do any genetic testing outside of the normal screens (which came back normal at first tri), we were scared enough to have amnios done on both babies. Afterward, I started having what I considered to be Braxton Hicks contractions fairly often--nothing regular and they did not hurt, but I had them often enough to make me call Doom. He said it was BH and he'd check me at my next scan in 4 weeks.

Fast forward to 20 weeks, my cervix had shortened from over 4.0+ to 1.2 and had funneled. Sh.awn's foot was kicking at my cervix. With each kick, my cervix moved. That was bad news. Doom contacted my regular OB, scheduled my rescue cerclage for the next day, told me he hoped we'd make it to 24 weeks (but did say that I didn't have great odds at that), and generally traumatized us both. He did give me P17 shots, but said he didn't think it would make much difference to the outcome. The good news was that the cysts were gone, but I felt like all of this started because of an amnio I never really needed... I knew in my heart the boys would be fine, but I allowed myself to be frightened into doing a procedure I didn't really want. (cue guilt)

Had cerclage done by my regular OB and went home to strict bed rest--up only to pee and shower for 10 minutes or less every other day.

Every week we went back to Doom who still predicted dire results...we were just waiting until I delivered any day in his eyes. (at least it felt that way)

26 weeks exactly saw my membranes rupture. I knew what it was immediately. There was no possible way I could have had that much fluid in my bladder. No way at all. When you add in that one side of my abdomen had deflated and I was clearly lopsided when I looked down, it was pretty clear in my mind. I called Is.aac, and we headed off to L&D.

Doom had a tech meet us there to do an ultrasound. Fluid was lower around Baby A, but still on the low end of normal. Doom came in later to check me, but said that I did not rupture my membranes and I should go home.

My OB, on the other hand, actually did an internal and confirmed that he found ferning (a pattern that can be seen with a microscope when estrogen and amniotic fluid mix together and cause salt crystallization). He's the one who gave me the steroid shots and admitted me into the hospital to make sure I had the entire series. During that first night, I was given shots of terbutaline to stop contractions I never felt.

The contractions stopped so I was sent home with heavy duty antibiotics to ward off infection. I was scheduled for another Doom visit at the end of that week.

At 27 weeks, 3 days, I went back to Doom for another ultrasound. There he found that Baby A indeed had lower fluid (duh) and confirmed that I likely ruptured the last week (duh) and sent me back to the hospital to be admitted.

There I sat...well, lay in bed for another week before I delivered the boys. We all were pretty sick from some sort of infection that had set in after my membranes ruptured.

So that is pretty much the story. I don't trust Doom, as I am sure you can see why. Unfortunately, he is the ONLY peri within an hour of us.

I don't exactly trust my body either, again I'm sure you can see why.

As for the dates of the posts that refers to all of this stuff, the posts are between August 2007 to October 2007.

**Updated - I made Is.aac read this to make sure I got the details right. He said I pretty much did, but I didn't convey the fear that we lived in constantly during that time. He's right. I didn't. Doom was so, so negative every single time we saw him. It was a really hard time. Blah.

He also reminded me that I left out that Doom asked the tech every single appointment if the boys were genetically normal. We always had the impression that the only reason Doom gave a damn (if you can call it that) was because both of them were genetically normal. Had one or both not been...well, I don't think we would have gotten much help from him at all. Makes me sad to think about that.

On This Day...

Today is an anniversary of sorts. It is the day that everything in my world was turned upside down. It ranks on the top ten list of the scariest days in my life, and with the way my life has gone this past year, that is saying something.

On this day last year, my water broke.

As is the case on anniversaries, the memories have flooded back. Many of them are not so great. I have been weepy and the dreams have made yet another appearance. Maybe, though, this will take me one step closer to coming to terms with that time, a hill I have to climb to take me just a little farther from the pain of all of that. Maybe this will help me heal.

I sure hope so.

I think I am ready to focus on the tomorrows and not be continually sucked back to the yesterdays.

Maya had a beautiful post this week about her feelings from a year ago when she went into preterm labor. Our pregnancies were similar in so many ways--we got pregnant at roughly the same time, our betas were almost the same, we were pregnant with twins, we both went into preterm labor the same week, and we ultimately delivered early, although she was able to hold on for two precious weeks longer than I did.

