at the end of this God forsaken ectopic pregnancy tunnel! Friday's beta came back nice and early in the day, so I wasn't stuck waiting all day long. Not only that, it came with good news that hCG was down to a 7. First thing out of my mouth was a really loud, "PRAISE GOD!" followed by the very important question, "Does this mean I can have a glass of wine?" My wish for a glass of wine was granted by the endocrinology fairy (a.k.a. Cathy the nurse) and I was told they will need to test once more next Friday 1/4, just to confirm hCG made it's way all the way down to zero.
Believe it or not, even when hCG numbers get this low they can really eek themselves out in the end. I have heard stories of women who's hCG got all the way down to 5, only to stagnate or go back up! They need to make sure it truly gets down to zero in order to verify everything. Whatever. One more needle won't kill me. I have realized, however, that the vein in my right arm is accumulating quite a bit of scar tissue from being stuck in the same place so many times. Just as I was getting so brave at giving blood, now it's starting to hurt more since the needle has to go through scar tissue, and I've regressed back into being a big fat baby about it. I've been trying to alternate arms as much as possible along the way, but I guess I was using the right one more. Boooo. I'm switching to my left arm solely for a while, but it's only a matter of time before that arm has an equal amount of scar tissue. I wonder if there is any way to get rid of scar tissue in your veins? The women at the lab tell me no, that you're stuck with it (no pun intended) for life once you have it in a certain vein. If anyone out there knows a remedy feel free to share!
Indeed we did celebrate with a nice glass of red wine and homemade lentils on Friday night and it was Mmm Mmm GOOD. It feels like forever since we've been able to just sit and enjoy a glass of wine together. I'm not some sort of alcoholic. It's just a very different thing to abstain from wine because you are pregnant with a nice healthy baby vs. not being able to drink because you are on meds to end a nonviable pregnancy. I personally think we deserved a whole bottle or two as long as it's been, but we were good and kept it to a glass.
Saturday we spent all day taking down Christmas decorations, cleaning the house top to bottom, and I started chipping away at tax return stuff. I normally HATE gathering tax info, so I was determined to get a head start this year. I sat down, printed out all of our bank statements and started going through them with a fine toothed comb. A few hours later, I marveled at my beautiful excel spreadsheet outlining $13,400 in medical expenses, $22,000 in education expenses, and a $2,600 loss on our rental property. Booyah! I knew we had quite a few medical expenses but wasn't sure if we would have enough to surpass 7.5% of our adjusted gross income (required to write off anything medical). Alas, we did for once.
If you are reading this and think you have some hefty medical expenses, take it from me...sit down and add them up, because you may have enough to write off. Don't leave anything out! You can claim mileage (23 cents/mi.) to and from doctor appointments and pharmacy trips, as well as tolls taken driving there. You might be shocked at how fast the mileage adds up! You can even claim acupuncture and non-traditional medical treatments. If you are a little bit short of 7.5%, you still have one more day to pay for medical expenses too. If you are interested in writing off your medical expenses but have never done it before, you can view the tax rules HERE and also some great FAQ's HERE. I have a brief chit chat with our accountant tonight, but I think most of my work is done. I can't believe I am saying this in December!
All of our hard work yesterday was rewarded today, as we used a Travelzoo voucher we had for facials and massages. How a tiny Asian man weighing no more than a buck ten can be so strong simply defies all logic, but I won't question a good thing when it happens. I can't tell you how amazing that massage felt today. I am finally feeling like I can breathe a little bit more.
Looking back at 2012, no doubt it was full of obstacles, most of which I'd love to just forget. Let's just pretend like none of that ever happened! Wouldn't that be nice. However, we made it out relatively unscathed. It looks like I will be avoiding surgery most thankfully. Our goal of entering 2013 with zero credit card debt was reached. We are in a good place to start anew. I'm trying my best not to look back at what we've been through, but rather look at the new year as a fresh new start.
We have a consult with a genetic counselor on 1/3 this week and then we're attending a group IVF orientation with Dr. Vaughn on 1/8 to learn more about the IVF process. We aren't running as fast as we can towards IVF but rather taking it one slow step at a time. We will get there... praying every single day that this will be our answer to having a healthy take home baby.
Sunday, December 30, 2012
Tuesday, December 25, 2012
Merry Christmas...Now GO AWAY!
If that isn't a bah-hum-bug of a blog title I don't know what is. I am trying not to let today get the best of me and stay cheery for the sake of my wonderful husband...failing miserably already at 9:30 AM I'm afraid. Blahhhhh!
I haven't had any bleeding or spotting for a couple days (YAY!) and with my hCG down to 108 as of last Friday, I thought I'd use my last HPT to see if by any chance it would come back negative. Isn't it crazy how much we let those darn pregnancy tests rule our moods? Normally I'd be overjoyed to see that second line. However, in this instance I just want that second line to GO AWAY ALREADY!
It seems like it is taking FOREVER for us to close this chapter. I have known since 5.5 weeks that this wasn't a viable pregnancy, and here I am at 9 weeks, basically walking around with a dead baby stuck in my fallopian tube. I know that sounds gross and dramatic, but let's not sugarcoat it. It is what it is. I just want it to be over.
Nothing has changed really, other than the fact that I was having some weird "twinges" in my left pelvic area yesterday right as we sat down at the movie "This is 40." Laugh out loud hilarious movie by the way...two thumbs up! I really needed that couple hours of intense laughter, let me tell you! I wouldn't describe the feelings I was having as painful, but I definitely felt something on and off sporadically all afternoon and evening....kind of like strong ovulation twinges. To be honest, it scared me a little, mostly because of the timing of it being Christmas.
I kept thinking that the last thing I want is to be in some emergency room on Christmas Eve or Christmas day with some surgeon I don't know operating on a burst fallopian tube and sucking out blood from my insides. I even plugged my iPad into it's charger before heading off to bed, just in case I had to fly out of the house at 2AM and needed some entertainment in an emergency room waiting room. Ugh! I hate feeling like I am walking on a tightrope and that I could fall off at any moment without warning. I was as far from relaxed as one could be, so to all the sugar plum fairies out there....you are welcome for having the night off!
Well, we made it through the movie and made it through the night, and no weird movement so far today. Still no bleeding or other telltale signs of a burst fallopian tube. If I can just make it through until Friday and get more good news of dropping hCG with my 11th beta test I will be SO relieved. I thought an early miscarriage sucked, but I've got to say that ectopic pregnancy is worse. Believe me, I know there are much worse things out there. It's just that we can't start our final chapter....the one with the HAPPY ENDING until we can close this one. Please pray for patience for us both and an uneventful end to this pregnancy, hopefully soon.
Merry Christmas and good riddance to 2012. I am ready for a bigger and better 2013! Bring it!
I haven't had any bleeding or spotting for a couple days (YAY!) and with my hCG down to 108 as of last Friday, I thought I'd use my last HPT to see if by any chance it would come back negative. Isn't it crazy how much we let those darn pregnancy tests rule our moods? Normally I'd be overjoyed to see that second line. However, in this instance I just want that second line to GO AWAY ALREADY!
 |
| 9 weeks today & hCG still present. Just want it to end already! |
Nothing has changed really, other than the fact that I was having some weird "twinges" in my left pelvic area yesterday right as we sat down at the movie "This is 40." Laugh out loud hilarious movie by the way...two thumbs up! I really needed that couple hours of intense laughter, let me tell you! I wouldn't describe the feelings I was having as painful, but I definitely felt something on and off sporadically all afternoon and evening....kind of like strong ovulation twinges. To be honest, it scared me a little, mostly because of the timing of it being Christmas.
