Perinatologist Appointment - 14 Weeks

Today we had our first appointment with the perinatologist - a specialist. We first met briefly with a genetic counselor who addressed the HLA-B27 gene. This gene can cause a few rare diseases which my mom and some of her siblings have. A med student sat in on our discussion. Basically, there is nothing that needs to be done at this time. It is just something that is good to know about in case the baby or I ever have symptoms of the diseases caused by the gene.

The main reason we were there was to meet with the perinatologist for any issues with the baby such as growth restriction or preterm labor and what we could/should be doing between now and delivery to help. The baby is sitting pretty much right in the middle of my stomach and no longer to the right. B and I thought it looked pretty crowded in there from the ultrasound. The measurements were all fine so the baby is growing at a normal rate which is excellent. There were two pieces of information that are not exactly good although they are not a big deal right now. First, the baby is breech (head up, rump down). This is bad because although most babies can turn to be head-first, ours probably won't have enough room to do so. Second, the placenta (I know, gross) is not in the ideal place. They are just going to keep an eye on it for now. It may be fine.

Nothing new has really changed. I think I am starting to show a little. I can't suck it in anymore so I guess I can officially blame my tummy on the baby. I also have to pee a lot more often and have to get up during the night to go.

I told two more co-workers last week. They are good friends that I thought should know before the rest of the office. I am planning to tell my boss next week which I'm sure will go fine but I am not necessarily looking forward to it.

12 Week Ultrasound

We had our 12 week ultrasound today. This one was to test for any genetic disorders, etc. Things like spina bifida and chromosome abnormalities I believe is what we tested for. We decided to go through with these tests since my insurance covers them and so that we would be aware if there was any type of problem.

I didn't know but the ultrasound was a 3D one. You can sort of see the face shape. I posted a picture. It is a little dark since I couldn't use the flash or there would be a reflection. The technician commented on how active the little thing was. She said I would probably be feeling a lot of movement after the next few weeks. She was having trouble getting the pictures she needed because of all the moving around Vegas Baby was doing and had to tap on my stomach to get him/her to get into a good position for a picture.

We also got a goodie bag at the doctor's office today. It had a bag with bottles and formula which was a big wake-up call. Although a little early - it expires about 2 weeks after the baby is due. We also got a run down of what we need to do to get registered with the hospital. It seems like such a long ways off but I'm sure it will fly by.

My next appointment is with the perinatologist on the 23rd. I'm not sure what they will do, I am guessing a physical exam. Ultrasounds are so much more fun!

Almost 12 Weeks

I am really excited that I will have made it through the first trimester as of this Thursday. I had another doctor appointment today. No sonogram but we did listen to the heartbeat and it sounded great. The doctor appointments so far always make me feel much better. I found out that I need to be drinking a lot more water. It helps with infection now and my nurse told me to get used to it because labor will be much easier if I am really hydrated (less painful, etc.). That's enough to convince me!

I also get to stop taking one medication which is awesome. I take progesterone twice a day and it is hard to remember. Plus, it has to be refrigerated so I almost always get to bed or ready to head out the door then realize I need to take it (and it is not fun to take). I also get to stop taking Metformin in two weeks. That one is three giant pills that I have to take with my evening meal. It is a pain when we are not at home or if I am not feeling like I can keep my food down. The downside is that two weeks later I have to take a diabetes test (this medicine is due to me having low blood sugar which throws off my hormones, a side effect of PCOS).

The most interesting thing I found out at the appointment was that the doctor thinks people will be able to tell by looking at my stomach that the baby is more to the right. It won't be terribly obvious but I should expect people asking if it is always sitting on the right. It will be interesting to see if we can tell.

Is it bad that I am already sort of going through a nesting stage? I think it is more that I am such a planner. We decided to furnish our basement. I wanted to get a huge comfy couch down there for a nice place to relax when I am huge and miserable in the spring and when we are trying to get some rest next summer. So we bought a big sectional, a 46" LCD TV, and a TV stand. It will be nice for the New Year's party too... which is still on pregnant or not! We are also going to have fully-furnished guest rooms so lots of beds for guests to stay in. I have planned out where I want each piece of furniture. Now if I just had some extra cash to redo my kitchen, put drywall in my living room, and remodel the garage entryway so that my car actually fits. That is probably asking a bit too much!

The other thing I have been trying to get done is scrapbooking. I have sooo much to do but I want to get caught up before I have another person's life to document. I got a ton of pictures developed and picked up supplies this weekend so I need to get to it.

Next on the agenda is another appointment on Monday. We will be doing some prenatal testing just to see if the baby is likely to have any genetic/chromosome disorders, etc. Insurance covers it so we decided to go through with it just so we are aware of anything that may be a challenge when the baby gets here. After that I have an appointment with a perinatologist (a specialist) on November 23 just to see if there is anything else we should be doing as a result of my condition. Then I have another appointment with my doctor on December 7 to check for diabetes and do a sonogram. My doctor said that I will have around 10 sonograms throughout the pregnancy... one of the positive effects of having to get out of work to go to an appointment every couple of weeks.

