Saturday, January 2, 2016

1 in 3: The Game of Numbers

When I first met with my new IVF clinic last July, the doctor there told me I had a 1 in 3 chance of conceiving through IVF. That's around a 33% shot, and was actually higher than the measly 20% odds I was given at my first clinic during my initial IVF round (which didn't result in a pregnancy).

I ended up producing 14 eggs, 12 of which were mature, 7 of which fertilized. On my 40th birthday, we opted to transfer all 3 embryos that looked ready- as we had been told at my age, 1 in 3 embryos would be genetically and chromosomally sound. We did waffle quite a bit between transferring 2 or 3, and ultimately went for 3 such that we wouldn't have any regrets if a pregnancy did not ensue. They gave me a 45% change of pregnancy with the two, up to 50% with 3 (based on quality)- which was the highest odds I'd EVER gotten. None of the remaining embryos being watched made it to freeze, so this was truly our one and only shot at growing our family.

At 9 days past my 5 day transfer (the equivalent of 14 days past ovulation)- I had a very healthy, strong pregnancy beta reading of 404. This number doubled to 891 two days later, and BC and I were super curious to see how many of the embryos had taken. My pants were already feeling quite tight and I had a noticeable bump developing, so we were suspicious there could be more than one in there.

This was taken at 5 weeks- I didn't have a bump like this until I was closer to 12-13 weeks with Iyla!

My first monitoring exam was scheduled for 6 weeks. I knew that it would likely be too early to hear any heartbeats, but BC and I expected we'd walk away from the appointment knowing how many babies were developing. I opted to have the monitoring done at my local clinic so BC could be there. 

The appointment was…. confusing. As the doctor moved his sonogram wand around, he started counting the sacs he saw…. one…. two….. and then THREE. I literally blurted out "NO!" as I knew that meant all 3 embryos had implanted. Yes, this was a risk we had run transferring 3 embryos, but never anything we fathomed could possibly occur. Further probing showed that 1 of the 3 sacs was much smaller than the other two, and the doctor surmised it would likely not develop. He said he saw what looked to be a fetal pole and yoke sac in the first sac and suspected a heartbeat there, and maaaybe saw a yoke sac in the 2nd larger sac. There was nothing conclusive; BC and I left that appointment joking we had "1 maybe 3" babies in there, and just hoping that we'd hear one strong heartbeat the following week.

I opted to drive to Houston for my 7 week check up, as I wanted the expertise of my IVF doctor at this all important visit. I also hadn't seen him since my initial monitoring, as he was out of the office during my egg retrieval and embryo transfer.

As the sonogram wand moved around he landed first on the smallest of the 3 sacs. He said there WAS a yoke sac in there (holy shit!) but that given its size, it would likely not develop into anything viable. Then he moved to the 1st of the larger sacs. Lo and behold, there was a baby in there measuring at exactly 7 weeks with a strong 123 heart rate! I now held my breath as he moved the wand again…. and there it was. In the 2nd large sac was another baby, measuring 7w1d, with another strong 119 heart rate.


I was, quite literally, in shock. The doctor told me that at this time, there was an 80% chance both babies would continue developing to birth. 

Shock and terror were the emotions that encircled me that first day of getting the news. Of course we knew that twins could be a possibility, but we never thought it would actually happen. I worried about Iyla, and how adding two new babies would affect her life. I worried about finances, as adding two new family members would definitely take a toll, both in equipment and overall care. I worried about my body- I am a petite 5'2 girl- how would I do carrying two babies? Would I need to be put on bed rest? Would the babies come early and have to spend time in the NICU? How would I breastfeed TWO babies? And on and on it went. BC was in a very similar place- when I called to tell him the news, there was deafening silence on the other end of the phone. Also shock and terror. This is the space we lived in for the first few days.

And then, slowly but surely, a tickle of magical excitement began to creep into our hearts. TWINS. What an amazing gift to be given, and how incredible it would be to watch the unique bond of two babies growing up together! I would get my dream family of 3 children after all. It seemed too good to be true, and I felt a sense of peace and completion unlike any I've ever experienced. Don't get me wrong, I was still super nervous about the realities of growing, birthing, and caring for two babies at once- but the excitement started to eclipse the worry. 

