Thursday, October 19, 2017

Gender Reveal

The amount of blogging I am doing this journey is indicative of how busy I am this time around! Between Stars & Stripes Doulas business and PTO stuff, plus cheer, baseball and everything else in between, I have just been super busy.

I finished shots at 13 weeks.  I have been feeling great.  No sickness at all this pregnancy. I have had pretty bad fatigue, but what lady doesn't in their first trimester? 

At 15 weeks, we went to a lovely little boutique ultrasound place to find out the gender of this sweet baby I am carrying -- that is being so kind to me!  So here's some photos from the ultrasound.




Baby snuggling with the placenta

So without further ado, here are the reveal photos that the fabulous Julie Gayler Photography  captured for me!


 




Yep -- That's right, Gayby is a little girl!!!  I am stunned - She's been so kind to me that I seriously thought she was a boy!  She looks fabulous and healthy and the dads are so excited that they will have a little girl to spoil!

In other news -- I got braces yesterday and they have me questioning life's choices.  They hurt pretty bad -- Keeping the end in mind here!

 

Finally, today I went in for an early gestational diabetes test.  Since I am not in the 'normal' range for BMI (Who makes these standards anyway?) I had to get 2 tests done this pregnancy.  I failed today's test as it was not fasting.  The soft foods that I can eat are all carb or sugar loaded -- so naturally, I failed today's test -- not significantly, but still. I have to now take a 3 hour test in the next week. I have never had problems with my sugar -- ever.  4 pregnancies and I haven't had an elevated result.  But today, I did.  Next test, the 3 hour, is fasting.  It is going to be brutal.  Drink this sugary drink on an empty stomach and sit there pregnant and starving for 3 hours.  Sounds like a dream! 

Hope you enjoyed this update and photos.

Thursday, September 14, 2017

11 wk update with Ultrasound Photos

It's been 4 weeks. I am not the best at updating this go around!

We are currently 11 weeks today!

A little catching up to do here -- I went in at 8 weeks for an ultrasound here at the clinic I will be seeing for the pregnancy.  I had been having spotting off and on for a week so I was a little nervous.  But all was good.  Baby measured perfectly.



The doctor I had that day was interesting. The nurse actually told me to just not disclose it was surrogacy because the doctor had strong feelings against surrogacy.  So I just answered questions very pointedly.  It was IVF, 5 day embryo and a donor egg.  I didn't really elaborate on it at all from there and fortunately he didn't ask because I am not sure what I would have said.

Today, we had an 11 wk check up and both of the dads got to be at the appointment.  I was placed with a really fantastic doctor and I asked her "How do you feel about supporting a surrogate pregnancy?" and she said she was excited. She hoped we would continue to see her and that she would be the one delivering the baby in April.  She was excellent and thorough.  My favorite part was the ultrasound.  This is the first time that the guys got to see their baby in more than just a video or ultrasound photo.  I couldn't see the ultrasound machine at all, but I didn't care.  I was enjoying their faces and remarks.  Their baby even moved... a lot... for them to see.  Baby's heartbeat was 156 today.






These pictures aren't great, but it was very clear on the monitor -- they did an abdominal ultrasound so they aren't as clear as a transvaginal ultrasound.

And this baby kind of has an unintended nickname.  The last one was called Teacup because her parents were British.  I really haven't come up with anything this time. I tried to. I wanted something that resonated with C specifically, but it just wasn't seeming right -nothing rolled off the tongue.  He likes Western themed things - Tumbleweed & Sheriff were two options... but they just didn't stick.

My Friend Melissa said one day "This is so not PC, but Gayby is the baby's nick name!" and it has kind of stuck in our circle of friends  People crack up over it.  We even got a laugh about it in the exam room today with the doctor in there -- the dads weren't offended!  They think its funny.  Maybe the nickname will come when they find out the sex!

Our next appt is in 5 weeks and they have put the request in for me to schedule the anatomy ultrasound!

