8w0d: Looking Good

What a difference a week makes. As soon as they showed up on the screen it was really obvious they had grown. We really loved that Dr. NFB had us in frequently to monitor the babies and my hormone levels. Both babies came through with flying colors at this appointment.

Baby A - 1.6cm with heart rate of 166bpm
Baby B - 1.5cm with heart rate of 159bpm

Quick note on fetal measurements prior to 20 weeks: lengths are crown-to-rump (CRL). Because their little limbs are forming and not proportional, it is inaccurate to include them in the length of the embryo/fetus. Therefore, the convention is to measure the top of their heads to the bottom of their butts.

The babies have little stubby limbs! This is Baby A.

Baby B's heartbeat. The inconsistency in the middle is me breathing and causing the monitor to move.

Progesterone-In-Oil Injections

Beginning on the night of the retrieval, Chris had to give me daily 2cc progesterone-in-oil injections. These are intramuscular using a 22 gauge, 1.5 inch needle. I still had my sharpie circles drawn on my upper butt/lower back from the trigger, so we just kept retracing them. I thought they would hurt worse than the prior shots, but they really didn't. Chris is awesome with injections. The downside is 2cc of oil is a lot of fluid sitting in a muscle. We had 36 of these total before switching to a different progesterone supplement.

Here is what I did to minimize the discomfort: iced my skin for about 45 seconds beforehand and then cleaned with an alcohol wipe. While that was drying, I eliminated the extra air from the needle and handed it to Chris. He injected it, checked for blood in the syringe, and then pushed the fluid (this part took a while - probably 60 seconds). Immediately after he pulled the needle, I put pressure on it with a gauze pad while we heated a facecloth in the microwave. That served as a hot compress for a few minutes and then I sat on a heating pad for about 15 minutes. This actually did a pretty good job at minimizing sore muscles, although some days were better than others.

Unfortunately, we either hit a nerve or got too much fluid built up around a nerve. My left hip, farther down my leg, hurt to walk for about a week, and is still numb/tingly/itchy. We left that side alone for several days and only injected into it occasionally after that. The last time we even touched that side, I felt the injection all the way down my leg to my foot so I knew we had re-irritated that nerve. Ah well. I had a positive pregnancy test to focus on making everything worth it.

Chris did such a great job. If you ever need an injection in your butt, Chris is a pro. Here is his diagram where he injected each needle so he knew where to put the next one. I love him.

7w0d: Two Heartbeats!

Dr. NFB had us come in one week after our first ultrasound to check growth and to make sure Baby B had a heartbeat. I was nervous, but I had a feeling that everything was going to be fine. Sure enough - both babies had heartbeats! Baby A was 116bpm and Baby B was 120bpm. They also tripled in size. A was 7.5mm and B was 6.8mm.

Here is the downside of the internet. I had researched before the appointment and knew that these heart rates were a little on the low side. I asked Dr. NFB if they were ok and all she said was, "They are fine." Not great, not excellent, not perfect - just fine. More worrying, but at least fine was better than marginal.

At this point, we had told our immediate family about the positive pregnancy test, but not that we had had an ultrasound. We wanted to see a heartbeat first and because Baby B didn't have one at the prior ultrasound, we continued to keep quiet. My parents were in town for Christmas and we were so excited to show them the picture when we walked in the door. They knew right away they were looking at two of something!

Dr. NFB had another blood draw ordered to recheck my P4 and E2 levels. The nurse called later in the day to say my P4 had gone up to 157 despite dropping the progesterone-in-oil dose in half. In other words, the babies were doing a great job producing it on their own. They had me stop the PIO injections and switch to Crinone. No more daily needles!!

The babies are the gummy bear looking objects.
The round circle visible near Baby B is the yolk sac. Both babies have them. They
provide nutrients until the placenta grows big enough to take over.

6w0d: First Ultrasound

The wait between the beta and the first ultrasound was the longest two week wait we've ever had. I was so worried that something had gone wrong. I even had Chris call the nurse as I had no symptoms. I figured I should have been nauseous by 5 or so weeks. She was really sweet and offered to have me come in for another beta draw. When it came down to it, I declined. I decided it would just give me something else to obsess over and it wasn't going to change anything.

Finally ultrasound day arrived. Dr. NFB came in and asked how I was doing. I said fine but I was really worried something had gone wrong and there wouldn't be anything in my uterus. She said nothing, the image showed up on the screen and then she said, "hmm...how about two somethings?!" REALLY? We were so excited.

She found Baby A first and saw a heartbeat. I couldn't see it, but Chris said he saw a pixel flickering. She measured it at 103bpm, so it had just started beating.

Amazingly, she was also able to see Baby B's fetal pole. It measured a day behind with no heartbeat yet. Dr. NFB said that was totally fine. They have about a 50/50 chance of seeing heartbeats this early.

Dr. NFB ordered a blood draw to check my progesterone (P4) and estradiol (E2) levels. The nurse called in the afternoon to say that my P4 was 138 - high enough to drop my PIO dose down to 1cc from 2cc. E2 was still really high at 2800 so she said to stop taking the Estrace completely.

Here are our tiny babies (both are a little over 2mm; yes, millimeters):

It is REALLY hard to see the fetal poles. Thankfully, Dr. NFB is excellent at reading
ultrasounds. What is easily seen are the gestational sacs (black areas) and
yolk sacs (round circles inside the gestational sacs).  Baby B on left, A on right.

4 weeks 2 days

There really are two pink lines on those pregnancy tests!

Originally, I planned to not take a home pregnancy test until the morning of my beta, scheduled for 11dp3dt (11 days past 3 day transfer). However, I lost my will power at 6dp3dt. A very very faint line showed up. Hmm...I assumed it was still the hCG trigger shot leaving my system. I tested again the next day and the line got darker. Same thing next morning. Ok, so there is something there making enough hormones to turn a test positive.

Finally on 11dp3dt I went in for my first beta. They drew at 8:00am and said they'd call around 2:00pm with the results. The six hours in between were torture. I finally called Chris at 11:00 to see if he could escape for lunch because I needed out of the office for a bit. That helped.

At 1:30 the nurse called. First words out of her mouth were, "Congratulations! You're pregnant!" Beta: 310. She said she hoped for 100, so 310 was awesome. Now more waiting - the individual draw isn't as important as the rate at which the beta increases. In early pregnancy, it's supposed to double every 48-72 hours. Two more days to wait to see if this pregnancy was progressing.

At 13dp3dt or 4 weeks 2 days, I went in for the second draw. Dr. NFB called with the results that afternoon. Beta: 624. Doubled perfectly! The first ultrasound is scheduled for 6 weeks 0 days.