Kind Of Here

Thanks, Sky, for encouraging me to post again. Lots of things have happened, but best of all is that we had the twins about a month ago. They were born at 34 weeks 3 days and spent 3 weeks in the NICU. Despite having placenta previa, pre-term labor and pre-eclampsia, we all thought I was going to go all the way. And then dd's water broke and they were born. (Hence, why I didn't have steroids to mature their lungs and why they were in NICU so long) That said, I was in the hospital off and on for 6 weeks.

One thing I've learned: DE significantly increases one's chances for pre-eclampsia, as does twins and advanced maternal age. Placenta previa increases with IVF, twins, and advanced maternal age. And preterm labor is increased by twins.

What's so amazing is NONE of those lead to the early birth---it was the premature rupture of membranes! What a bizarre thing!! For those of you out there thinking of DE and who are, ahem, older, keep that in mind. And I'm pretty healthy!!

The twins are wonderful and I finally feel like the family is complete. Those souls who have been trying to reach us finally have. I'm sleep deprived but so, so happy.

We have not told my parents about using DE and they are constantly looking for family resemblenaces in the babies, which is sad for them. However, the twins look very much like our first son and DH, so we're emphasizing that.

I am VERY annoyed at my OB for putting our DE status on my OB records: it ended up on the kids' NICU medical records which I am pretty sure was observed by some friends and colleagues whom we think is none of their business about our twins' origins. I specifically asked our OB NOT to do that. We are planning to disclose, but we live in a part of the country which is a little backward on non-traditional family formation, and don't want to be the object of gossip in the community. (ie, this ain't California where it's no big whoop-de-do how one forms one's family).

In any case, our twins are beautiful, healthy and completely normal. We are bonding now and getting to know each other. I do think about the donor sometimes and wonder what her kids look like as well as her other donations, but these are *MY* beautiful, wonderful, amazing children. I am so proud of what they have done already in their first month of life. They are wonderful.

Yes, I'll continue posting here and reading other DE blogs. But I still get annoyed at folks who have chosen DE and appear to regret it. I am thrilled that we have found this path and that the children who have been trying to reach me for the last 4 years have finally arrived.

Well, the babies are likely to be wanting their late morning snack soon. I need to have a snack myself before I become their cow. I love being where we are right now, even though I haven't slept more than 2 hours in a row for a month, and don't anticipate doing so for another 4 or 5 months, too.

Back on the Meds

Almost immediately after our meeting with the perinatalogist, I went off the Lovenox and started tapering off the prednisone.  Then last Thursday, while on vacation and on my last day of prednisone, I woke up completely covered in hives.  I've had hives in my life before and they have always been related to stress.  Since I was on vacation, I doubted that.  Additionally, the hives covered my thighs, my stomach, my back, my arms, my hands, and were in between my fingers.  

Despite being in another country, I called my doctor on my cell phone and got his lame opinion that I must have been "exposed to something" on the trip and his good advice to go back on the full dose of the prednisone.   Within two hours, the really bad hives on my hands began to recede.  6 days later, I still have the bumps, but they are not "hive-y."

I also decided at that moment that I'm going to stay on the meds as long as I can.  I did a little mental calculation, which is the worst error:  to be on the medications and not need them or to to be off the medication and need them?  

If I'm on the medication and I don't need them, what is the worst that could happen?  Well, for the Lovenox, the only harm is the amount of money I'm paying each month ($50) to be on the meds.  It will not harm the babies or me, even if I don't need them.  For the prednisone, it may make me more susceptible to colds and stretch marks, but again, it won't hurt the babies.  

If I'm NOT on the medication and I actually do need to be on them, what is the worst that could happen?  Well, the worst that could happen is that the babies die.  

So let's compare the costs of being "wrong" in this situation:  $200 for the additional medication vs.  my babies die.  Even as cheap as I am, the $200 seems like a lot less costly than losing my children.  

