24w0d: Milestones

There are all sorts of milestones that infertiles and babylost mamas mark (celebrate? cling to? white-knuckle their way to?). Milestones that regular fertile pregnant women don’t even know exist. While they’re counting months or trimesters, we’re marking a different set of dates.

• ~5 days past ovulation: implantation, hopefully
• ~9 days past ovulation: HGC may be detected by the more sensitive urine pregnancy tests (unless implantation was late, oh please G-d let the negative be because of late implantation and not what it always is)
• ~3 weeks past ovulation: gestational sac can be detected by ultrasound
• ~3.5 weeks past ovulation: fetal pole can be detected by ultrasound
• 4-5 weeks past ovulation: heartbeat can be detected by ultrasound

Up until this point, many regular pregnant women don’t know they’re pregnant. We already have baby photos.

• 8-10 weeks gestational age: heartbeat can be detected by doppler, meaning that those who get a doppler for home use can listen as often as they like to confirm that their baby is still alive
• 18-20 weeks gestation: quickening, or feeling fetal movement, meaning that there are periodic indications from the baby saying, “Hey, I’m still alive! And I don’t care for orange juice!”

From here, some infertile pregnant women relax. But some, especially those who have higher risk pregnancies, have histories of loss, or worry a lot, keep on counting.

• 20 weeks gestation: theoretically the halfway point of pregnancy, but for those of us who aren’t expected to make it to 40 weeks, the point at which people tell us it’s halfway and we make a face; also, depending on who you ask, the transition point between miscarriage and stillbirth
• 22 weeks gestation: the cusp of viability, or the time at which a baby born can have a chance of life (only actually achieved by a few of those record-setting babies); this isn’t one that I’ve heard other bloggers talk about, but it’s one that I’ve had in my mind all along… I thought I’d feel better when I reached 22 weeks, but I didn’t
• 24 weeks gestation: viability, or rather, the time at which a baby born will have a 50/50 shot at living
• 28 weeks gestation: survival quite likely
• 34 weeks gestation: if born, lungs may be developed enough to function without major intervention
• 38 weeks gestation: full term for singletons; for many of us, a shangri-la

Regular pregnant women may be counting the days until they can get that baby out of their body (and meet their child), but we are trying to keep them in as long as possible, one day at a time.

My bloggy friend Carrie, who is pregnant with triplets (from a two-embryo transfer), has made a countdown calendar to 24 weeks. The dates of her own milestones are burned into her brain.

I always know the exact count for the current day. I get strange looks when people ask how far along I am and instead of “5 months” they get answers like “23 weeks 3 days!” But unlike Carrie, I can’t tell you the dates of any future milestones without consulting the calendar. All I know is today. There are no guarantees tomorrow, but today, things are okay. 

Some of those milestones shouldn’t be as big a deal as they are to me, because they are still pretty bleak — and also, there’s no reason at this point to believe that we won’t make it all the way (or as close to all the way as twins tend to go). But still, the milestones matter. Today I am 24 weeks, and that matters a lot. As much time as I may spend worrying about tomorrow, and a hundred tomorrows after that, for today, this is enough.

When are you due?

A coworker recently mentioned that although she has never been pregnant, more than once she has heard the question, “When are you due?” It’s completely rude to say that to anyone, but this coworker happens to be on the slim side of normal. In her case, in addition to being rude, the question is just strange.

Today, I saw someone whose name I’ve heard but whom I’ve never met or seen in person before. She looks about eight months pregnant. She is also overweight. I have no idea if she is pregnant or if she always has a large abdomen. She doesn’t walk like a pregnant woman, but if I’m misjudging the pregnancy’s timing (if indeed there is a pregnancy to time), it could just be too early for the pregnancy waddle. I may be very curious, but I would never ever ever ask her if she was pregnant.

I don’t diet and I never have. However, since I started injectibles this spring I have been watching my weight to avoid weight gain. During that first cycle, I felt like I gained 15 pounds. The scale didn’t say that I’d gained any weight, but there was decidedly more fat on the part of my abdomen that happens to be directly over my uterus. That area normally has relatively less fat than other parts of my stomach. I didn’t enjoy that puffiness, but at least it wasn’t bump-shaped.

My vigilance to avoid weight gain comes out of two places: my concern that if I do become pregnant, I don’t want to show too early in case of miscarriage; and my concern that someone will ask me if I am pregnant when I am not. Often I am teetering on the brink of emotional stability, and a question like that is enough to push me over the edge.

It has to be even worse for people in the public eye. Eva Longoria, for example, is constantly the object of pregnancy rumors whenever she gains a couple of pounds. She keeps having to deny the rumors, explaining that she has been gaining weight because she’s not starving herself like she usually does. If she’s not TTC, the speculations are merely insulting. If she is TTC and has been unsuccessful, the speculations would be heart-wrenching.

A message to the jerks of the world: Hey, jerks, you can wonder and speculate to yourselves all you want, but stop asking us if we are pregnant (or writing articles about your speculations). No woman needs to have her expanding abdomen pointed out. Rather than asking, just wait a couple of months and see if we announce any news, or wait 9 months and see if any babies pop out.

Barren Advice: A Follow-Up

A big part of the impetus for finally starting a blog is that I was the anonymous question-asker for Barren Advice Nine on my favorite infertility blog, Stirrup Queens and Sperm Palace Jesters.

