Is this real??

You guys, I swear to god someone is messing with me. There hasn’t ever been a pregnancy in history that has had more ups and downs than this one. Our ultrasound today was either a very cruel joke or the best news I’ve had in years.

We showed up for our ultrasound this morning feeling pretty pessimistic. It’s not that I didn’t have any hope. I haven’t had any bleeding for weeks now, so I was kind of thinking that the embryo/fetus/baby was still in there plugging along. But the most I had ventured to hope for was that there would still be a heartbeat, but a slow one. I thought the best I could ever expect would be a continuation of the limbo I’ve been in.

The ultrasound tech was merciful and rather than starting with measurements of my ovaries and my peri-ovarian mass like she usually does, she went straight to the baby. It was immediately obvious that it had grown. It looked distinctly different than the last time, much more baby-shaped. And before I had a chance to even look, G said “there’s still a heartbeat”. The ultrasound tech agreed, and right at that moment I saw it kick. I immediately started to cry, and said “this is just too hard”. I thought, how can we be tortured like this with a moving baby that won’t survive? I hadn’t even ventured to hope yet that it could be okay.

She measured the CRL (crown-rump length), and it was 9w3d. I’m technically 9w5d, so that sounded a little low to me, but since it’s measured a little small every time, this probably isn’t anything to worry about. Then she measured the heart rate. You guys, it was 171. This is after a 117 and a 106 two weeks ago. I mean, how??? How does this happen?? I said, “Is that real???”, and she had a big smile plastered on her face. At this point, G dissolved into a full on crying fit. Not a few tears, but a full on snot-fest. I’m honestly not sure if I’ve ever seen him cry that much.

She took a bunch more measurements and couldn’t find anything to be worried about. The whole time the baby was squirming around like crazy. I don’t even know how to express how shocked I am. I never ever ever expected that I would make it this far in a pregnancy, and all of a sudden there’s a little thing that actually looks like a baby squirming around inside me. It doesn’t feel real at all. These things just don’t happen to me. In fact, I can’t help but think that this is just a cruel joke. We can’t help but be invested when we see a moving baby, and it will only be that much harder to have it ripped away if it doesn’t work out.

We met with Dr. O, and he agreed that there’s nothing visible today that looks worrying. He also agreed with me though that this is still a high risk pregnancy. He said there’s no one thing that’s happened so far, or in my history in general, that would make it high risk, but the whole package raises the risk level. So, we are by no means in the clear here. I wouldn’t kid myself that we are out of the woods and this is just a normal pregnancy. Since I’m now almost 10 weeks, he’s sending me to a high risk OB and a maternal fetal medicine doc asap (I graduated!). I’m really glad about this because it seems like the high risk doctors will give us the best chance of success. I’m definitely not comfortable being treated as a ‘normal’ pregnant woman at this point. We will schedule an anatomy scan for a week or two from now, and that will definitely give us a lot more information.

I’m having trouble even organizing my thoughts at the moment. I’ve barely even been thinking of myself as pregnant up to this point, and suddenly now I’m 10 weeks pregnant. My belly is sticking out for real, and I now need to look in to getting some bigger clothes. People are probably starting to suspect I’m pregnant, and I haven’t been hiding it that much because I figured they’d just think they were wrong when nothing came of it (they’d just figure I gained some holiday weight). I will actually be going to see an OB for the first time, and will actually have an anatomy scan. All of these things I never thought I would get to do.

For right now, I’m feeling really great. I know that the nerves will set back in soon, and I’ll start to worry like crazy. Given the way things have gone over the last few months, there is every reason to think the next scan will be bad. I know I will be freaking out about that soon. For right now though, I’m just feeling very very lucky. So lucky to still have a chance with this pregnancy, and so lucky to be having these experiences of pregnancy. Even if this ends badly, I never thought I would have the chance to see that little life moving around inside me, and to wear maternity clothes, and to share good news with people. Over the last three years I would have given anything for those experiences, and I wouldn’t have gotten to have them at all if we had adopted. No matter what happens, I’m getting to experience pregnancy. That is enough for right now.

