and I'm back...

It's been a few days over a year since I last posted and I am ready to start this up again. We started TTC again in March 2014. I weaned N around that time for fertility reasons, which was a difficult choice.

In early June we thawed our four frozen day 3 embryos. Our hope was to thaw them on day 3 and try to grow them to day 5 and then do SET if any of them made it blastocyst. We knew the embryos weren't great quality and we didn't want to transfer more than one because we were explicitly trying to avoid twins because of what happened with our first twin pregnancy. We figured growing to day 5 would be a good selection device.

I guess it was too good of a selection device, because after preparing a fluffy lining with a couple of weeks of estrogen, none of the embryos progressed to day 5 after thawing. It was disappointing to have nothing to transfer, but I guess it also wasn't shocking since we knew the embryos weren't great and I didn't regret that we chose to attempt a day 5 transfer.

After the transfer that never was, I had a meeting with my RE to decide where to go from there. I knew that I wanted to get pregnant soon and never having had a spontaneous pregnancy, I knew that I wanted to continue with treatment. I was uncertain whether I wanted to start with something less invasive and emotionally consuming like Clomid IUI or whether I wanted to dive right back into a fresh IVF cycle. I also didn't know what our health fund would cover based on our circumstances at the moment.

Our RE advised that he would support me in whatever treatment that I wanted to do and in whatever order or combination I wanted, but that he still thought IVF was our most efficient path to pregnancy. Fair enough. After talking it over with Y and some soul-searching, we decided to proceed with our fourth fresh IVF in July 2014.

We did the antagonist protocol and the stimulation went fine. We got 10 eggs, which is pretty standard for me. Unfortunately, only 5 fertilized with ICSI which is a pretty low fertilization rate for us. Our embryos were in an incubator with an embryoscope, a time lapse imaging system that takes video of the developing embryos. It is a pretty cool recent invention that is supposed to help in embryo selection and gives the embryologist and RE real-time info about the embryos without disturbing them in the incubator.

Our hope was still to do a day 5 SET but based on our lower fertilization rate and underwhelming embryo quality, my RE advised we do a day 3 transfer. We weren't so psyched about this, both because day 3 hadn't brought us success in the past and because suddenly it made the question of how many embryos to transfer much more confusing, since day 3 SET doesn't have such great results.

The day of the embryo transfer, the embryologist and our RE reviewed the video clips from the embryoscope. Our RE told us none of the embryos were more than 6-cell, all had significant fragmentation, and none of them met the freezing criteria. He and the embryologist recommended that we transfer three (!) We decided to settle for two, even though Y had significant reservations since we were (and are) still both traumatized from the pregnancy with Aminadav and Naava.

Needless to say, much to the shock of our RE and myself (and not to Y), we got pregnant with twins again. I am now 17w3d pregnant with a boy and a girl, and it's been a challenging and scary road so far. I had light bleeding from weeks 5-7 due to a subchorionic hematoma. At the NT scan I was diagnosed with partial placenta previa, and during week 13 I was hospitalized due to a major bleed. This was really scary since chronic bleeding is what we believed caused PPROM (premature rupture of membranes) with Aminadav and Naava -- basically due to blood wearing down the amniotic sac like sandpaper. I rested at home for a week and then returned to work.

I also had a worrisome cervical length ultrasound about a week ago. It shortened significantly based on that measurement but then when another technician measured it a few days later, all was good. I am not sure whether my cervix is dynamic or whether maybe the first measurement was incorrect or what, but I will ask my doctor what she thinks when I have my regular appointment next week.

This whole ride is very scary for us....every day I just feel thankful to wake up still pregnant. The only way through this is to make it to each new day as uneventfully as possible -- 10.5 weeks til our first big goal. Meanwhile, N fills our lives with so much joy (and activity!). We are so blessed to have her here with us.

dusting off the cobwebs

Its been a while. Quite a while. Since I last posted, we passed a lot of significant milestones. All of these milestones were pretty hard, and they actually made me feel less like writing. Instead, they made me want to crawl into my own little cocoon and burrow there for a while.

The Big Dates

The first big date was 19w2d, which was my PPROM milestone with the twins. It happened to coincide with the weekend before my SIL's wedding, so it was also a hectic family time. I spent a lot of time crying in the shower and crying in bed that weekend. Hitting my PPROM milestone was harder than I anticipated and made me sadder than I thought it would.

