Tell Me What You See

Today was our Nuchal Translucency screening. Severe nerves all day long. It's so hard to concentrate on your job when all you can think about is the health of your unborn child. Knowing that later on in the day I could be getting news that was really, really good, or potentially really, really bad, made time pass oh so slowly.

First, the ultrasound tech did my scan. I was surprised that I didn't have to change into any embarassing little gown, or even remove any clothing. I had to push my skirt down to expose my bloated belly, but that was all. I got to experience the infamous cold ultrasound jelly on the belly. Wasn't so bad; I'd take that any day over a transvaginal. The most significant part about the u/s experience was that this was the first time I've had an ultrasound EVER that didn't involve a dildo cam. Hooray for belly cams!

It took a while to get all the measurements. Blobby (who looks nothing like the bean-shaped blob it was a few weeks ago) wasn't in the optimum position to do the necessary measurment of the nuchal fold. So the tech jiggled my belly a bit, and suddenly Blobby was all over the place. It was rolling over on its side, moving its arms and legs- it was absolutely incredible to watch. Then there was the time that it faced us and it looked a lot like the Alien from the Sigorney Weaver movie, but I won't talk about that. So yes, we saw hands (and definitely counted five fingers on one of the tiny hands, but the other hand was too obscured to see clearly), feet with clearly defined lines to mark where the toes were, a nose, a spinal cord, and it just completely blew my mind. I can't believe how quickly these things develop. A mere 5 weeks ago, we were looking at a little round blob, and today it was human.

Yes, I have sono pictures, but I don't have a scanner at home so it will have to wait until I can sneak off and scan them at work (and hope that nobody busts me, since our secret is not out yet). Blobby is measuring 5.14cm, which corresponds to 11 weeks, 6 days (I am 11 weeks, 4 days according to my LMP and date of ER and fertilization). Right on schedule!

So last week I had to prick my finger and mail droplets of my blood off to a lab. Even though I had mailed them off with more than enough time to process the results, they were not ready. Luckily the u/s tech was able to call the lab and make sure that the results were available, which they were. All they needed to complete the report were the numbers from today's scan, and within minutes we had the results in our hands. At this point, Iwas still thinking that even though Blobby looks like a human, there could still be serious issues to deal with.

And the results? The results were great. Today's NT scan screened for the risk of having a child with Down's Syndrome (Trisomy 21) or Trisomy 18/13. Before the screening, my risk of having a Down's Syndrome baby was 1 in 162. After today's screening, my risk decreased to 1 in 3,221. Before the screening, my risk of having a Trisomy 18/13 baby was 1 in 279. After today's screening, my risk decreased to 1 in 5, 561. What a relief. That's when I started to breathe again.

The Maternal-Fetal specialist and I spoke briefly about amnio, which i would be doing at around 16 weeks, so in about 4 more weeks. We would need to meet with this hospital's genetic counselor before we decide one way or another. Hopefully i'll get all the Tay-Sachs testing back before then so we can make a more informed decision. CVS (which would be done much sooner, like next week) was not recommended for me, because it has a higher miscarriage rate. If the results from today had been bad, I might have considered it, but now I'm breathing a little easier and don't think there's a need to do the CVS, considering the risks.

So WHEW! I am just in awe that I was able to see our baby moving. With little fingers and toes, and a nose, and IT'S REAL. I have a baby that is developing inside my body and depending on me for nourishment and protection. Holy crap. With so many ups and downs over the course of our rollercoaster-like IVF cycle, I have been expecting each appointment to reveal the part of the ride where you plummet and scream. Knock on wood, cross your fingers, poo poo hand to God, we are still going up. It's almost too much for my puny mind to process right now.

In 6 days I have a follow-up appointment with my OB-GYN. I have lots of newbie questions to ask her, so I hope she's ready. God, I hope I'm ready.

Eight Days a Week

Will 12 weeks never get here? While I am so unbelievably grateful to have made it to this point (just shy of 11 weeks as of today), I am still so anxious to be safely out of the first trimester. I know that bad things can still happen, but the likelihood of them happening significantly decreases once a pregnancy has hit the 12-week mark. Yesterday was Thanksgiving, and all day my head was filled with thoughts of thankfulness and gratefulness that I so wanted to share with all who attended our large Thanksgiving feast. However, only a handful of people were in on our secret, and therefore I couldn't go public with any of my feelings.

Next week I am having a Nuchal Translucency Screening. It is a first trimester screening that is done to assess the risk of having a child with a chromosomal disorder such as Trisomy 18 or Trisomy 21. Needless to say, I am quite nervous about it. Every time I read something about TTC when you are over 35 years of age, inevitably there is some mention of these disorders. The risk of having a child with a genetic disorder increases significantly for those of us who are to become older mothers. And the irony is not lost on me either: if it wasn't for my infertility, I wouldn't even be an older mother. I don't know which is the more frightening possibility, as a woman in her late 30's who was struggling with IF- the thought of never having my own biological child, or the thought of having one who would never enjoy the kind of life that chromosomally normal children do. And it would be my own fault. Me and my bad eggs.

