6 weeks pregnant with...

One healthy baby!

This little cooperative baby showed us a heartbeat this morning!  Hooray!  Rick saw the little flicker of the heartbeat right away-- before the sonographer even pointed it out.  From my reading online, it looks like once you see a heartbeat, the risk of miscarriage drops to somewhere between 1% and 7%, so this is a good time to take a breath and be thankful for this healthy little baby.  Stay strong, kiddo.

Barb may send more details from the report later, but what I know right now is that the baby measured at 5w6d +/- 2 days (perfect), we could see the heartbeat, and nothing immediately jumped out as a concern.  I know from experience that a chatty sonographer is a good sign (they get quiet when something is wrong), and this one had plenty to say.

After the ultrasound appointment, Rick and I drove to the lab for my estradiol and progesterone tests.  Fingers crossed that those levels come back nice and strong so we can cool it with the PIO injections.

We called M and N with the news and everybody is excited!  Yippee!

So here's what the baby allegedly looks like up close:

6 Weeks Pregnant

It is 1/8" long-- about the length of a lentil.  The nose, mouth, and ears are all beginning to develop and the intestines, nervous system, muscles, and bones are all growing.  Pretty amazing to think all of that can happen in one teeny, tiny package.

Not much going on

That's my last test.  I may or may not have taken 16 total.  Gee whiz.

Anxiously awaiting tomorrow's ultasound.  Less than 24 hours now.

And hopefully just one more shot.  My hips/butt are a mess.  Bruises and knots.  They are extremely sore-- I feel them when I walk, I cringe when I get into the car, I can't sleep on my sides.  I hate to complain, but I do heartily agree with my former RE who said PIO is cruel and unusual punishment.  But the end is near!

Sidetracked

Hmm.  My plan to have the nurse at work give me the PIO shots is a great one.  Except when he's not here for the day.  Foiled!  Thankfully, Rick is home today, so he's going to drive to the office and do it for me.  He did a good job this weekend-- didn't hurt me at all, but he said he hated to be learning on me.  But by now, with shot #3, he should be a pro!

5 Weeks

5 Weeks Pregnant

Baby is the size of a sesame seed.  Both the heart and neural tube (to-be brain) are developing this week.

I still don't have symptoms to speak of.  I had some round ligament pain this morning-- just passing muscle pain in my abdomen, where my uterus is growing and claiming new space for itself.  Still taking pregnancy tests.  I only have two left, so that will stop soon.  But they're awfully pretty.

I prefer the other tests (OSOMs) to these (Dollar Store).  The black dye on the OSOMs doesn't fade nearly as much as the pink dye, so I can look back over my collection and compare them.  The pink dye tests fade as they dry, so unless I take a picture, I can't remember precisely what they looked like.

On day three of PIO and I'm back to hating it.  That first day was the best by far.  Now I have two sore hips and am amassing a collection of lollipops.  I continue to hope Barb was right in saying that I would only be on them until the heartbeat/s, which is hopefully next Friday, a week from today.  PIO is no fun.

The progesterone (whether Crinone or PIO) also makes me sleepy.  Yawn.

My family got back from Montana last night.  Sounds like they had fun.  I have all of two days with the girls before they ship off to overnight camp for 10 days.  I've hardly seen them!  Hopefully they can rest and relax over the next couple of days, so they're ready for camp fun.

All that fuss

My exciting new meds (look at my positive attitude!) were scheduled to be delivered today.  I had to have them delivered to work, since they need a signature, and I was stalking the door, waiting for the Fed Ex guy.  He finally got here sometime after noon.  I had managed to work myself up into a small frenzy by then.

I dug through the box and found:

The dreaded PIO and huge needles.  (Cue horror movie music).  What was awful about it was that I had watched the instructional video earlier and it used phrases like "using a dart-like motion."  Noooo!  Now to be fair, the gigantic needle is for drawing the oil up into the syringe.  The slightly less enormous needle is for the injection itself.