So, because we have so much in common, I am borrowing this idea of hers (I hope you don't mind, Maya).

On this day a year ago...

...I was exactly 26 weeks pregnant.

...I had been on complete bed rest for 6 weeks. And when I say complete, I really do mean complete--up only to go to the bathroom and shower for ten minutes every other day.

...I had stayed up late, unable to sleep. The babies were playing soccer, or whatever it was they did in there, every time I tried to close my eyes.

...I woke up at 9:00 am with the urge to go to the bathroom.

...I didn't make it the ten steps to the bathroom before my sweats were wet.

...I called Isaac at work, crying hysterically, because I knew something was wrong, and it was much too early for something like this to happen.

...I called my doctor to say that I had either lost control of my bladder or my water had broken. He told me to head to labor and delivery right then.

...I waited for Isaac to come home from work so we could make the scary ride to the hospital. I told myself over and over that it was too early, it was too early. I pleaded with God that this was just me peeing my pants and nothing more.

...I walked to the labor delivery ward, leaking the entire way. We weren't ever really sure where to go. We hadn't had the hospital tour yet and I had never been there before.

...I listened to the OB and the perinatologist disagree about whether my membranes had ruptured. The OB thought yes; the perinatologist, who was mister doom and gloom for most of my pregnancy, thought no.

...I saw my two sweet little men on the ultrasound monitor, acting as if nothing was amiss.

...I had the test that did show traces of amniotic fluid.

...I learned that Jason's sac (baby A) had ruptured, probably up high, which meant a slow consistent leak.

...I had our first scary discussion with the neonatologists about what birth at 26 weeks would mean to my babies. It didn't look good for the boys.

...I was told that girls are often stronger than boys when it comes to premature births.

...I was told that each day I was able to stay pregnant would increase their chance of survival 5%.

...I was told that most people who had their membranes rupture prematurely usually delivered within a week.

...I had the first of the two steroid shots given to help the babies' lungs mature; we prayed that they would wait for at least the 24 hours needed for the steroids to have an effect before they were born.

...I had my first shot of terbutaline to stop the contractions that I didn't feel but were, according to the monitors, two minutes apart.

...I felt the side effects of that drug for the first time. Fortunately, or unfortunately, it would not be the last.

...I started what would end up being a month of mega doses of antibiotics to try and ward off infection and keep the babies as healthy as possible. (We managed to get sick, and two of us nearly died, from an infection anyway.)

...I spent my first night ever in a hospital attached to two monitors for the babies, a third monitor for contractions, a blood pressure cuff, an IV for fluids and antibiotics, and a heart rate monitor for me.

...I was the most frightened I had ever been in my life up to that point.

...we began the countdown to the boys' birth.

In 17 days the boys turn 1.

May the healing begin.

All Consuming...

I have now entered a new phase of the ivf cycle. This is one of the ugly sides of ivf. Uglier than shooting yourself up wherever you can to make sure you take your meds during the right time "window." Uglier than the bruising said shots make on your pale stomach and even paler butt. Uglier than having so much blood drawn from your one good vein that you look like an addict. Uglier than being so comfortable getting wanded at the doctors office, that you practically drop your pants the second you enter the door to the clinic and really don't care who is doing the wanding.


This is the pee-on-a-stick-obsession stage. For me, this is the stage that proves I have gone over the edge (as if I wasn't before). I am truly a junkie now...a pee junkie. Now the obsession is to make sure the line on the stick keeps getting darker. Thicker. All that matters is that the line changes from one pee to the next. This is exhibit #1 (and I'll refrain from adding the other exhibits...trust me when I say there are more than a few):

The top is today's line, the bottom is yesterday's. It doesn't really show up here, but trust me when I say that the line is much darker today. It came up much quicker today, too. Yeah! Hallelujah!

Do non-ivfers go through this obsession? I am not sure, but my instincts tell me that they probably don't.


Sigh. I am also getting pretty worried about the success of this pregnancy. It has only been two days! I don't have the best track record when it comes to holding on to them. Plus, the retest for the Protein S Activity is not back yet. I was assured it would be here by the retrieval. Then I was assured it would be here by the transfer. Well, we are now at 7 days past transfer and still no results. I have put dh to the job of hounding the clinic until they get the results...I hope it isn't too late.


