We got our results back today from the 1st trimester screen. For Down Syndrome, our adjusted risk factor is 1:1500. For the other trisomies, 1:5000. These are good ratios and we don't need to get an amnio done! Yay! We still have another blood test in a couple weeks that will check other markers as well as a detailed ultrasound that will check for chromosomal abnormalities at ~week 20 - but for now, we are looking great!
Also I got my progesterone level checked today as usual and my level rose despite my progesterone dosage being decreased! This is great. So I have one more full week of further decreasing shot dosages, then one more week of every other day shots. On May 10th, I'm DONE with the shots!!!:))))) Yay!!
Monday, April 29, 2013
Tuesday, April 23, 2013
NT scan today
We had our Nuchal Translucency scan today. The scan is a type of ultrasound that measures the thickness of fluid at the back of the neck (aka 'the nuchal fold'). Cutoff values vary but generally, measurements higher than 2.5-3mm are markers for chromosomal abnormalities such as Down Syndrome and Trisomy 18. The NT scan will only detect a certain percentage of abnormalities on it's own - but when done as a part of 1st semester and 2nd semester screening (which are just blood tests: the first I did today and looks at the level of hCG and PAPP-A at 11-14 weeks; the second test is done at 16 weeks and tests levels of hCG, AFP, inhibin A, and estriol 3), it will detect about 90% of pregnancies where the baby has Down Syndrome or Trisomy 18. It will also detect about 80% of babies with an open neural tube defect. This is great because while I do have a relatively low risk of 1:465 of abnormalities, I am not getting any younger. Since I am 34, I want to know my individual risk (not just based on my age) without having to go through invasive testing like CVS or amniocentesis, both of which have risks of miscarriage. The result of the test is not a simple 'positive' or 'negative' - rather, it is a ratio of the likelihood of having a baby with an abnormality. If the ratio is high, we can be more certain our baby is okay. If the ratio is low, then we can see if we want to go on to an amnio and get a more definitive result. I will find out what our ratio is on Monday. At 16 weeks I'll get bloodwork again and they'll give me the final ratio.
Our NT scan went well! Baby was resting but would occasionally hop around. It was moving it's arms and legs around too. It kept touching it's face like it was thinking or wiping it's brow:) The measurements of the nuchal fold ranged from 1.5-2.1mm - normal range, especially with baby's crown to rump length (CRL). The allowable measurement for the nuchal fold increases with increased CRL. Our baby is measuring 13w2d today too. This is also a good sign as sometimes slow growth rate can be a marker of problems too. Baby is nearly a week ahead! Again, doesn't change my due date - that's just how the baby is growing right now. They usually slow down in the 2nd trimester. Here are a couple pics (the 2nd pic is where baby was touching it's face:)
Our NT scan went well! Baby was resting but would occasionally hop around. It was moving it's arms and legs around too. It kept touching it's face like it was thinking or wiping it's brow:) The measurements of the nuchal fold ranged from 1.5-2.1mm - normal range, especially with baby's crown to rump length (CRL). The allowable measurement for the nuchal fold increases with increased CRL. Our baby is measuring 13w2d today too. This is also a good sign as sometimes slow growth rate can be a marker of problems too. Baby is nearly a week ahead! Again, doesn't change my due date - that's just how the baby is growing right now. They usually slow down in the 2nd trimester. Here are a couple pics (the 2nd pic is where baby was touching it's face:)
Monday, April 22, 2013
Today's progesterone level
I had my progesterone level checked this morning and my level is way back up to 57. Yay! They are having me decrease my dose from 1.5cc to 1.0cc and retest the level again next Monday. The nurse was so sympathetic when talking to me today though. She said "I know honey, it's almost over". Ugh! I hope so. My butt is so lumpy and swollen from all the needles, I'm going to need a butt transplant once this is all over! We'll see what my level is next week.
We have our nuchal translucency scan tomorrow afternoon. I'm not too worried about it. I don't know if I'm being naïve but I just feel like the test will come back fine. My fingers are still crossed though. Excited to see the baby again and hope we get some more good pictures. Baby is still doing good - I've gotten out the Doppler only every other day since Thursday so I'm getting better (Heh heh!). The heart rate is down to about 150-160 which is exactly what is should be doing. The bpm initially shoots up to 170-180 at around 8-9 weeks and then decreases as it nears the 1st trimester. It gets lower after that but levels out at a rate that is still much higher than the mother's own heart rate.
