Monday, September 20, 2010

23 Week Appt

Today, I'm 23 weeks and 1 day pregnant and we had a routine office visit. I had some heart palpitations last week following a migraine treated with Fioricet that was pretty scary. It lasted for several hours, persistently, and then made a comeback sporadically on Thursday. The on-call MD on Wed said he thought they were caffeine-induced, thanks to the Fioricet. No problems Friday, but they made another appearance on Saturday and Sunday. This got me a referral to a cardiologist. Great. Another specialist. But, when you're dealing with your heart, you just can't take chances. Especially when you and a baby are depending on it. They also drew some blood to check for anemia and thyroid problems since these can cause palpitations as well. AND, we've made a (possibly temporary) change in migraine medication, so we'll see how that goes. Since the 2nd trimester began, migraines have become a weekly event.

Also, I've had an aggravating, dry, hacking cough since I got a severe sinus infection over a month ago. Since my last appt, 2 weeks ago, I've noticed that when I cough, it feels like part of my innards are trying to escape near my belly button. I started thinking it was a hernia. I got the Dr to check it out today. Yep. It appears to be a hernia. Yay. No treatment; they're pretty common in pregnancy thanks to stretching and hormones. They usually correct themselves after pregnancy, unless they become severe during pregnancy. I'm betting that having my gallbladder removed just before becoming pregnant didn't help matters since that required having my abdominal muscles sliced open.

Next in line -- I've noticed over the last year that my left knee becomes very stiff and painful after a lot of walking, or after my long days at work. It's gotten worse since becoming pregnant. I mentioned this today as well. I can only imagine that this will become much worse the further along we get in pregnancy. I received a probable diagnosis of Patellar Tendonitis. Great! What's the treatment? During pregnancy, ice. Just ice. Well, and rest and maybe some Icy-Hot (which I've tried). Usually, they treat with NSAIDs, which are, of course, a no-no during pregnancy. She said Orthopedics are very uneasy about treating pregnant women, but if it becomes too severe, there may be another referral coming, OR may have to reduce my 12-hr shifts to 8-hr shifts. My goal is to work until delivery. We need the money. Plus, I don't have much vacation time or any ST disability.

Some good news (finally). I've only gained 4.4 pounds over my pre-pregnancy weight. I lost weight in the beginning, and have gained all of that back plus the 4.4 lbs. Since I'm already overweight, I'm really watching my weight with this pregnancy. I'm not dieting, but eating sensibly since the extra poundage means increased risks to both me and Abigail. Also, we realized just how much of my abdomen is consumed by my uterus. It seems unlikely for there to be another 17 weeks worth of room in there. I guess that's why women who've reached term talk about the baby's feet being stuck in their ribs. There's no where else for those cute piggies to go! Abigail's heart rate on the doppler was in the 140's. Thommy got a few more tips from the nurse about best ways to locate Abigail during our nightly doppler ritual.

All in all, a good appt. As long as Abigail is well, all is well. Next appt is in 2 weeks.

Friday, September 17, 2010

Women May Not Need to Delay Pregnancy After an Initial Miscarriage by Laurie Barclay, MD

Very interesting study to those that have been affected by miscarriage. Personally, we were usually told that we could begin trying for another pregnancy after one normal menstrual cycle without trying. Due to things out of our control, conception of Abigail occurred approximately 5 months after our last miscarriage. That was the longest length of time between pregnancies for us. Now for the article (feel free to skip down to "Clinical Context" for a little less medical jargon).

August 26, 2010 — Women may not need to delay pregnancy after an initial miscarriage, according to the results of a retrospective, Scottish population–based cohort study reported Online First August 5 in the BMJ.
 
"How long a couple should wait before trying for another pregnancy after a miscarriage is controversial," write Eleanor R. Love, from the University of Aberdeen in Aberdeen, Scotland, and colleagues. "Some clinicians believe that there is little justification for delaying the next pregnancy, as an increased interpregnancy interval is unlikely to improve perinatal outcomes, whereas a new viable pregnancy and the birth of a child could enhance the women's chances of recovery.... Current guidelines from the World Health Organization recommend that women should wait for at least six months before trying again, whereas others suggest a delay of up to 18 months, based on reports that interpregnancy intervals of 18-23 months after a live birth can enhance maternal and perinatal outcomes in the next pregnancy."

