Saturday, February 6, 2010

Unexpected Surprise

David and I had decided to pursue another round of In Vitro once the holidays were over. We had all of the financials in place and called the fertility clinic to schedule our next steps. The clinic nurses said to call them on day 1 of my next cycle and I could come in on day 3 for a blood test and start the first round of medications. I had not had a period since before Thanksgiving, so on December 30th, I took a home pregnancy test. It came back negative (no surprise given our history), so I called the fertility clinic and explained that it had been about 6 weeks since my last period but a home pregnancy test was negative. I was familiar with this process. In patients with PCOS, ovulation does not always occur. In my case, if I don't ovulate, I don't have a period (some women do). In the past, when this happened my OB/GYN would have me take a home pregnancy test and then call in a prescription for 5 days of Provera, a synthetic progesterone tablet, to help me have a period. When I told the nurse the results, she said that she would talk to the doctor and then probably call in a prescription for 7 days of Prometrium. I told her I have never used Prometrium and that I have had successful results with the Provera in the past, not to mention Prometrium costs about 10 times as much as generic Provera. She told me that the doctor prefers Prometrium because it is a natural progesterone that can support a potential pregnancy where Provera cannot. I thought to myself, I'm not pregnant so it's no big deal, but I didn't want to have to go in for a blood test that was required before the Provera would be prescribed because it would have ended up costing more time and money in the long run. So I agreed to the Prometrium.

We went to a New Years Eve party at our friends' house, and while it was a great time, it was bittersweet to be the only ones not in the Parents' Club. There were babies asleep upstairs, and a couple of our friends officially announced their pregnancies. I was happy for them (especially TK who had some trouble of her own in the past), but I was jealous as well. I told myself that we were working on it and put the jealousy out of my mind.

I finished the Prometrium on January 5th. With the Provera, I could usually expect the first day of my cycle to be within the next 5 days. So a week passed, and nothing happened. I didn't really think anything of it because I had not had any experience with the Prometrium; maybe it needed more time to work. Another week passed, and I still had nothing happening; not even spotting, which I knew was not right. I figured the Prometrium did not work. I went to dinner with some friends from pharmacy school, and my friend SW asked me how things were going. She and I have been talking fairly regularly because she and her husband are going through the same issues of infertility as we are right now, so we are each other's support. I told her about everything that was happening (or more specifically what was not happening), and she asked me if I could be pregnant. I said, I doubt it. I'm 99% sure I'm not pregnant. She asked me if I took a pregnancy test; I told her I didn't want to. I didn't need it to tell me I wasn't pregnant again; I already knew.

I finally had enough waiting, so I called the clinic and told the nurse that it had been two weeks since I finished the Prometrium and nothing had happened. She told me to come in the next day and the doctor would do an ultrasound to see what was going on. I went in to the office on Tuesday, January 19th, and the doctor came in to the exam room. He said he would use the ultrasound to check the thickness of the uterine lining; if it was thick, he would try the Provera and if it wasn't we could go right in to the first phase of medications for the in vitro without having a period. So he looks at the ultrasound screen and then he says, "Well I see why you're not having a period; it looks like you're pregnant." I was shocked and absolutely sure I had just hallucinated. I couldn't believe it. He congratulated me and said that the Prometrium probably helped provide a little extra to the lining to help with implantation.

I had a blood test done to confirm the pregnancy and the nurse called me later to tell me that my beta HCG was at 1500 and my progesterone levels looked great. We scheduled another ultrasound in two weeks.

I don't remember the drive home. I still don't think I've completely processed the news. David called me and asked how the doctor's appointment went. I asked him if he really wanted me to tell him over the phone. He started to panic thinking that something was wrong; I told him we got our "freebie". He was just as shocked as I was. Many people don't believe in miracles; I do. This is our miracle.

We went back this past Wednesday for our second ultrasound. We were able to see the baby and it's little flicker heartbeat. We called all of our friends to officially share our good news. We told our families the weekend after we found out, but wanted to wait and make sure everything was okay before making it public knowledge. The fertility specialist wished us the best of luck and told us to send them a birth announcement. He then released me back to my OB/GYN. I see her in two weeks. Our official due date was kind of hard to determine since the doctor thinks I ovulated late but we can't be exactly sure when it was, so we have a tentative date of September 20.