Monday, June 29, 2009

Everything's Good For Now

We got the full results back from the screen today. Our risks are in range for both babies - 1/1001 for DS and lower still for Trisomy 13 and 18. Now, how exactly the risks for DS are the same for both babies I haven't a clue, since the measurements were different - unless the blood results are very heavily weighted. We're of course relieved and delighted. I suspect this won't be the last time we have a scare so we may as well get used to it now, right?

Sunday, June 28, 2009

NT Scan at 12 Weeks

Here are our little poppets. We know that it's a girl and a boy because of the microarray testing that was done on the embryos before they were transferred. But now we're almost certain that Baby A is the girl and Baby B is the boy.

We went in for our Nuchal Translucency Screen at exactly 12 weeks on Thursday. The purpose of this screen is to determine the babies' risks for Down Syndrome and Trisomies 13 and 18. It's a combination of ultrasound and blood test. The blood results will be back this week so we're waiting for the final risk assessment for each baby.

In terms of the ultrasound, we believed it was just the one parameter, measuring the fluid behind the neck - the nuchal fold. I didn't do any research before this screen and, as it turns out, there are other parameters as well, such as crown to rump length, limb length and presence of a nasal bone structure. Both babies look prefectly sized for their age and their nuchal folds were 1.4mm (Baby A) and 1.6mm (Baby B). These are great results, given that a normal nuchal fold measurement is below 3mm. We breathed a sigh of relief at those measurements and thought that was it, but when it came to Baby B's nasal bone measurements, they had difficulties finding the bone structure. The peri told us that this could be because the baby was not in a good position (it looked like a good position to me), because it was hypoplastic (small) or because it simply wasn't there. Since the absence or reduced size of a nasal bone is a soft marker for Down Syndrome, we were suddenly very concerned. To be fair, the doctor told us this happens "all day long" and usually everything is ok. Unfortunately we were both too stunned to ask any meaningful questions, so, once he had told us we were coming back in four weeks for our 16 week scan, we said our goodbyes. He must have seen that we were very worried because he came to find me in the nurses' station five minutes later to reassure me that everything will be ok. I wish he'd explained more about why he thinks that. He did earlier say that the nuchal fold measurement was the more useful one.

Since we participated in microarray testing in Denver and both embryos came back normal, we ought to be confident, however microarray and cgh do carry a 10% error rate. I spoke to the genetic counselor in Denver on Friday and she told me they've seen a much lower error rate than that in the 30 to 40 live births they've had from microarray and cgh tested embryos so far. So if we look at it statistically, it's unlikely that Baby B is affected, but of course we now have some doubt in our minds. We're preparing for Baby B's risks to come back extrememly high this week, based on the nasal bone and my age. Apparently all the measurements from Thursday's scan, the blood results and maternal age are fed into a computer program and it spits out a 1 in x risk for Down Syndrome or other trisomies. Given that this program won't take into account the fact that we had the embryos pre-tested, I think the risks will come back high, though they will in fact be lower, due to our microarray tests. I've seen different numbers for my age, but the highest risk assessment purely based on age I've seen was a 1/38 risk for DS. I don't know whether that will now go up based on the nasal bone issue. I suspect if we do get a high risk result for Baby B we'll be asked to come in to see the peri for a meeting soon. We're pretty sure that, either way, we won't be doing amnio or CVS due to the risk factors those tests present for miscarriage.

On a positive note, my sickness seems to be gradually declining, though it's still very unpredictable. Usually I'm ok in the mornings now, but get gradually worse as the day goes on. The late afternoons and evenings are still very difficult. I'm hoping to be much better in the next ten days, since I have a business trip coming up the week of the 6th. I can't imagine how I'll manage if I'm still feeling like this then.

Happily, I've suddenly started dreaming about drinking alcohol! I dreamt I was drinking a beer one night this week (despite my Bavarian upbringing I'm not a beer drinker) and another night this week I dreamt that I was out wine-tasting and eating blue cheese. Very civilised.

