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Follow the twists and turns of an ART newbie navigating international IVF in the USA!
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Term for a singleton is 40 weeks. But for twins, is considered 36-37 weeks. So I am considering myself half-way today. Yay!! I am starting to feel the babies move more, which is cool. But also, some nasty Braxton-Hicks contractions have started. Am not liking those so much!! A few of them actually hurt yesterday. Plus, if you start to have too many (I think it's 5 or more within an hour), you need to go get checked out for premature dilation/labor. Bad! But otherwise, everything seems normal and fine. I haven't weighed myself for awhile, but within the last 2 weeks total gain was already TWENTY-TWO POUNDS!! Ick!! lol My next prenatal appointment with my OB is in ~1.5 weeks. I'll know better how the twins and my elevated blood pressure is doing then. I have been taking all the supplements she prescribed for me last time. Seems okay so far. In other news, DH, DS and myself all got the H1N1 vaccine yesterday. It is being heavily recommended in my province and city. Because
I am less than 20 weeks, I was eligible to request the regular vaccine
*without* the ajuvant (which has not been thoroughly tested on pg
women). So I requested and got that one. I decided that
the complications that can result from swine flu in pg women (esp 2nd
and 3rd trimesters) outweigh any unknowns associated with the vaccine.
I am not usually big on vaccines, but this one is supposedly quite
similar to the seasonal flu shots, which tons of people get each year. Also, my young, healthy BIL literally almost died of swine
flu complications a few weeks ago (ICU, unconscious, life support, the
whole nine yards). I know it's not likely, but I could not imagine
myself and/or the twins surviving that if it had happened to me. Today we all feel fine, so I think we'll have no side effects from the vaccinations. We should have our immunity within ~10-14 days.
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We sold our last home almost three years ago, and since then have been living in a nice, very affordable apartment in our favorite neighborhood which is close to downtown and my work. We had been toying with the idea of buying a home in this area for about a year or so... so when we found out we had twins on the way, we knew for sure we could not stay in our current rental. So recently we bought a 3-bedroom home, with a small yard, cute back deck and a parking spot. I think my favorite part may be the fact that we now have our own laundry again - no more hauling off to the shared basement to do the weekly washing!! lol Anyways, we just moved into our new place on Friday. That was the culmination of two weeks' worth of packing and prep work. Definitely harder with a body full of two babies at the moment!! lol I am glad it's finally over. Now, we just have to keep unpacking, but that can be done at more of our own pace. Financially, this is a big year for us, since we just paid for our high-tech cycle this summer, plus now the home's down payment. It was a bit of a stretch, but I did not take on any consumer debt, just the mortgage. Also, because I know once the twins arrive our lives will be pretty much insane for awhile, I've already done all my research to find DS his first school for when he starts Kindergarten next year. Our chosen school is a bit of a walk from our new place, but I've verified he qualifies for the free bus service. Yay! They also have a very reasonable after-school care program, which was a requirement of ours since we both work full time. Also, I've booked the girls their spots at DS's daycare - actually did that a month or so ago. Yes, it needs to be done this early. In our city, good daycare is really hard to find, and many places have waiting lists a few years long (literally). DS didn't get his current placement until he was one and a half. But I digress. Yes, so we're all moved and settling in. Next up, finish unpacking, then eventually start furnishing the girls' room. AND, we still have to settle on names. We have not seriously discussed that yet. lol
BTW, I've been continuing to use my doppler. Baby A is usually ~150 BPM, while Baby B is usually ~140 BPM. I do feel them move on occasion, but not very often. I am looking forward to feeling them move more frequently.
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Arg! I was not really expecting this. First off, I just told my own family we are expecting. I was waiting until after we had "found out" the gender by u/s. Everyone is happy. But a few people have come out and asked if these babies were conceived naturally or not. This is my fault, as a few years ago when I was pregnant with DS, I was quite upset and had started talking about high-tech as a possible future option. I was not at all serious about it at the time. I was just venting. I had assumed people would not really remember, or would realize how expensive it was and assume we would never do it. Anyways, DH and I agreed upfront we would *not* tell anyone about IVF, so I've had to lie already a few times and say they are natural. Not cool! I would just prefer if people would not ask. Although of course they can and do. Normally, I prefer to just be very open in my life. But on this issue, we have our reasons not to disclose. Also, we have some natural twins within my family, so I sense that IVF babies would not be considered "authentic". Everyone wants to verify that they are natural so they are more "legit". Arg!!! lol Anyways, so we have chosen to continue lying about it. I think it will be for the best that way. I imagine the questions will die down after a little while. Doh, I was not really ready for this! lol But otherwise, everyone seems surprised and happy for us.