I kept thinking that the last thing I want is to be in some emergency room on Christmas Eve or Christmas day with some surgeon I don't know operating on a burst fallopian tube and sucking out blood from my insides. I even plugged my iPad into it's charger before heading off to bed, just in case I had to fly out of the house at 2AM and needed some entertainment in an emergency room waiting room. Ugh! I hate feeling like I am walking on a tightrope and that I could fall off at any moment without warning. I was as far from relaxed as one could be, so to all the sugar plum fairies out there....you are welcome for having the night off!
Well, we made it through the movie and made it through the night, and no weird movement so far today. Still no bleeding or other telltale signs of a burst fallopian tube. If I can just make it through until Friday and get more good news of dropping hCG with my 11th beta test I will be SO relieved. I thought an early miscarriage sucked, but I've got to say that ectopic pregnancy is worse. Believe me, I know there are much worse things out there. It's just that we can't start our final chapter....the one with the HAPPY ENDING until we can close this one. Please pray for patience for us both and an uneventful end to this pregnancy, hopefully soon.
Merry Christmas and good riddance to 2012. I am ready for a bigger and better 2013! Bring it!
Friday, December 21, 2012
Forever in our Hearts
We were informed that one of our best friends had been killed in a tragic auto accident. I will never forget getting that call, how my heart sank, how I rushed home from the gym to yank my husband out of bed frantically, shaking and crying that Dave was gone. I still cannot believe it. I've lost 4 friends thus far in life, but never have we lost a friend that we cared about as much as we did for Dave. This time we lost a brother. He and my husband were extremely close. In fact, if it weren't for Dave buying me and my girlfriend a drink at a bar in my hometown of Orlando, FL ten years ago, my husband and I wouldn't even be married today. He had just come to stay at our house for a whole week for the SXSW Music Festival this year, and we were constantly calling and texting each other. He was one of those people who wasn't scared to tell us, "I love you guys" and he said it every single time we spoke.
Dave would be the first to admit he was imperfect at times, but as a friend, I have never met a person so generous, honest, loving, forgiving, and kind hearted. He was open and honest about his struggles, even producing a movie called "Renee" about addiction and depression that will be released later this year. A portion of his experiences are depicted in the movie, and that story also inspired an entire movement and non-profit organization called TWLOHA (To Write Love on Her Arms). Dave was an extraordinary person who shared openly at all times, especially if it would help others You can see his story of addiction and recovery in his own words here....
I think anyone would be hard pressed to listen to his words and not be moved as he talks about putting Christ first place in his life. It is so very sad for me to watch this video knowing all of the amazing potential he still had left. We flew to Orlando to attend his funeral, cried for 3 days straight but even being home now, it still doesn't seem quite real. Our dear friend and brother Dave McKenna, we will never ever forget you and you will live forever in our hearts.
Sigh...In addition, I was waiting anxiously for my follow-up hCG test result that same day we found out about Dave, hoping that it would drop to show the methotrexate was working to absolve the ectopic pregnancy. Well, my hCG went UP instead of down... from 207 to 223. Frack! Back to the RE I went for two more shots of chemotherapy in my ass. I am racking my brain trying to think of a body part my OB & RE haven't seen yet, but I'm not sure there is one. I was going to say the bottom of my feet, but nope they've seen those too. Stirrups, hello! I was reassured that the 2nd set of shots should really do the trick by my nurse who also said, "I've never seen the second shot not work, so you should be fine once we give you this one." Haha! I have to laugh anytime I'm told "this rarely happens" or "that never happens" because Lord knows my body likes to defy odds. Hubby and I went on our merry way.
At this point on such a horrible day, it was ironically hard to even become upset about anything having to do with us. We could only imagine what Dave's family and girlfriend of 3 years must have been feeling. Losing someone you love is the biggest reality check you can ever get that is for sure. It kind of makes everything else pale in comparison, and no way was I about to feel sorry for myself because of an ectopic pregnancy and all of the crap that isn't going right. I know, I know....I deserve to experience feelings of anger and sadness over my own situation too, but honestly, I really haven't been lately. I just keep thinking of Dave and his family, and my problems just seem so small in comparison.
I had more blood testing done while in Orlando, which showed a drop of hCG from 223 to 147. I went again today and saw yet another drop in hCG from 147 to 108. Halle-freaking-lujah! I think it's finally dropping like it's supposed to be. You can see all 10 hCG tests so far over on the right hand side of this page under "Timeline" if you're interested. I'm updating everything there >>>>
I'm 8.5 weeks pregnant today and have been dealing with this rollercoaster of hCG for 3 solid weeks so far....well really almost 5 weeks if you count my stress from the very first hCG, which was low right off the bat. I'm just really ready to close this chapter, and hoping that this could be the light at the end of the tunnel for the ectopic pregnancy to finally be ending soon! I am scheduled for another hCG test one week from today. Just hoping and praying that hCG will be down to 0 by then, because if I don't have a glass of wine soon, I may end up doing something we'll all regret!
More updates to come on all of our recurrent miscarriage panel testing and chromosome testing. This is post is getting long, and I'm tired of talking about myself, but I'll update on those things soon. Please if you can all do me a favor, and tell those you love how much you love them this week, especially if you haven't in a while. Even if you are going through a hard time, try to be thankful for your spouse or your pets or anything you DO have. If I have nothing else in life, at least I have a husband who loves me, and not everyone can say that. We ALL have so much to be thankful for.
Wednesday, December 12, 2012
hCG Dropping Slowly... Along with my Blood Supply
I saw Dr. Youman on Monday, as suggested by my RE to discuss possible reasons for miscarriage and to order further testing. He asked me plenty of questions, and as usual right off the bat says, "You have quite a few things here that concern me." I could have predicted that one! Anytime you tell a dr. that your dad died at age 47 from cancer, your mom at 52 from cancer, and also your grandmother from cancer, they don't take a liking to that. However, I was not here to talk about cancer necessarily. I was here to uncover any unknown reasons that could cause miscarriage in the future. You see, outside of being an oncologist, Dr.Youman is supposedly the man when it comes to hematology and knows about all things blood related. My RE often refers to him for more in depth testing of clotting disorders and autoimmune stuff for women who have lost more than once pregnancy.
Upon first meeting this guy, I wouldn't have known what to think of him had I not already known he'd helped Lance Armstrong beat cancer. There are pics of Lance all over his office, and I couldn't help but get a little choked up thinking of all that cancer patients go through battling this horrific disease. By the way... If you haven't read It's Not About the Bike, I highly recommend it. It's one of my favorite books of all time. If you really want some inspiration and a reason to put on your big girl panties, that is the book for you! I linked the whole first chapter above for your reading pleasure.
Seriously though, Dr. Youman is extremely old school, scribbling everything illegibly on a half sheet of torn computer paper, and that is "your file." haha! He agreed that because I already tested positive for cardiolipin antibody, that I should do further testing for other related clotting disorders and autoimmune diseases. Off I went to their in-house lab to give 15 MORE VIALS OF BLOOD. Gasp! As of Friday, I will have given 24 vials of blood in one week, but who's counting? Honestly, I'm happy keep giving blood until I'm blue if it gives me answers on things I can keep an eye on going forward. If I have risk factors, I want to know about them so I can take precautionary measures to prevent any miscarriages in the future. I go back next week on Monday to meet with Dr. Youman and discuss the findings of the additional testing.
