Tag Archives: two week wait

The two-week wait after the two-week wait

I’ve gotten pretty good at the two-week wait over the years.  I am a model of patience and restraint: I never test before a missed period anymore (why would I?  It’s just a waste of a pregnancy test that I most likely wouldn’t need if I just waited for my period to come in its own time).  I’ve been pregnant five times, which means a heck of a lot of two-week waits, so I guess I’ve finally worn down my anticipation.

But the two-week wait after the two-week wait?  That’s a whole different story.

In my four previous pregnancies, I’ve always had an ultrasound at 6 weeks.  In our first pregnancy it was because we’d had some difficulty conceiving and were being followed by the RE, and after that it was because I was supposed to start Lovenox at the first sign of viability.

That first six-week ultrasound was magical.  We saw a heartbeat right away.  There was a living creature.  Inside of me!  It was amazing!  I was elated!  I cried!  I fell in love at first sight.  It was just incredible.  Later we found out it was a daughter, and that was a magical moment as well.  There was so much anticipation in that pregnancy.  Which probably made it all that much harder when it ended at 18 weeks.

Since then, the six-week ultrasound has been a different story.  I am more wary, guarded, less attached to that little bean, less surprised whether I see a heartbeat or not, more clinical as I interrogate the ultrasound tech.  In my fourth pregnancy, I warned the ultrasound tech before she started that pregnancy didn’t tend to go well for me, so I wasn’t expecting good news.  Why did I feel like I needed to warn her?  Indeed, when she had nothing but bad news to give me after that ultrasound, she was fine.  I was the one who held it together until my doctor asked how I wanted to end the pregnancy, and then I lost it.  The six-week ultrasound has gone well for me twice, and poorly for me twice, and even in the cases where it has gone well, only half of the outcomes (i.e., one) were positive.

Same with betas.  I’ve had betas drawn in three pregnancies: my first, second, and fourth.  They’ve always been great — I’ve never had a bad hCG draw.  (I say, knocking on wood, waiting anxiously for the second round of betas for my current pregnancy.)  Yet 2/3 of the pregnancies with good betas have ended poorly.  So you’d think I’d be over them by now.  But here I sit, the night after my 2nd hCG draw in my 5th pregnancy, unable to concentrate on putting together my lecture for tomorrow because I’m wondering what’s going on with my betas.

After everything that’s happened, I don’t trust betas, and I don’t trust the six-week ultrasound.  But… I still get so obsessed with waiting for the results!  I’ve been thinking and worrying about them all day.  The two weeks after the two-week wait, while I wait for blood test results and ultrasound results, feel like the longest weeks of the whole pregnancy.  (Except for the days after my due date in my pregnancy with my son — those were truly the longest days of the entire pregnancy.  Each one felt like a week!)  I torture myself: have they not called yet because the news is bad, and they want to wait to deliver bad news tomorrow?  Even if everything’s fine with the betas, it’ll be two weeks before I can have the ultrasound, due to some poorly-timed travel… how will I make it that long???

At least if the news is bad, I won’t have to wait long to find out what’s going to happen in this pregnancy.  The only way I was able to make it through my pregnancy with my son was through continuous distraction.  So I’m just going to try to distract myself like crazy for the next two weeks.  Traveling to the conference next week will help.  Afternoons with a toddler who demands all of my attention will help.  What else will help?  How do you survive the two-week wait after the two-week wait?

Pregnancy #4

So, remember how I said in my last post that I was just getting my period on Wednesday?  I was pretty sure, because it was the day my period was due, and I was cramping and I think spotting a little.  But then, it just… stopped.  My period never started.  This morning I took a test, and, yup. Pregnancy number 4.

But with cramping and spotting (which has mostly stopped), so, yeah.  I’m not counting any chicks just yet.

But at least for today, I’m pregnant again!  End of June sounds like a nice time to have a baby. Kind of in the same way that the moon Europa sounds like a nice place to visit.  (They both seem very far away and hypothetical at the moment.)

Here we go again!  Wish me luck!

