On 13w3d & making the announcement!

After a great visit at Maternal Fetal Medicine on 03/08 (officially 12 weeks), and an awesome NT scan, we decided to make the "official" Facebook announcement. Here's Mojo in his big brother shirt!

I was honestly surprised by the amount of people who responded to the post. My BFF says that this is a "celebrity" thing, lol. But, we really had hundreds of people "like" and comment the post. It feels nice that so many people are already being so great about the pregnancy. The day after our FB announcement, I posted a bit about our infertility struggles and our journey to the twins, and that was really well-received as well. I've gotten tons of messages, text messages, and hugs from people who have said it helped them to know others are dealing/have dealt with it. I will never understand why IF is treated as some dirty little secret.

Anyways, the NT scan was great. We got to see both babies, see their brains, the blood flow through the cords, their legs, arms, hands, everything. I loved the detail and to see them moving. We did Baby B (right upper) first, as that baby is sooo much more calm than Baby A, and always cooperates nicely. Baby B had a heartrate of 150bpm.

Baby A is definitely my wild child. This baby never wants to cooperate for ultrasounds, and is constantly flipping around and waving like a crazy person, lol. We would be doing pictures and measurements of Baby B, and you could see Baby A off in the background waving and moving. It was hysterical. Baby A had a heartrate of 145bpm.

Here are both of them in their fake bunk beds. ;) Baby A is on the bottom, Baby B is on the top.

I feel pretty confident that Baby A is a boy. I'm not exactly sure why, but I just feel that way. I've felt "boy" from the beginning, like I've felt "twins" from the beginning, so I'll be beyond shocked if they are both girls. DH's dad thinks Baby A is just a girl who doesn't like her picture taken, lol. My sisters all think it's 2 boys, whereas most other people think I'm having one of each. I'll be honest - I'll be happy with anything.

We find out genders on 05/10, and plan on doing a gender reveal party on 05/12 (Mother's Day). I need to start planning for that, but I plan on just having some family and friends over for some snacks and to see what the babies are.

Here's a picture of me with my bump on Saturday at the Irish Parade. I HATE the picture of me (I swear my face looks so round and fat!) but it's neat to see my bump. I definitely look much bigger than 13 weeks, but I was told to expect to measure about 6-8 weeks ahead throughout the pregnancy, so it makes sense. I've gained about 7-8lbs so far, and while I'm definitely more "flabby" since I haven't been able to work out, almost all of my weight gain is definitely in my belly area.

Overall, I've felt pretty good. I'm still nauseous most mornings, but the vomiting has definitely decreased. I have to eat small meals versus normal sized meals, my stomach just can't take that much in at once. I've definitely felt some "stretching" in my belly area, yesterday I swore my belly button was stretching, lol.

I've been weaning off of the progesterone injections, and in fact, my last injection is tomorrow! I'm so excited. I've also been weaning off of the Endometrin and should be done that soon, as well. :)

I feel so lucky about everything and I'll take every single symptom and every extra medication if it means a healthy pregnancy.

On 10w5d

Here are pictures of the twins from the visit at Maternal Fetal Medicine on 02/11/13.

It took me until just now to realize that the RE's office and MFM refer to the babies differently. Those labels are from MFM, but my RE refers to them in reverse.

Anyways, here is a picture of the twins from the visit with my RE last Friday, when I was exactly 10 weeks.

The baby laying sideways was asleep until the ultrasound tech jostled it with the ultrasound wand, and then it woke up and went crazy. The other baby was moving around like crazy the whole time. Both had strong heartbeats (163 & 164) and were really active. I always cry at the ultrasounds, but this one was special because they actually look like babies now. 

The RE released me from their care. They gave me my weaning schedule for the progesterone injections and the Endometrin, and it basically has me on some sort of supplemental progesterone through Week 16. :( I'm not happy about that (I cannot stand the friggin Endometrin anymore), but I am feeling a bit better since starting to wean from the injections.

I saw my OB yesterday, and she said everything looks great. We got to hear both babies' heartbeats on the doppler, which was pretty much amazing. It really does make things more "real". She was surprised at how easy it was to pick them both up, and it's funny to be able to tell where each one is in my body.

I've gained 3 lbs in 4 weeks, according to the OB's scale. She is really happy with that, especially given how much I've been vomiting recently, even with the Zuplenz and the Zofran, and said I could stand to gain a bit more weight. My next appt with her is in 4 weeks.

Next Friday, we go to Maternal Fetal Medicine for my NT scan, and then we plan on announcing the pregnancy (as long as everything looks good). I want to try to find out when they plan on doing my gender scan, because we are thinking of doing a gender reveal party. :)

On 9w5d

I feel like I've been neglecting my blog. :(

In general, right now, my life revolves around doctor's appointments.