I walked over to the nurse and he cheerfully took my medical history (none-- I'm boring that way) and got the syringe ready.  He did the injection in my left hip (upper outer quadrant of the glute, really).  And it was... totally painless.  I wasn't even sure he did it.  And so I feel like a bit of a drama queen now.  He did say that he prides himself on giving good shots, so maybe it will be more tortuous when Rick does it for me this weekend.  But this was nothing.  And he gave me a lollipop when I was finished, "for being such a good patient."

(Taken with the Capitol in the background, in an attempt to be artsy.)

I have a teeny headache all of a sudden, which I only mention because the timing is suspicious.  Hopefully it's just a coincidence and not a reaction.  Hopefully I only have 10 days of these bad boys.  I am suspicious that it will be longer, since I have 30 days worth in the box already, with 2 allotted refills.  Hmm. 

Surrender

I was getting nowhere with my retest argument, and Barb says I only have to be on PIO until we see a heartbeat, so I've resolved to just do it.  It should only be about 10 days.  That's not worth the fuss.  I'm going to have the nurse at work give me the shots, because I am too wussy to do it myself.  Rick will have to do it this weekend.  He's camping with the girls right now, so he doesn't even know about my PIO pity party.  "Welcome home, honey!  Here, give me a shot in the butt."

In much more exciting news, I scheduled the 6-week ultrasound!  Yeeha!  With any luck, that's when we'll see a heartbeat... or two.  It is on 6/29 at 7:30 in the morning.

I went to Costco today (it's a state holiday) and bought two huge cases of sparkling water.  That's my only craving right now.  I could drink all 48 bottles/cans today, I think.  But I won't.  I don't have any strong food aversions yet, but I feel it coming.  Pretty much everything at Costco looked unappealing, except for my water.  Oh-- one especially gross thing I saw was a case of oysters on the half shell in the freezer section.  But I'm not sure those would ever look terrific. The idea of oysters in bulk skeeves me out a bit.

I also picked up some estradiol pills-- I'm adding one a day, since I'm an all-around underachiever (except for hCG).  Pretty sure those are also just until we see the heartbeat.  Come on baby/ies-- grow, grow, grow!

So bummed (pun?)

Ugh.  I am not a happy camper.  Barb told me I have to start progesterone injections.  Not cool.  Progesterone in oil = PIO = what I thanked my lucky stars to avoid.  It's an intramuscular (IM) injection (not a subcutaneous shot, like the Lupron was).  Big needle.  In the butt.  Of thick, nasty oil.  People get welts from this stuff.  And bruising, and nerve damage.  Yuuuuuuck.

I don't want to.

If I have to, I will, obviously.  I'll do anything it takes to keep this a healthy pregnancy.  But I've asked for a repeat lab test (I'll go to another lab) to see if there might have been lab error at work here, or if doubling the Crinone dose is enough to make a difference.  I demand a recount!

I am totally dragging at this news.  I feel like crying.  Boo.  Hiss.

Repeat beta

Results are in!  Well, kind of.  The faxed results aren't going through for the lab, so they gave me the results verbally and will continue trying to fax.

Drumroll please...

At 11.75dp5dt, my beta level is 1,257.  That's a doubling time of 35 hours, which is really fast.

It's definitely a high number.  No doubt.  More than twice the average amount for twins.  BUT, I always have to put it in context for my super-hCG-producing body.  Last time around, at 12dp5dt (so the same day), it was 2,976.  That was twins.  So, given that this test is a few hours earlier than that one and just a smidgen under half the amount, I'm still guessing one stuck.  But would I be surprised to be proven wrong?  Not at all.  Definitely still in the running for twins.

My estradiol number was 124 and my progesterone was 4.4.  I know that before transfer, they wanted my estradiol level over 300, so I'm thinking that's not going to be high enough and I may need to supplement with Estrace.  The progesterone number is low too, but from what I've read, the Crinone releases progesterone directly to the uterus and does not enter the bloodstream (like PIO), so it's difficult to measure it clinically.  We'll see what they say.  I have a feeling more meds are coming my way.

