Over

The 3rd time, is not the charm apparently. The baby measured 6w5d, with no heartbeat. I am so very thankful my friend from Philly was there, she literally held my hand through that and the staff of OB clinic was very kind. They immediately whisked me off for the full RPL panel, an eye popping 22 tubes.

I'm too chicken for a natural miscarriage, and it also makes it harder to collect the fetal material for karyotyping. So a D&C will be scheduled at the earliest, latest by next Thursday. I don;t want to wait too long, just in case they cannot make the fetal cells grow. Its imperative that I get that karyotype done. I really want a chromosomally abnormal verdict, the alternative points to a much harder to deal with scenario. 

Somebody called me resilient, and I most definitely am that. I will get through this, and I'm pretty determined to not let it bury me under a shadow for too long. I really, really want my mother, especially for the day of the D&C though, and for after. As I told my friend- its better to have people around you, but they have to be the right people, only the ones you love and trust to that degree, who you can allow to see you break down, temporarily. And my mother heads up that short list. But she is in India, she has a medical practice that she just can't abandon. We'll see, I'm really dreading telling them tonight.

And of course- what is going on as a refrain in my head- WTF is wrong with me? Why does this keep happening? And..the hardest one to face- can it EVER be fixed?

I'm don't have the problem of declining egg quality and I thought my *maybe* PCOS was tackled, or so I believed. Very boggy, scary ground indeed, but in a while, everything may be hopefully clearer than it is now.

8w6d ultrasound: no heartbeat

Its pretty much my biggest nightmare come to life. We found at this ultrasound (8w6d) that though the baby had grown (4 days worth of growth in 5 days), that the heartbeat had inexplicably just stopped. It probably happened yesterday. I will go for an ultrasound to radiology to confirm, but a no hearbeat is pretty conclusive.

Given the pattern, its probably what happened with my first pregnancy too, and probably around the same timeframe as well. What this means I do not know. When we do the chromosomal analysis again, think there is a fair bet that this one will come back with a 'normal' karyotype too.

I'll have to switch donors for my next try, because everything is screaming genetics at this point.  Its a possibility ( though definitely not confrmable) that me and the donor are genetically incompatible in some bizarre way.

I'm dealing with this as well as one can in the the circumstances- lots of crying involved, but you realize how tough you are when you realize you are already planning the next round in your head, and that you are willing to be knocked down again and again in the hope that one day you produce one healthy child.

Either my dad will fly down here or I go to India to be with my family for the D&C. We can do this if they can analyze products of conception there by karyotype as well.

I'm utterly thankful for my parents now- they are here for me, no questions asked and can take care of me better than anybody else can.

Not sure what else there is to be thankful for though.

Wanting to feel crappy

Until the start of this week, Turbulence was a very, very good girl. She made me upchuck the entire bag of greasy popcorn I had consumed at the movies on Sunday. She made me cramp on and off too. I was miserable, but ecstatic to have such proof that she is doing well. Who cares if you look horrible and green outside when you are beaming mentally within?

Past three days, there has not been so much going on. There is the occasional mild wave of nausea (so mild I convince myself that its *really* there). Not much heartburn. Very little to no cramping. And of course, I'm miserable. I alternate between feelings of optimism and doom so violently I'm giving myself whiplash. 

My ultrasound is tomorrow, and it won't be a moment too soon.

And of course, my brain being the hyperactive thing that it is, I'm running through my mental lists. What is the possibility of a second miscarriage at this point?

Very, very low. Thyroid ( a possible issue in the last pregnancy), has been dealt with. I don't seem to have other antibody-related autoimmune issues. As far as overactive T and NK cells (linked to the thyroid issue by certain studies) go,  who knows, but those are usually an issue with implantation, and as we all know, I have absolutely no worries in that area.


About the thrombophilias, it seems highly unlikely. I had read a paper a while ago which looked at Indian women with recurrent m/cs. The authors examined the possible causes and found thrombophilias did not crop up. Also, there is my vast, unbelievably fecund family. Everybody reproduces without trying. My family does NOT have pregnancy losses, atleast, not that I know of. What they have, is lots and lots of babies. They are the disgustingly fertile lot everybody wants to desperately be, myself included.   
.
And finally, there is genetics. Although chromosomes  were normal, my overactive imagination has conjured up scenarios where there is a highly unusual single gene incompatibility between me and my donor, in such a case, 25 % of all of our kids would be at risk. Yes, knowing too much is an UTTER curse, combine with this a tendency towards neurosis and you've got yourself a nail-biting monster on your hands. I wish I was like my mom, she is calm, thinks positive, and nothing ever rattles her.  She is the calm center in any crisis. Wish those genes had not passed me by!  Hopefully they will skip a generation and show up in Turbulence.

My one loss was an unusual and mostly inexplicable one so I've got some reason to be nervous .But then, the possibility of a second loss is statistically very low and a lot of bases have been examined and covered.  This much fear is unreasonable. I'm just utterly glad I'm having frequent ultrasounds, and right now I just wish I would upchuck and cramp so I could get through the days in between comfortably.

I'm a gloom and doom kinda gal and....

