Change of Plans

I took my second dose of misprostol yesterday and had even less cramping than I did with the first dose and still no bleeding.  I called the clinic first thing this morning to ask about the possibility of a D&C and they called back fairly quickly.  The doctor wanted me to come in for another ultrasound and a consult.

She did another ultrasound and was unable to find anything other than a bit of fluid in my pelvis.  Nothing was visible in my uterus.  However, my HCG level was still high enough to indicate that there was something pregnancy related going on inside me somewhere.  I believe she called it a 'pregnancy of unknown location' aka ectopic pregnancy.

I was pretty surprised to hear this, but I suppose it could make sense.  I tested postive for pregnancy, but before I had my 7 week ultrasound I had the heavy bleeding and cramping.  Then when I went for the ultrasound the next day, there was nothing visible in the uterus.  So we assumed that it had been a uterine pregnancy and that it had been miscarried.

Then when the hormones rose last week, it indicated that something was left over.  When I had the ultrasound last week Dr. Case said it looked like there might be something leftover in the uterus, but she didn't sound really confident.  That is when she suggested the misoprostol. 

I went for MORE bloodwork today.  I think I have been for bloodwork at least 4 times in the last week and a half.  She said if the hormone is starting to drop on its own, we will track it with bloodwork and let it happen naturally.  However, the more likely scenario is that tomorrow the clinic will call and tell me to go to City Hospital to get a shot of Methotrexate which will kill any pregnancy related cells that are left, which will allow the hormones to drop and my body to return to normal.  After I get that shot I will have to go for bloodwork every 3-4 days to make sure the hormones are dropping as they should.  

I knew that it was possible to have an ectopic pregnancy with IVF and frozen embryo transfers....but I always thought it was so strange, that the embryos are deposited right into the uterus, where they need to implant, and sometimes they drift up the tube and settle in there.  I also feel a bit sad, because before I had just assumed that my miscarriage was caused by a chromasomal abnormality in the embryo that would have made it non-viable.  However, now I wonder if it could have been viable, had it implanted in the right place.  I know there is no point in playing the what-if game....but I can't help it.

More Waiting...

After a miscarriage it is typical for doctors to request blood work be done once a week until the HCG hormone levels drop back to zero.  I never really gave it much thought why they do this, until last week, when I got a call that my second weekly test, that instead of dropping, my HCG level had increased.  That means that my miscarriage was incomplete and that there is still some tissue hanging out inside of me that needs to come out.  If it doesn't it can cause infection and other complications.

After I had that blood test, my doctor called me in for an ultrasound, and confirmed the fact that there was retained tissue.  They then asked me to go for bloodwork to see if the hormones had started dropping again, indicating that my body might pass it on its own, but the hormones were still rising.  So I have been prescribed Cytotec/misoprostal.  It is a drug that is used for a variety of purposes, but seems to be fairly effective for forcing out tissue after a miscarriage.

I spent a few days feeling very anxious/scared about the prospect of taking this drug.  After reading numerous stories online about how awful it was....I was prepared for the worst.  Yesterday, after our company left, I dropped Fiona off at mom and dad's and I took it.  I waited and waited and waited, and other than some light cramping, nothing happened.  I am really quite disappointed.  Not that I wanted to be sick....but the tissue still needs to come out, and the first round of meds did not work.  I am waiting on a phone call from my clinic to take a 2nd dose today and hopefully it will do the trick.  If not, I suppose they would schedule a d&c.

I am really, really, really ready to be done with all this.   

Still Processing

I am still trying to wrap my head around the fact that our family is complete. After almost 5 years of waiting for treatments, and going through treatments, and waiting to see if I would get pregnant from said treatments, we are done. There is definitely a sense of relief coming through. I still feel sadness about the what ifs, and wondering what our other child might have looked like/acted like/etc. I do realize, that most miscarriages that happen early on, often happen because of chromasomal issues, so, it is all kind of a moot point.

The first cycle of IVF we did, I was so excited. Everything, seemingly went well. I was so sure during the two week wait that I was pregnant. Then I was blindsided and devistated to find out I was not. After that cycle, I went into all the other ones with a good amount of caution, and even some pessimism. 