But the important part: 1,257!  35 hours!  Looking good!

Waiting for repeat beta

Waiting for results...

4 weeks pregnant

Oh, and hey-- now that it's official-- here's what the baby is looking like right now:

4 Weeks Pregnant

But it's only this size:   .

Pretty neat, right?

And just to do some kind of official weekly check-in, right now, I'm not having many, if any, symptoms.  I mentioned the GOMN the other day.  I'm maybe a teensy bit more tired than usual.  But that's really it.  I'm bracing myself for the "fun" I know is yet to come!

The longest day ever

I expected results sometime around 10.  By noon, the anxiety was just too much and I started texting M and emailing Barb to see what was going on.  At 2:45, I called the lab to make sure they had faxed the results to the right number-- they said they had, but they would fax again.  And then finally, a little before 3:30, M called and said "Siiiiiiiiimmmmiiiiii..." with what, even over the phone, was obviously a big smile on his face. So I knew he had results.

And the number is: 302!  Yeeha!  Barb told them they wanted anything over 100, so this was a great result.  Going by averages, this would be a good twin number.  Considering my personal history, though, I'm going to guess we have one that stuck around.  Have to wait another couple of weeks to solve that mystery.

So very exciting news!  I will go in on Monday for my repeat test, and this time they'll also check my estrogen and progesterone levels, to make sure none of my meds need to get tweaked.  By Monday, my beta level should be right around 1,000.

The deed is done

It took a while to get in this morning.  I walked in the door at 6:59 (they open at 7) and put my name on the list.  It took 5 or so minutes for them to call me up for my paperwork and then quite a while for them to enter the order into the computer.  I think the computer was down for a bit, plus there seemed to be a lot of confusion about how to enter the test ("Did you search beta?"  "Yeah, but see?  It's linked to progesterone."  "Hmm, let me try."  "It says quant, right?"  etc., etc.).

When I did finally get called back, at about 7:15, the guy taking my blood fumbled getting his gloves on (and giggled), and then fumbled around trying to find the supplies he needed (the rubber band was in a different room).  Then he introduced himself as an ACC phlebotomy student.  I suspected he might be!  ;)  Despite not instilling confidence with the prep work, he did a good job with the stick.  After using about 5 cotton balls to clean me up, I was out of there!  Funny.

And then only reason I'm writing this ridiculously long blog entry about a blood draw is that there's little chance of me getting anything else done.  I'm so anxious to see what the number is!  I always have anxiety dreams when I'm worked up about something, and last night was full of them.  I hope it was worth it!  Come on, results!

Waiting

I am the first and only person in the lab. Let's go!

Number crunching

True to form, I'm sort-of kind-of obsessively researching today, in anticipation of our beta tomorrow.  The beta will give us a quantitative number for the amount of hCG in my blood, measured in mIU/ml.

My blood draw will be at 8.75 days past a 5 day transfer (7am, transfer was at 1pm), so we're a little short of a true 14 dpo (days past ovulation) result.  Adjusting the numbers on betabase somewhat for that, the average beta levels at this stage of pregnancy would be 92 for a singleton and 187 for twins.  I believe Houston IVF will be looking for anything over 100.

But I was a very high hCG producer during my first surrogacy.  At 15 dpo, my level was 1,416 with twins-- about 5.3 times the average and to this day, higher than I've ever seen someone else get.  There's no telling how much of that was me and how much of it was the embryos, I guess.  But if I were to have equally absurdly high numbers this time, the result would be 489 for a single and 988 for twins.