The two-week nail biter

I swear I’m going to make this a quick thought collection (something I’m really bad at usually!), because I’m at a conference and it’s late.

First: I saw on another blog this week the idea that when you achieve pregnancy after infertility there’s another two-week wait after the two-week wait.  Since I assumed I wasn’t pregnant (since I’d been told it was highly unlikely and we’d need to do IVF), I had the easiest two-week wait ever.  But this week and next are the nail-biters.  I’m being monitored very closely for an ectopic pregnancy, and I’m also at a conference in Tennessee.  Two separate nurses had told me that it would be fine to get my betas checked on Tuesday before I left for the conference and then wait until Saturday after I got back.  But after they called me with the results Tuesday afternoon (while I was waiting for a flight in the Charlotte airport — chaos!), they called back 20 minutes later and told me that the doctor wanted to monitor me even more closely and that I was supposed to find a lab in Tennessee where I could do the second beta on Thursday.

Why?  Well, apparently my first beta was higher than expected (921 at 18 dpo, baby!).  This is normally a very good thing… but apparently in the context of a suspected ectopic it’s cause for alarm, because a bigger number means a fast-growing embryo, and things start to get dangerous at around 2000 (that’s also usually the level at which the embryo is visible on ultrasound, not coincidentally).  As I understand it, my high betas are a positive sign, since a majority of ectopic pregnancies top out below a level of 1000 (i.e., they stop growing before that point).  But for the minority of ectopic pregnancies that do keep growing, they’re the most dangerous kind, since they’re the kind that causes tubal rupture and internal bleeding, which is a leading cause of pregnancy-related death in women.  So, yay high betas!  But also, ack high betas!  Hopefully I’ll have a better idea tomorrow.  Apparently the order is in the Quest system (a national system of somewhat standardized laboratories) as a “STAT” order, and my instructions are to call my nurses and give them the phone number of the lab I go to so that they can track down my numbers as soon as they are available.  Yeah, this week is a nail-biter indeed.

I’m also adjusting to the concept of being pregnant again.  There are several weird things about this pregnancy:

1) We conceived almost exactly 1 year plus 1 week after our last conception.  That means that everything is happening at exactly the same time of year as it did last summer.  This is seriously messing with my head.

2) I’ve got imposter syndrome on top of imposter syndrome with this pregnancy.  In our first pregnancy, we conceived after the relatively benign infertility diagnosis of oligoovulation.  But any pregnancy after infertility messes with your head.  I remember turning down drinks and thinking “well, this is silly, since I’m not really pregnant anyway.”  This year, when a fellow conference organizer offered me a drink, I almost said yes.  I’m not sure I can explain my thought process, but it was something along the lines of “I can’t even pretend that I’m pretending to be pregnant right now.”  Yeah, I’m not going to be able to translate this feeling into words.  It’s just too surreal!

3) I realized yesterday that I’m thinking of this as “Pregnancy #2.”  It’s a number.  Now that I’ve stuck it on the number line, not even the first one, it seems more like part of a process than like an event that might lead to my first living child.  I’ve watched so many people in this space go through so many pregnancies that I think I’ve stopped truly believing that some pregnancies do end well — my “new normal” is believing that you’ve got to slog through an awful lot of misery before you get that shiny living baby.  Maybe I haven’t been through enough yet, and I’ll just have to move on to pregnancy #3. When I found out I was pregnant for the first time, I wrote on my chart in all caps “I AM PREGNANT!!!!”  This year I wrote “I am pregnant again.”  I think I’m going through a lot of the things that second-time moms go through — the first time around I was freaking out about every twinge and bit of gas.  This time through I realize just how very, very far I have to go, and how very, very uncertain this pregnancy is.  Even with the frenzy over the possible ectopic pregnancy, I feel like I’m just along for the ride at this point.  Ectopic?  Well, I’ll deal with that.  Miscarriage?  Well, as long as it happens early.  Needles?  Bring ’em on.  I am just not going through another 4.5-month loss if I can help it.