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Okay, so it's good news all round today. As a recap, I've never had an OB before, or visited a hospital for prenatal appointments. So this was all uncharted territory! lol
First off, our new OB was punctual for our appointment (wow!). And she gave us plenty of time and information. We liked her. She's youngish, and has fraternal twins herself, so knows what I'm going through. She said I'm doing fine, but did write me a prescription for extra folic acid and iron. My blood pressure is also a little elevated (a bit early for that, but oh well), so she suggested I take extra calcium and baby aspirin to combat that. She did *not* ask why we went for IVF, so I was relieved to not have to "go there". lol She did mention that embryos who have undergone ICSI have a slightly
higher chance of birth defects (~4% vs the usual 1-2%). So that was a
bit of news.
Then we did the u/s. It showed that the twins are looking healthy and on track. She offered to do gender assessment and I eagerly accepted! Twin B is a "definite girl". She had trouble imaging Twin A's bits, but said it is "most likely girl". Yay!!! Even though we already "knew" the gender (PGD), DH and I felt excited and surprised when she told us, almost as if we didn't. LOL!!! Oh, I almost forgot... when we were getting ready to leave, I unexpectedly saw one of the excellent sonographers from the local clinic! It was F, who did my emergency ultrasound during her lunch break the day of my initial SCH bleeding, when I was so panicked that I had miscarried. Turns out, she works mostly at the OB's hospital, but also works 1 day per week at the local clinic. It was such a lovely unexpected surprise! She completely remembered me, so we hugged, and she asked how the twins were doing. BTW, at my last u/s (nuchal at the local clinic), the sonographer had said the SCH was resolved (or nearly so), but today we did see it still there, albeit quite small. The OB was not concerned, and said it is expected to resolve completely as the pregnancy progresses. She did not seem concerned in the least. I have not had any bleeding or spotting in 5 weeks or so, and am completely back in my normal routine, so I am not worried either. (I did ask if a past or current SCH puts me more at risk of premature labor, etc, and she said possibly, but again, she did not seem concerned.) So overall, a good experience. She said if I make it to 34-36+ weeks, that will be excellent. She said I can keep working for as long as I feel good and the twins are doing well. And that is my goal. I think I can do it!
So I have already been telling people today we now know it's two girls. Everyone is so happy for us. That has been an amazing feeling. Yay!!  PS - Weight gain so far is TWENTY POUNDS!! Argg!!! lol
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Uncharacteristically, I did not plan this momentous occasion, lol. I had picked DS up from daycare yesterday evening, and since it was Friday, we went out for our customary weekly "date" at a nearby family restaurant. Afterwards, we were heading home (through a local shopping center) and we stopped in at a large discount department store. DS asked if he could look at the toy section (we look, but don't often buy... it's a life lesson thing). Anyways, I said sure, so we headed over. The toys were in a corner, which was next to... baby clothes. Uh oh. lol So I let him browse the toys and when we were done, we stopped by the baby section. I fully intended just to browse quickly, which I've done on a few occasions elsewhere up until now. But I've never allowed myself to seriously *look*. But ah. I slowly fingered the pink newborn stuff and it hit me... I am nearly 14 weeks with a seemingly healthy twin pregnancy. We have not had u/s gender confirmation yet, but we used PGD which is 99% so... I COULD ACTUALLY BUY THIS STUFF (!!) The realization slowly sunk in and suddenly this new, joyful feeling washed over me. I CAN BUY BABY GIRL STUFF. BECAUSE SOON ENOUGH I WILL ACTUALLY *HAVE* TWO BABY GIRLS. Wow!!!!!!!!!! At this point, I became a little teary, but managed to hold it together. Meanwhile, DS was waiting patiently for me to browse. I chose a few things... several little pink clothing sets (Yes, for me! Not for anyone else. For *us*!!! Wheee!) and two baby sleeping sacks (we loved them for DS and have a few in blue - but I decided I'd like new ones and bought one in peachy pink and one in cream). I sort of decided on the spot that I don't want to dress the girls (the girls!) identically. But complementary. Oh, how fun!!! DS was super sweet about it. He looked at the clothes I'd selected and said "that's so cute!". Awww! Anyways, then we paid and walked home. I showed DH and he was excited for me, knowing how long I had forced myself to wait to actually buy anything. He liked what I'd chosen. Now, I just have to try not to go shopping crazy! lol We are moving to a larger place soon, so I don't want extra stuff to have to pack anyways. BUT, once we are settled, all bets are off!! BTW, my sister has confirmed she will for certain be coming to be our live-in nanny shortly after the babies are born. We will leave our agreement open-ended as to how long she will stay on. Now we just need to negotiate hours and pay, but we get on very well together so this will not be a problem. I am thrilled she will be coming!!!