The goal of this study was to evaluate the optimal interval to subsequent pregnancy after miscarriage in a first recorded pregnancy. At Scottish hospitals between 1981 and 2000, a total of 30,937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant were followed up during the second pregnancy. The main study outcome was miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy, and secondary endpoints were rates of cesarean and preterm delivery, low birth weight infants, preeclampsia, placenta previa, placental abruption, and induced labor in the second pregnancy.

Compared with an interval of 6 to 12 months between the miscarriage and second conception, an interval less than 6 months was associated with lower risks for repeated miscarriage (adjusted odds ratio [OR], 0.66; 95% confidence interval [CI], 0.57 - 0.77), termination (OR, 0.43; 95% CI, 0.33 - 0.57), and ectopic pregnancy (OR, 0.48; 95% CI, 0.34 - 0.69). The risk for an ectopic second pregnancy was greater with an interpregnancy interval exceeding 24 months (OR, 1.97; 95% CI, 1.42 - 2.72), as was the risk for termination (OR, 2.40; 95% CI, 1.91 - 3.01).
Compared with women who had an interpregnancy interval of 6 to 12 months, those who conceived again within 6 months and had a live birth in the second pregnancy were less likely to have a cesarean delivery (OR, 0.90; 95% CI, 0.83 - 0.98), preterm delivery (OR, 0.89; 95% CI, 0.81 - 0.98), or low-birth-weight infant (OR, 0.84; 95% CI, 0.71 - 0.89). However, they were more likely to have labor induced (OR, 1.08; 95% CI, 1.02 - 1.23).

"Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy," the study authors write.
Limitations of this study include potential lack of uniformity in documenting gestational age and outcomes of interest as well as possible misclassification. This study also evaluated only miscarriages that led to hospital contact, and the findings therefore cannot be generalized to all women with a miscarriage.

"Our research shows that it is unnecessary for women to delay conception after a miscarriage," the study authors conclude. "As such the current WHO [World Health Organization] guidelines may need to be reconsidered. In accordance with our results, women wanting to become pregnant soon after a miscarriage should not be discouraged."

In an accompanying editorial, Julia Shelley, associate professor of health and social development at Deakin University in Melbourne, Australia, discusses some of the methodologic issues regarding this study and earlier studies.

"[A]ll of the studies have selection and measurement biases that cast doubt on the value and generalisability of their findings," Dr. Shelley writes. "Of greatest concern is that women with short interpregnancy intervals are more fertile than those whose subsequent pregnancy occurs later because these women seem to have better pregnancy outcomes and fewer complications. Further research into this question may need to wait for data from more sophisticated linked primary care and hospital datasets or specifically designed research studies that can measure and account for such differences, even if they will not be able to control for them."

This research was partially funded by the Chief Scientist's Office in Scotland. Two of the study authors were employed by the University of Aberdeen at the time of doing this research and are independent from the funders. Ms. Love is a medical student, and another study author is employed by NHS Grampian. Dr. Shelley has disclosed no relevant financial relationships.
BMJ. 2010;341:c3967. Abstract
Additional Resource
Previous guidelines issued on management of early pregnancy loss are published online on the Agency for Healthcare Research and Quality Web site, and guidelines on investigation and medical treatment of recurrent miscarriage were published in the journal of Human Reproduction.

 

Clinical Context


Miscarriage, or spontaneous pregnancy loss before 24 weeks of gestation, affects 1 in 5 pregnancies. Women who have miscarried are more likely to experience threatened miscarriage, preterm birth, induced labor, and postpartum hemorrhage in the second pregnancy. However, the best interpregnancy interval for maternal and fetal outcomes after a first miscarriage is not well known. The World Health Organization recommends a wait of 6 months before attempting a next pregnancy after miscarriage; longer waits have also been recommended.
This is a retrospective cohort study of women with a first miscarriage who went on to a second pregnancy to examine the association between interpregnancy interval and outcomes of a second pregnancy.

