You Won't Believe This

I'm not sure I have mentioned this before, but I learned a while back that my star staff member (let's call her Stacy) was also trying to conceive. She has known about my situation for a while. She knew about the brief pregnancy a year ago and she knows about our going to CCRM and everything. A couple of months ago I briefly became obsessed with the fear that we would get pregnant at the same time and have overlapping maternity leaves. If I wrote about this at all, it was during that time.

Well, my fear has come true.

She told me yesterday during her annual performance evaluation. I was prepared for the news because I had pretty much figured it out. I think she was pretty scared to tell me because she was not sure that I was successful with the transfer. I congratulated her and asked when she is due. January 13. I said, "Are you kidding me?" She said, "When are you due?" (So she assumed the best, which is nice.)

She had her first ultrasound the day before and learned she was further along than she expected. She said she started counting the weeks (because she knew the date of the transfer) and went, "Oh crap!"

It was a lot of fun to discuss symptoms and such but then we got down to the serious business of how to tell the big boss, who is liable to freak out.

My boss (the big boss) and I had a great conversation about my plans over lunch on Monday (and I was going to post about it but have still been feeling miserably nauseous, especially at night, which is when I normally post). She asked if I was coming back to work and I told her I don't know yet. I was able to openly discuss my feelings, saying that my biggest concern is doing something I'll regret, either way. I learned that she had been thinking of ways to keep me on in a part-time capacity in which I could work from home (if I don't want to keep my current job). She said I'd been very loyal and she believed in rewarding that. She also had been thinking of whether or not Stacy (from above) could take on most of my job (the parts I wouldn't be doing part-time). We discussed this and also discussed the possibility that Stacy wants to have a baby, too. I was pretty encouraged by this discussion. My boss is so good when it comes to giving people opportunities to advance.

So. Fast forward from Monday to Thursday. Things are a bit more complicated now! The boss didn't freak out, but she is trying to figure out what to do now. She asked what I think we should do and I told her I need to think about it.
I think the most important question for me is what I personally want to do. But I am very concerned about what happens if I leave. I have worked so, so hard to build my team and have increasing success every year. We are now completing our best year ever. I want everything to continue growing even if I'm not the one to make it happen.

Gotta run. I took a vacation day today to get ready for the in-laws and the big birthday party for DH on Sunday. Yay!

A Big Sigh of Relief (or two or three)

The first sigh of relief is for my Atlanta RE, who hugged me 4 times and was soooo excited for us. She said she'd been thinking about me.  She could not have been nicer. (See yesterday's post for the back story on this.) I'm so glad I went out of my way to see her today for the ultrasound. She probably would have been disappointed if I had scheduled with one of her colleagues. And the outcome of the u/s was the perfect ending to this chapter of my story with the Atlanta clinic.

The second and third sighs of relief are for our TWINS!!!!

As soon as the image appeared on the screen, my doc sort of squealed and jumped and said, "We have two!"

I was just in awe looking at that monitor with those two gestational sacs and those tiny little fluttering heartbeats.

She took lots of pictures and printed them out. I'll have to see if I can scan them or photograph them another day.

Here are the details:

Embryo A
crown rump length (CRL) is .77 cm (7.7 mm) with a heartrate of 138 bpm
6w5d (based on size)
Projected due date based on size: 1/8/11 (my mom's 69th birthday!)

Embryo B
CRL is .71 cm (7.1 mm) with a heartrate of 137 bpm
6w4d
Projected due date: 1/9/11

I believe that full term for twins is 37 weeks, so those due dates are late. The u/s machine simply calculates things based on the individual size of each embryo.

I have mostly been in shock about this. I do feel like I now have an explanation for all the nausea. This evening I was going to take a short nap but my mind couldn't stop thinking about twins. DH was in the next room and every now and then, I'd say something like, "It just got a whole lot more expensive to fly home" or "Our childcare costs just doubled!" I started thinking about getting two babies in and out of car seats in my Volvo S60 and taking them ANYWHERE at all. Wow. If we do indeed end up with twins, I've got a lot to learn. I've got a lot to learn no matter what!

I am excited but kind of overwhelmed. I haven't cried at all. DH did get teary after the u/s. My mom cried on the phone. Actually the only time I got a bit misty was when I was walking toward the building from the parking lot thinking about all the times I've walked that path. I thought about coming and going before and after so many failures and wondered if I'd exit the building today with another failure under my belt. I thought about what good care my doc has given me, about the time she sent me to the ER across the street when I had unbearable pain a week after my first transfer. I thought about the times I'd been wheeled to the curb in a wheelchair post retrieval. It was odd knowing that any success I would claim today was not because of the work of this clinic. But I do give them a good bit of the credit. Without my Atlanta doc, her nurse, and the rest of the team, I would have never made it to this point. They weren't able to get me across the finish line but they've cheered me on along the way and my doc has coached me through this in many ways. It really has been a much more personal experience than CCRM. But that makes sense when I've only been to CCRM a few times in comparison. And I can't imagine Dr. Babycraft hugging me. Not in a million years.

