Hurdles

I mentioned previously the "hurdles" I need to overcome.  I don't even know entirely what I'm looking forward to - calm? peace? freedom from all fear?  I realize that no state in pregnancy will bring me "freedom from all fear".  It can be all too easy for a mother to get caught up in the "what if's" and dissolve into a fear frenzy.  And, let's be honest, the fears don't end with birth.  A mother can seem an awful lot like a concerned mother hen, clucking around her young.

I do want to elaborate a bit on what these hurdles are.  Maybe if I can successfully describe these mental roadblocks to you, then you can celebrate with me as I pass each one.

Hurdle:  Blood draws.  Each week I have my labs run, checking my hcg, progesterone, and estrogen levels.  I have no problems with needles.  It's the numbers game - I am constantly comparing this pregnancy's numbers to my December pregnancy.  Yesterday's draw equaled the highest hcg I got with my last pregnancy before I miscarried. 

Next blood draw is Monday. God willing, I will overcome this hurdle.  Fear, be gone!



Hurdle:  Bleeding.  Last pregnancy I had two bleeding episodes while maintaining great hcg levels.  And then I had a surprise miscarriage in January.  I had a bleeding episode Sunday morning (thank you, Lord, it wasn't at church!).  The fear is twofold: the bleeding in and of itself, but also what it represents - the beginning of my last miscarriage. 

Unfortunately, there's no "expiration date" of this hurdle.  I know that bleeding is not uncommon in pregnancy, especially early pregnancy.  Fear, be gone!



Hurdle:  The first ultrasound.  We've now had four transfers with our Texas clinic and I have not yet been able to see a heartbeat on an ultrasound. Last pregnancy, we miscarried the day before the ultrasound.  I did see one little baby, on her way out, no heartbeat.  While I haven't scheduled the appointment yet, the ultrasound will be sometime next week. 

Dear Lord, I am praying so hard that we see heartbeats next week!  Fear, be gone!



Hurdle: The transition from clinic to OB.  This obstacle dates back to our very first transfer in May 2009.  We had good initial numbers, and then a beautiful first ultrasound.  And then I went to my first OB appointment at eleven weeks only to see she had stopped growing already. And her heart had stopped. 

I have a lot more monitoring now than I did back then, so this hurdle is a teeny bit less scary than the others. It's also more remote, as the transition won't take place until probably early November.  Nonetheless, fear, be gone!



I'm praying the novena to St. Therese through praymorenovenas.com.  I typically am at least one day behind schedule with the prayer schedule which meant I prayed this Sunday, after my bleeding episode:

Despite great suffering during her life, St. Therese still trusted deeply in God. Today, let's pray to have the same trust and strength when we suffer through hard times.

The suffering can come in many forms, but none of us are immune to it. Jesus carried His cross and asked us to take up ours and follow Him.

Since that is what He asks, He will give us the grace and strength to endure the suffering of this life as long as we continue to trust and hope in Him.

St. Therese, pray for us!

While I don't know what the future may bring, I did find comfort in those words.  I continue to try to offer up my fear and exchange it for joy in the present gifts I have been given.  And maintain hope for the future.

7 Quick Takes: The Pregnancy Test

1.  I woke in the wee hours of the morning Wednesday. Before I rolled over to look at the clock, I told myself if were after 3:00, I'd take a pregnancy test.  If it were before 3:00, I'd have to force myself back to sleep.  It was 3:45. I stumbled out of bed and struggled unwrapping the test, my hands were shaking so badly.  I POAS and waited the requisite amount of time.  It was positive.  I just stared at it in disbelief.  I debated waking Bryan then or leaving it on his sink as a surprise when he woke later. I opted for the latter.

2.  It was not easy to fall back to sleep. My mind was racing, alternating between "Thank you, Jesus!" to "oh, I want to wake Bryan right now and tell him!" to saying Hail Mary's in an effort to calm my mind.  I eventually dozed off to be somewhat woken up by Bryan's alarm at 5:41.

3.  His reaction was exactly what I hoped.  I stayed in bed, eyes closed, and listened.  He stumbled into the bathroom, turned on the light, and picked up the test. There was a pause, in which I imagine he was forcing his sleep bleary eyes to focus and read the test.  And the next thing I knew, Bryan was racing into the bedroom, and pelting me with kisses.

4.  The kids were good sports with our drive down to get my bloodwork completed and I got my results mid-afternoon.  My hcg at 9 days past a five day transfer (9dp5dt) was a 300.  The clinic's goal was a 50.

5.  I had my follow-up bloodwork yesterday to measure the rate of increase.  There is a huge range of acceptable increase rates for hcg, but, as a rule of thumb, clinics like to see the number double about every 48 hours.  My number was 874 (we would have been comfortable with anything 600 or higher).  This means the doubling time was about 31 hours.