My first hCG results following the MTX shot came back yesterday. hCG went down to 196 from 207. This is progress, but the 2nd test done post-MTX shot (two days from now) will be kind of crucial. They want to see a 15% decrease in the next result to show enough progress to avoid having a second dose of MTX. It needs to drop about 30 points to be considered enough progress. I had quite a bit of pain and bleeding on Monday and a huge mass of tissue that passed (sorry TMI), a little bit of bleeding on Tuesday, and now just back to spotting with no cramps at all, so I'm hoping what they call "tissue separation" has already occurred and that hCG levels will continue to plummet fast! I do NOT want that second shot, nor do I want surgery, so please pray for me that these levels drop faster than a hoochie mama in a Fifty Cent video!
Speaking of politically incorrect things, I found something I would like for Christmas and figured you all might appreciate it. What a spectacular stocking stuffer...
How funny is that?! I may become a target of hate crimes or at minimum toilet papering if I put that on my vehicle in my small town family friendly Texas neighborhood. I'm almost willing to take the chance though, I like it so much. Seriously, this is a pretty hard time of year with all the family holiday cheer going on. Forgive me if I need to find a way to laugh amidst my own debacle of trying to start a family. I've got to find a way to keep it light, and if a chainsaw chasing the annoyingly perfect family and stroller won't do that, then I don't know what will!
Upon first meeting this guy, I wouldn't have known what to think of him had I not already known he'd helped Lance Armstrong beat cancer. There are pics of Lance all over his office, and I couldn't help but get a little choked up thinking of all that cancer patients go through battling this horrific disease. By the way... If you haven't read It's Not About the Bike, I highly recommend it. It's one of my favorite books of all time. If you really want some inspiration and a reason to put on your big girl panties, that is the book for you! I linked the whole first chapter above for your reading pleasure.
Seriously though, Dr. Youman is extremely old school, scribbling everything illegibly on a half sheet of torn computer paper, and that is "your file." haha! He agreed that because I already tested positive for cardiolipin antibody, that I should do further testing for other related clotting disorders and autoimmune diseases. Off I went to their in-house lab to give 15 MORE VIALS OF BLOOD. Gasp! As of Friday, I will have given 24 vials of blood in one week, but who's counting? Honestly, I'm happy keep giving blood until I'm blue if it gives me answers on things I can keep an eye on going forward. If I have risk factors, I want to know about them so I can take precautionary measures to prevent any miscarriages in the future. I go back next week on Monday to meet with Dr. Youman and discuss the findings of the additional testing.
My first hCG results following the MTX shot came back yesterday. hCG went down to 196 from 207. This is progress, but the 2nd test done post-MTX shot (two days from now) will be kind of crucial. They want to see a 15% decrease in the next result to show enough progress to avoid having a second dose of MTX. It needs to drop about 30 points to be considered enough progress. I had quite a bit of pain and bleeding on Monday and a huge mass of tissue that passed (sorry TMI), a little bit of bleeding on Tuesday, and now just back to spotting with no cramps at all, so I'm hoping what they call "tissue separation" has already occurred and that hCG levels will continue to plummet fast! I do NOT want that second shot, nor do I want surgery, so please pray for me that these levels drop faster than a hoochie mama in a Fifty Cent video!
Speaking of politically incorrect things, I found something I would like for Christmas and figured you all might appreciate it. What a spectacular stocking stuffer...
How funny is that?! I may become a target of hate crimes or at minimum toilet papering if I put that on my vehicle in my small town family friendly Texas neighborhood. I'm almost willing to take the chance though, I like it so much. Seriously, this is a pretty hard time of year with all the family holiday cheer going on. Forgive me if I need to find a way to laugh amidst my own debacle of trying to start a family. I've got to find a way to keep it light, and if a chainsaw chasing the annoyingly perfect family and stroller won't do that, then I don't know what will!
Saturday, December 8, 2012
It's Ectopic...Slight Change of Plans
Nothing like a shot of chemo in your ass to start the weekend off right! Really, can this week take any more turns? I better not say that out loud and test fate, because Lord knows it will the moment I even mutter the words.
A week ago I found out my hCG levels were dropping and that this was turning out to be a non-viable pregnancy. We met with our RE, talked about a plan going forward, and felt that although things were not ideal, at least we had a plan. I became a toilet paper detective and just kept waiting for the miscarriage to take it course.
Well fast forward to a few days later, and upon another follow-up hCG blood draw, they realized that my hCG was increasing, and not in a good way. It went back up to 205 from 185. It's supposed to be dropping! When this happens, it's an indication that the pregnancy is not taking care of itself naturally on it's own. I did a repeat test the next day and it was 207. They asked me to come in for an ultrasound to see if they could locate the embryo in my uterus, and they could not. The reason they could not see an embryo in the uterus could be one of two reasons...
1) My hCG never reached 1000, which is when you can usually see an embryo via ultrasound.
2) The embryo had implanted inside of the fallopian tube, rather than the uterus, where it's supposed to.
With the recent findings that my hCG is being wacky, I've been spotting for over a week now, and there is no embryo detectable in the uterus, it was determined that this is very likely an ectopic pregnancy. I was not shocked to be honest. All week I have been worried that something wasn't going as planned. I've had an early miscarriage before, and something here was very different. There was no real cramping, bleeding, and it had been a week already since receiving word I should be expecting to miscarry any day. I just knew something was off, and call me psychic, but I had a feeling they were going to say that the hCG wasn't dropping. I had even told my husband every day of the week, something is not right here! I think he finally believes me now.
Apparently only 1% of the population has 2 or more miscarriages and only 2% of pregnancies are ectopic. I feel like I have won some sort of twisted lottery. Ectopic pregnancy can be VERY dangerous, so I'm glad I was being monitored so closely and realized this somewhat early. What I'm not as thrilled about is that this means there was something that caused the embryo to implant there. By something, I mean disease, damage or blockages in my fallopian tube(s). That is really the only reason an embryo would implant in the tube versus traveling into the uterus to implant correctly. I had an HSG (hysterosalpingogram) in Sept. 2011, which showed the dye used in the procedure traveled through both tubes into the uterus. However, it's still possible that I could have endometriosis inside the tubes not quite detectable via the HSG and/or there has been new damage that could have formed over the past 1yr+. Really the only way to truly know what the inside of your fallopian tubes look like is to do laparoscopic surgery, something I haven't done because we've felt the risks outweighed the benefits thus far.
Finding another piece to this puzzle is a major game changer. Why? Well, it explains a lot. It could explain why we've been trying so long without a successful pregnancy. In fact, my RE said that my first miscarriage could have even been ectopic, but that we were lucky and it took care of itself naturally that time. It could have also just been a genetic defect. There is no way to ever know now if that was the case with #1, but it's certainly plausible given the recent development with this pregnancy. It's also a game changer, because it totally changes our RE's recommendations for treatment going forward.
Our initial plan was to hope that hCG dropped to zero on it's own and proceed with another Femara/IUI cycle....pretty easy right. However, since it didn't, I was given two shots of a chemotherapy drug called methotrexate to make sure the embryonic cells stop diving, and that the embryo doesn't continue growing. If we did nothing, the pregnancy could continue to linger, possibly grow a little more inside of the fallopian tube, and could cause tubal rupture and could be life threatening. The only other option to end the pregnancy would be to do surgery to physically go in and remove it. No way I am going to choose surgery over a simple shot, especially when surgery has it's own risks. Hubby and I asked A LOT of questions about the methotrexate, and all parties determined this is the easiest and best option for us to make this end as quickly and safely as possible. It's pretty standard protocol for ectopic pregnancies actually.