I really am a sane and rational person on most things. I even handle pressure well. You wouldn't know it during a cycle. I am, though. Really.

I Did A Bad, Bad Thing...

I did it. I succumbed to the call of the stick. I could resist no longer--and it was the slightest, faintest bfp! Yeah! Now, I realize that this could still be some trigger left in my system because it has only been 12 days. Still, the trigger usually quickly leaves my system. Plus, I did get a bfp last cycle on 11dpo. So...

I am going with pregnant. Now, I pray this one sticks!

"It Is Certain!"

I am pregnant. So says the Magic 8 Ball, at least! Is it a little crazy that I take some comfort from this? I am still too chicken to do a hpt even though I have four of them calling my name every time I go to the restroom. Right now, I am trying to be content with the wisdom of the ball. It is certain. I like that. I also got a "Most Likely So" from the ball, but this leaves some room for doubt, so I don't like it as much. I had to laugh when my dh asked if we were pregnant with more than one. He got "It Remains to Be Seen" for his question. I think the ball lost all credibility in his eyes after that. (It answered me on that question...said "Yes!" Yikes. Shh, don't tell dh.)

I've been trying to do some visualization techniques my acupuncturist showed me. I've never been really good at visualization, and told her that, but she still thinks it is important that I try. Ok. In my mind's eye, I try to picture my six little embies as little mountain climbers. You know, the kind you would see on the Swiss Alps or something. Their little outfits include the khaki shorts, long white socks, crisp white shirts, and little suspenders. Oh, and they have on little green hats with white feathers. (Don't know why my mind went to this place with this get-up, but there it is.) They have little hand and toe picks trying to climb up my uterus to some comfy place. (The picks are causing the cramping that I still have. Some of the cramps are quite intense, so I envision that as a particularly good jab with one of the picks, like they had to reposition for a really good hold.) Did you hear that little sound just now? I think it sounded something like a yodel! Yodel-Leh-He-Hoo! Hoo! Hoo! Hoo! Hoo! Hoo! (that is the echo/roll call) Ok, maybe that was just in my head. I guess this is why I don't visualize very often!

I went in for my progesterone and estrogen check today. My progesterone level was 34 (above 30 is what they want to see) and my estrogen was 400 (they look for above 150). "All looks good," said nurse Michelle. I am to stay on the same meds and wait for my beta next week. 6 days from now. A lifetime away.

I wonder if she would have let me come in earlier if she knew what the 8 Ball said...

What's Going On In There?

Well, my boobs are still sore. They're tender all the way out to my arm pits...and yes, I am still feeling myself up at every opportunity. I find it is a compulsion now. DH thinks I am losing my mind, because although they are too sore for him to touch, I can't keep my hands off myself. Each time I feel the pain, it is just a little more reassurance that things may have gone the way they are supposed to, and I just might be pregnant again.

The ute has been going through some transitions, too. The cramping that started on 6dpo has steadily increased. I have had several stabbing pains radiating from my belly today and the general feeling that AF is on her way. Once, the pain was intense enough to stop me mid sentence (try explaining that to a room full of 8th graders). So that of course meant that before coming here to write, I had to spend quite a bit of time on every search engine I could think of, researching ivf, cramping, and 8dpo. I found 794 posts, but none really answered my questions. Figures.

Anyone have any answers to these questions? The Internet has been of no help!

1) What causes the cramping during the two week wait? (Implantation? Progesterone in oil? Something else?)
2) If it is implantation, does that mean the more intense cramps equate stronger attempts at implantation? (I like this idea even though I am sure that there really isn't a way to prove it.)
3) If it is the progesterone in oil injections, why does it take so long for the cramping to start? Shouldn't the cramps start right after the first shot instead of taking six days to start?

These matters are the bane of my existence right now. It totally sucks. 2 days until my p4 and e2 check. 8 days left until beta...

Symptoms or Not?

