Welcome ICLW!

Welcome, ICLWers!

Ironically, I originally started this blog as a pregnancy blog when I became pregnant after our 2nd IUI. Stupidly optimistic, I thought the blog would be a great outlet for sharing our pregnancy with friends and family back in North America since we live abroad, officially catapulting myself head-first into the land of happy-go-lucky attention whoring Moms-to-be that we all love to despise. Long before we began to share news of our pregnancy or I went public with Journey to Baby G - The Puppies and Rainbows Version, we found out our baby had no heartbeat at our 7.5 week ultrasound.

After the loss, I felt a strong need to both write about my experiences for myself and to interact with others also grappling with infertility and pregnancy loss. This blog has obviously turned out much differently from what I originally intended, but I suppose our story also has ended up much differently than I had hoped just a few months ago. Already, I have benefited so much from being a part of this online community and I am daily humbled by the strength, grace, resilience and intelligence of the other women that populate it.

Currently, we are in the midst of our 3rd Clomid/IUI cycle. I was diagnosed with lean PCOS a few months ago, a diagnosis that was very surprising to me, since I definitely don't fit the classic PCOS picture. I am surprised by how different trying to conceive feels since the loss - perhaps because the loss is so recent.

On one hand, I am still shocked that we got pregnant at all to begin with. On the other hand, I am terrified that I will keep losing babies every time I get pregnant or that I won't get pregnant again. It seems like we keep falling on the wrong side of the statistics, so it is hard to have faith that one of these months it will finally be different. While I am excited to be back in the game, it is even harder to imagine myself pregnant with a healthy pregnancy and like everyone else, I hate not knowing how much pain it will take to get there or even if we will get there.

When we aren't obsessing over our future offspring, I bide my time in a research lab and Y operates on peoples' eyes with hands infinitely more coordinated and steady than my own.

I kidnap babies in my dreams

A few nights ago I was having a particularly fitful night of sleep. I woke up tired and with a slight recollection of having dreamt a lot. I didn't really think anything of it or waste any mental energy to figure out what I had been dreaming out. Not until I was on my way to work and a mother with the most beautiful baby sat next to me.

I know I stared for too long...inappropriately long. I've started staring at babies for longer than I think is really socially acceptable. At first I didn't notice that I had been doing it, but I am pretty sure you're not supposed to stare longingly like that. Anyway, then I suddenly remembered what I had been dreaming about. The fact that seeing this baby jogged my memory sort of creeped me out.

In my dream, I was with Y and for some reason we just happened to be at the hospital together waiting for something. We saw this baby boy, not an infant, maybe about a year old. Someone then explained to us that he had some terrible medical condition (maybe a social worker maybe a nurse...unclear). They told us that he was abandoned and that his parents didn't want him. The weird thing is, as far as I can remember in the dream, there was no formal adoption process. I just told Y that I wanted him so we took him home and he was ours. We became parents as simple as that - just a morning outing spent in a hospital waiting room:-/

The only conclusion I can come to is that I have some latent subconscious urge to take off with an unwanted child. I think it takes a special kind of crazy to have those kind of dreams (not the kind of happy-go-lucky, frilly pink dreams where you're pushing a healthy, beautiful baby in a stroller who got there by virtue of your uterus).

The only other baby-related dream I've had that competes in craziness is the one I had the night after we found out we were pregnant in October. In our dream, we were having our first ultrasound and the RE said quite matter-of-factly "The good news is that you have eight embryos implanted. The bad news is that none of them are viable as far as I can tell." Only my dreams reveal how truly crazy I am. In other news, CD1 surprised me out of nowhere on Thursday (I hadn't ovulated and was on CD32), so looks like we're back in the game. If all goes to plan, this cycle will be IUI #3. Tomorrow I go in for my CD3 (really CD4) bloodwork.

the waiting room game

During the past year, I have spent a lot of idle time twiddling my thumbs in the waiting room of the fertility clinic or the waiting room of the ultrasound clinic (about 50% of my monitoring ultrasounds have been at the fertility clinic, while the other half I've had at the ob/gyn ultrasound clinic located in the same hospital as the fertility clinic). I usually try to bring an article or book with me to pass the time, but I'm invariably too anxious to fully concentrate and instead end up using most of my time in the waiting room to assess the other clientele.