 

Study Highlights


  • The investigators conducted this study on data from the Information Services Division of the National Health Service of Scotland, United Kingdom, using anonymized patient data.
  • They used a retrospective cohort design extract data on all women with a first miscarriage between 1981 and 2000 and who went on to a second pregnancy, as identified by internal linkage of datasets using probability matching.
  • Women who had twin or multiple pregnancies and improbable interpregnancy intervals were excluded.
  • Women were divided into 5 groups by interpregnancy interval: less than 6 months, 6 to 12 months, 12 to 18 months, 18 to 24 months, and more than 24 months.
  • Admission dates less than 4 weeks apart for the first and second pregnancy events were assumed to be related to the same event.
  • The primary endpoint was reproductive outcome in the second pregnancy, including miscarriage, ectopic pregnancy, termination, stillbirth, and live birth.
  • Confounding factors accounted for were maternal age and socioeconomic status.
  • Only 57.2% of women had smoking status recorded.
  • Preterm birth was defined as occurring at 36 completed weeks or less of gestation and very preterm birth as less than 32 weeks of gestation.
  • Of 34,845 women with data available, 30,937 were included for analysis, of whom 12,744 (41.2%) conceived again within 6 months, 7791 (25.2%) between 6 and 12 months, 2958 (9.6%) between 12 and 18 months, 1995 (6.4%) after 18 to 24 months, and 5449 (17.6%) after 24 months.
  • Older women and those with higher social class had shorter interpregnancy intervals.
  • Women with interpregnancy intervals of less than 6 months were more likely to be older (26 vs 23.9 years) and were less likely to have ever smoked.
  • Live birth rates were highest among women with intervals of less than 6 months (85.2%) and lowest in women with intervals of more than 24 months (73.3%).
  • Termination rates had a similar pattern.
  • Adverse outcomes were more likely to occur with longer intervals.
  • Compared with women with interpregnancy intervals of 6 to 12 months, those with intervals of less than 6 months were less likely to experience another miscarriage (OR, 0.66; 95% CI, 0.57 - 0.77), termination (OR, 0.43; 95% CI, 0.33 - 0.57), or ectopic pregnancy (OR, 0.48; 95% CI, 0.34 - 0.69).
  • Women with the longest interpregnancy intervals were more likely to experience an ectopic pregnancy (OR, 1.97; 95% CI, 1.42 - 2.72) or termination (OR, 2.40; 95% CI, 1.91 - 3.01).
  • Women with interpregnancy intervals of less than 6 months were less likely to have a cesarean delivery, preterm delivery before 36 weeks, or an infant of low birth weight (< 2500 g) vs women with intervals of 6 to 12 months.
  • Women with an interpregnancy interval of more than 24 months were most likely to have a preterm delivery (OR, 1.21; 95% CI, 1.07 - 1.36) or very preterm delivery (OR, 1.40; 95% CI, 1.11 - 1.70) vs women with intervals of 6 to 12 months.
  • No association was found between interpregnancy interval and preeclampsia, placenta previa, or placental abruption in the second pregnancy.
  • The authors concluded that the best pregnancy outcomes with lowest complication rates after a first miscarriage occurred for short interpregnancy intervals of less than 6 months. They recommended that it was unnecessary for women to delay conception after miscarriage.
  • The authors also recommended that unless there were indications preventing a second conception soon after miscarriage, women should be counseled about potential negative effects of waiting more than 18 to 24 months before the next pregnancy, after a first miscarriage.

 

Clinical Implications


  • An interpregnancy interval of less than 6 months vs a 6- to 12-month interval after a first miscarriage and subsequent pregnancy is associated with lower risk for ectopic pregnancy, cesarean delivery, and another miscarriage. However, at less than 6 months, labor induction was more likely.
  • An interpregnancy interval of more than 24 months vs an interval of less than 6 months or 6 to 12 months after a first miscarriage and subsequent pregnancy is associated with increased risk for preterm birth and low birth weight for a second pregnancy.

Tuesday, September 14, 2010

Cravings (yummy!)

I've always heard of how pregnant women have these cravings that last their entire pregnancy, so I was thrown off when mine changed every 2 weeks to a month.

Last week started a new one: homemade vegetable soup. In less than a week, I've made 2 big pots full and I eat at least one bowl of it everyday. Hey, at least I'm getting fiber! This got me thinking.



I honestly don't remember my very first craving with this pregnancy. I just remember eating goldfish crackers and drinking V8 -- my anti-nausea fix. Weird, I know.


Then came macaroni and cheese. Didn't matter if it was homemade, Kraft, Velveeta, or from a restaurant.