So I hope you all have a wonderful new year’s. I’m thinking of all of you who could use some freaking good luck of your own. I sincerely hope 2014 is a better year for all of us. Thank you so much for your support the past few weeks, you have no idea how much it has meant.

8 week ultrasound. And the verdict is…

I wish I had a better post to write today. After last weeks good news, I was in shock and could hardly wrap my brain around the idea that things could work out with this pregnancy. This last week has been interesting. While not exactly optimistic, I had really started to think of myself as pregnant in a different way than I ever have been before. I pulled out my old embryology textbooks and checked out all the pictures of 7-8 week embryos, and I calculated a due date. I even did some google-searching for maternity clothes. This isn’t totally premature, I’ve already got this protruding belly that probably looks further along than I am, and all my clothes are too tight. I would never dare to actually buy maternity clothes while in pregnancy purgatory, but I might need them sooner rather than later.

I went in to this mornings appointment hesitant, but open to the possibility of good news. I duly dropped my pants and hopped up on the table, as if waiting for a judge to pass judgement. G was in a great mood, pretty confident of the outcome. He was making small talk with the ultrasound tech while I shot him death glares. As soon as she got the wand in, she said, “well we have a baby with a heartbeat! I don’t know anything else yet, but I know that”. After which she proceeded to check my ovaries, and take a million measurements of my peri-ovarian mass (more on this later). When she finally returned to the pregnancy, she had this happy look on her face. Remember, the last time she did an ultrasound for me, there was no embryo at all, and they were thinking there might not ever be one.

She started taking measurements, all the while smiling. She even made a joke (so cruel) that G would have to be more patient when (she said when!!) he was a dad. At this point I started crying. I figured, she’s never acted like this for any single other ultrasound we’ve had (like hundreds at this point, and she’s done all of them). Clearly she thinks this is good! G was squeezing my hand with all he had.

Then, she went to measure the heart rate and my heart dropped out of my chest. The number that popped up was 117. At 8 weeks, the heart rate should be 140-190, which I knew in advance because I made sure to google it this morning so I would know what to look for. I said in a quiet voice “it’s too low”. She said, yes, it’s pretty low. She waited a few minutes, then took the measurement again. 106. There was no more smiling or joking about when we would be parents.

As always, after the ultrasound we had to wait a good hour for Dr. O to show. The longest hour of my life (well, one of them since I’ve done it a hundred times now). He didn’t have anything surprising to share. He agreed that the heartrate is too low, and it doesn’t bode well. Especially since we know that last week it was higher (124). When asked explicitly he said he’s seen a pregnancy like this survive before, but it’s extremely rare. More likely, the heart will just keep slowing and eventually stop. If it does survive, there is an elevated risk of developmental defects.

Since we will be out of town for the holidays next week (good god, the horror of a week with the in-laws in the middle of all this), we can’t re-check until the 31st. That’s almost two more weeks of living in pregnancy purgatory. If the constant nausea, headaches, heartburn, constipation, and exhaustion wasn’t enough to deal with, I will have to do it all in the company of my in-laws. Oh! and all without any alcohol. I guess I should consider myself lucky that there are only 2 babies and one pregnant woman (that we know of)  in the family at the moment, some of you have much more.

So here goes another two weeks of pregnancy purgatory. It promises to be a very merry christmas.

 

I don’t know how to say this.

I don’t know how to begin to say what I have to say today. It’s already taken me almost a day to process before I could write anything at all, and I’m still in shock. Yesterday I had my appointment with the new doctor, Dr. A, and I also had an ultrasound. Here’s what I don’t know how to say: the ultrasound was good. Not just on the fence like my past ultrasounds have always been, but according to Dr. A, everything looks normal in there.

