The Miscarriage

*Note: I wrote this on October 11^th, even though I’m not posting it until now. I wanted to get the blog up to speed chronologically first. As I referenced in the last entry, we encountered a problem, and I wrote this in the moment when dealing with it…

Yesterday was a bad day. Everything changed.

The day started off normal, leaving for my monitoring appointment at the local IVF center. I was supposed to have bloodwork and an ultrasound. I got my bloodwork done. Then the nurse comes over to tell me that they don’t do OB ultrasounds for anyone except their own established patients. I am infuriated because now they’ve left me in a bind. Why wouldn’t they have told my clinic this when my IVF nurse arranged to have my monitoring done here? She said that they didn’t specify what type of ultrasound it would be. My IVF nurse setup my monitoring here in June! I wasn’t pregnant until October 1^st.  I would think that it would be part of the discussion when setting up my monitoring that I’m a GC and the time will come when I’m pregnant, so obviously at that point in time, they will also need OB ultrasounds. Why wouldn’t this IVF center think to inform them then that once I become pregnant, they won’t do my ultrasounds? It sure does make logical sense to me, since the expectation is obviously that I will be pregnant at some point. But I guess we can’t all be that thoughtful and competent. So instead they send me on my way and I have to figure out on my own where I’m going to get my ultrasound done. Highly unprofessional, if you ask my opinion.

I left there, furious (and I let them know), and I started by calling my doctor’s office. They gave me the number of an imaging center next door. I called them, and thankfully they were able to fit me in! I just had to make sure the payment was sorted and I had the prescription for the ultrasound. I knew, worst case scenario, that I could just pay it myself and be reimbursed, but I called my contact at the reproductive agency, and she took care of it all for me!

The next hiccup was this…my prescription said OB ultrasound, meaning that I am pregnant. The alternative ultrasound would be checking my ovaries, follicles, endometrium, etc., in preparation of the IVF transfer. So my clinic marked off OB ultrasound. But apparently down here, they interpret that as transabdominal automatically, when in actuality, when you’re pregnant, it could be either transvaginal or transabdominal. At this early stage of pregnancy, you can only see anything transvaginally. But because my prescription didn’t specify, they automatically took it to mean transabdominal and told me I needed to drink 32 ounces of water by an hour prior to the appointment. Done. I drank it. And at appointment time, I wanted to cry my bladder hurt so much! Then, of course, while I’m squirming waiting to be called, there was an issue with the credit card they were given. The woman wrote down too many numbers. So they made me wait until they got that sorted. It was unbearable. Seriously! I had to let out a little before being called back. Have you ever tried to just pee a little when you have to pee so badly you want to cry? It’s not easy!

Finally it gets sorted and they take me back right away. However, that little bit I peed only did the trick for a couple minutes. I’m in pain again. I’m in so much pain that when I got in there, I just started stripping for her to do it as fast as possible (because I was thinking it would be transvaginal). Then she said according to the prescription it’s abdominal. So I pull my pants back up and jump up on the table. She tried to get a quick image first, but I couldn’t take it. I had to run to the bathroom and squeeze out a little again. So I did that twice. Again, not easy! And in the process I also got that ultrasound jelly all over the front of my pants. Oh joy! But I have to pee so badly, I don’t even care.

So I’m back on the table again, relieved just enough that I can get through the transabdominal ultrasound. She can’t really see anything, as she explains how at this stage it needs to be transvaginal, but my orders don’t specify that. She takes all the pictures she can take, and lets me go to the bathroom. Thank God!!!! I don’t think I’ve ever peed for that long! I felt so much better. But, true to form, because I’m pregnant and drank so much water, my bladder continues to fill even after that and for a good hour or two I had to pee constantly. The good news is that I won’t have to do that again! Because we determined that it is in fact supposed to be transvaginally. After waiting on hold for a while with my clinic, I finally got confirmation, and they faxed over an updated prescription immediately so we could redo the ultrasound right away, the correct way. The ultrasound technician was kind enough to even let me wait in the room while I was on the phone and just waiting for the updated orders. Fortunately, she didn’t have another appointment right away. So we got them, and she was able to do the correct ultrasound again. It was quick. I was in and out. I don’t have to drink water for that one, so even every time I need it repeated, I don’t have to worry about holding my bladder like that again!