I think it was weeks 9-13 that I wanted fettuccine and virgin peach daiquiris. Every weekly doctors appt was followed by lunch at Olive Garden, where they have THE BEST virgin peach daiquiris. Pre-pregnancy, I didn't drink peach daiquiris and rarely ate at Olive Garden. This was the most expensive craving.













The next craving (perhaps the most famous one) was Wendy's baked potato with shredded cheddar cheese, a small chili -- most of which ended up on the potato -- and a small chocolate frosty. YUMMY! This craving was about 3 weeks long. The people at Wendy's knew who was ordering as soon as they heard my hubby on the drive-thru speaker. He went 18 out of 21 days -- about weeks 16-18. Funny thing, I never wanted Wendy's before this pregnancy. In fact, whenever my hubby wanted something from Wendy's, I'd try to talk him out of it.

Well, minus the sour cream and burger

Up next? Key lime pie. This one actually started in the middle of the Wendy's kick, but it didn't get satisfied until a trip to the beach where I finally got a piece of Piccata's key lime pie. It was all over after that. Thank God for Edward's Key Lime Pie from the grocery store's frozen section. AND it was on special the first week -- BOGO!

Another craving was my father-in-law's home-boiled green peanuts. This, I know, is a Southern thing, and it was oh so good. Loaded in salt and (thankfully) protein.


The next craving was simple and completely unhealthy. French fries with LOTS of ketchup and some Dr. Pepper (diet or regular; caffeine free or not). Thankfully, the FF only lasted a little over a week.















I have "off weeks" where I honestly crave nothing. During those times, I go back to my regulars: fettuccine alfredo with broccoli (Smart Ones), salads from a salad bar, and pizza. Oh, and I've had an aversion to meat pretty much this entire pregnancy. No steaks, chicken, pork, hamburgers, etc unless they were masked by other stuff I wanted. Good thing protein comes in non-meat items!

I wonder what the next craving will be?

Baby Kicks

Hands down, the best physical feeling I've ever felt.

I first felt her move at 16 weeks while laying in bed that morning. The kicks/rolls/punches were few and far between though until about 18 or 19 weeks. I actually went days without feeling her move, but at that point, I started feeling her almost every day. At 20 weeks, I started feeling her every day. Now, I feel her several times a day, every day. I've yet to find the perfect way of describing what I feel, physically. But, emotionally, I feel a connection to baby Abigail like no other. She reminds me that she's there, and that just because of that little fact, all the negative thoughts and feelings of the day go out the window and a smile comes across my face. I thank God for this little miracle he's blessed us with. Because, when it comes down to it, she's what matters. Not the rush-rush that is my job. Not the driver in front of me on the road that is going 20 mph under the speed limit. Not the bad dream that I just had. She assures me that she's okay, and that makes everything else okay.

I find myself asking her (sometimes out loud), "What are you doing in there, Abigail?" I would love to be able to see in there all the time. Pregnant women should have a see-through belly for this purpose.

Last night, she was really active. And I felt a huge kick while laying on my left side. Then another, and another. Probably about 5 times in a row but they got weaker (or more distant) each time. I kept thinking, "I wish her Daddy was here to feel this". Later in the night, he did get that chance.

This morning, I felt some light movement, then what felt like a complete body roll. I wanted more, and actually (lightly) pushed down on her to see if she'd kick back ... and she did :)

Since I can't find the words to describe what I feel, here's some descriptions that I've read:
  • popcorn popping
  • goldfish swimming around
  • butterflies fluttering
  • a muscle twitch
  • rippling sensation
  • bubbles bursting
  • bumping or nudging
  • someone hitting my stomach from the inside
  • like being turned upside down on an amusement park ride
If you've experienced this first-hand, feel free to add your own description in a comment below :)

Friday, September 10, 2010

Abigail's Song

Since before we were pregnant with Abigail, she had her own song. Michael Buble's "Haven't Met You Yet". Read the lyrics as you listen. You'll see why.

"Haven't Met You Yet" video

I'm Not Surprised
Not Everything Lasts
I've Broken My Heart So Many Times,
I Stopped Keeping Track.
Talk Myself In
I Talk Myself Out
I Get All Worked Up
And Then I Let Myself Down.