6.  What do all those numbers means?  Well, hcg levels very hugely by person and pregnancy.  Personally speaking, these are the highest numbers and fastest rate of increase I've experienced.  But that doesn't really amount to much. (There's at least one woman in my Facebook EA group who had higher hcg numbers with her singleton pregnancy than her twin pregnancy.)  I would make a guess that both Dash and Violet are snuggled in and growing.  However, we won't know anything until my first ultrasound.

7.  First ultrasound?  My clinic does things on the later end of things so our first ultrasound won't be until around October 10. We haven't scheduled it yet.

We are elated.  Someone asked if the kids were excited. Honestly, the kids never assumed anything otherwise.  They have just always trusted, with child-like simplicity, that Dash and Violet were indeed growing.  

I am struggling a bit with fear, as I feel like we have certain "hurdles" to overcome. Hurdles may not be the right word, but I think every woman who has experienced miscarriage breathes a little more easily after she has passed the point of prior miscarriages.

I am heartened by the very good numbers and by the few pregnancy symptoms I am experiencing thus far. I am daily making the choice to seek joy. For TODAY, I am pregnant. TODAY, God has graced us with new life.

Thanks be to God!

Babies on my brain

I am not a compulsive home pregnancy test (HPT) taker. I'll take one hpt the day of the actual lab work.  And while I have kept my brain busy during waking hours, apparently it gets back to the baby business while I'm sleeping.

I dreamed one night that Bryan was holding quintuplets in his lap, beautiful bouncy black boys of about nine months old. Needless to say, his lap was pretty full. In the same dream, I learned I was pregnant with triplets. The rest of my dream was spent wandering the house, contemplating which corners could support the weight of baby hammocks to accomodate our rapidly growing brood.

I've dreamed about quadruplets.  Sure, why couldn't both embryos split? ;-)

Last night I dreamed that my HPT could tell me the exact hcg level. I read the test and saw a 2170. Oh, that's a huge number, I thought. (For frame of reference, my positive tests thus far have ranged from 76 to 250's for my first blood draw.).  And then, dream me looked at the HPT again and read a 20,170.  WOW! Dream me was almost bowled over by the enormous number.  And then my dream fast forwarded to the clinic and the first ultrasound. And we're all staring at the screen trying to count just how many heart beats we're seeing.

Apparently my subconscious is trying to set me up for my own TLC show.

The Transfer Itself

Part of the embryo transfer protocol is a valium administered about an hour before the transfer itself.  Technically it helps to relax the uterine muscles.  But there's that ancillary benefit too, taking the edge off any nervousness or anxiety that might be felt.

Yesterday was the first time the nurse had ever made it sound like the valium was optional.  She knocked on the door and asked, "Would you like a valium?"

"Oh, yes, please!" I responded, my words practically running together in my eagerness. 

As she smiled and left the room to retrieve my dose, I asked Bryan, "Do you think I should have hesitated before answering?  Was I too eager?"

He just snickered at me.

I can say that between the valium and all the myriad of prayers that have been said (and are continuing), my nervous energy subsided.



I'd like to introduce you to "Dash" and "Violet". 

Dash and Violet were created in 2008 and vitrified five days after fertilization.  (And, if you're new to our story, we adopted them this past spring.)  These are blastocysts, and this picture was taken shortly after the thawing process.  These two were vitrified and stored in separate straws and thus thawed separately. The one on the right was thawed first and is a teeny bit more re-expanded/re-hydrated than the one on the left due to that approximate fifteen to thirty minute head start.

The embryologist was very patient with my myriad of questions.  Both of these embryos look great, with no noticeable cell loss.  It takes about fifteen minutes or so to thaw a vitrified embryo.  After the thawing process, each embryo "rests" for a few hours in a solution. 

The outside rim of each embryo is called the zona pellucida.  This is basically like a shell on an egg.  Through time, embryologists have learned that frozen embryos have a tougher than normal zona pellucida.  To help encourage embryos to hatch (a necessary step that must occur before the embryo can implant on the uterine wall), embryologist nowadays use a technique called "assisted hatching".  See that notch in the zona pellucida of the embryo on the right?  That's what the embryologist did to assist the embryo in its future attempt at hatching.  Both embryos had this done (it's actually standard practice at our clinic on all frozen embryos).  The left embryo had rotated since the assisted hatching was completed - the notch was there, we just couldn't see it.

You can just sort of make out an outer layer of cells, just inside the zona pellucida.  If I remember correctly, this layer is the trophoblast and will become the placenta.

The embryo on the right is a little clearer to see due, perhaps, to its short headstart from thawing first.  At any rate, you'll notice inside the outer rings are two masses, one a cell mass in the left center, and the other a clearer area in the right center.  The cell mass is what will grow into the baby and is called the "embryoblast".  I didn't think to ask what the clearer section becomes but it is called the "blastocoel".

Here's an color picture I found online that labels the blast components (this embryo is further along developmentally than Dash and Violet as pictured above).

