Two peas in a pod

This past weekend was my baby shower, put on by my sisters and my mom. The shower itself was fun, decorations lovely, food was tasty, and the guests were generous. All in all, it was a good day. The weather was even perfect for it!

The day before my shower, we had an OB appointment. My sister got to join us and was excited to get to hear those two little heartbeats. Baby B kicked the doppler a couple of times, which was fun. Baby A (per tradition) was squirming around to avoid the doppler and we managed to catch the heartbeat only for a few seconds before the baby found a good hiding spot away from the doppler. :)

OB gave us the bad news that she is leaving the practice and moving to another office 30 minutes north. She gave me a hug and said we could follow her, but since our trip was already 45 minutes, she recommended that we just stay at the practice and she would have one of her colleagues take over my care after she leaves in a few weeks. It was difficult news because we had grown pretty close to her and absolutely LOVED her as a doctor.

Today, we are officially 23 weeks along in this pregnancy and DH and I are celebrating our 8th wedding anniversary. What a great day!

Two babies!

"Two babies" is the phrase I hear from my sister almost every time we have a conversation. my 2 year old niece now does the same. These are the most recent pictures of our little blessings and things look good. Baby A is a little smaller (actually, Baby B is a little bigger), but both appear healthy and are developing nicely.

  Baby B is a thumb sucker and it was the cutest thing to watch as its little arms were over its head and covering its face until finally it found its thumb and all was well with the world again. We opted for the genders to be a surprise, but we have a pretty good guess about them at this point. My husband tells me every day that he can't wait to meet them in person. I agree, but at the moment, I am enjoying their active little kicks and punches and flips. Pregnancy is amazing!

Side effects I continue to deal with these days include hiccups (STILL!!) and issues with food. I certainly get hungry, but nothing sounds good. I eat, but am full almost immediately because there isn't much room in there. I am pleased that my earlier food aversions have basically ceased and I am once again able to stomach sweet treats like ice cream and chocolate (though I still watch it on this stuff). Also, sleeping is a bit of an issue. about 3-4 nights out of the week, I wake up between 2 and 3am and find myself to be wide awake for a solid 2-3 hours before I am able to fall asleep again. This is NOT typical for me as I am usually a solid sleeper. I guess it must be practice for after the babies are born.

Our most recent OB appointment was a lot better than the previous one. At this one, no concern was made about my weight. She appears to be okay with it given the development of the babies. Also, my blood pressure was within normal range at the appointment, so no medication just yet. I am still to monitor it at home and will return in 3 weeks for another check. She also mentioned something about wanting to do another ultrasound to check on growth in the next month, so I'm looking forward to that as well. At 19 1/2 weeks, I was measuring at 30 weeks compared to a singleton pregnancy. My OB believes I will get HUGE and asked if I was prepared...as if I have a choice. I think I can do this though and she agrees. She commented on how good things looked and how pleased she was at this appointment, so I am feeling much better in general about how things are progressing.

We got new windows in the bedrooms yesterday, so the nursery is no longer drafty. It remains mostly empty since we removed all the furniture and make a downstairs living space to make room for these little ones. Our shower is in a couple of weeks and our nursery (and house) will likely be overflowing with lots and lots of baby stuff. From there, we will assess our needs and start adding furniture and other baby essentials as we are able. As this pregnancy goes on, I am getting more and more excited!

Still going strong

This was a photo of our babies at 12 about weeks gestation. Twin "A" was chilling at a different angle than its sibling, so its view is of the top of its head, but twin "B" gave a nice profile shot for this one. I had intended to do a better job of chronicling this pregnancy, but alas I have let the ball drop so far. This picture was taken a month ago, so in a couple of weeks, we'll have a new picture to post of even bigger babies!

After an initially rough start to pregnancy, things have been much smoother. My first trimester, I had almost no nausea, but I had terrible gas until about 12 weeks. I stopped fitting into my clothes at about 9 weeks, but my bump really started showing at about 13 weeks. Second trimester symptoms have included some heartburn and daily hiccups. Also, it is becoming noticeably more difficult for me to get off the couch or out of bed. It takes much more effort, which is shocking to me because I don't feel like it should be that difficult already. Trips to the bathroom are a little less frequent than they had been a few weeks ago (for now). I have more energy, but get more winded when I do things.