I was all prepared yesterday to get fiesty with my OBs on my insistance on staying on the meds, when I was lucky enough to get the OB in the practice who has the most experience with immunology.  She absolutely no problem with me staying on the loveonx and wrote me a 6 month prescription.  She has decided that we need to get me off the prednisone (I agree) but we have to do it much, much, much  slower than my previous tapering method. (It is likely that the hives came from my body's withdrawal from the meds)  It will take me nearly 6 weeks to get off the prednisone now.  What I love about that is that we'll be close to 20 weeks or more when I'm off the prednisone and, God Forbid, if I do have a much more serious auto-immune problem than I thought, the babies will be very well established by then.  Also, if I get another outbreak of hives, we go even slower of a taper than that.  

So there we are.  

I am gaining weight at about the right pace.  I'm a few pounds behind my goal of 25 lbs by 20 weeks so I've got to pick it up a bit.  

I'm also hoping to post a bit more.  I do have some DE thoughts I want to work through.  And I have no idea why, but the NY Times continues its trend of writing stories that are highly relevant to what I am dealing with right now.  I hope we can discuss this article on what scientists are finding out about genes and their effects on personality, behavior and even height.  The long and short of it:  Personality, behavior and physical characteristics are all inherited.  However, the genes' role in "causing" these outcomes?  Not so much.  Go figure.  It's  A LOT more complicated than you are the way you are because you got half your genes from two other people.  It is not all environment, but it is most definitely not all genes.  

Just some food for thought to encourage you to read that long article, since I think it's highly relevant to us.  They have found the 12?  8?  strongest genes for predicting height in people's genomes.  And do you know how much variance the genes predict of people's height?  2%.  TWO PERCENT!!  One of the most inheritable, objective characteristics of people and genes predict 2% of how tall one will be.  (That means 98% of someone's height is predicted by something *other* than these genes)  Yeah.  I thought it was interesting, too.

Ok.  I'm posting early and it's time for breakfast number one.  

Perfectly Normal

We had our first trimester screen yesterday and the news was good.  Or, as I keep repeating in my head, the perinatologist told us that everything was "perfectly normal."  

I love perfectly normal.  I have absolutely no interest in "perfect" alone.  It's an impossible goal and statistically unrealistic.  We don't live in Lake Woebegone;  most children are "average". In my world, average is not only good, it's wonderful.  

So yes, heart rates for both twins at 160 something.  I was 11 weeks 5 days yesterday and they were measuring 11w6d and 12w0d. Their nuchal folds are thin.  Perfectly normal.  

I also had a wonderful conversation with our perinatologist, a man whom I now consider the best doctor I have.  As a research scientist, I don't expect doctors 1) to be up to date on the research, much less 2) able to effectively critique it.  Indeed, when I brought my OB a copy of Dr. Luke's research on the effectiveness of her nutritional program from a top peer reviewed journal, I attached my own critique of the study's strengths and weaknesses.  (Overall, my critique is that the effect sizes are so large that her program should be given serious consideration for mothers of twins) Anyhoo, my perinatologist was able to use his knowledge of the research to logically convince me that I can go off the Lovenox at the end of the first trimester (Saturday) without harming the babies.  He also said he would support me if I decided to stay on the meds, but there is no research based reason to do so---because I do not have a diagnosed thrombophilia problem.  

I'm not sure all my doctors understand how much I know about evaluating and interpreting research, but I do think that he understands research better than my other doctors.  

So things are moving apace.  I thought everything was going to be ok with the twins, because I am HUNGRY a lot of the day.  And I am TIRED the rest of the time.  I've never been this hungry or tired, so it seemed like all was going the way it should.  

We're off for a family vacation next week.  Happy New Year to everyone!  May we all have an easy year reaching our dreams.

Still Here

We're at 9 1/2 weeks now.  Although it sounds like it ought to be an especially tawdry time of the pregnancy, I am just starting to get fat and am moving into maternity clothes.  The bottom of my belly, where my uterus should be, isn't showing, but my waist has expanded, which is apparently what should be happening.  

