Bad news

Sorry to those of you I made wait for hours for this update, but the ultrasound this afternoon confirmed our fears - there is no longer anything going on in there. So there was just one and it didn't survive.

Needless to say we are pretty upset. We'd had all week to prepare ourselves, but had managed to hold out some hope so were disappointed and frustrated. I'm glad I didn't go for a blood test earlier in the week because it was good to find out together in a direct conversation with Dr. Teaff, and to find out at the start of the week-end when we get a few days to deal before I have to be with people.

Dr. Teaff has suggested a new set of blood tests to look for any possible things that might cause miscarriages. As miscarriages are fairly common these tests aren't usually ordered unless a woman has two or even three in a row, but she said we should just go ahead and do them in my case because we don't want to waste any time and don't want to waste the last two frozen embryos if there is another problem. I'll have that blood drawn next week, but some of these tests are complex and will take a couple weeks for the results.

We are going to take a little time to look at our finances and our calendars to figure out when we can go back to Brno.

Thanks everyone who was worrying and waiting anxiously with us. We really do appreciate all the love and concern and calls and notes. Maybe next time ...

Bad Week-End

Unfortunately, I had a lot of cramping and other problems this week-end and am pretty sure one baby is lost. We are just hoping there is another one in there and that it is tough and hanging on.

Its going to be a tough week waiting for the ultrasound on Friday afternoon to see if its all over or not. We are trying to be optimistic and positive, but we are also sad and worried. We are holding out some hope but bracing for bad news.

On a cheerier note, we had a nice visit with Mom and Dad this week-end, and I was glad they were here while I was going through everything. We did some house projects and I'll post pictures soon.

Beta Test 4 !

The number today was 13,700. So that is good news. It has tripled in four days so that is great growth rate. I think I was off on my day count before and that this is day 41 or 42. So this HCG count keeps us in the very bottom of the twin range.

I'm still nervous because I've had some spotting and cramping yesterday and today, but I'm trying to rest and be optimistic. We have to wait a whole week until the ultrasound, but hopefully it/they will continue to grow!

Beta HCG test three

My HCG level today were 4400, so not quite doubled from Friday's 2500. It is supposed to approximately double every three days. So we are a little nervous that it didn't increase more, but I guess the important thing is that it is still increasing. Based on the chart I posted a few days ago, this sounds more like a single baby instead of twins.

I have an ultrasound scheduled for a week from Friday. So that will be 7 weeks and we'll find out everything.

The nurse said they didn't need me to take any more blood tests between now and then, but that if I want confirmation that the numbers are still growing, I am welcome to call and come in. She said this two week wait is almost as stressful as the wait between transfer and test for some women. So I may go this Friday or next Monday, just to be sure the levels are still increasing. Especially as the number wasn't quite as high as expected today.

More confirmation! Yay again!

I returned to the doctor this morning to test my HCG levels in my blood again. My number was 700 on Tuesday and today it was 2500. So it definitely doubled (really quadrupled) so everything is progressing as it should. I go again on Monday for a third test to make sure the HCG levels are still increasing on schedule. Assuming it is, we will schedule an ultrasound as the next step - probably fairly soon as they said they like to do it the middle of the 6th week.

I asked the nurse if my numbers suggested the possibility of twins and she said maybe, but numbers vary so greatly from woman to woman that they don't say anything until the ultrasound. Of course I've been looking at averages online and found the interesting chart below.

My numbers, especially today's 2500, certainly indicate that it is highly possible. I'm not sure exactly what day I should be considered right now, but its been 15 days since the transfer, at which the point the blasts were 6 days past conception - so if we add 14 days to that (assuming conception is 2 weeks after the last period), that puts me at day 35. So I'm in the twin range on this chart for day 36, but the very low end.

Of course this is also some chart I found on the internet so may not even be highly accurate. I guess we'll know more next week after I take another blood test.

Confirmation! Yay!