I was also incredibly fearful. I knew there were no ominous warning signs that my water was about to break, but it still felt like maybe there was something karmic or evil about that particular gestational age that would rob me of this little one, too.

My FIL made a toast at dinner in which he listed month by month all of the babies born in our extended family over the past year and he omitted Aminadav and Naava. Given my already fragile emotional state, this really made me feel like crap even though I know he meant no harm by it. I didn't think it was worth it to call him out on it, especially not on my SIL's wedding weekend when the attention should deservedly be focused on her, but it did really upset me and the timing was just very poor.

Y's grandmother noticed the omission and also commented that she always remembers them. We shared a little cry and that made me feel much better.

Later in the week, I reached the gestational age where I lost Aminadav and Naava. Getting to that point was surprisingly less emotionally charged and sad for me than my PPROM milestone. I felt a small weight lift from my shoulders as the day ended.

And just a few days after that was the Hebrew anniversary (yahrzeit) of Aminadav and Naava's death. I knew that being essentially on the same calendar with this pregnancy as I was with their pregnancy, all of these significant dates would come one after the other.

Their yahrzeit falls on the Jewish holiday of Purim, a particularly joyous holiday, ironically. Y and I decided not to celebrate. Instead, I lit their yahrzeit (memorial) candle and we went out snowshoeing in a nature reserve.  I wanted to do something solitary in nature, so this felt right to me. In the evening, we went out to dinner. I spent a lot of time crying on their yahrzeit and the crying was very therapeutic for me and actually made me feel better, as I find sitting in the depth of my pain on occasion often does.

Then about 10 days after that was the one year anniversary of their birth/death on the English calendar. That date was actually much easier and lighter for me than their yahrzeit. I focused on my appreciation for the blessing of their brief existence instead of on all of the hurt, pain, and what-ifs and should-haves.

The Babe and Me

Thank goodness this pregnancy continues relatively uneventfully. My only major complaint is that I have frequent contractions and cramping/pressure, which coupled with my anxiety makes me really nutty. I go in weekly for a tv u/s to measure cervical length and take a quick look at the babe. My cervix continues to hold stable, usually measuring between 3-3.7cm. This is obviously a big relief.

At 21 weeks, I had my anatomy scan. Everything looked good and we were told for the 4th time that baby is a girl :) The only notable finding was an echogenic focus on the heart, but we are told that with improving ultrasound technology, this finding is becoming increasingly common and is very unlikely to have any significance in light of our first trimester screening and quad screen results.

Baby girl was super active during the anatomy scan, which was pretty cool to see. I have an anterior placenta again this time around, so movement was a little muted at first, but during the past few weeks I have been feeling consistent movement including some really good jabs and kicks that are visible from the outside, which is pretty cool. I started progesterone on the same day as the anatomy scan.

I had a detailed placenta scan at 22 weeks, which showed my placenta looks great. This is also a big relief since it seems placental issues are what began the series of disasters that ultimately resulted in the loss of the twins.

I've made one trip to L&D, which was actually a positive experience, but hopefully we won't have reason to repeat it for many more weeks. I was having menstrual-like cramping and lower back pain for a few days that wasn't going away and I was scared of PTL. My MFM happened to be on call that night and she was very reassuring. We were in and out within an hour with the knowledge that even if I was contracting, my cervix was stable.

I met with the hematologist again a couple of weeks ago. The current plan is that I can get an epidural as long as I take clotting drugs prophylactically beforehand (the concern with an epidural with a bleeding disorder is a subdural hematoma). I will see her again in May.

I am really fearful and anxious these days. I am so scared my body will screw up. I know these next few weeks until 28 weeks are really critical. I relive my water breaking all of the time - it was such a strong sensory experience. 

I know that right now I am very "lucky." Lucky in that I had a relatively easy journey (relative to my previous history, anyway) conceiving this pregnancy after losing the twins and lucky in that so far, I have had a pretty good go of it this time around. (It feels a little ominous and foreboding to write that.) I have experienced enough to realize that this journey has everything to do with dumb luck and little to do with deserving.