There is a strong heartbeat of 124 bpm, and the fetal pole measured 9mm, exactly 7 weeks. The sac looks normal, no poor margins or just plain weird stuff like in the past. I just. I don’t even know how this is possible. I don’t know how this can be the same pregnancy. The same pregnancy with no fetal pole at 5w6ds, that Dr. O described as ‘not optimistic’. The same pregnancy where last week Dr. O and the ultrasound nurse wouldn’t even look me in the eye. Dr. O is not a pessimistic doctor. He has always told me there was hope in the past, despite bad ultrasound results. He didn’t do that this time. I don’t know what to make of this, maybe he was letting my history affect his impressions (like it has mine, where to me blood = miscarriage)? Clearly I’m in shock here, I feel like I’ve jumped in to a different pregnancy than the one I was in two weeks ago.

Here’s how it all went down. We showed up for our appointment, and for the first time ever at an RE’s office, we were brought back to Dr. A’s office right on time, by Dr. A himself. Already I’m liking this guy. We had an awesome conversation, that I PROMISE to write about soon, because he said a lot of things that really clicked with me, and I think will be of interest to you guys. One of the things we talked about was that the vast majority pregnancies that end in first trimester miscarriages look unusual in some way on ultrasound by 5-6 weeks. That’s not to say that all pregnancies that look weird at 5-6 weeks will be a miscarriage, but the opposite is rarely true (pregnancies that look totally normal by 7 weeks miscarrying). Obviously it happens, but it’s much more rare, and potentially indicates a different kind of problem.

This fits my history very well. By 7 weeks, none of my pregnancies have looked normal. This makes a lot of sense because of how many thing are happening before this time, essentially all the parts of the embryo are getting in to place. We all know that embryos start from a single cell, then if you think of how many things have to move and arrange for an embryo to be sort of ‘baby shaped’ by 7 weeks, its just insane how much can go wrong. From 7 weeks or so on, things are in place, and the organ systems are forming. So, problems before 7 weeks tend to be problems with embryo formation. This all goes back to embryoscopy, because these problems with embryo formation result in embryos that look malformed when you do embryoscopy. There’s SO much more to say about this part of the conversation and I’m not explaining it as well as I should right now, but my point for now is that recurrent miscarriages that happen before 7 weeks (or missed miscarriages that begin before 7 weeks) mean something different from miscarriages that happen after 7 weeks.

At the very end of our conversation, Dr. A says “so, why don’t we just take a quick look at this pregnancy? I’d like see what your pregnancies look like”. We’d been talking about it as if it was miscarriage #7, and as per the conversation above, he was thinking that it would help him understand what kind of problem I have to see how things are going wrong at week 7. I wasn’t even nervous really, I was just thinking, hmm, I wonder if it’s over already?

Dr. A does all his own ultrasounds, there was no nurse or tech there, we just walked in to the ultrasound room and he flipped on the laptop that runs the equipment (very different from my current REs office!). He pops the wand in, and all I could think was, I hope he’s not looking at my super hairy legs (I wasn’t expecting to be getting naked in front of him!). And there it was. All I can say is it looked very different from any of my other ultrasounds. Right away he turned on the sound, and a heartbeat starts thudding. Very clear and strong, measuring 124 bpm. Guys, I’ve never seen a heart rate this fast before. I think the fastest we’ve ever had is 105 or something. That’s partially because of the timing, a slow heart rate is okay very early on, but our heart rates have never sped up enough. The measurement was right on track, no sign of the slow development at 5w6d. He looked for the ‘asymmetrical thickening’ of my endometrium noted on last weeks ultrasound, and it was there, but Dr. A said it didn’t bother him in the least. In fact, my bleed is even located as far as possible from the embryo, right at my cervix. This is about the best place to have a bleed if your going to have one because the blood basically just comes out, it’s not near or behind the embryo, causing pressure or shearing on the embryo.