One last thing -- Today, I was in the Lab getting my 10-14 week genetic screening drawn. When we were sitting in there, everyone started cheering out in the hallway. I was unsure of what they were cheering about but looked.  Apparently a car pulled up to the front of the hospital and a doctor ran down with a bag of things and delivered a baby right outside the front of the hospital!  The cheers were for mom & baby come into the hospital safely!  That baby is going to be reminded that story every year on his or her birthday!

Saturday, August 19, 2017

Beta and Ultrasound Update

So I might be a little bit of a slacker, but I have good reason -- As soon as I had my blood drawn on Monday the 31st, we hopped in the car and started a cross country trip that would take 18 days.  We just returned on Wednesday late at night (we came home a day early).


Needless to say, when you are traveling with a 10 year old, 7 year old and 4 year old, you are busy and you don't sit on the computer much! I only blog from my computer -- though I should figure out how to do it from my phone since I am on it all of the time!

The first beta results at 10dp5dt or 15dpo was


Second beta at 13dp5dt or 18dpo was:


Everything was looking great -- Progesterone and Estrogen were fantastic as well!  I can tell you that I suffered from terrible car sickness on this 4,271+ mile trip!  Not only did I have car sickness, but I also experienced tremendous altitude sickness in Denver and Colorado Springs! 

Our highlights on the road included Denver, Mount Rushmore, Badlands National Park, visits with friends in Omaha and Des Moines, a Wedding and family time in Wisconsin and meeting up with friends in Louisville, KY.  It was an exceptional trip with a lot of fun memories made.

On Saturday, August 12, my husband and I got to go to a wedding together with no kids (they stayed with their aunt and uncle and cousins).


This paragraph contains TMI -- If you don't want to read, skip this paragraph.

We had a great time -- good food, good company and we danced to a few songs.  We headed home and it was pretty late.  On the way home, I started feeling off.  Got sweaty, felt incredibly nauseous.  I thought it was the food at the wedding.  Then my stomach started cramping and I thought I needed to use the bathroom.  Told my husband that I wasn't even getting my purse, instead I was going straight to the bathroom.  When we got back to the house, I got out of the car and started heading into the house and bleeding started.  It was so much blood.  It was in my shoes, all over my dress, all over the pavement.  I was terrified.  I yelled for my husband but could not go in the house.  He ran in and got me a towel so I could at least get myself to the shower to clean myself up.  On the way, I ruined a rug.  As quickly as the bleeding started, it stopped.  Within 5 minutes, the bleeding ceased but so much blood was lost quickly.  I called the doctor on call and he just said to hydrate and to call my doctor on Monday.  I took it easy all day Sunday and aside from being extremely tired, there were no other signs of any of what I had experienced the night before.  Monday my doctor asked me to come in when I got back in town for an OB ultrasound but seemed optimistic that the bleeding did not continue.

We drove back from Louisville, KY on Wednesday night, got in around 11pm.  The next day we hopped right back into the car to drive the 100 miles to the clinic to find out how this little baby was doing.  Everything is perfectly on track and the bleeding is unexplained but thought to be a subchorionic hemorrhage or hematoma (SCH).  This is a pocket of blood between the baby and the uterus that can just spontaneous release the blood.  This type of bleeding doesn't typically last days, so it is easier to distinguish between miscarriage and SCH.  The doctor explained that this happens in 20-30% of their IVF patients.  While it is common, it is still terrifying when it happens to you.  SCHs can resolve and never have another problem, they can grow and ultimately put the pregnancy at risk or you can have many bleeding episodes throughout the pregnancy.  Looks like we had best case scenario, because this baby is hanging in there with a heart rate of 136 and growing right on target (Baby was 7w0d for ultrasound, measuring 7w1d).  Due date is April 5, 2018. It looks like the pocket of blood completely collapsed and we shouldn't have anymore issues.

This doctor was really fantastic and thanked us for allowing him to care for us -- it wasn't our usual doctor.  To know that the whole practice has compassionate and caring doctor really means a lot for recommendations!  The doctor asked if we wanted to facetime with the parents but due to their schedules and commute, I opted to record it so they could see it as many times as they wanted and could share with everyone!  I love that the doctor explained exactly what we were looking at for the parents -- as if they were in the room and that he congratulated them many times.  Dr. Shah with Virginia Fertility Associates really is a stellar doctor!

