22 Weeks

Probably time for an update hey? Well I was right and I do have gestational diabetes, so I’ve been on insulin since around 10 weeks. It’s fine, it doesn’t worry me because at the end of the day it is for the health of the baby and what’s one more needle in this whole process (it’s only a pen needle too) the way some women carry on about taking insulin you’d think they had to inject clexane daily or something (now that’s a painful needle!).  We are also having another girl which is fine by me! E is very excited about becoming a big sister but doesn’t fully grasp the concept really – she’s insisting there’s a baby in her tummy not mine.

My cervix has held fast… it did get down to 2.1 cms which is pretty short but since then it’s rallied and is back up to 2.6 – 2.7  cms (anything under 2.5cms is classified as high risk) so I was getting a bit nervous there for a while but am feeling better about it all at the moment. I just want to make it to at least 26 weeks when the baby will be classed as ‘viable’ and the hospital would fight to save the baby. 29 weeks would make me feel MUCH better, but beggars can’t be choosers sometimes.

The OB also found ‘amniotic sludge’ in one of my fortnightly scans – which is apparently the official term (how nice) which is a marker for pre-term birth. No one can tell me how pre-term that’s likely to be but I should be prepared that things might happen sooner than 38 weeks. I had course of antibiotics to combat the sludge (which indicates inflammation/infection) and it seems to have cleared up since, it also common in pregnancies with a short cervix.  So it’s just another thing to worry about I guess. I’m wondering if I should be packing my hospital bag sooner rather than later.

In other news, we have also bought a new house which is pretty exciting. It’s the opposite side of town which will be a big change for both my husband and I … it’s pretty much suburbia and that’s fine by me. It’s on the cusp of the country suburbs – my going out at night days are over, and driving to meet friends doesn’t phase me – I want peace and quiet, a bigger space and a nice garden… this house also needs basically no renovating so that’s a big win in my book as well. I’m sure my full time work at home husband will be very happy to get out of the corner of our dining room and into his own office. We move in about 3 weeks and it can’t come soon enough after a 3 month settlement period.

So that’s where we’re up to. This pregnancy is not without its stressors – I’m on edge a lot of the time and taking it very easy with the physical side of my work that’s for sure. I’m in bed at around 7pm just watching tv once E goes to sleep – keeping my feet up and relaxing. I do feel much better this pregnancy though (losing 30kgs has to make some difference!) and am still in mostly size 14 clothes… I have no idea where my weight will end up though and it’s freaking me out a bit. I’ve put on 7kgs so far so who knows and my restriction is not as tight as it used to be with my sleeve weightloss surgery, I guess I’ll reassess a month or so after having the baby and follow up with my weight loss surgeon.

A-Ok

First OB appointment yesterday and I have to say I’m so relieved in more than one way… first off the scan went well and baby was still kicking (my symptoms disappeared for a couple of days and freaked me out) so when I arrived to the new OB he asked if anything was worrying me and I admitted I was concerned I’d had a missed miscarriage so he scanned me straight up before we got into any background info so that I could relax. HB at 165 and all measuring bang on 9w5days – so then we got into my very elaborate medical history and discussed his approach to my issues. First up I have to do the Glucose Tolerance Test this week (boo!) as I had GD in my last pregnancy, I guess I’d rather know earlier rather than later and I highly suspect I’ll have it as my fasting BGL’s are a ALWAYS high or borderline, even when not pregnant… so I’ve resigned myself to having to do insulin… it’s inevitable. Secondly he told me that I am more likely to get pre-eclampsia again after having it once (my old OB told me I wasn’t more likely) all research I’ve done suggests new OB is right… so he will be monitoring my blood pressure and protein levels closely and if my platelet count from my blood tests is ok (I have ITP) I’ll be put on low dose aspirin to help avoid it.  My short cervix .. we are checking the length at my 13 week scan and if it’s still short or showing signs of getting worse he’s offered to do the cerclage stitch for me as a preventative measure (I can’t tell you how relieved that makes me feel).