You may think I'm crazy going on and on about the Atlanta clinic like this but I think it's something I have to do to put everything that's happened behind me.

More later!

Nauseous and Nervous

Tomorrow is our ultrasound! We will be 6w5d. I am nervous now that the day is upon us. I haven't had much time to emotionally prepare for it because I've been so nauseated and quite determined to find a way to manage it. I haven't even been anxiously counting the days until the ultrasound because just getting through one day is a major accomplishment right now. I read something yesterday about the importance of stellar nutrition during the first trimester and it launched me into action. Today I forced myself to eat a bagel, a small yogurt, some nuts, part of an apple, a few bites of a fruity granola dessert, about six cheezits, a bowl of chicken noodle soup made with egg noodles, and a small portion of ice cream. That's the most I've eaten in one day in quite a few days. And I wouldn't exactly call that stellar. But I think eating more helped keep the nausea at bay, to some degree. I hope my little embryos are still growing in there. I guess I'll know a lot more tomorrow afternoon.

The appointment is at 3:15 with our Atlanta RE. I haven't seen or spoken to her since last November after I got back from the one-day workup at CCRM and she was exhibiting a bit of professional jealousy. That particular day, we talked on the phone, and she actually told me it was a business decision that they don't do labs or monitoring for out of state patients. She said it was an inconvenience for the staff. By the end of the conversation, she had offered to "go to bat for me" with her colleagues at the practice. (She is one of the founding doctors of this practice... She can do whatever she wants. I knew this.) But I played along and following our phone conversation, I sent a very passive agressive email saying it is a lot more than business to me and for them to refer me to CCRM and then not continue to monitor me was contrary to the wonderful care they'd provided me during the previous 15 months. I also thanked her profusely for going to bat for me. About a week later, my nurse emailed and said they would do the monitoring. When I scheduled my first monitoring appointment, the scheduler acted like it was no big deal at all, so I casually asked, "So do you all do this pretty regularly for patients going to out of state clinics?" She said yes.

I was pretty hurt by this whole thing. I felt like my doc had kicked me in the stomach the day she said they wouldn't do the monitoring. She actually made me cry. She is the warmest, most friendly doctor I've ever had. She has amazing bedside manner. But she's human and I guess she got jealous.

I could have scheduled this appointment tomorrow with another doctor in the practice but I asked for her because I'd like to "feel the love" for her again. I don't want that kick-me-in-the-stomach phone call to be my lasting impression of her. She did pretty much talk me in to going to CCRM and giving them a chance, after all. So I'm turning the other cheek.

Obviously, my nervousness tomorrow isn't just about the ultrasound. I hope she acts like a grown up! I'll let you know. More importantly, I'll let you know the status of numbers 1 and 17. This seems surreal!

Six Weeks

I think my last post confirms a suspicion I had -- I have no readers (well, maybe one or two) from Atlanta! I still need to find an OB but I'll sort that out eventually.

This week I began having some difficult symptoms -- nausea, extreme tiredness, and food aversions -- off and on throughout the day. I haven't quite figured out how to manage the nausea and food aversions, which are linked. My aversions aren't exactly specific. It's more like food in general makes me want to gag. A lot of what I've read has suggested eating smaller meals but if I do that, it will be a big change. And I somewhat dread every meal, so if I have to eat six small meals, my daily dread will be doubled. I have found that if I eat something before my stomach gets really empty, the nausea and aversions are held at bay a bit. I have also found that if I make myself eat something, it usually turns out okay. My nausea isn't accompanied by vomiting, at least.

I really want to figure out how to manage this because I hate feeling like this all the time. Last night DH and I had agreed to go get something to eat at one of our favorite neighborhood spots and then I backed out because we waited too long to go and I started feeling miserably nauseous. I apologized and told him I'm afraid I've ruined his life for the next few months. Later, he said he was thinking about what I said and that that's just not so. "It's all about you," he said. Sweet!

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Some of you won't believe this after all of the thought and effort put toward NOT telling the boss -- I told her on Thursday. I was feeling so bad, I became concerned that I was going to have to quickly exit an important meeting or that she was going to notice me dragging myself through each day. The telling turned out just fine. I think she actually likes being the only person in the building who knows. She was very congratulatory and didn't freak out and start asking when my leave would be or talking about how she's going to find someone to cover for me, etc. -- there was none of that. I'm relieved that I told her because I was spending a little bit too much energy keeping it from her. Our offices are next door to each other and it's just easier this way.