Perhaps my fascination with the other people in the waiting room stems partially from having never met any other IFers in real life (I am sure that we know couples we are struggling with IF, but none who have discussed it openly with us). I always wonder why the other women are there, what treatment they are doing, how long they've been trying, etc. I also tend to jump to conclusions about their story based on their attitude (some women come in grinning from ear to ear, others are crying, some are visibly worried or annoyed etc.).

At the ultrasound clinic, most of the women are visibly pregnant, there with spouses, and generally happy and excited, so it is easy to guess what their story must be. At the same time, you see plenty of women who aren't visibly pregnant and/or who appear nervous, worried, or sad. I bet that as an ob/gyn ultrasound technician you get to deliver mostly good news and spend most of your days among couples who are happy and excited, but that you also see your share of awful tragedy as well.

I have always found it interesting that those of us who occupy the fertility clinic waiting room often suffer so much alone in silence and use the internet to find comraderie and other women like ourselves and yet, we spend so much time physically among our own ranks in the waiting room, but do not speak a word. I am not saying that I wish people did speak to each other in the waiting room. In fact, I have pretty ambivalent feelings about being approached by anyone in that setting. Frankly, as nosy (and perhaps hypocritical) as I am, I enjoy my privacy and would rather not be questioned by strangers when I am feeling so anxious and vulnerable. I just think the dynamic is interesting. So, am I the only one who is so helplessly curious and nosy about all those other women in the waiting room or are you sizing me up, too? :)

Post-Miscarriage Follow-up

Today I had my miscarriage follow-up appointment with Prof. L. It was my first time back to the fertility clinic since the miscarriage, and let me tell you, I don't miss that place at all. First, the receptionists gave me a really hard time for being there at all, since appointments during the morning clinic hours are generally reserved for women who are actively cycling. Interestingly, the receptionist giving me the hardest time was the one who scheduled the freaking appointment with Prof. L. right there, who told her to schedule the appointment for that time. Of course I wanted to pull my hair out and I was feeling extra sensitive in general since it was my first time back after the miscarriage.

The good news is that the miscarriage is complete - both the ultrasound and exam confirmed this. I never thought I would be so relieved by the sight of an empty uterus. I just stopped spotting 2 days ago, so now we wait patiently until AF arrives. The plan is then to do another Clomid/IUI cycle, since that's what worked last time. We'll also repeat CD3 b/w, as well as testosterone and DHEAS. Also, I was clearly a little upset, both by discussing the miscarriage and by the hard time the receptionists gave me, but Prof. L. was super reassuring as usual, and encouraged me to call him directly on his cell phone to keep him posted or with any problems.

Crazy IF thought of the day while observing the throngs of new moms with over-priced strollers bedecked with over-priced accessories during my visit to the Mother & Child Center for my ultrasound: If I'm not pregnant by this time next year, I'm buying Harriet [the cat] a Bugaboo frog for Chanukah...with a little parasol.

In other news, I have a nasty cold with fever and left work early. Really, it's just an annoyance, but I still feel like crap.

Space Camp

What has shocked me the most about our loss is how unshocking losing this pregnancy was, despite the fact that everything was going so well until it wasn't. I remember when I was little, whenever something I deemed to be very important occurred, I divided my life into the before and after based around that single event. Inevitably, I would find the after incredibly depressing - the let-down after a big trip or significant event and all of the anticipation that led up to it.

When I first became pregnant and then later when we learned that our baby didn't have a heartbeat, I came to believe that these events would be the same - defining points against which everything that followed would be subsequently measured - separations differentiating the old before from the new after. Perhaps if my pregnancy had been healthy and marked the beginning of the life of a child we brought into this world alive and into our arms, this would have been true. Instead, I have found it surprising that the loss hasn't really felt like a defining point at all.

Perhaps it's because I spent so long hoping and praying to be pregnant and comparatively so little time actually pregnant (just shy of 8 weeks when I was admitted to the hospital for Cytotec), but the pregnancy itself feels like a strange but hopeful dream I had for 10 minutes one night. Now that its been a week since the miscarriage, nothing about the pregnancy feels real anymore. More accurately, I've been asking myself, did it ever feel real?

Not really. In fact, the whole time I was pregnant, I felt like an impostor. Part of me could never actually believe it was true or that it finally happened. I kept repeating over and over again to myself, to Y, to anyone who knew and would listen, really, that it was too good to be true.