Before we did the embryo transfer in September I had mentally prepared myself more for a negative outcome, than a positive one. I did not think that I would possibly get pregnant and miscarry, I just did not expect to get pregnant at all. In my mind I made a list of the positive sides of only having one child. I knew the postivies of having another baby....but I wanted to prepare myself for the possibility that Fiona would be our only child.  I am starting to look ahead and trying to appreciate the list of positives I made.

After I miscarried I had all these thoughts about things I wanted to do.  Things that I felt like I had been putting on hold because I might get pregnant.  Get back into an exercise routine, cut my hair, buy some clothes (maybe once I lose some weight...), sell Fiona's baby stuff that she has outgrown....and I think I will pursue some of these things, but last week it felt like I needed to do all of it RIGHT NOW.  I think it was maybe just a way to distract from my sad feelings.  I think I will do all of those things....but I know there is no rush.  

 I have been savoring my time with Fiona. She is at a really fun age. She started walking a week or so ago! It is amazing how quickly she picked it up once she started. She is still pretty wobbly and falls down a lot, but I would say she walks the majority of the time now. She is becoming more expressive and loves to giggle. The other morning when I was getting her dressed in the morning, I had her laid across my lap.  She reached up and touched my armpit and said 'tookatooka' which is her way of saying 'tickle tickle' and giggled.  It was so sweet!

What a difference a year makes!  Top photo is her at 1 month, bottom is her at 13 months!

Goodbye little one

When I got pregnant with Fiona, it was such an amazing surprise.  After going through extensive fertility treatments, I felt so thankful to have gotten pregnant, and stayed pregnant, and have a healthy little girl.  I am still so thankful for her!

We knew after we had her, that we would not be going through any more cycles of IVF.  We were spent, both physically and emotionally from the ups and downs of what it entails.  We did however, have one little frozen embryo left.  We knew that we wouldn't wait too long to transfer it, as we were longing to either have another baby fairly close in age with Fiona, or just move on from this chapter of our lives.

Earlier this month we transferred our beautiful little embryo.  I was a lot more calm this time around after having Fiona.  I knew not to read too much into the 'symptoms' I was feeling because most of them could be explained away by the progesterone supplementation the doctor uses for these types of procedures.  However, about 2 days before my blood test, I was hit with the same crazy fatigue that I was hit with when I got pregnant with Fiona.  I was pretty sure our little embryo had stuck!  Sure enough, two days later my blood test came back positive, and 3 days after that the 2nd blood test indicated that the hormone levels were rising appropriately.

Since then I have felt pretty good.  I have been really tired and occasionally nauseous, but that was pretty average for being 5 or 6 weeks pregnant.  Yesterday I had a bit of spotting.  I was not too concerned, as it was pretty light, and I had had a couple of bouts of spotting when I was pregnant with Fiona.  Then this morning when we were out grocery shopping, I started to feel crampy.  When we got home I found that I was bleeding, but nothing too heavy.  I decided to phone the doctor on call for our fertility clinic.  She said unless it gets really heavy, sit tight until tomorrow and call the clinic in the morning and they will get me in for an ultrasound.

Since then the bleeding has gotten a lot heavier and the cramps have gotten quite a bit worse.  It still isn't much worse than a bad period.....but I would be really surprised if that little one is still in there.  Sigh.  After all this....all the thoughts that you have when you find out you are pregnant (what we will name him/her, is it a boy or a girl, I will have to give up my massage practice because my office is the only spare room we have left, I will need to get a double stroller, how will I manage to sleep with a toddler and a newborn, how will I look after Fiona and a newborn while recovering from a csection, how will Fiona interact with a baby, etc etc etc), I am pretty sure that Fiona will be our only child.

I feel sad for her that she won't have siblings....and her cousins are 8 and 10 years older than her....but I hope that she will have good friends who will be like sisters/brothers to her, and maybe she will marry into a family with siblings.  I know there are no guarantees about siblings being close.....but I am sure parents hope that they will be.  I know being an only child has its advantages (as Jason can attest to), but I think there are disadvantages too.