The other big game changer is finding out that obviously something is obstructing at least one of my tubes that we know of at this point. People who experience ectopic pregnancy have more trouble getting pregnant AND are more likely to have another ectopic pregnancy in the future. Because of that, our doctor's recommendations going forward have also changed. Yep, you guessed it....IVF. I never thought we'd get to this point, and I really hoped we wouldn't, but now it is looking like the smartest course of action.
In Vitro Fertilization was actually invented as a sole treatment for people with blocked fallopian tubes, but it's now used for many more infertility related diagnoses including:
-sperm production, number, or function
-endometriosis
-pelvic adhesions
-tubal blockage
-diminished ovarian reserve
-abnormalities involving the uterine cavity or cervix
-ovulation disorders
-unexplained infertility
-recurrent miscarriage
Obviously, we have been trying everything we possibly can to avoid doing IVF. It's invasive, difficult emotionally and physically, and as we all know COSTLY! However, looking at everything we have been through over the past 18 months (and really starting in 2008 when I became anovulatory for 2.5 yrs straight) I think it's safe to say I fit the description for someone who may need IVF if I ever want to have a family. Out of the list above I have been diagnosed by a reproductive endocrinologist with 6 out of 9 of those listed diagnoses above, 7 if you count the possible endometriosis my RE suspects is in my tubes. I think I had an "aha!" moment reading that list yesterday, realizing that IVF is likely our best option considering the circumstances.
Sure, plenty of women might choose to give it one more shot with IUI, but if I do that and do become pregnant, I'm still more likely to have another ectopic. I honestly don't know I would be able to endure another pregnancy loss, and it doesn't seem smart to continue putting myself at risk when we know the possiblity is pretty high that could happen. I could choose to have laparosopic surgery to go in and definitively diagnose and remove endometriosis or whatever is blocking my tube(s), but anytime surgery is done on the female reproductive system, there is high risk of scarring, which would just end up causing more blockages in the future. Surgery would also require quite a bit of recovery before even being able to try again, and then who knows how long it would take to become pregnant again. Even with injectables and IUI (my best case scenario outside of IVF) we'd only have about a 20% chance at conception each month we tried. Furthermore, if it's endometriosis blocking my tubes, and we remove it via laparoscopy, it can just return again rather quickly within months. Laparoscopy is many times more of a bandaid than it is a permanent solution. We are really analzying our options from all angles, and continuing to discuss things, but as of now it's really looking like we may proceed onto using IVF.
I am still continuing to do recurrent miscarriage testing in the meantime. My RE did a few tests, and I tested positive for cardiolipin antibody. This antibody is found in those with antiphospholipid syndrome, and can also be a cause for miscarriage (usually late term miscarriage). We don't think this could have caused any of my issues, but it's good we are testing for things across the board. In light of finding that I carry this anti-body, I will most likely begin taking a prescription blood thinner when I become pregnant again. This will help reduce any risk of a later miscarriage ever occurring.
I'm also being referred to a top notch hematologist/oncologist, Dr. Dudley Youman, for further testing. He was actually Lance Armstrong's oncologist, so I think I will be in good hands. I will call Monday to make an appointment for a consult and complete blood work-up. Even though he's not a fertility specialist, my RE has worked with him for years and is referring me to Dr. Youman because he is simply the best when it comes to hematology. We want to make sure I am uncovering any auto-immune or blood disorders that could cause issues that we haven't thought of. I love that my RE is so thorough and entertains every last concern I have....I am one of those people who asks a bazillion questions, and he makes sure they are ALL answered to my satisfaction. I am happy to make the visit to Dr. Youman if it means dotting more i's and crossing more t's. We want to make sure that if and when we choose to do IVF, that we are not missing any other pieces to the puzzle first.
Over the next couple of weeks, we'll continue to monitor my hCG and pray that the methotrexate works accordingly. I've been given a list of things I can't eat or drink while on this drug, and unfortunately alcohol is one of them. Kick me while I'm down why dontcha?! In spite of all the ups and downs this past week, we are still thankful for a lot. I don't know if I am truly becoming numb to it all at this point, but I haven't cried in a couple days. I am really just thankful that I didn't have a tubal rupture. I'm thankful that I have an amazing husband, and that he is healthy. I am thankful I have a specialist I completely trust who can guide us. We are thankful for more things than I can even write here, and it's those things that are keeping us going.
A week ago I found out my hCG levels were dropping and that this was turning out to be a non-viable pregnancy. We met with our RE, talked about a plan going forward, and felt that although things were not ideal, at least we had a plan. I became a toilet paper detective and just kept waiting for the miscarriage to take it course.
Well fast forward to a few days later, and upon another follow-up hCG blood draw, they realized that my hCG was increasing, and not in a good way. It went back up to 205 from 185. It's supposed to be dropping! When this happens, it's an indication that the pregnancy is not taking care of itself naturally on it's own. I did a repeat test the next day and it was 207. They asked me to come in for an ultrasound to see if they could locate the embryo in my uterus, and they could not. The reason they could not see an embryo in the uterus could be one of two reasons...
1) My hCG never reached 1000, which is when you can usually see an embryo via ultrasound.
2) The embryo had implanted inside of the fallopian tube, rather than the uterus, where it's supposed to.
With the recent findings that my hCG is being wacky, I've been spotting for over a week now, and there is no embryo detectable in the uterus, it was determined that this is very likely an ectopic pregnancy. I was not shocked to be honest. All week I have been worried that something wasn't going as planned. I've had an early miscarriage before, and something here was very different. There was no real cramping, bleeding, and it had been a week already since receiving word I should be expecting to miscarry any day. I just knew something was off, and call me psychic, but I had a feeling they were going to say that the hCG wasn't dropping. I had even told my husband every day of the week, something is not right here! I think he finally believes me now.
Apparently only 1% of the population has 2 or more miscarriages and only 2% of pregnancies are ectopic. I feel like I have won some sort of twisted lottery. Ectopic pregnancy can be VERY dangerous, so I'm glad I was being monitored so closely and realized this somewhat early. What I'm not as thrilled about is that this means there was something that caused the embryo to implant there. By something, I mean disease, damage or blockages in my fallopian tube(s). That is really the only reason an embryo would implant in the tube versus traveling into the uterus to implant correctly. I had an HSG (hysterosalpingogram) in Sept. 2011, which showed the dye used in the procedure traveled through both tubes into the uterus. However, it's still possible that I could have endometriosis inside the tubes not quite detectable via the HSG and/or there has been new damage that could have formed over the past 1yr+. Really the only way to truly know what the inside of your fallopian tubes look like is to do laparoscopic surgery, something I haven't done because we've felt the risks outweighed the benefits thus far.
Finding another piece to this puzzle is a major game changer. Why? Well, it explains a lot. It could explain why we've been trying so long without a successful pregnancy. In fact, my RE said that my first miscarriage could have even been ectopic, but that we were lucky and it took care of itself naturally that time. It could have also just been a genetic defect. There is no way to ever know now if that was the case with #1, but it's certainly plausible given the recent development with this pregnancy. It's also a game changer, because it totally changes our RE's recommendations for treatment going forward.
Our initial plan was to hope that hCG dropped to zero on it's own and proceed with another Femara/IUI cycle....pretty easy right. However, since it didn't, I was given two shots of a chemotherapy drug called methotrexate to make sure the embryonic cells stop diving, and that the embryo doesn't continue growing. If we did nothing, the pregnancy could continue to linger, possibly grow a little more inside of the fallopian tube, and could cause tubal rupture and could be life threatening. The only other option to end the pregnancy would be to do surgery to physically go in and remove it. No way I am going to choose surgery over a simple shot, especially when surgery has it's own risks. Hubby and I asked A LOT of questions about the methotrexate, and all parties determined this is the easiest and best option for us to make this end as quickly and safely as possible. It's pretty standard protocol for ectopic pregnancies actually.
