First Trimester Screening Medium Risk

Week 12- 20
I had my first trimester screening when I was 13 weeks. NT scan looked ok at 1.4mm. I also had to do a blood test, and the results from the blood test came for trisomy 13/18 as 1:305.  Below 300 is high risk and mine in border level high risk. Trisomy 21 was at 1:3989.

at 13 weeks 7.9 cm

Dr called me up for a detail discussion and had to do draw further blood for panorama testing – Non-invasive pre natal testing. Links for further reading about this test. http://www.lifelabs.com/Lifelabs_ON/Patients/TestInfo/Special/Panorama.asp

It usually takes 2 weeks to get the Panorama test results. But I had to do again after 2 weeks as in the first testing they could not find enough sample of baby's DNA. Time passed and at 16 weeks I gave another sample for panorama screening. To our surprise they could not find enough sample again!!! Apparently I'm one of the 1% of people from whom they are unable to get enough sample.

My regular Dr recommended me to do a special screening similar to anomaly scan with a fetal specialist. He measured many parts of the baby to check any abnormalities. Scan lasted for up to 15-20 minutes. Finally he said baby looks fine.

at 18 weeks 3D image

In the meantime the Lab offered to do panorama testing one more time and did not charge us for the previous 2 attempts. At 18 weeks I gave a 3rd round of blood sample for panorama screening.

Finally at week 20 we got the all clear 'Low risk' results.

Meanwhile I have gained 5 kgs so far, and still vomit even at week 20 when my stomach is empty for a long time.

I think this whole trisomy drama occurred because I had low B12. I feel it is one of the important pregnancy vitamin that is ignored by many. See link on http://www.webmd.com/baby/guide/anemia-in-pregnancy

However finally I'm relieved to have the results and now trying prepare myself mentally for the arrival of Baby Boy!

Week 8 – 12 & Being Vegetarian during Pregnancy (Aug - Sep)

Since last scan at week 8 things have started to get back to normal. Less nausea in morning. Occasional cramps, dizziness and headache but no more breast tenderness. I wasn’t sure. I worry all the time. AK keeps saying how much would you worry? ‘It happens if it has to happen’ That’s pretty true if I keep worrying there will be no end as this is something that will continue till… I don’t know when. (education, exams, job, wedding, birth of grandkids) Stop Worrying!

Week 9

We went to our usual Dr Pavic again. Scan was ok, things were normal. But I had to do a blood test to check Vit D, Iron levels and B12. I follow a vegetarian diet and eat egg only occasionally purely due to health reasons. Therefore these levels needed to be checked. Results came out to be Vit D low, Iron Ok, B12 low but no need of injections. I had to take Vit D supplements and I also started drinking Marmite for B12.

My diet so far…

Breakfast – Full cup milk with nescafe and ovomaltin, 1 cup Marmite, 1 Apple

Lunch – Salad, legumes, corn, rice, relatively light lunch

Dinner – Noodles with vegetables, tofu and egg

Pasta, tomato, mozzarella Rice and curry etc.,

I drink milk, eat cheese and consume legumes like lentils, chickpeas, kidney beans etc.,

I also take supplements which is Centrum Materna, Vit D and Omega 3

 

Week 9  Size 2.5cm

Week 11

After my scan on week 9 Dr mentioned that I could come back in a month for week 13 scan which would be Nuchal Translucency scan. I could not wait that long so went for a scan during Week 11. It was a miraculous scene! The little embryo had grown into a tiny human with small head tiny hands and tiny legs at a total length of 4.6cm (No photo)

Week 6 – 8 July - Aug

Since my last scan seeing the yolk sac I had intermittent cramps and vomited again one morning. I was walking to work, on my way I had to stop vomit in a plastic bag carry it for a while till I came across a bin. Quite weird!

Close to  the scheduled scan on Week 7 I had cramps they were more frequent started on a Thursday evening last till Friday night. Some were pretty sharp. Eventhough scan showed heartbeat and good growth, I was very apprehensive specially considering my last miscarriage happened with lots of cramps. Dr keeps telling me, if you don’t bleed no need to worry. But it could happen that you aren’t bleeding due to the progesterone suppositories.

Week 7

Around week 8 I did not experience much symptoms. I prepared myself mentally and my hubby as I did not want to get it as a shock via the scan. We went to the scan and I told Dr that I’m not sure due to lack of symptoms. Dr directly did a ultrasound scan. (all this time scan was intrauterine) Surprise!! It was quietly growing.

