The Tough Cupcake Returns

Dear readers,

I stopped posting on this blog about three years ago. I had left off at the beginning of the second trimester of my FET pregnancy. The pregnancy went on, and I made it til 33w5d before our precious bundle arrived. There were several complications with accounted for her early arrival (a story for another post), but now we have a healthy, happy two-and-a-half year old. **Trigger warning: photos posted below**

So why has the cupcake returned? Well, we have always wanted two children, so this past spring, we took steps to work towards having baby #2. So far, things haven’t gone as we had hoped, and I realize now that I need a place to share the journey once again.

And so, the adventure continues...

The First Trimester

My last post left off when I was 4 weeks, 2 days along. We had just found out that my HcG had doubled as we were hoping. That same day, we began telling our immediate families. A couple of days earlier, we had prepared a short video to share the news with them. We made it up on the spot, did only one take, and we were ready to share!

Diwali 2015

Our parents and siblings shed tears of joy. It was so nice to have good news to share this time after a treatment cycle. For the following week, we were floating! At the back of our minds, we knew we still had a few weeks til the first ultrasound where we would find out if baby was still hanging on and had a heartbeat. But until then, we made the most of being pregnant. We enjoyed looking at baby products and started using pregnancy apps. We planned and talked about baby and enjoyed every minute of it!

A week later, at 5 weeks, 2 days, I started feeling queasy. A couple days later, I was definitely nauseated, and then morning sickness was in full swing! My clinic prescribed Diclectin to try to manage/reduce the symptoms, and it did help, but once morning sickness began, I was sick pretty much every waking moment. I then added in Ranitidine (Zantac) twice a day at the maximum dose to reduce acidity and help cut down the nausea. It helped a fair bit for a few weeks, but I was still pretty sick. My all day sickness made it hard to enjoy pregnancy, and some days I felt sick and miserable enough to literally cry, but I was glad to see it disappear around 12 and a half weeks. I was back to feeling blissful and stopped taking anti-nauseants. Unfortunately, it came back two weeks later, and now I'm back on my meds. What really kept me going through those two really challenging months was the ultrasounds.

At our first ultrasound, we saw the baby for the first time. A tiny little blob, but we could see the heartbeat on the screen. That made us feel more confident about the pregnancy and made everything more real.

Two weeks later, we had our second ultrasound. By now, baby was bigger and looking more like a peanut! This time, we got to hear the heartbeat for the first time. Of course, we cried! It was the most beautiful, precious sound. The same day, I was released from my fertility clinic, PCRM. I had graduated to my family doctor and OBGYN. I was a bit sad to leave behind the amazing staff at PCRM, but I was also happy that baby was healthy and were ready to move on.

Our Little One

Our third ultrasound was done through my OBGYN's office. By now, baby had grown quite a bit and actually looked like a baby. The doctor pointed out arms, legs, facial features, and more! We were relieved to see that baby looked healthy once again. And it was exciting to see baby literally jumping around in my uterus and waving arms.

This past Tuesday, I happened to have my next OGBYN appointment on my birthday. My hubby told the doctor it was my special day, so as a present, the doctor wheeled in a portable ultrasound machine and let me see baby and hear the heartbeat. What an incredible birthday gift!

Everything feels a little more special now that I know we have our little one on the way. Diwali was a little brighter, and the Christmas season feels a little more merry. I'm happy that I survived the first trimester which is supposed to be the hardest one. Now I'm 15 weeks and 2 days and hoping the second trimester will be an enjoyable one... I know for sure that it will be a memorable one!

I'm back! And backtracking...

It's been about 5 weeks since I went silent on the blog. A lot has happened since then. I'll backtrack to September 14th, which was my first day back to classes for the fall semester.

I'd had my frozen embryo transfer 6 days earlier, and instead of patiently waiting for the blood test, I was impatiently testing early at home with home pregnancy tests. I woke up went to catch my FMU (first morning urine) in a cup so that I could use it for testing. I dipped it in and waited, and the place where the second pink line should show up looked pretty white to me. Or was it? I squinted and stared. Yup, white. Or is there a bit of a second pink line? I took a picture with my phone. Zoomed in. Stared at it. Looked at it in different light. Okay, definitely no second line. Negative test again. And off to work I went.