The other big game changer is finding out that obviously something is obstructing at least one of my tubes that we know of at this point. People who experience ectopic pregnancy have more trouble getting pregnant AND are more likely to have another ectopic pregnancy in the future. Because of that, our doctor's recommendations going forward have also changed. Yep, you guessed it....IVF. I never thought we'd get to this point, and I really hoped we wouldn't, but now it is looking like the smartest course of action.
In Vitro Fertilization was actually invented as a sole treatment for people with blocked fallopian tubes, but it's now used for many more infertility related diagnoses including:
-sperm production, number, or function
-endometriosis
-pelvic adhesions
-tubal blockage
-diminished ovarian reserve
-abnormalities involving the uterine cavity or cervix
-ovulation disorders
-unexplained infertility
-recurrent miscarriage
Obviously, we have been trying everything we possibly can to avoid doing IVF. It's invasive, difficult emotionally and physically, and as we all know COSTLY! However, looking at everything we have been through over the past 18 months (and really starting in 2008 when I became anovulatory for 2.5 yrs straight) I think it's safe to say I fit the description for someone who may need IVF if I ever want to have a family. Out of the list above I have been diagnosed by a reproductive endocrinologist with 6 out of 9 of those listed diagnoses above, 7 if you count the possible endometriosis my RE suspects is in my tubes. I think I had an "aha!" moment reading that list yesterday, realizing that IVF is likely our best option considering the circumstances.
Sure, plenty of women might choose to give it one more shot with IUI, but if I do that and do become pregnant, I'm still more likely to have another ectopic. I honestly don't know I would be able to endure another pregnancy loss, and it doesn't seem smart to continue putting myself at risk when we know the possiblity is pretty high that could happen. I could choose to have laparosopic surgery to go in and definitively diagnose and remove endometriosis or whatever is blocking my tube(s), but anytime surgery is done on the female reproductive system, there is high risk of scarring, which would just end up causing more blockages in the future. Surgery would also require quite a bit of recovery before even being able to try again, and then who knows how long it would take to become pregnant again. Even with injectables and IUI (my best case scenario outside of IVF) we'd only have about a 20% chance at conception each month we tried. Furthermore, if it's endometriosis blocking my tubes, and we remove it via laparoscopy, it can just return again rather quickly within months. Laparoscopy is many times more of a bandaid than it is a permanent solution. We are really analzying our options from all angles, and continuing to discuss things, but as of now it's really looking like we may proceed onto using IVF.
I am still continuing to do recurrent miscarriage testing in the meantime. My RE did a few tests, and I tested positive for cardiolipin antibody. This antibody is found in those with antiphospholipid syndrome, and can also be a cause for miscarriage (usually late term miscarriage). We don't think this could have caused any of my issues, but it's good we are testing for things across the board. In light of finding that I carry this anti-body, I will most likely begin taking a prescription blood thinner when I become pregnant again. This will help reduce any risk of a later miscarriage ever occurring.
I'm also being referred to a top notch hematologist/oncologist, Dr. Dudley Youman, for further testing. He was actually Lance Armstrong's oncologist, so I think I will be in good hands. I will call Monday to make an appointment for a consult and complete blood work-up. Even though he's not a fertility specialist, my RE has worked with him for years and is referring me to Dr. Youman because he is simply the best when it comes to hematology. We want to make sure I am uncovering any auto-immune or blood disorders that could cause issues that we haven't thought of. I love that my RE is so thorough and entertains every last concern I have....I am one of those people who asks a bazillion questions, and he makes sure they are ALL answered to my satisfaction. I am happy to make the visit to Dr. Youman if it means dotting more i's and crossing more t's. We want to make sure that if and when we choose to do IVF, that we are not missing any other pieces to the puzzle first.
Over the next couple of weeks, we'll continue to monitor my hCG and pray that the methotrexate works accordingly. I've been given a list of things I can't eat or drink while on this drug, and unfortunately alcohol is one of them. Kick me while I'm down why dontcha?! In spite of all the ups and downs this past week, we are still thankful for a lot. I don't know if I am truly becoming numb to it all at this point, but I haven't cried in a couple days. I am really just thankful that I didn't have a tubal rupture. I'm thankful that I have an amazing husband, and that he is healthy. I am thankful I have a specialist I completely trust who can guide us. We are thankful for more things than I can even write here, and it's those things that are keeping us going.
Tuesday, December 4, 2012
Fairweather Friends? WWYD?
I need to vent and ask your opinions please. There is something weighing very heavy on my heart and today is the second day I've woken up at 3 AM completely upset about it and unable to sleep...
As you may know, I was pretty torn apart Friday evening, finding out I was going to lose this pregnancy. I blogged about it and posted about it on facebook. I felt like I was going to explode if I didn't get the heartache out of my system and connect with others who have gone through something similar. I got tons of great support from you all here on my blog and on facebook, with many nice comments and private messages from women who have gone through it.
I was extremely hurt this weekend, when right after I posted my heartfelt post about miscarrying, that someone I thought was a "good friend" posted a bunch of joyous gender reveal pics on facebook, knowing I would see it and knowing exactly what we were going through. Her husband had actually texted my husband the day we found out, and we had already relayed the bad news. Not to mention, this girl posted a comment saying "We're crushed that you are going through this" on my page. Then, literally 24 hours later posted all of her wonderful announcements complete with balloons and smiles, and tons of congratulatory comments. I knew that she was finding out the sex of their baby the same day we found out we were miscarrying, so it was poor timing, but to have her post her gender reveal front and center the very same weekend of my horrible news CRUSHED ME to say the least.
Surely a true friend wouldn't do that. Why did I think she was that close of a friend anyways? Maybe because when she was first diagnosed with cancer years ago, I cried myself and made sure I took time to send her a care package of resources from LIVESTRONG, where I volunteer, to help her navigate through the health care system and help her feel she wasn't so alone and had support. Maybe because I always made sure to offer words of encouragement from the time she was diagnosed until the time she beat it. Maybe because she and her husband were the only people we mailed a Christmas package to outside of our own family last year, the ONLY ones! Maybe because my husband and I opened our home to them and they stayed with us to celebrate my husband's entire birthday weekend recently. Maybe because when she reached out to me several months ago frantic about her ability to conceive after seeing a doctor and being told her chances were slim, I spent an hour on the phone providing advice to calm her down and giving her a whole list of books to read....which she did and became pregnant right away using what she learned with no medical intervention necessary. Maybe because I squashed my own pain from the struggle I was still experiencing when I found out she was pregnant and sent her a card AND reached out to congratulate her personally via phone.
Now I don't expect people to put their lives on hold according to what Emily and Matt might be experiencing that week, and I even told her on the phone when I called to congratulate her on her pregnancy "don't feel like you need to censor yourself just because we are struggling". However, that was when there were no real changes going on for us at that time. I just feel like the game kind of changes and some extra tact should be used when someone loses a pregnancy suddenly. And to give them credit, this couple had been thoughtful enough to let us know about their pregnancy before they announced it to the world, but all of a sudden now it seemed like all regard for our feelings had gone completely out the window! I logged into facebook, saw her joyous gender reveal smack at the top of my newsfeed and I could instantly feel steam coming from my ears and rivers streaming down my cheeks. I didn't know whether to be hurt or extremely pissed off, or both. I have just never felt so worthless as a friend in all of my life.