My first OB appointment was scheduled at 12 weeks, but because my doctor got called away to deliver 2 babies, we were rescheduled for the following week. Fortunately, I was still able to get my ultrasound and blood work taken care of, so by the time we did get to see my OB, the test results were back and she was very pleased with how everything looked. It was a HUGE relief to know that she was okay with my weight gain of 2lbs in a week, that I am at low/no risk for gestational diabetes, and my blood pressure is good so far.

Tomorrow will be the official 17 week mark in my pregnancy and I swear I have felt some movements occasionally since about week 15. This morning, I distinctly felt some movement and I am looking forward to being able to feel even more. What I really can't wait for is when my husband will be able to feel and see the babies moving. He kisses them every night before I go to bed and tells them goodnight. It's so sweet!

We officially broke the news of our twins on Facebook. It was initially a passive announcement, noting that we are starting our pediatrician search and wanted some recommendations. While our close friends and family have known for quite some time, there were several of our FB friends who didn't have a clue. We have been getting lots of congratulations messages from people since the big announcement. It never ceases to amaze me how genuinely excited people have been for us, not only because of our pregnancy after years of infertility, but because we are having twins! While I would be lying if I said I was not excited, I live with it every day and know we have several more weeks to wait until we meet these blessings, so I am not jumping up and down with excitement as much as some of our friends and family have been. I told my husband that it makes me feel good to know how excited others are for us, which perhaps makes me feel less like bopping up and down myself. Also, our infertility journey has been so long and so physically and emotionally draining. I feel so very blessed to be pregnant after all we have been through to make this happen, but I feel like it wasn't like, "Surprise, you're pregnant! Bet you didn't see that coming." It feels more like, "It's about time, geez!" Of course, my husband and I are the only ones who really understand this feeling we both have. We are VERY excited, but just overwhelmed at how much it took to get to this point. Last night, we agreed that it would be amazing if we were able to get pregnant on our own after this, or with much more minimal treatment (if we even want to try again someday).

This has been a long road and I am so glad we have finally had some success. I pray every day that our babies continue to be healthy and that I continue to be healthy and that all goes well. Our official due date remains January 14, 2014 a this time, but we are still expecting these two amazing blessings to appear before the close of 2013.

First picture

This ultrasound was done at 8 weeks, 0 days. It was our first ultrasound and our last appointment with RE before being released to the OB.

We have 2 babies growing (baby B is a little fuzzy in this, but everything looks good). Both babies looked good and had great heartbeats.

I have spent the 8 week mark with a cold complete with laryngitis, so it took me a couple of days before I had enough of a voice to call to schedule the first OB appointment which has been set to occur when I am 12 weeks along with these babies.

My family and the few friends who know are excited. Actually, my sister who has kids is over the moon. Every day, she tells me what she is saving for me from her own collection of baby stuff and she has already told me that she is getting stuff together for my baby shower. Baby shower...my mom suggested we do this in September when my sis is in town, so it is still a few months away. I appreciate her excitement. I was excited when she was pregnant too, but she is topping the charts with her enthusiasm.

Other than the cold, I have been managing fairly well since the OHSS. It took a couple of weeks for the swelling to subside, but I am finally able to wear some of my clothes again for the moment, though I am again outgrowing them at this point.

Since this is my first pregnancy, I am not sure what to compare it to, but there really hasn't been a day that has gone by that I haven't felt something...round ligament pain, cramping, soreness, something to remind me that there are amazing things happening inside me right now. I'm going through that mix of excitement and terror with my emotions, but overall I am enjoying this.

Pregnancy and OHSS

I have developed late-onset ovarian hyperstimulation syndrome (OHSS). This is a condition in which the ovaries swell because of increased HCG levels and cause the body to release fluid into the abdomen instead of flushing it out of the system properly. It can occur as a result of the trigger shot prior to egg retrieval, or in my case, because of a positive pregnancy when HCG levels are rising quickly. It varies in severity from mild to severe and can include symptoms such as bloating, cramping, decreased urine output, decreased appetite, fever, weight gain, shortness of breath, etc. There is no actual "treatment" for late-onset OHSS because it is pregnancy-related. All they can do is monitor symptoms and do maintenance therapy, such as procedures to drain some of the fluid, encourage increased intake of fluids that contain electrolytes (like Gatorade), increase protein intake, and increase salt intake.