All of this is to say that no matter what happens here (I still can’t wrap my brain around the idea that it could be okay), this is different from all my other losses. We’ve never made it this far, and according to Dr. A, the fact that we’ve made it this far means something. In fact, he thinks it means an awful lot. I still can’t manage to type out just how high he things the odds are for us with this pregnancy,  but it was high. I’m keeping my expectations lower than his, but even if I admit that there’s, say, a 50% chance of this working out, this is distinctly different from every other time. I think I might be as happy about that as I am about anything else at this point. We’ve broken the pattern!

My brain feels very very confused about what to think and feel right now. On the one hand, I just can’t wrap my brain around the idea that it could be okay. When Dr. A told us how good our odds were in his opinion, my reaction was, you can’t tell me these things. I might get hopeful, and then it still won’t be okay. On our drive home yesterday I was barely speaking, and G kept saying, “you don’t seem to realize what just happened!!”. He’s right, I don’t realize it, I’m confused. It isn’t even that I’m really trying to protect myself from getting hurt, because the more I thought about it, the more I realized that if this goes badly I should be upset. If I made it this far and I have a 124 bpm heart beat inside me now and it dies, I should be upset about that. It would be wrong to think that didn’t matter and I don’t need to be upset about it just because I expected it. If this goes badly, I have a right to be upset and I won’t take that right from myself.

It took me until this morning to figure it out, but the real reason I’m afraid to be or admit to being hopeful is good old superstition. I’m afraid that if I show that I’m optimistic and things could work out, the universe will catch on and rip it all away from me (because it has a history of doing that, you know??). It feels like I need to not admit any hope in order to protect myself from the evil universe that hates me and wants to steal everything I love. That sounds totally rational, right :)?

So, this morning I’ve started to re-engage in this pregnancy a little. It’s so odd, I feel like I jumped right in to this pregnancy at 7 weeks. I was not paying attention to much of anything from the day I started bleeding. I never calculated a due date, I never thought about what was happening in there on a given day. I hardly even thought of myself as pregnant. Suddenly, now there is a 7 week embryo inside me with a heart beating away. I don’t want to get carried away, there are still a million and one things that can go wrong. Part of me even thinks that we’ll go in to our ultrasound with Dr. O next week and none of this will have been real. There will be a sac with no fetal pole, and this will all have been some sort of bad joke (the universe messing with me again).

There are 6 days until my next ultrasound, at which point this will either start to feel a little more real, or it will be clear that this was just a little blip on the road to a miscarriage. Right now, all I can do is try to stay calm and appreciate the fact that for now I’m still pregnant.

The beginning of the end

Two days ago, at 5w2d, I started bleeding. Bright red blood along with some decently strong cramps. It only lasted for a minute or two, but it was enough to show that the process is starting. This is identical, practically to the minute, to my other miscarriages. Everything is peachy until 5w2d, and then it all turns to shit.

I have an ultrasound scheduled for Tuesday, which I expect will involve a heartbeat. The first one always does. But then the bleeding just continues to get heavier and heavier and we all know what the outcome is. It usually takes 4 weeks or so from the start of the bleeding before I have a dnc scheduled and the whole thing is over. 4 weeks of feeling horribly sick, depressed and hopeless. Here we go again.

I can’t say I was that surprised when I saw the blood. I had been checking religiously. Scrutinizing the tp every time I peed. But I had managed to convince myself that it was possible that it could be different this time. I wouldn’t say I was totally optimistic, but I was being negative either. I was even talking to the embryo, telling it to ‘please please please please be okay this time’. G was much more involved this time too. In the past he’s been so detached, not wanting to get his hopes up. But last week (after an emotional breakdown on my part) I convinced him we both needed to be present this time, even knowing it might go badly. I spent so long wishing to be pregnant again, I didn’t want to ignore the experience while I was having it. So G was asking me about every tiny symptom, and he even started calling the embryo peanut. It’s been a totally different experience, feeling like I’m not the least bit alone in this.