I realize I told her "not to censor herself" previously, but my God this was so soon after such crushing news on our end! I kept asking myself if I would do the same thing if the tables were turned. What if it were me who was just trying to enjoy my pregnancy? What if I had never experienced a pregnancy loss and just couldn't really relate 100% to how that must feel? What if it were me who had gone through cancer years before and was just happy to be alive and now bearing life?
I am open and honest enough with myself enough to ask these questions, but the only answer I come up with was HELL NO I still wouldn't be so inconsiderate. I would have waited at least a few days for the dust to settle. I wouldn't have cared what I'd been through to get there or how excited I was, I still wouldn't do that in the face of someone who had just experienced a loss. It's just plain selfish. Period.
Then I asked myself if any of my other true friends would have behaved in the same manner? Would Tammy ever do such a thing? Or Michelle? Or anyone else who's close to me. Still again, the answer I came up with was NO WAY would they EVER do such a thing knowing what I must be going through at the same exact time.
For the past couple of days my heart has just been aching over this, because it just feels like a friendship I put effort into was one sided all along. Not like we're best friends, but more like longtime friends and were becoming even closer the past year through phonecalls and visits more regularly. I mean looking back, I guess I have probably gone out of my way for this person more than she has for me, so why should I be surprised really? I am definitely not the type of person to do things for others and expect something back in return either. I don't keep tabs or feel like people owe me, ever. I do things because I want to and because I'm a caring and good and loyal friend. However, I do expect just a little compassion and selflessness in return, even if it means a little sacrifice on the other friend's part from time to time. Believe me, I'll be overjoyed when I do get pregnant and find out the sex of my baby, but if a friend of mine reveals they are miscarrying the same exact day I find out, I'll probably use my better judgement and contain myself for just a little bit longer until the dust settles. That's just me though. Maybe I'm crazy.
I have gone ahead and removed she and her husband from my newsfeed on facebook. It just hurts too badly to see their posts now. I figure if they are going to do a public gender reveal while they know I'm miscarrying, I shouldn't have any interest in continuing to make emotional deposits into a friendship which has left me feeling so brushed aside at this point. I'm torn in how I feel about them at all anymore, because I know that deep down they are good people, but this just caught me so off guard in a way I never imagined would happen. I thought about approaching them directly and telling them how much their actions hurt me, but what's the point really? How is my telling them going to make the experience go away? It won't, and as much as I'd like to, it's not something I'll forget very easily.
I would really love some honest feedback though. Am I overreacting? What would you do?
As you may know, I was pretty torn apart Friday evening, finding out I was going to lose this pregnancy. I blogged about it and posted about it on facebook. I felt like I was going to explode if I didn't get the heartache out of my system and connect with others who have gone through something similar. I got tons of great support from you all here on my blog and on facebook, with many nice comments and private messages from women who have gone through it.
I was extremely hurt this weekend, when right after I posted my heartfelt post about miscarrying, that someone I thought was a "good friend" posted a bunch of joyous gender reveal pics on facebook, knowing I would see it and knowing exactly what we were going through. Her husband had actually texted my husband the day we found out, and we had already relayed the bad news. Not to mention, this girl posted a comment saying "We're crushed that you are going through this" on my page. Then, literally 24 hours later posted all of her wonderful announcements complete with balloons and smiles, and tons of congratulatory comments. I knew that she was finding out the sex of their baby the same day we found out we were miscarrying, so it was poor timing, but to have her post her gender reveal front and center the very same weekend of my horrible news CRUSHED ME to say the least.
Surely a true friend wouldn't do that. Why did I think she was that close of a friend anyways? Maybe because when she was first diagnosed with cancer years ago, I cried myself and made sure I took time to send her a care package of resources from LIVESTRONG, where I volunteer, to help her navigate through the health care system and help her feel she wasn't so alone and had support. Maybe because I always made sure to offer words of encouragement from the time she was diagnosed until the time she beat it. Maybe because she and her husband were the only people we mailed a Christmas package to outside of our own family last year, the ONLY ones! Maybe because my husband and I opened our home to them and they stayed with us to celebrate my husband's entire birthday weekend recently. Maybe because when she reached out to me several months ago frantic about her ability to conceive after seeing a doctor and being told her chances were slim, I spent an hour on the phone providing advice to calm her down and giving her a whole list of books to read....which she did and became pregnant right away using what she learned with no medical intervention necessary. Maybe because I squashed my own pain from the struggle I was still experiencing when I found out she was pregnant and sent her a card AND reached out to congratulate her personally via phone.
Now I don't expect people to put their lives on hold according to what Emily and Matt might be experiencing that week, and I even told her on the phone when I called to congratulate her on her pregnancy "don't feel like you need to censor yourself just because we are struggling". However, that was when there were no real changes going on for us at that time. I just feel like the game kind of changes and some extra tact should be used when someone loses a pregnancy suddenly. And to give them credit, this couple had been thoughtful enough to let us know about their pregnancy before they announced it to the world, but all of a sudden now it seemed like all regard for our feelings had gone completely out the window! I logged into facebook, saw her joyous gender reveal smack at the top of my newsfeed and I could instantly feel steam coming from my ears and rivers streaming down my cheeks. I didn't know whether to be hurt or extremely pissed off, or both. I have just never felt so worthless as a friend in all of my life.
I realize I told her "not to censor herself" previously, but my God this was so soon after such crushing news on our end! I kept asking myself if I would do the same thing if the tables were turned. What if it were me who was just trying to enjoy my pregnancy? What if I had never experienced a pregnancy loss and just couldn't really relate 100% to how that must feel? What if it were me who had gone through cancer years before and was just happy to be alive and now bearing life?
I am open and honest enough with myself enough to ask these questions, but the only answer I come up with was HELL NO I still wouldn't be so inconsiderate. I would have waited at least a few days for the dust to settle. I wouldn't have cared what I'd been through to get there or how excited I was, I still wouldn't do that in the face of someone who had just experienced a loss. It's just plain selfish. Period.
Then I asked myself if any of my other true friends would have behaved in the same manner? Would Tammy ever do such a thing? Or Michelle? Or anyone else who's close to me. Still again, the answer I came up with was NO WAY would they EVER do such a thing knowing what I must be going through at the same exact time.
For the past couple of days my heart has just been aching over this, because it just feels like a friendship I put effort into was one sided all along. Not like we're best friends, but more like longtime friends and were becoming even closer the past year through phonecalls and visits more regularly. I mean looking back, I guess I have probably gone out of my way for this person more than she has for me, so why should I be surprised really? I am definitely not the type of person to do things for others and expect something back in return either. I don't keep tabs or feel like people owe me, ever. I do things because I want to and because I'm a caring and good and loyal friend. However, I do expect just a little compassion and selflessness in return, even if it means a little sacrifice on the other friend's part from time to time. Believe me, I'll be overjoyed when I do get pregnant and find out the sex of my baby, but if a friend of mine reveals they are miscarrying the same exact day I find out, I'll probably use my better judgement and contain myself for just a little bit longer until the dust settles. That's just me though. Maybe I'm crazy.
I have gone ahead and removed she and her husband from my newsfeed on facebook. It just hurts too badly to see their posts now. I figure if they are going to do a public gender reveal while they know I'm miscarrying, I shouldn't have any interest in continuing to make emotional deposits into a friendship which has left me feeling so brushed aside at this point. I'm torn in how I feel about them at all anymore, because I know that deep down they are good people, but this just caught me so off guard in a way I never imagined would happen. I thought about approaching them directly and telling them how much their actions hurt me, but what's the point really? How is my telling them going to make the experience go away? It won't, and as much as I'd like to, it's not something I'll forget very easily.
