then and now

Tuesday was bittersweet. We feel incredibly lucky and blessed that our embryos and my uterus get along so well, of course, but when we went for celebratory sushi we ended up also talking a lot about A and C. How happy we were to be expecting them, how sad we are that we didn’t get to keep them, and how we worry about the second trimester with Strawberry Baby (on top of the first trimester that everyone worries about).

It may seem like we dwell on the past, but I think it is necessary for us. This all happened less than a year ago, it was our very first pregnancy and we were so excited. Now, excited, but cautiously. But we do have a lot of hope for this baby, and push our doctors harder to take any concerns seriously – although given my history, I think they will do that anyway.

It was my husband who coined the term “Strawberry Baby”: during the 2ww, he said he hoped we’d get another Strawberry Baby. When I inquired, he explained that one of our daughters had looked like a little strawberry on the first ultrasound (which I think to this day remains his favorite ultrasound).^* In our native language, strawberry starts with an E, so it’s even consistent. Once he noticed that I picked up the term enthusiastically, he was quick to point out that of course he hoped this little one would stay with us much, much longer than the strawberry stage.

And at the same time, we are embracing this pregnancy and celebrating every day. Reading about what Strawberry Baby is doing in the pregnancy book he gave me last year. We have told a few friends and family members as well as my boss (who has been incredibly supportive through everything) and a good mentor. I want serious weekly pregnancy photos (H is a good photographer, but somehow last time wasn’t too interested early on as he figured that’d have time…). I’m still working on a theme though and might pick something else than what I tried yesterday.

^* I thought about including that picture here, but decided it’d be too confusing.

Strawberry Baby

Thanks for all your wonderful wishes! It really warms my heart and makes me even happier than I already am.

Beta rose nicely to 644 – “Everything looks very good” were the words from my nurse. If I wasn’t so tired I’d tell you why we call it strawberry baby. But tired is probably good and normal and all, so I just need to sleep more and tell you tomorrow.

Pink

To pass the time waiting for my nurse to call, I did a routine experiment. And in the second-to-last step, the solution turned pink – which it never had before.*

Hours (hours) after this, my nurse finally got the results and immediately called: 215. A great, solid beta 14d3dt. I almost feel guilty as so many fellow bloggers have had chemical pregnancies lately, and at the same time I know this was only the first hurdle. But for today, I will celebrate having made it thus far.

* After some random guesswork, my colleagues suspect it was just from the marker I used – but I prefer to think it was my baby saying “relax, Mom”

sidelined

My brother called to tell me that his girlfriend is pregnant.

The fact that he called (we mostly just text) told me it was something important – good or bad. He really tried to do this in the kindest and most gentle way possible, and he knew this would not be easy for me to hear. But, as you probably know from experience, some news still sting even if transmitted ever so gently.

I was ok on the phone, congratulated them and wished them all the best, asked how his girlfriend was doing (pretty good) and whether they were planning to get married (yes, but later, once the baby is there). But of course this brought up all those ugly infertility feelings: they are younger than we are, they have been together for a fraction of the time we have! (because clearly it works this way) Maybe they weren’t even trying! Add to that the ugly loss feelings: she’s 9 weeks, and they assume they will have a baby in September. Even if I am pregnant now, I will worry about losing the baby until we have reached at least 26-28 weeks (not that it’s “safe” after that, I just haven’t been there, and the likely outcome is better than at 20w). Probably beyond that, too.

I finally burst into tears just before H came back home. We spent some quiet time missing A & C, and being hopeful for this cycle.

Of my three brothers, this is the one I am least close to. Not that we have big arguments or anything, we’re just different. I had told my two other brothers about the FET but not him, and didn’t feel like mentioning it yesterday. The others might have told him, it’s not a secret – but as he didn’t bring it up either I think he might not know.

And yet, there is some sort of silver lining when looking beyond the stings. I grew up in a big family and always enjoyed spending time with my cousins – and, as it looked like neither of my brothers was going to start a family soon, I was a bit sad to think that our children might not have this. Admittedly, much of this thinking was before we lost A & C, so now there is an extra layer of complicatedness. But as I’m really hoping to bring home a baby someday soon, I’d be happy if he or she had a cousin to play with.

breaking the silence – part 3

Earlier this year, I got an advertisement that I thought was hilarious, in a nerd humor kind of way, and forwarded it to a friend I went to university with. His girlfriend had sent me some text messages after A & C died, so I knew they were thinking of us and trying to stay in touch. His reply included that he just found out he’d be in my city next week, and if there was a chance to meet up for breakfast on Thursday? There was. He wrote back:

Great! Looking forward to seeing you!