I go for my second OB appointment tomorrow and am (hopefully not obnoxiously) bringing a research article on the benefits of Dr. Luke's diet, so that they will not give me grief for gaining 5 lbs already.  That is the bottom of Dr. Luke's range of what I should have gained by 10 weeks.  

In any case, if they don't want me to gain as much weight as Dr. Luke recommends for twins (40-65 lbs), they are going to have to show me the research, not just state their opinions.

Do you see why I worry that I could come off as obnoxious?  I don't want to be obno, but I am probably a bit more informed than the average patient.  And if I can help other MOMs (mothers of multiples) in the practice, why wouldn't I?

It's almost time for my next snack.  And yes, I am getting hungry for it, less than 2 hours after I've had breakfast!  

Eating for Three

The spotting has gone away:  Hooray!

Now I'm focusing on having a healthy pregnancy and carrying these twins to term.  Has anybody else started following Dr. Luke's book "When you're expecting Twins, Triplets or Quads?" I'm on day 2 of the feeding frenzy and wondering how every one else is doing.

I have never eaten so much food in my entire life.  But her research shows that gaining a boatload of weight early on reduces NICU, preterm labor, preterm delivery and preeclampsia (all the bad pre stuff).

Anyhoo, any of you other twinners following her advice?  Can we commiserate on how much food 3500 nutritious calories really represents?

Spotting

Despite reassuring everyone that spotting is completely normal in IVF procedures and telling them not to worry, my spotting has gotten worse and freaked me out.  I've been spotting, slightly, about every day in the last week.  

Today, however, the spotting turned into bright red bleeding for about 30 minues.  It stopped after that and is now back to the brown blood which indicates that things are "resolved."

Nonetheless, I finally broke down and called the OB to get an ultrasound.  I'm heading out in about 30 minutes and then heading to work after that.  

All I really want to do is nap.  I think everything is ok.  I know I'm not shedding my lining because my HCG is nowhere near 0.  Nonetheless, I have looked up the vanishing twin synrdome and freaked myself out.  

I'm hoping this is just a problem with my fluffy estrogen induced uterus and using Lovenox.  I really just want to take a nap.

UPDATE

The ultrasound went really well.  Both babies have great heartrates:  151 and 156, which indicates a 3% miscarriage rate at 7w4d.   I am also happy that they are going to go ahead and keep my u/s appt on Friday.  So more looks at the babies, then, too.

Ohmygoodness

Well, we just got back from the OB for our ultrasound.  And much to my surprise, there are actually TWO in there!  Holy Cow!  I had totally convinced myelf that there was only one, and I was once again, wrong.  WOW.  

They are measuring exactly on schedule:  6w4d and their heartbeats are 124 and 125---perfect.  Once you get heartbeats in the right range, things just look a lot better for a positive outcome.  

So, we're pretty excited!!  And a bit freaked out!!!

Holy COW!

Checking In

I have to be honest:  I hate when the blogs I follow do not update regulary.  It's annoying, worrisome, and it makes me cranky.  So to the folks out here who are following:  my bad.  Work is crazy and also as this is my donor egg blog vs. my "regular" blog, I'm just more focused on discussing issues DE issues here than every thing else.  

So far, I'm not feeling a lot of "DE" issues. In fact, I mostly forget that this wasn't a traditional IVF procedure.  I'm certainly much, much less worried over this pregnancy since any of the others since DS.  I'm certainly having a lot more "signs" in this pregnancy (fatigue, nausea, boobage pain) than the other pregnancies.  I did look to see if this was related to age, and couldn't find any research that supports that.  So maybe there are two in here.  I'm not convinced, to be honest.  Maybe both blastocysts made it, but I'm thinking there is just one strong one in there.

That said, my best previous indicator that I was pg was being convinced I was not.  So maybe for the first time believing that there's only one in there, I'll be very surprised.  

