Saturday, December 19, 2009

Another Reason to see a Fertility Doctor

I thought there was a big stigma attached to going to a fertility doctor. When my OB strongly suggested it over our disagreement over progesterone, I was upset. I kept thinking, I don't need a fertility doctor, I can do this on my own.

From previous posts you might have read that once I met with my RE I felt so much better, like we had a plan if the natural route didn't work or if I did in fact have a luteal phase defect.

Now that I am pregnant there are a couple things that truly made me appreciative of having a fertility doctor.

1) Her whole job is to get you and keep you pregnant. She has more tools at her disposal and knowledge than a regular OB/GYN whose primary function is keep you healthy and help you deliver a healthy child. OBs pretty much can offer you clomid. But many REs feel that clomid should be used with IUI because of the affects of the drug on CM. An OB can't perform IUIs.

2) The level of responsiveness is unparalleled by any doctor I have ever dealt with. You can get your doctor on the phone and in my experience she remembered me, or at least was courteous enough to review my file before calling me. You can get in the same day for blood work (betas, progesterone) or an ultrasound need be and results usually came a couple hours later for me.

3) My first month trying after surgery, my progesterone was tested 6dpo and it was high but at 10dpo I started spotting. I called her 11dpo. She personally took my call and said it was an unusual way to present but wanted me to get checked out before she put me on progesterone moving forward. I went in the next day and it showed I did have a problem. She wrote me a prescription that day to start using the next month after ovulation. It wasn't a fight about the use of progesterone. I wasn't forced to go on Clomid either.

4) Here is the biggie. Even though I conceived naturally, I was still in the care of the RE. As her patient, she insists (and I happily obliged) to do an ultrasound every week until the 9th week. At that time a healthy heartbeat has been sustained and you get released to your regular OB. Again this comes back to my theory that an RE is all about getting you and keeping you pregnant and an OB is all about your health. When you go in, there isn't a weight check, urine test, blood pressure screening. It is just an ultrasound. She would always ask me how I was feeling, but it wasn't like I came in with a big list of questions. She also did the ultrasounds herself, not a tech, which made me feel better. She was very understanding of my anxiety and my spontaneous explosion of emotion the first time I saw the baby's heart beating. Once you go to your OB, it is more about you. You get tested and checked but it isn't fun because you aren't seeing your baby. One more point, it is truly an unbelievable experience to have 4 ultrasounds in successive weeks because the sixth week it is a little blob where you can see the heartbeat. The seventh week you can see tremendous growth and hear the heartbeat. The eight week I saw legs. And at the nine week appointment, which my DH joined me for, we saw our little baby kicking. A normal OB won't allow you to have so many ultrasounds.

All in all, for me and many, it was a big psychological hurdle to go to a fertility doctor. I think it was one of the best decisions I ever made. What is the point of putting it off because of pride? Just because you go doesn't mean they are going to push you into fertility treatments. They first will check if you have an underlying problem (or you man) and then gauge how aggressive you want to be.

Thursday, December 17, 2009

The Sleeping Cult

Last night, I went to my husband's work holiday party. He had just told some people that we were expecting that day and then others at the party. After the obligatory congratulations and when are you due inquiries, two people about two hours apart said, "you have to read Healthy Sleep Habits, Happy Child".

It is all about sleep training. Essentially after about 8 weeks the baby should never be up for more then 2 hours at a time and it also helps to get them to only wake up once during the night. One mom said she was militant and it is really hard because you can't leave your house much while doing it because you live and die by the schedule. For both they said it took about 6 weeks.

I am starting to believe this book is a cult classic because the day I told my sister-in-law and brother-in-law I was pregnant both said we needed to read this book and luckily they had 2 copies so gave me one. The irony is, their eldest slept through the night at 3 months but the little one, who is honestly the sweetest best baby ever, still doesn't and is 8 months old.

I am going to start reading it today.

Wednesday, December 16, 2009

Who took my symptoms?

You see on and the all the time, what I can symptom stalking. A girl will eat some bad shellfish at 3 seconds past ovulation and take it as a sign. So I was expecting some big symptoms.

Lucky and unlucky for me, I am not one of those girls. As I said, the only weird thing I had was a heavy feeling in my uterus on 7dpo for half a day. That's it. The month before, when I convinced myself I was pregnant and was going to surprise my husband on his bday, my boobs killed and grew. Well when I really was pregnant, there was no pain, no growth.

At about 4 weeks 6 days my boobs got a little sore, but honestly nothing compared to my false alarm in September. This last about a week or two.

