Friday, June 6, 2014

The Road to Baby #2 + The First 20 Weeks

My poor blog has been grossly neglected over the past 6 months (for good reason), but I am going to do my best to get caught up over the next few weeks. First things first, I'm pregnant again! We couldn't be happier, but this pregnancy has been rough, as was the road to getting pregnant.

After all of our difficulty getting pregnant the first time, we didn't do anything to prevent pregnancy after Jackson's birth. We crossed our fingers that it would just happen. At first we weren't trying very hard (we had a little baby so it definitely was not at the forefront of our minds). Once Jax was about six months old, however, we put a little more effort into it. After trying this method for about a year, to no avail, we started fertility treatments in September of 2012. Over the next 6 months we endured five rounds of various fertility drugs plus IUI. We had a glimmer of hope in November of 2012 when we saw a faint second line on a pregnancy test, but when we went in for a blood test a few days later, it came back negative. My doctor said it was a chemical pregnancy. We were heartbroken, so we took a month off before diving back in for a couple more rounds (with no success). After the fifth round, I developed a cyst which forced us to take a break and discuss our options going forward. (My body had clearly had enough at this point). My reproductive endocrinologist told us that she wasn't sure that this was the best course of action for us anymore. My response to the meds was okay, but I wasn't producing as many mature follicles as they would have liked. She explained that we had three options:
1. do one more round of Femara + IUI
2. injectible meds + IUI
3. IVF

I was emotionally and physically exhausted from the rollercoaster of the previous months, so we decided to take a couple months off to think about our options (and try on our own again for awhile). Well, a couple months turned into almost 6 months... We decided that we would go forward with injectibe meds. At least it was was something different to try and less expensive and invasive than IVF. Upon talking to my doctor again, however, we were thrown a bit of a curve ball. She said she strongly believed that, at that point, IVF would be the most logical choice for us. The injectible meds would add up pretty quickly and didn't offer a much greater success rate than what we had been doing previously. She also equated it to playing "fertility Russian roulette" because there was a high chance of higher order multiples (triplets, quads, etc..). We went to their IVF seminar for more information and made our decision pretty quickly after that. Even though the price tag was quite a bit higher, the 60% success rate had us sold. Plus, we didn't want to waste any more money on treatments that weren't likely to work. After another saline infused ultrasound and entire battery of bloodwork (since it had been a year) we were set to start our IVF cycle in October of 2013!
The intimidating supply of meds.
I was absolutely dreading the weeks of abdominal hormone injections and monitoring. Overall, it wasn't as bad as I was expecting. Some of the shots hurt more than the others, but they weren't too painful. (Although, by the end my stomach was a bruised mess). Even better, the side effects weren't any worse than those with Clomid or Femara (I was a bit more emotional than normal and got some headaches, but it really wasn't bad). It took a little longer than expected for my eggs to mature, but my doctor was really happy with my response and the number of eggs I was producing. My egg retrieval was scheduled for October 29. This was the part that I was the most nervous about. I had only ever been put under sedation when I had my wisdom teeth removed and it was not a good experience. I had also heard horror stories about awful swelling and pain after the procedure, but it was a breeze! I was really loopy after I woke up and apparently made some pretty embarrassing jokes and asked several times how many eggs they got. The answer was 15! We were thrilled!

Next, they injected John's sperm into my eggs and put them in an incubator for monitoring. After a couple days, they called to let us know that 9 of the eggs had fertilized and seemed to be maturing. We scheduled our transfer for November 3.
All dressed up for the transfer!
That morning, they told us there were two level 2 blastocysts that would be great for transfer. They were still watching a few of the others, but weren't convinced that they would mature any further. We had to decide right then if we wanted to transfer both of the embryos or just one of them. We had talked this over, ad nauseam, in the previous months and weeks. It was not a decision we took lightly, but we wanted to have the best chance of getting pregnant, so we decided to transfer both blastocysts.
Our beautiful little blasts under the microscope!
The transfer went smoothly and I was sent home for 2 days of bedrest and 10 long days of waiting before my scheduled pregnancy test. Although I had promised to save myself the torture of peeing on a stick at home, the day before my appointment I made an impulsive trip to Target to buy a test (while John was at work and Jackson was at preschool). I had just a few minutes to stop home and take the test before picking up Jax. Lo and behold that glorious second line showed up almost immediately!! I was over the moon!

The next morning I went in for my beta test, which confirmed the good news. I was officially pregnant! They scheduled a second beta two days later to make sure that it was increasing appropriately. Well, it went from 220 to 1800, which was a very drastic jump, so we started to suspect that it could be twins. They scheduled one more beta, the following Monday, to make sure things kept heading in the right direction. Well, that beta came back at only 1395. This number was still high for a singleton pregnancy, but a little low for twins. Our elation turned to anxiety and worry at this point. A decreasing beta can be a sign that you'll miscarry or of an ectopic pregnancy. We had to endure a grueling two weeks before an ultrasound to confirm if the pregnancy was viable. Although I kept busy with Thanksgiving celebrations, a concert, and a couple photo sessions, my mind was always drifting back to the baby (or babies). I hadn't had any spotting or cramping and I was already starting to experience some pregnancy symptoms (all good signs) but it was still torture!

