26 week milestone

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Today we’re officially 26 weeks…me and the boys.  They could be born today and have a 80-90% chance of surviving.  This decreases my anxiety quite a bit, but, as I’ve read, we IVF Mom’s tend to worry more than other Moms every single step of the way.  We’ve been through enough heartbreak and tragedy that we do not take any of this journey for granted.  That being said, I’m having a lot of fun.

They have gone from little butterfly kickers to rabid weasels tied in a pillow case.  They are actually PAINFUL.  One likes to cuddle up into my ribs and decrease my lung capacity to half and the other thinks Bertha (my uterus) is his personal DoJo.  I have gone from a little paunchy to freaking humongous.  I no longer fit into my size 10 pants at one point, so I brought out the 12s.  I no longer fit into the 12s, so I bought size large maternity clothes from thrift shops.  I have now OUTGROWN MY #@^$% MATERNITY CLOTHES and have had to buy a new set in XL.  Apparently, my ass is pregnant too.  There’s a set of twins back there, presumably girls, just to keep things balanced.  And, speaking of “balanced”, there’s no such thing in pregnancy.  I am truly a T-rex, just flailing around, running into everything, knocking stuff off tables and shelves, then just staring at said items. “What falls to the floor, stays on the floor.”  My hubby told me to stand up straight for our last couple of belly pictures, so I had to look in the mirror to see what he was talking about.  I straightened my low back to a normal bend and promptly fell forward.

Sleeping is always an adventure.  I run a humidifier because the pregnancy congestion makes me mouth breath and snore otherwise.  I have a full bottle of Gaviscon in arm’s reach for the deluge of acid that likes to sit in my esophagus.  (There’s actually a bottle in every room at this point.)  Then, I have 5 pillows that need repositioning whenever I turn.  I tried one of those big pregnancy “U-shaped” pillows, but the shape and bulkiness is just not flexible enough for my needs.  Now, let’s talk about the turning in bed. I’ve started sleeping on what a nurse would call a “draw sheet” so that I can pull on it and help myself turn.  Otherwise, I’m just a turtle on its back.  Don’t want to have to wake up hubby to help.  He’ll get his turn at sleep deprivation when the boys come.

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But, with every hardship and every pain, I just smile and thank the boys for being there and being healthy.  How can I complain?

Vastus lateralis muscle

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I got tired of being impaled in the same two muscles every day.  “Choose a different spot!” I says to myself.  I’ll tell you right now that myself is really stoopid.

I decided to give my progesterone in the thigh…the vastus lateralis muscle.  Now I can’t climb stairs, stoop, or…pretty much anything.

Will someone please remind me not to listen to myself any more?

The Final Countdown

Today is the day.  I’ve tolerated the deluge of white, chalky discharge.  I’ve learned to trust my spouse with a 1 1/2″ dagger pointed at my flesh, filled with honey.

Any number of things could go wrong. It seems so remote that it all will work perfectly.  In times like this, I understand the lure of a belief in a micromanaging, omnipotent being.  I feel so impotent.

Money Well Spent

As the clock ticks down on my fertile period, I feel fortunate that I am able to afford and am given the opportunity to have PGS on my little guys.  As insurance paid for all the actual IVF costs (minus copays for medications), we shelled out approximately $10,400 for genetic screening.  DH did not want the complication of caring for a special child and while I agreed, I did not want to have to explore the ethical concerns that come with terminating a chromosomally abnormal child.  In the end, we cycled 4 times and tested 15, day 5-7, expanded blastocysts and found 4 normal.  2 boys and 2 girls.  Ah, sweet perfection.

I had a moment yesterday when I questioned all that expenditure for the last 3 cycles.  For 6 embryos, certainly we could have just used the plug and chug method.  Whichever embryos took, were good. There.  $6,600 saved.  Then I took a good look at the results and consulted with Dr. Google:

Cycle #1

          Karyotype        Result or phenotype

  1. 48,XX,+6,+21      No pregnancy or Miscarriage
  2. 47,XX,+13           Patau Syndrome: late development, mental disability, multiple malformations, cardiopathy, kidney abnormalities, decreasing of muscle tone, small hands, small ears, small head and mouth, as well as wide and short hands with short fingers. More than 80% of children with Patau syndrome die within the first year of life.
  3. 45,XX,-19            Miscarriage
  4. 46,XX                   Normal
  5. 46,XY                   Normal
  6. 46,XY,+1,-22        No pregnancy or Miscarriage
  7. 47,XY,+22            Miscarriage 1st trimester
  8. 45,XY,-7               Myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML). Bone marrow failure/MDS/AML follows within a few months to years of identification of a monosomy 7 cell line in peripheral blood. Nearly all individuals reported with familial mosaic monosomy 7 have died of their disease.
  9. 48,XX,+9,+22       No pregnancy or Miscarriage

Cycle #2

           Karyotype                   Result or phenotype

  1. 46, XY                                 Normal
  2. 47, XY, 18+                         Edward’s syndrome: Edwards syndrome occurs in around one in 6,000 live births, and around 80% of those affected are female. The majority of fetuses with the syndrome die before birth. The incidence increases as the mother’s age increases. The syndrome has a very low rate of survival, resulting from heart abnormalities, kidney malformations, and other internal organ disorders.
  3. 46, XY 14(q31.3q32.3)x1  Phenotype depends on what parts of the chromosome are altered. Cannot find this exact alteration.