The blood test today confirmed that I am pregnant. I did another home test this morning before I went just to make sure there weren't any changes. I go back on Friday morning for another blood test to confirm that the HcG levels in my blood are increasing at expected rates. So this is really happening!

Good news, everyone!

We had decided not to test today, so I didn't do it this morning. But then around 3?30 in the afternoon Miran said we should do it just for fun. So I did. And it was positive. We were in such disbelief we went to CVS and bought another test. I took it when I got home and it was also positive.  So I guess it worked. We are very excited and looking forward to official blood confirmation on Tuesday.

no news is good news

I have nothing to report. I haven't really experienced any symptoms though I am analyzing every feeling throughout my body these days. But we are encouraged - we've made it longer than last time and no news is good news.

Thanks everyone who is thinking and hoping for us. We're so glad to have such a wonderful BIG and supportive family worrying for us on two continents.

I'll do a home test this week-end - we can't wait all the way until the doctor on Tuesday! Let's hope this time it FINALLY works. I'm getting tired of this and Miran is so excited this time and convinced this is it. So we will both be crushed again if it isn't.

And now we wait ...

I'm home again and now we just have to wait impatiently until next week when we can test. I just called my doctor here and schedule a blood test for next Tuesday morning.

Here is an ultrasound the Czech doctor took right after the transfer. Allegedly the two parallel white spots/lines together in the middle are the embryos. They are too small to be visible, but we can see them because they are each encased in a blob of fluid. So really what we can see is the fluid.

We are trying to be super positive this time - and so far so good. I even got out all the pregnancy books that Cecilia and Margaret gave me years ago and put them by my bed for a little light reading before going to sleep.

 

And one last picture from the trip - Saturday I spent the afternoon at Miran's cousin Jasmin's house and he grilled outside on his big balcony. Here he is at the grill with his kids eating in the background. It was a really nice visit and I really like Jasmin and his wife Lucie. Even though I'd only met them once before, I felt very comfortable spending the day with them and enjoyed talking to them.

 

Transfer Complete

Now the wait begins.

Both embryos thawed perfectly and looked good, according to the doctor. One is slightly more developed than the other, but he said there was no difference really between them. The whole procedure took 2 minutes, after which I lay there for 15 minutes and then left. Somehow it seemed so quick and simple for something so big and complicated.

I am back in my sweltering hotel room now. Its in the 90s outside and I think also in here because there is no air conditioning. I'm trying to lay still and relax but its pretty uncomfortable. 

Here are pictures of the two embryos before the transfer and me shortly afterwards ...

Off to Brno, take two!

My flight is at 5:10 tomorrow, I'm nearly done packing, and I've already printed my boarding passes! Then I decided to check the weather in Brno ....

Apparently its going to be insanely hot ... 101 degrees the day of my transfer! I hope I don't have  issues with the heat. At least Friday and Saturday will be more reasonable if I do decide to take an afternoon walk to get out of the hotel room. In any case, I think I better unpack the pants and long sleeved shirt I put in my suitcase and put in a few sun dresses instead.

Ultrasound

Today I had my pre-trip / pre-FET ultrasound and everything looks good. My uterine lining is 13 mm - which is apparently optimum (needs to be more than 8, last time at 17 they thought maybe it was too thick). Also my  lining is trilaminar (three-layered), which is apparently a good thing.

So starting tomorrow I add the progesterone to the estrogen I'm already taking and then I'm off to the Czech Republic on Tuesday! Lets hope the little guy(s) attach to the lining this time. My appointment is on Thursday, August 8 at 12:30.

And happy birthday to Milada and happy anniversary to Mom and Dad!

Baby-making update

I started taking estrogen yesterday in preparation for my planned August 8th Frozen Embryo Transfer. I leave for Brno on August 6th, arrive the next day, and return home on the 11th.  I go for an ultrasound with Dr. Taeff on the 2nd to check that all is in order before I leave. I'm thinking positive and hoping this time it will work!

