Saturday, August 27, 2016

A Happy Occasion

My second-cousin is getting married today. I am so happy for her and excited for the festivities. It will be a big Russian celebration filled with a mix of folk and modern music and so many of our family members. These are best types of receptions and I have been anticipating it for a while now.

The ceremony is in the early afternoon, meaning that there will be several hours before the reception begins in the evening.  My immediate family had planned to go to the hotel near the reception location to spend time together. My sister and her baby (and husband) will be there from out-of-town and it will be a relatively rare occasion when my whole family is together in one place.

During the intermission, we planned to have our daughter (hopefully) take a nap in one of the hotel rooms while the adults spend time next door. I fantasized about changing her into more comfortable clothes for napping, which happen to be a new shirt saying "Big Sister, Est. 2017". She walks out into the other room to tell everyone her favorite word ("bye!"), they notice the shirt, and everyone is shocked and excited. It is perfect. I bought the shirt and it arrived today.

Then there was the spotting, that fact that there is only one HCG number 5 days ago, and the reminder that I do not feel an ounce pregnant aside from enlarged breasts.

I am so torn about this. On the one hand, this is a rare opportunity to actually tell some of my immediate family in person and I'm not sure when I will next see my sister. Plus, keeping it from them for a multi-hour hiatus where I am sure alcohol beverages will be the primary option and then again for an entire wedding reception (the stereotypes of Russian weddings and vodka are accurate) sounds nearly impossible. I have also heard that it could be useful to tell anyone that you would want support from if it did go wrong. My family isn't always the most supportive (although having multiple psychologist friends, I probably have exceptionally high standards of support), but I would definitely want them to know no matter what the eventual outcome.

On the flip side, making such a big show of it this early (5 weeks, 3 days assuming all is well) seems inappropriate. I hate believing in jinxes, but I do and this seems like I'm setting myself up.

But this was what I wanted. I purposefully didn't tell anyone in my family ahead of time, unlike our first IVF, because I really wanted to be able to actually surprise them. I really wanted to see their expressions morph from confusion to shock to joy. I felt robbed of this experience last time and I really really wanted to reclaim that.

As far as I see, I have the following options:
A) Trust the tests results and nurses' reassurance, live my fantasy, and enjoy the moment.
B) Try my best to continue hiding it through the festivities, hope they don't notice or suspect anything, and then attempt a different "reveal" after the ultrasound.
C) Tell them tomorrow, but without the big show/shirt. Present it with cautious optimism given the circumstances and avoid the bravado.

The first two options feel very risky, each in their own way, and the third option is just disappointing.

I am honestly still undecided. C mentioned we could always pack the shirt and decide in the moment, but I am usually much more thoughtful then this. Stay tuned! ...or feel free to chime in with an opinion...

Wednesday, August 24, 2016


The nurse was very pleased as she told me the blood work was positive. I was pregnant. She asked about my spotting, which has continued, and didn't seem to be concerned at all. At all.

They want me to return in a week for a second HCG reading. This is when I started to cry on the phone, trying to keep it muffled. An entire week to see if the number is rising or falling. An ultrasound wouldn't be for  a week after that. Two weeks to determine if I am in the process of miscarrying one embryo right now.

I want to believe her that there is nothing be worried about. I want to trust the high number. I want to feel overjoyed with excitement that the FET was successful and I am pregnant for a second time.

As soon I got off the phone, I went to bathroom to find more blood. It was brighter red and with a small clot again. As if just to remind me that this wasn't over.

In the research I could muster, approximately 20-25% of pregnancies will have first trimester bleeding episode(s). The research reports that 50% of these will end with a healthy birth. The other half aren't so lucky. I also read that bleeding is more likely in the case of twin pregnancies.

On this exact day in my first pregnancy, the HCG was over 1,000. This was with two blastocysts transferred,  one healthy heartbeat discovered the following week, and no bleeding. I could not find any research comparing blood test results from one pregnancy to the next and what this could imply. Clearly my research has not been particularly helpful or comforting.

My fear is that I was pregnant three days ago. Then the bleeding began with a full miscarriage to follow but the HCG was still high today. My fear is that it was higher three days ago and now it is dropping.

My other fear is that all of this is a partial miscarriage of one of the embryos. In two weeks we are going to find one developing embryo and remnants of a second. They say that if not implanted the embryo will likely just "re-absorb" into the uterus, which is what I am assuming occurred with our first IVF. I find this oddly comforting. It is still with me, reabsorbed within me, because it was not suitable to grow into a human on its own. This is much more comforting then the embryo being slowly dejected from my body. I fear now that if there is one embryo on the ultrasound in two weeks that I won't have any other interpretation of the bleeding but this and it sickens me.