On 02/08, I went for a follow-up with my urologist about my kidney stone. He said everything looked good, the stone probably passed (thank you, lemon water!) and that he wants me to come back after I have the babies so they can do x-rays to make sure there are no issues and so that I can finally do metabolic testing to figure out why I always get stones.

On 02/11, I had my first appointment with Maternal Fetal Medicine. First, a tech did my ultrasound, and we got to see both babies. They were really in-depth with measuring everything and checking in on them. I loved it because they have a large TV screen so DH & I could both watch everything that was going on. Baby A (on my right) had a heartbeat of 167bpm. Baby B (on my left) had a heartbeat of 163bpm. Overall, both babies were measuring right on target and were much closer together in size.

After the ultrasound, I met one of the perinatologists. I loved this guy! He was hilarious and wanted to do his own ultrasound to check on everything. You know how with most doctors you feel like they are just waiting to move onto the next patient? I felt the exact opposite with this doctor, I felt like he would've stayed with me all day to answer questions if I had them. He was really happy with how everything looked and said that he's about 85% certain they are fraternal twins, due to 2 sacs/2 placentas/a thick membrane between them. He answered any questions I had and told me I should be prepared to deliver about a month ahead of time. He said I could always carry longer, but just to be ready for it. He also went over my list of other specialists and he seemed so pleased with the doctors I have - he spoke so highly of all of them, which put me at ease.

The next day, on 02/12, I had an appointment at my RE's office. I got to see the babies again, and she gave me a script for Zuplenz. Basically, it's the new version of Zofran, and instead of being a dissolvable pill, it's a little dissolvable strip (remember those breath strips things, it's just like that), and it works in 10 minutes, plus it's double the dosage of Zofran. I love it, and it works so well.

On 02/14, I met with my endocrinologist. My thyroid has been perfect with the Synthroid and he hasn't even needed to bump up my dosage yet.

DH & I had a great Valentine's Day dinner with friends and he got me new earrings that I love. For his gift, I bought us plane tickets to California in May to see all his friends and his dad "back home". He loved it!

I did my first 1 hour glucose test on Monday, and also handed in my 24-hour urine. My OB wants to be proactive about the family history of diabetes and heart disease/hypertension, so they wanted good baselines before I have any issues (hopefully I don't have any issues, but who the heck knows!)

My next appointment is Friday with my RE. I'll get to have an ultrasound and they are going to try to start weaning me off of the progesterone injections. I'm so excited, lol. I also started gathering up all of my unused fertility medications and syringes and stuff - I'm hoping they will accept them as a donation for other patients.

I ordered the first set of baby furniture, and that came in yesterday. My plan is to keep the babies in a bassient in our room for the first few months, and then move them into the same crib in the nursery. After a few months, I'll separate them into 2 cribs, and then maybe once they move into toddler beds, put them into 2 separate bedrooms.

Overall, I have felt pretty good. I've had some intense nausea and vomiting the past week or so, but the Zuplenz really helps, as does drinking juice first thing in the morning. Crackers and ginger ale don't seem to help me at all. :( I'm super bloated, have been in maternity pants or using the belly band since the Superbowl, and I've gained about 7lbs so far. I know alot of it is water weight from all the progesterone, but I'll take the 7lbs regardless. I already have a baby bump, which I love. It cracks me up to look at it in the mirror.

On Cycle #12: 7DPIUI Ultrasound & my crappy lining

Well, even with the daily progesterone injections and the 300mg daily of Endometrin, my lining is still shit - 4mm IE/TL. The TL part is good, but the rest is just shit.

I spoke to my favorite nurse and she plans on asking the RE if I should have laproscopy or a sonogram done to see WTF is causing my lining issues. In most cases, normally, you only see lining like this if a woman has had D&Cs or several infections before. Obviously that's not me since I've never been pregnant and I've never had an infection, so who the hell knows what's going on. She said IVF isn't even an option right now because there just isn't much for the embryos to attach to. As always, she said it's still possible for me to get pregnant, but let's be real here - it hasn't happened yet, so what REALLY are the chances of it happening? She said there are also some other medication options since the Menopur didn't bulk up my lining like they hoped. Her plan is to talk to the RE today to figure out next steps if this cycle isn't successful - hopefully by my call back this afternoon, I should know more.

I cried the entire hour long car ride from when I pulled out of the RE's parking lot to work. I am crying at my desk writing this.

I am physically exhausted from the poking, prodding, injections, suppositories, and all of the side effects. My butt is bruised from the friggin progesterone injections.

I am mentally exhausted from worrying about timing everything correctly and getting to my appointments and trying to figure out what is going on.