Here's the video. 
video

We have another appointment coming up this week on Thursday as well to get us established with the OB that will care for us throughout pregnancy -- so I will update after that appointment! 

We could not be more excited -- especially the daddies to be -- They are OVER the moon -- I am sure their family is too!  Great things to come! 

Monday, July 24, 2017

A follow up on the positive digital test.... And an explanation about TWINS and 5 day embryos

You didn't think I quit peeing after getting my positive did you?



Just a few progression photos.  They are getting darker with each test which means my HCG is increasing which is exactly what we want. 

So speaking of HCG, our blood test is on Friday.  With that test, it will tell us how much HCG is in my system and the doubling rate shows if the pregnancy is considered healthy.  If the test started showing positive on Friday, we can theorize that the level was about 20.  The standard doubling rate for HCG is every 48 hours.  That means that by Sunday it would be 40, Tuesday 80, Thursday 160 and Friday around 240.  These are all guesses and the first number is not indicative of anything except PREGNANT.  When you get your next number, it should be doubling in about 48 hours.  So the test for this pregnancy will be on Monday which is 3 days later.  The speed of doubling can be indicative of twins too.  If you double much faster than 48 hours, it could mean you are carrying twins -- but it would mean fraternal twins which isn't a possibility with this pregnancy.

Fraternal twins means TWO eggs were fertilized.  Since we only had one embryo transferred, that is not possible.

So let me give you a little anatomy lesson as to why my early positive tests are not indicative of a 4 letter word (TWIN) pregnancy. 


We transferred a 5 day blast.  DI/DI twins are cleaved at the morula stage-- 1 to 3 days after fertilization.  With this type of identical twins, there are two sacs, two placentas.  Placentas make the HCG.  This type of identical twins would have high level of HCG produced in early pregnancy.  Mo/Di twins would be possible for this type of embryo transfer since the blast cleaves at days 4-8.  these types of identical twins have a separation in their sac but they share a placenta.  Mo/mo twins cleave days 8-13 and the twins share the same sac of water and the same placenta.

So theoretically, we have a really strong embryo that is hanging on tight so that is why our tests are so beautiful.  We won't have an ultrasound until 7 weeks. 

If you think I have seen enough positive pregnancy tests, you're wrong!


So I have all of these tests I have done... but it is still not enough -- look at how many I have left to go! 


Sunday, July 23, 2017

Digital Test Video -- But it is still early.




You know what makes me nervous?  Doing digital tests.  Nothing worse than spending $7 on a test that is negative.  It is the nature of surrogacy and IVF.  You need to see the word "pregnant" for it to be real.  But let's be real, it is still early.  This test was taken at 4.75dp5dt (4.75 days past a 5 day transfer) or 9.75dpo (days past ovulation).  Digital tests aren't sensitive at all.  But I can't help but continue to pee on all sticks -- even when they show up negative.

Other side notes, I have a tripod, why didn't I use it?  This video makes me dizzy.

Tuesday, July 18, 2017

Post Transfer Update

 Today was transfer day and it couldn't have gone any better!  C&E came over to my house first thing this morning and gave me a gorgeous bouquet of flowers and a nice little thank you card and we rode down to Richmond together where we took a pit stop to Nonnie's house to drop the kids off.  But first, E&C got roped into playing with the kids before leaving.  The kids gave a whole tour of the garden and the chickens and they went to the pond to skip rocks and played on the swing.

I got this little Willow Tree Figurine with a card.  I was trying to come up with something sentimental and symbolic when I saw this and I knew it was perfect.  It is a little boy holding a small plant.  This plant grew from a seed and one day will be something amazing and big.  On the box it said "The gesture of this piece, something special, is on e of protection and caring for something precious, our children... I see it as a piece about possibilities." 
We got to the clinic on time and I quickly got undressed for the nurse to come in and check the visibility of the uterus on ultrasound.  The nurse commented on how beautiful the lining was. You have to have a full bladder for this procedure -- but mine was painfully full so they let me relieve some.  Came back and waited for Dr. Steingold.  He came in and we went over consents and got the news of the embryos which was fantastic!