My case was determined to be moderate. My RE says he sees this in approximately 1 out of every 100 patients and was able to confirm my fluid retention with a ultrasound that showed fluid in all four abdominal quadrants. He was sure I had at least 2 liters of fluid, but they were only able to drain 800 ml. I have experienced some relief in that my swelling is not as severe as it was and the fluid seems to move around from my belly, to my hips, to my back and sometimes seems to decrease in volume slightly (especially after eating my protein and salty foods). I have been assured that OHSS doesn't negatively impact pregnancy, may be an indication of multiples, and is actually a good sign that pregnancy is progressing appropriately.

This OHSS may last anywhere from couple of weeks to the end of my first trimester which means that it is very likely that I may look 5-8 months pregnant for at least 2 more months. None of my pants fit (except for my few pairs of stretchy pants), so I am having to take myself shopping for some maternity clothes to get me through until I can fit into my old clothes again (whenever that may be).

This makes keeping my secret pretty tricky. I had explained at work that I had surgery (I told them I was having a cyst removed when I was actually having IVF) and this is an uncommon complication. It is true...this isn't a common condition and it is related to IVF. However, I'm waiting for other people to start asking because I have literally ballooned overnight.

We told our families on Mother's Day. I'm only 4.5 weeks pregnant, but given the slight complication and the holiday, we thought we could use the extra support. Our closest friends won't be told until after our first ultrasound which has been scheduled at the end of this month (I'll be 7 weeks by then). Other friends, relatives, work people, and general acquaintances will be told after 12 weeks. Almost everyone knows how long we've been trying and how difficult this journey has been, so we want to make it as special as we can when we share our news to each group.

At this point, I hope and pray that this pregnancy goes well and that this OHSS is the only major bump in the road.

BFP

Well, transfer day arrived and we only had 2 blastocysts that made it. We had planned to transfer 2 which meant we didn't have any left to freeze. The blastocysts we had were graded BA and AA, so they looked good. I'm not sure what happened to the other 8, but that left my husband and I to feel a sense of defeat and desperation for at least one of our two little blasts to stick since we wouldn't have anything left to do a frozen cycle later if necessary.

Transfer went well and I felt nothing essentially until four days later when I woke up feeling strange. I felt bloated and fat (I don't usually feel like this, especially when I first wake up), had noticeable cramping and strange pains here and there and my appetite changed...either I wasn't hungry, or was craving foods that I don't eat very often. This went on through the next day as well, so I caved and decided to start testing early. I fully anticipated a negative test this morning when I was testing 6 days after my transfer (and three days early), but it immediately turned positive.

I am cautiously optimistic about this. I know it could be a false positive, but I plan to continue testing until my blood test in three days. In the meantime, I have an appointment to get my progesterone level checked tomorrow, so I might mention it to my RE, but this is the first time I have ever had two lines show up on a pregnancy test, so I'm enjoying the moment for now.

I've been busy!

I kept thinking that I needed to update my progress, but things have been so crazy this month, between taking time off from work and going to appointments and trying to stay on top of everything else, that I just haven't had a chance to update until now. When I left off, I was finishing my birth control and was starting Lupron injections...

Lupron is no fun! It came with headaches and made me grumpy and I was an emotional mess (don't know if that part was the Lupron, or if it was a mix of several factors). Historically when on birth control, AF tends to do stupid things like show up in bits about a week into to pills. She didn't let me down this time, either. Official day 1 was the day after my last birth control pill, but AF had been unofficially around for a couple of weeks already. In spite of this, my baseline testing was good.

Baseline results:
     Estradiol- 38.12
     LH- 3.76

I started my FSH injections shortly after and was fully expecting my emotions to be even crazier. My husband swears I wasn't "that bad," but I felt like I was. I guess I just did a REALLY good job of keeping it to myself, or at least not taking it out on him. I had a couple of anxiety/panic days, but felt pretty good until my CD7 testing. RE's nurse seemed "okay" with results, but she and RE agreed that they needed to bump me up a bit on the hormones (as expected...they always do that to me).

CD7 results:
     Estradiol- 100
     LH- 3.72
     Progesterone- 0.57
     Lining- 8
     Follicles- 7

So, after getting my blood work back, RE decided to double my dose of medication. I was okay with this, but realized I would then need more than I had stockpiled (I bought a lot of my medications ahead of time to "save" them for this cycle, so I could save some money). This sent me into a bit of a panic, which was worsened of course by the meds which prevent me from being able to logically talk myself down from a panic. However, I was sure I had worked this out and was able to relax for a couple more days.