Week 8  15.9mm

Btw anybody out there reading my posts?

Week 4 – Week 6 _ July 2014

On the following week from the Beta test we had a pre-planned summer holidays. So my next scan was not until I’m back from our holidays. Usually when we are on holidays we do a lot of walking this holiday was no exception. I had also pre-planned a small hike to a national park by Mediterranean sea. I checked with the Dr and we did the hike as planned. I did it slower than my normal pace. I did not have much symptoms other than usual bloating caused by the estrogen patches.

Week 6 – At the beginning of this week I experienced more cramps and vomited orange liquid in the morning. I take my pregnancy multi vitamins (I find centrum has a complete package) and Omega 3. Since I do not eat fish I take them. The fish oil usually worsens the nausea. We had our first scan with another Gyne as our regular Dr too was on summer vacation.

Yolk Sac at 6 weeks

2 Weeks Wait July 2014

Day 2 after D1 transfer - we went on a shopping trip. So I did moderate amount of walking but I did not carry any heavy stuff. A was not happy about me walking on the next day but I took it as usual. Walking should not be harmful right?

Day 3 Usual regular activity watering plants, cooking etc., One thing I remember is we had a big fight over some minor issue. Later I regretted this thinking I stressed myself too much.

Day 4 After lunch I felt a twinging pain in my lower abdomen. For a minute I felt happy then googled and realized it’s too early for implantation to occur.

Day 9 Felt a bit of cramps like period it was also the time for my period.

Day 12 I get a weird pain just before bowel movement around the time of my period. I had a similar pain. Later I also noticed a line of blood, pinkish in tissue.

Day 13 Blood test. Positive Again, HCG of 147  to be repeated to confirm. I’m skeptical due my past experience.

HCG to be repeated in 2 days which was HCG of 398 fairly good because it has more than doubled. I’m 4 weeks PUPO (Pregnant until proven otherwise). 

FET Frozen Embryo Transfer - July 2014

Everything is beneficial it is a quote in Bhagawat Geeta we grew up hearing this. Since the last MC I took a break from all these TTC efforts. Focused myself in outdoor activities climbing greater heights. During my last pregnancy even though I was for only 8 week I gained some weight. Since I’m a foodie I used pregnancy as an excuse of binge. But taking a break helped me to shed all that excess weight. Not only that I also started working full time again. I never imagined that I would eventually be working here in a foreign land. The TTC break had to be pro-longed as I wanted to settle down in my new Job.

After more than a year break I decided to try it again. But I was in a totally different mindset this time. I’m not desperate like before. I have accepted to live the life to the fullest with what I have and not to chase behind the unrealistic desires. If it doesn't happen it is not meant to be! Well at one point if everyone learns to accept the fact that not everyone will be blessed with everything in life, this acceptance will help one to move forward instead of being stuck.

FET procedure

Injection on Day 21 I think it is for down regulation

June 13^th Period

Day 2 of the cycle start with 2 patches of estrogen once in 2 days (I usually place it below my belly button)

In between in week 2 I went for an intra-uterine scan, Dr informed me that the lining can be improved. Therefore increase the patches to 3 a day and also introduced ultrogestan.

During this time I had an office party and had to drink champagne, Dr’s advice was that I can have light alcohol until the time I do FET. I’m only a social drinker.

Day 21 FET was scheduled I took a medical for this day.

Procedure is pretty simple in this clinic. No full bladder! Usually since I find it a bit painful, I take a painkiller 30 minutes before the procedure.

After we minutes in the waiting room, we get called into the transfer room embryologists brief us about the thawed embryos. We had another embryologist this time. We both liked the earlier one who did last year. Not a good results. As one embryo was 3 cells and the other one had not cleaved. It is a Day 2 transfer. Ok not much hope then. But just before the transfer embryologist informed that the other embryo has cleaved into 2 cells as well.

 

3 cells and the one that cleaved into 2 cells last minute

I had to lie down, Dr will insert the vaginal speculum, clean the remaining of ultogestan, once its ready embryologist brings the catheter with the embryos are inserted. While doing this Dr asked me to slightly lift my buttocks. Its over in few minutes. Embryologist confirms that catheter is empty. I lie down for 30 minutes and get a taxi ride to home.

After reaching home I just made myself warmed up pre-cooked food. Watched TV and took a  good nap afterwards. As it was a Friday I had the weekend to take rest.

After BFP

March - April 2013
at 4 weeks  – I felt very warm specially my head was heaty just like it is before cold and right side sharp pain

15^th day post D2 Transfer – HCG 117 line of blood!