I tell myself to trust the nurse and medical team. I tell myself that there is nothing anyone can do at this point regardless of the outcome. I tell myself to take care of my body and the likelihood that I am supporting life. None of this seems natural. And with my "high" number, I feel so ungrateful and whiny that I am not more enthusiastic and hopeful. This is not at all the reaction to a positive pregnancy test I expected from myself.

Monday, August 22, 2016

Child #2 Anxiety

This is not about the anxiety about my blood draw results tomorrow. That is there, yes, but this time I am aware of a different type of anxiety. It nears ambivalence, but ambivalence seems like too strong of a word to use.

This is the anxiety about if everything does work out. The blood work comes back positive and so does the next one. The ultrasound sound shows a heart beat, or two. The trisomy test is negative and the anatomy scan is normal. Sometime in April, 2017 we welcome home one [or two] healthy child[ren].

This scenario is anxiety provoking in a way I didn't feel with our daughter. With her, the anticipation was entirely positive. And it largely has been. She's had her share of challenges, but she is perfect to us. Our family is near perfect as well. On many days I would argue it is perfect. Which then makes me question, Why are we trying change this?

I question how our daughter will react to a new sibling and how we will manage with dividing our time and our resources. When I spend hours in the evenings playing tea-party and reading books, I am now acutely aware that this will not be possible with a second child. At least not in this way. I get sad when I think about the new child getting attention from others and the thought of our daughter getting brushed aside. I'm not sure how much of this is rationale.

This time I also go into pregnancy and motherhood unblinded. I miss the snuggles and fresh-baby-smell but I am not looking forward to returning to sleepless nights and those periods then they are inconsolable and nothing you do can stop the crying. I cringe when I think about the heartburn of the third trimester and the inability to be comfortable for months at a time. Trying to do all of this with a toddler sounds like an impossible feat.

Yet, clearly having a second, or third, or fourth child has worked out a million times over for women across the world. I have two siblings and my husband has three. I can't imagine growing up without siblings and wouldn't want that for my daughter. I look forward to watching them play together and hearing them giggle in their bedrooms when they should be sleeping. I believe our daughter will be a wonderful, albeit sometimes bossy, big sister.

If the results are positive, I look forward to eventually being able to talk with other mothers on how they balance a second child. Until then, at least I have the blogging world.

Sunday, August 21, 2016

Spotting and Symptom Spotting

I woke up this morning to soiled underwear and pink spotting on the toilet paper. Then I made the grave mistake of googling "miscarriage while on progesterone". I do not recommend this under any circumstances! Forum after forum, story after story of miscarriages.

I have to wait until Tuesday to get my first beta, a full 2 weeks after the transfer. These seems excessively long given that the transfer was equivalently five days after "ovulation". I cope with this by reminding myself that I would rather wait to see a higher a number then a much lower number and fret over what this means. As in, I would rather know that I am not pregnant and likely never was then to know that I was pregnant at 4 weeks 1 days but not by 4 weeks 5 days. But then spotting has occurred so this argument doesn't really stand up.

I also tell myself that if I tested early and it were negative that I would lose all motivation to continue the progesterone shots. These are not the most enjoyable way to begin my morning. Neither is spotting.

Clearly I'm stuck on the spotting. And now extremely eager to get to Tuesday. Last pregnancy there was never any spotting or really anything out of the ordinary in the beginning. The worst was when I had a period of cramping between the period of being released from the RE to my first OB appointment, which put me into a tizzy for a few hours, until I realized it was simply constipation pains that resolved itself with a trip to the bathroom.

I am reminding myself that approximately 30% of pregnancies have early spotting. I may to repeat this every 5 minutes, but at least it is something. As long as the spotting doesn't get worse, I will keep from panicking.

In other news, I was planning to write a post on "symptom spotting". I need to preface this by saying that I completely understand that pregnancy symptoms and progesterone symptoms are largely the same. I do not put much stock in these, especially after the one cycle where I had so many convincing symptoms that turned out to be nothing, but for posterity sake, here goes. These are the symptoms I have noticed over the past 1-2 weeks:

  • Slightly increased fatigue, but this is very subjective and not nearly to the level that I remember at certain points of my last pregnancy. 
  • Slightly more sensitive nipples. 
  • Definitely a small increase in breast size and a feeling of fullness. 
  • Occasional "twinges" in my pelvic region. It feels like a muscle or tendon is pulled. If I stretch in a particular way then the feeling can be downright severe and painful, but most often it is just a nagging sensation. 
  • Spotting. (Does this count as a potential symptom? Ugh.)

Two more days and then hopefully there will be answers. Two more days.