The only DE issue that continues to work me us is seeing people whose cycles don't work.  It's very frustrating and sad and it still bothers me a lot.  

In any case, ultrasound next week to see how many people are in there!  I'm glad on the days I feel like crap, of which today would be one of them.

Beta's are In

The clinic called and I have, I think, good numbers for the betas:  the first one was 600 and the second one, 4 days later, was 2900.  

The dates are 10dp5dt and 14dp5dt, which are in the normal range for both twins and singletons at betabase.info.  BTW, if you don't obsess ove the numbers at betabase.info when figuring out how your numbers compare to others, you should.  

The doubling rate is about 43 hours, which is good, although not great.  40 hours would be "great."

In any case, I voting on a very strong singleton in there.  I don't think there are two little ones making a home any more, although I did after the first numbers came in.  

I have to be honest that I don't feel out of the woods yet.  I know this is a whole new ball game with fresher eggs.  Nonetheless, after a bazillion miscarriages, I'm just not sure when I'm ever going to feel "safe" and "pregnant."  The only time I felt that way was the first pregnancy, when I was too stupid to know any better.

I'm Freakin' Pregnant

I have mixed feelings posting this because although I'm thrilled for me, some of the blogs I'm reading do not have good news.  So I'm very sad for folks who do not have good news.

But Holy Crap, we're pregnant.  I've taken 3 HPTs starting at 5dp5dt (10 dpo) and we started off with a faint but visible BFP and this morning it is a shining, bright pink line.  I know by the darkness of that line that we've passed the level of chemical pgs that I've had in the past.

The official blood test is still Friday, but we are feeling very positive about how things are going.  

Holy crap!  Yay!!!

Thinking of Testing Soon

Well, I know I'm not supposed to be having any real symptoms yet.  I'm really only 9 dpo. 

Nonetheless, starting at about 2dp5dt (7 dpo), I started getting serious indigestion after eating.  This has always been a good sign of pg for me, especially when it occurs after several meals across several days, which it has.  

Last night at 3dp5dt (8 dpo), I started getting the tingly boobs.  This, again, is generally a good sign for me. 

And then today, 4dp5dt, I have had the worst nausea.  It comes and goes, but when it's here, it's pretty damn crappy.  I have also had anxiety nausea, but this feels completely different.  

Yes, I do understand that this could all be in my head.  Or it could completely be side effects of PIO.  But usually I have one or the other, not all three and not at "appropriate" times.  

I am so not one to wait for the blood count.  Even if I do test too early, I'd rather be prepped for bad news than to have bad news sprung upon me.  Plus, I've taken so, so, so, so, so many pregnancy tests (including a positive one with a 4 beta blood count), that I do know the difference between a really faint positive test and an absolutely, completely negative one.  (At least on a FRER).

Of course, the only times I've ever been pregnant have been when I've been completely convinced I'm not, so now I'm pretty much doomed.

Holy Freaking Shit

We ended up with 14 frozen embryos.  

That means with the 2 that are digging around in my body (and can I just say OH!  I'm having real cramps), we ended up with 16 out of 21 high quality embryos.

I am *only* putting this number on this blog and am telling only one or two friends about this.  Clearly, we are excited, but realize we are going to have several serious choices down then road.

But right now,  hooray!!! Something is going to work out some how!!

(And yes, I do feel guilty for others out there reading the blog who are not getting as good as news.  I am sorry.  I hope my 8 miscarriages allow a little softer feelings directed our way)

Transfer

So far, so really, really good.

They transferred 2 blastocysts that were just beginning to hatch.  The doctor said they look "great".  The embryologist said that they were starting to hatch is a good sign that they are going to continue developing.  The hatching thing, in the DE Mommy household, means that the embryos have got their downpayment in their pockets and are looking for a good location to buy their house.  

I am actually not overly stressed right now that things might not work out.  They have already frozen 9 other blastocysts (a number the embryologist called very "unusual" and "good") and it's possible that there are another 2-5 yet that could make the grade for the clinic to freeze them.  

