NT Scan and Perinatologist Update

I swear that was the longest appointment ever.  It was good news. Squishy looks great. But because of some of the issues with my last pregnancy and with Smudge, there was a lot to talk about .

First, the NT Scan. It looked great. Squishy is CRAZY active. More than Smudge ever was. Just as stubborn too. Goodie. But the NT measurement looked awesome. 1.4mm. The perinatologist said that's a great measurement at any point in the pregnancy. They also saw the nasal bone, which is good news. There were no other soft markers present that would indicate a chromosomal abnormality. They saw all of the major organs they were looking for, 2 arms and 2 legs. The umbilical cord has 3 vessels and Squishy is measuring a couple of days ahead, at 12w2d. 

See... Squishy.

It's a picture of a monitor, so please forgive the quality.
Our actual pictures won't be scanned until tomorrow.

We talked a lot about my Smudge pregnancy. He's concerned that I won't be able to VBAC, but that's not his expertise, so I'm not really considering his opinion. If Dr Z and the midwives think I can do it, that's all that matters. Dr C (from the perinatology institute) can make sure Squishy grows and thrives while s/he's inside, my midwives will take care of things from there. He had some concerns about placenta placement, but it's nice and posterior for now, so there are no concerns with my incision. Two fibroids have made an appearance (background: I had three at the beginning of my Smudge IVF cycle and at my c-section they found nine. At the beginning of my Squishy cycle there were none, so we fully expected them to make an appearance at some point, since they're likely hormonally driven) but they're on the exterior of my uterus, like the other ones were, so not concerned about them at this point. Also, the cyst that was on my right ovary (and at one point the size of my head) has completely resolved. So yay that. 

I brought up my concerns about Smudge not having grown in my last month of the pregnancy. (At 35 weeks, she was measuring approximately 5lbs 12oz, and then was born 5 weeks later at 5lbs 8oz - just this side of low weight for gestational age.) He reviewed all of my records from my pregnancy, and said that at every scan I had, she was measuring 40-50%.  He agreed that it was concerning that it appears she didn't gain any weight from 35-40 weeks. He plans on monitoring me a little bit closer at the end of this pregnancy. I'm okay with that. A few extra ultrasounds aren't going to hurt - but it they indicate that the baby is in trouble, then we will be able to do something about it. We were fortunate that Smudge was healthy, despite her lack of growth. It might not be the same next time. 

We also discussed the two congenital issues that Smudge had. Her severe hip dysplasia and her cardiac defect. The latter automatically got me signed up for a fetal echo. I'm okay with that. Dr C said I could go back to Smudge's cardiologist for the echo, which is great. I just love her (another Dr C). Her hip dysplasia was another story. As of right now, Smudge's orthopedic surgeon at Children's Hospital of Philadelphia (CHOP) is calling it Developmental Dysplasia of the Hips. If Squishy is born with hip dysplasia as well, both babies will be given the diagnosis of Congenital Dysplasia of the Hips. Unfortunately, this is something they can't look for in utero. Dr S (the ortho) has already agreed to see us soon after birth for an ultrasound, rather than waiting the standard 4 weeks. I just can't wait that long. Smudge was in treatment at 6 days old. I'd feel negligent if Squishy needed something that we weren't providing in that time. 

I know this has already been so long - but wait - there's more. 

My MTHFR comes back into play, as being homozygous for the mutation makes me a higher risk for having a child with a spinal/neural tube defect (which we were initially concerned about with Smudge). However, since my homocysteine level has been normal, he's less concerned. Even though, he's recommending that combined with my age, I have the 2nd trimester AFP blood test done. He said at their clinic, they're 95% accurate with picking up spinal defects via ultrasound, but it's better to be safe than sorry. 

After all of that, I had my blood drawn for my 1st trimester risk of chromosomal abnormalities. 

He also told us that the clinic has been involved in some groundbreaking research, and that they're now offering a blood test (not covered by insurance now, but hopefully one day will be) which can indicate the trisomies and certain other genetic disorders like Turners Syndrome with 99% accuracy. That's just amazing. Hopefully we won't have to be concerned about the risk enough to pay for this test, but it's nice to know there's a more accurate blood test available prior to having to submit to an amniocentesis, should it come to that. 

That's enough, right?

It was a lot of information in one day. I practically fell asleep on my way home and I'm still really dragging. Smudge's Dad is working hard on trying to get her to bed, because I'm pretty sure if I were doing it, I'd be asleep before she would. 

Now we wait for the results. But based on the ultrasound, we hopefully have little (other than my age and egg quality) to worry about. 

Stay tuned....

Honestly - How Many Pregnant Chicks Check the Paper EVERY Time They Wipe?

I can't be the only one.  Not by a long shot. 

Today is 11w6d, which is an interesting anniversary of sorts. With Smudge, at 11w6d, I started bleeding. I'll never forget shaking like a leaf, calling Smudge's Dad and then my nurse. Then my emergency u/s where I could breathe when I still saw her heart beating. 

Sub-chorionic hematoma AKA the scariest day of my life. The day I thought I was losing her, just like I lost her twin. 