I came home from work and went straight upstairs to test again. Which really makes no sense because FMU is strongest and that's what you're supposed to use for testing. Instead I was now testing again with dilute evening urine. Same thing. Peed in a cup, dipped the strip. Waited 5 minutes. This time, I thought I saw a faint second line showed up. I stared at it in shock. In over 5 years of trying, I'd never seen that desired second pink line. I squinted. It was still there. I took a picture of it. It was there. My mind was racing. So I did what anyone would do in my situation - I sent the picture  of my test stick to two of my IVF friends and asked if it looked positive to them too. And they both assured me that it was. And then I cried.

Hubby was downstairs making dinner this whole time (and probably wondering why I was taking so long upstairs). I came down holding my peed-on test stick behind my back. Then I showed it to him in tears. He was shocked and excited and in disbelief. It was pretty early to be testing and getting a positive result. But there it was, our second pink line. He picked me up and spun me around. He couldn't believe it. I couldn't believe it. He cried, and so I cried some more.

I looked over to see what he was cooking for dinner, and noticed an open jar of sauce on the counter. It was Prego sauce. A couple months earlier when we'd bought it, I'd jokingly said that maybe it would be lucky for us and we'd end up prego. But this day was the first time we'd ever used that brand of sauce. So, of course, it was the perfect opportunity to take some pictures.

The following few days, we were excited and nervous and jumpy and really really wanted to have that blood test which was the official test. I re-tested at home each day just to make sure that the second line was still there. It was. On Thursday, I went in for the beta-HcG blood draw. We were hoping for a number over 50 which would indicate not only a pregnancy, but one that was doing well so far. It's very common for early testers to see a positive and get a low beta number, and then the pregnancy disappears a day or two later.

My dear hubby was obsessing over the My E-Health website, and I'm surprised he didn't crash their servers. I was keeping busy at work, so I couldn't check online for the results. Finally, he called me to tell me that he saw the result: 295. We were thrilled that it was official - we could now say it: We Are Pregnant!

I was so pleased to see that number. I felt like things were good and we'd be fine going ahead. It was really nice to hear the nurse from the fertility clinic call and say "Congratulations" instead of "I'm sorry" this time! But the tricky part about getting your first beta number is that if it doesn't double in about 48 hours, that means the pregnancy isn't viable. So while I was feeling blissful and fairly confident that the next blood test would be fine too, hubby was stressing out big time. He couldn't eat and sleep. He just really wanted to fast forward to the next result. Finally on Saturday I went for the second blood test. Our result was 636 - more than double! And then it was really really official.

And so, dear readers, I am happy to share with you the news that after over 5 years of trying, 7 attempts with fertility treatments, and countless pills, invasive tests, injections, prayers and tears... we are pregnant!

A Note to my Readers

Dear readers,

I'm taking a short break from posting on the blog. I decided that I need some time to just spend with hubby. I promise I'll be back with updates when I'm good n ready! 

Write soon,

A Tough Cupcake <3

PUPO!

Lucky Tinkerbell Socks!

 On Tuesday we went to the clinic for our second IVF embryo transfer. Our previous IVF was a fresh transfer, and this one was our first time using a frozen embryo. I wore lucky Tinkerbell socks this time! Excited, hopeful, and with way too much water in my bladder, we changed and met with the embryologist. She gave us the good news that our first embryo thawed perfectly, so they didn't need to use any of the others. We still have 7 frozen ones left.

Placement in my Uterus

The embryo they were putting back inside me was graded 4AA, the highest grade. It was frozen when it was 5 days old, so its age continued at day 5 when it was thawed (even though it's been sleeping in the freezer for a few months). During the transfer, my main focus was not peeing on the doctor. Same as last time! It doesn't help when the nurse pushes down on your bladder with the ultrasound probe during the entire procedure. The doctor showed us where in my uterus the embryo was placed and printed out a picture for us. Then we were good to go!

Normally, a woman is assumed to not be pregnant until, of course, she finds out she is pregnant. When you go through IVF, it's the opposite. After your transfer, you are said to be PUPO - pregnant until proven otherwise. Being PUPO is an exciting time because "until proven otherwise", you can live in the world of being "maybe pregnant"... which is a whole lot more hopeful than not being pregnant. 