At this point, things seem good.  I'm "taking it easy" for the next three days.  I don't need to be flat on my back, but they'd prefer I stay off my feet, so I am going to.  

I'm already feeling a little crampy.  I hope the little guys have decided the location has a good view and it's time to dig out the foundation.

Didn't See That Coming

For the first time in what seems like a long time, the surprise has brought us good news.

As of yesterday morning, we have 15 fertilized eggs.  As of today, we have *21* fertilized eggs.  Apparently, some of eggs decided to wait a little bit before they got going.  

Yes, that is right.  15/22 yesterday 21/22 today.  I have to be perfectly honest with you:  this is the first time EVER that I think things have a chance to go well.  

Of the 21 embryos that we have now (21!!!),  there are four 5-cell ones rated fair, 16 4-cell ones with 6 good and 10 fair and 1 little 3-celler who is fair and trudging along.

I repeat: Holy Shite.  Maybe, just maybe this is going to work out.

Fertilization Report

We were on the road yesterday and just now got an internet connection.

15 of the mature eggs fertilized. 

They said that was a good number.  We are waiting for the report today which tells us how the eggs are doing and whether the transfer will be tomorrow or on Tuesday.  

Emotionally, I'm doing well.  15 fertilized eggs is good, I know.  I, oddly, remain anxious for each day's update.

The nice thing is that my insomnia is keeping me on east coast time.  So hopefully, the trip back will not require a lot of adjustment.  I remain happy for the little things.  ;-)

Update on Eggs

Well, things are so far looking good. They retrieved 26 eggs and 22 are mature. They are going to call us today and let us know how the ICSI and fertilization rate. They decided to go ahead and fertilize all 22 of them.

This is all good news for us, but I am sad for one important person. Our clinic has a policy of freezing any extra eggs past 20. One reason is: what is a couple going to do with 10 extra embryos after they have twins? With an 80% success rate with fresh embryos and a 70% success rate with FETs, couples in this clinic are probably often faced with this issue. In fact, I came to this clinic because my good friend had 15 frozen unfertilized eggs that she donated to me. I guess because it was so "easy" to get those eggs, I thought it must be a common occurrence. Apparently, having extra eggs to freeze is not all that common.

We wanted to give these extra eggs to a good friend of ours who, as we do, really wants to have a baby. In every, single scenario I've imagined for this cycle, we were going to have extra eggs to give her and she was going to get a "good" chance with these frozen eggs. I felt like we would be paying karma forward.

So I am very happy for us. I think we may actually have a chance with these eggs, although like Summer said, when it's your cycle, you expect the next news to be bad. But I am very sad for our friend. I feel like we promised her something we can't deliver and took back an incredibly precious gift.

I feel like this post sounds sad even though we have some great news. And I'm not sad for us. But I am sad for my friend. And sadness while trying to get pregnant? Well, that's an emotion I'm used to.

Also, my ass hurts like hell. PIO doesn't hurt going in, but my booty is wondering what the hell it ever did to me for me to treat it like that

Retrieval is Thursday

One weird thing about using an out of state clinic is getting on the airplane and thinking, "Holy crap, we are going to California to get pregnant.  This is a BIG deal."  

Trust me on this one.  

The retrieval is officially on for Thursday.   I went in today for my final uterus review:  it was perfect.  It's nice to hear one's woman parts are doing well and even attractive.  I don't have an estimate of the number of follicles right now, but everyone is very excited about it.  The nurse says "all the boxes are checked" for us to get pregnant.  We are planning on a 5 day transfer on Tuesday.  

YIKES!

I am still not fully convinced this is going to happen.  DE Daddy was late coming home the other day (by about 10 minutes).  I heard some sirens and I thought "well, that's it.  He's dead. That's this cycle's reason why it won't work."  I'm actually a positive person, but with all that's happened, I'm still not convinced about our good luck.