 

 



 

Our clinic here in Texas has a big screen tv in the operating room.  We are able to see the embryos right before the transfer and watch as the embryologist sucks them into the catheter and brings them into the operating room.  There is probably a technical term for "the act of sucking into a catheter" but I do not know what it is.  ;-)

You want to know something truly amazing? The embryos had both noticeably grown in the short time since the first picture was taken. I don't know exactly how much time had lapsed between the first picture and the transfer itself, but it could not have been more than a few hours.  And both embryos had visibly grown - it was incredible!

The blastocoel (the clearer inner mass) had grown considerably on both embryos.  One embryo was more than two thirds filled with blastocoel, the other about half filled.  And, one embryo was already hatching, almost like the random internet picture below.  The embryo was just starting to hatch, though not near as far along as the one pictured below.

I didn't really notice the moods of the crowd in the OR (and there was a crowd: techs, doctor, intern, embryologist, plus me and Bryan).  But Bryan said everyone seemed very upbeat and encouraging about Dash and Violet and their growth.

Our clinic had recently changed their post-transfer procedures, so we didn't have to rest for any requisite amount of time.  Just transfer, bathroom (as procedure is done with a full bladder you cannot underestimate the necessity of this step), change back into civilian clothes, and then we were released. 

We then had some of the best burgers in our life at Hopdoddy's.  I had the Greek burger and it was AMAZING.  Perhaps I was still on a bit of a valium high and riding the good vibes from the transfer, but that was one good lunch.

We then wandered a unique toy store (Terra Toys, if you're ever in the area) and then headed back home.

I slept wonderfully last night and my nervous energy is mostly gone today.  This is due in part to the encouraging-looking embryos but most of all due to your prayers.  I am so very thankful for the family, friends, and even relative strangers offering up a few words on our behalf.



I do not know what the future will bring.  However, I know that today I am pregnant. Today, I have both Dash and Violet on board.  I am choosing to live in the moment and embrace it.  And pray without ceasing.

Thoughts Before the Transfer

I've done a good job keeping my mind busy and not over analyzing all the transfer possible outcomes.   Until last night, during my shower.  I felt my spirits plummet as I started down the black hole of "what if's".

I wallowed for a few minutes, hopelessness creeping in.

And then I decided if I have to go to an extreme, I will choose the other extreme. The one of faith and hope.

I am clinging to these beliefs for dear life, attempting desperately to banish those dark, heavy thoughts.

If I believe in a God who can move mountains, then I will choose to believe that He could even turn two into three and grant us triplets if He so desired.

The important thing is not really the exact words I'm saying but the acts of faith and hope that I am deliberately choosing to utter.

God, I believe.

I trust.

I hope.

Four Days

Four days until we meet our last waiting ones, our last snowflakes.  For a while there, I kept telling people I was terrified of this final embryo transfer.  And then, after some contemplation, I realized I'm not.

I am not terrified.

I am not exactly sure what I am.  Resolute is the word that keeps coming to mind, but I've rechecked the dictionary and that word doesn't quite fit. 

I have hope.  Not excessive hope, I don't see things through rose colored lenses.  But I do believe that these embryos will complete our family.  For a while, until I get the adoption bug again.

I have courage. Sometimes it's hard to march back into the same situation, in this case the clinic, when the prior three times have not ended as desired.  I am moving forward.  And with a smile. It may be a teeny tiny little Mona Lisa smile, but by golly, I will smile and go forth with cheer.

I have respect.  For the genetic parents who chose to give up their remaining embryos in hopes of fulfilling another couple's dreams.  For the adoption agency, for believing these embryos are worthy of life. For Bryan, for walking down this road of hopes and dreams, again.





I have been busy and that's helped limit my daydreaming.  Don't know if anyone else is like this, but whatever I daydream never comes to fulfillment. So for now, I limit myself to one of two scenarios.  A negative.  And a positive yielding triplets.  Both situations are possible, though I'd like to think highly unlikely.  And, honestly, after the length of this road, part of me (perhaps the less sane part) would welcome triplets.  (The sane part would be hyperventilating into a pillow.)  Statistically, since we're transferring two embryos, triplets are possible if one of the two embryos splits.  Not altogether unheard of, but extremely rare.

A negative is a real possibility too.  I recognize that.  I don't want it, but I name it as a possibility.  For the sake of transparency with myself, I have to admit that a negative could happen.





I guess in some small way maybe I am finally learning to put my hopes fully in God?  With each of our last three transfers, I always had that back up plan - we can use the remaining set of embryos, or rematch.  I still exerted some miniscule amount of control on the situation.  But now, we're done.  This is it and there's nothing I can do except pray and follow my drug protocol.

One startling aspect: my type-A brain might actually be more relaxed in totally relinquishing control to God.




"Dash" and "Violet", we'll meet you soon.  Your first parents love you.  We love you.  See you Monday, little ones.