26w3d ~ Last Cervical Check

I’m so hoping today was my last vaginal ultrasound for a long time.  Perhaps until we’re ready for baby number two and thus another IVF cycle.  I’ll worry about that when the time comes though…

Today’s appointment went really well.  My cervix is now measuring 1.3 cm compared to 1.4 cm three weeks ago, therefore my doctor is considering it stable, crediting the progesterone supplements.  The plan now is for me to stay on the progesterone and monitor any changes in how I feel, meaning any signs of pre-term labor.  My weekly cervical measurements will cease, as apparently it’s difficult to measure past this gestational age due to the size of the uterus, and also because baby girl is now viable.  Emergency steroids would still be given if labor seems imminent before 37 weeks.

The only concern my doctor had today was baby’s position, still feet down.  She said it’s possible for baby to change position until around 32 weeks, so I’ll probably have at least one more ultrasound to check her position before delivery.  Has anyone else’s doctor commented on positioning this early?  I guess I just assumed we had weeks yet for her to move and flip.  Doctor did tell me not to panic yet, as there are ways for them to turn the baby.  (That sounds fun!)

All in all, a good appointment.  I did get a few more pictures of baby girl, I’ll post tonight if I remember.  My next appointment is my regular 28 week checkup on March 10th for my glucose screening.

20w2d – Ultrasound Pictures

First, the ultrasound pictures, as promised.  These have also been uploaded to the scrapbook page 🙂

141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d

image2

141 days ~ 20w1d
141 days ~ 20w1d

I did a lot of thinking last night, and reading.  Reading seems to get me in trouble though.  The short of it is, it appears that progesterone is the only approved treatment for a shortened cervix during pregnancy, and it only works about 1/3 of the time.  That said though, I’m telling myself this can’t be that serious, as if it was, my doctor wouldn’t be waiting 3 weeks to recheck me.  Right??  I mean, for the most part, I’m going about my life as normal.  A small part of me does feel a bit like a ticking time bomb though.  After everything we’ve been through to get to this point, I honestly can’t imagine starting all over.  And perhaps I’m getting way ahead of myself, but those fears are obviously there.  I received a few clothing items for baby in the mail yesterday, and immediately wondered if they would need to be packed away, not to be used come June.

As for the progesterone, I’m waiting for the mess so many of you have mentioned 🙂  And why don’t they come with an applicator??  Is that really too much to ask for??  They are smaller than I imagined, they look like little round pearls, which just happen to be an unpleasant shade of pink/orange.  Directions are two each evening before bed, and of course, when I got up this morning I fully expected gravity to take over…  But nope, no mess yet.  Does it take a while??

I do want to thank everyone who commented yesterday.  One of the main reasons I’ve kept up with this blog this long is the constant support it provides.  Yes, each and every one of you is amazing, and I promise to respond to each of you later today.  Thank you so much for your kind words, prayers, and advice, for those of you with first hand knowledge.  It truly means the world to me 🙂

20 Week Anatomy Scan – Good & Bad

First the good…

Baby is perfect!  It was so fun to watch her wiggling around during the ultrasound, sticking out her tongue and swallowing some of the amniotic fluid.  She was sure busy!  The technician was very detailed, measuring each organ and body part and explaining all in detail.  She estimated baby’s weight at about 14 oz. today which is right on track developmentally for 20 weeks.  We received several cute pictures, but I’ll post those separately once I have a chance to upload them.

I did ask about movement, or rather my lack thereof, being it’s been on my mind so much.  The tech confirmed I have an anterior placenta, meaning it’s in front of the baby closest to the front of my abdomen and thus the reason I haven’t felt much movement yet.  My doctor confirmed that since I have an extra barrier between baby, I might not feel definite movement for a few more weeks, but that I shouldn’t worry.  The ultrasound confirmed baby is healthy and active.

So now the not so great…

One of the measurements the ultrasound tech needed was the length of my cervix and whether it was closed or open (dilated).  Thankfully it’s still closed, not dilated, but it is much shorter than it should be at this stage of pregnancy.  Basically the cervix should be about 4cm throughout pregnancy and shorten (efface) during labor.  Well, mine is already effaced to 2cm, which is apparently not good.  At first the tech thought maybe she just wasn’t getting a good view of it, so out came the dildo cam.  Yes, and here I thought I was finished with ‘those’ ultrasounds.  Oh the memories!  The second ultrasound showed the same though…

My doctor explained the risks of a shortened cervix at 20 weeks, mainly miscarriage and pre-term labor.  My regular OB contacted a high risk physician and it was decided that for the time being we’ll try progesterone suppositories, as they have been known to stop effacement (further shortening of the cervix).  The problem though is, nothing has been known to increase the length, so getting to 40 weeks could be problematic.  Side note, I’ve heard from fellow IVF bloggers that progesterone suppositories are nasty messy, but in this case going back to the injections isn’t an option, as we need the localized effect of the vaginal suppositories.  My directions are to use them nightly, beginning tonight.  I’m sure I’ll have some great stories for you all soon!

So going forward…  I pray the progesterone stops the shortening of my cervix.  In three weeks I’m to return for a repeat ultrasound to check my cervical length.  If it’s the same, I assume I’ll stay on the progesterone.  If it’s shorter we’ll have to be more aggressive.  My doctor mentioned perhaps bed rest, steroids, stronger medication to deter labor, etc.  I didn’t ask a lot of questions about what’s to come, maybe I should have.  For now, I’m going to focus on the next three weeks.