Anyway, these are the kinds of things that go through my mind when I think of what I am faced with. It is not all doom and gloom, however. Sometimes, I actually allow myself to entertain thoughts about the perfect bouncing baby boy or girl we could be doting on in a little more than 6 months. But when you don't know what is going on in your own body, the imagination can really take over, and bad thoughts can fill your head. The not knowing has always bothered me more than the knowing; even if the news was not what I wanted to hear.

Which is why I am so anxious for Wednesday to arrive. We should have more information by then about the fate our our Little Embryo that Could. Then a few days after that, I will have a follow-up appointment with my OB-GYN, after which we will hopefully feel comfortable enough to share the happy news about this pregnancy with the rest of our friends and family.

So now we just wait. And waiting, for me, always seems to be the hardest part. Especially when the days crawl by and the weeks seem to last much longer than they really are.

The Fool on the Hill

I admit it: I'm a pregnancy newbie. I feel like such a moron sometimes because I really don't know anything about anything. As well-versed as I've become with infertility lingo, I find myself stammering when it comes to talking about this pregnancy.

Which is why I am relying so much on my doctor to tell me what is going on. In plain English. Like she's speaking to a 5 year-old.

Today, at 9 weeks, 3 days, I had my first appointment with a real OB-GYN. Not an infertility specialist, but where 'normal' women go when they get knocked up. It was very strange, being there for the first time for my first pregnancy check-up. I was hoping that she could provide the same kind of attention that my IVF clinic had. Most of all, I was terribly nervous that my Little Embryo that Could would stop could-ing.

Not knowing what to expect for my first OB appointment, I felt like an idiot. It was like my first visit to the 'girl parts doctor'. I was shaking and sweating and praying to Whoever Is In Charge Of This that everything would be ok. I was hoping that I would get to have another ultrasound for a few more weeks of peace of mind.

First, the nurse weighed me and measured my blood pressure. Surprisingly, I hadn't gained any weight. Probably has something to do with my food aversions and nausea. I'm sure that my weight is being distributed differently though. I have quite the belly pooch now.

Then the doctor came in and we went over some stuff. I made her aware of the progesterone scare I had a couple of weeks ago, and that this was the lone embryo out of 18 so I am still so nervous about this one not developing properly. I told her about the two fibroids that were seen during my first ultrasound at the IVF clinic. She assured me that fibroids do not grow that quickly and that I shouldn't worry that they're going to get too big.

She did a pelvic exam and took a cervical culture. It wasn't so bad. One thing I can say about this doctor is that she is very gentle. She said everything felt completely normal. That was good.
I asked her about getting another ultrasound. She said that she would be referring me to the Maternal Fetal specialist at the hospital, since I am more of a high-risk case. Which is fine, because I certainly want to be monitored more often, and by someone who specializes in high-risk pregnancies. But I also wanted another ultrasound today. I don't know how I managed to get her to offer to do one, but she rolled in the little cart and did a quick scan. The resolution on this equipment wasn't as good as the type that was used to at the IVF clinic, but it was really all I needed to get an idea that Blobby is still growing. We saw the heartbeat and Blobby is measuring 2.5 cm, which is about twice the size it was less than 2 weeks ago. The doctor told me that this size corresponded to 8 weeks gestation, but I looked here, and according to this table, we're right on track!

So, I feel much better about things today. I still feel like a worrying fool who has no idea what she's doing; but with any luck, in a few months I'll be worrying about our new baby.

I Will

On this last day of National Infertility Awareness Week, 2007, I am very contemplative about where I fit in. The other 'pregnant after IF' women will understand this, I am sure. Being pregnant doesn't necessarily mean that my infertility has been cured. It has been temporarily overcome, thanks to a shitload of medical intervention; but my infertility is by no means gone for good. If we are ever lucky (and I use this term very loosely, since I do not believe that it has anything to do with luck) enough to have another child, it will most likely be via IVF. I am reminded of my friend Kate's signature from a forum I used to frequent. After she got pregnant using ARTs after several years of TTC, she wrote, "I am not a fertile, I am not a fertile, I am not a fertile". This speaks very strongly to me, because even though I have made it 'to the other side', I identify most with my friends who are still struggling to conceive.