I don’t know why, but I haven’t cried or gotten emotional. And it’s not because I think it’s going to be okay. I’m 98% sure this is over. I think it just hasn’t hit me yet. When I saw the blood, I called G in to the bathroom to see (I know, gross, but he said he wanted to see), and we just sort of stared at it for a minute and said, ‘okay, well I guess that’s that’. We got into bed and had a long talk, but mostly we talked about what comes next. I have a feeling that at some point it’s going to hit me that this is happening now, and I will have to deal with it.

So what comes next? Ultrasound this week, more waiting and bleeding, then eventually another ultrasound with no heartbeat (I know I sound morbid, but it’s just the reality). Most importantly, this will hopefully give us the opportunity to do the embryoscopy procedure I wrote about before. The last thing I wanted was for this to happen again, but if it had to happen again I want to know as much as humanly possible about what’s going wrong. I know I’m getting my hopes up because there are a lot of factors that have to work out to do the procedure (doctor agreeing to do it, not having a natural miscarriage first, not having so much bleeding they can’t do it, etc), but I just so badly want to know what’s going on it’s driving me insane. I just keep thinking if I had some clue what was going on, I’d be able to come to terms with it. Not to mention having an idea of how to proceed from here. After my hopes get dashed over and over, it seems like too much to ask to even be able to get some answers.

On top of everything, now I’m getting sick. G has had a cold for the last week, and we tried so hard not to share germs, since I didn’t want to risk getting sick while pregnant. I managed to keep it at bay until today, but now I feel awful. Interestingly though, I don’t feel like I have a cold, I feel like I have the flu. My chest is super heavy, I’m dizzy and weak, and the nausea I’ve had for the last two weeks has increased dramatically. I don’t know if it’s just that the combo of morning sickness with a cold feels like the flu, or if there’s something else going on, but I feel like crap. I’m just SO not in the mood to be feeling so sick on top of everything else right now.

All the gory details (part 2)

bellingham

When I left off last time, I was one miscarriage and two months into the ordeal of trying to have a baby. Although my husband (let’s call him G) and I were devastated when we found out the pregnancy was going to fail, by the time the surgery was over I was relatively okay. I was so glad to be done with the awfulness of the pregnancy symptoms (the hormones have always been pretty rough on me, more on that another time), all I wanted was to skip ahead a few months and try again.

As I was coming out of anesthesia from my first DnC, I have a woozy memory of my OB telling me that during the procedure, she thought she had seen a septum in my uterus . Being the nerd that I am, I responded (probably slurring), “so my mullerian ducts never fully fused??” I taught anatomy and physiology several times, and my first thought was I wonder if I can get a picture to show as an example for my reproductive development lecture? (in case you’re curious, I did get a picture and have used it several times :), without my name attached of course). In any case, the septum was quite small, and the OB wasn’t sure that it would ever cause a problem (it almost definitely didn’t cause that particular miscarriage), but she felt she should send me to an expert to be certain.

I think this was pretty lucky really, because it meant I ended up in a RE’s office very early in the process. Most people have two or three miscarriages before they even see a specialist. Not that we did any tests or treatments for the miscarriage at that point, but it was reassuring to be in ‘good hands’ so to speak, and I never had to deal with the office full of healthy pregnant women again (the importance of this can’t be understated- I would rather shoot myself in the foot than go to a regular OB’s office at this point).

The doctor I was referred to (Dr. O), has been my doctor ever since, and I really do think he’s amazing. He listens to absolutely everything we say and will spend hours talking to his patients (literally, he’s almost always running at least an hour late because of this), and I honestly feel like he cares about us.  He’s extremely conservative in his treatment plans, and doesn’t beleive in doing things unless there’s evidence it works. This meshes well with my science-loving brain; I love data and evidence and significance testing (like I said, I’m a nerd). I hate anecdotal evidence and ‘well such and such worked for my aunt’s sister’s cousin’.

