August 01, 2011

A Mixed Bag of Results

Here's how I feel right about now:

I got today's results in a voice mail:

Progesterone: 5.8 (down from 11 on Tuesday and 7.5 on Friday)
Hcg: 3,672 (up from 2,091 on Friday, a doubling time of about 88 hours)

The reproductive immunologist's take: It's bad that the beta didn't double, it's bad that the progesterone is low, get an ultrasound now to see if it's ectopic or a missed miscarriage. (I don't think he realizes that the clinic's threshold for progesterone is 5 since they're suppositories, so maybe he'll feel differently when I have a chance to talk with the office tomorrow.)

The on-call nurse at RE's take: The progesterone is still technically in the normal range, they have to supplement sometimes, put in an extra suppository tonight and pick up PIO tomorrow morning. The HCG is rising, and at some point it's hard to tell whether it's a good indicator or not. E-mail my regular nurse tomorrow morning to see if I should get an early ultrasound. She said she isn't "overly concerned", but then again I also didn't go into my history of 6 prior 1st trimester losses with her, either. If I had shared all of that, she might have sung a very different tune.

Beta Base comparison: The Beta Base site has been down at least through Friday. (It was up when I had the test last Tuesday, so not sure what happened.) However, through the magic of Google, I found a thread someone had posted on a forum with average singleton numbers for 24dpo, which is what I am today. The most common range was 3,667-5,506, so we're right there at the bottom of the most common range. The thread was posted in 2008 so the numbers might have changed a bit since then, but that's all I've got to work with at this point.

The bleeding/spotting: Had pretty much stopped, but today I went out for labwork, came home, went back upstairs, took a shower, came down to go out for the RhoGham injection, and now there is bright red again. Not a lot, and I think it's already tapering off a little since I have my feet up again, but it's still very stressful any time I see it. Per RI's instructions, I'll be stopping the Lovenox and aspirin until it stops.

My take: The beta is still hopeful, particularly if I did lose a twin on Friday night. I think something in there is still growing since then, or the numbers wouldn't have gone up that much. The progesterone dropping from 11 to 5.8 in 6 days is more concerning to me at this point.

I'm honestly not sure what to make of the bleeding. It's most like pregnancy #1 - I spotted for the first time (bright red) on a Thursday at 4w6d, it continued on and off. Went for an ultrasound at 6w0d, and there was a lot of blood when I went to the bathroom right before the ultrasound started. At that point, it didn't stop. I lost the pregnancy the next day, and continued to bleed what looked like a full period for the next 4 or 5 days.

In the other ones, there wasn't this spotting in advance, and once the bleeding started, it just kept getting stronger until it was over.

So I guess we'll go in for an ultrasound and see if there's a sack. Other than the one pregnancy where we saw a heartbeat, in the other three that got to the point of an ultrasound, it was an abnormally shaped sac each time, and they couldn't necessarily see a definitive yolk sac or fetal pole.

I'm so tired. Of course, part of that is that I barely slept last night because I was stressing about today's tests, and I took Benadryl this afternoon for the IVIg. (The nurse had to try 3 different locations before she could get one this time. I almost passed out after the second one and had to put my head between my knees for a while before we could try again.)

Mostly, I'm just tired of the uncertainty of this process. I did tell R that if this doesn't work, I might want to try one more time in the far distant future (hopefully after a successful adoption), using the IV antibiotics again, since that's what's gotten us the farthest. (We didn't do it this time because we wanted to see what the IVIg would do, and because of the expense involved, and because apparently the IV antibiotics can cause an NK flare in some people, so we didn't want to conflict with the IVIg.)

But if this rollercoaster ends by going off the tracks, I think I'm ready to walk away from it for now. This has reached the point where it has become too hard. I'd like to think I've had a fair amount of fortitude for the past 9 years, but I have officially reached my limit.


MyTwoLines said...

I hate the GRAY AREA! Sheesh. Obviously I want this to WORK, but I know you'd mostly like to know one way or another. I'm so sorry you have to go through these types of ups and downs. I think there is reason to be hopeful--for sure!--but I know how hard it is not to guard your heart.

MrsSpock said...

Sweet Mother of God. Somebody really needs to cut you a break!

Aries said...

I really wish you would know something soon and I sincerely hope it is a viable pregnancy.

Anonymous said...

I'm sorry you are going through this. As for your beta, once you get past 1000, doubling time slows to every 96 hour so I wouldn't be concerned about the 88 hour doubling rate.

Libby said...

I always hesitate to leave comments in these situations - who wants to hear from someone with multiple miscarriages? - but I still see hope in your situation, and I'll be hoping for you all the way. Thinking of you...

bibc said...

hoping for you. enough is enough and i just really wish for some good news to come your way.