At 18 weeks, little frog is nearly 6 inches, the size of a bell pepper or a sweet potato…or the length of a dollar bill. And we’ve had some action this week, mostly pokes and tap to the left and right of my navel, this time further apart (geographically) than they were last week…which implies growth! Our MSAFP is back and it’s just dandy…Next week, on day 19w exactly, we get to say hello again…and maybe find out whether pink or blue is in our future?
So, last week I left off right at the point where the RE figured out that my pituitary gland was falling down on the job and my ovaries weren’t able to make any eggs. No eggs = no babies. Every ultrasound showed egg follicles, tons and tons of potential eggs, but blood tests revealed that the hormones meant to tell my ovaries to start growing a follicle never appeared.
The minimal medical intervention — high-dosage extended-release metformin tablets — didn’t bump things along. For some women with PCOS, high dosage ER metformin — a medication for diabetics that manages insulin resistance, which mind-bogglingly enough affects the ability of the endocrine system to process reproductive hormones as well — is all they need to get their reproductive abilities in order. It was surreal to me that though not a diabetic, I was on a higher dose of metformin than my mom, who is in fact a diabetic (and a very well-managed one, too). The metformin worked well enough for me that somewhat regular, although extended, cycles began again, but halfway through each cycle “dysfunctional anovulatory bleeding” would begin. That just means “there’s something amiss and there are no eggs and there is bleeding, we don’t know exactly why.” A hysterosonogram to diagnose the source of this bleeding ruled out the usual suspects, growths, fibroids, or tumors causing interference (<——this is the infamous cancer-screening test my health insurance wouldn’t cover). We took it as confirmation that the metformin just wasn’t enough to convince my pituitary gland to do what it needed to do, lowered our heads, and soldiered on.
The next-minimal medical intervention for me was a low dose of the follicle-stimulating drug Clomid, followed at the appropriate time by a subcutaneous injection of the follicle-busting drug Ovidrel. The “appropriate time” is determined by multiple, stringently scheduled ultrasound examinations and the growth of the follicle. All of a sudden, your month looks like this:
Cycle Day 3: Baseline ultrasound.
CD 3-7: Take Clomid.
CD 10: Ultrasound. No follicles over 10mm, skip 2 days.
CD 13: Ultrasound. No follicles over 18mm, skip 1 day.
CD 15: Ultrasound. Follicle measuring over 19mm, take Ovidrel shot at 10 PM, which your poor husband must administer by jabbing you with a pre-loaded hypodermic syringe. Time your, um, “activities” for the next three days.
Wait two weeks. You will either bleed like you have never bled before — failure — or not — potential success!
Repeat as needed.
It took two repeats to conquer the two-week-wait and reach the day when the RE nurse said, “Well, come on in for a blood test, we’ll see your beta levels.” The stress the night before was so terrifying, I took a home test that came up positive. We tried to not be excited. To myself, I urged “Lefty” — the left ovary having shown up for work this time around — to stick. I could frequently be overheard in the kitchen rubbing my belly like jump-starting an old car and chanting “sticky stick sticky sticky!”
(For what it’s worth, I still rub my growing belly like jump-starting an old car, frequently following it up with chanting “Grow grow grow!”)
Beta Day 1: Nurse calls me in the afternoon and says, “For women in your treatment we like to see levels between 50 and 100 micrograms. You have 84 mcg! Congratulations!”
Skip a day and come back to retest.
Beta Day 3: Nurse calls me at lunchtime and says, “We like to see an increase of 50-60% for women in your treatment category. Your level is 293 mcg! That’s almost 350% increase. Hooray!”
Skip a day and come back for one last retest.
Beta Day 5: Nurse calls me around midday. They would like to see a tripling from the previous beta test, which would put me around 880 mcg. My levels were at 1,367 mcg. The nurse is practically giddy with the solid growth of my numbers. The first ultrasound is scheduled for 5 weeks, 6 days.
5 weeks, 6 days: If I push on my right side and hold my breath, we can see a heartbeat. RE is giddier than me. Measuring 5w5d.
7 weeks, 6 days: I don’t have to hold my breath to see the heartbeat this time — 4 clearly visible chambers thump along nicely. Measuring 7w5d. RE “graduates” me to a regular OB, and the rest is history. RE is still giddier than I am. I’m just in shock.
12 weeks, 6 days: Jim’s first look at the active little person. Heartbeat first heard. Measures somewhere between 12w5d and 13w exactly.
15 weeks, 6 days: Jim’s first listen of the heartbeat.
17 weeks: I might have felt the first gentle taps and waves of activity this week…kind of like someone shyly tapping on my shoulder, only to the left and right of my navel. Heard heartbeat again.
Here is an excellent article on going from IF — infertile — to FI — formerly infertile: “Formerly Infertile: Becoming a Mom After IVF”. This sufficiently describes the various mental shifts that occur during the diagnosis and treatment — and success thereof — of infertility. The author underwent in vitro fertilization, which thank heavens we did not have to decide whether to do or not, but if the level of treatment we were at had not been successful, there were one, maybe two other medications we could have tried, before having to attempt IVF. But I can identify with the feelings and anxieties the author experiences — and who knows, maybe you are too? I know it’s cliche, but it’s natural and right that you feel this way. And it will get better, bit by bit, and I believe in you.
Jim and Rachel 