I need a BIG rap on my knuckles for it! I've been an impatient and overanxious knucklehead. I've had my scary test results for over a week now (because I made them give it to me), but thanks to the inefficiencies in communication between my OB-GYN's office and my RE's office, have not had the official medical interpretation until today. The part that was driving me nuts was my cardiolipin antibody levels (slightly elevated, but nowhere near the big, scary danger zone) and the fact that I could not interpret my lupus anti-coagulant test results by myself, with no reference ranges. Its a complicated test, I I think even docs would have a hard time with that one. Btw- its called the 'Direct Russel Viper Venom test'- kinda cool.

Anyway, I finally got the verdict from my doctor- I don't have to worry about clotting issues!!! They will retest if I make them (and I will) but right now its nothing to worry about. Most people trust what their doctors say implicitly but with my training and my neither-here-nor-there knowledge of medicine and science, cannot help second guessing them, which can be both a good and a very bad thing.

I still have the anti-thyroid autoantibodies and I start synthyroid before pregnancy to see how I respond. Its quite amazing how we adjust to new realities. When I first found out about this, I was a mess (with guilt and fear) but now I'm shrugging it off.

Finally- its CD2 of my new cycle and looking at my day 1 and day 2 temps (low, low, low) I know I'm going to ovulate early this cycle(by day 15-16) and its probably going to be a pattern similar to the one I conceived and lost in. I had sworn I would avoid such a pattern again because I thought there was something wonky with it, but now I'm not so sure it had anything to do with the egg and I'm sick of waiting. Oh for a crystal ball!

Subclinical Hypothyroidism?!?!?

My thyroid hormones (TSH and T4) test results are back- all still in normal range, when I clearly have anti-thyroid antibodies! Just tells you that if I had not run this test, I would have never known. If everything else (Lupus Anti-coagulant and anti-cardiolipin autoantibodies) come back as normal, then I guess I will be put on thyroid hormones during the next pregnancy, though managing it will be tricky.

The thing that is making me very nervous is that these anti-thyroid antibodies are known to go hand in hand with T cell dysfunction and other B cell dysfunctions too, in which case you have an immune system running amuck- VERY difficult to keep it from kungpao-ing your baby :(

Praying its not this, and its just this one isolated autoimmune issue. I get hypothyroidism from both sides of my family, so its logical that I might have this problem.

Just a note for all mommies to be- if you have a family history of hypothyroidism, maybe its worth getting this test run, because as I am clearly demonstrating, this problem might not show up if you just test for thyroid hormones.

Not 'normal' anymore

Every single blood test I have had so far has ended up with values smack dab in the middle of the 'normal' range. Well, that no longer stands. The first of my test results are back- I have anti-TPO(thyroid peroxidase) autoantibodies, with a high but not too insane titer of 107, with the normal range being 1-9. The presence of such antibodies is strongly correlative with first trimester pregnancy loss- sound familiar? Now we need to figure out if these are the only autoantibodies I have or whether my immune system has truly gone nuts.

I should be grateful I badgered my doctor to test the products of conception and the results of that led to this being tested by my super proactive RE. But right now, when I get emotional and unscientific, all I can think is this- my body killed my baby.

Don't know what is in store for me, whether its going to be hard or easy. I have my worst case plan ready already- surrogacy in India, where it costs a measly 12000 dollars to do it. I get to supply the defect free embryos :(

Being kind to myself

Its been a few days of serious mental conflict. After first deciding that I'd go ahead with insemination this month, I realized I just couldn't. You cannot do something so potentially life-altering when your mind swings like a pendulum every 2 minutes. I don't know if this guy I'm interested in could feel the same way about me, but I've realized that if I later discover that it is indeed the case, it would be a pretty messed up situation. One more month should be enough to figure out how he feels. I honestly don't think he returns my feelings, but I need to rule out the possibility before proceeding.

Plus, I just want to have some fun. These past few months have been grueling mentally. I went from somebody who has never experienced death to losing a child (thank god only at the embryo stage) and then 2 days ago, my beloved labrador was put down because of kidney failure and arthritis. I'm having visions of my dog meeting my baby in heaven, and its pretty funny because I'm agnostic.

But, boy is there conflict. There is a part of me that is saying, enough punishment, time for a little respite and then there is the other part of me that desperately wants to try again, wants to be pregnant RIGHT AWAY, and more than anything, wants to find out if I am capable of actually sustaining a pregnancy.

But the one thing I do have a lot of, is time. I met my new RE- LOVE him! Had the most seriously painful ultrasound which helped determine that:
a) my uterus has normal structure (slightly arcuate but still ok, according to the doc). No fbroids or anything else problematic.
b)I have so many antral follicles (16 in each ovary!!) that he is having me tested for PCOS. I have no symptoms nor family history of PCOS so I'm only slightly nervous about this blood test.
c)He wants my miscarriage investigated further by running an autommune (anti-cardiolipin and lupus anti-coagulant) panel, because he says the fact that the chromosomes came up as normal is a little suspicious. Quite a change from all my other docs who looked at the normal karyotype result, shrugged and said, just try again!

So I'm being sensible, taking myself off to New Mexico this weekend instead of sitting around in town trying to keep myself away from the Doc's office. I'm getting blood tests done next week. And after that, until that next ovulation rolls up, I'm going to have FUN. Maybe a trip to Vegas with the new gang!