Back to the point though, Dr. O thought that my septum was small enough that it might never cause me a problem, but given the relative risks for and against, it was probably safer to just remove it. So, in the summer of 2011 I had my second surgery in about 5 months. Follow up tests showed that it was totally successful, and so after several more months of healing time we were given the all clear to try again. I was highly frustrated by how much time we’d lost already (9 months or so all told), but I felt lucky to have found the septum before it had a chance to really cause problems and of course, everything would be smooth sailing from there on.

In fact, I got pregnant very fast the second time around as well. In Sept. of 2011, the very first month we tried, we got a positive test, and we were only slightly less excited than the first time. We had learned to be a little more cautious inside, but we still told our families pretty much right away, and I whipped out the calender to figure out how the due date would affect dissertation writing and defense plans. Then week five rolls around, and just like the first time (almost to the day), I started spotting. I called Dr. O’s office and they rearranged their schedule to get me in for an ultrasound almost immediately. G left work early to come meet me for the ultrasound (he has managed to be at every single ultrasound I’ve ever had, which is no small task and speaks volumes about how much he cares, even though early on he had trouble showing it).

Right from the beginning, it was clear that pregnancy #2 was no more normal than #1. Whereas at 5 or so weeks embryo #1 was so small as to be invisible the first time around, this time there was a heartbeat, even before 6 weeks. But, the sac was oddly shaped, and had poor margins. Over time, we’ve learned you can read volumes from the face of an US tech, and this one was not impressed. Talking with Dr. O afterwards, he was wonderfully honest, and told us the likelihood that this pregnancy would succeed was not great. He doesn’t like to give odds, and my husband (an engineer), always pushes him for a number. Its become a running (if morbid) joke between them. With prodding, Dr. O said he gave it a 25% chance. I’d like to say I heard that number and moderated my expectations realistically based on it. But I did not. Outwardly, I said it probably wasn’t going to work out, but inside I still believed I couldn’t possibly be that unlucky. We suffered through two weeks of torture before we could go back for another US, but by the time our second US came around, there was no longer a heart beat. We scheduled my second DnC for a week later.

From here on out, my story becomes pretty repetitive. A few months later (January of 2012) there is pregnancy #3. Again I got pregnant fast, again I started bleeding at 5 weeks, and again on our first US there is a heart beat. In fact, #3 is the closest we have had to a normal embryo, at least in all the ways you can measure normalness in a 6 week embryo. Heart beat normal, size normal, sac normal, everything normal except the bleeding. And the bleeding was heavy. Like, pads are useless, I need a diaper kind of heavy. It was always a total shock when it would start too, once I was in the middle of a meeting with my advisor and had to excuse myself because I was fairly sure my khaki’s were not khaki any more. Another time was in the middle of giving a lecture to 30 undergrads (that one was particularly bad because the sudden loss of blood caused such a big drop in blood pressure that I almost fainted. talk about embarrassing).

With #3, the 6 week US was normal enough that the US tech actually smiled once and at the end offered to print a picture for us. Well this is certainly new, we thought. By then we knew better than to let our hopes get away from us though. And sure enough, by 8 weeks or so the US showed no heartbeat. This loss is probably the hardest, from the standpoint of my hopes that I’m capable of ever carrying a pregnancy. By every possible measure, this pregnancy appeared normal. Afterwards, karyotyping confirmed normal XY chromosome count. Yet, my body still spit it out. This makes it impossible for me to beleive that it’s just bad luck, and nearly impossible to beleive that it would ever be different.

After #3, we talked with Dr. O about testing and treatments. We did every test available, which isn’t much really, and for most of the tests out there even if you find a positive result, there’s no evidence-based treatment available. I was not one of the lucky ones (well, lucky is probably too strong a word), who get a diagnosis. I have idiopathic (unexplained) recurrent pregnancy loss. In this case, there are really only one or two things that doctors ever prescribe, and there isn’t much scientific evidence to support either. One of these is progesterone, and although Dr. O felt that it was extremely unlikely that it would make any difference, he agreed to let me try it, because it couldn’t possibly hurt. Honestly, I didn’t think it would make a difference either, but I thought at least we can say we tried everything.