So much for those quick thoughts, eh? 🙂 Well, we’ve got a plan, we’ve coordinated a set of appointments over the next few weeks with the RE, the MFM specialist, and oh yeah, my local OB.  Thing is, I know there’s nothing that any of them can do to help keep my pregnancy healthy at this stage, but at least the constant information will be reassuring (in the best case scenario).

It’s a nail-biter, all right, but I’m happy about my high betas on Tuesday and nervous/excited to see if they’ve ~doubled tomorrow.  Wish me luck.

Next Steps

Today we had our long-anticipated consult with the RE to go over everything that’s happened since our baby died eight months ago and talk about next steps.

This morning I organized my thoughts into three concerns I wanted to discuss, and one question (the big “what next” question).  My three concerns were (in order of biggest to smallest concern):

1) During the hysteroscopy when my intrauterine adhesions were treated, one of my tubal ostia was never visualized.  Should I be worried?  Is it possible that I could have tubal scarring in addition to endometrial scarring?
2) My periods have been noticeably lighter since the D&C.  Should I be worried about the quality of my endometrium?
3) Every time I have an ultrasound (and I’ve had a LOT of those!), I’m told that I have a cyst on my ovary and that they’ll “keep an eye on it.”  They never do.  Should I be worried?

Here are the RE’s responses, condensed:

1) Tubal scarring is possible, and now is a good time to check on it.  Given my history, it’s not clear exactly when the scarring of my uterus occurred, and I had enough wacky interventions (like manual removal of the placenta) that infection at some point is a distinct possibility — if infection was involved, it very well might have affected the tubes.
2) In essence, no, I should not be worried about my endometrium since I have full-color hysteroscopic images of the inside of my uterus and it’s clearly nice and vascular/glandular.  She pointed out some good spots and bad spots on the images, and said that it seems clear from the images that most of the endometrium is just fine.  So, while she would normally be concerned by lighter periods given my history, she said that this is good evidence that there’s no need for concern just now.
3) She basically said that the sort of cysts they’ve seen in the past were no big deal, but that she plans to do another ultrasound in the near future if I don’t get pregnant in the next couple of months (or if I do, for that matter) and we’ll check then.

As for next steps… I get to do a repeat HSG and some bloodwork next week (woohoo!) unless I’m miraculously pregnant this cycle which I’m pretty sure I’m not (10dpo today and no implantation bleeding again).  If that comes back normal, she sends us off to keep trying on our own for 2-3 more cycles with the same sort of digital OPK timing we’ve been doing, and after that we start escalating with other treatments — probably superovulation with timed intercourse at first.  On the HSG they’ll be looking both at tubal patency and at cavity regularity, and if any hint of irregularity is seen in the cavity she’ll do either another sonohysterogram or another hysteroscopy to check the lining before doing extra-stimulatey ovulation.  (I’m hoping for hysteroscopy, assuming they can do it in-office like my last one — that procedure was a cakewalk compared to the others!)  If both tubes are closed, we go straight to IVF.  If one tube is closed, we discuss, and maybe go to superovulation quicker.

So that’s the story.  I’m very comfortable with the RE’s suggested balance of trying naturally vs. being proactive, and I felt reassured after our conversation with her.  She emphasized that now that we know about the clotting mutation they uncovered after our baby died, my chances of carrying a baby to term eventually (with the help of daily injections of blood thinners, which she was very positive about) are “excellent.”  So that was nice to hear.  I can’t say I really trust probabilities much at this point, even vague probabilities like “excellent,” and I’ll believe it when I see it, but I’m allowing myself at least a little bit of optimism as a result.  I have to say, though, it’s a mark of how my “normal” has shifted that I left the consultation thinking “yay, another HSG, and then a few more months of trying, and then more treatment!”  Yay, another HSG?  What sort of alien creature have I become?!  But at this point, anything to assuage my fears that there’s something (else) wrong and that our attempts are just more wasted time is far more valuable to me than worrying about the pain and discomfort of one more invasive test.  After all, I’ve had all these tests before, and they really weren’t so bad… bring it on!