Monday, August 15, 2016


My transfer date was this past Tuesday. It was fairly mundane, with the exception of finding the right balance between having a full bladder and not wetting myself. I recall this to have been much easier before having our daughter... Needless to say, I did need to use the restroom before the procedure. They gave me a cup and told me to fill it half full to not let too much, but I couldn't stop myself and kept peeing! Then, for about 10 minute, I felt very stressed that I let out too much urine and ruined everything. Luckily, shortly before the procedure I started getting the urge to urinate again and the ultrasound technician reported that my bladder looked great. Immediately after I had to run to the restroom again so apparently there was still enough in there!

We agreed to transfer two embryos, just like last time. (We also ate at the same restaurant for lunch before the transfer so really going to replicate some past results here!).  Shown on the huge TV screen right before they were sucked up into the straw, both embryos were nearly 50% hatched, which everyone in the room was very excited about.

I felt noticeably calmer or more confident then the last time. Enough so that I was asking more curiosity questions, such as why they embryos shine so brightly on the u/s monitor (that is actually the little pocket of air that they are incapsulated in).

Afterwards, we picked up our daughter from a family friend who agreed to watch her last minute (C turned out to be much more upset that the wouldn't be able to be in the room then I originally anticipated), and returned home to nap and then play. The whole day was very casual, and very typical. Except for the part where I may have gotten pregnant.

Sunday, August 14, 2016

Privacy and Support

I made a conscious decision at the very beginning of us talking about a second child that I did not want anyone to know about us "trying".

Last time my family knew quite a bit. I didn't divulge nearly as many details as my sister, but they knew the retrieval date and the transfer date. So did several friends and coworkers, largely because of how it all played out with the ED and internal bleeding issue. Mostly, though, it was because I wanted and needed support. This was a long road and I needed to be able to talk about it and explain away my moodiness.

The down side of telling everyone ahead of time is that they are reasonable humans who can then logically induce when you would be able know if you are pregnant. This changes the entire dynamic of the "reveal". It is no longer a surprise because they are anticipating an answer, and there are only two options.

This time I wanted to be able to surprise them. I was to come out of nowhere. I want to see a different emotion on their face: the combination of shock and joy, not the combination of joy and relief.

I still want that. However, I seem to have underestimated the need for support. Any my horrible ability at lying or anything that seems like like lying, such as withholding the truth.

I told my boss on Friday. He is called me into his office for an impromptu meeting on a topic he likes to call "succession planning" where he tells me that he would like me to take over his job sometime. This first started occurring right before our daughter was born, so by this time I have gotten used to hearing about it but not expecting anything. However, this time was different. This time he started talking about an immediacy and I actually got him to give me some concrete dates/time-lines. His current plan is to make an announcement at the large full-department meeting this fall and then spend a year training me and a back-up person to take over. With this information, I felt compelled to tell him that I will not be present for part of that year if everything goes according to plan. More pressing was the fact that, if everything goes according to plan, my first trimester will be nearing its end right around the departmental meeting and I this did not seem like a good time for him to learn about that news.

A few weeks ago, due to another set of unforeseen circumstances, I ended up divulging a lot of specific details to one of the physicians whose office is next to mine and one of the graduating fellows (I should really devote a whole post to this one). Now the physician asks how I'm feeling every time she sees me.

My best friend knows that we are trying sometime this summer and my best co-worker friend knows that we are actively trying now, but I didn't tell her the specific transfer date.

So it turns out I am really not good at this keeping this private.

Saturday, August 6, 2016

Ready, Set...

My transfer is scheduled for Tuesday afternoon. They called for my credit card information on Friday so I know this is really happening. The last lining check showed my lining increase from 8mm up to 12 mm in four days, so if anyone is curious about the effects of one extra little estradiol pill intravaginally, here's some good evidence. The estradiol levels also jumped from high 100s to 500-something. I looked back as my last number and I was over 3,000, but then there was concern about OHSS.

I feel calm. Initially I was stressed about the one vs. two embryo debate and trying to do everything to be healthy as possible before the transfer. The latter ultimately increased my stress because the scale kept creeping up from bloat no matter I did. Then there was a subtle yet profound shift where I accepted that my actions right now will make little difference and that I will leave the rest up to the universe (and the hospital, technically, at this point). I stopped focusing on everything that went into my mouth and instead started eating for pleasure, including a lot more sushi! I stopped using my Visualizing Pregnancy meditation because I kept getting stuck on whether I was supposed to visualize one or two embryos implanting. I accepted that the medications are doing thier job, the doctors and nurses will do their job, and then everything else is out of our [human] control.

I vaguely remember a similar calmness before my last transfer, and anything that feels similar to the last time adds to my trust in the universe.