I exist in this really weird place where I am constantly trying to mentally prepare myself for losing this dream little girl while in the same moment I can look at cute baby clothes and read carseat safety reviews. Stuck between preparing for the future I have dreamed about for so long and preparing for the death that I pray won't happen. 

                                                   23 weeks

a quick week 16 update

I was just updating the "our journey" tab of my blog and it made me so sad to think, when will I ever update the "Aminadav and Naava" tab? I can't believe we are quickly approaching a year since they were born and died. A little trite to say, but it certainly doesn't feel like a year since I lost them and yet my pregnancy with them and the happiness of that time feels like it was so long ago.

I have been thinking lately what I might want to do to acknowledge the one year anniversary of their birth and their death and I am still stumped. I just don't know. Unfortunately, early March is not such a nice time of the year for a special hike or outdoors activity. And of course the creeping thought has occurred to me: Will I still be pregnant with this baby on March 7? G-d I hope so.

I haven't even wrapped my head around what exactly this one year anniversary is - to be born and die on the same day - a birthday and a death day - what is that exactly? A celebration? A somber remembrance? I am not really sure. I guess it is up to us to make up the rules of this day.

In happier news, I had my weekly clinic appointment and the MFM was thrilled with the way my cervix looks. It is measuring around 3.4mm, so I actually gained a bit of length over the past two weeks' measurements, and she said it is curved (not stretched taut) and has a glandular pattern, which is also apparently a good prognostic marker. I am happy to be boring and hope to stay boring for a long time.

We also found out that baby appears to be a GIRL! I am equally thrilled with either prospect, but I was pretty convinced that this babe is a boy, so it was a bit of a surprise :) I had my quad screen drawn this week as well as a bunch of platelet function tests.

My only complaint is that I continue to have weird cramping and what I think are probably sporadic Braxton-Hicks contractions, but painful ones. The various pains definitely put me on edge. I just have no idea what's normal and since I had some pretty significant cramping both before my partial abruption and before my water broke, I never know whether any given 2am cramps are just insignificant, normal pregnancy pains, or whether they are the harbinger of a new disaster.

Does anyone have some ideas of what we might do to acknowledge the one year anniversary of Aminadav and Naava's birth and death? Unfortunately, since we are currently in Canada and they are buried in Israel, visiting the cemetery isn't an option.

these two lands

I hold a kernel of hope deep in my heart that this pregnancy is going to end in a baby that we get to take home. It seems a bit bold and gutsy to confess to that, but it's true. I am not confident in my ability to carry to term, but I think the odds of me getting to something like 28 weeks are much better with a singleton and I think that each new week that passes by with no bleeding bodes well.

Still, it is hard not to be consumed by my fear. This is a different pregnancy, a new pregnancy, and yet it all feels so familiar. I have done this before, walked many miles in these shoes exactly a year before, and we all know how that turned out. Sometimes I even slip up, forget it's not Aminadav and Naava in my belly, and sometimes friends and family slip up, too, asking a question about 'the babies.' If only we really got a do-over, but Aminadav and Naava are still buried in the ground in Israel and in my belly I carry a brand new little one in Canada - the little sister or brother we haven't met yet.

I suppose it makes perfect sense that this winter feels like an extension of last winter and that my pregnancy with this baby feels like an extension of my pregnancy with the twins. After all, this winter and last winter, those babies and this baby are part of the same story and the same journey.

The memories of the terrifying moments are so visceral, so engrained in who I am, it is hard to not constantly relive the sheer terror of my water breaking (exploding really) way too soon and all of the sensory details of the experience.

I was really nervous during the first trimester about an early miscarriage and then I had a brief respite from anxiety, but now I feel my fear slowly creeping back up as I approach the gestation where I began having complications with Aminadav and Naava. 

Every morning I wonder is this the day I will go to work, end up in the hospital, and not come home? Is today the day I'll start bleeding or the day my water will break? Is today the beginning of the end, or just the beginning of the beginning, like it should be? 

I exist straddling a weird in-between of hope, excitement, and fear. Just like last time, I want to read reviews of fancy stroller models and daydream about baby-wearing and making my own baby food, but in my sleep, I give birth in tens of bizarre and disturbing ways to a baby that is not yet viable. Sometimes in these nightmares the baby is somewhere on the floor but so small I wonder if I will find him at all. 