Monday, June 15, 2009

First Belly Shot

This was taken at 10 weeks 2 days. Though my belly has popped out quite alot over the last week, this is also what I look like after Christmas lunch with all the trimmings. Well, maybe not quite. I'm feeling quite alot of pulling, pinching and tugging these days - probably indicates all sorts of stretching going on. By this Thursday at 11 weeks the babies will be the size of limes.

Next week we have our ultrasound with my regular OB but we've also been booked in for our first trimester screen on the 25th at exactly 12 weeks. This will be done at the perinatologist's office. It's the nuchal translucency ultrasound and bloodwork that goes with it. I'm looking forward to meeting with the peri (high risk OB) and already have a long list of questions......

In terms of the sickness, I had a really good weekend with a long stretch of no nausea or vomiting and was even able to leave the house a couple of times for a few hours. It was good to be out and about again. Today I'm not feeling quite as good, but still better than I have been. Perhaps dropping the estrogen tablets and the progesterone shot is helping, coupled with moving swiftly towards the second trimester.

Thursday, June 11, 2009

10 Weeks

We're at 10 weeks today and counting down to the second trimester. For one, I sincerely hope I will start feeling better soon. The "morning" sickness is ruling my world at the moment. Lately I've seen pockets of improvement for some hours here and there, but it's still very unpredictable and overwhelming. I've also been feeling slightly feverish, clammy and am getting some pretty nasty stomach aches, whether I eat or not. I wonder whether the clamminess and feverish feeling is a touch of dehydration. In terms of the stomach aches, those Tums are always by my side (they're allowed of course). Having said all that, I wouldn't want to miss any of it, if this is what it takes to get to our babies in December. It's a long stretch between our last ultrasound and the next one on the 23rd but I think everything is ok. I have no reason at all to believe otherwise and my belly seems to suggest there's some serious growth going on. It's popped out quite a bit in the last week.

The best news of the week is that our last PIO (progesterone in oil) shot is tomorrow! My progesterone jumped from 36 last week to 55 this week, despite my going down to half the dose. So I go cold turkey tomorrow, which is a bit scary but also excellent - those daily IM shots are not for the faint of heart. I take my last estrace tablet on Saturday and then I'm down to just one estrogen patch for support. I asked whether I could get rid of the tablet next rather than the last patch, since I have a suspicion that the tablet is contributing to my sickness. Even if I'm wrong, taking any tablet is difficult with the mother of all gag reflexes hounding me. I'll be glad to get rid of it. Talking of gagging, our poor dog and two cats are very confused and worried. They all meet outside the bathroom door and exchange concerned looks whenever I'm in there.

I want to finish by congratulating my girl Sue for her positive betas. I'm really happy for you. Another great CCRM success.

Tuesday, June 2, 2009

Little Chicks

We had our second ultrasound today and everything is looking perfect! Both little beans are measuring right on time, at 8w5d. The heartbeats are 171 and 182 bpm, which is normal for their age. My OB told us that this appointment was a huge milestone and he is very confident, now that he's seen great growth since the last ultrasound two weeks ago. According to him, we're not totally out of the woods, but "standing on the edge of the woods looking out". Great news! Perhaps it will all start really sinking in soon.....

My sickness hasn't got any better yet. I weigh 7lbs less that I did when I got pregnant, which obviously means I've got more to make up. I'm supposed to gain 25lbs before week 20, plus the 7lbs I've lost. Hmmm, that will be a challenge. Isn't it ironic that the one time you're supposed to put on weight you can't stand the sight of food? We're going to add fruit smoothies with protein powder so that I'm getting the necessary amount of protein. I think I'll be able to stomach those.

I'm down to two estrogen patches and a progesterone shot every other day now. My progesterone has dropped to 36 (from 52) but it's still well above the minimum rate of 20 so I think I'll be allowed to stay on the dose I'm on now. I'm waiting for the official word back from Denver about that. My estrogen number wasn't in yet but will be back today as well.

Our next appointment is on June 23rd, just shy of 12 weeks.