Dr. Update

I went to the doctor yesterday as scheduled and basically confirmed that my internet research on endometriosis and its treatment and its connection to implantation was pretty accurate.

Dr. Taeff and I discussed the surgical option, but as it would cost between $2000 and $3000 out of pocket (instead of about $50 for the hormones), because its invasive, and because its possible the pills won't take months to make a difference - I decided to just stick with the hormone therapy.

I go back on June 19 for another CA-125 blood test, so 6 weeks after I restarted the treatment. After that test we'll have more information on if and how quickly my CA-125 level is lowering and hopefully even when I might be able to plan a new trip to Brno for the FET.

Major Setback

Unfortunately, I just cancelled my trip to Brno for next month and have postponed  the Frozen Embryo Transfer for at least half a year, probably.

I had a follow-up blood test earlier this week to re-check my CA-125 levels. This was the test I had in March when we learned that implantation hadn't been successful after the embryo transfer. In March my CA-125 level was 44.2, and after six weeks of hormone therapy, it was 40.8. My Charlotte doctor, Dr. Taeff, said that she would not recommend an embryo transfer to anyone with CA-125 levels over 30. Why no one suggested I have this 2-second blood test previously I don't know.

Apparently CA-125 is a possible indicator of endometriosis - which means growth of uterine tissue outside the uterus, usually in the pelvic cavity or in/on the fallopian tubes and ovaries. The only way to really know is visually, which means by having laproscopic surgery and looking. And apparently, endometriosis can cause fertility problems, particularly implantation problems, for chemical not mechanical reasons. The uterine lining is itself fine physically, but the other growths elsewhere give off hormones that confuse the uterine lining and can cause it to reject the embryo's "requests" to implant. Or at least that is my understanding based on reading  about it online. There are other connections between endometriosis and fertility, but this is the one I think Dr. Taeff is focused on.

So basically we don't really know for sure that I even have endometriosis, but I might, and we don't really know whether it is causing implantation problems for me, but it might. So even though there are a lot of maybes in that sentence, I would never stop second guessing myself if I went ahead with the embryo transfer in a couple weeks and it didn't work again. Its just such an emotional and financial investment, and we only have four embryos, I really have to take every step to optimize my chances of sucess.

So I've cancelled the trip and the transfer. My flight ticket was non-refundable, but fortunately Luftansa has a medical condition clause that allowed me to keep the money as a credit for a future ticket instead. So that is good.

I made an appointment to talk to Dr. Taeff about next steps regarding confirming and treating the possible endometriosis; however, her first available consultation slot isn't until June 3, so it may be awhile before I even know what happens next. I did leave a message on for her nursing team so I may get squeezed in if there is a cancellation or they may go ahead and prescribe more hormones in the meantime.

Obviously I'm not very happy about this setback. I was already discouraged after March's failure, and was not particularly positive about my odds in June, but now the indefinite postponing of the next step is very frustrating. I just want to know if and when. This inability to plan my life is really hard for me. And of course every development seems to suggest it is less and less likely this is ever going to work, which is depressing

June 7th = Frozen Embryo Transfer

Plans are set for my return to Brno. I will have a frozen embryo transfer (FET) on Friday, June 7th. I bought a plane ticket to Prague and arrive the day before and leave the following Monday.

Unfortunately the cute hotel with kitchen we stayed in is totally full that week, but I have reserved a room at the other place we stayed on the first night last time. It was also fine and actually a little closer to the clinic so that is good. I won't rent a car this time, but I found a very reasonable bus directly from the Prague airport to Brno. It takes longer but is simple and cheap.

It feels good to be moving forward on the next attempt. Lets hope this one works.

Endometriosis, maybe?

Last week when I saw Dr. Taeff for a follow up she did a CA125 blood test. My results came back elevated, which according to the internet can mean a variety of things, but according to Dr. Taeff possibly indicates endometriosis: a condition of the uterine lining which might be complicating attempts at implantation. So she recommended six weeks of yet another different combination of hormones and retesting on May 7 to see if things look better.