16^th day post D2 Transfer – Line of blood with stretchy mucus

17^th day post D2 Transfer – Brown spotting!! Am I getting my period?

18th day post D2 Transfer – Intra vaginal scan to confirm pregnancy but no embryonic sac seen! HCG 722

at 5 weeks – Yolk and sac seen. Relieved….Can I finally be happy that I’m pregnant. At least I will till the next scan.

at 7 weeks – Heartbeat seen, finally I can call myself pregnant. DH started to think about baby names. Not me as I’m more wiser on this whole journey and aware of the hurdles on the way.

7 weeks image

Since my last scan, I was occasionally nauseous bloated some cramps on right side.  However on Sunday and Monday I felt a bit more cramps. My next scheduled appointment is only on Thursday.

at 8 weeks - Dr scanned in several angles to detect the heartbeat but no heartbeat seen. Dr informed it is a spontaneous miscarriage most likely fetus stopped developing 5 days before. Perhaps this was the reason for cramps.

This was when heart beat could not be detected anymore

I should say even though it was hard to accept I was reasonably brave. I asked Dr about the next attempt for FET. First step is to wait for a natural miscarriage to happen. I started bleeding on the following week on Saturday. It was unbearable pain and blood flow was so heavy that I used 4 pads in an hour. By the time K went to pharmacy and got the pain killers it had come out. If you wish to see how it looked like click on this link. Warning image could be disturbing!!!!

Update - IVF Attempt No 3 with Dr Pavic

Feb 2013

New doctor (Dr Nenad Pavic, Fertilitas) in a new country with a new procedure. I was on long protocol which means more injections. Started on injections from Day 21 wait for the period and start stimulating. Egg retrieval on Day 21.

D1 - Egg Retrieval day – I was put on half anesthesia which means I was half awake when they retrieved eggs. Which was unusual compared to my past experiences.  Nurse will push my lower abdomen and Dr will basically suck those eggs from my ovaries. They retrieved 14 eggs. Ah haven't got this many in the past.

D2 Received a call from clinic informing that 12 fertilized and 10 will be frozen.

D3 2 4 cell embryos were transferred. Now the wait begins

4 cell embryos in D2

2 Week wait

These are the symptoms I had during the 2 week waiting time.

3^rd day post D2 transfer – noticed pimples, may be due to the increased hormones I had been injecting into me.

7^th day post D2 transfer – Cramps in lower abdomen

8^th day post D2 transfer – Cramps again

9^th day post D2 transfer – Noticed a different smell when I passed urine in morning (More of a flowery cinnamonny smell) very different.

11^th day post D2 transfer – Noticed stretchy liquid from down below

13^th day post D2 Transfer – Blood test day HCG of 75 (Not high as in usual cases) Even though it is positive it is not that high therefore test has to be done again in 2 days to confirm pregnancy! Good news not good enough to celebrate the pregnancy.

Post "BFN" Consultation with Dr Prashant

I was very nervous while waiting for 1+ hour to see Dr. Longest I've waited to see Dr. But Dr also prefered to speak to us last, since its gonna be a long discussion. Which I totally agreed. I was hoping that I don't melt down and create a drama in front of him. Luckily I didn't.....


After my ET Dr mentioned that he'd be surprised if I don't get pregnant. Apparently it's due to 2 reasons.


1. My uterus lining was perfect on the day of transfer (I think it was 8mm)
2. My 8 cell embie was compacting which means edges between the cells are getting blurred, so it's becoming harder to count the number of cells. Compacting embryo has more chances of implanting compared to my 2nd embie which was 6 cell.


Ok, in that case 'Why didn't I get pregnant?' No answer for that. This stage is beyond anyone's control. So we have to leave it to fate.


Could it be due to my dry cough? No you cannot clearly define the cause for BFN.


Dr believes that we should continue to try. He firmly believes that I can get pregnant due to these reasons.


1. Age Factor I'm going to be 34 
2. We got good quality embryos.


But my problem is getting matured eggs, since my eggs were not matured enough it had been difficult to retrieve them.


So challenge now is to get matured eggs. For which Dr recommended I should continue with my medication. 


I want to take a break, I really don't like dumping whole loads of tablets into me. So both of us can start medicine 3 months before our next cycle. And of course loosing weight could help to improve egg quality and uterus lining.


Also it is believed that fish oil, royal jelly, green tea, acupuncture and Co-Q 10 could improve egg quality. But I'm not sure if its ok to take all these together.