******

I don't know what it's like in other cities and towns, but in Atlanta, I'm told if you are going to need childcare for an infant, you need to get put on a waiting list as soon as you get pregnant -- and there might be a spot available by the time you need it. A year ago, I took this advice to heart and within less than a week of my first good beta, I started making calls. I got really excited about the possibility of finding a great situation for the baby and about the new relationships we'd have with our child's caregivers. Plus, it made everything seem very real. However, within two days of making those calls, things faltered and they started using the phrase "not genetically viable." Having had these conversations with childcare providers made this even more difficult.

So this week, I made one call. It freaked me out, so I decided to take my chances and wait a bit longer for such research. If worse comes to worse, I have no doubt that my mother, the first-time grandmother who would probably move in with us if I asked her (not gonna happen!), will gladly bridge the gap until our time on the waiting list turns up. Within a few weeks, though, we do need to get a move on finding the best situation we can. This will mean tours of facilities, applications, and wait list fees.

*****

Our big backyard project is almost complete -- on time! But something horrible like 40% over budget. The contractor and I have had a few moments because he just doesn't listen to me. Does what he wants, even though it is my yard. I haven't had to go so far as to ask him whose yard it is, but I have thought about it. Luckily he usually gets everything right in the end. The whole thing is going to be awesome. So much better than we ever envisioned.  We have two weeks until the inlaws arrive, so we're now in the phase of finishig touches. We're going today to shop for a new outdoor dining table because the one we had picked out is now on back order until 6/30. We may just wait for it because the price was right and it was just what I want.

******

So that's about all my news. Not a lot to report. I have not felt like posting much but I have been reading and commenting on others' blogs. Our ultrasound is next Thursday, at six weeks, five days. I'm sure I'll post again after that, if not sooner.

Need an OB in Atlanta

I don't know if anyone from Atlanta is reading, but I am -- fingers crossed -- going to need an OB/GYN. My regular doc is way out in the 'burbs and I don't want to drive to his office for prenatal care. I love my regular doc so I've been waiting for pregnancy to occur before switching. It looks like the time for the switch is approaching.

I want to deliver at Northside Hospital and want someone with an office near Northside or somewhere between there and Midtown. I also would like a female but am not married to that idea. After all, a male doc "got me pregnant."

If you don't want to post your recommendation in a comment, please email me.

Thank you!!

Not Telling, Encouraging Stats, Rooting for Pie

Ahh, it's a lazy Saturday morning! I love it. Thought I'd do an update on a couple of things:

I made it through the meeting with the boss yesterday without any inquiries about the outcome of the FET. I was ready, thanks to comments on my previous post, but didn't even need to evade any questions. I had a stroke of luck, actually, and was able to preempt any inquiries by bringing it up first. My boss told me that one our colleagues, a man with a big personality who's always making people laugh, is leaving the organization. This is a big loss for us. I was saying things like, "Oh no!!!! This is terrible!" Well, this guy always conducts a "baby pool" among all staff whenever a woman is expecting. (I have never participated but basically, people bet on when the baby will be born and the person who's closest wins the pot of money.) In the midst of my very genuine "oh no" reaction, something flashed through my mind. My opportunity! So I said, "WHO is going to do my baby pool when I have a baby someday?!" Somehow I knew that my boss, who I know pretty well, would not ask me about the FET after I said this. She just said, "I don't know. I guess someone else will have to do it." And that was it! Ha! I am probably safe until my next meeting with her, which isn't until after the six week ultrasound. Whew!

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I left work a little bit early yesterday because I worked so late Thursday night. I went home to rest a bit and found myself feeling anxious about making it nearly 2 more weeks to the six week ultrasound. This is a whole 'nother 2ww! I pulled up an old email from CCRM's genetic counselor in which she provided me with a statistical summary for people who've had comprehensive chromosone screening (CCS). Here it is, verbatim:

2007-2009 Blastocyst-CCS General Update
N = 154 transfers
Average maternal age = 37.5
Average number of embryos transferred = 1.87
97% survival post vitrification
~61 % implantation rate
~74% clinical pregnancy rate (6 week ultrasound)
~71% ongoing clinical pregnancy

13% of patients who undergo blast biopsy had all aneuploid* embryos. This means 87% of the patients had at least one normal embryo available to transfer. Of the 154 woman who have had transfers (this does not include the patients whose embryos were all abnormal) of euploid** blastocyst embryos, ~110 have delivered a healthy baby (or babies). I calculated this number by taking 71% of 154 (see stats above).