The advice from Mel (a.k.a. Lollipop) and all of the commenters was truly helpful, and their genuine shows of support were truly heart-warming (“comments are the new hug” in action). I wanted to be able to repay the favor, at least in part, with a report on how it turned out. In a Dear Abby type of advice column, we never find out what happens. Mel says:

No really, the beauty of a blog advice column is that you get to weigh in with your two cents too.

But another beauty of a blog advice column is, or should be, that because the advice is for a member of the blog community, you get to see how the advice fared and hear the rest of the story. If Ann Landers gives very good or very bad advice, no one ever knows because there is no follow-up. Mel would never give bad advice, but I still think she and everyone else deserve to know what happened.

If you haven’t already, you should read Barren Advice Nine before reading the rest of this post. I will wait………

Okay. Thanks for coming back. So, here’s what happened. In addition to the main issue, I will include some other issues that arose in case they help anyone else faced with a similar situation.

The Barren Advice consensus was very clear that I should test on my own, so I decided to listen to the wisdom of the group and pee on a stick.

Egg retrieval was on 6/11. Beta was scheduled for 6/25, but because I was out of town it was rescheduled for 7/1. POAS date would reasonably have been around 6/25; if I tested a day early like I sometimes have in the past (so that a negative test wasn’t really negative, at least not yet) POAS date would have been 6/24.

I didn’t end up testing until 6/28.

There were several reasons:

• I was occupied with family stuff or other obligations almost all day every day and couldn’t make it to the store to buy a pregnancy test.
• When I finally did have some time to go to the store, I realized that I would have to walk back into the house with the test. To maintain my secret from family members, I might have to hide the test under my shirt or something. Even for a secretive liar like I have become thanks to IF, hiding something under my shirt was too much duplicity for me to handle.
• I didn’t entirely want to know the result. This whole time, dealing with dozens of natural cycles and 8 assisted cycles that didn’t work out, IVF has been the fall-back, the fail-safe. Disappointment after disapppointment was horrible, but still manageable, because there was always something that would definitely work if it came to that. The idea that this IVF cycle, and by extension possibly all IVF cycles, could fail, was too scary to face, at least for a few days.
• My logic was this: “If I test and it’s negative, it’s negative. If I don’t test, it may still be positive.” Okay, I realize that’s not actually logical. I was less concerned with actually getting a positive, and more focused on dealing with the negative result that I thought was likely.

One of the commenters, Kathy V, offered the additional advice to be careful not to leave the pee stick lying around or throw it away. This advice was appreciated though unnecessary, since this isn’t the first time I’ve had to hide a pee stick. This time, the new twist was that I was on progesterone suppositories that had to stay refrigerated. Refrigerators are very public places, and it was out of the question to leave my meds for everyone to see (even though I took off the labels, I couldn’t risk questions or worse, having someone throw them away). In the house where I spent most of that week, and where I would have tested if I’d been on schedule, there actually is a second refrigerator in the basement. Still, I couldn’t risk having my meds discovered if someone went to the second fridge for a spare bottle of wine or carton of milk.

My solution was to use ice packs inside a cooler bag hidden in my luggage, and to rotate the ice packs from the freezer every 12 hours or so. If the medication were truly temperature sensitive, ice packs would not keep it cold enough, but for the progesterone they did the job. One suggestion for anyone else who may need to use ice packs for this purpose: find ice packs without leaks or condensation. The packs that came with my medication from the pharmacy didn’t have a problem, but the regular packs that the family uses for lunches released so much moisture through condensation that the progesterone got all wet. Yuck.

Oh, I didn’t give you the pregnancy result, did I? Yeah, well, long story short, I was but now I’m not.

When I finally got around to testing, it was a BFP. By that point, I had started getting a bit nauseous so I had a clue that it might be positive. My husband, who is usually as patient as I am, had been pestering me to test several times a day by then. Yet at the time of the actual test, we had a comedy of errors. I stupidly decided to pee in a bathroom with no toilet paper, so I got to sit on the toilet and stare at my BFP for over 10 minutes until DH finally happened to walk by and I could ask him to bring me a roll. He did, then before I could tell him the news, he immediately disappeared (he has no interest in watching me go to the bathroom) to a room occupied by others. I went to that room, quietly asked him to join me in the bathroom, and showed him the stick. He said, “I’m not familiar with those sticks. Is two lines good?” Yes.

He was happy, then increasingly thrilled as the days went on. I, surprisingly, was not. So much for grabbing happiness where I can. The first couple of days, I was guarded and didn’t believe that the BFP would stick around. Even though I was experiencing continued and increasing nausea, I wanted two beta results to really trust the pregnancy. I was also spotting a bit, though I didn’t take this as an indication.

By the third day, I had gotten over my reservations enough to start conversations with DH about planning for the pregnancy, baby stuff, and keepsakes I wanted to buy now so that the child would have them as an adult. Later that day I started bleeding more.

The next day, my first beta. The number sounded low to me, but the nurse said it was fine.

Two days later, my beta hadn’t changed. I knew something was wrong when I heard the doctor’s voice on the phone instead of the nurse’s. I wasn’t sad, though, because I was too busy with other stuff.

I wasn’t sad for over a week. And then one day it hit me. Halfway back now.

The heavy period the doctor promised never actually came. All of the bleeding occurred when I was still “pregnant,” and by the time of the second beta I’d stopped spotting altogether.

Back to the drawing board, IVF #2. Next time I’ll try to stay at home during the 2WW so that I can get my beta as scheduled. Not that it made any difference in the outcome, but I don’t think all of this secrecy is good for my karma — or my sanity.

Thanks for reading and for being interested in what happened. And, another big thanks to Mel and all of the Stirrup Queens who helped me out.