Today my boobs are sore...super sore actually. I jogged across the campus today and had to grab my chest because it hurt as I moved. This probably doesn't seem all that monumental to many of you, but for someone with a smaller sized chest (I'm a "nearly" A on a good day) it was big. I've had to watch myself because now I have the compulsive need to feel myself up at every opportunity just to make sure they are still sore. They are. Do you suppose all my groping is causing the pain? :-)

Is it a sign? Or, is it the stupid progesterone finally kicking in? If it is the progesterone, it seems strange that it would take seven days to finally make my boobs hurt. I am sure it isn't unheard of, but it still seems strange.

I've had some slight cramping yesterday and today. The action is even happening in the uterus area now, slightly below the belly button and on either side of my belly. They're just little twinges here and there, nothing earth shattering. Still it is something. I hope my embabies are digging in for a nice long stay.

Hmmm...if it is implantation, when should I start testing?

6DPO

Try as I might, I cannot help but analyze every single little thing I feel today. I am sure this will continue throughout the two week wait ahead and I am not really looking forward to it. How I will manage to stay sane during this time is a mystery. If I feel even the slightest twinge somewhere near the vicinity of my uterus (and that could include anything, even the slight pain I had in my armpit for Pete's sake) I automatically think it has something to do with implantation. I want it to be implantation...I pray that it is implantation. This causes some serious head trips if you've never been there!

I've been thinking about the differences between this cycle and my previous two. This time I told two people what we are doing. I didn't even tell my mom and dad (had to lie because she asked me directly if I was cycling). I think I am trying to save everyone from the disappointment if I miscarry again. Maybe I am trying to save myself from the pain of having to go back and tell people that I am not pregnant. Who knows what the reason is, I just know that it feels different.

I went back to work today. I wasn't exactly looking forward to it, although I wasn't opposed to the idea either. I do feel guilty about missing work, and I left my poor student teacher alone to fend for herself. I had called to check on her Monday evening and all seemed well. Yesterday apparently wasn't a very good day. She had a freaky, noneffective sub to help her (who told her about how he doesn't know how he became a sub because he really didn't want to teach, his friend's disappearance and ultimate murder, and several other off the wall things--a real top of the gene pool selection here--and how do these topics come up in a conversation anyway!?). I think because of that, it was the day the students decided to have a mutiny. (I am so sorry I wasn't there, Christie!) Maybe they missed me? Maybe they are just tired of all the work we are doing getting prepared for the state testing? Who knows what the reason was, it happened and it was ugly. The student teacher, Christie, took the whole thing to heart and somehow felt like she was responsible. She wasn't, these things just happen some times!

I had to go in today and be the disapproving mom. I told them how disappointed I was that they were not able to behave, blah, blah, blah. I made them write an explanation of what happened (of which they were brutally honest--named names and pointed fingers left and right), tell how they will respond differently the next time I have to be gone, and then write an apology to the student teacher. The responses were pretty heart felt. They knew they took advantage and seemed sorry about it. I gave the letters to the student teacher and she seemed to feel a little better about it all. I just wanted to tell her that she had finally arrived...she was an official teacher!

I guess that is all for now. Time to get back to analyzing my body again.

Scary Research

Okay, with nothing better to do, I thought I would research the issues I think are causing my miscarriages. The two problems (that we've found at least) are MTHFR mutations and Protein S Deficiency. Maybe this can help someone else diagnosed with these. This stuff scares the crap out of me! Here it goes...

MTHFR (Methylene-Tetra-Hydro-Folate-Reductase) mutations- it is important that you find out which category of this mutation you fall under. This mutation could be either:

a) heterozygous (there are two parts to this gene, and each part has two parts, so there is a possiblity of 4 places for mutations. Heterozygous means you have one mutation on one part of the gene. This is the most common and impacts you the least),

b) compound heterozygous (this would be one mutation on each part for a total of two mutations. This would be a little more serious, but still fixable), and

c) homozygous (this is when you have both mutations on one part. This is the most serious of the mutations)

I did some more research and found an interesting site (which I lifted this info from).

"First, with MTHFR, there are two different kinds of mutations, as you've said, and it's possible to be "heterozygous," "compound heterozygous," or "homozygous."

The most severe MTHFR problems occur with homozygous C677T, meaning two copies of the "C" mutation. Next most serious is compound hetero, which means one copy of the "A" mutation and one copy of the "C" mutation. (LUCKY ME!) Next most serious is one "C" mutation. After that, it's two "A" mutations. The least serious is a single "A" mutation.

