Friday, October 31, 2008

First ultrasound

Had first ultrasound this afternoon (at 6w3d). It was pouring with rain and I was very nervous on my way there. Met up with my hubby at the doctor's office, luckily he was a lot calmer than me. After waiting for 35 minutes the doctor finally called us in. After some formalities she started the u/s: one sac with embryo detected, with heartbeat! Yes!! Felt immediately very relieved.

So one embie didn't make it, which I already thought, based on my rather low betas.

Doctor also checked my ovaries, still pretty enlarged from the stimulation: right one between 7-8 cm, left one around 6 cm (normal size should be about 2,5 cm).

Got a nice print-out with all the images. Maybe I'll post one here if I can get it properly scanned.

On to the next appointment with the OB (even though she isn't really one, but I will call her that anyway because it's easier and she's a specialized general practitioner). She wasn't there though, but a replacement, very young, but very nice. A few basic exams, some prescriptions (for the entire pregnancy) for blood work etc, and some warnings about toxoplasmosis and listeriosis and what foods not too eat (most of it I already read on the web of course).

Next appointment (both with OB and for next u/s) around week 12. Seems a long way off... Have to go to the hospital on November 17 to register at the maternity ward. As this doctor is affiliated to the hospital where I want to go, I can stay with her for the entire pregnancy, and don't have to change for the last 2-3 months (like two of my friends had to do). The only thing that will change is the location for the consultations - first seven months at her office, last two months at the hospital.

Have to call my RE's office with the results on Monday and check how long they want me to continue with the progesterone and the baby aspirin (the prescription says at least one month after the first positive beta, and I'm not there yet, so in the meantime I'll just continue).

Now off to enjoy the weekend. Happy Halloween (not that I'm celebrating that here in France)!

Thursday, October 30, 2008

(Bad) mood

Someone told me I was too hard on my sister-in-law (and maybe even on my mother) in yesterday's post. Well, maybe, yes, but that was how I was feeling, so I wrote it down (and it doesn't mean that I don't love them both dearly and really appreciate it that they are always thinking of us).

I have the feeling though that my raging hormones are not making me a nicer person these days. Yesterday I had a music ensemble rehearsal and I lashed out at the violinist, because he told us he was just counting and couldn't listen (yet) to what the others were playing, with the result that he started (and finished) too early every single time. So I told him to listen, instead of count, but he refused. I insisted. He refused. So I got angrier and told him again to listen to the others, isn't that the whole point of ensemble playing...?! He asked me why I was so irritated, I said I didn't know, but that I just couldn't understand his attitude. We started playing again... he finally listened, and we were together...

So, I do apologize to anyone I've been grumpy to lately. Blame it on the hormones.

Wednesday, October 29, 2008

Optimistic or cautious

Yesterday evening my sister-in-law called to check how I was doing. "Oh, I'm so happy for you! I told my colleague that you're finally pregnant and that you might have twins, or even triplets or...!" Eh... looking at my low betas I think it's only one. "Oh, that's fine too, but two would be great!" Hmm, yes, of course (but it also means additional risks - I didn't say that though). I briefly considered sending her Busted's doodles video, but it wouldn't work anyway. She's living a blissfully naive life in a small Swiss village, surrounded by farm animals and lots of women who just got pregnant the easy way (including herself).

My mum can't hide her excitement either, and calls me about ever other day, wondering when I'm finally going to react more enthusiastically myself (for sure not before Friday's ultrasound and maybe not even before the end of the first trimester - which doesn't mean that of course I am really happy that we've already come this far, but also pretty anxious about everything). She also seemed a bit taken aback when she found out that my hubby had told one of his best friends, but I still haven't told my cousin.

Well... it's true that there might not seem to be much logic (at least to her) to which friends / family members we've shared the news with and to whom we haven't said a thing yet. It's just that some people we feel much more comfortable sharing it with than with others. In the meantime my mum is very proud of herself for keeping her mouth shut, which makes me smile.

By contrast, I got a lovely letter from my grandma (the only person my mum did tell), cautiously congratulating us, while not even daring to write the word 'pregnant'. Very sweet.

Tuesday, October 28, 2008

Job interview

This afternoon I had something to distract me from thinking/worrying about this little thing inside me: a job interview. Only the seventh in the more than three years since we've moved to France! This one was not even for a job in my field, but hey, after three years I though I might need to expand my search area a bit.

