I'd imagined two possible scenarios for today. The one where everyone was happy and congratulating me and I was truly released to the OB never to return again, except to show off the baby next spring. And the one where the embryo had stopped growing and Dr. Gorgeous and I had a sit down in the conference room and talked about D&Cs and FETs.
You have to know where this is going, right?
I find myself, still, uncertain about the viability of this pregnancy. The good: Peanut's measuring around 8w5-6d (though Dr. G said the angle was really difficult, and she had a hard time getting a good measurement), heart rate of 173, wiggling around all over the place. The bad: gestational sac continues to be small, small enough that Dr. Gorgeous is actually concerned (I think the measurement was 7w4d?). Things I didn't want to hear her say: increased risk of miscarriage at any point during pregnancy, could be due to your natural tendency toward clotting issues, I wish I could send you off and say this will turn out fine, but I can't. I'm sorry.
Still, I've been released to the OB. She said she'd make a note of all this in my chart for the doctor; asked me to keep in touch with her. For now I'm supposed to stay on Lovenox, increase fluids, and rest. I was sort of shell-shocked when I left, so I have a call in to find out what exactly she had in mind in terms of activity level and also if she thinks this warrants seeing a perinatologist (I assume it does, but there's only one in town, he's an asshole, and I'd like a referral to someone else).
I'm not sure what to do with this information. I'm not sure how dire the situation is (Dr. G mentioned a few other patients, some with positive outcomes, some not, including other DE folks). I do find it interesting that during my pregnancy with LG my amniotic fluid level was measured monthly (via ultrasound) and it tended to run high (almost problematically so). So I'm guessing at the very least I've got increased monitoring in my future. And hell yes I'm renting a doppler.
*sigh* why can't it be easy. get the doppler... wish I had something comforting or funny to say.
ReplyDeleteUGH! Thinking of you.
ReplyDeleteWow, I hate this uncertainty you are having to endure. Will you be able to see a peri besides the one who is a jerk? I am staying positive and thinking only about you being one of the patients with the good outcome. Hang in there and I totally agree about the doppler!
ReplyDeleteI am so sorry you have to go though all this - But I am so impressed with the way you are dealing with it.
ReplyDeleteI'm willing to travel to see a different peri, depending on what Dr. G says. I need major handholding and I know I won't get it from the guy in town.
ReplyDeleteBun, you think I'm dealing with this well? I guess that's the illusion of the internets for you. I feel like my uterus is a coffin for this poor embryo.
shit shit shit
ReplyDeleteI hopr you get good answers to your questions soon.
love, inB
Did she tell you difference in diameter of the gestational sac and the embryo? I have heard stories where it was a bigger difference than a week - like a couple weeks - and it did come out fine. I will be sending you good thoughts and hope the sac catches up in the next couple weeks.
ReplyDeleteI'm so hoping that you're one of the success stories. I have never heard of the sac having its own gestational age/measurement, I guess I assumed it grew in proportion to the baby. I hope you get a referral to a good specialist who can provide not only top notch care but the reassurance you need!
ReplyDeleteRachel, yes, in a normal pregnancy they do grow in proportion; but the sac size does have its own measurement, which is very reliable early on.
ReplyDeleteI'm not sure of the exact difference in mm, Kristina, but the sac seems to be about dating about 8-9 days smaller than the embryo. Which is about 12 days off from actual gestational age. If you've got specific blogs/studies to point me to, please do!!
Hi again Gwinne - here is an abstract I found for a related study: http://www.ncbi.nlm.nih.gov/pubmed/1553175
ReplyDeleteIt seemed like if you were close to 5mm difference, it's very reassuring so I was hoping. . .
I did also read about a couple other people on other listservs/websites who differed by 2 weeks timewise and it came out okay.
Damn Gwinne.
ReplyDeleteHow can you ever rest with this? I think you can only hold on to the good stories and file them in your head. The Peanut is holding steady and I love this news.
I find the clothing changes a constant terrifying reminder of how fragile this whole thing is still.
I cannot answer your question about why SCH is easier on the IVF pregnancies except that it is more common and expected? I dont know. I let myself get railroaded in the exam and I hope to pull out some better information this week.
Dammit.... Why cant SOMETHING be easy??? UGH!
ReplyDeleteSending you big hugs and warm thoughts...
Kristina, thanks, I appreciate the link. I've seen that study, and ones done after it. What's blatantly obvious (based on my own inept math) is that we're probably talking about a 1-2 mm gap between CRL and GS. Which is pretty fucking dire.
ReplyDeleteThe sac started about 2 days small, and then about 4, and then a week, and now about 12 days. While the embryo continues to grow at a pretty normal rate. Doesn't take a mathematical genius to figure out what happens next...
I'm not sure how you figured the mm out. Sounds like you might be wrong in your calculations, yes? - could you ask Dr. G? The hope we might hold onto is that it HAS been growing (the GS) right? and what seems to have happened in other cases is that it picks up it's pace or kicks in gear at a certain point and catches. up. . . I'm thinking of you and sending positive thoughts.
ReplyDeleteI think my math is probably pretty sound. The formula, I think, is sac size = age of embryo in days + 30 mm. So it's pretty easy to reverse that to figure out sac size in mm. Which is pretty much the same size as the embryo. Which sucks.
ReplyDeleteThe one thing I'm holding on to is most of those studies looked at GA 5-9 weeks, which I'm past. And soon the embryo should start producing its own fluid, as opposed to being dependent on my fucked up body. Given that I'd used an egg donor, the likelihood that this is due to a chromosomal problem is small. Oh, the joys of clotting disorders...
Dr. G is supposed to call me in the next day or for a chat, and her staff is getting it worked out for me to see a perinatologist at a major medical facility where she used to work (1.5 hrs from here).
So, one day at a time, I guess...