Completing embryo transfer also means you're in the two week wait, often abbreviated tww or 2ww. The two weeks is the time between transfer and the beta-HcG blood test that tells you whether the treatment was successful or not. During that time, you hope that you are pregnant. You get scared that you're not pregnant. Time goes by slowly. You feel something and wonder, is that a sign of pregnancy? And you feel something else and wonder, is that a PMS symptom? You act like you're pregnant. You watch what you eat, get lots of rest, walk to keep good circulation, avoid pushing or pulling or lifting anything heavy. You do anything and everything you can to make yourself feel like you've done your best to make that embryo stick!

Ready for Transfer #2

I've been mostly happy and hopeful during this two week wait. I'm lucky that I was able to take time off to take it easy as the doctor recommended. I'll be heading back to work tomorrow - the first day of classes - so that will help the 2ww go by much faster. I'm finished with antibiotics, so that has helped my digestive system. It's still moving in slow motion because the progesterone makes everything sluggish. I'm not as terrified about heartburn either. Last week I was napping almost daily, exhausted from the hypothyroidism and also the progesterone. I'm trying to wean myself off of naps for the last couple of days just to get ready for work. 

I'm currently 5dp5dfet, five days past a five-day frozen embryo transfer. Today, implantation should be complete, and the cells that will eventually become the placenta and fetus have begun to develop. 

The Schedule

As of a few days ago, my medications/vitamins routine has become more complicated. I had to make a schedule to keep track of what to take, when to take it, and under what conditions. I spaced out the ones that will interact with or affect the absorption of others. And I tried to time them so that I could take the majority of them at home instead of at work. It doesn't help that in my work week, I have three different sets of start/end times. This is what I came up with.


7:00 am - Synthroid (thyroid medication):  need to take it on an empty stomach. No antacids or dairy or iron or multivitamins for 4 hours before or after (3:00 am - 11:00 am). No food for one hour after. I miss eating cereal for breakfast!

Get it? hehe

8:00 am - Doxycycline #1 (antibiotics): need to take on a full stomach which is hard to do since I can't eat the hour before because of the Synthroid. This leads to a big rush to eat something filling within a few minutes. Having toast with peanut butter n a glass of juice most mornings. These pills make my liver unhappy (and last time around helped to land me in the ER with severe heartburn). As of today, these make me nauseated if my stomach doesn't stay full.

8:00 am - Estrace #1 (estradiol). Same as I've been taking the past several weeks. Better on a full stomach.

8:00 am - Crinone #1 (progesterone gel suppository) - this one always ends up being late because of needing to fill my stomach to take the previous meds. It also requires me to lie flat on my back for several minutes after using it to prevent it from coming back out.

11:00 am - Pre-natal multivitamin #1: Yay for gummies!

11:00 am - Folic acid. Nothing much to say here.

8:00 pm - Doxycycline #2

8:00 pm - Estrace #2

8:00 pm - Pre-natal multivitamin #2

8:00 pm - Crinone suppository #2. I haven't figured out yet how I'm going to manage this one when I'm back at work as it conflicts with my Thursday shifts. I'm picturing myself lying on the floor in the staff bathroom at work.

My Daily Cocktail

So that makes 10 items on my daily "to take" list. I've been staying home a lot because it's just easier to deal with the meds and the timings and the side effects. But I did have a few girls over last night and had a fantastic time chatting and eating and watching Frozen together!

The hypothyroidism is still keeping me pretty tired. But I'm keeping my eye on the prize. And tomorrow is the BIG DAY! Our sweet little embryo will be back in my uterus where he or she belongs.. and will hopefully stay and grow there for nine months!

Blood!

Yesterday morning I headed to the lab with my two requisitions - one for LH and progesterone as part of my FET protocol, and one for TSH and CBC as part of the routine updating of my bloodwork for my fertility clinic's records. A 40-minute wait and three vials of blood later, I was good to go.

I was hoping my blood would show low numbers for LH and progesterone indicating that I hadn't ovulated and wasn't about to. Ovulation would mean that my estradiol pills haven't been doing their job and also that my body is prepping to shed the lining.. that would be bad because then there wouldn't be a nice cushion for my embryo to stick to. I wasn't particulary concerned about the routine TSH and CBC check.