So this week it’s GTT time for me (I was going to do it this morning but the kid woke up at 5.30am and there’s no way I could make it to 8.30am with no coffee waking up at that time! So I’ll do it tomorrow on my annual leave day. Next week it’s NIPT time and we’ll find out the Gender then a couple of weeks after that it will be time for my 13 w scan and follow up OB appointment.

My arse is absolutely killing me now from the gestone shots, I have a tennis ball sized lump on one side and a golf ball sized one on the other… I’m switching over to Crinone for a few days to give my bum a rest and stop meds completely in a couple of weeks as they run out.

So everything is looking good – in amongst all of this we are trying to sell our farm and find a bigger house in the city (once the farm sells) so lots of stress around that with people putting in offers then reneging , we are trying to take it one step at a time but we do kind of have the deadline of a baby coming now so it makes it a bit more time sensitive.

Short People…

Sorry for the drop off!  Things got a bit crazy around here and my 4th beta was a bit wonky and on the low side so I of course panicked and thought the worst.  I wasn’t very confident going into my scan but the baby was seen at 6+3 with a heartbeat of 117 bpms, and bang on track. My worry free time was cut short at the end of the meeting with the sonographer when she gave me my written report and said, ‘now I’ve put here that your cervix is at 2.5 cms which is short, but I didn’t want you to see that and worry’…You know what lady? I have no idea what length my cervix should be and if you hadn’t pointed it out I would have been oblivious until perhaps my meeting with my OB… but now of course I get home and google it… and reams of info come up on people having second trimester miscarriage due to incompetent cervix and needing cervical stitches etc., babies falling out in the toilet and all other horrific stories.  If you measure under 2.5 you’re considered high risk … brilliant, and I’m only 6 weeks at this stage. So I dig through my files and find my ultrasound report from when I had my first scan with E and I was 2.9 cms for that pregnancy at the same time… my measurement just before leaving for Cape Town this trip was 2.5cms… so I think the D&C might have contributed.

I had booked in with the same OB I saw last time, so when I found this out I had no idea if I should be doing anything differently.. ie seeing him earlier, bedrest etc. so rang for advice. He got his secretary to call me back and tell me he wasn’t worried and that nothing could be done until the second trimester anyway.  And I just lay in bed that night and thought, ok this is the way it’s going to be the whole way through with this pregnancy with this OB – he’s very low intervention, low fuss and if he can’t be bothered actually talking to me about my fears over the phone already, I don’t think he’s the guy for me in this pregnancy. I had pre-eclampsia last pregnancy and it was only picked up when I was at a random GP appointment and I was made to feel like a freak for wanting an elective C section- I just don’t think I could deal with it again. I want to be monitored, micro-managed  and confident I can be as neurotic about this pregnancy as I like and not be fobbed off.  So I switched to a high risk OB who a couple of friends have used and have been really happy with and they by no means had ‘easy pregnancies’ or  ‘easy past pregnancies’ – this guy is also a MFM specialist and had headed up the Obstetrics team at the major women’s hospital  here in Melb. I’ve also joined a group on Facebook for Aus ladies with incompetent cervix, just to get info and to have some idea what I’m dealing with – he comes highly recommended from those in the group who have used him in there and he has experience in doing cervical stitches / cervical abdominal stitches which not many do.

So I am sleeping easier at night as a result of making this change… my first appointment with him is on the 8th which is seeming like an eternity away – and I’m hoping the bean is still hanging in there at that point which will be 9 weeks.  Symptoms wise, it’s pretty mild… super sore boobs, complete exhaustion (but that could just be life with a toddler) and on and off nausea but nothing a maxalon won’t fix.  My arse is bruised and lumpy as I’m still on PIO shots… most stop them and move on to crinone at 6 weeks but because I had a drop in progesterone early on and also because I’ve read that progesterone can help with keeping the cervix length stable I’m powering on until 11 weeks on the injections.

 

 

Waiting…

for scan day… I’m booked in on the 13th which is actually pretty early, but still seems a long time away.