I also scheduled our gender scan for the 16 week mark on May 18th! Sooooo excited for that one:) We could wait to get it done at our OB's office at 20 weeks, but I want to know as soon as possible so we are going to a private ultrasound clinic. If the baby doesn't cooperate or if it is still too early, we can reschedule for free. I REALLY don't care if it's a boy or girl either way, but I just want to start referring to it as a 'he' or 'she' rather than 'it' and we can start picking names. Plus once we know, then we can start planning out the nursery décor. Fun stuff! My hubby is so excited he has already cleaned out the room that we're planning to use. He is on vacation this week and I got home today to see that he cleared out everything that once was in that room (including the contents of the closet)! LOL!
We have our nuchal translucency scan tomorrow afternoon. I'm not too worried about it. I don't know if I'm being naïve but I just feel like the test will come back fine. My fingers are still crossed though. Excited to see the baby again and hope we get some more good pictures. Baby is still doing good - I've gotten out the Doppler only every other day since Thursday so I'm getting better (Heh heh!). The heart rate is down to about 150-160 which is exactly what is should be doing. The bpm initially shoots up to 170-180 at around 8-9 weeks and then decreases as it nears the 1st trimester. It gets lower after that but levels out at a rate that is still much higher than the mother's own heart rate.
I also scheduled our gender scan for the 16 week mark on May 18th! Sooooo excited for that one:) We could wait to get it done at our OB's office at 20 weeks, but I want to know as soon as possible so we are going to a private ultrasound clinic. If the baby doesn't cooperate or if it is still too early, we can reschedule for free. I REALLY don't care if it's a boy or girl either way, but I just want to start referring to it as a 'he' or 'she' rather than 'it' and we can start picking names. Plus once we know, then we can start planning out the nursery décor. Fun stuff! My hubby is so excited he has already cleaned out the room that we're planning to use. He is on vacation this week and I got home today to see that he cleared out everything that once was in that room (including the contents of the closet)! LOL!
12 week belly pic
Wednesday, April 17, 2013
Low progesterone level
I'm 11w4d today and things are going pretty well! However I got my progesterone level checked on Monday (I get weekly progesterone checks as directed by my RE) and it came back pretty low at just 22. It's still a safe level, but my levels are dropping at a rate that they don't like to see. 2 weeks ago it was in the 50s and they reduced my progesterone dose down to 0.7cc shots every night. Last week it was 32. They told me to continue with 0.7cc. But Monday it dropped again so they are more than doubling my dose back up to 1.5cc! UGH!! I am told that this is all pretty normal but it still makes me uneasy. They are currently trying to wean me off of the progesterone-in-oil shots (PIO) and it's sort of a trial and error type thing so they are telling me that the low level is seen quite frequently. Once they increase the doses, the levels pop right back up again. I thought I was getting so close to being done with these shots though! The nurse I talked to said that usually women who had a Lupron trigger go off of the shots around 14-15 weeks. That's 3-4 more weeks! UUUUGGHHHH! Anyway, whatever lets me keep my baby, I'll be fine with!
The process of weaning occurs over several weeks where they gradually reduce my dose until my levels stabilize - then they reduce more until eventually I don't need the shots anymore. Right after egg retrieval and embryo transfer, women undergoing IVF don't make enough progesterone to support a pregnancy due to the fertility drugs and surgical procedures. In a normal menstrual cycle, usually one egg is released from a mature follicle during ovulation. The follicle sticks around forming a cyst-like structure called the corpus luteum that produces progesterone. This is what keeps the uterine lining from shedding if an embryo implants into the uterine wall. If implantation does not occur, the corpus luteum fades away, progesterone levels drop which triggers the uterus to release it's lining - resulting in a period. In IVF our eggs are surgically removed from the follicles which prevents a corpus luteum from forming and producing enough progesterone. Plus, with women given a lupron trigger (which is what I received) their ovaries are totally shut down which results in absolutely no progesterone being produced. With women who take the normal hCG trigger, some progesterone is still able to be produced because the ovaries aren't completely shut down - it's definitely not enough progesterone, but it's something. So we are either given progesterone suppositories or shots to keep our levels high enough so the uterus maintains it's lining and thus produces a healthy pregnancy. At some point close to the end of the first trimester, the placenta takes over progesterone production and usually progesterone support can be stopped. I am 1.5 weeks away from the end of the 1st trimester so theoretically my placenta should be ready to take over soon. But with women who had the lupron trigger, extra care needs to be taken to ensure that the placenta will be able to produce a level high enough so we may be on supplements for a bit longer. We'll see what my levels are next Monday but I'm definitely feeling the effects of the higher dose. Evil progesterone! I am so bloated today that I look like I'm 5 mos preggo! Glad I don't have to get a belly pic taken today - we'll see what it looks like on Saturday though. It may be worse!!