I had a relaxing morning and then headed out to meet hubby for lunch. It's kinda nice to have a lunch date on a weekday because that's not something we can normally do. While we were eating, I checked my blood results online on My E-Health. First up was progesterone - 1.7 meaning there was no way I ovulated - YAY! Next was LH - 12.9 indicating that I'm not likely to be currently ovulating - another YAY!

The CBC was good too. It showed that my red and white blood cells were in the normal range. This was a bit of a relief because last time I had them checked, my white blood cells were out of range. This was due to the IVF meds, but it still scared me.

The results for TSH took a while longer. When they showed up, I saw a level of 3.88 which is well within the normal range, but not within the desired range to do fertility treatments. Most clinics want your TSH to be under 2.5. This also explains why I've wanted to sleep so much and take naps after a full night of sleep. I thought it was the estradiol pills, but now I realize the fatigue is from hypothyroidism. All the meds I've been taking increase TSH too, so when unmedicated, it's possible my natural TSH isn't as high.

When I went in for my initial consulation in the summer of 2014, my doctor said that my level was higher than he wanted to see, and he'd re-test me in a few months. By November 2014, my level was significantly lower, showing that it was moving in the right direction, so I was never sent to have it tested again... until now!

So if it's within the normal range, what's the big deal? Well, even though under 5.5 is considered normal according to the lab reference range (although recently, endocrinologists say under 3 is the "new" normal), levels over 2.5 in the first trimester are highly linked to miscarriages. So unless you're pregnant, 3.88 isn't a big deal. And since I'm intending to be pregnant in a week, I got pretty jumpy. 

After lunch I headed to my parents' place for a while. I was waiting for the clinic to call me even though I knew I might not get the call til the following day. I worried that they would cancel my FET and that I'd have to sit around and wait for months to try again. I felt sad and mad. I wish they had tested it routinely to make sure my TSH kept going down, so we could have prevented this. Then I realized that maybe I wanted them to cancel it, so that I wouldn't waste my embryo. I'd rather not get pregnant then get pregnant and miscarry. Dr. Google confirmed what I already knew: going ahead with this level of TSH was pretty much asking for a miscarriage.

Eventually, I thought I'd drive myself crazy, so I called the clinic myself to talk to a nurse even though I was supposed to wait for them to call me. As usual, I got the voicemail. I explained that I was concerned about my TSH level and that I wasn't sure if my cycle was cancelled and that even if it wasn't, I didn't want to go ahead with it unless they could treat my TSH simultaneously. And then I went back to waiting for a phone call. I thought about how I'd taken 60 of those little blue Estrace pills, how I'd paid a good chunk of money, and how I'd woken up in the wee hours to take trips to the clinic... and now it might all be for nothing.

I was relieved to get a quick response - the doctor reviewed my results and said I'd start Synthroid right away to deal with my hypothyroidism and get my TSH down and that we'd continue with the transfer as planned. If I get pregnant, they'll test the TSH again to make sure it's gone down. Umm.. well that was simple. And unexpected. And made me feel silly for letting my thoughts take over without even knowing what would happen.

Fertility treatments make your mind funny like that. You try to be positive, you try to be optimistic, you hang onto hope even when the odds are against you, but one tiny thing really can ruin everything. This time I was lucky, but I've already had two cancelled treatments, so I know it's a very real possibility. I'm glad it didn't happen for the third time, though. I feel relieved and happy and blessed and excited that things are moving forward.

Our transfer date is Tuesday, September 8th, the first day of the fall semester! With two days of bedrest following the transfer day, that means I'll need Wednesday and Thursday off of work too. And since I don't normally Fridays, that means I'm missing the entire first week. Not ideal, but I'm still lucky because:

A) it's registration week, not classes;

B) I have a colleague who can cover for me; and

C) I have another colleague who's helping me get set up for when I begin teaching the following week. 

So now there's five more days. FIVE. MORE. DAYS!!! My entire life might change in 5 days and that is just oh-so-exciting. Meanwhile, I'll be busy trying to keep track of all the stuff I need to pump into my body to get ready for our little snowflake to be thawed and brought home to my uterus. I'll save that for my next post though.