So, here are ranges for my predictions:

<92 = I'd be worried (not going to happen)
92 - 187 = singleton
187 - 489 = could go either way
489 - 988 = twins
>988 = I'd be worried.  :)

On SMO, there's a Master Beta Break Down List of people's beta levels on various days with various types of transfer.  I tend to prefer betabase, only because it has a larger sample size, but here's what SMO says:

9dp5dtSINGLETON: 8.4, 21, 39, 40, 48, 50, 51, 52, 55, 57, 60, 60, 68.9, 73, 77, 90, 90, 92, 93, 94, 96, 99, 99, 115, 118, 120.5, 122, 124, 128, 133, 137, 141, 146, 150, 151, 153, 156, 160, 199, 203, 210, 262, 285, 308, 345, 348, 360, 477
TWINS: 79, 119, 120, 127, 141, 147, 149, 160, 173, 180, 187.51, 194, 197, 199, 200, 224, 234, 242, 243, 245, 248, 254, 255.3, 260, 274, 275, 290, 300.8, 306, 309, 320, 323, 329, 334, 340, 347, 350, 354, 363, 374, 379, 419, 432, 448, 496.3, 753
TRIPS: 89.5, 110, 123, 254, 289, 345, 374, 514

So there's just a little more context for whatever we see tomorrow.

My official, out of thin air prediction is 255.  Tomorrow we find out if I should go to Vegas.

First symptom?

A friend of mine and I share the same early pregnancy symptom, called "Get Off My Neck."  I don't know how to explain it other than the very idea of something on my neck is untenable and makes me feel ill.  Today I'm wearing a v-neck dress that does not even come close to my neck and I still feel the GOMN.  Blech!

Just a friendly precursor to morning sickness, I suppose.  I have another couple of weeks before that kicks in in earnest.  Last time around, it was 23 days from transfer to my very cruddiest feeling day (coincidentally, the day I interviewed for my current job-- that's how I know the date!). 

My boss has been out sick for two days, but is back in the office today, so I got to share my pregnancy test pictures with her.  I'm so lucky that she's a huge supporter of this whole process-- she's looking forward to our beta on Friday nearly (ok, not really) as much as I am.

I did email Barb yesterday to ask when my repeat beta would be and she said it would likely be on Tuesday.  She also asked if I'd been "cheating" (since the clinic discourages home pregnancy tests) and I said I had been, many times, and that it had been positive since Sunday.  She replied "Yay!"  Cheating is not a cardinal sin in this context.  :)

Testing 1, 2, 3

Now that is a pretty sight, don't you think?

My plan was to start testing on Sunday, 4 days past the 5 day transfer (4dp5dt).  But some friends convinced me to test on Saturday.  Stark white test.  Totally depressing, despite my knowing it was too early.  Peer pressure is a bad thing, folks.  Just say no.

But Sunday morning, as planned, I tested again.  Our transfer had been at about 1:00 pm, so this was technically 3.75dp5dt.  Stark white again.  But when I went back to the test after the time limit, once it had started to dry, there was definitely a ghost of a line.  I've never had that happen without it actually being a positive test, so I felt pretty confident that it was a real positive.  Positive enough that I called M and N at 10 that morning (and woke them up!) to tell them.

I tested again at about 1:00 (true 4dp5dt) and had the same result, which made me more confident that the first one wasn't just an evaporation line or defective test.  That's the one pictured on top above.  And then I tested again Monday morning and this morning.  The lines are a really nice progression-- each is about twice as dark as the one before it (but the first two are super light, so it's hard to tell, really).

Today's line looks great.  I had some nagging fears of a chemical pregnancy, but they're being quieted by this non-squinter line.

Looking forward to our beta on Friday.  I think I'll email Barb today to see when the repeat will be.

No freezing

Texts from M this afternoon:

"No embryos to freeze.  So the ones you have must work!"
"Sorry"
"Maybe GOD knew there was no need because you are going to have TWINS"

Hear that embryos?  You've been ordered to stick around by your dad and quite possibly God.  So you'd better listen.

Transfer!

Short version:  We transferred two embryos Wednesday, 6/6/12! 

Details:  I left the house at about 7:30, dropped off the girls at my mom's house, and drove to Houston.  Rick had planned to come with me, but on Monday, he found out he had to work an overtime shift, so so much for that plan.  I rolled in at about 10:30 and met M at the house.  Then we headed out in time for my 11:15 acupuncture appointment.

