On Fecund Thought

Timeline

The “TL;DR” Version

  • April 2001: Stage II endometriosis diagnosed
  • January 2013: spontaneous pregnancy after only 2 cycles TTC
  • February 2013: missed miscarriage at 8w3d
  • August 2013: Diminished Ovarian Reserve (DOR) diagnosed
    • Antral Follicle Count: 6
    • AMH: 0.17
    • FSH: 12.3
    • E2: 46
    • TSH: 2.53 – 2.56
  • September 2013: abnormal karyotype diagnosed
  • October 2013: decide to do DEIVF
  • November 2013: matched with donor, mock cycle begins
  • January 2014: in cycle with donor
  • February 2014: Donor Egg IVF transfer
  • March 2014: I’m pregnant!
  • June 2014: I’m still pregnant!!

Here’s a good post to bring you up to speed on everything post miscarriage.

The “I Wanna Know Every Detail” Version

A blow by blow account of the journey so far, with posts that I think sum up each month.

April 2001: Laparoscopy to diagnose and treat Stage II endometriosis. Surgeons said fallopian tubes and ovaries were clear so I shouldn’t have trouble conceiving. Put on birth control pills (Microgynon in the UK, aka Levora in the US) which I tri-cycle (three packs back-to-back with no break) for medical management of endometriosis.

August 2012: Came off the pill after 11 years. Expect to be hormonal. I was.

September 2012: first (and last) ever attack of PMS. New-found sympathy for friends who suffer every month with this condition.

November 2012: Wonder why I haven’t conceived yet. Look into BBT charting. Realise there’s more to learn about one’s fertile time than I thought.

December 2012: Start charting using the Fertility Friend app. Am sick with a fever over Christmas, when I would have ovulated, so am not surprised that I didn’t conceive. Pleased with baseline data. Find out SIL is pregnant with her second child and feel a huge pang of envy.

January 2013: Got my first BFP on January 26th. Am simultaneously over the moon and fucking terrified. Shit suddenly got real. It’s the most amazing news I’ve ever had. Due date is October 5th 2013, exactly 2 months before SIL’s baby is born.

February 2013: Eating well, sleeping well, looking after myself, and am delighted in the changes in my body. Boobs grew a cup size. Bought a new non-maternity bra and tops to accommodate my swollen boobs and bloated belly.

February 8th: I can’t shake the feeling that something is wrong. The stretching pain has stopped. I call the nurse, she says not to worry, which I try not to do until my first prenatal appointment 2 1/2 weeks later.

February 26th: First ultrasound reveals an 18-day discrepancy. I should be 8w3d, but my Bean measures 5w6d. If I’d screwed up my dates (which I knew I hadn’t) then he’d be too small to detect a heartbeat. All the signs suggest this is a missed miscarriage. Am told to return a week later to confirm suspected diagnosis of Intrauterine Fetal Demise. In my heart, I know this to be true, but agree to return a week later. HCG levels: 31,877.

March 2nd: Started OnFecundThought to collect my thoughts, chronicle my journey, and generally try to make sense of what the fuck just happened.

March 4th: Slight spotting over the weekend, HCG levels of 30,932, and second ultrasound confirm that my baby died. Am in shock but, true to my British lineage, keep a stiff upper lip. I fill the prescription for Misoprostol and Vicodin and that night kickstart the process my body couldn’t. Live in pain for two days but nothing happens.

March 5th: Return to doctor for my shot of MICRhoGAM, as I am rhesus negative. Have hysterics when I see a waiting room filled with pregnant women. And so the grief begins properly.

March 6th: Avoided my pregnant SIL when she came over. Second dose of Misoprostol, which didn’t work the first time. Pain constant. I discover Jizo.

March 8th: Am worried I’m heading for a D&C. Still no show of blood or anything that could remotely be a miscarriage, but in agonizing pain which intensifies after 5pm. By 23:30, I am having contractions 1 minute and 15 seconds apart.

March 9th at 00:10: I deliver the placenta and tiny bean shortly after midnight. It is the most horrific, beautiful, and visceral moment of my life.

March 10th: Still cramping badly. WTF?

March 11th: Return to doctor who confirms there is retained tissue and that I need a D&C after all. I learn to despise the term “Products of Conception”.

March 14th: Dilation and Curettage. I am no longer pregnant.

March 17th: the meds wear off, and the physical pain subsides, leaving me in more emotional pain than I thought possible. This is not helped by the fact that my SIL is pregnant. I can’t bear to see her and dub her P-SIL on this blog.

April 7th: I lean towards Jizo, and  bury my Bean with a peace lily in a ritual the Japanese call Mizuko Kuyo.

April / May 2013: I am grieving hard. My only consolation is that everything I am feeling and experiencing is normal. A textbook reaction to my loss. I do lots of research! But where the hell is my period? And why do I keep seeing pregnant women everywhere?

May 2013: Still grieving. And now I’m worried about my thyroid — did pregnancy-induced hypothyroidism cause my miscarriage? Is that why my period still hasn’t returned?

June 5th 2013:  Aunt Flo finally arrives, two days shy of 12 weeks after my D&C. Finally, my body is returning to normal! A few days later, a scheduled ultrasound in radiology shows that my right ovary is getting ready to release an egg.  We decide to neither TTC nor prevent, qué será, será — but I’m still a bit disappointed when Aunt Flo shows a second time. (I console myself by reminding myself that it’s really good news that my body is working.)