There are limitless demons that can haunt you once one truly awful thing happens - one of those sort of things that isn't supposed to happen. It opens so many new possibilities and avenues of horror. All of the sudden every freak complication seems equally possible because you are one of those people.

The belief that there are those people and then there's you is what keeps your imagination from plunging too deeply into the menagerie of horrors that could befall you. But once you become one of those people that wall comes down and you skate on thin ice because every manner of disaster could happen to you. Suddenly, the improbable odds and freak statistics feel very personal.

So I carry this kernel of hope deep in my heart; this belief that this time will be different but I have another foot grounded in a land of fear and disaster. Praying that in the right time I will land, two feet on the ground, with a screaming, cooing bundle in the 'normal' world - the land of the lucky.

**In mundane medical news, I had a MFM appointment on Thursday. Cervix is funneling a tiny bit at the top, but with fundal pressure, the cervix doesn't go below 2.8-2.9cm and my baseline measurement at 13 weeks was 3.0cm, so there is very little if any change there. The NT results combined with the first trimester screen gives us a 1:29000 odds of trisomy 21 and the appropriate PAPP-A levels combined with u/s suggest that my placenta is functioning well at this point. I think we will do the quad screen at my appointment this week.

I had a hematologist appointment on Friday. They asked me to enroll in a study following pregnancy and medical outcomes of women with bleeding disorders. There is so much known about the role of thrombophilias (clotting) disorders in pregnancy but much less known about the implications of bleeding disorders in pregnancy. The suggestion that my bleeding disorder may have played a role in my abysmal obstetric history is actually pretty unsettling to me.

14.5 weeks - long overdue update!

I am so far behind, I am not really sure where to begin. I often wish I had been much better at documenting my pregnancy with Aminadav and Naava since in the end, my pregnancy was the only time I had with them. I have mused about how I did a good job recording all the mundane details of our fertility treatments and yet I did such a crappy job of documenting the next stage. And here I am again, doing the exact same thing. Actually, I have been even worse about documenting this pregnancy than my pregnancy with the twins.

I suppose it gets back to the age-old question that has boggled many an infertility blogger - how do you blog about the next stage? Who is your audience? And based on your answers to those questions, how comfortable do you feel writing about pregnancy and maybe even parenting? 

I still feel pretty uncomfortable writing about pregnancy. I realize this is pretty stupid given that despite several pregnancies, including one that came very close to living take-home children, I know firsthand that pregnancy doesn't necessarily translate into a baby or babies in your arms and that pregnancy isn't always the holy grail to The Other Side. It is just another stage in the journey to The Other Side. Yet regardless of these experiences, it seems like I will never make the easy transition from infertility/baby loss blogging to pregnant after infertility/loss blogging. 

But I do still feel a tugging to document this pregnancy for myself, for this babe, and for anyone else out there who is experiencing something similar or will in the future. I am so incredibly grateful for this pregnancy. I still can't believe that it is my current reality. At the same time this pregnancy is also of course really complicated for me emotionally. I am very fearful that it could all be taken away from me at any moment and with each day further I get, I feel the stakes increasing. 

I also still desperately miss and long for Aminadav and Naava. I feel like I knew them. I still don't understand why they aren't here with me and I know if they were here, this baby wouldn't exist in the first place. That's complicated. I feel like I knew them. But not this little one. Not yet anyway. I ask all the time: Who are you? Who are you in there? 

And while I have not been busy imagining up a personality for this little one, I think of this baby as a he. I am nearly convinced of it. I will honestly be so happy with either a girl or a boy, but I will be a little surprised if this baby is a girl :) 

On the practical front, I had my first MFM appointment at 13 weeks. I stopped progesterone supps at 11 weeks and I am now tapering off Prednisone while continuing baby aspirin. We did the NT scan and the first tri screening blood work, but I won't have the results until my next appointment. I was just really satisfied to see that baby was still alive! I am so far very impressed with the MFM - he seems very compassionate and knowledgeable. 