Thinking about the future

Sometimes these days I try not to, but most of the time I can’t help thinking about the future.  That’s what all this is about, right?  Future babies, our future as parents, the future of our families.  Trying to conceive is long (for us), pregnancy is long (in the best case scenario), and when you mix in a combination of infertility and pregnancy loss, it all gets even longer.  The future that we are hoping for keeps slipping farther and farther away.

One of the few things that makes this process bearable for me is setting milestones to work towards, so that the future becomes a little bit less blank, uncertain, and terrifying.  Today I had a milestone-setting conversation with my husband, and thought I’d write about it here.

The next milestone on my list is the appointment with our RE in about two weeks.  I made the appointment in March after we found out that our second try post-adhesiolysis surgery had failed.  Thinking about going back to the RE after only two tries was perhaps premature, but that’s part of the point — it’s not that I wanted to go back immediately, but rather that I wanted a date on the calendar so that the blank future of trying again didn’t stretch out forever.  I made the appointment for a date in the future that would be after four tries (the nurse I spoke to recommended 3-6 based on our history).  If I’d had to cancel the appointment because I was pregnant, I would have done so gladly (and only a little sheepishly), but since I’m not pregnant it’s been an immense source of comfort knowing that it’s coming up.  I don’t know if I can make it until we’re pregnant again (which might be never), but I do know that I can make it to the RE appointment in May.

Now that it’s only two weeks away, I’m already thinking about the next milestone.  Today I brought up the subject of an adoption timeline with my husband.  I tried to make it clear that no, I wasn’t saying we should start looking into adoption immediately, but rather that I wanted to think about the timeline on which we’d start seriously looking into adoption.  There’s a big difference in my mind.  (He understood, because he’s clever like that.) 🙂

I don’t know how most people decide to start seriously considering adoption as a way of building their family when biology fails.  Part of the problem is that there’s often no obvious point at which biology has failed — it’s more of a question of how much time, energy, and money you’re able and willing to invest in trying to make biology work.

Today, I started thinking about possible outcomes that included adoption.  Here are some possible outcomes, with my thoughts about them:

  • Outcome #1 (a.k.a. worst case scenario): Neither biology nor adoption works for us.  This seems highly unlikely, but possible.
  • Outcome #2: Both adoption and biology work out for us, and we wind up with two babies nearly-simultaneously, one biological and one adopted.
  • Outcome #3: Biology doesn’t work, and we adopt a baby (or two or three)
  • Outcome #4: Biology works and I give birth to a baby (or two or three)
  • Outcome #5: Both biology and adoption work for us, but at different times, and we end up with both biological and adopted children of various ages.

Of all possible outcomes, only one is a bad outcome in my view (Outcome #1), and that’s the least likely.  Outcome #2 is not ideal, but has advantages.  I recently found out that our across-the-street neighbors (one of whom is my coworker, so we carpool together a few days a week) built their family through egg donation, resulting in their adorable 5-year-old twin girls.  The twins are a handful, but they’re great playmates for each other, our neighbors enjoy being done with a stage once it’s over (i.e., no more diapers forever!), and clearly if we wound up with two similar-age babies we’d make it work (and count our blessings!).  A mixed biological/adopted family has its challenges, but as I’ve mentioned before, I’m very pro-adoption (I’m very close to my adopted cousin, who is also married to an adoptee), and I would be thrilled to build our family partly or wholly through adoption.  My husband is also positive about adoption, although he has a few more concerns, some of which I share (mostly related to the likelihood of special needs of various sorts).  But when I think about the options above, I feel quite positive about all but option #1, which makes me wonder whether it really makes sense to wait to think seriously about adoption — and to think that maybe it’s time to consider a timeline for when we might start taking steps towards building our family through adoption.