Around 5.5 weeks I started feeling tired. And from about weeks 6-8, I was queasy. I would wake up queasy and it would last until about 1pm, everyday for 2 weeks. And then it went away. I never threw up once.

The only two things that have been consistent are pure exhaustion and not sleeping through the night. A couple times a week, I wake up around 2 or 3am, like it is daylight. I am so awake I could prepare my taxes or clean the house. I stay up for about 2 to 3 hours, then fall asleep.

So in all, I have been exceedingly lucky. The downside is after my experiences with miscarriages, I wanted some symptoms, just to let me know everything was ok with the baby. You can always explain away exhaustion (it is gloomy out, I might be coming down with something). Then on the birth club boards people are writing how they lost 15 pounds from throwing up and I didn't have any food aversions. Also, I had food aversions with a previous pregnancy that only lasted 6.5 weeks, so that freaked me out too, that my hormones were stronger with a doomed pregnancy.

Truly every pregnancy is different and if you are lucky like me to need a few naps and not become intimately acquainted with your bathroom floor, they rock on and don't brag to your friends who did lost 15 pounds those first three months.

Line Judges

I used to silently mock people who uploaded pictures of a completely unnoticeable line on an HPT and ask others if they saw a line. But then came a woman on who has some innate ability and cool photography computer program who actual found lines where the human eye could not.

Since I was gearing up to go to Italy I had a lot to consider in terms of testing early.

I was leaving at 10dpo, still very early for an HPT.

I was planning to definitely test at 13dpo, because that day we were going wine tasting in Chianti, so I needed to know if I would partake. I also would test on 14dpo because I had to know if I should stop taking progesterone

If I did get a BFP early, I could leave behind my monitor, thermometer, and AF products

Then there were the symptoms or complete lack there of.

On 7dpo, I got this bizarre heavy feeling in my uterus, like a weight was attached to it and I felt very bloated. I knew it was my uterus because it felt similar to how I felt after fibroid surgery when I would go on a long walk. Not pain, just discomfort.

I remember seeing a post on called "heavy feeling in uterus", which is how I would describe what I was feeling. So I checked it out and the vast majority of posters ended up pregnant.

Other than that 8hr stance of weird uterus feelings, I have had zero symptoms.

I had been very tired and having extremely vivid dreams, but I knew this is from the progesterone.

So I thought back to the 2 times I was pregnant and I didn't have any symptoms until my 5th week.

On 8po, my temperature dips .3 degrees, the bare minimum to be consider an implantation dip.

On 9dpo, my temperature returned to my 7dpo level, proving I did have a dip of some kind.

The Results:

I took a dollar tree test (the Pee-in-a-cup kind) and was about to pass it off as negative, when I kinda sorta saw something, a second line. It really was as faint as a line should be. But it was there.

So then I went to get my luggage, where I had packed my First Response Early Result Pregnancy tests.

Luckily, I had used a cup. At the end of the test window I looked. At first glance, you wouldn't see anything, but when you held it just so, a second line appeared.

Part of me thought I made it up, but part of me knew I never made it up before and I have had many many many months of BFNs

What to do:

Given I won't be on American soil for 48 hours, I can't get two beta tests to see if my numbers are going up, but I did want to confirm it so I knew I wasn't crazy.

I called my RE's office on the nurses line.

I got called back an hour and a half later.

I have to say, the nurse was mean. She told me I should postpone my trip because they highly recommend not traveling until the baby is confirmed to be growing in the uterus and doing well. It could be etopic. I really hadn't been worried about it. She said four times there was no point of me going in to confirm pregnancy since I won't be heeding their warning by staying in town, which would allow them to see if my numbers double.

I finally convinced her to let me come in today for a blood test. On the phone I made it clear I was 9dpo so I tested very early.

Later that day, she called back and said, "You are pregnant but your number is very low, 22, so expect to miscarry." I said,"But I am only 9dpo, so that is a good number right?" And she said, "it is very low".

Sorry, but what a bitch. You work for a fertility doctor, anyone who is seeing you has been through hell already in this department, so don't be a world class bitch. I remember I had written a post about early pregnancy betas on my blog so I pulled it up from my phone and my numbers were totally normal. Also, most tests don't test below the number 25 which are designed to be read at 14dpo if not a day or two before, so clearly 22 wasn't a bad number.

I put a call into my doctor and she said since I conceived naturally have no worries about going to Italy and enjoy myself.

Back to the lines, it was really so light that I came out of the bathroom and said, "I might be pregnant". I really thought it could have been bad lighting.

It's Official!