Ever since I learned that I was pregnant, I have been struggling with the concept of being 'one of them'. A good friend of mine, who had gone through two rounds of IVF (and successfully conceived her daughter during the second round) told me that the first IVF is usually a learning cycle. That is, our bodies may not react to the medication the way they are supposed to, and even though the cycle may not be successful, the doctors will apply this information and adjust our protocol accordingly, for the next attempt. Many times, what is considered to be a standard IVF protocol just doesn't work. However, ours did. Despite being a 37-year-old woman, I responded well to the medication and they were able to retrieve 24 eggs. Lots of women my age have difficulty producing 1/4 of that number. Out of those 24 eggs, 18 fertilized, but only one of those 18 made it to blastocyst by day 5. And yet, despite losing 17 out of 18 embryos, there was something about that one little embryo that made it hang on. It is The Little Embryo that Could.
So what was it about me that allowed me to become pregnant when the majority of women I know, who are going through IVF, could not? I have been wracking my brain trying to figure this one out since I got my BFP. Am I luckier than the other women? I don't think so. I've always considered myself to be very lucky in other aspects of my life, but it's not like I believe that my IF friends are walking around with a dark cloud looming. It's not like I believe that I deserve it more than anyone else. It's not like I believe that I am in better physical condition than anyone else (and if you saw me, you'd vouch for me on that one!). And it's not like I believe that my IVF protocol was the only one that works. I really don't know the answer. Something just clicked, I guess. The right combination of meds and the right physiological conditions and the right timing equaled a recipe that worked for us.

And I know that had something about our protocol been just slightly off, I could be sitting here writing in my TTC journal, trying to figure out how the hell I'm going to find the strength to go through another IVF cycle and possibly another devastating failure.

I am on a message board forum that consists mostly of women who already have kids. Many of those women are pregnant with their second child and some of them are preparing to start trying for additional children. It seems like every time I look, someone else gets a surprise BFP. 'Oops' pregnancies are such a foreign concept to me, and I have so much difficulty relating. Imagine having sex with your husband a couple of times, and BAM- you find out two weeks later that you're pregnant. I am struggling to identify with and understand these fertile women, but I am having such difficulty making sense of it. After all of the medical intervention I have been through, it just boggles the mind that for some, conception can be so easy.

Which is why, as a pregnant woman, I will never lose sight of how much it took to get me where I am. I will never complain about pregnancy symptoms to anyone who would give her left arm to be experiencing those symptoms. I will never say to one of my IF friends, 'If it can happen for me, I just know that it will happen for you'. I will never pretend to see two pink lines just to make a hopeful woman feel better. I will always remember what it feels like to truly believe that I won't ever be able to be a mother to my own biological child. I will always remember the hopelessness that overcame me every single day. I will always remember what it feels like to feel broken. I will always remember what it feels like to hurt after hearing one of those insensitive comments. I will always remember what it feels like to believe that I am a disappointment to my husband and to my family. I will always remember just how much it hurts to see yet another BFN, staring me in the face. I will always remember what it feels like to be the only couple at a social event who doesn't have kids. I will always remember how bad it feels to not feel strong enough to hold my friend's new baby. I will always remember what it's like to be lapped.... yet again. I will always remain sensitive to my IF sisters who are still struggling. I will always be supportive of my dear friends who are still fighting the good fight, and I will always remain in their corners. And I will always remember that I AM NOT A FERTILE, I AM NOT A FERTILE, I AM NOT A FERTILE!

She Said She Said

On this 4th day of National Infertility Awareness Week, I'd like to pay respect to the millions of women who live with infertility every day. I've come to know a mere fraction of them and I think that one of the most important things to remember about infertility is that it has many different causes, and every single case is different.

Which is why those 'helpful' comments and suggestions that are offered to us- from people who think they know what they are talking about- are not just inappropriate, but are dead wrong. Like the woman who tells you that her cousin's accountant's sister-in-law went through the same thing as you and here's what worked for her; or the woman who heard that her friend's friend's sister went to a specialist and was told to pop some mystery pills and she got pregnant that first month. It is going to sound way obvious to many people who are reading this, but you cannot compare one woman's story to another. You don't know the complete medical history (and even if you did, do you have a degree in Reproductive Endocrinology?), so keep your opinions and advice to yourself and let us seek out qualified professionals to help us, if we choose (and can afford) to do so.

Not to mention that often, the woman passes her battery of fertility tests with flying colors, but her partner is the one who does not. I also have come to know women who are dealing with male factor infertility, which comes with its own set of challenges. Or women who are struggling with both female and male factors. Not only do they have to diagnose and treat two sets of issues, but they have to coordinate treatment and deal with the frustration of maybe having one partner's issues resolved, but the other's are not.

Then there are the unexplained cases. I know a few of these women as well. Their battery of tests comes back normal. Consultations with specialists do not reveal any issues. And yet, month after month after month, they get BFN after BFN after BFN, even after a full year of trying. How do you proceed with medical treatment when you don't know what you're treating?