Update: This morning I went to the clinic for an ultrasound and our baby is gone.  I know we will be okay, but it will definitely take some time.  You really do get attatched to these little ones, or the idea of them.....and then they are gone.  I am SO SO SO thankful we have Fiona, and will be giving her extra hugs and kisses in the next while because I can't imagine how much harder this would be if we didn't have her.

It has been a while....

I am pretty sure no one probably ever checks here anymore.  I feel like a lot of what was going on in my life in the last six months or so were things that I wasn't wanting to share publicly.  So, I just didn't write anything.  Things have been happening in my life.  Big things.  Life changing things.

I am going to be a mom.

That last sentence brings a tear to my eye.  It has taken us a long time to get here (though maybe short compared to some others who are still waiting, still hoping).  There were moments, even last fall, when I didn't think it would ever happen for us. 

When you are in the trenches of infertility, you often ask yourself how do you know when to stop.  There are those who try every treatment under the sun, and bring themselves to the brink of financial ruin and have nothing to show for it (other than an empty bank account/pile of debt and a lot of emotional scars).  If you would have told me about people like this a few years ago, I probably would have scoffed and wondered how anyone could do that to themself.  But after going through a small portion of it, I understand what it's like to desparately want a child and to be told that the chances of it happening naturally are slim to nil. 

I am thankful to have kind, supportive friends and family who do not ask us insensitive questions or make comments that hurt.  I have read about all sorts of garbage that people with infertility have had to deal with from those who should be supporting them.  For some reason a lot of people do not see infertility as a medical condition.  Would you look at someone with cancer and tell them that they shouldn't take treatment, because if they are meant to live, it will happen?  For a lot of people with infertility (1 in 7 couples deal with infertility!), it is a matter of hormonal inbalance, blood clotting disorders, immunilogical disorders, sperm quality/quantity, or sometimes the complete absence of sperm (just to name a few!).  It is not just women who have waited too long and their eggs are too old.  That can happen, but there are some women whose bodies are going through a sort of menopause which stops them from conceiving and they are still in their 20s and early 30s.   

And for goodness sake, please don't ever tell someone that they should 'just adopt'.  Adoption is a beautiful thing.  There are so many orphans and unwanted children in this world that need to be adopted.  But adoption is different than having a biological child and you have to prepare yourself differently.  It is not the answer for everyone.  It is not simple, quick, inexpensive, and there is often no guarantee of a child at the end of it.  I often feel, when I hear people telling those with infertility to adopt, I wonder why is it up to them to step up and have the moral obigation to adopt.  I know that some people who have biological children of their own, still adopt children as well.  But there are a lot of people who say 'hey, let's start a family' so they have their biological children without having to stop to even consider the idea of adoption.  I am not saying adoption is a bad thing, but just never tell someone that they should 'just adopt'.

One other thing I have learned from my experiences in the last few years is NEVER pressure someone about when they are going to have kids, even jokingly (or for that matter, when they are going to get married, or go to university, or get a better job, etc).  I remember one of my first massage clients after I graduated.  She was a lady in her mid to late 40s.  In my profession, sometimes you just try to make small talk to get to know your clients a little bit.  I asked this lady if she had kids.  She said no.  That was the end of that discussion.  She did become a regular client but she never mentioned it again.  I don't know if it was upsetting for her to be asked.  I know for me, when I was occasionally asked by a client if I have kids, it wouldn't upset me, but depending on the day it would make me sad.  I know that you can't be aware always of what is going on in everyone's lives and try not to offend them.  But think before you speak, and be aware that there may be more going on in someone's life than it looks like on the surface.

I am not trying to be a downer.  But what we have been through has opened my eyes to a whole world that I was unfamiliar with before.  I have learned a lot, and I feel like I have gained a lot of compassion for those who are not able to have children on their own.  Especially those who are unable because of financial barriers.  Fertililty treatment is expensive and because of that a lot of people are unable to persue it.  And in the end, even if you can afford it, there are no guarantees of success.