I think I need to go have a glass of wine.  While I can. 

Still Still On!!

It looks like retrieval is going to be on Thursday.  

!!!!

The donor has between 25 and 30 mature follicles.  She's coming back in tomorrow and I think they will trigger whenever it is so that retrieval will be on Thursday.  I am actually quite relieved because we're flying out on Tuesday and I would rather have a day of wiggle room in case there are problems with the flight.  And please don't let me have just cursed the flight by blogging that.

I also learned that they have a pretty standard protocol that is what Beer's recommends and that my real struggle (?) is going to be getting my regular OB to follow Beer's protocol should I be fortunate to get pregnant.  My OB is pretty progressive, so I'm thinking that will work out, too.

In any case, we're packing up the pharmacy and a few clothes and heading out tomorrow.  I'm hoping the hotel has internet so I can check in and let folks know the status.  I still am not convinced this is going to happen.  We'll see.  And we'll definitely hope!!

Getting Ready

We've spent some time this weekend getting ready for the trip.  I took all the medicine out of the cabinet and put it on the counter so I can pack up the small pharmacy to carry on the plane with me.  I would look like a terrorist with all these syringes if it wasn't for the fact that all I could do is make the pilot get a better uterine lining.  At least if I was doing traditional IVF, I could make him or her ovulate.  

I also went through the boatload of books on my bedside table to clean up a bit.  There, I found the Dr. Beer's book on auto-immunity and pregnancy.  Despite being an academic and an infertile turtle (thus reading everything), I found that book very hard to read and understand.  His web site is not much better.  It doesn't help that he's been dead for quite a while, eh?

Nonetheless, it's been a year and a half since the doc's suspected an auto-immune problem and I started looking through the book.  That's where I discovered that the low dose aspirin/prednisone/heparin (or lovenox) regimine that I am on is pretty much the real standard one.  Beer recommends a couple of other transfusions, but those are quite controversial and my problem, if I have one, does not require that.

I generally am skeptical that I have a problem.  I mostly see this as a "can't hurt and might help" approach.  And then I read about rashes, like the massive excema I had during my last pg and have never had before or since, are good indicators that the body is dealing with some "inflammation" from the pregnancy--a sign of an autoimmune problem.

And then I start to freak.  I am using donor eggs because it's obvious my eggs have gone past their use by date.  However, if I have an auto-immune problem, it doesn't matter whose eggs I'm using, there is still going to be a problem and I could not be able to carry my child(ren) to term.

Here is where 1) I love my clinic and 2) I'm glad I reread the book.  I have emailed the clinic several times asking about this problem:  I don't have the MTHFR mutation (I call it the m*ther f*cker mutation), but the excema is still a sign.  They have apparently done additional research and are now running bi-weekly tests on my blood to see how things are going.  This is exactly the protocol from Beer for auto-immune testing before conception.  

Folks, the clinic actually took my questions and concerns seriously.  Holy Cow.  I don't recall that ever happening before.

I also now know what Beer recommends for both protocol and testing during a pregnancy.  The heparin should last until 34 weeks.  Testing for progesterone among other tests should continue weekly until 12 weeks.  Ultrasounds should occur every 2 weeks after week 6 for the entire pregnancy to see how the placenta and the baby are developing.  I know this is a lot of monitoring.  But if something is going wrong, we need to know soon enough to adjust my meds so I don't lose the baby.

In any case, things don't seem so carefree any more.  I am happy that I am at a place that I trust and who will listen to me.  But I worry about being more of a freak than I originally thought.

Tune in tomorrow when we find out the donor's next follicle count and when she will trigger.  It's getting kind of crazy!!

Still a Go

Our donor went in for her follow up today.  She has 20+ follicles from 8-13mm today with a 500+ Estradiol.    Apparently, that is good. 

Even better, we are fully on.  The FDA tests came back normal.  We are, at this point, planning on going to CA for our retrieval and transfer.

It's on!