Which leads me to the point of this entry. Instead of assuming that all infertiles are the same, please view us as individual cases with very different medical histories and physiologies. I invite everyone to take a look at my blogroll and read a few (or more) of the blogs that I've listed. Most of them are friends, and most of those friends are dealing with infertility in one form or another. Please take a moment to learn a bit about the people and the emotions behind the disorder.

All Together Now

When I read yesterday's entry from Baby Steps to Baby Shoes, I was reminded that November 4th began National Infertility Awareness Week. Here are some things you can do to raise awareness and be supportive of those who are living with infertility. It took me a long time to 'come out' about my infertility, for fear that I would be a disappointment to my family. I've very recently come to terms with the cards I've been dealt, and have rejected my past feelings that I am to blame for my medical issues.

So now that I am 'out', I choose to do my very best to raise awareness and promote sensitivity. Here is my contribution (again, not very original, but sometimes you can't improve on a perfect thing). The following links are excellent articles which I encourage you to read; especially if you are blessed with fertility and have friends and loved ones who aren't.

• Infertility Etiquette, by Vita Alligood
  
• Being a Good Friend to Someone Struggling with Fertility, by Jen Jobart

And finally, the following jewel. I'm not even quite sure where I found it but I had saved it so I could forward it to any insensitive fertiles I encountered :P. I tried to locate the original publisher so I could give proper credit, but I couldn't locate it! Anyway, it's a great example of how completely ridiculous some of the comments we hear truly are:

"So, what do you think people would say to you
if you were paraplegic instead of infertile?

1. As soon as you buy a wheelchair, I bet you'll be able to walk
again!

2. You can't use your legs? Boy, I wish I was paralyzed. I get
so tired of walking, and if I were paralyzed I wouldn't have to walk
anywhere!

3. My cousin was paralyzed but she started shaving her legs in
the other direction and she could walk again. You should try that.

4. I guess God just didn't mean for you to be able to walk.

5. Oh, I know exactly how you feel, because I have an ingrown
toenail.

6. Sorry, we don't cover treatment for paraplegia, because it's
not a life-threatening illness.

7. So... when are *you* going to start walking?

8. Oh, I have just the opposite problem. I have to walk walk
walk - everywhere I go!

9. But don't you *want* to walk?

10. You're just trying too hard. Relax and you'll be able to
walk.

11. You're so lucky... think of the money you save on shoes.

12. I don't know why you're being so selfish. You should at
least be happy that *I* can walk.

13. I hope you don't try those anti-paralyzation drugs. They
sometimes make people run too fast and they get hurt.

14. Look at those people hiking... doesn't that make you want to
hike?

15. Just relax, you'll be walking in no time.

16. Oh do my legs hurt, I was walking and walking and going up
and down the stairs all day.

17. I broke my leg skiing, and was on crutches for weeks, and
was worried I'd have a permanent limp, but I'm 100% healed.

18. I'd ask you to be in my wedding party but the wheelchair
will look out of place at the altar.

19. You're being selfish, not coming on the hike with us, and
looking at all of my track & field trophies.

20. Don't complain, you get all the good parking places.

21. If you just lose weight your legs will work again.

22. If you would just have more sex, you could walk!

23. You don't know how to walk? What's wrong with you? Here let
a real man show you how to walk!

24. You are just trying too hard to walk. Give up, and then
you'll walk.

25. Here, touch my legs, then you'll walk!

26. Just take a vacation, and the stress-break will be sure to
get you walking!

27. When *we* were young we only had to worry about having to
walk too much.

28. And I bet a paraplegic going to a bookstore doesn't find
books about paralysis stacked next to all the books on running...

So here's a little hint. If someone you know tells you that she's trying to get pregnant and it's taking longer than expected, DON'T tell her to just relax. Don't tell her to adopt and then surely she'll get pregnant with her own child. Don't tell her that God has a plan for her. Don't say, "At least it's fun trying!" Scheduling sex with the person you love isn't fun. Getting vaginal ultrasounds every other day and intramuscular injections in your ass twice a day isn't fun. Finding out every single month that - yet again - it didn't work this month either is Just. Not. Fun.

DO tell her that you're sorry she's going through such pain/grief/frustration. Do tell her that you're glad she told you. Do tell her that, even if you don't bring it up (because you want to respect her privacy and understand that she might not feel like talking about it sometimes), that you're there for her if she ever wants to talk or vent. And DON'T feel that because she told you that it's okay for you to tell your other friends, children, co-workers, neighbors, cousins, mailman, whomever - unless she tells you that it's okay to do so. Your need to share news pales in comparison to her need to maintain a shred of privacy and dignity. The last thing your friend needs is to be at someone's garage sale and get unsolicited advice from said secretary's sister's cousin's dogwalker's barista about how she and her husband just need to get really drunk one night and jump in the back seat of the car. Because she's probably already tried that, too."