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Well, 12w0d was actually the first day I found both in the same session... but Baby B's was found and lost so quickly that I couldn't even take a BPM reading. But today I had better luck! As always, Baby A is pretty easy to find, always hanging out somewhere right above my pubic...line. lol. BPM is usually ~156. Baby B is much trickier. She (well, I very much *assume* she!) is floating somewhere above Baby A. Trouble is, she is in the zone where I usually can only hear a lot of my *own* blood pumping loudly around in there. So I had to go very slowly and carefully. BUT, I found her! She was hidng somewhere on my right side, a little below my belly button. BPM was ~158. It's great to find them both in the same session! BTW, I have been back to my normal routine of walking briskly to work in the mornings. I feel so much better! People are saying "why are you so happy?" and it's because I can finally be active/normal again. After taking it easy for the (now resolved) hematoma for ~4weeks, I am ready to get my old routine back!
Oh, btw, net weight gain so far is... 13 POUNDS! OMG! I already see the fat pooling under my chin. Ew! lol Oh, here is one more bit of happy news... we decided that with twins we should think about hiring some extra help when they are born, since we have no family nearby to assist us. I have a younger sister (currently residing across the country) who has experience as an au pair. I asked her if we could hire her for a few months or more once the babies are born, and she has tentatively agreed! I love this sister very much, so would not only be thrilled with her help, but also her company. Am very happy and hopeful this arrangement will work out!
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Yay, so we made it to the magical 12 week point! I am very pleased and grateful that the babies seem healthy. AND that we achieved pregnancy on our first IVF attempt. We know we are fortunate. 
Okay, now onto the fun! I thought I'd share the u/s pic that the sonographer called "the bunkbeds". It was taken at 10w5d:
 Twin A is on the bottom, while Twin B is on the top.
So, they look pretty cozy in there, no? I cannot even imagine how much bigger my stomach is going to get!!
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We had our nuchal u/s today and the results are great. Both were 1mm, which puts us in the lowest risk category. So we are all clear on that! Twin A measured 12w1d - HB 154 Twin B measured 12w2d - HB 156 Both measured ~5.5cm long. So all good for my dates. AND, the HEMATOMA IS ALMOST GONE!! It was only 1cm this time, so that is GREAT! I am slowly starting to get my activity level back to normal. Yay! BTW, the sonographer asked if she could "guess" on the nubs... she guessed Twin B to be a girl, and Twin A to be a... boy!!!! lol, yeah RIGHT!! Anyways, DH was like, "gee, okay, maybe we're having one of each" and I replied that nub guessing is notoriously unreliable, and not to count on it. I have my faith in PGD! lol
Meanwhile, in work news, a few of the execs at my job are still shocked by the twin thing. These are all men, most with 2 children each (with wives who are SAHMs). So while they are being congratulatory towards me, a few of them have made comments about me "really" being able to come back to work as planned, etc. I am rather frustrated and annoyed by these guys *presuming* what DH and I are capable of and/or how we truly want to arrange our professional and personal lives. How would they know?? They are just comparing my situation to their own and assuming I would make the same choice they would. No thanks! Anyways, so now I am sort of nervous about my job being here when I return. My usually-supportive female boss didn't help much either... when I shared my concerns with her, she *tried* to be reassuring but said she "cannot say for sure what changes may happen to the business" while I am away. Oh thanks, I feel so much better! (not) lol. Anyways, I just said I would expect my old job to be here for me. Most women in our offie take their full 12 months off, while with DS I took 7, and with these two I am planning 6. Because I love my job and my team, and I am trying to be a good trooper here. So give me a break! So this job concern is a new, unexpected stress, which is annoying. Since I really just want to focus on other things, not be worrying about my job or position changing while I am on leave. I am going to speak to two of the execs that I know "best", to let them know my expectations. So we can be ALL CLEAR on that, and I can try to head off any funny business. And then that is about as much as I can do. If they really want to make drastic changes when I am gone, I cannot really do anything about it.