So the Doppler has been coming out daily since this progesterone stuff has been making me a bit uneasy. I found baby really easily Monday and today but yesterday was really tough and I got pretty freaked out! Turns out baby was hanging out on the right side instead of it's usual left side. I guess it just decided to go for a swim or something;) I didn't realize they could move that far though. Well, it took me 20 nerve-wreaking minutes, but I did find baby yesterday and was able to breathe a sigh of relief! Everyday baby's heartbeat was right on track, still between 160-170. So all I can do is assume everything in there is going great! I am just so thankful that I am getting my levels checked weekly. I think they are checking them so often because like I said above, I had the Lupron trigger. I don't know if women who had the regular hCG shot get monitored this closely.
The process of weaning occurs over several weeks where they gradually reduce my dose until my levels stabilize - then they reduce more until eventually I don't need the shots anymore. Right after egg retrieval and embryo transfer, women undergoing IVF don't make enough progesterone to support a pregnancy due to the fertility drugs and surgical procedures. In a normal menstrual cycle, usually one egg is released from a mature follicle during ovulation. The follicle sticks around forming a cyst-like structure called the corpus luteum that produces progesterone. This is what keeps the uterine lining from shedding if an embryo implants into the uterine wall. If implantation does not occur, the corpus luteum fades away, progesterone levels drop which triggers the uterus to release it's lining - resulting in a period. In IVF our eggs are surgically removed from the follicles which prevents a corpus luteum from forming and producing enough progesterone. Plus, with women given a lupron trigger (which is what I received) their ovaries are totally shut down which results in absolutely no progesterone being produced. With women who take the normal hCG trigger, some progesterone is still able to be produced because the ovaries aren't completely shut down - it's definitely not enough progesterone, but it's something. So we are either given progesterone suppositories or shots to keep our levels high enough so the uterus maintains it's lining and thus produces a healthy pregnancy. At some point close to the end of the first trimester, the placenta takes over progesterone production and usually progesterone support can be stopped. I am 1.5 weeks away from the end of the 1st trimester so theoretically my placenta should be ready to take over soon. But with women who had the lupron trigger, extra care needs to be taken to ensure that the placenta will be able to produce a level high enough so we may be on supplements for a bit longer. We'll see what my levels are next Monday but I'm definitely feeling the effects of the higher dose. Evil progesterone! I am so bloated today that I look like I'm 5 mos preggo! Glad I don't have to get a belly pic taken today - we'll see what it looks like on Saturday though. It may be worse!!
So the Doppler has been coming out daily since this progesterone stuff has been making me a bit uneasy. I found baby really easily Monday and today but yesterday was really tough and I got pretty freaked out! Turns out baby was hanging out on the right side instead of it's usual left side. I guess it just decided to go for a swim or something;) I didn't realize they could move that far though. Well, it took me 20 nerve-wreaking minutes, but I did find baby yesterday and was able to breathe a sigh of relief! Everyday baby's heartbeat was right on track, still between 160-170. So all I can do is assume everything in there is going great! I am just so thankful that I am getting my levels checked weekly. I think they are checking them so often because like I said above, I had the Lupron trigger. I don't know if women who had the regular hCG shot get monitored this closely.
11 week belly pic
Ugh! Getting really bloated! Nearly popping outta my pants on this one:(
FYI - I've been a slacker getting these posted! Even though I've been posting these pics on odd days (today I'm 11w4d) the pics are all taken at XXweeks0days (ie: Saturdays for me). Maybe this Saturday I'll actually post the pic after we take it;)
Wednesday, April 10, 2013
10w4d u/s!
My spotting seems to have stopped so I was thinking of not going to my u/s this morning since I heard the hb last night with my fetal doppler. But I decided to go anyway. Glad I did. Things are looking great! Baby was resting this time so we got some good pics. The baby has hb of 171bpm and is measuring 5 days ahead currently which is great too. It doesn't change my due date or anything. The tech said that babies have growth spurts like that and then level off for a couple days. After the tech was done measuring, baby started dancing like it was last week. So cute! It was doing headstands and stuff too. It's certainly enjoying it's new arms and legs and is busy learning how to use them. LOL!! My next u/s at my OB's office is not until I'm 20 weeks! Such a long time away! That's alright though. I'm feeling pretty secure about things right now and really don't think it's necessary to see baby every week - even though it is so cool to see the progression week to week. We have our NT ultrasound and bloodwork on April 23rd (I'll be 12w3d) so we'll see baby again then and see if it has markers for down syndrome and other abnormalities. Probably at 15-16 weeks we'll get a private u/s done where we can find out the gender. Can't wait!