We talked about it some, and agreed that September seemed like a good time to evaluate our feelings about adoption and think about taking some proactive steps in that direction.  By September we’ll have been trying for about 9 months post-adhesiolysis surgery, so we’ll have a better idea about how bad the damage to my uterus has been and whether or not the corrections are likely to work.  (Some of this is also contingent on our appointment with the RE and any testing or treatment she might recommend.)  September will also mark two years since we started actively trying for a baby (as opposed to two years since I went off birth control, which is coming up next month), and one year since the death of our daughter.

Starting the adoption process only two years into the process of trying to conceive might seem fast to some people.  But I’ve already built up a laundry list of known fertility issues that make any path a long and rocky road, and since we both generally feel positive about adoption independent of biology, it seems like there’s not actually much of a down side to pursuing the two in parallel.  It’s not just impatience to be parents to a living child, although that’s part of it — it’s a recognition that parenting is more important to us than propagating our genes, and that going through a high-risk pregnancy after years of infertility and loss (which is simply the reality of what we’re facing at this point) might not be the best way for our family to grow.

So, that’s where we are right now.  I’ll admit, not being pregnant last month hit me hard, and I’m not even sure I can fully explain why.  But thinking about the future in a concrete way, and setting milestones for proactive behavior rather than leaving the future as a big blank uncertain fog, is helping me deal with the mini-loss of another unsuccessful cycle.  I’d be interested to hear how others have started factoring adoption or other family-building methods into their thinking about their future family.  What factors are important to you in setting a timeline?  When did you start to think seriously about alternatives to biology (i.e., wife’s eggs plus husband’s sperm), or when do you plan to?

False Alarm

My BBT chart tricked me again.  Spotting last night, and when I woke up this morning my temperature had plummeted.  I’m not pregnant.  No baby in 2015 for us, and if this month doesn’t work, then no baby by the time I turn 33 (despite the fact that we started trying when I was 30).  Oh, and I’ll have to weather my first Mothers Day since the death of our baby with an empty womb.

It seems insane to keep getting my hopes up just to have them fall all the harder each month, but I just can’t help it — this month’s chart really looked just like my pregnant chart, and my temp stayed high as a kite for the full 14 days, whereas I can often see it start to drop on day 14.  Now, of course, I’m back to imagining everything that might be wrong.

What if my lining is so damaged that we’ll never get another blastocyst to implant?  What if my tubes were scarred along with my uterus and there’s no hope of fertilization anyway?  What if the scar tissue wasn’t actually corrected during the hysteroscopy?  (This is not a totally baseless fear — the doctor said that normally he gets a before-and-after picture of the uterus showing both tubal ostia clear, but he ran out of saline at the end and couldn’t get the “after” picture.  He said he had gotten it all, but now I’ve got this persistent doubt nagging at my mind.)

At least I know I’ve got the appointment with the RE a month from now — that’ll give us a chance to discuss all my fears with someone who is actually knowledgeable about this stuff.  Although of course now my fear is that she either won’t or can’t do anything to help us at this point.

Mostly I just want to know: how long is this going to take?  Is it ever going to work?  If not, we’ll just skip straight to adoption right now, thanks!  But imagining going through years more of this, and then potentially years of adoption work, makes me feel crazy.  I don’t know if I can do it.  But what choice do I have?  Living childless is not a choice that we’re willing to make.

OK, well, time to pick up the pieces and head off into yet another cycle.  May, here we come.

If I’m pregnant today, I’ll be pregnant on Saturday

chart_1

Is that not the prettiest triphasic chart you ever did see?

If I’m pregnant today, I’ll be pregnant on Saturday.  (And if that’s not true, I don’t want to know about it.)

That’s the mantra that went through my head this morning as I fought the urge to test at 13DPO.  It’s been an interesting luteal phase this month — I’ve pasted my chart for the chart addicts, showing a clear mid-luteal-phase dip followed by a triphasic jump.  Looks exactly like my chart from the month I got pregnant with my daughter.  That month I tested at 14DPO and got a clear positive result.