ETA: I spoke to the exec that I know best (we socialize as couples on occasion, and his wife is on mat leave at the moment with their first). He seemed a bit surprised that I felt concerned enough to need to speak about it, but ultimately he said he does feel it is extremely likely my job as-is will be here for me when I return. He felt the president's comment (about me "really" coming back) was totally off-hand, and that he has said the same thing about other women in our office who have babies. (Um, okay, but that makes me feel even more strongly that the president has some weird perceptions about women, childbearing and their careers. Geez.) Anyways, my secret plan here is to make sure this guy and a few key others are TOTALLY CLEAR on my leave plans and returning expectations, so if any "planning meetings" come up where I am not present, no one needs to "assume" anything on my behalf! lol. I do feel somewhat better having spoken to him. I think I will also go back to the president (who made the most concerning comment in the first place) and do the same.
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So now we've told DS, our local friends, and our employers. We decided to tell now because we had a great u/s last week, *and* I am majorly showing and need to be able to wear comfy clothing. We live far from both our families, so have not told them yet. Still deciding how and when to make that lovely revelation... lol Anyways, everyone is shocked that it's twins. I was most concerned about my work, as this company is run by a group (club? lol) of all-male execs, save my boss, the sole female (but a fairly recent addition). My boss, to her credit, took the news extremely well. She was super supportive, and wanted to talk all about having children (she's in her late forties, so that time is over for her). Meanwhile, I had come prepared with a plan for handling my work during my mat leave, which we didn't even get to! lol I know most of the male execs fairly well, so I let them know my news directly too. They were all supportive. Except something weird did happen with the president... at first he congratulated me. But then in private he asked "Are you *really* planning to come back to work when you have 3 children?" And I was like WTF!!!! I had already told them clearly in writing I was intending a 6 month mat leave (DH will take the other 6 months - I know, we are lucky here in Canada). ANYWAYS, I was rather annoyed that he could a. presume a working mother wants/needs to stay home after a certain number of children and/or b. assume I was *saying* I'd come back, but secretly be planning not to (?!). I would think after all my (well-performing!) years here, he would know me better than that. Arg. I tried to keep it casual and said firmly there was no doubt I planned to return (barring any major health crisis). Because my career is very important to me. It is a large part of my identity and I've worked hard to achieve my current situation. So I told him "Do not count me out", and left calmly, but secretly fuming. Doh! Absolutely I plan to come back, and will totally expect my same position and department/team to be here for me. Of course, I know I will have to "prove" myself (again!) after returning, but I will fully expect to be considered for future possible promotions/opportunities once my home life is stablized and I am able to perform normally.
Grrr, I will need to bring this up with my direct boss, to ask her to ensure nothing "funny" happens while I am away. She herself took 6 months off with her son (not here, elsewhere), so she understands my perspective, and I feel confident she is taking me at my word. In other news, tons of people are stopping by my desk to express their shock at the twin thing. There is a lot of "oooh, your life is over now", "wow, glad that didn't happen to me", "you're going to have your hands full" and other such comments. I try not to take it personally, or to heart. My nuchal ultrasound screening is this Friday. I hope/assume it will all be good news. Meanwhile, everyone is curious about the babies' genders... publicly, I say I'd like at least one to be a girl, but secretly I know the truth!! lol 
BTW, I am *almost* ready to start shopping for pink (girly!!) baby things. Oooh!!
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One twin measured 11w. HB of 160. Moving normally. Nuchal looks "thin" (good). Other twin measured 10w6d. HB of 160. Moving normally. Nuchal looks "thin" (good).