Sure, I clumsily stumbled through all the motions of being pregnant. I was starving for lunch every day at 10:30am and ready to go to sleep at 7. My breasts increased a full cup size and I finally worked up the courage to buy a copy of The Book - What to Expect When You're Expecting, which lay splayed open proudly on the couch, not tucked away in a drawer like infertility books. I ordered cooked salmon maki and veggie rolls at sushi and sipped Cokes and Shirley Temples at our friends' wedding. I turned down wine, quit coffee cold turkey, and when the bloat made it impossible to comfortably wear jeans, invested in 2 pairs of elasticized maternity pants. I secretly enjoyed it when people would stare down at my protuding little belly (in reality more bloat than bump) and wonder.

On the outside, I acted like someone who believed she would have a take-home baby and yet on the inside, I was just an opportunist - a little kid version of myself who wanted to take full advantage of this longed-for virtual reality experience before school was back in session.

That's because in reality, I felt like a nine-year-old girl who wants to be an astronaut when she grows up more than anything else in the world. Finally, she gets to go to space camp. She is delighted and squealing with excitement- how lucky she is to get such an authentic experience! But even as a young girl, she still knows in the back of her head that this is just make-believe, a token or morsel of her real dream. This is all a high-tech stimulation - she has yet to see the moon.

And so, ultimately, my brush with pregnancy amounted to a few weeks at space camp. In the end, the only moment of my pregnancy that stands out in my mind as being real was lying on the crinkly paper of that ultrasound table with three technicians and one doctor crowded around me, nodding and talking to each other about the body on the table and the image of a womb on a screen, not a single word uttered to me.

That's when I knew that my time at space camp was through. Catapulted back to the reality of Earth, I was no longer an astronaut or mom-to-be, but an infertile finally pregnant, but with a baby without a heartbeat. All of those prayers and wishes and dreams for that miraculous ball of cells, that splendid little life growing inside me, slipping further and further from my reach, like so many dreams of outer space or Orion descending. I am here in Jerusalem, Israel, Planet Earth. I am 238857 miles from the moon.

Serial Killers and Statistics

Last night, 2:15am -- I am awoken from a nightmare when Y comes into our room to go to sleep.

Me: Can you please make sure that the door is locked.

Y: Okay...

[returns]

Me: Did you check?

Y: Yes.

Me: Are you sure?

Y: Yes.

Me: It's just that I was having a nightmare, so I want to be sure that you checked.

Y: Yes, I definitely checked.

Me: There was a serial killer in my nightmare.

Y: You know, serial killers are extraordinarily rare.

Me: We've fallen on the wrong side of the statistics more than once.

Harder than we imagined, stronger than we thought

The physical part of the miscarriage has been much harder than we thought. After reading the experiences of others with Cytotec, I knew it was a dreadful drug. In addition, a miscarriage in of itself, whether induced or natural is no picnic to begin with. Still, I think Y and I both underestimated the physical pain and the physical recovery.

I had it in my head that the worst of it (physically) would be over after 48 hours and that after that, the pain and bleeding would be similar to a very heavy period. In truth, the heaviest bleeding didn't occur until 3-5 days after the Cytotec and while the worst pain was definitely a few hours after they put the Cytotec in, I had intermittent severe pain that was completely incapacitating until today.

The mornings have generally been my good hours, with the worst pain in the late afternoon and evening. Luckily, Y has been home for most of the severe pain. Without him and his grade A back rubbing and culinary skills, I wouldn't be able to be manage. Finally, this morning (Sunday), which marked 7 days since the Cytotec, I was able to get up in the morning and feel functional.

Since I hadn't had a "good" straight 24 hours, Y thought I should take today off, too. In the end, I decided that today was a gamble but a week was enough, and it was time to tough it out and see if I could make it through the day. It was definitely the right choice. I made it through a hectic day and it felt right to get out of the house for the first time in 7 days and face the outside world.

Only 2 of my co-workers know about the miscarriage. The rest, including my boss, just know that I was out with some vague illness (however, my boss does know that I was hospitalized because Y called him to say I'd be out for the week when I was being admitted). In some ways, it feels odd that people think I've been out with "flu", but on the other hand, the ones who do know have of course managed to put their foot in their mouth ("You are so young and healthy." "At least it was your first." "It's not the end of the world." "You shouldn't worry." "Haha, now you don't even have an excuse to yawn.") You know, all the standard gems. Whatever.