The other thing I found in my reading (which I did a ton of), is that there is some reason to beleive that androgen levels may have an influence on the uterine lining, and consequently implantation and miscarriage. This was extremely telling to me because ever since the first time I got pregnant, I had been noticing super annoying signs that my androgens might be out-of-whack. Granted, they measured my actual androgen levels and they were within the normal range, but it can’t be as simple as the absolute number because I started breaking out and growing hair around my jawline in a most unladylike fashion. I know lots of women deal with this, and I’ve never had great skin to begin with, but it had become a real issue, and it was very distinctly around my jawline, which is indicative of overactive androgens. I brought this info with me to Dr. O, and he agreed that it couldn’t hurt to try a treatment they prescribe for PCOS patients to reduce androgens. He put me on metformin, which has some side effects (which can actually include weight loss, finally a perk!), but couldn’t possibly hurt a pregnancy.

So armed with the fact that we were doing something different this time, even if it only had some sort of placebo effect, we jumped back in. To my extreme frustration, month after month passed without a positive result. For those of you who have spent years trying to get pregnant, I apologize in advance for whining about this, but because I knew just getting pregnant at all was not the point, I was massively frustrated to be wasting so much time. It felt like moving backwards not forwards. I needed to get pregnant, at which point I would most likely miscarry, but at least I’d be moving in a direction. After about five months of trying (yes, I know this isn’t that long, again, I’m sorry for whining about it) we decided that the timing was really going to get too complicated to handle with my anticipated defense and graduation dates, so I called Dr. O to say I was going off the metformin and we’d stop trying for a while.

As it turns out, not trying is almost impossible for me to sit with. I became so frustrated and depressed; I was just stuck in limbo treading water (mixed metaphors much?), not even moving in the direction of what I wanted. We didn’t even make it a month before deciding to keep trying, the hell with any complications it might (or likely would not) have on my professional life. The only difference was I was no longer taking the metformin (you have to ramp it up, so after stopping I couldn’t just go back on it immediately). And I got pregnant that month. I have no good reason to think that the metformin made a difference, its only coincidental, but I have a strong suspicion it was related in some way (this is absolutely not a criticism of the drug or anything like that, it was never indicated for me to be taking it at all). In either case, we had the progesterone this time, and I was pregnant again.

With #4 I started bleeding the night Obama won re-election. I was in bed crying when G came in to tell me the news, and barely even heard him. At the first US, things were just weird and confusing. There was a strong heartbeat and the embryo was appropriately sized, but the sac was huge and abnormally shaped. The US tech was not smiling, and she did not offer us a picture. Again, Dr. O refused to give us odds, but we knew it was not going to happen. The pattern was too strong: bleeding at 5 weeks, heartbeat at 6 weeks, nothing at 8 weeks. Yet again we waited through the horror of the two weeks until the 8 week US. And for the first time, we still had a heart beat at 8 weeks, but things had gotten totally wonky in there. The sac had grown to the size of a 9.5 week sac, it was long and stretched out, and had something unidentifiable inside it (besides the embryo). This was clearly bad news despite the survival of the embryo, and Dr. O said to plan for a DnC in a week. Sure enough, by 9 weeks the heartbeat was gone and I went in for surgery #5.

So there you have it. DnC #4 was in December of 2012, exactly two years after we started trying, and here I am no closer to the prize. After I was healed and would have had the go ahead to try again (probably March), we decided to hold off trying again until after my graduation in May. Not because of graduation itself but because we felt we deserved an amazingly awesome reward, both for me getting through a PhD and to make up for the sucky few years we had had. In May we went to France and Italy for 11 days, and it was really one of the best memories G and I have together. Amazing enough to make up for wasting another 5 months or so.

Well this turned out very long (again), but I’m just about all caught up now. If you made it to the end, you deserve a prize :).