At my 8 week monitoring appointment here in Austin, both babies still looked amazing. Baby A measured at 8w1d, Baby B at 8w- both with strong 169 heartbeats. The doctor said there was now a 95% chance they would both continue to birth, and everything started feeling VERY real. I ordered a few books on multiples and started researching equipment we'd need. I joined twin mom forums and introduced myself. BC and I talked about the two little buddies in my belly, and started throwing out different names. We talked logistics with their nursery, about who would come to help upon their arrival, and planned a financial date to talk further about budget. We were having TWINS! We shared with family and close friends and were excited to graduate to my regular doc for our 10 week appointment.

This was my belly at 8w2d, about as big as I was with Iyla at 17-18 weeks

The day of my 10 week appointment came. BC and I were looking forward to meeting up with our beloved local clinic- the team who had delivered our sweet Iyla. It would be such a special pregnancy journey to share with them.

We got into the ultrasound room and began the appointment. The tech was moving the wand all around, and I caught a glimpse of Baby A on the monitor. She kept moving the wand, and I couldn't help but notice when she got to Baby B, she kind of quickly moved past, and as she did I saw that this baby looked quite a bit smaller than Baby A. She measured Baby A and said it was measuring right on track at 10w1 day, with a strong 168 heartbeat. She kept moving the wand around and around and around, saying she was taking extra measurements of my uterus.

After a little more time went by, she said "I'm so sorry, but I can't find a heartbeat in Baby B, who is only measuring at 8w1d." 

Silence. Shock.

There was nowhere in my periphery where I even considered this a possibility- to lose one of the babies after our 8 week appointment when we were told there was a 95% probability they would continue on toward coming home with us in July.

Then the shock was joined by deep, deep grief- which completely shook me and quite honestly surprised me. In an instant this dream we'd been envisioning of twin babies- who had both been growing beautifully in my belly- was gone. There wouldn't be twins. There wouldn't be a family of 3. I hadn't realized how attached I'd already gotten to this idea and to each of these babies. 

And of course, there was deep fear for the remaining Baby A. Who was to say that this baby wouldn't also suddenly stop developing Everything felt so fragile and unsure. I'd gone from a strong, thriving twin pregnancy to a shaky, uncertain place. 

I was told it was very likely Baby A would be just fine, and indeed have heard many tales of the "vanishing twin," where one twin stops developing early in pregnancy and the other continues to develop to full term (the baby that passes typically stays in the uterus and just gets reabsorbed by the body). I read that the time frame between 8-10 weeks is an extra sensitive time for chromosomal abnormalities to reveal themselves, and that many women hear a heartbeat at 8 weeks, only to have the baby stop developing shortly thereafter. Why hadn't anyone prepared me for this possibility? All I had heard was the  95% chance they will both continue to birth- which sounded like a pretty sure thing to me.

Today I am 10w4d… and as far as I know, still pregnant. But terrified of losing the one baby remaining. The sweet midwife at my clinic told me I could come in every single day to hear a heartbeat if I needed to- and for now, we have appointments scheduled at 12 and 14 weeks for reassurance, and I may just stop by next week at 11 weeks to check in.

The deep grief kept hold of me for a solid 2 days, and now with each passing day I am feeling a little better. Quite honestly there is a sense of EASE that comes with re-thinking this as a singleton pregnancy (which I am sure is part of my coping mechanism). I've been there, done that. I have all the equipment. My body knows how to handle and birth one baby. Our finances won't be stretched nearly as far, and we can truly dote on our two children and give them everything. 

I am trying so hard to trust in this baby still inside me… to believe that he/she is meant to be here and is our 1 in 3 fighter. More than ever, BC and I are so glad we ended up transferring all 3 embryos, as who is to say which one of the three was THE one? Obviously the other two played the odds and had something not quite right in their development; now we hold out hope that this baby still growing- this ONE- out of 14 eggs, out of 7 embryos, out of 3 transferred- is our take-home baby. The completion of our family.

I'd be lying if I said I wasn't on pins and needles about it all. I hope with each week that passes I'll have more reassurance in this pregnancy and start to be able to really enjoy it. BC feels strongly this baby is our warrior- the one meant to come to us. I am leaning on that for now, as my faith has definitely been shaken. There really isn't any 'frou' to be found in all of this; rather, it seems an act of pure odds- of science and biology.

In the last week Iyla has started snuggling my belly and saying hello to the baby in there…. it is beautiful and heartbreaking at the same time. We all so dearly want this little one to grow and thrive. 

And the quest continues….

1 comment:

  1. I'm sorry for your loss and so hopeful that your warrior joins you healthy and hale. Do you have a due date for warriorino/a?