The biggest problem here in France is that if you don't have a degree from a French 'Ecole Nationale Superieure' of something something, you already don't really count. Then if you've studied something (music recording), but got a job/career in a related field (MarCom/organization, but still in music/audiovisual sector), but not quite what you studied, they get confused and don't know what box to put you in. This then usually results in that they throw your CV in the bin instead of making them curious and inviting you for an interview. On top of that, the professional networks are really really closed, especially the cultural/musical ones...

Oh well, today's interview was for a MarCom position at a business school. I think it went OK, but they really want someone with a marketing degree, which I obviously don't have. Honestly, I can't get very upset about it right now, this pregnancy is way more important at the moment (but yes, of course it would be great if I would finally have a job). I'm leaning more towards freelancing at the moment anyway, much more flexibility, and I think I could get some small projects going. The only thing holding me back is the French bureaucracy...

Friday, October 24, 2008

Decision made

OK - I've made my decision - and two appointments!

Third friend called back - had same OBGYN as other friend that was not happy (the third friend said she thought the doc was OK, but a bit cold).

No news yet from the one with the midwife contact, but I wanted my mind to stop racing and make an appointment for that first ultrasound soon. So got in touch with my friend who gave me the very positive recommendation and asked her about the separate ultrasound person - she said that she had that with both her pregnancies (in two different cities) and she would highly recommend her ultrasound doctor too (not one from the list that the other doc's assistant had given me).

So I first called the ultrasound office - appointment for next Friday, October 31 (they first wanted to schedule me for December, but I said that my RE had told me I needed the first ultrasound 25-30 days after the transfer), yay! Called the doctor's office right after that - appointment for the same day, after the ultrasound.

Feel OK about the decision. If after the first visits I have the feeling that I need to see someone more specialized, I can always change, right?

Still undecided

Well, I'm still undecided when it comes to choosing an OBGYN.

I called my friend's recommendation (the non-OBGYN) this morning, and she would be able to take me as a patient, but she doesn't do ultrasounds at her own practice, so I would need to go to a separate ultrasound office for that, which I don't really want to do.

My second friend does not recommend her doctor, and my third friend has not responded to me yet.

I did call the RE's office to ask for recommendations, but they say they don't know anyone except for Dr 'Speed'... So I considered maybe going to him after all, at least he knows my history, and even though he's speed, he's also quite human...

Hmm, so I called a friend who had several IVF cycles with Dr 'Speed' and stayed with him for the first five or six months of her pregnancy. She basically said that yes, I could go to him, but I would always sit at least one hour in the waiting room before he would see me and then have a very speedy consultation. So... probably not.

She did however offer to call her sister-in-law (who's a midwife) for me and ask her for OBGYN recommendations. So I'm waiting to hear back from her, as from my other friend who hasn't responded yet.

Oh yeah, the other thing I found out is that apparently here in France for the first six months of your pregnancy you go to an OBGYN and then for the last three you need to go to another one, who's affiliated to the hospital you want to give birth at, and whom you stay with until the delivery (but you cannot go to this one from the beginning of your pregnancy). Strange...

Thursday, October 23, 2008

Changing

Today I had my third beta: 853 - everything is going fine, yay! (and thanks to the betabase I now know that the doubling time between beta 1 and 2 was 48.1 hrs and between beta 2 and 3 49.31 hrs - if this interests anyone at all).

I had a strange conversation with my RE's office though. When I had gotten the result from the lab, I called my RE's office to tell them (standard French procedure, see my post below on 'labs and nurses - the French way). The assistant asked me if I already had an OBGYN for the rest of my pregnancy. Eh, no... She told me I could stay with them, but that would mean with Dr. 'Speed'. Eh, no thank you... Or otherwise find an OBGYN myself. Oh, but what about the ultrasound that they told me they want me to have about a month after the transfer (which means next week), would that not be done at the fertility clinic/RE office? No, I should just schedule that with whichever OBGYN I'm going to pick...
So that's it? No last 'good luck' RE visit? Why won't they do that first ultrasound? Wouldn't that be a better way to really say that the IVF procedure was a succes? I think it's weird...