* “aneuploid” means chromosomally abnormal
** “euploid” means chromosomally normal

I wanted to know where I am in those statistics now, so I called her -- and luck was on my side, I caught her! -- to ask a few clarifying questions. I was thinking the 61% implantation rate was a typo but she said it is not, because it is a calculation of implantation of each embryo transferred.

I asked about rates of miscarriage and she said they don't track them at every step of the way. BUT what she did say was very good news -- the miscarriage rate for women in this study after they had positive betas was just 4 to 5 percent!! This is exactly the kind of reassuring information I was seeking. I could, of course, be in that 4-5 percent, but my mind is at peace with those odds.

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Last but not least, today I am thinking a lot about Pie, whose beta is tomorrow -- on Mother's Day! That's just wrong. And to top it off, her husband is out of town until tomorrow. If you have a minute today, say a prayer, send some sticky vibes, or visit Pie's blog and leave an encouraging comment. Pie, I am rooting for you!

A Strange New Place

Thanks again to everyone for your comments and support!

I don't have time to post this, but I feel the need to get some thoughts out. Now that I've had two strong betas, I'm officially pregnant. I've never been THIS pregnant before, which is sad since I'm only 4 weeks and 4 days along. I feel like I should be further along, given my symptoms -- lots of weird feelings in my midsection and extreme tiredness.

Don't get me wrong -- I am HAPPY -- but I am realizing something: I don't know how to be pregnant. I know how to be infertile. And this is sad but true, but in some ways, I'm more comfortable being an infertile underdog than a pregnant CCRM "graduate."

Right now, since it's too early to tell people, I'm spending a little bit too much time thinking about how to NOT tell people, especially my boss. I have a meeting with her on Friday morning and I'm hoping she's not going to be asking about where things stand. She knows about the FET and knows it was on 4/22. I've thought and thought about a way to say, "We're not ready to say yet" without ticking her off. If she gets testy about things, then I'll be ticked off. We've been having that effect on each other quite a bit in recent weeks, so chances are good. I just hope she doesn't ask, because I have no doubt that she expects to know as soon as I know something, which in itself infuriates me (and is pretty much illegal).

Anyone have suggestions for handling a nosy boss who already knows too much?

Gotta run. I have a VERY long day tomorrow -- it's my organization's "signature" event and I'll be working a 12+ hour day, much of it on my feet.

Still Pregnant

I am sooo tired -- meant to post earlier but got sidetracked with DH's birthday party invitation -- but I couldn't let the day pass without a quick update.

To recap -- Saturday's beta was 387. Today's was 1,108!
I'm still pregnant and very relieved.

My nurse asked, "How many did we transfer?" (two)
She also asked, "So you're okay with multiples?" (yes)

Of course it's still too early to tell. We'll have our first ultrasound on May 20, so I would think we'd know then.

Thanks to everyone who's reading for your wonderful support and happy comments. I just keep reading the comments over and over because almost no one in my real life knows and it's fun to be happy and excited with you. I appreciate you all -- my followers, my lurkers, and anyone who's prayed or sent baby dust, sticky vibes, or positive energy my way.

A Call from Summer on May Day

So the call came in at 10:26 a.m. (so early!) and I was in the middle of a session on international adoption at the Resolve Family Building Conference in Atlanta. I had been thinking "oh I hope don't really need this information" not five minutes before I looked down and saw my phone light up and begin to vibrate. It was CCRM. I jumped up, steppped over a few people and bolted out of the room, leaving my purse and other belongings behind.

The caller, whose name I didn't catch because I was so surprised they were calling so early and because I was flustered from rushing out of the room to catch her call, said, "Well, we got your lab results back." And I thought it was going to be bad news - just for half a second. Then she said, "And everything looks great. Your HCG was 387!"

At that I pretty much started rambling things like, "Oh my gosh! Are you serious? I can't believe you called so early! Do you know where I am? I was just in a session about international adoption...."  She asked me what time I went to the doctor because she was surprised to get the results so early, too. My appointment was at 8 a.m., which is 6 a.m. in Denver. Good for my Atlanta clinic for sending results over so promptly!

She confirmed that I'm doing daily PIO shots and 3 endometrins per day and then said for me to keep that up. I didn't even think to ask what my progesterone level was. I did ask about the HCG of 387 and confirmed that even though that's kind of high, it's too early to make singleton or twin projections. The nurse said she's seen numbers like that result in both.

Before we hung up, I asked, "What was your name again? I want to remember this." It was Summer. I thanked Summer for such great news.

Yahoo!!

Now on to the next hoop: Monday's beta -- HCG needs to double!