Such a common expression, and yet it meant so much to me. Because I’ve noticed that many people are apprehensive of meeting me, meeting us, now. We went to our favorite but rather famous coffee shop – the rule is, whoever arrives first gets in line, and then you still have a while to chat until you actually get to the counter. First we chatted about “normal” stuff – travel, work, etc. But once we sat down with our breakfast and coffee^*, he asked how we were doing. If I wanted to talk about that. So I told him about going back to work, where 50% of my colleagues have never so much as said a word about our loss, the family visit for Christmas with its good and difficult sides, and the upcoming FET and our hopes and fears around that. He acknowledged that healing will take a long time, and wished us luck for the FET. And then we went back to talking about other things.

* in case you’re wondering, I had decaf – I’m not sure this actually makes a difference, but I will do the few things I have control over

E is for embryo

E thawed well, with all his or her 10 cells, and was transferred this morning. By the same doctor that did our transfer with A & C, who remembered us and expressed his hope that I’ll get pregnant again, but with a better outcome this time. E did show more fragmentation than A & C, but I hope it’ll develop into a beautiful baby regardless:

I took it easy for the rest of the day (my clinic doesn’t believe in bed rest) – napping, knitting on a bench outside, then lying and just enjoying the weather (ok, you may envy me for this one). I have some light cramping, but it seems that may be normal. I went to my post-transfer acupuncture appointment but was quite relaxed even on the way there. I think I was worried that for some reason the transfer wouldn’t happen, so now I’m glad we made it. Work will keep me busy for the next few days, which may be a good thing (though I plan to spend most of that time sitting down listening to other people).

Here’s something we came across on a recent afternoon stroll. I’m taking it as a good sign:

in between

Thanks for all your good wishes! I really appreciate your support. I’m very hopeful, but simultaneously quite scared. Perhaps because I now have a better idea of what we could lose… and what we could gain.

A & C’s due date, February 25/26^* will be during my 2ww. Somehow that seems fitting. It would have been a waiting period – theoretically at least, given that they were twins they’d have been early either way, but I never specifically calculated any other date. Now it will be a waiting period, filled with hopeful thoughts for a first step towards bringing home a sibling for them.

For Christmas, H gave me a ring in memory of A & C. We bought it in the same place where we had gotten my wedding jewelery^**, and a part of the ring was called “starry sky”. Obviously it was perfect. When I got back here, a few people admired it, but then nobody commented on it for a while – until just before and just after the lining ultrasound. I like to think it was A & C telling us they’re ok with us moving forward.

* even with IVF we didn’t get an exact due date…
** that sounds so fancy and expensive, but in reality I think it was quite modest, or at least appropriately modest for a grad student wedding

a call and a hug

It was the only day during the week after we lost our babies that I actually had to be somewhere: we had to visit the mortuary to arrange the cremation.^* I got out of the shower in the middle of the day (don’t judge a grieving mother) a few minutes before we had to leave the house when my phone rang, indicating Palo Alto as the area code. That’s odd, I thought, I don’t know anyone from there who has my cell phone number… but picked up anyway. “Hi CC, this is Dr. RE” I recognized the voice and, even in my grief-addled state, was somewhat amused that she referred to herself as “Dr. RE”. I was surprised as I hadn’t expected this at all – she’s an MD/PhD and sees patients about once a week, if that; getting an appointment takes a month easily. She told that she had heard of our loss and was terribly sorry, and that both Dr. Head of RE (who did my retrieval) and Dr. Head of MFM (who saw us after C’s amniotic sac ruptured) had talked to her about me, and she had promised them to call me. Now, considering that I had sent an email to her nurse about whether I should to back on my drugs to prevent endometriosis earlier that week I cannot be entirely sure that they thought of me all by themselves, but regardless, it was nice to feel like an actual person and not just patient #1234567.

Dr. RE talked a bit about the psychological support systems the hospital offers, to make sure I knew that these were available to me, and proceeded to ask if we had frozen embryos (yes), how many (7), and which day (3). Given what had just happened, she said she’d definitely recommend single embryo transfer, and that of course there would be a lot more monitoring in any future pregnancy, and that the clinic had several excellent MFMs (it’s a big teaching hospital). I mentioned the doctor I had seen at my anatomy scan and selected for my follow-up appointment, and she immediately raved about how brilliant he was and where they had recruited him from. We also talked about whether I should take any medication to prevent endometriosis, but agreed that it might be better to give my body some time to recover and heal.