Eric was with me today during our ultrasound and appointment, and thank God, as he understands all this medical stuff so much better than me.  Problem with him sometimes though, is that nothing serious really seems to phase him, as serious to him is about dead.  He did seem worried today though…  As we walked out of the doctor’s office he said, “We just need to get to 30 weeks for baby to be healthy, that’s only 10 more weeks.”  Um, frankly, I’m still holding out for my 20 more weeks.  I am not about to assume at this point she’s coming early, nor am I ready, on any level, for her arrival in 10 weeks!

Beta #1 Results

If you read my post from earlier today you know I called my clinic and asked if I could come today (14dpo) for my beta, instead of tomorrow as it was originally scheduled.  So at 10:30am this morning my blood was drawn by a very nice women around my age.  We chatted about how she’s been trying for seven years to get pregnant and thinks perhaps it’s time she saw her doctor for some assistance.  Wow, she is way more patient then me!

Maybe an hour later I received an email that I had a new message in MyChart, a new test result, my hcg level.  Beta #1 at 14dpo was 189.  I was honestly shocked to see the number, hoping for 100, but never guessing it would be that high.  A wave of calm passed over me, but it was short-lived.  I didn’t see the results of my progesterone or estrogen levels posted, so I figured they would be relieved in the usual way through the patient information line, so like any inpatient IVF patient, I began calling the 800 number every 10-15 minutes.

Finally at 2:30pm this afternoon there was a new message posted by one of the nurses.  She confirmed my beta of 189 and passed along results of my hormones levels as well.  I wasn’t too concerned about my progesterone level since I inject 50mg each evening; that level was 58 compared to last cycle of 52.  If you remember, last cycle we transferred two 3-day embryos, found ourselves pregnant with one, but weren’t able to find a heartbeat at our 7w6d ultrasound, with our embryo measuring just 6w6d at that point.

My estrogen level today was 584 compared to 74 last cycle.  My first question to the nurse, why the much, much higher level this pregnancy, as I was expecting it to be low again.  The nurse explained that your estrogen level early in pregnancy is a good indicator of the strength of the pregnancy.  She said that they supplement if the level is low to help the pregnancy along, but that needing to supplement is never a good thing.  Wow…  I really wish they would have explained this to me back in May when I got my first positive.  While it obviously wouldn’t have been happy news, it might have prepared me a bit better for what was to come, my miscarriage.

So here is a little recap of my IVF cycles, if you find yourself at all interested 🙂

Due date is June 1st as based on the date of my egg retrieval, and first ultrasound is scheduled for the morning of October 13th, three weeks from now, at which point I’ll be 7 weeks pregnant.  Hopefully I’m not getting ahead of myself, as I obviously still need to see a healthy doubling beta Wednesday morning.  Ultimately though, looking back on my first pregnancy, I’m feeling a lot more confident this time around.

As far as symptoms and such, the majority are a result of the progesterone injections, the sore, slightly enlarged breasts, peeing more often than usual, maybe a little extra heartburn, but I have issues with acid reflux as it is.  I noticed today that the palms of my hands and underside of my fingers are incredibly dry.  As in, almost peeling.  I’ve heard progesterone can cause dry skin, but this seems a little extreme!  As for the light spotting I was experiencing, the nurse confirmed with me again that as long as it’s light and brown in color I should be okay.  Thankfully though, I think most of that has come to an end, for now anyway.

As confident as I’m feeling, I’m still scared as hell for Wednesday’s beta #2 results.  If I’ve learned anything from this process, it’s that months of planning and years of dreaming can all disappear in the blink of an eye.

That Patient…

I am officially that patient. You know, the one who calls and emails and bothers their doctors and nurses.

Yesterday morning when I woke I was all worried about the numbness and tingling around my PIO injection sites. So I hopped on my MyChart app on my phone and emailed my clinic, from my bed. Got to love that! A nurse responded quite quickly saying there wasn’t much that can be done but that I shouldn’t worry, the numbness and tingling should go away but could take a while.

Then I got out of bed and went to the bathroom. And saw the light, brown spotting. While still sitting on the toilet (TMI?) I emailed the nurse back and asked about the spotting. Later yesterday afternoon she wrote back and told me not to worry too much about the spotting, as they don’t get too excited about brown, light spotting.

So I made it to today. This morning, 14dpo, my HPT looked darker than yesterday, but I’m still spotting. Still light brown in color, and light, but still. And did I mention that yesterday’s test actually looked lighter than the day before? Eric keeps telling me those tests aren’t exact, but we all know how comforted that made me feel. Comparing 12dpo to this morning though, today was definitely darker, although the week’s estimator test still displayed 1-2 weeks pregnant this morning. Somehow I was hoping for 2-3… although if I remember correctly, 1-2 weeks on those tests is anyway from 5-300 or so.

So being that patient, I called the IVF clinic maybe an hour ago and asked if my first beta could be drawn today instead of tomorrow. Today is 14dpo, I mean, haven’t they made me wait long enough???

Actually, I had another reason in mind for not wanting to wait again day, fear of a low estrogen level. Last cycle when my first beta was drawn they determined that both my progesterone (considering I was already on supplements) and my estrogen were low. I was told to immediately start estrogen pills twice daily. Knowing that history I inquired this time if I could start estrogen on transfer day when I started the progesterone, but my doctor assured me there was no reason. Well, I don’t know, but something tells me my level is low, and I figure the sooner I start supplements the better… I should know my levels soon.

Prayers for a strong first beta, despite my continued spotting. I’ll update once I have the results!