I checked in at the clinic, since I was supposed to have my bloodwork done first.  It took quite a while to get called back.  M went to go sign consent forms (he was heading to work before the transfer itself).  Once the blood draw was complete, they walked me over to the acupuncture suite.  And I downed two bottles of water, to fill up my bladder for transfer.  I hugged M goodbye and told him I'd see him when I was pregnant.

I'd already filled out the paperwork while I was waiting for the blood draw, so the acupuncturist took me straight back and started the treatment.  This wasn't my first acupuncture rodeo, so everything was pretty familiar.  There were needles in the top of my head (in my hair), on my hands, on my feet and legs, and in my belly.  Also in my ears.  She left me for 20 minutes with relaxing music/the sounds of water playing.  Then she came back and replaced the ear needles with permanent ones I would wear until Saturday (little sticky patches).  There are two on each ear and they don't bother me much, though the upper ones are annoying/a little painful if I touch them.  I didn't take pictures of the needles, but here's the little acupuncture figure.  Imagine it's me.

After acupuncture was done, the nurse walked me back to the surgical suite to get changed.  And Gayle showed up!  So good to see her!  I kept my shirt on and had a gown on in front and another in back.  That's also when the nurse had me take the Valium.  Blech.  When I tried to open it, it broke in half and got all powdery.  Double blech. 

The nurse walked Gayle and I back to the transfer room and we waited a bit for N to show up (she was coming from work).  In the meantime, they did a quick abdominal ultrasound to see if my bladder was full enough and decided to have me drink another bottle of water (which put me at 51 ounces, rather than the 20 instructed-- I always knew my bladder was an overachiever).  And then N showed up-- we were in business!



Things moved quickly from there.  They wheeled in the incubator with the embryos.  That's N seeing her babies!

Dr. Hickman came into the room and it was time to get down to business.  He checked the ultrasound and said "is that her abdominal wall?" and the nurse said it was.  He said "Wow, you're so thin, this is really easy to visualize.  Really good visability."  First time I've been accused of being "so thin."  Ha!

We were transferring two embryos-- the ones that had been the 11 and 9-cell embryos at day 3.  Now they were a stage 2 blastocyst and a morula (more on stages later).  Here's the process from my perspective:

He ran a small tube into the cervix and then injected the embryos through there, into my "fluffy" uterus. 

All smiles afterward:

Me on the table, embryos on board:

After the transfer, the acupuncturist came back in the room for my post-transfer treatment.  I think I was probably supposed to be quiet and meditative, but we were talking and happy.  Oops.  :)  Here's a shot of the room, as we were leaving.

Gayle and I met N out in the waiting area, where she was talking to Barb about the embryology results.  She had printouts from this transfer and the last one, so that gave me plenty of data to obsess over later. 

These are the embryos we transferred:

I think the one on the left is the morula and the one on the right is the blastocyst.  Ideally, they expect the embryos to be blastocycts on day 5.  We just had one make it that far.  Blastocysts are graded on a developmental scale of 1-6, with 6 being the most advanced.  This blast is a 2, which means the blastocoel cavity is more than half the volume of the embryo.  A morula is more typical of what is expected on day 4, so this guy is a little slower growing.  That doesn't necessarily mean anything other than that it's slower growing than average.  Morulas still have a good pregnancy success rate, just not as good as blastocysts.

We hugged Gayle and Barb goodbye and went out to lunch at Pappadeux.  After my last transfer, I had salmon, so I gave into tradition/superstition and had it again-- it was delicious.  Just as my entree came, I felt the valium working for the first time (I'm convinced it did nothing for the actual transfer), and I started fighting the sleepiness.  After lunch, we went back to N and M's house and I sacked out for 2-3 hours.

I woke up right before M came home from work.  And, true to form, they totally outdid themselves for dinner.  Salad, asparagus, mashed potatoes, mushrooms, steak, pistachio pudding, and two kinds of cake.  Oof!  It was so, so good!  By 10:00, we were all exhausted and went to bed.

Oh!  Worth noting.  Houston IVF did not require me to do any bedrest.  Just basic "take it easy" instructions.  So that was great.  I was afraid they were going to chain me down.