A few weeks later, I had my follow-up appointment with her. Given that the transfer part of my IVF had gone perfectly (we transferred 2 embryos and I got pregnant with twins), I didn’t expect there would much to talk about. Dr. RE was standing up when we entered the room, and declared that she’d first have to give me a hug. Another unexpected sweet gesture. She asked how we were doing, how I was doing (I think my poor husband felt a bit left out at times). We all agreed with trying single embryo transfer next, and worked out a timeline that would allow us to fit the FET in our contract to cover it. Then we learned that our embryos were frozen in pairs. I’m not sure this was ever mentioned before, but of course it was too late to change that now. Anyway, thawing two and re-freezing one seemed less than ideal. We essentially deferred that point for discussion with one of the embryologists when we got there. She also asked about Dr. MFM’s plan for the pregnancy (weekly progesterone shots starting at 16 weeks, biweekly monitoring, cerclage if cervix shortens below 2.5cm). “And perhaps bedrest, too?” she inquired, but I declined – there is no evidence that it actually improves outcomes. She nodded, but at the same time chuckled in what seems like a “young fools” way to me… that bit wasn’t particularly comforting, but I think we’ll cross that bridge when we get there.

Just a few days ago I had my lining check – the only appointment in this FET cycle, other than the transfer itself, much to my surprise. I had been worrying whether I’d been responding properly to the drugs (just because I tend to worry) but then started producing EWCM about a week ago, which seemed like a good sign. And indeed, my lining was trilaminar and 8.5mm, just perfect. Before getting started, the NP that does lining and pregnancy ultrasounds at my clinic commented how she’d seen us back in July and then now, how sorry she was for everything we had been through in the meantime, and that it must be hard for us to be back. While I appreciate the thought, and there is some truth to it, just minutes before I had mentioned to H how wonderful it had been to see our babies’ heartbeats in this room back then.

Then we met with the embryologist, who thinks that all our embryos are of similar quality – 8 to 10 cells, fragmentation and grades of 2-3. A & C had both been 822 and implanted and developed beautifully. According to the literature, she said, there isn’t much of a difference in pregnancy rates between grades 2 and 3, so we might as well thaw the lonely unpaired embryo to avoid having to re-freeze and thus potentially lose one. If a 10-cell embryo were to loose more than 2 cells in the thawing process, it’d be considered too damaged for transfer, and they’d thaw another (or a pair, in our case).

Long story short – my transfer is on Wednesday! I’ll take the day off to relax, go to acupuncture before and after if timing allows, and then I have a conference the following days to take my mind off things. Cell-division-and-implantation-supporting thoughts (however exactly these may look) will be much appreciated.

* A difficult task in an already difficult week, probably deserving its own blog post, but not today.

patches and needles

• I’m trying to find a witty start for this post but can’t. My transfer, which I have largely neglected to talk about so far, should be in just over a week. Isn’t that amazing?!
• I have learned that the worst part about estrogen patches is tearing them off, and am not exactly looking forward to removing four of them on Wednesday, just to put four more on (also, I seem to be running out of space). But I am looking forward to hosting another of our precious embryos. Hopefully for the whole nine months this time.
• My big grant is almost submitted. Of course, once the stress over that stopped I began to actually think about the transfer and freak out a little…
• I imagine that, in some parallel universe, there’s a copy of me (or however you call the version of yourself in a parallel universe) that has babies at home or still in the belly, and fretting about how to get this grant done with the babies or the pregnancy exhaustion. And it makes me sad to think that, even after all we went through to get pregnant, I still didn’t quite appreciate what a miracle it is to actually bring home a baby, healthy and screaming and alive.
• After going through the new patient paperwork, my new acupuncturist said she was very sorry, and then asked a bit about my symptoms and what I was here for. She has a community practice together with some other practitioners, which among other things means that it’s much more affordable. She doesn’t talk much, just checks in with me when I get there to ask if anything has changed. She also mentioned that some people like to bring their own blankets or pillows. So I started taking this:

  

  It’s the baby blanket I was knitting for A & C. Just one, you ask? I had bought the yarn on a trip to the east coast in this lovely store before we even started IVF. I never really expected twins, but due to the skein size would actually have had enough for two. I knit through stimulation, retrieval, transfer, the 2ww, and some more during pregnancy. But I hadn’t even finished this one when we lost them. And initially I thought it would be terribly hard to get back and finish it. But it was surprisingly easy, soothing even. It gave me hope that someday there would be a baby in our home to wrap in it.

or perhaps it was wishful thinking, after all

Do you ever not write about something for fear of jinxing it? I felt this way with my symptoms. And, of course, yesterday afternoon I started spotting, which has since developed into a proper period. Oh well. It would have been too nice.

I am less hungry but still kind of ‘meh’ feeling. Who knows if it was just the progesterone or there actually was something that didn’t make it… I hate the thought of my body failing yet another baby, so I kind of prefer the ‘overinterpretation’ variant. H still wants to do a test tomorrow, before I start the BCPs for the FET, but I don’t think we’ll learn much from it.

I’m still very hopeful for the FET – and terrified it might not work (who isn’t?). With the current schedule, the transfer will be right around a conference I’m organizing. I hope they’ll be on different days… but on the upside, I will be distracted. And if anything, these past few days have shown me how much I want to be pregnant again.