I Tried So Very Hard Not To Lose It
I Came Up With A Million Excuses
I Thought I Thought Of Every Possibility

And I Know Someday That It'll All Turn Out
You'll Make Me Work So We Can Work To Work It Out
And I Promise You Kid That I'll Give So Much More Than I Get
I Just Haven't Met You Yet

Mmmmm ....

I Might Have To Wait
I'll Never Give Up
I Guess It's Half Timing
And The Other Half's Luck
Wherever You Are
Whenever It's Right
You'll Come Out Of Nowhere And Into My Life

And I Know That We Can Be So Amazing
And Baby Your Love Is Gonna Change Me
And Now I Can See Every Possibility

Mmmmm ......

And Somehow I Know That It Will All Turn Out
And You'll Make Me Work So We Can Work To Work It Out
And I Promise You Kid I'll Give So Much More Than I Get
I Just Haven't Met You Yet

They Say All's Fair
In Love And War
But I Won't Need To Fight It
We'll Get It Right
And We'll Be United

And I Know That We Can Be So Amazing
And Being In Your Life Is Gonna Change Me
And Now I Can See Every Single Possibility

Mmmm .....

And Someday I Know It'll All Turn Out
And I'll Work To Work It Out
Promise You Kid I'll Give More Than I Get
Than I Get Than I Get Than I Get

Oh You Know It'll All Turn Out
And You'll Make Me Work So We Can Work To Work It Out
And I Promise You Kid To Give So Much More Than I Get
Yeah I Just Haven't Met You Yet

I Just Haven't Met You Yet
Oh Promise You Kid
To Give So Much More Than I Get

I Said Love Love Love Love Love Love Love .....
I Just Haven't Met You Yet
Love Love Love .....
I Just Haven't Met You Yet

Thursday, September 9, 2010

Baby Abigail (with pictures)

On May 4, 2010, the week of Mother's Day, we had another positive pregnancy test. I took a home test every day for a week, and finally had a blood test done a week later. My hCG was great, the progesterone level was low. Both were rechecked many times over the next several weeks. The hCG was going to levels I'd never experienced before. The progesterone level was staying low. I was started on an additional supplement, an intramuscular injection that I'd need once a week in addition to the Prometrium. The level still stayed low. The doctors were, once again, baffled. On 6/2 we had our first view of "Pookie" (nicknamed by our u/s tech) via u/s. She measured 8w0d and had the best sounding heartbeat we'd ever heard at a rapid rate of 175bpm. We were still a bit stunned we were pregnant, and even though things looked great overall, we were still very scared. We'd been through this before where everything is perfectly awesome ... until it isn't. Every week we had another ultrasound. Every week, Pookie had grown by leaps and bounds. On June 14, we not only heard that precious heartbeat, we saw her "dancing". The progesterone level continued to be low. We had one more option -- a supplement called Crinone that is used with IVF patients to help build up progesterone and uterine lining. The problem was, our insurance saw it as a fertility drug, so it cost $175 per week. We bit the bullet and went for it. Afterall, little Pookie was worth it. Meanwhile, our doctor called and wrote letters to the insurance company and the company that made the medication. After about 2 weeks, it was approved and now only cost a small copay.

By June 23, she was measuring a week ahead and doing flips. My progesterone level remained low, but was climbing. On July first, we got our first view of her profile, and my progesterone level was finally at an acceptable level. And we'd finally made it past 10 weeks.

July 14, I was finally 13 weeks. I'd completed the first trimester for the very first time. And this was the first time we started looking at genitalia.

On July 28, our 9th wedding anniversary, we started our day by seeing Abigail, who was officially declared a girl at 15 weeks. This was the very first visit to the doctor that I was excited about. Every single week up to this point, I feared there would be no heartbeat. This is the day we announced her existence to the world, via Facebook. 
July 28, 2010 - 15w3d


On 8/6 I'd been having abdominal pain for about 18 hours. In the beginning, I was positive it was just ligaments stretching and nothing to be alarmed about. But, everything I'd heard and read said that pain only lasted for several mins to hours. We were going on almost a whole day. I called the doctor's office and got worked in for an appt. By the time I made it to the office, I was a nervous wreck. I just knew we'd lost her. My hubby was at work but met me at the office. When I heard her heartbeat on the doppler, I cried. No, scratch that. I wept. Like a baby. And, upon physical examination and u/s, all was well with me and Abigail.