I would really love some honest feedback though. Am I overreacting? What would you do?
Monday, December 3, 2012
Why I Miscarried & Our Next Steps
We were able to get an apt. with the RE today to discuss his thoughts on my recurring miscarriages. As always, Dr. Vaughn did not disappoint. Did I mention I love this man? He keeps it simple, while also being very thorough and caring. I already knew he wouldn't be able to give a diagnosis of the situation with 100% certainty. Miscarriage has many gray areas.
Basically, he says that with miscarriage lost so early in a pregnancy, it is most times due to a genetic abnormality from either the egg or the sperm. Progesterone deficiency also happens to be a cause of early miscarriage, but since I was taking Prometrium during my luteal phase and during the pregnancy and levels measured fine, this is ruled out as a cause for the miscarriage. So chances are it was a genetic abnormality. Finding out which person the abnormality came from is somewhat impossible at this point, because the sperm and egg have already come and gone. The only real way someone can make sure they are getting pregnant (before even getting pregnant) with a sperm and egg that have NO genetic defects whatsoever, is to do IVF along with something called PGD or Preimplantation Genetic Diagnosing. This is where they test the genetic make-up of the embryo before inserting it back into the woman's uterus.
For most people who have gotten pregnant and miscarried even more than once, IVF with PGD still isn't the next step, because it's just so crazy expensive and invasive, and the chances are favorable that miscarriage won't happen again. Yeah, tell that to people who have miscarried 3 or more times! Nevertheless, we are definitely not considering IVF with PGD yet, especially considering it costs $18,000 to go that route. Dr. Vaughn certainly wasn't suggesting we do that, but was just explaining how genetic abnormalities happen and the ways in which they can be avoided.
So, what are the odds that this happened 2 out of 2 pregnancies with me? Well it isn't shocking due to the fact that my age is creeping up, my eggs are getting older, and the amount of eggs I have left is falling as well. I mean, I'm still just under the 35 year old mark for Advanced Maternal Age, but I'm not a 24 year old either. AMH or Anti-Mullerian Hormone is the hormone used to test for ovarian reserve, and although I knew mine was low (0.88) I never knew that I actually had the diagnosis of DOR or Diminished Ovarian Reserve. However, apparently I am considered DOR. You've got to be kidding me! Hmmm, that's a pretty important piece of information for my previous RE to leave out ya think?!
I'm not a huge expert on DOR. It is a fairly complex diagnosis, but from what I do know, it basically means that I have a lower than normal number of eggs left in my basket. Lowered egg quantity sometimes (not always) lends to a lowered egg quality, and thus another reason why it's more likely for older women with less ovarian reserve to produce eggs with genetic abnormalities. You following me here? Bear with me! The only real way to assess the quality of each individual egg is by retrieving the eggs from your body, as is done in IVF. And again, we are not there yet.
There are plenty of other reasons for miscarriage including chromosomal abnormalities in the parents themselves, autoimmune issues, clotting disorders, etc. Even still, my RE thinks it is unlikely that these would cause such early miscarriage, and still thinks that mine are due to genetic issues. However, just to be on the safe side, both hubby and I are having a complete chromosomal blood panel done. I will do an extra "recurring miscarriage panel" which will test for the autoimmune issues and clotting disorders. Should be interesting to see if our insurance covers this, as it is VERY expensive. I made sure it was coded for "recurring miscarriage" and nothing fertility related, but insurance companies like to fight people on getting these tests done, so we shall see! No matter what, it is worth it to us to have a definitive answer whether any of these things could be causing our issues, and we are happy to have it done.
As long as the blood tests come back normal and I'm able to have this miscarriage naturally with my hCG dropping to zero sometime soon, we should be on track to TTC again. We will be testing down my hCG to make sure it goes to zero, making sure there is no chance it was an ectopic pregnancy before proceeding with any further treatments. We will be able to begin again with Femara/IUI once the miscarriage actually happens, hCG returns to zero, and a new cycle starts...hopefully in January. The chromosomal testing and recurrent miscarriage workup takes about 3 weeks to get results anyways, so I feel we have a really good timeline in place to follow.
All in all we are happy that we are having further testing done to check for possible causes, but also happy to know that we still have a shot continuing with Femara and IUI. I do think it could just be a matter of a better egg and sperm hooking up. If at first you don't succeed try and try again! If only I could host a little party with free cocktails to coerce all the studly sperms and miss priss eggs to finally unite with their perfect healthy mates!
Basically, he says that with miscarriage lost so early in a pregnancy, it is most times due to a genetic abnormality from either the egg or the sperm. Progesterone deficiency also happens to be a cause of early miscarriage, but since I was taking Prometrium during my luteal phase and during the pregnancy and levels measured fine, this is ruled out as a cause for the miscarriage. So chances are it was a genetic abnormality. Finding out which person the abnormality came from is somewhat impossible at this point, because the sperm and egg have already come and gone. The only real way someone can make sure they are getting pregnant (before even getting pregnant) with a sperm and egg that have NO genetic defects whatsoever, is to do IVF along with something called PGD or Preimplantation Genetic Diagnosing. This is where they test the genetic make-up of the embryo before inserting it back into the woman's uterus.
For most people who have gotten pregnant and miscarried even more than once, IVF with PGD still isn't the next step, because it's just so crazy expensive and invasive, and the chances are favorable that miscarriage won't happen again. Yeah, tell that to people who have miscarried 3 or more times! Nevertheless, we are definitely not considering IVF with PGD yet, especially considering it costs $18,000 to go that route. Dr. Vaughn certainly wasn't suggesting we do that, but was just explaining how genetic abnormalities happen and the ways in which they can be avoided.
So, what are the odds that this happened 2 out of 2 pregnancies with me? Well it isn't shocking due to the fact that my age is creeping up, my eggs are getting older, and the amount of eggs I have left is falling as well. I mean, I'm still just under the 35 year old mark for Advanced Maternal Age, but I'm not a 24 year old either. AMH or Anti-Mullerian Hormone is the hormone used to test for ovarian reserve, and although I knew mine was low (0.88) I never knew that I actually had the diagnosis of DOR or Diminished Ovarian Reserve. However, apparently I am considered DOR. You've got to be kidding me! Hmmm, that's a pretty important piece of information for my previous RE to leave out ya think?!
I'm not a huge expert on DOR. It is a fairly complex diagnosis, but from what I do know, it basically means that I have a lower than normal number of eggs left in my basket. Lowered egg quantity sometimes (not always) lends to a lowered egg quality, and thus another reason why it's more likely for older women with less ovarian reserve to produce eggs with genetic abnormalities. You following me here? Bear with me! The only real way to assess the quality of each individual egg is by retrieving the eggs from your body, as is done in IVF. And again, we are not there yet.
There are plenty of other reasons for miscarriage including chromosomal abnormalities in the parents themselves, autoimmune issues, clotting disorders, etc. Even still, my RE thinks it is unlikely that these would cause such early miscarriage, and still thinks that mine are due to genetic issues. However, just to be on the safe side, both hubby and I are having a complete chromosomal blood panel done. I will do an extra "recurring miscarriage panel" which will test for the autoimmune issues and clotting disorders. Should be interesting to see if our insurance covers this, as it is VERY expensive. I made sure it was coded for "recurring miscarriage" and nothing fertility related, but insurance companies like to fight people on getting these tests done, so we shall see! No matter what, it is worth it to us to have a definitive answer whether any of these things could be causing our issues, and we are happy to have it done.