I am emotionally exhausted from wondering WHY this is happening to us and WHY other people have babies so easily.

I know it's bad when I hear disappointment in DH's voice when I give him the news.

I am no longer hopeful at all about this cycle and almost want to stop the progesterone injections and the Endometrin because what the fuck is the point?

If it's not one thing with my body, it's another fucking thing.

I am beyond bitter and mad at the world right now.

On Cycle #12 & IUI #4

I had my 4th IUI today - maybe fourth times the charm?

I had to drive to a further office because, due to the fire at my RE's office, they aren't doing procedures there. I definitely needed the "avoid ghetto" button on the GPS today, good lord.

Anyways, I got there and had my ultrasound. It showed the bigger follicle definitely released, but they were unsure if the smaller follicle released, although they think it did. My lining was only 5mm IE. The IUI nurse said that the lining measurement today isn't as important as what it looks like in 3 days. She said that they'll start me on the Endometrin tomorrow and the progesterone injections tomorrow. I go back in a week for bloodwork and ultrasound to see how the lining is doing. At this point, I really have no clue what else we could possibly do to boost up this lining, ya know? I have faith the progesterone injections will do the trick.

I turned my normal Negative Nancy thoughts into positive thoughts today. I refuse to let my lining number affect my thinking. We had 1, possibly 2, good eggs in there, great timing, and 30 million or so strong swimmers to work with. The progesterone injections are going to help my lining, the Lupron is going to help implantation and this is going to be my cycle. While I laid  there for the 20 minutes, I just kept thinking "those little guys are going to find my egg and it's going to be great." That's how I'm thinking today. :)

Edited to add: That was the most uncomfortable IUI I've ever had. I was feeling super crampy all morning, and what normally feels like a Pap felt very uncomfortable, almost painful. The IUI nurse said that sometimes when you release a large follicle, or multiple follicles, the fluid stays in your abdominal cavity and that's the pain/cramping you feel. Here's to hoping that different means good things.

On Uterine Lining

Since my primary issue seems to stem from my uterine lining, I decided to do a little internet research on it.

From looking at my ultrasound slips, I've noted there are 3 types of lining "grades" that my RE likes to know about: TL, IE, and HH.

From Livestrong: "The pattern changes during the menstrual cycle; a good pattern in the first half of the cycle, before ovulation, is not a good pattern after ovulation. A trilaminar lining, also called a triple lining or a TL pattern before ovulation is best for conception. Once your body produces progesterone, your lining should change to a homogenous pattern, sometimes called an HH pattern. A lining of between 7 and 12 millimeters is optimal for conception, but people can and do get pregnant with linings as thin as 3 millimeters, Dr. Timothy Hickman of Houston IVF reports on the Fertility Today website..."

From INCIID: "As you approach your LH surge, it should be above 6 mm, ideally between 8 and 12 mm. (If it is much more than that, it may be advisable to ask about a hysteroscopy or sonohysterogram to see if perhaps there is a polyp inside the uterus). You want to have a triple stripe pattern around the time of the LH surge and ovulation. Towards the time of implantation, you want to have a more integrated HH or IE pattern. The triple stripe occurs in response to estradiol; the HH/IE conversion is in response to progesterone. It should also be noted that, although most doctors prefer the above pattern of linings, there is no conclusive research on whether a better pattern actually results in higher pregnancy rates..."

Then, I found this article about pregnancy rates and lining, which shows that the lining should be at HH 3 days after transfer (in IVF, so you'd have to conclude the same should be true for IUI).

I had an IE pattern yesterday at my baseline, now time to see how it goes the rest of the cycle. At my last cycle, I had HH (I forget what thickness) at 7DPIUI, and that's when the nurse said I needed the progesterone injections daily versus every other day.

On Progesterone Injections

... they hurt.

My poor little butt cheeks are sore!

On Being Hopeful & Thankful

After my complete breakdown last night, and my puffy eyes this morning, I felt absolutely desperate about my situation.

I was scheduled to see my favorite nurse at the RE's office to get a progesterone injection at 8:15am. When I went there, I saw the damage that had been done to their building as a result of the fire. They are now working in another, older, building that hadn't really been used in years. They have no phone lines, so they are all using their private cell phones to contact patients. They don't have fax machines, so they are using the fax machine at the pharmacy across the street. The absolute dedication of this staff is amazing to me. My nurse relayed to me that they were able to save all of the embryos from the fire - it truly touched my heart.

My nurse told me that not only is my endometrial lining thin, but it also isn't the best 'grade' to sustain pregnancy. They like it to "switch over" to a certain grade after ovulation and mine doesn't do that, so they are hoping the progesterone injections help with that. I'll do the injections every day after O, in addition to the 300mg Endometrin. I'm going to be a progesterone monster, lol.