Pff, so now I have to find an OBGYN. Of course I could call the RE's office tomorrow morning and ask them for any recommendations in my neighborhood (I forgot to do that this afternoon). I also asked three friends who live near me and had babies last year. One already responded and said she had a wonderful doctor, who was recommended to her by the hospital, but that she's actually a general practitioner, who does have a lot of pregnant patients, but is not an OBGYN. Hmm, if she was a real OBGYN, I would immediately call, but now I'm not sure. Maybe I should just call, explain my situation and see if she thinks I can be her patient or if I should go to a more specialized doctor?

Well, I have to wait until tomorrow anyway before I can call, so have some time to think this over a bit. If you have any great suggestions, please let me know!

Tuesday, October 21, 2008

Happy and sad

This morning I'm both happy and sad. Happy that my beta has doubled like it should have, that I dare to dream a bit more about what is to come (and therefore had a pretty bad night, because my head was way too full to fall asleep).

But I'm also sad, because my blogger friend PJ's beta dropped to 5 yesterday... I found her blog only about a week or two ago, and it was comforting to have someone who was in the 2WW at the same time, who was having similar neurotic spells, similar dreams, and who'd been through quite a journey herself too. I hoped and prayed that her beta would double like mine, and we could go on this special journey together.

I'd also like to use this to respond to those around us who tell us we should just relax, we shouldn't google too much, we should leave the pee sticks in the box, because we're healthy, so why should it not work... Well, as much as they are right, we have all been experiencing more negatives than positives, no matter if our fertility journey started 6 months or 6 years ago. So we have a reason to be cautious, neurotic, stressed out and overjoyed but still scared at a first positive result. Despite the hopes and prayers, despite us being healthy and perfect looking embryos being transferred back into our wombs, we know that it can go wrong. We've all studied equally hard for our exams, but why some pass and some fail remains a mystery to us.

All these thoughts never leave us, but especially during the 2WW, when there are no daily clinic visits, less or no hormones to inject, when we've done everything we could, and we just have to wait, they drive us nearly insane (thank god for blogging though!). We don't want to think about it failing and having to start a new cycle again (if that would be a possibility at all). Of course, because we don't want the injections, the clinic visits, but most of all, because we're afraid the next time will not work either and maybe it will never work at all...

So, I am hoping and praying that this one sticks. That my beta will continue to rise, that the first ultrasound will show a sack with an embryo, in the right place, that there will be a heartbeat, that I will be able to carry a healthy baby to term.

I feel very blessed already. I think I've deserved it, but I know there are many women who deserve this as much or even more than I do. So PJ, kalina, splitpea, emily, busted, and all those I don't know but are going through the same, I wish with all my heart that you have the strength to continue and that you will have BFPs very, very soon!!

Monday, October 20, 2008

Yes!

Today's beta is 310! Yay!!

So, I'm now trying to calculate my doubling times (unfortunately the doubling calculator on betabase.info doesn't work, at least not on my Mac) but I'm not that great at logarithms and exponentials... Exact number will have to wait until I have an Eureka moment or I'll ask a math-wizard, but a rough calculation gives a doubling time of just over 48 hrs.

3rd beta on Thursday.

Saturday, October 18, 2008

Stupid

I've done something stupid this morning: I took a home pregnancy test. It was positive (of course), but the line was not as dark as I would have hoped. So now I'm worrying that my beta is going down instead of up...

Of course this is completely stupid, because I have nothing to compare this line to - I didn't test yesterday or the days before and I don't have another kit at home, so can't test tomorrow (my initial idea was to buy several kits and test a few days in a row, but in the end decided I shouldn't spent too much money and try not to obsess about it).

Other than that my symptoms are still the same: sore breasts, tired, lower back pain, and some (minor) cramping. I wish I could just be a normal ignorant pregnant woman...

Wednesday, October 15, 2008

Reassured

Well, of course I had to google some more about hCG levels and luckily found some quite reliable sites that were able to reassure me that 55 is actually a pretty ok number and that you basically can't say anything after just one hCG test. So a new waiting period starts - 5 days until Monday - but for the moment I'm pregnant!

So far so good

Got my beta hCG result: 55 - BFP!
Well maybe not BF, the number seems quite low when I compare it to what other women had at this stage (12dp3dt), so I'm not jumping for joy yet (it's also quite surreal to have a BFP after more than five years of TTC/BFN). But the assistant at the clinic said it was positive and we should wait and see what the second beta is on Monday. If that one's OK, then maybe I'll be able to relax a bit more...