In case you’re interested, Fertility Friend has run analyses on >100,000 charts showing that mid-luteal-phase dips happen on 11% of non-pregnant charts and 23% of pregnant charts.  So not a sure bet by any means, but it flips the probability of pregnancy this cycle from 1/3 to 2/3 — I’ll take it. Similarly, they found triphasic chart patterns on 4.5% of non-pregnant charts and 12.5% of pregnant charts.  Which ups the odds even more.

So, why am I not jumping up and down?  Well, when I saw the triphasic chart start to emerge, I freaked out and tested at 11DPO — with a Target-brand test that had been sitting in my medicine cabinet for over a year.  It was negative.  Cue misery.  I’ve also been sleeping poorly this week, waking up at around 5am and then dozing until my alarm goes off at 6:30, so I might be fooling myself with the triphasic rise (your BBT can increase if you wake up and/or move around early).  One thing I have gotten very, very good at through this whole process is fooling myself.  So I’m trying to calm the heck down and be f**ing serene for a change.  It’s not easy.

Hence the mantra.  If I’m pregnant today, I’ll be pregnant on Saturday.  (And if that’s not true, I don’t want to know about it.)  If I am pregnant, I’ve got a long nine months ahead of me (in the best case scenario), so it makes no difference whether I find out today or Saturday.  And if I’m not pregnant, it’s silly to waste money on a(nother) test to tell me what I already suspect.  I’ll find out Saturday one way or another.  Either my temperature will drop or it won’t.  Either my period will arrive or it won’t.

And until then, I’m going to be f***ing serene.

A Funny Story that I Couldn’t Possibly Tell Anywhere Else

Dear Prudence: our advice column addiction

Oh, guys, this whole TTC journey is just so ridiculous, it’s a shame that it would be wildly inappropriate to share our funniest stories with people who know my husband and me in person.  But thanks to internet anonymity, I can tell you about the hilarious interaction that my husband and I had today.

We were sitting down to eat a delicious dinner freshly prepared by my wonderful live-in chef (i.e., my husband — we do approximately equal shares of cooking, and he’s really good at it!).  As we always do, we started telling each other about our days.  When I was done with my recital he said,

“Are you sure that’s all you have to tell me?”

“Um… yes?”

“Promise?”

“… Yes … ????”

Then he told me about his day.  At the end, he said that he’d been reading Dear Prudence (a Slate advice column that we’re both addicted to) and had found today’s column particularly interesting.  I said that I hadn’t read it yet, but would check it out tonight.

“Oh, really.  Are you SURE you haven’t read it?”

“Um… yes?”

“Promise?”

“I swear it on my life!”

He made me promise six more times that I had absolutely no idea what he was talking about.  I really didn’t!  I swear it to you now, and I swore it to him over and over again!

Then he told me about one of the stories in today’s column (the first letter on Page 2).  He spent the whole day convinced that I was the author!!!  It’s pretty funny, because it really does sound like it could have been written by me, and it describes our recent situation almost perfectly.  I’d even been contemplating how to bring up the possibility of discussing his ED with a doctor, and had been scheming to gently bring it up before our RE appointment in May.  Not that it’s been a huge issue for us — we’ve managed just fine in the end, thanks — but I know it’s been causing him stress (which is a familiar downward spiral to many infertility patients) and I thought it might take some of the pressure off to fill a prescription and have it around, just in case.

As ultimately positive as it was to have this discussion (it was a really lighthearted way to talk about something that is clearly a sensitive subject), I have to say that I’m relieved he took it so well.  He was clearly just amused by the whole thing, instead of upset because he though I’d aired our problem on a national news site that thousands of people read every day (my mom included — we’ve passed on our obsession to her!).  As we were laughing about it, we agreed that it was a shame that this wasn’t the kind of funny story we could tell to anyone we knew — but then I realized that I could tell it here!

So, that’s our absurd escapade on the TTC journey today.  Despite this new wrinkle, we timed things very well again this month and are now just sitting out the two week wait. I’ve recovered from last week’s daycare setback after a wonderful weekend of visiting family and friends leading up to a lovely Easter celebration with my family, and am feeling more like my old buoyant self these days.  I hope you’re all enjoying some springtime sun wherever you are!