At this stage, I will be going to the MFM every other week and they will check cervical length by u/s. I will also continue to be followed by the RPL specialist. At 20 weeks (assuming I get that far), we plan to start progesterone to prevent PTL. Since it is not so clear-cut whether there may have been an element of incompetent cervix in my PPROM and since the 2 D&Cs for retained placenta could have caused cervical damage, cervical change is something they will be closely monitoring. The other thing they will be monitoring closely is my placenta since I had a partial abruption with the twins preceding PPROM. The good news is no bleeding so far in this pregnancy. My next appointment is this Thursday at 15 weeks.

To wrap things up on a light note, here is a recent bump pic. I still treasure my bump pics from my pregnancy with the twins, so I know even if things don't turn out well this time, I'd still like the little momentos. Lastly, in silly news, the most exciting thing that happened this past week was that I got a Snoogle. I can't believe I was deprived of a pregnancy body pillow when I was pregnant with the twins and spent so much time in the hospital and on bed rest - I guess what I didn't know I was missing then couldn't hurt me.

week 10 update

Today I am 10 weeks + 2. I am beginning to gain a little more confidence in this pregnancy, or at least feel a little more positive about our chances of making it through the 1st trimester, but I still worry constantly that everything could change in a second, maybe without me even knowing it.

I know I have written about it many times before, actually in a way that was eerily foreshadowing when I was pregnant with the twins, but I hate how when things go wrong you feel like such a sucker - like how could I have even thought that everything would turn out ok or how was I was oblivious to my fate.

Yet when things go well, you tend to feel just a little smug or you even berate yourself for having so much unfounded anxiety when everything is just dandy. And as I have also written before, of course the only thing separating Mrs. Sucker from Mrs. Smug is, well, the outcome of the pregnancy, but it's really something you have zero control over and sometimes while all available data points to yes, the outcome is still a no.

In the past week, we unearthed the doppler and I've been able to listen to the babe's heartbeat, so that has definitely been reassuring. Morning sickness has steadily gotten worse, which makes sense because it peaked pretty late with the twins, too. So far I have needed IV rehydration twice which is pretty unpleasant, but the intense vomiting (fun!), still hasn't been as frequent as with the twins. I am now taking diclectin a few times a day, which is a combo of vitamin B6 and antihistamine and that does seem to help, though it makes me really drowsy.

I also started packing up clothes that are clearly too tight and I've now taken out my maternity clothes. This feels like a leap of faith that I am just not totally comfortable with, but I am beginning to grow (mostly just bloat, I think) and it is pretty impractical to have all of these clearly too-tight clothes taking up space. I am more comfortable in mat jeans now than my regular jeans, but I don't plan on putting on any maternity shirts until the start of the new year, which will correspond to the beginning of 2nd tri, if I make it that far. I feel like maternity shirts make it really obvious, so in the mean time I prefer sticking to big sweaters.

I am weaning off of progesterone now, though the plan is to continue Prednisone until 12 weeks and then slowly taper between weeks 12-20. Even though I am on a low dose, I am definitely beginning to feel the side effects of 2 months of Prednisone but I can't complain.

I still have so much unresolved grief for Naava and Aminadav, which isn't at all surprising, but this new pregnancy definitely sometimes intensifies my grief. I just wish so so badly I had the chance to really get to know them and raise them. It is all so confusing - I know I wouldn't have THIS little one on the way if they had survived and I feel much more of an attachment to them than I do to this baby (I feel horrible just writing that) and I suppose all of that makes sense because I carried them for much longer and delivered two very real to me little people, whereas at 10 weeks this pregnancy is still obviously much more abstract.

Sometimes it definitely makes me feel guilty, like I am not 100% there for this little one. But I know that should this pregnancy G-d willing continue, my love for this baby will grow and grow, even if it might take me longer to become attached due to my past experiences and my ongoing grief. And little baby, I can't wait to get to know you and learn who YOU are.

 I think that is all the news fit to print in our corner...pretty boring, I think, but for now boring is good!

beta anxiety (second edition)

Last night Y got a script from his dad for a beta, if I wanted to repeat it today instead of waiting. I toyed with idea - I figured if this pregnancy is truly on its way out right now (a possibility), it would be reflected in a beta that is the same as yesterday or falling. But an equally likely possibility, perhaps even more likely, is that the number would be up, maybe another slow rise, and repeating it within 24 hours instead of the traditional 48 would just make it unequivocal and hard to interpret. The final possibility, that my hcg is playing nice again, is also definitely possible, but just having the 24h result, I'd still be nervous.

