Sorry for the long silence. There isn't really a lot to say, other than we are still hanging in there. Our next ultrasound is two weeks away, which is a freaky thought... just two weeks ago we were averaging better than one a week.

Update

We had a surprise ultrasound today with the RE. It's hard to explain the crazy shifts of a day like today: the two hours of fear starting when JF tells me she's just scheduled an ultrasound, followed by the cool excitement of seeing the little fellow wave around his limbs on the ultrasound.

The RE did a great job of explaining that we weren't crazy to want an ultrasound, while reassuring us that things seemed to be going well.

More Good News

Today's ultrasound went well: strong heartbeat and appropriate growth. The doctor and JF said they could see limbs, though I couldn't really make them out. He also poked around a bit and found the cause of the spotting which has been driving us past our wits' end. The bad news is that it doesn't sound like it is likely to stop; the good news is that it doesn't seem to be a major problem, either.

After killing twenty minutes at the comic book store, we then had our first meeting with a nurse from the ob/gyn's office. She was very nice and reassuring in her manner, though she seemed distressingly unprepared to figure out how to make an IVF pregnancy fit into their computer system. She also was much more conservative than our RE on the subject of what JF is allowed to do activity-wise. (Sigh.)

I feel like my mood has shifted very noticeably in the last 24 hours or so. I think I may be ready for the return of hope and optimism.

SF and I keep talking about how we want to put up a blog post, but we can't figure out how to give voice to what we're feeling. He's out skiing with the dog this morning; I've decided to give it a shot.

Despite the reassurances of our doctor, we're both finding it hard to relax and stop worrying. My body seems to be misbehaving just enough to suck the joy out of every day: the spotting stopped for about 4 days before the last appointment, but it started up again, heavier, on Thursday. Then just a spot Friday evening. Nothing so far today, but I expect it's in the mail.

Every good thought I have seems to risk bringing misfortune down upon us. I know that sounds melodramatic. I know it is melodramatic. But I can't deny the feeling is there. It's strong enough that, after going through three miscarriages and 2 1/2 years of ART without the help of a therapist, I'm considering calling the one our RE recommended to see if she can help us relax and find the joy in what we're experiencing.

It felt like a risk to request the information packet from our hospital. It felt like a risk to call the OB/GYN. It felt like a risk to stop the PIO injections.
Our doctor has given us a 3-5% chance of miscarrying at this point. We've "beaten" the odds in so many ways before, though, that SF and I are both fully aware that those numbers above the 95th percentile still represent people. Logically, I know that requesting the hospital packet doesn't cause miscarriages, nor does filling out the OB's paperwork, nor sneaking a peek at cribs online.

Emotionally, though, it's a different story. SF sat me down a couple of days ago and said, "It's all right if we pretend we think things are going okay. If we don't, we won't ever do anything to prepare, because there's never a guarantee that things will continue as you hope."

This post feels clumsy ... but so do I.

Good News

We have a heartbeat.

I cannot begin to say what a relief this is -- we've both been worried sick the last three days (see JF's previous post).

I'm afraid I'm finding it hard to be coherent enough to post, so I'll leave it at that.

TMI all over the place

We went shopping yesterday and as we were getting ready to leave the store, I went to the ladies' room and saw the thing I've been dreading for weeks -- bright red blood.

Reassuring:
-- The quantity seems to be decreasing and the color fading to more brown
-- Our doctor said maybe to expect some spotting through week 10 because my ovaries are still huge and abused
-- I have had no cramps

Worrisome:
-- Definitely red, not pink
-- A couple small clots
-- Initial quantity was scary

We still have the ultrasound scheduled for Monday morning. I don't see much point in calling them earlier, on a weekend, because if it's a miscarriage I'm pretty sure there's nothing they can do.

Lying low

Sorry for the radio silence this past week. SF and I are just trying to get through all of the days until we find out whether this pregnancy is viable. Or at least the ones until the next milestone -- the heartbeat. We've got an ultrasound scheduled for tomorrow morning, 5w6d. I know it's still early to see a heartbeat, but I'm hoping.

Good News

The beta today was 741. That's a 56-hour doubling period (three days since 306), and to quote the nurse, "Things couldn't look more perfect or normal than they do."

I'd say I told you so, but honestly, I've spent the afternoon quaking in my socks at the thought of taking this phone call.

So our next scheduled test is the ultrasound on the 15th.

Resilience

I've been vacillating all weekend between "que sera, sera" and "Please let this cycle work ... I can't do it again." There seem to be tons of examples around the web of people who had one less-than-ideal doubling rate and then went on to have healthy pregnancies. There are also tons of examples of people who went on to miscarry. This time tomorrow, we'll at least have another number to add into the mix.