The white line going through the middle of the uterus is the center of the lining




The one we transferred was a 4BA grade which was nearly perfect.  Each of the dads made embryos and out of the 15 eggs that fertilized on Friday, there is a possibility of the one we transferred plus 3 from one of the dads and 4 from the other dad.  So that means that 7 may be frozen -- they are growing them out a little bit longer before making the determination of their grades.

The Beautiful Embryo Transferred
After we talked about consents, they called the lab for the embryos to come in via isolette -- truly a beeping incubator.  The guys were able to check out their embryo under microscope while the Doctor performed a mock transfer to make sure all went well with an empty catheter passing through the cervix.  The worst part of the entire transfer is the speculum putting intense pressure on an already full bladder.  Then the Transfer happened in just a few seconds.  The doctor puts the catheter through the cervix and says "This looks like a good spot -- Everyone in agreement?" Embryologist agrees, nurse agrees.  Then the embryo is released.  Count to 10 then slowly draw the catheter out so that it doesn't create a vacuum and bring the embryo with it.

Not a great photo - was taken from the procedure table


The white dots to the left and right of the embryo is the air that surrounds the embryo in the catheter.  It is hard to see the actual embryo, but when you see the video of the transfer, you see the white dots of air bubbles instead.
Next comes the 15 minute wait that feels like 2 hours because your bladder is so full it hurts... tick tock tick tock.

After that, we snapped a photo on our way out!

E Left in photo, C right in photo
We were all starving by this point and we went around the corner and got PF Changs.  What is good Chinese without a fortune cookie?  Check out C's fortune

Hopefully it is a positive pregnancy test!
Speaking of pregnancy tests -- I think I am ready for this cycle.  I won't probably see anything positive until Sunday would be a safe guess.  But don't start pressuring me to start early -- No need to, I will probably already be testing.  The guys want to know if I get a positive so hopefully the anticipation doesn't kill us all!

This is totally a normal amount of pregnancy tests for one cycle for a surrogate I promise!  Some are expired so you can't trust them. Some are blue dye tests, so you cant trust them.  Basically I am out of practice peeing on tests so I need a lot to practice on!
Finally, I got home and we all hung out in the yard for a bit.  E showed the kids that he could do cartwheels (He will be paying for that tomorrow! lol)  C was throwing baseballs with Weston.  So they will fit nicely into the family life very soon.  E says his mom is so ready for grandkids so he will be sharing the transfer video with her.  I came in the house, had dinner and kicked my feet up for a bit.  Of course I had to wear my stork leggings for the transfer -- it's a good omen for what is to come -- me delivering a baby for them! 



Now off to bed because as I was laying on the table waiting for transfer, my phone was ringing over and over.  Turns out a client is in labor today so I will be heading off to a birth overnight.  I hope that is another good omen!  Babies, Babies Everywhere!

Sunday, July 16, 2017

A blog about Surrogacy/IVF Medicines

Just thought I would update with a timely medication blog.  I started the progesterone shots on Thursday and will continue these daily until about 10 weeks.  So I wanted to share information about the medications that  surrogates may find themselves on during an IVF Cycle.  Just as a disclaimer, I am not a Reproductive Endocrinologist.  I am just a surrogate who has been around the medication a few times.

Necessary Medications:
Birth Control
Lupron
Estrogen
Progesterone

Routes of Medication:
Patch
Oral
Vaginal
Injections

Birth Control Pills are necessary to quiet the ovaries.  When doing IVF, they have a specific date in mind that they want to keep your ovaries from taking over and producing the hormones that they are using to alter your cycle.  The doctor wants ovaries with small follicles on them and the birth control can also help to reduce fluid that is in the uterus. You will usually be on this medication for  Cycle Day (CD) 1-16 or the entire pack until you start your next cycle -- the next cycle meaning the one that you will use to transfer the embryo.