I’ve had a few blood tests just to check things are rising and that my progesterone is ok…

Beta#1 @ 13.5 DPO – 163 / Progesterone 190

Beta#2 @ 15.5 DPO – 438 / Progesterone 70

Beta#3 @ 19 DPO – 2195 / Progesterone 97

I’m due for another beta on Thurs and then my scan will be at 6+1 weeks on the 13th. Holding onto my hat until then.

Duffed

Yep it worked! I didn’t want to bog you all down with my neuroses during the two week wait… so I spared you the pee stick shots etc.  Needless to say I was peeing on sticks as soon as I got home, at first I thought it was a chemical because the line was so faint (at 10dpo mind you – the tww does insane things to your reasoning skills)… but first beta came in at 163 and yesterdays was 438 so rising really well. I bit the bullet and booked in with my old OB so I could secure a spot with him as they book out crazy early here.  My first scan is on the 13th so fingers crossed that all goes well. When I see a heartbeat I start to relax a bit more and get a bit more excited … until then I’m quietly happy! I did have a bit of a bleed the other night (nothing is ever smooth sailing) so have upped my progesterone to 1 x PIO and one Crinone daily now in attempt to get the levels up. Hoping they stay nice and high but am being monitored with twice weekly blood tests thankfully. I have to say, my Marie Claire fertility specialist has been such a dream to work with this time around and her team – all my questions are answered and I don’t have to repeat my story a thousand times with going overseas to do the cycle. It makes it so much easier!

It Doesn’t Get Better Than This…

That’s what my doctor said to me at our appointment just before transfer yesterday. This has been a phenomenal cycle, the kind I’ve only ever read about before from others… never for me, so I’m a bit in awe that it’s actually happening.

Of our 20 embryos, 15 were of freezable quality – two were hatching and graded 5AA – we opted to transfer one of the hatching 5AA  blasts and to freeze the next top 10 embryos and discard the rest. I realise that sounds harsh but we had to consider what the point of freezing them would be when realistically I am only prepared to come back for one more cycle and even that is questionable right now, I’m pretty over all of this and want to get on with our lives. Even 10 being frozen seems excessive, but you never know what can happen and I want to assure we have at least one top quality one if we come back or we might do PGD on them if we have to come back one more time, it just gives us options really.

So the bottom right embryo was transferred yesterday and I’m feeling very positive and hopeful that this might just be the sibling we’ve been chasing.

I went for acupuncture with a lovely lady named Sarah Hewland who fitted me in on short notice and I’ll see her again on Friday for a second session.

I have two more days in Cape Town – most of it will be spent bumming around, I’m going to head up to the movies in a bit and see Passenger in 3D, eat some popcorn and might even head to another session in the afternoon and see Sing! I never get to go to the movies at home so it’s a bit of a treat and two in one day is unheard of! Tomorrow I’m having a facial in the morning, acupuncture,  then going to pick up some Wonki Ware homewares I purchased the other day (the lovely lady is packing it for travel for me) and buying a few gifts for family.  I’ll then have dinner in the top end restaurant downstairs here at the hotel and try to get a good nights rest before the flight home on Saturday. It’s been a nice trip, I’m missing the family of course but it’s been relatively stress free and enjoyable – I feel relaxed and happy that we’ve done everything we can this cycle. The rest is up to the embryo.

Hold on to Your Hats…

Here I am in Cape Town again! Back at the Vineyard Hotel and relaxing my ass off.

I’ll just recap for those who aren’t up to date with this cycle (or can’t be bothered reading back over 3 years of my writing)…. this is donor cycle #4 for us. In 2014 after 6 of our own egg cycles including a miscarriage we decided to use donor eggs in South Africa (Cape Town specifically) first cycle was a positive and he had our lovely daughter (she’s now 2). Since then in 2015 I returned for a FET with the remaining 2 embryos from her cycle – 1 didn’t thaw (it was a pre-blastocycst so I’m not sure why it was frozen anyway) and the other 3AB didn’t take.  Later in 2015 we used a new donor and I stupidly went for an unproven donor who had never been pregnant herself.  From go to woah the cycle was a bit average – 7 eggs, 4 fertilised, 2x3ABs transferred and 2 x 3AB’s frozen.  I also found this donor online (it’s supposed to be anonymous) but she put a pretty unique professional role title  on her profile so I googled that + “Cape Town” and she came up  – and through out our cycle in pretty much every photo she had a beer in her hand. So I asked the clinic for follow up information on how her ongoing cycles had gone for other couples  (hey it could just have been me!) and the results weren’t good, out of two more cycles she did no one got pregnant.  She herself also stated she was in a long term relationship not using protection and had never been pregnant.  So I totally went off the idea of going back for those embryos.  I was ruthless in my search for a new donor (my daughter’s donor agreed to donate again and then got pregnant herself in the interim) only someone who had donated before, had good numbers and resulting pregnancies for recipients, and I found someone who fit the bill, she also sounded nice.