In the morning, I got up, had some pineapple, and talked a bit before heading back home.  M was pacing in the kitchen, talking about when I'd be able to test and let them know-- funny.  I had an easy drive home, picked up my kids, and went back to regular life.

This morning, they still haven't heard whether any of the three embryos left in culture on Wednesday made it to freeze.  I hope so!

In any case, I'll start testing on Sunday morning.  That's likely too early to see anything, but I'm a fan of "early and often" for home pregnancy tests.  We should have a positive test by Wednesday, I would think.  And the blood test will be Friday.  Grow, grow, grow little embryos!  Stick around.  It's worth it!

Very quickly

Transfer Wednesday.

Embryo report:
4 Grade 4- embryos:

• 11 cells
• 9 cells
• 7 cells
• 6 cells

1 embryo that likely won't make it - 4 cell

Here’s what the grades mean:
Grade 4 : even cell division, 0% fragmentation
Grade 4-: even cell division, less than 10% fragmentation
Grade 3+: even cell division, less than 20% fragmentation
Grade 3 : even cell division, less than 30% fragmentation
Grade 3-: even cell division, less than 40% fragmentation
Grade 2+: uneven cell division, less than 50% fragmentation
Grade 2 : uneven cell division, less than 60% fragmentation
Grade 2-: uneven cell division, less than 70% fragmentation
Grade 1+: uneven cell division, less than 80% fragmentation
Grade 1 : uneven cell division, less than 90% fragmentation
Grade 1-: uneven cell division, 100% fragmentation

Bromelain

There's some evidence that eating pineapple can help with implantation and improve the uterine lining. For me, it falls in the "can't hurt" category- I love pineapple anyway and when I read about it with my first transfer, I stocked up. The core has the highest concentration of bromelain, so I'm sure to eat that too.

Here's my stash, thanks to our local Mexican grocery store that had them on sale: 2/$3.

Fertility report

Quick, while I'm waiting for a movie to start. 9 eggs mature, 6 fertilized. Now we are on-call for a Monday transfer (3 day). Barb will call me Monday morning and tell me if I have to drive to Houston. Hopefully not, as I will be on the road to San Antonio when she calls! And a 5 day transfer would be better. AND Rick will be able to go with me on Wednesday, but not Monday.

So fingers crossed for Wednesday, but if it's meant to be Monday, we'll make that work too. In any case, it's going to work! Heck, technically I'm already 2 weeks, 1 day pregnant. :)

Tonight's pill haul

Makes me feel like an old woman. And the Medrol tastes horrendous. Off to drown my troubles in ice cream.

Egg retrieval

N's egg retrieval was scheduled for 8 this morning.  We exchanged a couple of texts last night-- everybody was feeling good and optimistic.

So all I could think of this morning was the retrieval.  I sat on my hands until about 9:30, then texted M to see how it went (didn't want to bug N in recovery).  He texted right back and said they were still in the waiting room!

So more waiting.  Waiting, waiting.

And then, at 11, another text from M:  "13 eggs.  Last time it was 7."

I cried!  I didn't think I was being emotional about this, but 13 is just so awesome and I was so happy.  I was expecting 7-8, based on what N had said before.  13!  So great.

And... last time, Cara had 13 eggs (which, strangely, turned out to be 14-- one was hiding or something).  And 13 is my lucky number (and my birthday).  I feel good about 13.  Yay 13!

So now we sit and wait again (surrogacy = waiting) for tomorrow's fertility report.  For a little context, with my first transfer, 13 eggs turned into 8 developing embryos at day 2.  Seven of those continued developing to day 5.  Supposedly, that was a little over average.  According to Cara's research, 13 eggs should have yielded five early stage embryos (60% of eggs mature, and of those, 60% fertilize).  With M and N's last transfer, 7 eggs yielded 2 embryos on day 5 (so at the same rate, we'd get 3 or 4 this time).

Five would be great.  4 would be great.  2 or 3 would be just fine!  We'll see soon.