Lupron injections are also used to suppress ovulation.  It can be used or fresh or frozen embryo transfer, but generally used on fresh transfers because they need to get the surrogate's cycle synced with the Intended Mother or Egg Donor.  This medication is crazy expensive and rarely covered by insurances.  It is also called Loopy Lupron because it gives this foggy state of mind.  It can be used for frozen cycles when the surrogate's ovaries are not suppressed with just birth control and estrogen and also if there is free fluid inside the uterus that would not be an ideal environment for an embryo to snuggle in. - I am not familiar with the dates this is used as I have only done frozen transfers.

Estrogen is used to further silence your ovaries.   It also builds up that lining that the embryo will be snuggling into.  Estrogen is started anywhere between CD1-4 usually.  It is continued until week 10 of the pregnancy.  Prior to the start of the progesterone, many times women experience extreme headaches from the imbalance of hormones used to manipulate a cycle for IVF.  These headaches cannot be fixed with any over the counter efforts -- the only thing that will help is adding the progesterone in to balance out those headaches.  Estrogen can be given in many different forms.  It can be given in a patch you put on your belly or lower back as well as being taken orally.  The blue tablets can also be inserted vaginally which then creates a gross blue discharge ... Did I mention you do this for 10 weeks?  Finally, you can take estrogen in the form of injections and usually it is given twice a week or every third day. 

Progesterone is the final medication added into a cycling protocol usually. Generally it begins 5 days before IVF is to occur. When having a natural cycle, progesterone is released when the follicle cyst bursts.  Progesterone is the hormone that signals to your body to not shed it's lining yet.  When you have a sudden drop of progesterone, that is when you have your period.  Progesterone is made by the cyst of a follicle until the placenta begins to grows and then the placenta takes over the creation of progesterone. 

Progesterone is generally prescribed in 2 forms -- injection and vaginal.  Occasionally it can be given orally bit is considered less effective.

In the form of injection, progesterone is generally mixed with some form of oil -- think cooking types of oil-- sesame oil, cottonseed, ethyl oleate, and peanut oils.  The problem with injections is that some people may be allergic to the oil that is prescribed causing big itchy whelped hives.  It can also cause painful lumps from the ultra thick oil.  The needles for this are 1.5 inches long (yes the needle goes all of the way into your muscle up to the plastic) and you must have an injection every night for about 8 weeks (until you are 10 weeks pregnant usually).  Many surrogates have reported painful lumps after having injections for weeks and surrogates sometimes report nerve damage years later.  More recently, the pharmaceutical industry is trying to create a subcutaneous progesterone injection that is water based which means less allergic reactions and less lumps

In the case of vaginal insertion for progesterone, there are a few options.  Crinone is a gel that is inserted into the vagina.  Suppositories or pessaries are also used.  One specific brand is endometrin.  When I was on this protocol in the past, I had to have 3 vaginal suppositories a day.  These suppositories are $12+ per dose so $36 per day or about $2000 per cycle and insurance will not cover this often.  Whereas Progesterone injections and syringes are often covered by most insurances with no copay. Aside from that, what goes in, must come out.  With suppositories, you are leaky every single day, all day for 8 weeks.  Many people also end up having some type of reaction or have vaginal infections from the suppositories.




But Melanie, why are you telling us all of this!?  Well because many times people ask me about surrogacy and I think people think about the end result but forget how the surrogates get there.  It is not an easy process.  If you don't like needles, this may not be for you.  If you cannot commit to taking medication every single day at the same time, sometimes multiple times a day, then this is not the journey for you.  If you would rely on the money made from surrogacy to live day to day, this is not the journey for you.  If you aren't ready to say "I am done growing my family" this may not be for you.  These synthetic hormones can really screw up a body and make it so you have secondary infertility where the woman cannot conceive in the future. Do you want that for your future?  These are all things that other people won't tell you about -- but I will.  Surrogacy itself is a beautiful journey.  The end result is beautiful.  But not everything about the journey is glamorous. 

Do you have questions for me about surrogacy?