Today, I'm 21w4d and happier than I've ever been. It's taken lots of doctors, lots of tests, lots of medicines, lots of poking and prodding and needles and tears to get here. I've come close to losing my faith more times than I'd like to admit. If it wasn't for my husband, I honestly don't think I would have ever made it. Infertility can make or break a relationship. For us, it made us stronger as individuals, and as a couple.
7w3d
9w1d
11w4d
11w4d
12w4d
13w3d
13w3d
15w3d
15w3d
15w3d
16w5d
16w5d
17w3d
17w3d
17w3d
21w2d
21w2d (foot is 1.5" long)

As a daily regimen, I take an 81mg Aspirin, Folic Acid, Prenatal Vitamin, and a Lovenox shot (that my loving husband doses me with). The Lovenox shots will continue until 37 weeks, and then I'll have to start them back up for 6 weeks postpartum. Every week, I still require a intramuscular injection of progesterone that my coworker gives me. But, every night before bed, we get to hear our little miracle's heartbeat via a rented doppler (www.bellybeats.com) and it makes everything else seem so minuscule.

More of the same (and it's a long one)

After the loss of our baby, we grieved like you'd grieve the loss of a close family member, only worse. Not only did we lose this little person made by us, we lost the dreams we had for him/her and our family. We lost the overwhelming excitement every couple should feel when they see a positive pregnancy test. For now, we'd feel fear of the past repeating itself.

And it did. On December 18, 2008, we lost baby #2 at about 5 and a half weeks. The good news is we didn't have any issues getting pregnant this time. The added bad news? We've now lost 2 babies and no one can tell us why. Christmas was Hell. How do you celebrate with family and friends, most of which didn't even know about the babies, just one week after losing a second one?

At this point, our doctor said that based on the gestation that we lost both babies, and the fact of the luteal phase defect (LPD) I'd observed by doing my BBT's, he was pretty sure the miscarriages were due to low progesterone. I was to begin a supplement called Prometrium immediately following ovulation the next month we tried to conceive. But just in case, he sent us to a genetics counselor where everything checked out with both mine and my hubby's DNA. As a precaution (and because no one had any answers for us), I was to start taking additional folic acid (I've been taking a prenatal vitamin since Aug 2007) and a baby aspirin every day.

We now had some restored hope. I was started on Clomid to help my body to ovulate sooner to help avoid problems with the LPD. And, on February 19, 2009 when we had another positive pregnancy test, more fear than excitement was present. I'd been on the Prometrium, Aspirin, and additional folic acid. I had a blood test the very first day I had a positive home test. The hCG level was very low, but the progesterone level was awesome! I took a home pregnancy test every day for a week just to be sure the lines were getting darker. On March 5, 2009 we had our very first ultrasound. There was indeed a gestational sac. I had my hCG level checked twice a week, every week, and my progesterone level checked every week. On March 12, my hCG and progesterone levels had dropped from the last test. On March 17, the hCG had risen a little bit. I upped my Prometrium. On the 19th, it dropped again. We were told that we were most likely losing the baby. On the 20th, we had another u/s. The sac was present, but no heartbeat, and it was only measuring 5w3d despite being almost 8 weeks along, and the hCG had dropped even more. On March 24, it was declared a missed miscarriage (one my body didn't want to let go) and I was started on Cytotec to speed up the process of miscarrying. I actually required 2 doses instead of the usual 1 dose.

We'd now lost 3 babies. And we still had no answers. I'd done everything I'd been instructed to do. We were referred to a local infertility specialist who diagnosed me with PCOS (polycystic ovarian syndrome) and started me on Metformin. I had a (very painful) hystersalpingogram where they dilate the cervix, inject dye into the uterus, and watch the dye move through the reproductive tract under xray. This showed that I had a normal uterus, normal open fallopian tubes, and normal ovaries. We proceeded with probably about 20-30 blood tests, all of which came back normal. For the next several months we continued the Clomid and had monthly ultrasounds to look at the follicles present in my ovaries to be sure I was producing good eggs. I continued the Prometrium, aspirin and folic acid. All looked great and I was having normal ovulation and normal cycles.