Countdown to Craziness

There’s circumstantial evidence that my cycles may be starting to act up again, but I’m surprisingly sanguine about it all (no pun intended!).

I’ve been tracking my cycles carefully for a long time now, both with basal body temperature (BBT) measurements and with digital ovulation prediction kits (OPKs).  At first I did it as part of my initial infertility workup, and now I do it because I like the reassurance of knowing what’s going on with my body, and the lack of guesswork when it comes to how to time sex.  Since our daughter died, I’ve noticed an interesting trend.  Here are the days of my cycle I’ve gotten a positive OPK since September:

September:   15 days after D&C (so, call it CD 15)
October:        CD 15
November:    CD 14
December:    CD 14
January:        CD 12
February:      CD 11

Seeing a trend here?  Shorter and shorter…

Now, all of a sudden for my March cycle it’s CD 14 and there’s no positive OPK or temp spike in sight.  Am I worried?  Nah.  I mean, for one thing, I’m still entirely consistent with a normal period length — if I got a positive OPK tomorrow, I’d have a 29-day cycle, which is still pretty textbook.  After 6 months of looking at cycle lengths in the 40s, 50s, and 60s before I got pregnant, I’m only sort of looking sideways at these numbers.  By now, I know irregular periods, and it’s clear even in my freaked-out state that these are not.  For another… well, if my cycle starts acting funny again, it’ll be all the more fodder for my appointment with the RE in May.  My main worry at this point is that she’ll say “Oh, your cycles have been normal since your loss?  Go away and come back in 6 months!”

Having this appointment on the calendar has been good for my psyche in a number of ways.  Now instead of freaking out about every little thing and worrying that it means we’ll never have a living baby, I just silently note each symptom or worry and add it to my mental list of concerns I want to discuss with the RE.  On that list right now are:

– Could whatever caused the scarring of my uterus have also scarred my tubes?  It’s not like I *want* to do a repeat HSG, but I admit that I would find it reassuring to know that my tubes were still open.
– Really short/light periods.  I barely bleed for two days, and it’s been consistently much lighter and less clotty than before I had our daughter.
– Occasional ED on my husband’s part (poor guy… I think it’s mostly anxiety, but would like to discuss it with a doctor just to cover our bases).
– Cervical mucus that doesn’t seem to bear any relationship to ovulation (it seems random and often at its best 4-5 days before ovulation…?).
– High temperatures.  When I look at other women’s BBT plots online (and there are thousands of them out there), almost nobody’s temps are as high as mine — mine are typically 97.7-98.0 in the follicular phase and 98.6-98.9 in the luteal phase.  When I got pregnant, I knew it because my temps stayed at 99.1 for three days in a row before I tested and got a positive.  Is it healthy for a baby to be cooked by what is nearly a low-grade fever all the time?  I’m pretty sure my thyroid got tested along with everything else in my infertility workup, but maybe it’s borderline high?

Anyway, all of this is why I’ve got no news about our TTC efforts so far this month — because I’ve just been chugging along waiting for ovulation to hit!  I do feel much more relaxed about it than I have for the last few months, and I think it’s mostly thanks to having the appointment scheduled.  I think the scariest thing for me is having no milestone coming up — that’s when I feel like our TTC efforts might stretch out into forever, that we might never be parents.  I always feel better when there’s a clear “what comes next” time to work towards.  During pregnancy I felt the same way — whenever I freaked out, I’d just try to save up my worries for the next appointment.  I’d surely love to cancel that appointment with our RE, thanks to news of another pregnancy (which would bring with it more prenatal appointment milestones to mark the future), but unless that happens, I’m willing to sit back and see what the next two months bring.