After receiving my injection, and progesterone supplies for our vacation, I spoke to my nurse about moving to injectibles. The conversation with her made all the difference in the world. She has a very "kick ass" attitude, and talks to me like I'm her friend. She told me she really studied my chart before asking the RE the best steps, and it made me feel like they are really trying to fix the underlying problem and treating me as an individual patient, not a number. She said if I wasn't pregnant next cycle, I should definitely move to the injectibles. I told her that if I'm not pregnant this cycle (I honestly am not hopeful about it at all), I want to move to them for next cycle.

She is going to have them handle calling my pharmacy to get them all ready for me. I don't know my exact protocol yet, but she said because I already ovulate on my own, and early, I'll probably only need 5 days of low dose injections. She said I'll still do an HCG trigger, IUI, Lupron, and my progesterone. She said the biggest risk with the injections is overstimulation and multiples. Honestly, after this struggle, I would welcome multiples. I don't want to be Octomom, but twins would be more than welcome. Also, because they monitor you so closely, we'd know ahead of time if this is an issue and she said I could cancel the cycle or do emergency IVF. Overall, her attitude was very much "you've got this" and she told me it would be easier, side effect wise, for me versus the oral medications.

Because I've been such a whiny bitch, I want to come up with a short list of things I'm thankful for in this journey.

• A supportive husband who deals with my crazy ass, and comforts me during my crazy and has never, not once, complained about a single thing ever. "Look, in my opinion, the best thing you can do is find a person who loves you for exactly what you are. Good mood, bad mood, ugly, pretty, handsome, what have you, the right person is still going to think the sun shines out your ass. That's the kind of person that's worth sticking with." - that's my husband
• My husband's awesome insurance that covers all of this stuff with very little OOP cost to us.
• Living in an area where we have a few excellent RE practices to choose from.
• Being able to seek treatment before the "1 year of trying" guideline.
• Having the ability to seek a 2nd opinion about this journey, and falling in love with a new RE practice.
• The support that my friends and family who know about our issues have shown me. They, too, deal with my crazy and haven't complained about it, yet.
• Having friends who are also going through the same thing that TRULY understand the emotions associated with it. I don't wish this on anyone, but having friends on the same journey makes a huge difference.
• Thong pantyliners - life on Endometrin would not be the same without them, lol.

On Cycle #11: 7DPIUI Ultrasound & Bloodwork and Next Steps

I had my 7DPIUI bloodwork and ultrasound today. I didn't get my hopes up about my lining, and I'm glad I didn't - it was only 5mm. This is after the increased Endometrin (300mg daily) and alot of hoping and praying on my part.

The nurse, actually, my favorite nurse, just called me a little bit ago with the results and with some news. The office caught on fire today. She said it was really bad and that they are all working off of their cell phones in another building. I felt awful but it speaks to the practice's dedication to their patients.

Anyways, she told me about my lining and asked if I'd been doing my Endometrin as prescribed. I, admittedly, had slacked off in previous cycles, missing doses and what not - but had really been on my game this cycle. I friggin plan my life around this crap and the ridiculous side effects. She said that I need to come in tomorrow to learn how to give myself progesterone shots. Something else to add to my repertoire.

She told me not to lose hope about this cycle (is not losing hope even possible when you are on this journey and the doctor's office calls with any news other than "you're pregnant!"?), but that the RE's recommendation is that if I'm "not pregnant in a few cycles", I should move to injectibles.

The same news the original RE told me.

The reason I sought a 2nd opinion from this practice.

The thing is, moving to injectibles in and of itself is not all that distressing to me. I know it'll be a lifestyle change, and there will be alot of work on my part (not that there isn't already), but I'm accepting of that. I have already accepted that my husband and I will not get pregnant "the easy way". Any baby I have will be the result of endless talks with nurses and doctors, endless needle pokes, endless ultrasounds, and endless tears. We will not ever get to be carefree about this journey. Every little thing will have some meaning to us along the way.

The thing that frightens me about the injectible medications is that if they don't work, it's onto IVF we go.

Of course, DH had already left for work when I got the phone call. So, when I called him with the update, I really tried to stay strong. He asked if injectibles are what I want to do - but the answer is always the same, what choice do I have? I want a child. I'll do whatever I need to do to have a child. THAT is what it comes down to.

I hung up the phone with him and have been just crying since.

I just made this my Facebook status, and it basically completely sums up how I feel - my complete & total Type-A personality does not understand a task where you do all of your research, follow all of the directions, do everything right, and still fail. I am not accustomed to not achieving things I set my mind to and do my best at.