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IVF – “It Was Positive – What now?!”

IVF – “It Was Positive – What now?!”

Positive test result and utter disbelief…..weeks 5 & 6

Just over three years of trying to conceive to conceive and a strong feeling that my period was imminent.  It is safe to say that I was expecting a negative result.  I had even planned my negative result message to my family and friends.  It was humorous, light hearted and hopeful for the future. I was prepared to start another round, being sure to have more medication on hand knowing they would start the same day as a negative result.

So, sitting at the dining table, hands held really tight….I could not wait any longer. 5 hours had gone by, then 5.5 then 6 after the blood test and I decided to call Monaish myself. The world paused for a moment when the nurse said “Congratulations your HcG is at 13,600 and your P4 is 20.5″…she then went on to explain why she had not called us yet (my P4 level was a little low and she wanted to hear from the OBGYN before calling us. I stopped listening for a moment at Congratulations – then had to hold it together for the remaining 5 minutes of the phone call. A level of 21,400 is the upper end of High for a pregnancy hormone level….this was a STRONG positive! P4 is the progesterone hormone, the one that keeps the uterus happy during pregnancy. They would like to see this up around 25 – 30. So, we upped the progesterone medication and we wait for the 6-week blood test in 7 days!!!

What is the BETA is everyone talking about?

Beta tests, also known as the quantitative hCG blood test, measures the level of the pregnancy hormone hCG in the blood.  This is the same hormone that is tested in a home pregnancy urine test and creates that all important yet elusive second line.  But unlike pee sticks, which just tell you whether hCG is present (yes/no) a Beta test provides the exact level in the blood.  In most healthy pregnancies (there are exceptions to this) the levels of hCG will double every 48 to 72 hours. HCG reaches its peak level around 8 to 11 weeks after conception and levels then decline, remaining steady for the rest of the pregnancy.  Beta tests appear to be incredibly common – and I can honestly say I have come to rely on this test for the past week to be sure my levels are rising!! As long as the Beta HCG numbers continue to rise….so does the pregnancy.

Staying positive we are officially 5 weeks pregnant! 

That moment of excitement and PURE JOY lasted for about 15 minutes, before my head was filled with all that could go wrong, especially in the early days where miscarriage is unfortunately devastatingly common. I was well versed in know that this pregnancy could have disappeared as quickly as it came and there would be nothing that I could do about it. So….with a little mindfullness work, some firm self talk, I continue to trap Negative Nancy in the past, a moment in time reserved purely for the two week wait. My grandmother was VERY superstitious about pregnancy and if there was an old-wives tale to follow she did – so – sorry gran…..I am breaking all the rules and putting my Positivity Pants firmly back on, with panty liners (always be mindful of the pessaries or they’ll take you for a ride). A lot of cups of tea are helping!!!

What is a viability scan? Can you see the heartbeat at 6 weeks?

Between 6 and 7 weeks (bearing in mind everyone counts back to the date of your last period to calculate foetal gestation) a scan is offered to check whether the embryo has lodged itself in the correct place and has a heartbeat – I prefer to call it a Heart Pulse because this will TURN INTO a heatbeat. It is actually part of the fetal pole (which is only 6mm usually) and forms part of the brain, spinal cord, organs and heart.  It is the callously named ‘viability scan’, a clinical description that in no way reflects the sensitivity and emotions wrapped up in that particular ultrasound. This scan came early for us……we were going to have it at 7 weeks….but a horrific 3 days of bleeding between Week 5 & 6 meant we had our scan early.

Monday morning of the Week 6 blood test I taught a class, had a cup of tea, kissed hubby good-bye to send him on the road for work and drove to the Pathology clinic. I knew there was going to be about 5 hours between the blood collection and them ringing to tell us what my BHCG and P4 levels were at! 3/4 of the way into my drive I felt a twinge….I though nah, you are imagining things Anne. Then, another. Okay, no panic, I had not had breakfast yet I figured it was a hunger pang. I pulled into pathology and popped to the loo, only to discover what my brain was trying to block out. The bright red reality that this round had not stuck, my heart dropped knowing I had to sit and wait for my blood test then another 5 hours to hear the news I had already seen. At this time, I did not even consider what I was seeing, could be a normal part of a week 6 pregnancy.