On June 28, 2009 we had another positive pregnancy test. This one lasted about 5 weeks. This specialist declared it a "chemical pregnancy" saying I wasn't really pregnant. His nonchalant attitude and lack of compassion made the loss that much worse. It was then that I decided I really didn't care to see him again.

He started me on a 1-month Rx of birth control pills to "regulate my cycle". Then we resumed the Clomid and monthly mid-cycle ultrasounds. October 10, 2009 we had a positive pregnancy test. I waited close to a week before getting a blood test done because I didn't want to face another low hCG level. The level was higher than it had ever been. And the progesterone level was acceptable. That was the very last time I went to that specialist's office. He wasn't going to bum me out this time.

And then it happened. On October 29, 2009 at almost 8 weeks pregnant, we heard our very first heartbeat. It was at 126 bpm. All my blood levels were good, although the progesterone was on the low side of normal. The doctor said we'd made it. All was great. We needed to relax and get used to the idea that we were actually going to have a baby. We were ecstatic. We were now having weekly ultrasounds since we were such high risk. The following week, everything was still great. My hubby and I FINALLY relaxed at almost 9 weeks. Then we went for our (almost) 10 week u/s. There was no heartbeat and the baby measured just 9w2d. We were stunned. The u/s tech and doctor were baffled and had no words or explanation. Everything looked perfect, but the heart had stopped beating. We scheduled a D&C for 2 days later on 10/20/09 when I would've been exactly 10 weeks. We asked that the baby, placenta, and all other tissues collected be sent for testing. We'd get the results in about 6+ weeks. We were grasping at straws now. We'd lost 5 babies and still had no known cause.

In December 2009 we went to see a new specialist an hour and a half away. He had national recognition for infertility practices. Within 2 visits, he had diagnosed me with an elevated anticardiolipin antibody (ACA) which causes my body to attack a pregnancy and cut off it's blood supply. He also diagnosed my hubby with misshapen sperm. He was told to start detoxing his body with Acai Berry juice and a fertility supplement. We were told that this had to be a new development or I'd never have become pregnant. I was told I needed to be on a blood thinner, a type of heparin, called Lovenox starting after ovulation each cycle, and it would continue throughout the first trimester if we became pregnant. A month later, my hubby's sperm showed some improvement, and I was put through another test -- a saline ultrasound which would look for the same things as the hystersalpingogram. This was uncomfortable, but not nearly as painful as the HSG. All looked normal. Later in the month of January, we attempted intrauterine insemination (IUI) to be sure only the good sperm would reach an egg. It failed. We tried again in February w/o results.

Meantime, we got the results on the baby from the D&C. Normal DNA. Normal development. A perfect little girl.

In late February, I started having gallblader attacks. Finally, in March, it was decided by a surgeon that it needed to be removed. Once I had a negative pregnancy test, I scheduled the surgery. I told the surgeon that the surgery had to be after a period and before ovulation so that it wouldn't interfere with trying to get pregnant. I'm sure he thought I was crazy. I had surgery on 4/8/10. I had planned to recuperate in the mountains of TN, where we'd casually try again for a baby. No fertility meds. No blood tests. No IUI. Just a husband and a wife with a few ovulation tests. God had other plans. The surgery screwed up my cycle and pushed back my ovulation by a week.

But God knew what He was doing.

And so it began.

I don't think any woman expects to become pregnant the first month she and her partner begin trying, but you are still disappointed when it doesn't happen. After about 5 months of negative pregnancy tests, I became very proactive. I was on a mission. I purchased ovulation tests and pregnancy tests online (so much cheaper online!), bought a book (The Everything Getting Pregnant Book), and began charting basal body temps (BBT) (online). Of course, this meant an even bigger disappointment when the pregnancy tests were negative over the next several months. However, I learned a few things about my cycle by doing all of this. #1 I don't have a by-the-book 28 day cycle; #2 I do, in fact, ovulate every month, #3 however, I ovulate LATE in my cycle every month and have a luteal phase defect making it difficult to get pregnant since my body wasn't producing enough progesterone before cascading and signaling for menses to start. And, #4 working nights had my hormones, and therefore my cycle, all over the place.

This was a bitter pill to swallow and a bit overwhelming. But, now that I knew what was wrong, I could find a fix. Everything I read said that in my age group, it was unnecessary to seek professional help in getting pregnant until we'd been actively trying for a year. So, I didn't. Plus, I was afraid they'd find something else wrong with me and take all hope away.