Dr recommended a change in approach for our next cycle. Which could be freezing the embryos and transferring them after a natural cycle. Sometimes patients uterus can be sensitive to stimulation hormones. Scan cannot determine this sensitivity. (Japanese usually practice this method)


Also getting the embryos to blastocyst stage and doing D5 embryo transfer is another option. But in my case I'm not sure if I'd get embryos till blastocycst stage, because during past 2 cycles I only got 2 embryos.


Other important factor facilitating implantation is stress levels. More positive, stable and cheerful you are greater the chances of implantation. This is proven in an Israeli research where clowns performed to patients for 15 minutes after the procedure. “Medical Clowning” improved pregnancy rates compared to a group not exposed to a clown on the day of implantation." In conclusion patients who are less stressed and are positive in attitude had better outcomes.  (See source article)


Since having this kind of entertainment is not available everywhere, we can take our own entertainment devise with us to keep us relaxed after ET. Also figure out our own means of being cool and calm during the whole treatment process. It could be meditation, exercise, yoga, acupuncture.....


Ok now my focus is on weight loss and on improving my egg quality.


One major relief is Dr's strong belief that I can get pregnant. sigh....our journey continues...

The Results

After the embryo transfer I came across this wonderful info about "What happens to the embryo after transfer?" from http://www.nyufertilitycenter.org/ivf/embryo_transfer.


3-Day Transfer

Days Past Transfer (DPT)	Embryo Development
One	The embryo continues to grow and develop, turning from a 6-8 cell embryo into a morula
Two	The cells of the morula continue to divide, developing into a blastocyst
Three	The blastocyst begins to hatch out of its shell
Four	The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus
Five	The blastocyst attaches deeper into the uterine lining, beginning implantation
Six	Implantation continues
Seven	Implantation is complete, cells that will eventually become the placenta and fetus have begun to develop
Eight	Human chorionic gonadotropin (hCG) starts to enter the blood stream
Nine	Fetal development continues and hCG continues to be secreted
Ten	Fetal development continues and hCG continues to be secreted
Eleven	Levels of hCG are now high enough to detect a pregnancy

So I kind of knew everyday what would be happening to embies inside my body. So by Day 6 post transfer, I was absolutely certain that I'm not pregnant. My friend challenged me, telling that I could be wrong. My answer was I'm 100% certain. My hubby believed what I said. How can I be so sure of my results, when my test is due only on Day12 post transfer?

When implantation occurs, there is increased blood flow to the uterus, and increase in hormone production i.e. estrogen and progesterone. This results in increased creamy cervical mucus(CM). In my case till D6 post transfer since ET day it had been very dry.  Usually it is the case after ovulation for me i.e. from mid cycle it's always dry till I get my menses  Since CM  was completely dry I was absolutely certain that I did not succeed.


Besides I did not have any other pregnancy symptoms, although these can be mimicked by lutel phase hormone support medicine. For example these medicine causes abdomen cramps, breast tenderness and bloatedness.


I cried, cried and cried; I could not take it, why does it always have to be like this? I've never experienced, the feeling of being pregnant. Will I ever experience? How many times do I have to go through IVF before I succeed? We both hugged and cried not knowing what to do?


I'm determined to do one thing before my next attempt i.e. "loose weight". My BMI is 26.6 I want to bring it down to 24. My thought behind it is, at least I'll do whatever is manageable i.e. within my control. Coz obviously pregnancy is something beyond my control.


Only time can answer if loosing weight could bring me success......

On Beta Test Day - Today

Went to the clinic by 9.30 am, did the blood test. And was hanging around in nearby mall. Decided to do a hair treatment while waiting. I was very nervous, even-though I knew my results. By the way yesterday morning I did a HPT which was 'negative'. Dreaded call never came till 12.30pm even-though they said that they'd get the results in 2 hours.


I called them at 1pm, and nurse said they have just got the results and will call me back. I spoke to my hubby and we almost guessed it. Because if it was positive they would have immediately congratulated me right?

Hubby told no point in hanging around, he told me to just go home. It's confirmed now. So I finished small errands in the mall and was just getting into the car, when I finally received the call confirming that my cycle didn't work out.


So now what? I really want to loose weight and improve my egg quality before I do my next cycle. So please share with me any tips you have


1. To improve my egg quality
2. Improve DH's sperm count
3. How to succeed in IVF ?


I hope and pray I too can be pregnant and become a mom for healthy babies one day.......