Any and all of these mutations can affect homocysteine levels, but there is much dispute as to whether elevated homocysteine levels are actually needed in order for MTHFR to cause trouble. Many other MTHFR patients have normal homocysteine levels, yet have had implantation problems and/or m/c's due to clotting problems. So it is important to find out your homocysteine levels (although again, normal doesn't necessarily mean all is well). This is a serious field and MTHFR is a serious condition, so consulting an expert is wise.

http://www3.fertilethoughts.com/forums/showthread.php?t=351238

Heterozygous MTHFR is fairly common in caucasion populations and is the "lesser" of the mutations. Compound heterozygous and homozygous MTHFR have definitely been linked to implantation failure, late term miscarriages and overall vascular health and also anything dealing with birth defects that lack of folic acid can cause. Which ever type of MTHFR you have, it should not be discounted.

Essentially what this means is that the genes that instruct MTHFR to convert homocysteine to Methionine are mutated and may not be capable of doing this important function. MTHFR is an enzyme that converts homocysteine to an essential amino acid (methionine). When the genes are mutated you may be lacking this enzyme. Your homocysteine levels can possibly climb making the blood clot. Some doctors don't check for the MTHFR mutations and rely only on homocysteine levels. This isn't as reliable as testing for the mutations because homocystein levels fluctuate (if you catch your level on a normal day, you may go undiagnosed).

Many doctors prescribe folgard which is high levels of folic acid, b12 and b6. These vitamins are what the body essentially needs to convert homocyteine to methionine. To put this into perspective, the average prenatal has 800mcgs of folic acid (200% of the normal daily value). I am compound heterozygous, and I am required to take 5mgs of folic acid/b vitamins (6 times more than the prenatals have in them plus the prenatal!) --compiled by "Sparkle"

Protein S is a vitamin K–dependent anticoagulant protein. It is apparently quite rare to have this deficiency (lucky me!). According to my protein s activity test, my levels are at 29% with the normal range above 60%.

Protein S deficiency also is associated with fetal loss in women, in the absence of VTE (venous thromboembolism which occurs when red blood cells, fibrin, and to a lesser extent platelets and leukocytes form a mass, clot, within an intact cardiovascular system). Some authors suggest that as many as 40% of women with obstetric complications other than VTE may carry some form of thrombophilia. Protein S deficiency is one of these factors along with several other more common genetic thrombophilic states.

Protein S deficiency was also associated with a 7-fold increase in fetal loss.

Many experts recommend that women with protein S deficiency and a history of fetal loss, and severe or recurrent eclampsia, receive low-dose aspirin and prophylactic dose LMW heparin during pregnancy, and the LMW heparin should extent for 6 weeks postpartum.

For women with heterozygous protein S deficiency some recommend prophylaxis for the entire pregnancy and 6 weeks postpartum.

For women with no prior history of VTE and protein S deficiency plus any other thrombophilic defect, active prophylaxis with LMW heparin should be given during pregnancy and for 6 weeks postpartum.

I think that is it for now. Here is a link of where I found the protein s info http://www.emedicine.com/med/topic1924.htm

Just Sitting Here Incubating!

Well, I am lying here actually. It is 1:20 pm and I am still in bed. Don't get me wrong, I've been up and around the house, but I still find myself migrating back to the bed. Needless to say, I am bored silly.

It gives me too much time to think this way. Think and worry. Worry item number one is that we didn't get the Protein S results yesterday. I am a little annoyed by that. I was assured the results would be here by my transfer. When I asked, I was told to check back with them in three days. Sigh. These results are so important to me...I really feel like this is the reason for the miscarriages, but I can't do anything about it until I have those results. I want to be prepared (mentally) for giving myself the daily heparin injections. Plus, I want to start the heparin as soon as possible and give my little embies every chance possible!

Worry number two is that I transferred six embies! Good God, what will I do if they all implant? The realistic side of me really doesn't see that happening. The hormonal side is freaking out!

Worry number three is the age old question of "I transferred six, but what if none of them imlant?" That would throw me over the edge in a bad way. The implications of that is that my eggs truly are old...then what?

Worry number four is that I do get pregnant. What if I miscarry yet again? What would that do to my increasingly fragile emotional state!?!