Early Pregnancy Symptoms… or Lack Thereof

Predictably, at 9dpo, I’m driving myself crazy.  You’d think I wouldn’t be.  After all, this is only our second try since I had surgery to remove intrauterine adhesions, or our third perfectly-timed try since the loss of our daughter (we tried once early on, before the MFM suggested we put the brakes on things).  But I’ve been so desperate to be pregnant again, and so distressed by the enforced waiting period, that now that we’re actually trying I’ve got a lot of pent-up excitement about the possibility that this could finally be the month.

This month I’ve been obsessing particularly about implantation bleeding.  In the 11 months after I went off birth control and started paying attention to my cycles, until I got pregnant with our daughter, I experienced it twice: the only two months (at the end) that we used digital OPKs and finally got our timing right despite my wacky cycles.  It was classic implantation bleeding: light, only lasting for a couple of days, starting a week after ovulation.  The first time didn’t result in a detectable pregnancy (I suspect a blighted ovum), but the second resulted in our daughter (who died from a placental abruption 4.5 months into the pregnancy, for anyone who’s new here).

Of course, now that I’ve been pregnant once, I’m driving myself crazy looking for signs that are just like the last time.  Or looking for evidence from other women on the internet that different pregnancies are different. (I have googled “implantation bleeding in one pregnancy but not another” in approximately 50 variations, and I’d love to hear any relevant stories from anyone reading this!)

In the three tries using digital OPKs since the loss of our daughter, there hasn’t been even a hint of implantation bleeding, and it’s freaking me out.  Why did I get it both times I used a digital OPK before I got pregnant, and zero of three times after?  Are there yet-to-be-discovered complications from my first pregnancy that are preventing me from getting pregnant again?  Aside from the intrauterine adhesions, I mean… something else?  Were my tubes scarred along with 10% of my uterus?  Are we just spinning our wheels?

Or is it a good sign that I’m not experiencing implantation bleeding this time?  Neither of the cycles with implantation bleeding resulted in a live baby, so maybe it’s good that things are different now?  (Assuming I ever do get pregnant again, I suspect this will be a recurring theme for at least the first 4.5 months of that pregnancy… I can’t trust any of the experiences I had the first time around, since they all ended in disaster, but anything new is also suspicious because it’s new!)  There’s plenty of anecdotal evidence on the internet that women who’ve experienced implantation bleeding in one pregnancy sometimes don’t experience it in subsequent pregnancies, so maybe it’s no big deal.  Or maybe it is.

This endless back-and-forth is what’s been going through my mind for the past several days.  With both pre-pregnancy cycles I experienced implantation bleeding at 6dpo, so if it were going to happen it should have happened by now.  So it’s likely that I’m not pregnant this month.  Unless I am.

I talked with my mom (who also happens to be a women’s health nurse practitioner), and she reassured me that implantation bleeding is not common, doesn’t always happen in different pregnancies for the same woman, and is not a reliable indicator of pregnancy.  She also reassured me that we probably don’t need to wait for a full year before going back to the RE, since we’ve got so many other complicating factors (diagnosed oligoovulation, intrauterine adhesions, and FVL) — she said that if I were her patient she’d send me back after six months.  That was the most reassuring of all, honestly.  I do feel like I can make it through three more months of trying without driving myself totally batty, but I would feel better if our attempts were overseen by our RE so we don’t waste too much time unnecessarily.  I know some people reading this have been through way more than I have, but I do feel that we’ve been through quite enough to ask for some help.  I’ve hit enough super-low-probability problems at different stages of this process that I don’t trust my body at all anymore.

So I’m waiting, and trying not to obsess about every early pregnancy symptom (was that a cramp I just felt?) or lack thereof (where is my implantation bleeding?!).  It helps that I’m on a work trip this week to the Pacific Northwest, where it is beautiful and springlike with tree blossoms and sunshine everywhere.  I’m too busy to obsess too much, too jetlagged for charting to be useful, and I didn’t bring any pregnancy tests in my suitcase.  Take that, obsessive brain!  I get back late Wednesday night, so if my period doesn’t arrive by Thursday you can bet I’ll be pulling out the tests Friday morning, but that’s about the worst I can do.  We shall see.  For now, I’m enjoying the sunshine and lack of snow!