Part of me wishes that I could muster up the gumption to respond and make them very uncomfortable. The truth is, I know people mean no malice. I have learned umpteenth times from the first "Just relax and it will happen" that many smart people are totally moronic when it comes to "consoling" or "counseling" those of us with fertility problems.

I think part of it stems from the fact that trouble TTC or IF is something that many fertile women think they can relate to, since to some extent it does fall within their spectrum of personal experiences (i.e. most women in a committed relationship have indeed gone through the life experience of trying to getting pregnant). They just sort of miss out on the nuances of how the experience might be completely different if you're, you know, broken.

Anyways...I am proud of myself that I went back to work and had such a productive day. Physically this has been much harder than we imagined but emotionally, I think we are perhaps more resilient than we thought. We'll take what we can get.

Broken

Baby G was never growing hands and feet or developing a brain or any of the things I wrote about in my 7w post, because on Sunday (7w3d, or 7w5d by LMP) when I went for my 2nd ultrasound, we received the horrible news that Baby G had no heartbeat. In the end, that slight brown spotting from last week was an ominous foreshadowing of what lay ahead. My cervix was still closed, my uterus measured 7w0d, and there was no active bleeding, so my body was essentially staying pregnant even though the pregnancy wasn't viable. This meant we had to make the horrible decision of how to complete the miscarriage.

The two choices were either a D&C or Cytotec. With the Cytotec, they place the medication in the cervix and contractions are induced. Since the process can take days to be complete and can be extremely painful and since there is only an 80% chance of "success", I decided I wanted the D&C, which would be over quickly and give definite closure.

Unfortunately, there was a 12 day wait for a D&C and I didn't want to remain pregnant carrying around a non-viable pregnancy for that long. That is how we came to choose the Cytotec. I was admitted to the hospital yesterday morning and had the drug administered. Just before the doctor put the Cytotec in, I saw 2 little drops of blood. I know this sounds silly, but seeing those two drops made me feel much more at peace, like my body was perhaps beginning to realize that this was not a viable pregnancy.

I felt nothing but mild menstrual cramps for about 3 hours. Then the cramps steadily worsened until they became full-on contractions with 5-10 second breaks in between. The pain was absolutely excruciating -- well beyond anything I had ever experienced before. I was in a room with 3 other women (two of whom were pregnant), and at first I felt really self-conscious about my moaning. Later on, this gave way to full-out screaming and wailing, which I had really no self-control over. I just remember screaming "Oh my G-d" over and over again. Y held me and rubbed my back and squeezed my hands. He was so brave for me. He was and is my rock.

The doctors and nurses kept referring to "performing my abortion" and "you're now in the middle of the abortion" etc., which really upset me. I know it is the medically correct term, but since they also perform elective abortions in the department, I really wondered how many of them looked at my chart and history closely enough to know that I was an infertile who lost her baby, not someone trying to undo a bad choice. It also upset me to think that the other women with whom I was sharing a room may have thought I was having an elective abortion if they overheard the doctors and nurses talking to Y and me.

Eventually, the worst of the pain subsided and I waited to bleed. It took a while for the bleeding to start, though it did pick up around 12am. By morning, I was still too nauseous to eat or drink so I got IV fluids and IV Zofran, which made me feel a whole lot better. They sent me for an ultrasound, which showed that the miscarriage was still in process. However, the gestational sac was no longer intact and we were told that the Cytotec was likely a success. Finally, I was discharged around noon.

Now we wait and go back for an ultrasound and a follow-up appointment in 2 weeks and we hope that I won't need a D&C. The doctor said that we can return to fertility treatments after I have one normal menstrual period. Hopefully, this will happen by the start of the new year. Speaking of the new year, it upsets me to think that we were 25 and 33 when we started TTC. In January, we turn 27 and 35, and still no baby or even viable pregnancy to our name. I have faith that some day we will have our healthy, take-home baby, I just spend a lot of time questioning how much pain and suffering it will take us to get there.