The weekend of August 23,2008 was my first weekend back on day shift at work. I'm sooo not a morning person, but trying to get pregnant working nights wasn't working out, and since I'd been charting BBT's, I realized it wasn't going to happen. Also, working nights was making it very difficult to see family and friends. This was month 13 of trying to conceive. My very first cycle of day shifts brought a positive pregnancy test.



I was ecstatic! I was shaking and in disbelief as I sat on the commode lid staring at the test. I smiled. I laughed. I cried. My heart was racing. Then it dawned on me that it could be a false positive. I got myself together and drove to the store for more tests (and chugged a bottle of water on the way). I had been planning for at least 5 years on how I'd planned to tell my hubby the happy news. It all went out the window! I now had 2 positive tests. Different brands. Different urine samples. I laid them side by side and took a picture with my phone -- and sent them to my hubby who was at work. It seemed like an eternity before he called. I could hear the shaking in his voice as we happily cried together on the phone. This was Friday, September 26, 2008.

Following a blood test to confirm, we wanted to shout it from the rooftops, and basically did just that, but just with immediate family. Our excitement was short-lived.

On October 4, while at work, I started having cramping and bleeding. I called my hubby and we met the physician on call in the ED where we spent most of the night having blood work, ultrasound, urine tests, physical exam, etc. We'd lost the baby at just 5 weeks and 3 days. We were beyond devastated. That was the longest, quietest 40 minute ride home filled with nothing but tears.

The physician was encouraging. He said that 25% of pregnancies end in miscarriage, and most people at the gestation we were at wouldn't have even known they were expecting because it was so early. He went on to say that the many, many people that experience a miscarriage go on to have a healthy, full-term pregnancy. He also shared that, while he has 4 grown children, his wife also experienced 4 miscarriages. At the time, none of this helped at all. I felt like my hubby and I were the only 2 people on the planet who knew how we felt. I felt alone.

I asked him when we could start trying again. His answer surprised me. He said after one cycle, we could have another try. This gave me hope.

Getting Started

I married the man of my dreams, the love of my life, my best friend, my soul mate, on July 28,2001 when I was a mere 20 year old young woman. We had a rough start in our marriage, financially, but I feel it's part of what shaped us into the couple we are today. For that, I'm eternally thankful. When you're at your worst, and look around to see people offering a helping hand, you know you're loved.

I've wanted to be a Mommy more than anything else for as long as I can remember. My biggest fear since reaching adulthood was that this dream would never become a reality. Just after getting married, I was ready to start planning a family. As fate would have it, my husband was laid off about 2 weeks before we wed, and I was a full-time student in a Medical Assisting program working only part-time at a hotel chain. Obviously, this was not the time to try to get pregnant. Things got worse. Following 9/11, and a huge slump in travelers, the hotel chain I was working for laid me off. There we were, newlyweds, both in school, and jobless. Over the next several months, my hubby found temp job after temp job, one of which finally turned into a great full-time, permanent job. He put his schooling on hold.

I graduated from college as a Medical Assistant in December 2003, became certified, and began working full-time at the doctor's office I'd been introduced to during clinicals in school. One problem: no benefits. Approximately 1 year later, I found another job, WITH benefits and great pay at a brand new Urgent Care office. We started looking for a house and started thinking of expanding our much desired family. Due to slow business in this brand new office, I was laid off. Again.

I was a bit more positive this time. After a long talk over some Southern barbeque with my Daddy, I decided to go back to school. For Nursing this time. Something I was too scared to attempt right out of high school. I applied and was accepted into the Nursing school program. I'd start in the Fall of 2005. My dear hubby began working 2 jobs to support us so that I could concentrate completely on the educational version of boot camp that is Nursing School. I graduated in May 2007, accepted a job at a local, small-town hospital, and passed my nursing boards on the first try in July. Finally, things we're looking up. Except my hubby was laid off, again, from his full-time job during the exact hour I was being interviewed for my first nursing job. Thankfully, he still had that part-time job he'd started while I was in school. We were still ok.



We relocated to the small town where I was now employed in August 2007. We were finally, actually, going to try for a baby of our own, and couldn't be happier.