So...I decided I would POAS this morning and if the FRER was clearly getting lighter, I would go in for another draw this morning to confirm a fall, if it looked the same or even darker, I would wait 48h for the next draw....very scientific, I know :)

I had a really weird dream that I was getting some work done in an empty classroom, which apparently involved spreading my possessions about, including a massive collection of saved FRERs from this pregnancy. In the dream, I proceeded to pack up most of my stuff, forgetting the FRERs, and realizing only too late that a class had begun and a bunch of kids were now in the room...WEIRD.

In my second dream, this morning's FRER shattered before I could really interpret the result. And for what it's worth, in reality, today's FRER looked the same as the one from 2 days ago, but since the pregnancy line is so much darker than the control line, it is hard to interpret beyond safely saying that my beta is not likely plummeting.

So now I get back on the waiting train. I know I was a bit dramatic last night....but I was really so sad and disappointed. I know I have a tendency to jump right to the post-mortem before disaster has been confirmed (or sometimes even, denied).

What doesn't help this tendency to jump to the worst conclusion whenever anything is less than perfect is my history. It seems that anytime anything is slightly less than stellar for me pregnancy-wise, it inevitably leads to a succession of events that culminates in something bad.

The truth is, I am barely coping with my fear and anxiety when everything is going perfectly, so when stuff goes less than perfectly, it really throws me a curve ball. For now, I am just trying to get through the day.

I know that betas that stop doubling nicely can be ominous and unfortunately, the first sign of a pregnancy that isn't doing well can be jittery betas, even if it's only weeks later that the pregnancy actually fails.

Two rather innocuous possibilities for the slower rise:
1) There were two embryos and now there's one....a vanishing twin. My betas have been higher than average, even for a twin pregnancy, according to betabase, though I know there is no hard science to predicting multiples based on betas...high betas can also of course correspond to a singleton who implanted on the earlier side. If there was in fact a vanishing twin, my betas should recover with the next draw.

2) Y suggested that perhaps I was a bit dehydrated for beta #2, artificially raising the result. If you consider only the first and third beta values, the overall doubling time is still within 48 hours.

I am so anxious about the future, but like with everything else, unfortunately only time will tell.

beta blues

I wish those magical two pink lines didn't make my heart sing with glee every time I see them. I wish those magical two pink lines didn't tempt me to fantasize about my dream life, the life I took for granted that would be mine for so many years every time I see them.

Every time so far that I've seen those magical two pink lines, I've been duped, and yet, every time I seem them again, I am filled with renewed hope and anxiety and fear and forboding, yes, but also so much joy too.

Why? Why can't I view those magical two pink lines of a pregnancy test with the same detachment I view the two very unassuming lines on an ovulation predictor stick? Why can't I just learn my lesson? In my world, those magical two pink lines -- they pretty much mean...nothing. But I seem to be very late to the game in accepting this on an emotional level.

The doubling time between betas 1 and 2 was 33 hours -- from 146 at 13dpo to 391 at 15dpo. Those were some pretty strong betas. However, beta 3 at 18dpo was 956, a slowing to a 56 hour doubling time. Coupled with the awful headache and lower back cramps I've had today, I can't help but worry that this pregnancy has begun to fail.

Also, this is ridiculously subjective, I know, but I POAS yesterday morning and the pregnancy line was soooo much darker than the control (it stole most of the dye from the control line), I really think that it would have corresponded to a beta of at least 1000 and that things just took a downturn in the past 24 hours.

I know a beta can take 72 hours to double and it can still be okay. I know the 48 hour doubling time rule is a little arbitrary and that there is a whole spectrum, but I have never had betas not double in 48 hours and had it been okay. Also, these cramps are for real. So, I think I might be pretty close to bidding pregnancy #4 goodbye. I only hope that if it's not meant to be, it won't be a protracted ordeal with unequivocal betas and ultrasounds and that it will end quickly.