Hematoma
is a little smaller (finally!!): 2.6cm x 1.4cm x ??? (sonographer didn't give me the 3rd
dimension). But she said it's smaller than last time. Great!
So
babies are looking excellent, and the hematoma is much smaller relative
to the twins' sizes. The sonographer said it will probably resolve in
a few weeks. I hope so!
I have not spotted since Monday, but I know not to panic if I do again. BTW, I had her check where the placentas are relative to the hematoma... and the clot is still not close to them (yay!!). The hematoma is on my front left. Twin B's placenta is on my front right, and Twin A's placenta is on the back of my uterus, near my spine. So that is great! In other news, I found out my new high-risk OB cannot fit me in until I am 15weeks (!) Lori told me I will "graduate" from HRC's care this week, so I guess I am on my own for the next month! lol (BTW, the OB's secretaries seem VERY CONFUSED in general, just like the local clinic used to be. Oh great, more of the same!!! lol) In related news, I got smart and had the local clinic make me copies of my initial blood workup today, to take to my new OB (HIV, blood type, etc). I will wait for Lori to send me the results of my Estrodial and Progesterone blood tests today. My last PIO shot was Wednesday and I want to make sure I am doing okay without it. Wouldn't it be a nightmare to lose the babies because of low progesterone!! I have read online about that happening (rarely) to a few people... ETA: Lori said: "The estradiol level was 2415
and the progesterone level was 39. These are both good levels you are
now making your own progesterone and estradiol and both levels will not
continue to go up during pregnancy they mostly stay
the same." And, in response to my obsessing/probing (lol): "No patient should need any supplementation after really 8 weeks, miscarriages at that stage in pregnancy are not caused by lack of progesterone, it is most likely a genetic issue. So you have nothing to worry about." Okay!
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In Canada, we don't need a prescription, so I ordered one on Monday and it arrived yesterday (Tuesday)! I have it for 3 months. I rented from Fetal Assure.
I could hardly wait to put DS to bed to "play" with it. It's a digital model. They also sent a squeeze bottle of u/s gel. Fun!!! Well, I managed to find my *own* HB a lot. It was ~90-97 BPM. Only once did I find one little HB, for 3 seconds or so... it was 169 BPM. That was thrilling! I know the babies are still quite small, so it will be hard for me to find them. Let alone both of them in the same session!! lol Anyways, I rented the doppler for peace of mind, and for fun. Since I am now "high-risk", I have ultrasounds almost every week. So I'm sort of addicted to them now! lol With DS, I had only *one* u/s in the whole pregnancy (the dreaded 20wk gender u/s, which is when my GD first manifested! lol). In other news, the high-risk OB I was referred to has left me a message to setup an appointment (well, her secretary anyways). Yay!! So hopefully I'll find out soon when I will first be seen! I believe this is the last week HRC/Lori will be officially monitoring me. Mixed feelings about that of course!
Last PIO shot is tonight! My sides are sooo sore and inflamed by the injections, I cannot wait to be DONE!!!
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My ET was on a Sunday, so of course my weekly milestone anniversaries are too. So today we are 10 weeks. Yay! Only 2 more until the magical "12" is reached. I've scheduled my last u/s and bloodwork tests for HRC at the local clinic next week. Also, I am almost done my PIO shots too! After that, HRC will release me to my local OB. Which, by the way, I have finally found!! The RE at the smaller local clinic kept his word and is referring me to what he considers to be one of the best high-risk OBs in our city. And it's a woman this time! Yay. I am considered "high-risk" because of the twins (multiples) and my SCH. I am okay with that! On the SCH front, it's been fairly quiet the last few days, only a little dark brown spotting. It doesn't stress me, and I can live with it. Also, I scheduled my NT screen with my usual local clinic. It will happen when I am 11w5d. I am already majorly showing, so the sooner I can feel confident the pregnancy is "okay", the sooner I can tell at work and bust out my real mat clothes! BTW, if you have multiples, you can do the NT u/s only, not the bloodwork. Because the levels they are looking at will be elevated due to the multiples and can give false positives. I am also looking forward to telling our friends and families our happy news, and of course, DS. I think he will be really excited, and will make an excellent big brother. Meanwhile, I've now gained a total of SEVEN AND A HALF POUNDS!!! Argggggg!!! This is due mainly to what I call "crazy twin hunger", but is also exacerbated by the fact that I have been told to stay off my feet for the SCH. So no more brisk walking to/from work (I used to do that for an hour a day), which is my usual favorite weight management strategy. Actually, I am starting to feel restless and sad about that! I can totally see that most of the weight gain is actual fat, collecting in my abdomen, on my thighs, and on my buttocks (I know this because the spots I do my PIO injections in are... rounder than usual, lol.) Niiiiiice!!! lol
