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8 - Elizabeth Unexplained
Lots of data but no answers
greyautumnrain
greyautumnrain
8
This morning I got out of bed, and went to use the bathroom. When I was done I looked down and saw some brown spots in the toilet. An inspection of my underwear revealed more brown. Eit. I was pretty darn sure it was over then. This was my period, held at bay by nothing more than my nightly progesterone shot.

After my shower I installed a maxi pad. There wasn't any more blood, but I figured it was just a matter of time; I might as well be prepared. Then I went off to get tested in what seemed like an excercise in futility. In addition to the maxi pad I was wearing my "My Husband Loves Me Anyway" pendant. Its too sparkly for daytime wear, really, but I needed it.

I went to work. I've been on the brink of tears all morning, but hey, I'm leaving this job on Friday, so its probably not a big deal that I'm getting nothing done. I got lunch. I got a coke to go with. My work has free soda, but the selection doesn't stretch to heretic coke (caffine-free coke), so I had been drinking ginger ale. I figured what the heck, caffine now wouldn't change the results. I sat down at my desk to eat. After two sips of the illicit caffinated coke the phone rang.

The tone of the nurse's voice immediately told me that this was bad news. I was expecting bad news. It was not, however, exactly the bad news I was expecting. The test was positive, but the number was 8. Anything under a 5 is negative, and at this point they expect a number over 100. The nurse said to discontinue the progesterone and come back on Friday for more blood work. I asked to talk to Grace. I didn't want to give up the progesterone... well, I basically didn't want to give up on even the most marginal of positives. This is as pregnant as I've ever been before.

Grace called back less than 15 minutes later. She is sure that this is not going to work out. If it were just late implantation they'd still expect to see a number over 20. Best case scenario: its a chemical pregnancy that will resolve itself soon. Worst case scenario: its ectopic. Lovely. My risk of ectopics is increased by both the fact that I used IVF and the fact that I have endometriosis. Oh well. My tubes may be allegedly clear, but its not like they've shown any evidence of actually working.

Of course I am completely insane. I'd quit drinking the coke after the first phone call. I went back to the kitchen and got a ginger ale. I'd also gotten permission from Grace to continue the progesterone. It won't actually hurt me. I'm just way too stubborn to give up, and stopping the progesterone is giving up, even though I know that this is almost certainly not the little embryo that could. I just can't kill it myself by stopping its support mechanism, it has to go splat on its own.

So, there you have it. I'm pregnant, kind of, but not for very much longer.
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Comments
chenoameg From: chenoameg Date: March 13th, 2007 05:52 pm (UTC) (Link)
I'm sorry. Just when you think you're steeled for the bad news they have a new different kind of bad news to lead you on with.
remcat From: remcat Date: March 13th, 2007 06:28 pm (UTC) (Link)
I'm so sorry. Talk about insult to injury! :(

I didn't know that IVFs could result in ectopics -- I would have thought that skipping that journey would mean a lower (or zero) risk.
greyautumnrain From: greyautumnrain Date: March 13th, 2007 07:21 pm (UTC) (Link)
I'd have thought that too until I did some reading. Interestingly, it also increases the risk for placenta pervia, the thing where the embryo implants a tad too low and the placenta starts growing over the cervix. Apparently IVF just adds more error in where the darn embryo ends up.
remcat From: remcat Date: March 13th, 2007 08:52 pm (UTC) (Link)
I guess that makes sense, in a way ... by "helping" a body process, it's not too surprising that things can get mucked up.
psychohist From: psychohist Date: March 13th, 2007 09:31 pm (UTC) (Link)
One of the things about standard IVF is that it puts the embryo in the uterus about three days before it would normally be there, when it would normally still be travelling down the fallopian tubes. I suspect this gives it more of a chance to wander from the correct spot, at least with regard to placenta pervia. I'm not sure whether it's actually a causation for ectopic pregnancy, as the people who use IVF may be at higher risk for an ectopic pregnancy in the first place.

Eventually people will probably switch to blastocyst insertion, where you wait three extra days and let the embryos develop beyond the 8 cell stage into blastocysts. It normally isn't done right now because it's more expensive and doesn't increase the overall chance of pregnancy. Also, people may prefer inserting 3 embryos to waiting for two of them to die off and inserting the one remaining blastocyst, even when the chances of pregnancy are the same.

That points up another positive in this result: if an embryo actually implanted, that means it made it to the blastocyst stage.
kirisutogomen From: kirisutogomen Date: March 14th, 2007 03:20 pm (UTC) (Link)
That points up another positive in this result: if an embryo actually implanted, that means it made it to the blastocyst stage.

Despite the bad-news nature of the event, it seems that the new information is an important aspect. Knowing you can implant and start dividing seems pretty important.
enugent From: enugent Date: March 13th, 2007 06:45 pm (UTC) (Link)
God DAMN it, that is totally unfair. I'm so sorry.
twe From: twe Date: March 13th, 2007 06:59 pm (UTC) (Link)
I'm very sorry. :(
countertorque From: countertorque Date: March 13th, 2007 08:23 pm (UTC) (Link)
I totally understand being stubborn.

I'm sorry to hear the news.
merastra From: merastra Date: March 13th, 2007 08:24 pm (UTC) (Link)
oof :-(
I sympathize with your stubborness.
psychohist From: psychohist Date: March 13th, 2007 08:27 pm (UTC) (Link)

More Data

I found more data at a variety of pages, of which this one is seemed to have the most:

http://www.bobrow.net/kimberly/birth/hcglevels.html

According to that page, 5 is the cutoff for a negative, and 25 is the cutoff for a positive. "If you are unsure, repeat the test in two days to see if there is an upward trend, which indicates pregnancy."

It also says that the range for pregnancy at 14 days post conception is 3-426.

Of course, especially given the spotting, most likely it's a chemical pregnancy - which is to say, a very early miscarriage, one that occurs before a period can be missed. This is not anything to worry about, as these are evidently more common than actual pregnancies. It's just that most people aren't testing early with clinical tests, so they just never know about them.

There is an upside to this. It's evidence that we can get an implantation, which given the endometriosis we weren't sure about before.
twe From: twe Date: March 13th, 2007 08:50 pm (UTC) (Link)

3-246

Well, that's quite a range.
remcat From: remcat Date: March 13th, 2007 08:51 pm (UTC) (Link)

Re: More Data

The same thought did occur to me -- at least this is one tiny step in a positive direction. But, I didn't know if E was ready for silver linings just yet.
enugent From: enugent Date: March 13th, 2007 09:53 pm (UTC) (Link)

Re: More Data

I wasn't going to post this, since I didn't want to feed possibly false hopes, but if you're searching anyway....

From a set of self-reported beta levels from women with successful pregnancies, numbers could be as low as 3 at 14 DPO and lead to a viable pregnancy. As you say, a chemical pregnancy is the most likely, though. I'm sorry you're having to go through this, and the fact that it has to be extended for a couple more days makes it all the worse. Take care of yourselves, and each other.
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