We had our 6-week ultrasound today for pregnancy #4. It did not go well. There wasn’t much of anything to see — a bunch of irregular lumps that might have been bleeds and might have been products of conception but no gestational sac, yolk sac, or fetal pole. The OB gave me the option of waiting and coming back in a week for another ultrasound, but admitted that she thought there was basically no chance that it was a viable pregnancy, so she gave me a prescription for misoprostol to take this weekend.
I knew, going in. I’d had some extremely light spotting on and off, and zero pregnancy symptoms. Even with the encouraging betas last week, I’ve been pregnant enough times now that I just knew something was off. I usually get stretchy round-ligament-type feelings, and I’d gotten them the week after the positive HPT, but then they tapered off. I’d had some tenderness while nursing, and it tapered off too. But even though I expected it, it’s not much easier to deal with.
I just feel the overwhelming weight of needing to (1) get through this miscarriage, (2) go through the whole long process of trying to conceive again, and (3) going through another anxious pregnancy where I’ll be freaking out at every stage. It just feels like too much right now. But there’s no getting around step 1 — my only hope is that it won’t drag out too long (like it has the other two times, says my pessimistic self). I can’t say I’m really looking forward to step 2 either — I just hope that awful ovulation pain doesn’t come back. And while step 3 is a necessary mile marker on the way to the goal of having another living child, I’m really not looking forward to it either. I’m just so tired of everything conception- and pregnancy- and miscarriage-related. God, I can’t wait for this phase of my life to be over.
The other set of decisions I’m having to make is how aggressive to be with follow-up. I put in a call to my RE’s office this afternoon, although I haven’t seen them in 8 months so I don’t know if they’ll get back to me quickly or have me come in for an appointment before they’ll talk to me. I need to decide whether or not I want to ask for testing of the products of conception, for example (probably, since I always think that more data are better). I had a lot of testing after the 2nd-trimester loss of our daughter, but I will probably make an appointment with the RPL clinic at my RE’s office for a consultation to make sure there’s no other testing they recommend (they encourage consultations after two consecutive losses). For example, it seems like it wouldn’t hurt to have my thyroid and some other things checked again, since they haven’t been checked in several years. My guess is that everything will come back normal, and they’ll just tell me to quit breastfeeding and send me on my way, but you never know. My OB did tell me she’d recommend progesterone next time as a precaution (the RE had me on it for my pregnancy with my son, so I’m no stranger to it).
Breastfeeding is a whole other can of worms. I know that it probably makes sense to wean before we try again. While there’s no really good evidence, there’s circumstantial evidence that it can lead to difficulties with implantation, and so it seems like a sensible step to take now that my son is 20 months old. But… he doesn’t want to wean, and I don’t want to wean, and the whole idea is just making me feel a lot more miserable. It’s like, on top of dealing with dead baby #3, I now have to face the prospect of making my one living baby miserable and bringing an end to one of the few things that has gone perfectly right during my reproductive years — depriving myself of a beautiful part of my relationship with my son just on the off chance that it might help me not kill another baby. It’s just not fair, dammit.
Well, as many of the readers of this blog know all too well, even with recurrent losses the odds are still reasonably good (though not great) that next time will be a success, so probably the main thing to do is just move on with getting un-pregnant and then trying to get pregnant again. I can only hope that it will go quickly and not drag out for another eternity.