Sorry this post is so long... I guess I should post more frequently!

2nd Ultrasound

We had our second ultrasound today. It was so amazing... we were able to see the baby moving around! Vegas Baby was kicking and punching like crazy. We might have our hands full with this one. Also, everything was measuring well and looked good. I am much more confident now that I know that the little one is growing and alive and kicking! Even though we had already heard the heartbeat, this ultrasound with all the movements really made me feel like there is a baby.

 And you can actually tell that it is a baby at 9 weeks... not just a blob!

We really wanted to wait until Christmas to tell anyone but we were just dying to break the news to someone. Plus, I thought it would be nice to be able to talk to someone who had been through this before.

The first people we told were my parents. It seemed like a great time since it was my dad's 50th birthday. My mom had called a day or two earlier saying that this milestone birthday was bothering him. We were throwing a surprise birthday party for him but she was still worried that he might not be real happy. So I told her I had a homemade gift for him that would cheer him up but I had to give it to him when it was just the four of us. When Brett got into town I pulled my parents away from the party and handed my dad a quick handmade card and grabbed my camera. I told him to read it out loud. "Just in case 50 didn't make you feel old... you are going to be a GRANDPA!"

I snapped a picture to capture the moment. My mom's mouth was so wide open. She gave me a big, long hug and had tears in her eyes. Dad was just as excited. We had prepared ourselves and everyone around us that it could take a long time for this to happen so it is shocking and exciting that we are actually expecting a baby in May. Now the true test is to see if the secret can remain a secret until Christmas when we are planning to tell the rest of our families. Don't let me down Mom & Dad... I convinced your son-in-law that you guys were secret-safe!

Beginning & First Ultrasound

I am still in shock and cannot stop thinking about being pregnant. I sort of hope that I "get over it" (to an extent of course) so that time goes by faster and I can focus on things like work or cleaning my house instead of spending every free minute learning everything I can about pregnancy. In the past few weeks, I had been complaining about weird things like my stomach feeling yuck, the "twins" hurting, and other random things. I thought it was nothing since my cycles are often long and we thought it to be pretty much impossible to get pregnant on our own. But Brett thought it was funny and kept saying things like "maybe I knocked you up" or "are you pregnant?". I took my first pregnancy test when I was around 4 weeks pregnant. It came back inconclusive... even though I had bought the kind that says "pregnant" or "not pregnant." I didn't think much of it at the time except that it was a waste of money. The next couple of weeks I continued to feel really nauseous and still no period so I picked up a cheap-o pregnancy test at the grocery store. I took that test on Monday (Sept. 28) in the morning and it was pretty clear that it was positive. I called my nurse and was told to come in for a blood test. My numbers were really good and we had an ultrasound scheduled.

Today (Oct. 1) was my first doctor appointment and ultrasound. It was really neat and sort of made it set in that there really is a baby growing inside me. Brett perked up from the Consumer Reports magazine when he heard the heartbeat. Wow! I had no idea we would hear the heartbeat that early. We also got ultrasound pictures to take home.

Going into the appointment, we thought I was around 8 weeks pregnant based on my last cycle. So we would have conceived around Aug. 15. However, the ultrasound showed that the size of the baby was consistent with someone 6 weeks pregnant. This makes sense due to the fact that my normal cycle had been around 45 days without medication (rather than the regular 28 day cycle). So, conception would have occurred around the end of August. When the doctor told us that we were actually 6 weeks, Brett had a "shit-eating grin," if you will, on his face. He was doing the math out loud and I realized what he was thinking. We were in Vegas at the end of August and he had been wanting to be able to tell people that what happens in Vegas doesn't always stay in Vegas. The doctor got a kick out of that story.

So now we are just waiting for my next scan which will confirm whether our "Vegas Baby" is growing at an appropriate rate. We are also trying not to tell anyone until we are well into the pregnancy due to all the risks. I can already tell that this is going to be difficult. Our goal is to wait until Christmas and I will be four months along.

Treating Infertility

On June 11 after all of the infertility testing was completed, we had a consultation with the doctor to determine what the next steps needed to be. I was put on Metformin (started with 500mg and was told to work up to 1500mg). Metformin is an insulin resistance medication often prescribed for PCOS that helps regulate blood sugar which somehow gets the hormones straightened out. It is a pretty difficult medication to get used to. It really messes with the digestive system which is why you start with one pill and try to work up to three by adding another one every week or two. The pills are also huge which is sort of a pain. I was also told to take low-dose aspirin which has an unexplained positive effect on fertility and prenatal vitamins. So at that point, I was taking 5 pills each night. When my next cycle started (who knows when that would be), I would take fertility medicine and we would do the IUI procedure (think turkey baster).

You may be wondering about the cost of all this testing and treatment. Luckily, my employer's medical insurance includes up to $10,000 (lifetime) for fertility treatment. Additionally, many of the tests and maybe even some of the treatments were coded as a birth defect rather than infertility. We are extremely fortunate in that all of this only cost us a hundred dollars or so (most of which was for the medications).