The list of worries go on and on. There are really too many to name in my little blog.

I will try to not worry too much. Easier said than done!

Welcome Home, Babies!

Okay, are you ready for this? We transferred all 6 embies. My powers of persuasion are pretty intense I guess! I should have been a lawyer.

It looks like 4 were grade a morulas (one pretty well compacted as of this morning, and the other 3 beginning to compact), 1 grade a/b morula with slight fragmentation, and the last little guy (which they had pretty much figured had stopped growing yesterday) who is a grade b beginning morula (whatever that means?). All were ah'ed for this cycle.

Anyway, I kind of see this as our hail mary approach to ivf with this clinic at least...I am hoping with all of the potential babies I put in today, at least one will take and stick for the long haul. I would love it if two stick...or three even. Not sure what I would do if all six want to stick around, but I really don't think that will be an issue. Good God I hope that at least one sticks!

I go on the 6th to check my progesterone and estrogen levels. I always wonder if they also do a pregnancy test at that point to see how things are progressing. That will be about 12 days from the trigger shot, so I would think that if the beta was high, it would indicate pregnancy. I haven't ever asked and they have never told so I don't know.

My beta will be on the 12th, but I know I won't be able to wait that long. I am, as I read somewhere, "a poas ho"...can't keep myself from them. So, I am sure that by the time I get to 10-11dpo I will have started the testing.

My dh wrote "Welcome Home, Babies" with 6 little hearts on my belly today. It is just something that we decided to do in the very beginning...he is so sweet when he writes it, he talks to my belly and kisses it. He really is a neat guy and I am really lucky to have him in my life. I am off for a valium induced rest.

Always Waiting!

Thought I would pop in and let you know that I am still waiting for the transfer. My appointment isn't until 4:15 (California time!) so I still have about 3 and a half hours of waiting left. In case you didn't know this, I don't do "waiting" very well!

I have already been to the acupuncturist to prime myself before the transfer, so I don't even have that left to keep me occupied. I'll be able to calm down quite a bit when I get to take my valium at the clinic...that stuff is goooooood! lol.

Did I tell you what we decided to write on my belly this time? I think it is going to say "Welcome Home, Embabies!" At least at this point that is what I think it will say (it will depend on if it feels right at the time). I'll def. update after the transfer. Wish me luck!

Go, Embies, Go!

Well, my transfer has been pushed until at least tomorrow. I still have 5 grade A/A- embies that are still going strong (WooHoo!). They are all within the range of 6-8 cells that they want on day 3. The embryologist and my doctor have decided that the embies should grow for at least one more day (or two if needed) so that some of the stronger embies might distinguish themselves from the rest and we can transfer only 2-3 of them. I am in a strange state of nervous energy right now, so I will check in a little later once I have had a chance to calm down a little.

WooHoo!

I got the fertilization report, 8 were mature and 2 were immature. Of the eight, 1 was "over cooked" and therefore was knocked out of the game. 5 fertilized and look to be "normal." A 6th one fertilized, but is off somehow...the embryologist said that it could catch up and be okay, only time will tell. The 7th embie had not yet fertilized, but could still, so they would let me know at the next report (on Sunday).

So, the tally is 6 - 7 eggs are in the running to be my baby(ies). Still having a lot of cramping (more than usual I think) and still bleeding enough to reach a pad--tmi, I know. Sorry. Tylenol and a heating pad are my best friends at this point. If the bleeding doesn't stop by tomorrow, I am going to call the office to see what they think.

Okay, how strange is this? Just got a call from the nurse while I was typing to you. Looks like transfer will most likely be on Sunday. Told her about the bleeding and she said that I should see a substantial decrease by tomorrow afternoon, but she will call to check up on me anyway and schedule a transfer time. I don't know if it will throw things off if I am still bleeding tomorrow, but it is nice that she'll call to check on me.

Well, back to the heating pad.

The Aftermath...

I had my cervix dialated again, so I am really crampy and have been bleeding off and on today. That part isn't all that much fun, but it is liveable. I'll let you all know how many fertilized tomorrow after I get the report. Transfer will be on Sunday or Monday. I can't wait to be pg again...it is just around the corner!

ER--Get Out Here, Eggies!