Tuesday, October 14, 2008

Cramping

Another not so great night. Lots of trips to the bathroom. After the fourth one I finally registered in my sleepy head that it was more cramping than having to pee that woke me up. Not super horrible cramping, but still, it kept me awake. In a normal cycle I would have swallowed an Aleve already, but don't want to risk anything now. Tried lying on my stomach / curled up / deep breathing, but it didn't help much. Finally put one of those microwavable heat things on my stomach, which worked and allowed me to sleep for another hour until the alarm woke me up.

No night sweat this time, although now and then some minor hot flashes. Breasts still hurt, no spotting or bleeding yet, so I'm still hopeful (or am I just in denial?). Also felt better after seeing that someone left a comment on my blog (yay! thanks PJ!) and reading a long email from my sister. Hubbie left for the airport, I think I'm going back to bed for a little bit.

Monday, October 13, 2008

Nightmare

Had a horrible night. Got up four times to go to the bathroom (note to self: don't drink too much tea just before going to bed). Woke up again around 5.30am from a night sweat. No!!! Tried not to freak out too much, stayed under the covers and managed to fall back asleep. But of course then the dreams started... Woke up half an hour later, crying - because I knew it was all over: night sweats and no more sore breasts (I dreamed other, really ridiculous things, but that's not too uncommon for me). Hubbie asked what was wrong, so I told him, then checked my breast... still hurting. So I calmed down a bit, but still not happy about the night sweat. Now I'm slowly trying to start the day as normally as I possibly can...

Friday, October 10, 2008

Labs and nurses - the French way

I had to go to the lab on Wednesday to have my estradiol level checked. Here in France, you can't just go to your own clinic to get this done, but you need to go to a 'laboratoire d'analyses médicales' of your choice (there are lots of them). In a way this is convenient, as you can choose one that is close to home or work, but what I hate about it is that these people at the lab have no knowledge at all about your medical/infertility history, and sometimes ask stupid questions, which would never be asked if you could have this all done at your own clinic. Plus, it's not just only for the (simple) blood work, but I also had to go there for a pre-IVF vaginal examination (so they asked if it was for a yeast infection...). On top of that, you always have to call them yourself for the results, they will never call you.

In the case of the estradiol test, if it would be under 500 pg/ml, I would need to get a HCG shot, which had to be administered by a nurse. Again, for this you can't go to your own clinic, but you have to call a nurse yourself, who then comes to your home. This is of course convenient for chronically sick patients who have trouble leaving their home, but I find it adds additional stress because you sometimes have to try to find a nurse at the last minute (you get the test results in the afternoon and need the injection the same day) and you always get their voicemails, so you're never sure when and if they get your message.

So I planned a bit ahead and left a message with a nurse close to where I live (also important, because if you live too far away, it's not worth it for them to come to you as I think they can only charge 3 euros for a home visit) on Tuesday morning, saying I wanted to make an appointment for Wednesday, but I was not sure that I needed one... By 6 pm I still had not received a response, so I left another message. Got a call back within 15 minutes, there was no problem, she would come by the next day between 5 and 6.30pm, I just needed to confirm or cancel Wednesday before 4pm.

In the end, too much stress for nothing, because my estradiol level turned out to be 1982 pg/ml, well above the 500 pg/ml threshold, so I didn't need the hormone shot after all...

Going crazy

I woke up very early this morning from a night sweat (and a brief, sharp pain in my belly), which freaked me out completely, because usually this is a sign that my period is only a few days away... so now I try to find reasons why this time it might be different.
  • My breasts still hurt - I know this is probably due to the progesterone, but during my first IUI cycle I didn't have sore breasts at all, and during the other ones it stopped about three days before my period would start (so, this can still happen, but the night sweats would be during those last three days...).
  • Every day I'm dead tired in the afternoon. I've had this before, and I know it might as well be a sign of PMS as of early pregnancy, but I think this time it started earlier...
  • I had a night sweat last weekend too. Way too early to be associated with impending period...
  • I seem to be a bit clumsier than usual...
Maybe I should buy a test kit and start testing already, but I'm too afraid the result will be negative. Wednesday seems a long way off...

Thursday, October 9, 2008

Locked

My blog has been locked since Tuesday morning because Blogger thinks I'm a spammer. They said they would fix it within two business days, but I guess due to the time difference between here and California, it's already going towards three. Grrr...