CD10 results:
     Estradiol- 646.88
     LH- 2.66
     Progesterone- 0.43
     Lining- 13
     Follicles- 15

RE's nurse was sure that by day 10, RE would decrease my meds, but they didn't. This sent me into a panic again because my "prior arrangements" had fallen through at the last minute. Fortunately, I was able to order just enough in the nick of time, but as a result of my panic, I skipped a dose and took only a partial dose one day, thinking I would run out otherwise. Fortunately, I was mistaken and had exactly what I needed by the time my additional meds arrived the next day.

Side story...my meds arrived no thanks to the FedEx guy...have never had a problem before, but he delivered my packages (I actually had two shipments of meds I was expecting on the same day) to my neighbor's house instead of mine. My address is clearly posted on my house and my mailbox in front of my house and my neighbor's address is clearly posted on her house as well (right above where he left the packages). I was home and waiting and even saw the truck take off after he left, then noticed that my packages had been marked as "delivered," which immediately sent me racing out the door to try to track down my mail...fortunately, they were still sitting on my neighbor's porch, so I grabbed them and brought them to my house. Lessons learned from this: Don't waive the signature and FedEx doesn't have a way that you can file a complaint.

CD13 results:
     Estradiol- 1,999
     Lining- 13
     Follicles- She stopped counting at 17 and said there were several more, but she said there was no 
                     reason to keep counting at that point.

On day 13, I was informed that I was "ready." Things looked good and they didn't even run all the lab work because my ultrasound and estradiol levels were evidence enough that things were where they should be. I was told to do my HCG trigger that night at 7:30 and my egg retrieval was scheduled two days later...we had to be at the clinic by 7am.

Let me just say that I am a morning person, but to be at the clinic by 7 meant that we were up at 4:45 to take showers, get dressed and head out the door by 5:30 because it is an hour and a half drive from our house to the clinic. It was definitely a long day!

Egg retrieval wasn't like I pictured it would be. The anesthesiologist said that some people are awake through the whole procedure, just medicated enough to keep the pain away. I was really looking forward to this, but no sooner did she put the meds into my IV did I feel them hit me and the very next thing I remember is hearing them tell me they were almost done. What the heck? I missed the whole thing! I had not been adequately prepared for how I would feel after the retrieval, either. I had expected some cramping, but didn't realize that there would also be pressure/bloating/gassy feelings in my abdomen and I further didn't realize that it would make any bathroom activities very painful! I have a high pain tolerance, so it was more uncomfortable than painful, but I think having not been fully prepared for what to expect made it a little worse initially. After I discovered that my feelings were normal, I went online to see how I could help ease the symptoms a bit. For those who may need some support with this, here is what I found... drink lots of fluids (especially ones with electrolytes like Gatorade---yuck!), sleep sitting up (RE had told me this one) for a couple of days, laxatives as needed (and in my case, they were definitely needed), high protein and low sodium diet. I also had pain meds which helped quite a bit, but made me feel really strange, so I used those sparingly. Today is "the day after" and I'm feeling a lot better. All my symptoms are still there, but to a much smaller degree. Hopefully, within another day or two, I'll be feeling somewhat normal again.

Got the fertilization report from the embryologist this morning.

     Eggs retrieved- 15
     Mature eggs- 12
     Fertilized eggs- 10

So, I'm off the hook for a few days while these little guys and girls grow. The embryologist will call us on day 3 to give us an update on how they're progressing and we are planning to transfer 2 of them on day 5. We will be freezing the rest.

I am so excited about how well this cycle has gone. RE's nurse swears I have never before responded this well and she felt really good about how things were progressing. I hadn't always been as convinced, but I do believe several factors may have helped us out: 1. weight loss- I've lost 60 pounds since our last attempt 2. herbs- I have been regularly taking false unicorn root and cramp bark per the recommendation of my herbalist even though most of this cycle 3. time off- I took several days off work to "regroup" and tried to schedule as many of my appointments during those times as I could which helped lower my stress levels. I feel really good about our results now that I know we have our 10 fertilized eggs sitting in an incubator. I'm hoping they develop the way they are supposed to and that our transfer goes smoothly. Then... I am praying that  I will soon be able to announce my first pregnancy after nearly 8 years of trying!