The trouble is, I seem to have used up all of my resilience. At each step in this IVF cycle, things have gone basically well. Not just basically -- better than we'd hoped. But as soon as something doesn't go perfectly, I'm lost. Paralyzed with fear. Every time in the past, the first less-than-perfect milestone has been a marker for eventual failure.

The web says doubling within 48-72 hours is acceptable, but there seems to be a clear message (emphasized by my RE's nurse) that they really want to see doubling within 48 hours.

SF is a paragon of strength here. He believes if not this time, then surely the next. I'm just hoping to be able to rely on his strength over the next day or so, fearing that I may need to save my own for later.

It's still all about the waiting

Well.

The nurse called. The beta rose from 181 to 306 in just about exactly 48 hours. That gives us a doubling time of about 62 hours, far short of the 48-hour ideal.

We are to return on Monday for another test.

The Transfer (The Good Parts Version)

As promised, let me go into a bit more detail on why Monday was so great. Back in March, the doctor told us that between the miscarriages and not producing very many follicles on the first round of injectables, we might be looking "reduced ovarian response" (probably not exactly the right medical term). If that were the case, we would be facing the likely possibility that none of JF's eggs were any good, and donor eggs would be the only viable option. The next round of injectables, at double the dose, went much better, but the doctor left us both with the impression that there was still serious doubt to the quality of those eggs. So I, at least, spent the last nine months thinking there was a good chance that we were going to eventually start IVF, spend the first round learning that it was hopeless, and then move on to donor eggs. The doctor did tell us this month that he no longer considered this a likely diagnosis, but that wasn't enough to clear the idea out of my mind.

So I spent the weekend trying to enjoy the early Christmas with my family, while inside I was bracing myself for disastrous news, either in a phone call or at our appointment on Monday. I'm pretty sure JF felt the same way -- she said she had nightmares that only one embryo made it far enough along to transfer. I found myself thinking that wouldn't be so bad, at least in her dream there was one that worked! But I didn't want to say anything that would get her down.

So Monday morning we said goodbye to my family, and I drove us to the fancy IVF center with dread in my heart. (Example imagined bad scenario -- there is nobody else there when we get there, because we missed the message saying none of the embryos made it, and it being Christmas Eve they just stayed home.) Because it was a fairly long drive, in winter, we left early, and arrived at the center 30 minutes early. Moments after we got there we were ushered back by a nurse, and that's when I knew we were really in trouble -- surely it could only mean they wanted to give us the bad news quickly.

Only then she took us to a gurney, and gave us hospital gowns, and suddenly there was a ray of hope -- I figured it was unlikely they'd give us gowns to sit down and give us bad news. Then she casually told us that seven embryos had been cleared as normal by the PGD testing, and the doctor would soon be checking over to pick the best ones to transfer. That's when it finally got through to me that this might work out. I felt comfortable enough to joke that this was probably the only time children of ours would be considered normal. I think JF expressed a worry that maybe the doctor might still find a problem with all the embryos, but in my mind the situation had shifted from inevitable trouble to strong hope.

Finally the doctor showed up, and gave us the news. Of the seven, two were still a bit behind, and two were absolutely prime for transferring. (I think this means the other three were merely average.) The question of gender came up, and I momentarily panicked, because this was something we hadn't really thought of ahead of time. But luckily the situation was ideal -- the best two were one of each. The other five would be evaluated the next day (ie yesterday) to determine if any were suitable for freezing.

Exciting as that was, the big news was that the possibility of problems with eggs or sperm is off the table. It now looks like the issues have been hormones and timing -- things IVF is already designed to work around. All the pills and the shots every morning may be a pain in the arse, but they're a lot easier to put up with when it looks like they have a good chance of making everything work.

So there you have it -- easily the best news all year for us. It doesn't mean that this cycle is necessarily going to work. But it does mean there is a good chance it will, and plenty of reasons to be optimistic that things will work out eventually.

Which is pretty much the best Christmas present ever.

Fertilization report

The nurse called this afternoon and said that of the 17 eggs retrieved, 10 fertilized. I don't know anything about quality yet. Maybe ... tomorrow?

Today was pretty slow for me. Between the anaesthesia and the pain meds, I've been pretty out of it for much of the day ... probably could have made it through work if I had to, but (a) I keep falling asleep and (b) we're closed right now for renovations, and the work that needs doing is primarily heavy lifting, which is off limits.

And ... I just threw up. So we'll have to see about work tomorrow. Thank goodness lunch was a long time ago, because it was Spaghettios, and not to be crass, but they taste like puke going in. I really wouldn't care to meet them again.