7 week update

The spotting seems to have stopped and I still feel pregnant, so now we are just hoping and praying for the best. Today I am 7 weeks and 1 day pregnant. Baby G is now the size of a blueberry (about half an inch long -- twice the size of last week!). Baby G is growing hands and feet. The only thing shrinking is Baby G's tail -- yup, embryos have a tail, which is an extension of the tailbone and decreases in size until it disappears. Baby G's brain is growing and its liver is making red blood cells. Baby G is now connected to me through an umbilical cord. I am sending lots of good vibes to our blueberry for lots of continued growth!

Here is a bump pic from yesterday at 7w0d. So far, I think the only thing increasing in size are my breasts (anything else is just bloat), but it will be fun to chronicle the progression to a real bump.

Scared

A couple of days ago I noticed a tiny bit of dark brown CM. It freaked me out a little but it was such a tiny bit I didn't dwell on it and almost forgot about it. Fast forward to today and I have seen brown-streaked CM every time I've gone to the bathroom (you can thank me now for all of the graphic detail). The only other time I have seen this happen is a couple days before AF. All I can think of now is that I knew being pregnant was way too good to be true.

I am supposed to have an u/s on Sunday (7w3d) to confirm a heartbeat, but I know I could probably go in tomorrow if I want. The truth is, I think I am more scared of having an u/s and finding out "the truth" and the anxiety leading up to it than I am to just wait it out and let nature take its course until my original appointment on Sunday.

I have just been resting in bed for the past few hours since I got home from work. Harriet, ever needy for affection, is keeping me company and enjoying lots of her favorite behind-the-ear rubs. I hate being in limbo and I am really scared. If I am going to miscarry, I just want it to happen already, but I pray that we get to keep our baby.

6 week update

Today I am 6w3d. Last Monday I had my 3rd beta draw at 25 dpiui (5w4d). My hcg level was 3567, up from 279 at 18 dpiui, so thankfully my numbers were doubling nicely. We also saw Prof. L that same afternoon. He answered many of our remaining questions about lean PCOS, PCOS and miscarriages, and my over-response to the Clomid last treatment cycle. He did do an u/s, though he warned us that there would likely not be much to see. All we could really see was a small gestational sac, but it did give us peace of mind that at least Baby G implanted in my uterus. Also, we only saw one sac, so while we can't quite yet rule out multiples, all indications point towards a singleton pregnancy.

Prof. L told us that our chances of an early miscarriage are 15%, compared to the normal 10% (50% higher than average), but if we are able to detect a fetal heartbeat, the chance will decrease to ~7% and will again further decrease to 3% at 12 weeks. I am still so scared but at the same time so hopeful, too. When I was struggling to get pregnant, it was difficult to think beyond the excitement and thrill of some time getting a BFP. Now that I am there, I haven't really experienced the ecstacy I imagined because I am so frightened to lose the little life growing inside me. I am so scared of waking up one day soon to "game over" and having to go back to square one with the dreaded fertility treatments.

Everything about this process has been so hard and uncertain until now, it is difficult to imagine that anything could proceed smoothly without lots of emotional pain. In short, after a lot of disappointment, finally being pregnant just feels too good to be true. I am just trying to remember, that even if our odds ARE worse than the average couple, the odds are still in our favor that this pregnancy will continue and we will get our Baby G at the end of it all.

This weekend I had some serious stomach issues. We went up to the Golan for Shabbat and I was scared I was going to not make it during the 3 hour car ride. Thankfully, Y picked up some Zofran before we started our trip and things got much better for me. Since then I have felt much, much better.

Our next u/s will be next Sunday (exactly a week from today) at 7w3d. Unfortunately, Y won't be able to join me because the appointment will be in the middle of the day, the only appointment time we could get. We have another u/s at 9w0d, and then assuming all is well until that point, the next time I will see Prof. L is at 10w0d. I pray that I will get to see our baby's strong and perfect heartbeat next Sunday, the most beautiful image I can possibly imagine.

Second beta results are in!

Today I had my second beta drawn at 18dpIUI. It was 279. A normal doubling time is every 48 hours and since 4 days ago it was 42, on target would have been 168. I think that we're actually doing pretty well so far! I am starting to let myself imagine what being pregnant and having a baby might actually be like. I guess you could say I am feeling more cautiously optimistic now, but still terrified. Again, each passing day feels like a new milestone. I am so filled with gratitude every morning.