I am with child. I am sorry for not coming forward sooner, we have just been so on edge given my history and didn't want it coming out to friends/co-workers before we were ready.

I am 13.5 weeks and doing great. I want to thank you for emails, comments, and support along the way. And please don't think I am abandoning those trying because I will never forget my fertility roots.

Here is the brief recap and then I will do more posts on specific things like what to expect at different points.

The day before we left for Italy I wanted to test because I didn't want to lug my monitor, thermometer, notebook for temps, and everything else needed to help me micromanage my fertility. I was 9dpo and used a Dollar Tree test it was a super faint positive (more to come on that) and I then took a First Response Early Result and it was also super faint. I went to the fertility doctor for blood work and got confirmation that day.

Knowing was both exciting and scary. I was very worried it would turn out be a chemical pregnancy. So I was really on edge until that Sunday, when my period was due. Also I was on progesterone, so on one hand it was comforting, on the other hand, I thought my body would keep the baby even if it wasn't going to make (not sure if that was true, but you know how my mind works). The best part about knowing was that we were alone and no one else knew. We spent our days walking the cities and brainstorming baby names.

About 4 days into the trip we decided to table the naming discussion because we cannot agree on anything. He thinks names I like are newfangled, not withstanding them being biblical. But I digress.

When I got back I had an ultrasound at 5 weeks and 5 days. I was worried it would be an empty sac, but I actually say the heartbeat. Tears started streaming down my face and in all honestly, it wasn't joy, it was sheer relief. I then went back every week, to the Re's office for an U/S until 8 weeks and 5 days. At that point she had me go off progesterone and released me to the regular OB.

I had to wait 4 more weeks until my next U/S which was last week where they do the first trimester screening (will explain more in a different post). I was such a wreck going this. I was petrified the baby would have been dead for weeks. Most people think this is irrational but this is exactly what happened to my cousin. Luckily all was good and the baby was kicking up a storm not to mention flipping and punching. It is unreal that this is all going on inside and I can't feel any of it.

So in addition to commenting on the latest wives tales about how to get pregnant, I will share what to expect when you do get pregnant.

Tuesday, December 1, 2009

Chemical Pregnancies- Nature's Cruel Joke

My friend's doctor recently told her that she may be experiencing a chemical pregnancy. Given her specific sent of circumstances (beta numbers going up at a very fast rate) I am not sure I agree. That said, I wanted to find out more about chemical pregnancies.

Up until my foray into the world of obsessively TTC, I had never even heard of a chemical pregnancy. Essentially, it is a very early miscarriage. Typically it occurs right around when your period is due. Back in the dark ages, when our parents were trying to have us, they had no clue they were even pregnant. But with early home pregnancy tests, we can find out we are pregnant almost a week before our period is due.

This is one reason some women are against testing early, because you get a positive test, do the happy dance, tell your parents and best friend, and then a couple days later your period arrives.

The most common cause of a chemical pregnancy is a chromosomal abnormality, meaning the baby couldn't have survived. Other reasons are hormonal problems (luteal phase defect), uterine lining abnormalities (such as fibroids), or inadequate uterine lining.

I haven't been able to find in my search what the beta levels are in a chemical pregnancy. One site said a chemical pregnancy occurs when a baby isn't able to be seen on an ultrasound (nothing in the sac). I know from my experiences that my doctor likes to wait until your beta reaches 3000 to do an ultrasound. So by the transitive property I learned in geometry, perhaps a pregnancy that doesn't experience levels of 3000 is considered a chemical pregnancy. This is just my middle-school conjecture, though. It does seem for the ancedotal posts I have read online that numbers tend to be much lower than 3000.

Regardless of how, why, or when it happens, a miscarriage is a miscarriage. The upside for those who have experienced a chemical pregnancy is the knowledge that they can get pregnant. But let's be honest, it still sucks.

Public Service Announcement

I know this has nothing to do with fertility or getting pregnant, but it is so bizarre I had to share.

Last night I was watching something on CBS and I saw a PSA that was a huge departure from the don't drink and drive and don't do drugs of our generation. I don't want to butcher the words, but it was essentially, "Do you want to do something special for your woman this Christmas? Schedule her for a pap smear. Give her a gift even Santa can't give her."

I thought it was so out of left field, I called my husband over and replayed it. He had a horrified look on his face. It looked like a commercial you would see on Saturday Night Live spoofing public service announcements.

I went to Youtube to find it. I didn't find the one I saw but did find the Hanukkah version. So check it out and maybe send it to you man. In case he was thinking of getting you diamond stud earrings this month, he can now get you an even better gift, a pap smear appointment.