Cycle Day "CD" 1 was July 1st. CD 3 through 7 I was put on a low dose of fertility medicine called Femara/Letrozole which was one pill per day. Luckily, the only side effect I had was a few hot flashes (some people have a lot of side effects with these types of medications). I was put on a low dosage because it is sort of a trial and error calculation to determine how much you need to get an egg to develop and grow and how much is too much, causing multiple eggs to develop. The low dose seemed to be enough because on CD 10 I had an ultrasound and there was a follicle measuring 12 (the goal is to get it to grow to around 20). The hope was that it would continue to grow. And it did - at CD 13 the follicle was measuring 19. It was a little later than normal but since my cycles are a little longer it made sense. Since the follicle was big enough, I was told to take Ovidrel which is a shot you have to give yourself in the stomach to tell your body to release the egg from the ovary. I could not get myself to do it myself so I had to have Brett inject me. The needle was so tiny that I didn't even feel anything. On CD 15 we had the IUI which was pretty awful and painful. Because the egg was on the right side, they had to inject into my right cervix which is very difficult to get to. Starting on CD 17, I had to start taking progesterone suppositories twice per day. Let's just say I am glad I am finally done with those! On CD 22 I had my blood drawn to determine whether I had ovulated (which would mean the egg was released). They are looking for a number above 10 and mine was at 20. Then it was the waiting game - after seven days I would take a home pregnancy test to see if this worked. On July 29, I took a test and it was negative. So we would have to start over next cycle. The doctor said that if IUI didn't work after 2-3 times we would have to move on to IVF which Brett and I were not comfortable with.

The next cycle started August 1. We decided to not do any treatment this cycle because Brett was traveling for work probably around the day that we would need him and we also had a vacation scheduled in Las Vegas at the end of the month. We would wait until the next cycle started... which was taking forever! It was almost the end of September (close to 2 months) and I had not started another cycle.

Investigating Infertility

At my first appointment with the infertility doctor on April 20, 2009, I had a physical exam, an ultrasound, and blood tests. I had done quite a bit of research on fertility issues in the past due to my uterine abnormality so it did not surprise me when I was diagnosed with PCOS (poly-cystic ovarian syndrome). This was diagnosed in part by the ultrasound which showed many follicles on each ovary and in part by the blood test which showed that my blood sugar was lower than normal. I has previously suspected that I might have this because I experience some of the other symptoms, one of which was an irregular menstrual cycle - I would go anywhere from 45 days to 9 months between periods. PCOS is a very common cause of infertility in women and is basically caused by a hormone imbalance. This causes the eggs to not fully develop or release from the ovaries - which creates the follicles that were shown in the ultrasound.

The next appointment I had was an MRI on April 29th. The purpose of this scan was to determine which type of mullerian anomaly I had. Depending on the type, it is sometimes necessary to have surgery in order to increase the chances for a successful pregnancy. I was diagnosed with a didelphic uterus which was great news because the pregnancy outcomes are the best and there is not a surgical procedure to correct this defect. On May 4th I had an IVP performed to look at my kidneys because many people with mullerian anomalies also have kidney abnormalities. A lot of people have extra kidneys. The IVP showed that my kidneys were normal - I have two and both are functioning.

On June 3rd I had one of the most painful procedures I have experienced. It was an HSG where they basically insert dye into the cervix which is pushed through the uterus and eventually into the fallopian tubes. This test was a check to make sure my fallopian tubes were not blocked and that an egg could pass from the ovaries to my uterus. Because of the pain I was in and the difficulty in accessing the right cervix, only the left side was tested but it showed that that tube was in fact open.

Getting Started

We had known since we were in college that having children of our own would likely be a challenge. I was diagnosed at that time with a mullerian anomaly. This means that there is a birth defect that makes my uterus abnormal. There are different variations of mullerian anomalies but mine is such that my uterus is basically divided into two small uteri. I was diagnosed during one of my annual pelvic examinations. My doctor discovered that I had an extra cervix and an ultrasound confirmed that my uterus was also abnormal. The pregnancy complications that generally result from this type of abnormality include miscarriage, preterm labor, and growth restriction.

We had decided that since we might have problems, we would not use birth control after we were married and would see what happens. We didn't want to eliminate the possibility of having children if "our time" happened to be right after we were married. At the same time, we were hoping that time would not come too soon because we wanted to enjoy a year or so of newlywed bliss. ;)

After about ten months of "seeing what happens" nothing had happened. We still didn't know if we were quite ready to have a baby but I wanted to see a doctor just to make sure that there was nothing I could do to help prevent a miscarriage in the event that I did get pregnant. After doing some research, I found that I needed to see a reproductive endocrinologist. So I called an infertility doctor in our area and set up an appointment. Generally, you would have to wait until you had tried to conceive for 12 months without success to be considered "infertile." But since I knew that I had problems they let me go ahead and schedule an appointment.

Welcome

We went to Vegas and lost all the money we put on the table (and in the slot machines), but it turns out we had some luck in the end. After months and months of trying, doctor visits, a self-administered shot, pills, and a procedure that felt much less than natural, it finally happened. So what happens in Vegas does not always stay in Vegas. Here's the story of our "Vegas Baby."