Next week we have an appointment with our RE, Prof. L. I am also hoping we will soon get our first peek of Baby G by u/s in the next couple of weeks. When I had my last u/s 4 days ago, the technician told me that once my beta level reaches 1000, we should be able to see something. So cool. Since we had a lot of follicles, I am also extremely anxious to see whether there is more than one baby in there (that would be Babies G!).

Must pee on stick.

After looking at stark white pregnancy tests month after month for just shy of a year, we finally got the miracle we had been hoping and praying for last week: a second line. I remember when we first started TTC, I used to think that maybe if only I could find a better or more sensitive pregnancy test, I could will that second line to appear. With each passing cycle, I would think that positive pregnancy tests were something that clearly happened to other people. Eventually, I came to believe I would never see a second line. Still, every month, I would habitually enter my POAS craze near the end of every cycle. I couldn't help myself. I was an addict. An addict who likes pain and heartache and blank white test windows.

This month, 11 dpIUI happened to be our wedding anniversary. Like the masochistic moron that I am, I decided that there was no better way to kick off our anniversary celebration than to POAS and get the requisite BFN. With that out of the way, I spent the rest of the day sulking. We had NINE freaking follicles (3-4 of which were mature, we weren't going for an Octomom thing here), I triggered with hCG at just the right time, and the timing of our IUI was perfect--if I couldn't get pregnant with that, I am completely helpless, I thought. In fact, I was feeling so despondent I seriously considered asking Y if we could push off our anniversary dinner. In the end, I sucked it up and we went out and had a wonderful evening during which I drank WAY too much wine for a pregnant woman (but how could I have known? :)

As soon as we left the restaurant and started walking back to the car I started to feel terrible. I was crampy, sweaty, clammy, and to be fully honest, either about to vomit or get the runs--which one was unclear. As I lay scrunched up in fetal position in bed on the eve of our anniversary I was feeling pretty full of self-pity. "I have a stomach virus and killer PMS," I thought. Awesome. The next day I felt no better.

The following morning, when I was still feeling like crap and AF had stayed away, I could resist no longer. MUST PEE ON STICK. Too bad I was donating my last FRER from my "American" stash to the cause and would have none left for later. The test generated a true curiosity: a faint faint hint of a faint faint hint of a second line barely visible to the human eye. Y confirmed that he saw what I saw, he also confirmed that as far as he was concerned it was a 100% completely positively negative pregnancy test.
Can you see it? Probably not unless you use your imagination.

The next day, 14dpIUI, AF had still not shown and my temp was still high. This was just getting curioser and curioser to a seasoned TTC sleuth like myself. Out of stock of FRERs but not defeated, I peed on the most sensitive and expensive Israeli stick I could find, the "Yes or No Professional" test. Behold, there was a very faint but undeniably present second line. I had imagined this moment so long--I can't say I reacted quite as dramatically as I had envisioned it. My hands got all shaky holding the pee stick and I said in a high-pitched voice, as if I was posing a sensitive and uncomfortable question, "Y, I think I'm pregnant?" My naysayer husband even agreed it was true, this was a positive pregnancy test.
That's a bit more like it. I think this picture makes it look lighter than it was:-/

Next, I headed to the fertility clinic, where I had my first beta drawn to confirm the pregnancy and an ultrasound to make sure my ovaries weren't overstimulated from the fertility drugs. My first beta came back on the lower side of normal for 14dpIUI at 42. Tomorrow, I head back for my second beta--the indication that things are going well will be to see a clear doubling pattern every 48 hours. Today, I am 4 weeks and 3 days pregnant. Based on the date of my IUI, our EDD is 6/30/11. Baby G is just the size of a poppy seed! Still, lots of action and growing is going on. The amniotic cavity and the placenta are forming. Baby G is transforming from a miraculous little ball of cells (the blastocyst) to an embryo with three different layers that will soon start differentiating into organs.

I have been so wracked with fear. Just to have reached this point feels like a miracle, after many months of waiting and hoping and praying. Despite my fears, I am trying to be positive. I believe in my heart that this will be our sticky, healthy, take-home baby, and for now that faith will have to be enough. Today-17 dpIUI - 'pregnant' popped up quickly (POAS note: got
a CBE digital 2-pack in America only for the purpose of seeing
'pregnant' appear once I already knew I was pregnant:)