Retrieval came and went today without many problems. I actually find the retrieval the most exciting and less stressful part of the whole process. Well, once I convince myself that I haven’t ovulated early or something, there is less stress for me. Science is amazing, and it still fascinates me that all of this can actually happen outside of my body. I can get pregnant and not even have sex! It really is surreal.

The retrieval process was really interesting although slightly unnerving. First I went into the clinic, undressed, and changed into a surgery smock (opening to the back, please), booties, and a hair net. Then they took me into a little room, which is where the men gather their “collections” so I tried not to touch anything, and I spoke with the anesthesiologist, Kelly. Kelly asked me about my medical history and took my height and weight measurements. After that I kissed my husband goodbye and watched him leave to go wait in the waiting room. I was led into the procedure room and laid down on a table. The Kelly inserted the IV in my arm and started a water drip while the nurse’s assistant, Jackie, started talking to me about what was going to happen during the procedure. Jackie busied herself around the room, gathering the tools for the procedure and setting up the ultrasound machine. The doctor finally poked his head into the room to say hello to me and tell everyone he was about ready to scrub up. At that point, Jackie helped me scoot to the end of the table and place my legs into the stirrups. (This was the part that got a little nerve wracking. I didn’t like the idea that they would need to strap my legs!) Kelly placed an oxygen mask into my nostrils. Thankfully, at that point the lights above me started swimming. The next thing I knew, the procedure was over. I think the whole process took somewhere around twenty minutes.

When I woke up, Jackie was with me in the recovery room. I think that Kelly was around somewhere, but I am not totally sure where. Jackie asked me how I felt and gave me a nice warm blanket to help me stop my shivering. She called the reception desk to get Isaac and brought him back to see me. I was given juice and crackers while they continued to monitor my vital signs. After explaining possible complications to watch for, they explained that the doctor wanted to meet with me before we left.

They retrieved ten eggs. I was told they would call with the fertilization report tomorrow.

Still No Results--What's Up With That?

We are still waiting for the retest on the protein s defficiency (apparently the lab didn't complete the right test), but I have been assured that it will be here before my transfer on Sunday or Monday. Then I will know if I will have to add the blood thinners. I am getting excited because this time the little one(s) are gonna stick for the long haul!

It's Trigger Time!

Trigger is tonight at 11:00 p.m. I can’t wait to get this show on the road. There is no turning back now…it’s all or nothing after that trigger. I am so excited, I may just explode! And sometimes I think that is literally!

Things are looking mighty fine in the old ovaries at this point. At first, I was worried that I may only end up with six eggs. Now it is looking like I may end up with eight to ten eggs! Woo Who! The uterus isn’t looking too shabby, either. I have managed to thicken my lining to a healthy 9-10mms. Like I said, all is looking good in there. Hopefully this means good things will start happening to me now!

Now I am starting to think about how many embies I want transfer on Sunday or Monday. I want to be as aggressive as possible while saving myself from unnecessary pain. I want to be pregnant. I would love twins. Triplets may not be too bad, although I realize that it might bring harm to the babies’ or my health with that many. What about quads? Would I be able to reduce a pregnancy after working so hard to achieve it? Tough questions to worry about and there is not much time to think about it.

I transferred four embies on the last cycle. Two embies were transferred the time before that. Six embies were sentenced to the doom of my uterus. For awhile, that is the way I thought about my own body…the uterus o’ death. That was before all of the testing indicated that I probably have a blood clotting problem. Excuse me. I most likely have a Protein S defficiency. I am waiting for the retest results to make sure (I am assured that this will be done before my transfer). That, along with the MTHFR mutations I have, made my body a not so hot place to live. I so wish that I knew about all of that before I did the last two IVF cycles. Maybe I would have a baby in my arms at this point.

So. I am back to what to do, what to do? Stick to the lucky number four, or get even more aggressive. These are tough, tough, tough questions to ask myself. I can’t wait until there is an answer.

I pray this is the time…let it be, please.

One More Day to Cook!

My trigger will be tomorrow. Yea! I made it to day 9 of stims! I am very happy about that and hope that the one more day to cook positively affects my egg quality. I am keeping everything crossed that it does.

I go back to the clinic tomorrow (yet again--I feel like I live there or something) for more blood work and another ultrasound.