I am sad tonight. I really believe in my heart every time that this is the time that will be different, but sometimes to continue trying just feels like punishment. I also believe in my heart that this is a problem with my body and not our embryos.

i have a secret

I have a secret. I am currently in the middle of an IVF cycle. (Wow it feels good to say it.) A little slip-under-the-radar IVF before our one-year sojourn in Toronto for Y's fellowship and the end of our amazing Israeli fertility coverage until we return in summer 2013. We aren't telling our families or anyone, really (except for the internet, apparently) about this cycle. It feels quite liberating, in fact - this covert IVF business. It suits me and I think we should keep our reproductive pursuits under wraps more often, as far as family is concerned. Or at least be much more vague.

In the off-chance that all the stars align and I win the reproductive lottery, both by becoming pregnant and then remaining pregnant long enough that the baby is viable before my body sabotages the pregnancy, it would be my ultimate fantasy to tell no one at all of the pregnancy; rather, I would just show up one day with a robust, squeaking, living baby safe in my arms.

Everything about this IVF is actually pretty liberating. It is so vastly different from my previous cycles in that I really don't care. I know I will be truly, honestly sad and disappointed if it doesn't work, but in the past I was really short-sighted, and that made the consequences of a failed cycle seem much worse. What I mean by that is that it felt really high-stakes when I viewed the worst possible outcome as either a failed cycle or an early miscarriage. Now my deepest fears lie elsewhere.

In the past, I was obsessed with having complete control and doing everything just right - the IVF meditation CDs, acupuncture, reciting tehillim (psalms), eating well, nutrition supplements, knowing the size of my follicles and E2 off by heart at any given moment, actually handling dangerous chemicals in lab with caution. I believed that no one was more invested in the outcome of my cycle than myself so the weight was on my shoulders to do everything in my control to get everything just right.

My control freakery has at least temporarily been replaced largely by indifference. It is too early to say whether my newfound zen is the real deal or just a temporary manifestation of apathy that is part of my mourning. For now, I am just injecting whatever medications in whatever quantities my doctor recommends and trying not to think about it much beyond that.

The decision to cycle this month was actually extremely impulsive and last minute - as in, we had a vague and general conversation with Dr. T. about cycling again before the retained placenta disaster and then I woke up bleeding one morning last week, shocked myself, and asked Dr. T. whether he would support me in doing something really nuts and allow me to cycle right now. The next morning I went in for a baseline and got my prescriptions and that evening I started my injections.

I knew Y was secretly delighted when I called him at work to say I had my period and was thinking of calling Dr. T, though he had done a really good job not explicitly pressuring me to cycle when I didn't feel ready, which I really appreciate.

I also know it is a little radical what I did - leaping off a cliff with my eyes closed and deciding to cycle last-minute when I had already started bleeding - but for me, it is what worked. I was really incapable of knowing I was ready until that moment arrived, and if I had a lot of time to think about it, it would have just made me very anxious and agitated.

I also have the unusual luxury of an extremely accommodating and understanding RE who could make things work on very short notice. (I suspect he is also happy to have the opportunity to try to get me pregnant again before we leave for Toronto because I know our loss was the loss of a victory for him, too, and he is a really swell guy who certainly makes me feel like he has an investment in our outcome.)

Since losing Aminadav and Naava, I have had many days when I feel like never trying to get pregnant again, but underneath those doubts and dark feelings, is my belief that while nothing will ever fix what happened or my incredibly strong desire for them specifically, Y and I need a happier focus to our lives in the form of a living child.

I did think maybe it was a little bit overly eager to be returning to IVF and attempting to get pregnant again so soon after the twins died. I think that sometimes, still - that it is somehow disrespectful towards them to move forward with cycling so quickly. But mostly I see that a living child will connect me back to the twins - that the love I have for a living child and the mothering I have the opportunity to do for him or her will also allow me to mother the twins in the way I never got to and allow my love & appreciation for them to deepen even more.

It is incredibly scary and unnerving, as always, never knowing exactly what still lies ahead in our pursuit of a living child - the same, familiar wondering as before - whether we are very far or closer than we think. Except this time, it is tinged with the awful first-hand knowledge that you can get very very close and come back up with empty arms, having lost and gained so much. (It is always important to remember & acknowledge how much we gained.)

anxiety girl returns

Remember this chick?



I think she's back in rare form! I have this creeping unsettled feeling that is making me so anxious lately. I secretly think everything is a hidden sign of pre-term labor and it is my job to crack the case and figure it out. Every new pain arouses new suspicion and I feel like it is impossible to differentiate between what is just me being me and what is a potential issue.