And today, in the face of my newly surfaced pregnancy nightmares, I'll spend the day waiting for the other shoe to drop. 

Tomorrow is my NT scan. Between my age, my egg quality, my nightmares, my teething toddler and my lack of sleep, I just need it to get here already. 

The Two Week Wait Sucks PLUS the State of our Remaining Embryos.

So, I've meandered around the interwebz and I've noticed that in more than a few blogs, tuesdays are referred to as "Top 10 Tuesdays". I'm not usually one to jump into the mainstream, but this time i figured, "why not?". So, today, i'm going to give you "The Top 10 Reasons the IVF 2ww SUCKS".

Disclaimer: these are my reasons the 2ww sucks.
You may have entirely different reasons or not agree with mine at all.
I give complete validity to ANY reasons why the IVF 2ww sucks.

10. Unlike way back when you were actually just trying to get pregnant "the old fashioned way", you KNOW there are embryos in there. Now you have to spend the next 2 weeks wondering if your body is good enough to keep them there.

9. Wondering if every little thing you're doing is going to impact implantation in some way. My favorite (and you know we have ALL thought this at some point) is wondering if straining at all when going to the bathroom will cause them to get pushed out. Don't lie. You've wondered that too. How many of you have actually ASKED the RE that though? I have. Yep. Last cycle. Totally asked. 

8. The phrase "PUPO". I'm completely guilty of using it. It's a mindfreak.When the call comes that beta was negative, it almost makes the depression even worse - because for two weeks you were PUPO. And now you're nothing.

7. The bloat. Yesterday, I was wearing my only pair of maternity pants that didn't get packed away. That's how bad it is. Smudge's Dad promises me I'm not this fat all of the time. He says I'm just really bloated. He might be lying to me... but I'm hoping not.

6. The FLUID. My RE wants me drinking a MINIMUM of a gallon of liquids a day (preferably mostly juices, electrolyte drinks, etc) to help move the aforementioned bloat. OMG. Between the PIO (progesterone in oil) and the fluid, I can't get out of the bathroom.

5. Okay - since I already brought it up, the PIO. Really. An intramuscular injection every day. Don't get me wrong, I'll take it over vaginal suppositories any day of the week, and should this cycle work, i'll bare my ass to Smudge's Dad happily every morning for 12 weeks so he can shoot me up. But we're three days in, and i'm already a member of the painful lumpy butt brigade. It makes me itchy. And honestly, scratching ones rear in public is strongly frowned upon.

4. Okay - more about the PIO. Every 2ww (even the regular plain "old fashioned way" kind) comes with phantom pregnancy symptoms. But seriously. The IVF 2ww comes with those symptoms on steroids. We don't just get the regular NORMAL hormones. We're taking mega doses of them.  Voluntarily. Via pill and injection. IVFers are crazy. I'm sure of it. 

3. The people you told. Ugh.  Each time we do this, we say we're going to tell fewer people and this time, we've really only told immediate family.  It was necessary since the transfer  was on fathers day weekend and we needed some assistance with childcare during retrieval. But really, the "keeping everything crossed" with huge smiles and "Call me if there's news" is really getting old. I get that they're excited too - but can't they just follow our lead. If we're not talking about it, can't you not talk about it too. Don't you know how scared I am? How this isn't just sunshine and daffodils? Don't you remember that it doesn't always work? And you're not going to want to talk about it then... so drop it now.

2. You're still spending the entire 2ww waiting for the phone to ring. If you have extra embryos and you're waiting to see if they freeze. When you have your progesterone checked. And then when they finally draw your beta HCG.

And the #1 reason why the IVF 2ww sucks is..........

1. The pictures. 

Unlike when you're trying the old fashioned way, I have a picture of my embryos. Granted, once you have that baby, the embryo shots are surreal. But during the 2ww, you spend the entire time looking at those embryos, wondering what they'll be like or look like. Wondering which one is your baby. And when it doesn't work, you have something tangible to look at and know you lost. 

FUIF.

Speaking of what we lost, I'm a little heartbroken and worried this morning. I just got off the phone with Fran. Our remaining four embryos are not able to be frozen. They didn't die. Their quality is just not what it would have to be to survive thaw. How many questions does this open for me? What about the ones we put back? Are they the same way? Will they not make it this far? Are they bad too? 

Fran assured me (while I'm a crying idiot on the phone) that it means absolutely nothing for this cycle. Scott (embryologist extraordinaire) said he picked the best three and he has a really good feeling about them. I know his freezing criteria are really strict. I shouldn't feel too upset. Fran said she would hate to get me all ready for a FET, just to call me and tell me that we didn't have anything to transfer. So, while she didn't tell me so, i know this means that our remaining four embryos are going to be discarded. That makes me REALLY sad. Smudge's Dad says it's too late and we can't go back and pop the last four in there too. He said he doesn't want a reality show that badly. But the thought of just throwing them away is making me really sad. 

And I'm not going to lie - I'm now really worried about the three embryos that we transferred. 

Progesterone check tomorrow.