...or a lack thereof.
Short answer explaining last week's event - no one knows what happened. Even my doctor is mystified.
My first bloodwork was done December 23 at 8 days past a 6 day transfer (aka 8dp6dt). My hcg was a 206.
At 11dp6dt my hcg was 588.
At 18dp6dt my hcg was 6499.
At 24dp6dt my hcg was 22048. (This was Wednesday, January 8.)
Doctors like to see hcg levels doubling about every 48 hours in the beginning and then the rate will slow down as the hcg level hits/passes the 6000 marker.
My hcg levels were not only beautiful but were also very comparable to my pregnancy with Cora and Mac. I was totally convinced both embryos were growing and that we had twins on board once again.
I had a few pregnancy symptoms here and there prior to last week, but the queasiness and exhaustion really picked up once I hit the six week marker, January 6.
I had been having bleeding episodes every few days. A few episodes were due to cervical irritation (a common side effect from progesterone suppositories). One episode was different - it was like a blood bubble had burst. Though I was alarmed by that episode, I comforted myself that it was short lasting and there were no cramps or clots.
My pregnancy symptoms continued and my hcg numbers provided comfort that the bleeding episodes were ultimately not harmful.
I tell you all this to show that Thursday's miscarriage really was unforeseen.
Unfortunately, my Friday morning ultrasound didn't resolve things either. The doctor saw clumps and clots still remaining in my uterus. And, after searching a great deal, she was able to find one baby. The baby's sac was cloudy and no heartbeat was visible.
From the clinic, I was sent to the lab to see what my hcg levels were like. If they were above a 10000, that little one had a fighting chance. Below that, then she too had passed on.
All day I waited for that phone call. Finally, at about 4:30 my phone rang. My levels had come in - 7400. Cease all meds.
And I crumpled once again.
I've spoken to my doctor since then and we've come up with a most basic of plans. In the average singleton pregnancy, miscarriage is very common up until about 6 or 7 weeks. The baby simply isn't strong enough to survive. While we can't know for sure that I was carrying twins, my numbers seem to indicate that I was. Given my healthy hcg numbers and their regular increases, it seems incredibly unlikely that the pregnancy ended because both babies weren't strong enough.
My progesterone and estrogen levels were tested along with my hcg each time. Not only were those numbers fine, but my levels were at the upper end of what my clinic could have hoped for. The miscarriage was not caused by insufficient hormones.
Women with recurrent miscarriages are often tested for clotting disorders. While I don't entirely fit the bill, my doctor has ordered the tests run for all clotting disorders that exhibit in first trimester.
There is another possibility that we just don't have enough data to prove or disprove. A subchorionic hematoma (sch) is essentially a blood bubble that develops between the placenta and the uterine wall. These cause bleeding in pregnancy and can even end a pregnancy depending on the location/size of the sch. For example, if a sch grows along the top of the uterus, it can completely sever the placenta from the uterine wall causing a miscarriage. If the sch is located at the bottom of the uterus, it will normally drain without causing too many problems (other than the anxiety-inducing bleeding). Nothing can be done to prevent a sch from forming and fertility patients have a higher chance of one forming.
Where does that leave us?
Well, I have to get repeat bloodwork done. Going to check for clotting disorders. And we have to monitor the decrease of my hcg.
Since we did see a baby on Friday's ultrasound, I now have to wait for part two of my miscarriage to resolve itself. My doctor estimates that this round will be far less severe than what I experienced Thursday afternoon.
I don't think I need to go into detail how low Thursday and Friday were for me, for all of us. What I do need to express is my gratitude for the prayer community that has supported us. While these prayers have not taken away my pain or allowed the pregnancy to "stick", we have been supported and lifted up. Our burden has been made lighter and for that we are very grateful.
Thank you, friends, from the bottom of my heart.