During my daughter’s cycle my husband left and extra sperm sample over here –  “I’ve got jizz all over the world!” so we are using that sample and I’m over here solo cutting down travel time to a pretty minimal time frame of 5 days in Cape Town for a fresh cycle when they generally like you here for 12 days.

Pros of this approach:

  • I’m not paying for another 7 nights accommodation, meals etc.
  • If for some reason there’s an issue with fertilisation or egg collection I still have time to cancel flights / accommodation re-assess – when you’re over here and things go pearshaped the stress is enormous

Cons of this approach

  • You feel even more detached than normal to your cycle.
  • You’re paying for extra scans etc. in your home country and get no discount from the SA clinic for not doing scans with them

I have to say it’s been a pretty good cycle so far aside from one point – and if the clinic happen to trawl the internet for information on themselves then please take this feedback on board.

My doctor was on leave while my donor was stimming and another doctor was filling in for him. So maybe let your patients know that  you’re not going to be there for part of the cycle (same went for my nurse/coordinator she was off on leave during my cycle and I had no clue this was happening) to get right in the thick of things for a cycle and to send an email and get a bounce back from your doctor and then your nurse saying you’re both on holiday is pretty annoying.

But hey I can deal with that, my doctor would be back for my transfer day.  I’m then assured by the filling doctor that I’ll get an update on how egg collection went on the day (my night) I wait up all night for an email, I don’t want to be rude or pushy even though my now unmedicated anxiety is going into overdrive,  so I wait and wait until 4pm Cape Town time and send an email query if it went ok, or even if it went ahead because at this point I have no freaking idea and I’m leaving in 24 hours. No email comes in so I’m in a panic, was it bad news? Did she not turn up? Did she not trigger correctly? Who the fuck knows?  Not me that’s for sure, I’m just the chump at the other end paying the money!

I was livid at this fill in doctor that no update came through as promised on the day of egg collection. I mean, let’s face it, it’s just one of the biggest parts of how a cycle pans out. Egg collection/fertilisation (which I also requested an email outlining so I could know what I was dealing with on the flight over) and pregnancy test… the Big 3 of any IVF cycle.  And fuck you very much fill in doctor you failed one of the big 3.  So it’s Saturday and I email the donor agency I used to see if at least it went ahead, she confirmed thankfully that it did so that I could take comfort that the cycle was still going ahead.  So I wait until the next day and call the lab directly for results of how egg collection went.

So far this has been our best cycle yet – 20 eggs collected, yes 20! 19 fertilised normally, yes 19! I’ve never had a cycle like this ever – and you’re always waiting for the other shoe to drop, gotta make it to day 3 and see the impact of the sperm… day 3 is generally where you’ll see a bit of a drop off in numbers if the sperms a bit iffy. That day was yesterday and not only were 19 still where they needed to be, the 20th rallied and is back in the game. 20 freaking embryos…

So I am bumming around Cape Town waiting for my transfer tomorrow – wallowing in ‘me time’ as only someone with a 2 year old can.  I’ve had my hair coloured, a foot massage, manicure, been waxed, having a pedi and massage later today and all systems are go for a day 5 transfer on Wed lunch time (thankfully with my own Doctor) and be peeing on sticks by  Thursday night (hey at least I’m honest – although I did limit myself to 2 when packing as testing at 3dp5dt is pretty pointless as we all know…right? Right?