Most days I am just still so shocked to be pregnant, to be gestating life and sporting this little baby bump and whatnot, it is so hard to imagine all of us coming out of this ordeal alive and healthy because me + reproductive success is such uncharted territory. I do take comfort in knowing that my anxiety is probably very common among People Like Me. It doesn't help that I was unusually anxious and neurotic before infertility and miscarriage entered my life.

I really pray that one day I can look back on this time of my life and think to myself how silly and unwarranted all of this anxiety is because I will have had my happy ending (the alternative is I will look back on this time of my life and reflect on what a sucker and smug self-entitled jerk I was to surreptitiously compare overpriced double stroller models and fawn over cute lamb mobiles like someone who might give birth to two intact children in the near future).

Of course the only thing that separates the wistful, omniscient "See, everything turned out okay" me of the future from the self-loathing "I told you so, sucker!" me of the future is the outcome of this pregnancy.

And now here is a summary of what actually happened this week in list form:

• Horrible food poisoning over the weekend that incapacitated me through Monday. I think it was worse than it would have been otherwise because I am pregnant. Vomiting Olympics 2012 ensued. Things were finally brought more or less under control by IV Zofran. I still don't know what the culprit was, but I hope to G-d it wasn't the lethal baby-killing kind of food poisoning. We've heard the babies' heartbeats on the doppler since, so it appears they're still kickin'.
• Discovered the show Homeland. Actually, that didn't happen this week, but it is an awesome show and I highly recommend it.
• Hematology appointment...pretty uneventful (we like uneventful!). I go back in 2 weeks. The cancer building where the hematology department is housed is a very depressing building. Not only is the clientele largely very ill, but the building is incredibly physically depressing.
• Lightning crotch:) Is this normal during early 2nd tri? I wasn't planning on enjoying this loveliness until later on. Shockingly, I find it contributing to my anxiety.
• Bump shot - for better or worse, the first one I've posted (14w5d):
  

7w3d - still kickin'!

I am so relieved today is over. Thankfully, both babies are still alive and growing! 7w3d is when I found out that my pregnancy was doomed last time, so I was pretty uneasy about having an ultrasound at 7w3d. Now I can finally begin to feel that this pregnancy is entirely different from my last pregnancy and stop with the constant comparisons. I can't believe I will wake up tomorrow morning at 7w4d and still (presumably) be pregnant...and so, the uncharted territory begins!

Baby Aleph, who was measuring 4 days behind last week is now measuring 2 days behind, at 7w1d. Baby Bet, who was also measuring 4 days behind last week, is still measuring 4 days behind but at least he/she is growing proportionately. Also, both babies definitely have a yolk sac, which is good to know after the scare last week when the u/s tech couldn't find Baby Bet's yolk sac! The nurse I spoke to told me today that she thought that was super weird and she had never seen in a report before that a baby had a heartbeat but no yolk sac was observed. I knew it was strange, too, but I am glad she waited until today to tell me she had never seen that happen before!

The only thing that is a little disconcerting is that both of the babies' gestational sacs are measuring quite small. I know I find something new to Google grimly and obsess over after every ultrasound. Also, I have a SCH. I am a little surprised because last week, when I was actually complaining of a little spotting, the u/s tech didn't find any source for it. This week she said that the SCH might cause more spotting or outright bleeding but hopefully it will just be reabsorbed. My next ultrasound is scheduled for 9w2d.

Since I can no longer button my jeans, I was brave and went to the maternity store to buy a belly band. My first pregnancy-related purchase - I really, really hope this is not something I will regret in the coming days and weeks! I know I made that mistake last time. I am trying to focus on being more grateful and less anxious. It is hard for me to feel properly appreciative and really, awe-struck that this is actually happening when I spend sooooo much emotional energy worrying. I now understand more than ever how you can remain infertile in mindset when you are, in fact, pregnant in body.

Here are some pictures from today of our little smudges:

the google monster

Need to STOP googling vanishing twin syndrome. I am performing my usual night-before-ultrasound CRAZY routine. The intense cramping that came on suddenly isn't helping things (I really hope that's just growing and stretching). I feel like we used up all of our good luck with our last ultrasound. Please let me see 2 growing, thriving babes tomorrow.