Cycle #3

          Karyotype                                         Result or phenotype

  1. 47, XY, 16+                                                    Miscarriage in 1st trimester
  1. Complex chromosomal abnormalities     No pregnancy or Miscarriage

Cycle #4

        Karyotype      Result or phenotype

  1. 46, XX              Normal

It occurred to me that decreasing the chances of living through all the drama of getting excited over a BFP and then the subsequent pain of losing the baby is well worth a few thousand dollars.  Eliminating the incredible weight of the choice to terminate a child with Patau or Edward’s syndrome is well worth a few thousand dollars.  The opportunity to save me months of subsequent frozen cycles is well worth a few thousand dollars.  My closets, house and jewelry box won’t give a shit.  So I drive a 2002 Saturn with 200,000 miles on it for a few more years.  DH is outside right now trying to make repairs to keep the old girl limping along.

Plus, this way I have some semblance of control over what sex we have.  (Insert DH’s bad joke here: “LOTS!”)  In the beginning, I was adamant about not having any girls.  I’ve never been a “girl” and don’t know how to relate to one.  But over time, in the struggle to conceive any child at all, that all became completely unimportant.  But, I will choose to try for a boy first, then a girl.  I like the idea of a big brother to take care of his little sister.  Which leads me to my question.  If you have two embryos that were conceived on the same day, but transferred on different days, are they still twins?  How about two embryos conceived on different days, but transferred on the same day?  Which ones are twins, and which ones are not?  I could potentially have two children born on the same day, but one is technically 6 months older than the other.  Alternately, I would have 2 children 24 months apart in age, but still conceived on the same day.  Think of that.  A 12 year old girl who is actually older than her 14 year old brother.  What the what!?

That leads us to the plan.  With legal ugliness continuing to rear its hideous head (from my former job where I was essentially terminated because they didn’t like the fact that an older nurse was going to need accommodations to go through IVF, then have 2 high risk pregnancies), I’ve decided to just stay the course until my stress level has diminished some.  In the meantime, I’ll continue to lose more weight to get me in a healthier zone.  I have an appointment with a lawyer July 9th.  If she takes me on as a client, then she will be able to do all the heavy lifting and decrease the ridiculous stress level in this house.  We’ll transfer the two boys.  If there are two live births, then we’re done!  If there is one live birth, then we’ll transfer the two girls after that.  If we have one live birth after all four embryos, we’ll be entitled to another 2 fresh cycles.  I’ll do ONE more, then do a donor cycle.  How’s that for long-term planning?  I’m not type A.  Not at all.  Why did you say that?!

Finally, a note about Father’s Day.  I didn’t even think about it.  Neither of us had a father who was worth a hill of beans.  The day never meant anything before and it didn’t even register for me that Sunday.  We were out to breakfast where our waitress has known us on sight for years.  She took our order as usual: “Ladies first!”, then went to take the order of the family behind us.  “Fathers first!”  That stopped DH in his tracks and put a horrible grimace on his face he probably didn’t even know was there.  When he told me how much that bothered him, I felt like a heel.  As a Man who believes that “real men don’t cry”, “real men don’t use sunglasses, they squint”, “real men don’t dress for the weather, they take what’s next on the pile.”, I was caught by surprise.  I need to stop letting him care for me all the time and remember that, though he may not show them, his emotions around this whole family building experience are just as strong and just as valid.

A phone call from the MD…never a good omen

So, I came back into the house from mowing the lawn and checked my beloved patient portal for my fertilization news.  Nothing.  I checked the time – 7pm – and mumbled under my breath, “Not cool guys. You forgot me today.”

Alas, they did not. The news was so bad, they couldn’t post it. I had a message on my cell waiting for me from Dr. M. He wanted me to call the office and if it was after hours, to have him paged. He certainly wasn’t calling to say all 12 fertilized and looked great.

One. That is, one mature egg.  Two were immature and matured in vitro, one was very immature, 1 atretic and 7 were “empty zona”.  So, there was a shell, but no genetic material inside.  He called it “extremely unusual” and had no explanation for it.  I’d like to say I had a lengthy conversation about the implications of this and where we go from here, but:

1) I was a blubbering mess

2) This is the last cycle my insurance would cover, so what does it matter what caused it?

So, the one mature guy fertilized, and the two that were matured in vitro did not.  We have one fertilized egg.

I have no words.