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Well, mixed news again. First off, twins look great. Twin A measured 9w3d, Twin B measured 9w2d. Heartrates and fetal movement were normal. Yay! Also, cervix measured 6cm, which is supposedly "very good". lol
SCH is still about the same size as in the beginning. Today it measured 3.9cm x 2.0cm x 1.4cm. So no smaller, but also no bigger. Supposedly it has "stabilized". lol Also, the brown spotting continues daily, but I have decided this does not bother me. My body just needs to do its own thing. Meanwhile, I continue pelvic rest (not bedrest), and try to stay off my feet. Today's ultrasound was performed at a local fertility clinic that I've never been to before. I went there only because they were the only place that said they could refer me directly to an OB (yay!). So now I have their list of good "high-risk" OBs in my area. Once I choose, they will make the proper introduction so I don't get turned away (which is what would normally happen in my city - most OBs say they are not taking new patients). Here is the one weird thing - the local RE from this new clinic that did my ultrasound today was VERY SURPRISED that HRC and my usual local clinic had *not* recommended bedrest for my SCH. In his opinion, my SCH is "quite large" and "had put the pregnancy at risk" (when it had first occurred). I already knew that many doctors have divided opinions on the requirement for bedrest, but obviously this guy is a fan of it! Anyways, after my ultrasound, he revised his opinion to "it's okay" for me to keep working, since the SCH has seemed stable over these last few weeks. Whew!!!! The last thing I need is to take unscheduled time off work! lol Also, I asked his opinion on the daily brown spotting and he said it's "not the best thing", but as long as there is no fresh red bleeding and/or cramping, I should be alright. He did feel strongly I should should be followed by one of the best high-risk OBs in the city, so I will have to think about that. He also thinks I should not use my usual local clinic for the NT screening (which I was planning to). He recommended that I instead go to a local OB who is known to be excellent at performing these screens (as opposed to a sonographer). He wrote me a referral in case I choose to use it. Hmmmm. I don't feel "scared", but I don't feel as relaxed as I did going in either. I will need more time to process. At any rate, this new RE was very nice, prompt, and also, their prices are very reasonable. It's a much smaller practice than the larger other local clinic I usually deal with. Anyways, I am not sure if I will need to go back to this new one or not. For sure once I choose one of his recommended OBs, I will contact him as arranged so he can make the proper introduction so I can get seen!
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We've made it to 9 weeks! Only 3 more to go until the much-idealized "12" is reached! lol
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SCH = Subchorionic Hematoma
Okay, just wanted to log that I spotted brown a wee bit yesterday, and this afternoon there is more of an actual brown flow. No clots, mostly just a dark liquid. I know, TMI, but I want to keep an accurate log in case anyone else goes through this and wants to refer. lol The local clinic seems to feel that no flow is "ideal", but brown is second best, as brown is "old blood" and hopefully means the hematoma is breaking down and the body is flushing it. BUT, some women with hematomas spot/bleed brown and/or red off and on for weeks, so I know not to panic if this happens to me too. We are actually feeling a lot calmer about the SCH... there's a few IG July girls now with one, so it can't be *that* unusual or scary. I will have another ultrasound in the upcoming week, so we'll check the size/location again then. Honestly, I expect my SCH to hang around for at least a number of weeks longer, possibly even more. My dream is that it would be gone by 12 weeks when we start announcing the pregnancy (so I can feel that much more relaxed about it), but I know this may or may not happen. BTW, I went out today and bought some larger-sized work clothes (not mat clothes, still regular ones) to help hide my burgeoning abdomen (and my general increasing overall pudge factor). lol!!!
On another note, I ended up accepting the promotion I was offered at work (discussed in this thread). Supposedly I will get final confirmation on all that next week. I am guessing that everything will work out fine. Thanks to everyone who offered their advice and support.
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