So I waited…..I knew that 5 hours after my blood results they would know what I already knew, it had not worked. The bleeding was too heavy on that Monday to be anything but. I rang my husband as soon as I left the pathology clinic at 7:10 am to give him the news that I had already seen. He was on the road for a week, on his way to Rockhampton and as soon as I told him he turned the work truck around and came on home. For those long 5-hours we waited for the results. We talked about another round, and the frozen embryos we still had. We were upset and worried, but we had a positive solution going forward.

So once again….we were sitting at the dining table, hands held really tight….I could not wait any longer. 5 hours had gone by, then 5.5 then 6 after the blood test and I decided to call Monaish myself. The world paused for a moment when the nurse said “Congratulations your HcG is at 21,400 and your P4 is 26.4”. Holy moly was this just THE BEST feeling!!! I was totally over the moon but then the thought came crashing back “if my levels have increased again…why am I bleeding like it has failed? We saw the OBGYN on Thursday last week who showed us the embryo sac and yolk sac via ultrasound…and showed us the dark patches where the bleeding was likely coming from. She explained this bleeding is VERY common (and I was reassured when a couple of members told me the same thing) and it is likely “sub-placental bleeding” or blood clots. These can be easily re-absorbed by the body, but I had to take it easy for a few weeks. It also meant we would have our scan early.

What can you see at an ultrasound at 6/7 weeks?

The viability scan is yet another transvaginal scan (hello twat wand my old friend) and it is the most nerve wracking of the lot.  The biggest question of the day: Will there be a heartbeat? I am so grateful we have the OBGYN we do…she is caring and takes her time. We were in the scan room for about 10 minutes, before we spoke in her rooms for another 20. Honestly, I was expecting more from the moment, a fanfare perhaps or a cuddle or hand holding, maybe a little confetti…. But it was a kind yet professionally performed test but the confetti fireworks inside were REAL.

In terms of what you can actually see on the scan, please keep expectations low.  Our OBGYN has her screen turned to face us so we can see. She takes the time to explain everything she can see and then and said triumphantly ‘Look!  Here is your embryo’ whilst pointing to what appeared to an untrained eye to be a grainy black and white photo of a fried egg.  I nodded enthusiastically, whilst simultaneously squinting to see whether that had the same effect as the sharpen filter on Instagram.  It didn’t.  ‘And here is the heartbeat, do you see it?!’. ‘Yes!’ I DID —- it was tiny and looked more like a thrashing of greyscale. Basically, the heartbeat appears as a slightly lighter grainy grey blob in the middle of the fried egg and the beating is represented by a it flickering between different lighter shades of grey. Either way it was PURE JOY. She said the heart pulse rate is 122bpm (beats per minute) which is excellent, and there is approximately 1 litre of blood flowing around the uterus per minute!! She explained the grey candy cane looking line outside the uterus is the blood flow line – a mix of venous and arterial blood flow and it looked healthy. She then pointed to 3 fluid pockets above the uterus where I may still have blood pockets. She warned me I may still bleed, but everything is looking fantastic!

And then, back in her office –  that was it.  We were discharged from the IVF clinic, from Monaish, from fertility treatments. We are no longer a fertility couple! Our OBGYN said we needed to have a think about how we wanted treatment to proceed from here and she listed off a whole bunch of options, which honestly, went over my head…..the only thing my brain was screaming was “you can’t leave us now!”. And no sooner had my brain thought it I blurted out “but I want to stay with you”. Looking back this may have sounded needy but all I know is this woman had helped us for over 18-months, she had our medical records, our test results she had every step of our journey documented in that clinic. I did not want to have to explain ourselves to someone brand new.

A quick talk about what drugs I needed to remain on and for how long (progesterone till at-least 36 weeks – ouch!, oestrogen till at-least 20 weeks) and we headed home proudly clutching a printed photo of a grainy grey blob, our little blob, in a state of disbelieving relief that maybe, just maybe, the dark days of infertility were behind us and this may be our time.

What does the future look like now?

With our grainy heart – pulse in hand, a medication plan in place and a follow up appointment in 2 weeks….this is it! We now, like many other couples just ride out the pregnancy. We are officially 7 weeks along…with a due date at the end of April 2021. It feels strange to not have blood work every 6 days, or scans weekly. No more nurse specialist phone calls to check up on us or trips to the Monaish office. There are no more updates on our little frozen embryos (till we are ready to try again) it is like the last page in a book – it just ends and the back cover is there. I did not realize how much I needed those blood tests to tell me how my hormone levels were doing…now it is blind-waiting.

So for now, life returns to normal and we wait till we see the little bundle agin!


 

xx Anne & Josh

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