July 2013: Cautiously begin TTC again. Delighted to be back in the game, but am also fucking terrified. How will I cope if I don’t conceive this month? How will I cope if I do? And what happens if I miscarry again?

 August 2013: Borderline high FSH of 11.7 – 12.3 means I should have AMH tested. It came back at 0.17. A total of 6 antral follicles.  I have Diminished Ovarian Reserve (DOR) and am advised to proceed straight to IVF.  I am devastated.

September 2013: First IVF consultation with Dr. D who I really like.  An hour before the appointment I learn my grandmother is dying. We delay starting IVF for a month because I had to fly to London at short notice. Whilst there, I receive the news that I have an abnormal karyotype: I have a pericentric inversion of chromosome 8, which is so rare there are ony 50 known families worldwide with this disorder. We begin to consider egg donation. The good news is that DH semen analysis shows he has no fertility issues. Phew!

October 2013: Meetings with the genetic counsellor and our RE, Dr. D, to discuss options: either proceed with egg donor IVF, or proceed using my own eggs and a very specialised form of PGD called micro array CGH with a further bespoke test designed for my specific chromosome.  Both are wildly expensive options. Meanwhile, my undue date passes.  It is bittersweet. The good news is that my HSG — painful though it was — reveals no blockages. Phew! However, Reprogenetics says they expect 75% of our embryos to be abnormal. Considering that my DOR means I won’t produce that many eggs to begin with, we make the decision to proceed with Donor Egg IVF (DEIVF).  I also made a video art project about miscarriage and infertility.

November 2013: My least favourite month begins wonderfully! I learn that I have been chosen as a contributing writer to Three Minus One, an anthology of pregnancy loss stories that accompanies the film Return to Zero.  The same day, we are matched with a fabulous donor who I refer to as Nellie on this blog.  I pass my sonohysterogram (SHG) with flying colours and we learn that DH is genetically normal (general karyotype as well as cystic fibrosis and beta thalassemia). We are also overjoyed to hear that Nellie is open to future contact and that she and I look uncannily alike! And, finally, I start the mock cycle. There are a couple of dark moments about losing the genetic connection to my future children, but all in all, November proves to be our first good month of the year.

December 2013: After a pregnancy scare (oh, the irony kills me) at the end of November, Aunt Flo makes her appearance 3 days late and just in time for Thanksgiving.  Her arrival means I call the fertility clinic and schedule a CD3 appointment for a mock cycle baseline ultrasound.  I start taking estradiol (generic Estrace) that evening, and increase the dosage every 3 days until I am taking a whopping 10mg a day (that’s over 30x more than is in a birth control pill). Side effects include nausea and a headache, but are relieved when I start taking the pills vaginally. Weekly ultrasound show that my uterine lining isn’t thickening as quickly as the RE would like.  Perhaps I am not as responsive to the meds because of my low AMH (women with DOR don’t always respond well to stims because of their low AMH)? This isn’t the end of the world — it just means that I will probably have to do estrogen injectables during the real cycle in January. Other fun news includes more pregnancy announcements and finding a second lump in my breast.

January 2014: The new year starts very well with the arrival of Aunt Flo, which means I can go on birth control to sync me up to Nellie. A week later, we learn that she is happy with the contract, and we sign. Our nurse sends me my calendar — a schedule of medication and sequence of events — and calls in a prescription to the specialist pharmacy. I pay for Nellie’s and my meds over the phone, and mine arrive the following morning. It’s a big box, and I’m very excited. Things are getting very real, but never more so than when we got a copy of our executed agreement and exchange email addresses with Nellie. I email her the next day. Other highlights so far include doing my first ever injection (I bypassed regular IVF and went straight to donor eggs, so this is a big deal for me!). Emotions run high when you’re about to do DEIVF, and there’s a lot of residual shame and grief — as I keep saying, my anxiety is at an all time high, but so is my hope…

March 2014: DEIVF worked, and I am pregnant! Technically it’s a twin pregnancy, but the second gestational sac is empty. I feel okay about it though. I would never have wished one embryo not to make it, but a singleton pregnancy will be much less worrisome than a twin pregnancy. I’ll always be grateful to Baby B, without him I doubt I would have strongly suspected in the days after transfer that I was well and truly knocked up. Meanwhile, Baby A, who I thought was a girl from the moment I saw her tiny heartbeat on the first ultrasound, is thriving. And OFT takes off in a different direction: that of a woman who is, at long last, pregnant. That is should be via another woman’s eggs is a unique slant…

I also learned that the letter I wrote to the baby I miscarried was included in the Three Minus One anthology which accompanies the Return to Zero film.

 April 2014: I graduated from my RE and had my first prenatal visit. A month of firsts whose highlights included seeing the baby move and hearing the heartbeat.

May 2014: The first of the month marks the first day of my second trimester, and I am very excited. A few days later we have our nuchal scan, where we saw a baby-shaped baby for the first time. Seeing that tiny baby kicking and stretching and hiccuping was the most wonderful sight. I fell in love, and started to realise how unimportant it is that this darling little thing doesn’t share my genes. All that matters is that this baby is here and thriving. Later in the month, we learned that Tiny is almost certainly a girl.

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