10 week belly pic
Here's the kickoff for the belly pics! Hoping to take one of these once per week to see the progression. No baby bump yet, but definitely a bloat bump and am generally thicker up around my belly button:/
Tuesday, April 9, 2013
Got my fetal doppler yesterday!
I ordered the Sonoline-B last week and it came yesterday! The sonoline-B had the best reviews online and was pretty cheap at only $54. It came ready-to-use right out of the box - just add 2 AA batteries and you're ready to go. I did not have time to find baby yesterday but tried immediately after getting home from work today (instead of taking a nap like I really should have done). It took quite awhile to find. Baby at this point is sitting pretty low - right above my pubic bone. In it's natural state, my uterus is tilted backward instead of forward so that makes baby a bit harder to find too. My OB says my uterus is gradually shifting forward as baby gets bigger. It has started shifting already, but I don't know if it is quite where it will be for the remainder of the pregnancy. Anyway, I wasn't sure I would be able to find anything due to the fact that I'm only 10w3d and my uterus is tilted. I did find it eventually though! Like I said above, baby is hanging out pretty low and slightly to the left. There was a lot of competing noises that I had to sift through. First was my heartbeat. Even though the probe is not above my heart, it still is sensitive enough to pick it up if the probe is at the right angle. Second and most frequently competing noise was the artery that I have down there that supplies blood to my legs. It clocks in at a lower rate and sounds much different though so I knew it wasn't baby. There is also the placental blood sound and umbilical blood sound (both of which aren't really strong enough to be picked up yet). Baby clocked in b/n 160-170bpm which is right on track! You can hear it in this video:
Thursday, April 4, 2013
A surprise 3rd ultrasound today!
The spotting saga continues. I thought it was finally over yesterday and thought that I was done with the pantiliners for good. I was good all day yesterday but then this morning, more brown spotting - heavy too. I wasn't too concerned - was just pissed that I had to wear a pantiliner again - but decided to call my OB just to let her know that over a week after my pap smear, the spotting was still going on. Well, I called her at 1pm and she wanted me to come in at 2pm for an ultrasound! It sort of surprised me at how prompt they were with just a little bit of brown spotting - but I was eager to oblige.
I pretty much had to leave work right away to get there by 2pm but my work is flexible with that stuff so it wasn't a big deal. While driving there though I started to get nervous, trying to replay the entire conversation with the OB to see if maybe there was something else that I may have said that would have made her want me to come in so quickly. I think I remembered mentioning that my sides were feeling crampy, but nothing else that would be alarming. By the time I got there I was pretty nervous but kept telling me to trust my gut - that everything was fine. And of course it was. I got in for the ultrasound and we saw the baby right away, saw the heartbeat (178 bpm today!), and saw arms and legs too this time. Everything was great! The baby was bouncing all over the place too! It was putting on a dance show for us:) The tech had a hard time getting a good picture because the baby was so active. She managed to get one shot, but it's really bad quality so I won't bother posting it. I have another u/s scheduled for next Wednesday so maybe the baby will be sleeping and we'll get some better pictures!
The u/s also didn't detect any blood in my uterus and my cervix looked good so my doc wasn't too concerned with my spotting. She did get out a speculum to take a peak up there - no scraping! She didn't see anything bad - just some of my brown spotting - but nothing was actively bleeding and again, my cervix looked good. So just have to assume for now that spotting was just old blood and it'll all work itself out of there soon.
I pretty much had to leave work right away to get there by 2pm but my work is flexible with that stuff so it wasn't a big deal. While driving there though I started to get nervous, trying to replay the entire conversation with the OB to see if maybe there was something else that I may have said that would have made her want me to come in so quickly. I think I remembered mentioning that my sides were feeling crampy, but nothing else that would be alarming. By the time I got there I was pretty nervous but kept telling me to trust my gut - that everything was fine. And of course it was. I got in for the ultrasound and we saw the baby right away, saw the heartbeat (178 bpm today!), and saw arms and legs too this time. Everything was great! The baby was bouncing all over the place too! It was putting on a dance show for us:) The tech had a hard time getting a good picture because the baby was so active. She managed to get one shot, but it's really bad quality so I won't bother posting it. I have another u/s scheduled for next Wednesday so maybe the baby will be sleeping and we'll get some better pictures!
The u/s also didn't detect any blood in my uterus and my cervix looked good so my doc wasn't too concerned with my spotting. She did get out a speculum to take a peak up there - no scraping! She didn't see anything bad - just some of my brown spotting - but nothing was actively bleeding and again, my cervix looked good. So just have to assume for now that spotting was just old blood and it'll all work itself out of there soon.
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