On Monday, December 2, John and I picked up Jackson from school a little early and brought him to a friend's house while we went in for the ultrasound. I don't know if I've ever been more nervous in my life. I was shaking. Well, almost immediately, we saw a little sac and a heartbeat!! I was so, so relieved! A few moments after that we saw another sac and a heartbeat! It was TWINS!
Now I was shaking for an entirely different reason. We were in shock. My doc assured me that my height and long torso and previous full term pregnancy made me an ideal candidate vessel for twins. She said that everything looked perfect and that I should schedule an appointment with my OB/GYN in a few weeks.
Over the next few weeks, we started to make plans for welcoming 2 babies into our family! We decided that we would try to sell our house that Spring because we would most definitely need more room. We also determined that we would probably have to trade in one of our cars for a minivan (oh the horror!). We were overwhelmed, but so incredibly excited. So much so, that we started to tell some of our close friends and family the news. I think Jackson was the most excited of all!

On December 23 (I was 10 weeks pregnant at this point), we went in for our next appointment. I filled the nurse in about how we were pregnant with twins and that I had been experiencing some pretty bad morning sickness (much worse than in my previous pregnancy). After my routine physical, it was time for the ultrasound. We could tell something was wrong almost immediately. After a moment, that feeling was confirmed when she told us she was very sorry, but we had lost one of the babies. John and I both fought back tears throughout the rest of the appointment. I could hardly focus on anything the nurse was saying or on the remaining, thriving, beautiful baby. All I could see on the screen was the empty small sac. It was truly heartbreaking.

Christmas definitely had a cloud over it. We did our best to put on a smiling face for Jackson, but it was hard. I had another ultrasound on December 30 to make sure that everything was "resolving" itself. Since I lost my baby during the first trimester, they refer to it as a vanishing twin. In these cases the baby that has passed away is usually just reabsorbed. We were lucky that it happened when it did because if it happens later in the pregnancy serious complications can occur that would put the other baby at risk. That ultrasound showed that the sac was indeed shrinking and that our surviving baby was growing right on track. While we were still devastated by the loss of one of our precious little ones, we were so thankful that the other baby continued to thrive.

Breaking the news to Jackson was harder than we expected. We weren't sure that he'd really even understand what had happened at 2 years old, but we underestimated him. We first tried showing him the ultrasound picture of the healthy baby. We told him that this was going to be his little brother or sister. Immediately, he said "I want 2 babies!" We told him that there was just one baby and he got really mad and wanted to know why. At this point, I felt horrible that we had told him about the twins so soon. How were we supposed to explain the loss of a baby to our toddler? We said that the other baby stopped growing, but that we were so thankful and happy that the other baby was healthy. I think we tried to change the subject after that, but he continued to bring it up and ask questions over the next several weeks (in fact he still does). It is gut wrenching.

The next couple of months went well, despite my constant nausea. Our baby continued to grow strong (measuring right around the 50th percentile) and Jackson started to read-up on the whole "big brother" thing!
The day before I hit 20 weeks (March 3), we had the big growth ultrasound. Of course we were more than excited to found out the gender of our bundle, but we were more anxious to confirm that the baby was healthy. We were so, so grateful to learn that all of baby's organs looked excellent and that it continued to develop normally. We were also thrilled to find out we were having a GIRL!!!
She was not shy- we had a clear view right off the bat!
Unfortunately, this appointment also had a bit of concerning news. The perinatologist noticed that my umbilical cord wasn't attached normally to the placenta- they called it a marginal umbilical cord. It's a pretty rare occurrence, but it's more common in pregnancies of multiples and when reproductive technology (like IVF) is used. Basically, instead of being attached to the meaty center part of the placenta, mine is attached at the bottom (very close to the cervical opening). She said they would perform ultrasounds every 4-6 weeks to make sure that the baby wasn't showing any signs of growth restriction and to rule out a velamentous insertion and vasa previa. She told me not to worry and that everything would probably be just fine. Of course I couldn't just leave it at that. I googled both terms as soon as I got home and learned that both can be extremely risky for the baby. Needless to say, the worrying continued. (Thankfully, I was somewhat distracted during this time because we were also in the midst of buying a new house and selling our old house).
I did my best to think positively and focus on the excitement of announcing the gender to Jackson and our immediate families. John and I fudged the date of our appointment a little so that we'd be able to surprise everyone at Jackson's family birthday party on March 7. Since the very beginning, Jackson was adament that we were having a girl. Every time I'd try to tell him that we didn't know if it was a boy or girl yet, he would say "Mom, I'm having a baby sister!!" He was so sure, that he would get downright angry anytime I said it could be a baby brother. It got to the point that John and I decided that, if it was a boy, we better not tell him during his party for fear of ruining his birthday. Since it was a girl, we could happily move forward with our plan.

I bought and wrapped a bunch of pink helium balloons in a big box. We brought it out just as Jax finished opening his presents and said that this one was from the baby... This is what happened next:
I absolutely love the looks of surprise and excitement as my grandma and mom start to figure out what the pink balloons mean! (Side note: About 10 minutes into his party, the birthday boy decided that clothing was optional). Everyone was shocked (and maybe a little mad that we had kept them in the dark for a few days). Jax, on the other hand, wasn't surprised at all. He just looked at us, like "I told you so!"
To be continued...

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