I consulted with Dr. Machac in Brno who agreed with Dr. Taeff's plan. And we agreed that this wouldn't work with the May 17 frozen embryo transfer we had previously scheduled - because we wouldn't be able to start the hormone protocol for that until this is over.

So no we are looking at early June instead for my return trip to Brno. I'm impatient to try again and it'll be a little more expensive to go then because its summer season, but obviously if we can do something to increase the changes of implantation - its a good plan to wait two more weeks.

Side note: if anyone is counting, I just realized that I've posted considerably more so far in 2013 than 2011 and 2012 combined. I know I was remiss at blogging in recent years, but I'm making up for it now!

Plan B (or actually F? G? H? - I've lost count)

We are still sad of course, but I'm feeling a little better because we've started planning for the next step. I've been in contact with Dr. Machac in Brno this week-end and made an appointment for a Frozen Embryo Transfer on Friday, May 17.

That's the week after the semester ends so I'll be free to go back and should be feeling very relaxed. I'll go by myself this time to save money - but it looks like I'll fly as far as Munich on the same plane as Azra  (she's heading back to Sarajevo for the summer) - so that will be fun for both of us.  We were upset because we didn't know when we'd have the money to go back, but my wonderful Mom and Dad offered to get me the plane ticket. That is about 60% of the cost of the trip, so we figured we could come up with the rest! We are so lucky and grateful and appreciative that we have such generous parents: Daddy gave us the plane tickets for the last trip, which also helped tremendously. We literally couldn't do this without all their help!

It feels good to be looking ahead and thinking about the next step, instead of dwelling only on the last failure, even if I'm not quite as positive and optimistic as before that trip.

official confirmation of what we thought ...

I just talked to the nurse who told me the blood test I went in for this morning confirmed what the at home test said this morning, and what we've pretty much known since Friday: we aren't pregnant.

I'm frustrated and I'm sad, but I've had a few days to prepare for it. Even though I knew, I guess I was entertaining a sliver of hope because I've been pretty down all day. I'm starting to wonder if it was better years ago, before all this technology, when doctors told ladies they couldn't have kids and they were upset but dealt with it once and then lived with it. Instead, now we have to deal with it over and over and over again for years.

The only consolations are that we have four embryos waiting for us in Brno and that the frozen embryo transfer is much less expensive than the whole process we went through this time. Of course that trip still costs something and it may take us some time to get organized to afford to go back - and of course the odds decrease a little each time because we put the strongest of the six embryos in already.

Doubts 2/3s of the way through the wait

I just posted three times to finish up everything from our trip, but now wanted to quickly update everyone on how I am feeling and how we've begun to doubt this whole thing worked.

[warning ... there may be too much information for some below ... but I don't know how to explain the situation without giving a few gory details ... sorry]

Unfortunately, I have had a period the past few days so we are very discouraged and fear the worst. Everything went so perfectly and our numbers were all above our expectations on the trip so we were feeling so positive, and we're still trying not to completely give up. I've had multiple conversations with my nurse at the clinic here in Charlotte and she says bleeding doesn't have to mean I've lost the little guys and that one of the drugs I am taking often causes bleeding. She also thought it was unusual to have a period so soon after embryo transfer so it could be from implantation. I feel like she has seen more of these cases than I have so wouldn't give me false hope unless she really thought there was a chance I'm pregnant. But based on extensive reading online - it sure seems more like a period than implantation bleeding.

So I'm trying to stay upbeat and positive - and I've been  resting. I even called in sick to work Friday. We spent a couple hours yesterday having both our cars worked on at the VW dealer, and while we were there we test drove a Routan, which is a minivan, so definitely a car we'd only buy if we had twins. I've also wasted hours completely planned out the nursery (with two cribs) and picked out the furniture and accessories. So we are trying to act like its all ok and proceeding according to plan. But to be honest we have our doubts.

We'll find out for sure on Thursday when I go in for a blood test. So prepare yourselves for bad news, because that is what we are doing.