So I was able to get all that sorted and could then be on my way. Did the rest of my errands and went home. Then I got the call…my results were abnormal. My HCG was at 416, and it should be around 1500. They also were not able to see much on the correct ultrasound, and it seemed that the pregnancy could be low in my uterus. These are indications that it’s an abnormal pregnancy. I had questions, obviously. If it turns out that in fact it is an abnormal pregnancy and not viable, the 2 options will be miscarry or abort. They can take me off my medications and allow my body to naturally miscarry, or they can do a D&C to remove it. I haven’t discussed the details of either of these with them yet. I want to wait to see what happens still. I’m told that I need to go back in 2 days for all these tests again to see if there’s progress to indicate a viable pregnancy or if it is in fact abnormal.

After I get off the phone, I’m in a daze, for a few hours. This is certainly not what I was expecting. The emotions I’m experiencing are all over the place. It’s only natural for me to be upset. Plus I’m upset for the parents. Plus this changes everything! It would take at least a month or so for my levels to return to normal before they can start again. So suddenly, I must start thinking about plan B as well when I thought plan A was working. I also just realized that I had not fully thought about the possibility of things turning out this way. I mean, I knew it was possible. But I didn't imagine going through a miscarriage alone. I imagined going through a pregnancy alone and I was fine with that. But not a miscarriage. And all I wanted in that moment was to be hugged. But it was only one night that I felt like that. I was better by the next day. I could deal with it then. I was anxious about the results, and generally felt from the conversation that they were expecting a confirmation of an abnormal pregnancy, so I wasn't very hopeful.

After those few hours in a daze, I took to google. I learned a lot. Yeah, it’s not good that my HCG isn’t growing as it should be. My HCG the previous Wednesday was 198, and this Wed was 416. It should be much more than that. But I also learn that the HCG growth rate of doubling every 2-3 days is true for 85% of pregnancies. There are still 15% of pregnancies that have a slower HCG growth rate. I also learn that until the HCG is at 1000, you can’t really see anything on an ultrasound. I also learn that even though the pregnancy may be low in the uterus, that is something that can correct itself as the pregnancy progresses because the placenta often moves up the uterine wall. So I read a lot of pros and cons. It’s highly likely that it’s an abnormal pregnancy that will end. But it is still possible that it may be okay. So I’m feeling more hopeful and positive.

I also did a lot of praying last night. I slept very well, and I woke up feeling okay. I still feel hopeful and positive, but I also feel okay with it however it goes. I do believe that everything will work out the way it’s supposed to, and everything will be okay. Everything always seems to work out. So I’m just going to trust that.

I did speak to my IVF nurse again today. Nothing new really. They didn’t get any better information from the imaging center today, so it’s all as planned with my tests for tomorrow. She did sound even more so like they are expecting the results to confirm an abnormal pregnancy. I asked her what the chances are that it is okay, and she said the chances are still there but they are very small. I mentioned the statistics I read and she said that is true and exactly why they continue the tests to make sure. I asked her if she told my IP’s, because I didn’t know if they knew. She said she did. I actually got an email from them today asking how I was as well. So we will see how tomorrow turns out, and we’ve all got our fingers crossed!

Update…the test results came back worse. My HCG had dropped to less than 300, and the ultrasound basically confirmed that it was an abnormal pregnancy. My IVF nurse told me that it was implantation failure, and that this occurs in 25% of cases. What makes me sad about it is knowing that it was a healthy embryo. It feels like a waste, or a lost baby, that way. But there’s nothing anyone could have done to prevent this. It’s just something that happens. So I was told to stop all the medications, and my body naturally miscarried.

Well, that was fun. Not! I was anticipating cramps, but I didn’t really know how bad it would get. Then, I was pleasantly surprised and thought it would be pretty easy. I didn’t even feel anything, but I saw what I believed to be the gestational sac, when it passed. All I had was some light spotting. However, the next day was different. That is when the light spotting became heavy bleeding and the cramps were very bad. Bad enough that I took 3 Excedrin Migraine pills. (They work for all pain, not just migraines!) They made it bearable to get through the day. Fortunately, the cramping was just the one day, though the bleeding did take the rest of the week to stop, even if it was pretty light. I felt bad for the ultrasound tech the next day because I had to go confirm that it was all cleared out and a D&C wouldn’t be needed even though the bleeding wasn’t done yet. But they said they’d do it, and she did. Fortunately, it was all gone and barely any lining was left. So now it’s the waiting game again.

We are going to try again, as soon as possible. I am now waiting to get my period again, which will take 2-4 weeks. Then I start the medications all over again. We are hoping for a late November or December transfer date. As my IP dad said, hopefully this time, those percentages (on implantation failure) will work for us instead of against us. Will keep you updated!