As long as the blood tests come back normal and I'm able to have this miscarriage naturally with my hCG dropping to zero sometime soon, we should be on track to TTC again. We will be testing down my hCG to make sure it goes to zero, making sure there is no chance it was an ectopic pregnancy before proceeding with any further treatments. We will be able to begin again with Femara/IUI once the miscarriage actually happens, hCG returns to zero, and a new cycle starts...hopefully in January. The chromosomal testing and recurrent miscarriage workup takes about 3 weeks to get results anyways, so I feel we have a really good timeline in place to follow.
All in all we are happy that we are having further testing done to check for possible causes, but also happy to know that we still have a shot continuing with Femara and IUI. I do think it could just be a matter of a better egg and sperm hooking up. If at first you don't succeed try and try again! If only I could host a little party with free cocktails to coerce all the studly sperms and miss priss eggs to finally unite with their perfect healthy mates!
Sunday, December 2, 2012
Waiting...
for an inevitable miscarriage to occur is like waiting for someone with a terminal illness to take their last breath. This isn't the ending that you would have hoped for, but you realize there's just no turning it around and want the whole thing to just be over already. While there haven't been chemo treatments or radiation for months or years on end, there have been plenty of other invasive procedures, needles, and what now are clearly turning out to be unanswered prayers. The feeling in my heart right now I can only compare to how I felt when I sat at my mother's bedside and told her, more like encouraged her, that it was time to go be with the Lord. It's a grieving process like any other I suppose, except that it's happening to me instead of watching it happen to someone else.
Plus, there are the questions of how it will happen. Will it be like last time? I assume it will be, since I'm exactly the same amount of time along in the pregnancy. It basically felt like someone was stabbing me with a huge knife to the uterus before the longer bouts of excruciating cramping and bleeding began. I have no idea how experts can say that many people may have had early miscarriage and not even known about it, just thinking it was a late period or something. In my experience it feels nothing like a period when it first begins. It was very difficult for me to even get out of bed for about 2 days the last time this happened and then it continued on and off for a week. I've blocked some of it out mentally, but I'm sure some of that was also due to the intense depression that set in, perhaps from the sudden drop in hormones. It really puts your mind and body through the ringer.
Where will I be....getting my hair done on Tuesday night? Will I be able to act normal and not break down in public crying if and when it happens? Please Lord give me the strength to hold it together.
How long will it last? Will I see the sac holding the embryo? Should I save it and have it tested for chromosomal abnormalities to figure out what could have happened? Would it give me any real answers anyway or would it just come back inconclusive? Can I even bare to look in the toilet? How could I not?? Ugh, I just want it to start so it can be over!
People have been amazing the past couple days, including those of you reading and commenting. I can't tell you how much a small note of encouragement helps. I never announced my pregnancy on facebook, but I did announce it's ending. Honestly, I did it because I just know there are other women out there who have gone through similar things, and it drives me absolutely nuts that no one talks about this stuff. It really bothers me that it's such a hush hush thing, and I wish people were more educated on infertility and loss. I also wish other women felt more comfortable about going through it themselves and realize that it's ok to cry out publicly and seek encouragement from those around you. Of course, I am the type of person that if I don't talk about it and get it out of my system I will implode. I have to talk about things. It's just who I am.
Hubby and I also had a great talk last night. He is just SO amazing. I think he should write a book for men, because he has a phenomenal gift for always saying the right thing at the right time. If there is only one thing in life I can find to be grateful for in light of the circumstances, it's him! We talked about where to go from here, and we both agreed we will let Dr. Vaughn guide us in what the next steps are. We will have our own questions for him of course, but we truly feel like we are in the best hands possible, and we completely trust his advice on what to do as far as testing if needed and our next steps in trying to conceive.
We feel like we have found what works in trying to conceive, since obviously the Femara, IUI, Prometrium cycle worked the second time around. For some reason though, my body is not holding onto pregnancies, and so there are a lot of unanswered questions. We're really interested to see what Dr. Vaughn's thoughts are. I don't even know when that will be, but I may request that his nurse have him call us to chat or set up an appointment for us to come sit down and discuss our next steps. I think we just have too many questions to be going back and forth with the nurse, who is more just the messenger than the decision maker.
We're not looking forward to being back to square one, but we have come to terms with it and are trying our best to stay grateful for the fact that I CAN get pregnant. We'll hopefully have more answers soon, or at least the ability to try again.
"I declare nothing I face will be too much for me. I will overcome every obstacle, outlast every challenge, and come through every difficulty better off than I was before."- Joel Osteen's book I Declare
So no, we're not giving up!
Plus, there are the questions of how it will happen. Will it be like last time? I assume it will be, since I'm exactly the same amount of time along in the pregnancy. It basically felt like someone was stabbing me with a huge knife to the uterus before the longer bouts of excruciating cramping and bleeding began. I have no idea how experts can say that many people may have had early miscarriage and not even known about it, just thinking it was a late period or something. In my experience it feels nothing like a period when it first begins. It was very difficult for me to even get out of bed for about 2 days the last time this happened and then it continued on and off for a week. I've blocked some of it out mentally, but I'm sure some of that was also due to the intense depression that set in, perhaps from the sudden drop in hormones. It really puts your mind and body through the ringer.
Where will I be....getting my hair done on Tuesday night? Will I be able to act normal and not break down in public crying if and when it happens? Please Lord give me the strength to hold it together.
How long will it last? Will I see the sac holding the embryo? Should I save it and have it tested for chromosomal abnormalities to figure out what could have happened? Would it give me any real answers anyway or would it just come back inconclusive? Can I even bare to look in the toilet? How could I not?? Ugh, I just want it to start so it can be over!
People have been amazing the past couple days, including those of you reading and commenting. I can't tell you how much a small note of encouragement helps. I never announced my pregnancy on facebook, but I did announce it's ending. Honestly, I did it because I just know there are other women out there who have gone through similar things, and it drives me absolutely nuts that no one talks about this stuff. It really bothers me that it's such a hush hush thing, and I wish people were more educated on infertility and loss. I also wish other women felt more comfortable about going through it themselves and realize that it's ok to cry out publicly and seek encouragement from those around you. Of course, I am the type of person that if I don't talk about it and get it out of my system I will implode. I have to talk about things. It's just who I am.
Hubby and I also had a great talk last night. He is just SO amazing. I think he should write a book for men, because he has a phenomenal gift for always saying the right thing at the right time. If there is only one thing in life I can find to be grateful for in light of the circumstances, it's him! We talked about where to go from here, and we both agreed we will let Dr. Vaughn guide us in what the next steps are. We will have our own questions for him of course, but we truly feel like we are in the best hands possible, and we completely trust his advice on what to do as far as testing if needed and our next steps in trying to conceive.
We feel like we have found what works in trying to conceive, since obviously the Femara, IUI, Prometrium cycle worked the second time around. For some reason though, my body is not holding onto pregnancies, and so there are a lot of unanswered questions. We're really interested to see what Dr. Vaughn's thoughts are. I don't even know when that will be, but I may request that his nurse have him call us to chat or set up an appointment for us to come sit down and discuss our next steps. I think we just have too many questions to be going back and forth with the nurse, who is more just the messenger than the decision maker.
We're not looking forward to being back to square one, but we have come to terms with it and are trying our best to stay grateful for the fact that I CAN get pregnant. We'll hopefully have more answers soon, or at least the ability to try again.
"I declare nothing I face will be too much for me. I will overcome every obstacle, outlast every challenge, and come through every difficulty better off than I was before."- Joel Osteen's book I Declare
So no, we're not giving up!
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