Monday, October 6, 2008

No reserve

I just talked to the embryologist. None of the five remaining embryos continued to develop enough to be frozen for a possible future cycle... I feel a bit empty. These two inside me really need to hang on now!

Sunday, October 5, 2008

Giving them back

Friday was transfer day. We had to be at the clinic at 8.15am. Traffic was horrible and I was afraid we would be late (only by about 3 minutes, while hubby was still looking for a parking space, but I still arrived ahead of the doctor). I heard him come in, Dr 'Speed'... "En route!" and off we went to the transfer room, which wasn't ready at all yet - the cleaners had left the waste bin on the step of the exam table, and the doctor's stool was also upside down on the table. So he jokingly complained about it and opened the 'drive through window' to the lab (this window is something that really surprised me when I had my first IUI: you're in stirrups and suddenly the doctor opens this window/door behind him, which opens up to the lab, from where a lab technician will hand him the catheter while checking your name. All the while you're in stirrups with full view to/for the lab... oh well).

While I was getting ready, one of the lab technicians came up to the window to say that they would transfer two embryos back after all, because the quality was not too great and they wanted to give it the most chance (I had briefly discussed this with the embryologist before my discharge from the hospital on Tuesday - we'd choose one, unless the quality would be so-so). My heart sank, until a second lab technician said that one of them was actually looking really good and the other was a bit behind. The procedure itself went all pretty quickly, but it was a bit uncomfortable (I had a hard time relaxing), basically the same as with the IUIs I've had. No guiding ultrasound (the doctors at my clinic must be very sure about themselves, ha) and no gifts of petri dishes and/or photos of the embryos, like they apparently do in the US (but hey, a whole IVF cycle costs a lot less here too, so US patients are entitled to some additional perks I guess).

Just as the doctor was leaving the room, hubby arrived and asked if I was in there. So of course Dr 'Speed' took the opportunity to make a few more jokes. "Is this really your wife?" "Are you sure this is your husband?" A bit lame, but still good to get rid of whatever stress was left.

Had to go to the secretary to get some paperwork done, pay for the ultrasounds, triggering and transfer (all to be reimbursed a 100% later by the insurance). She also gave me some instructions for further blood work, continuation of the progesterone suppositories , and a possible additional hormone injection next week if my estrogen level is under a certain level.

After that we got to talk to the embryologist. She's very kind and reassuring. She told us that out of the 14 eggs, initially 8 were fertilized, but one with two spermatozoa, so that one had to be discarded. Of the the two that were transferred back, one was looking very good (the embryologist thought it was "très joli"), with 8 cells, and one that was a little behind, but otherwise still ok, with 6 cells. The other five were also a little slower (between 4-6 cells I think), but also showed fragmentation - she told us that they don't really know why that happens, but they wanted to keep them until Monday to see if they would develop to blastocyst stage without further fragmentation. If the fragmentation is 50% or more, they won't be able to freeze the embryos....

The coming 12 days will be testing our patience to the max. Here's hoping...

Thursday, October 2, 2008

There is no real answer

Well, I ended up sleeping most of the afternoon, the day of the 'ponction'. Yesterday I still felt pretty tired, but today is OK. Abdominal area is still feeling very tense though, but I think it's more from the stimulation than the 'ponction'.

Yesterday I felt quite insecure about our decision to only transfer one embryo. Would it be enough? Should we change to two or not? But what if one of the embryos divides after transfer..., I don't want triplets! Talked with hubby about it, who had some great philosophical answers, but it mainly came down to that he doesn't want me to run too much health risks and we can always decide to do two the next time, if this time fails. I did some additional research on the web and in some books I have at home, had a good night's sleep, and this morning came to the conclusion that we should stick to our decision. A lot remains speculation, we'll never have definite answers to all our questions, and certainty about which risk outweighs the other. Just statistics and our our gut feeling. So we'll keep it at one this time and hope for the best.

However I still had prepared some questions for the embryologist for when she would call today. When the call came, it was not her, but a lab technician, who actually just wanted to tell me at what time I need to come in tomorrow for the transfer. Luckily I did manage to ask her what the results were: 7 embryos. Not bad! But no additional info about quality etc. Have to find that out tomorrow morning, when we'll speak with the embryologist. The rest of my questions have to wait until then as well...