Crash and Burn: On the Fringes of the Bell Curve
I was put thru to Nurse J. "I'm sorry I don't have good news for you" was followed by an explanation that my HCG level came in at 2. TWO. Progesterone was fine at 33, but all I could hear was that resounding "2" buring a hole into my brain.
She went on to explain that it's rare, but sometimes a "2" can turn around and turn into a pregnancy. So I get it to mean this: I've had implantation, but it's either dying, or it's just started to attach. My gut instinct is that it's on the way out because of the timing of my cramps would seem to imply that it tried to attach last Wednesday and Thursday. By now, if it were successful, the numbers would be somewhere closer to 100. Not 2.
Nurse J recommended that I stop taking all of my meds and to do a pee-stick HPT in two days. This baffled me. I think I said something like, "Wait. You want me to stop taking progesterone, which is the baby's lifeline at this point, and then to test in two days with a pee-stick?? Even if my HCG doubles everyday from here to then, a pee-stick won't be able to pick up the result!" She pondered this and then said, "Well go ahead and take the meds for two more days, then take a blood test and we'll see where you're at. I'll let Dr. Z know you are continuing on with your meds"
Aha.
Now this made more sense. If a 2 really could turn around and turn into a baby, I'd be damned if I was going to cut off it's supply of progesterone and then rely on a test near guaranteed to miss its presense. Now we were on the same page. But despite all of this, the reality of not really being pregnant, or should I say, being "safely pregnant", hit me like a tidalwave. By the time I clicked "end" on my cellphone, rivers of tears were already flowing down my face. By the time J picked up the call I immediately made to him, I was close to bawling.
J must have IM'd our friend JM pretty quickly because he mentioned that she was somewhat baffled that we were doing a pregnancy test (beta) 10 days past our transfer (aka, 10dp3dt). Her test was on the 14th day past transfer (I do wonder if she's remembering this clearly tho). Maybe, maybe not. She felt we were testing way too early. Well, if her memory is correct, maybe we did test too early. We'll be testing again tomorrow, but it will still only be on day 12 past the transfer, so it might STILL be early. J let me cry into the phone until I was spent. He went back to work and my next call was to my best friend, JS, who said she was going to leave work immediately to come over and sit with me. While waiting for JS, I had a call from my cycle buddy AP, who also cycled with Dr. Z. She had received her devastating news a day prior. It was good to hear from her and she, like no one else, could understand exactly the pit this news had carved out in my heart.
It is comforting to have people to talk to during this hell.
But last night things didn't get better. J suggested that maybe I should have spent part of my time in January taking stress management classes. OMFG. I spent, what, $800 on acupunture sessions that were designed to help me with stress (as well as infertility and low back pain)? I came out of my acupuncture sessions feeling absolute wonderful. But if I dared to make a call to J to talk to him, he would find some reason, some detail to pick on me about and my feeling of calm would disappear in an instant. I told my acupuncturist about how talking with J would destroy my sense of calm and told her, "Maybe you should just leave the needles in my head permanently?" I am normally so unstressed, so calm, and most people who know me, know that the ONE thing, the one person who can stress me out to no end is "J" himself.
I realize that stress is defined as "One's reaction to their environment", and I've been hating my environment since we moved into this new house: boxes everywhere, our bedroom is a shambles, our guest room is a shambles, I have an arms length list of things that need fixing, my old car STILL doesn't have a garage space (but I'm paying for it?), our office is a sheer disaster site to the point I refuse to work in it. Yes, my surroundings are a constant source of my stress. I will admit that. And the fact that "J" doesn't have time to "fix" these things is also a source of stress. (Well my opinion on this is that he chooses to do things away from home such that he doesn't have time to finish the things that need fixing...but that's another source of stress to recount this today). My only way of dealing with any of this right now, since I am still not supposed to pick up heavy boxes, is to ignore it all as long as I can. But that only works for a while as JS will tell you. At some point you flip out and run away to Umbria to herd goats. We're headed there, I tell you.
So at some point yesterday, I found a website called the BetaBase that posts the beta scores of women who went on to have pregnancies where a heartbeat could be visualized on an U/S. According to this database, the lowest reported HCG value for a women at 10dp3dt (or 13 days past ovulation) would be 5. And I'm at 2. But I'm eternally optimistic. I wonder how many women with 2's have been told to "Stop taking your meds" and they just follow the doctor's orders and "give up"? How many 2's would make it to form viable pregnancies if only the women forged on and gave it their best shot? I figured that the answer might be, "Too many", and decided that we would give it antoher two days to see what might happen. Another two days of heparin, progesterone in the ass, and steroids. But what the hell. We've come this far. I'm not giving up until my HCG plummets.
There was also some comforting reading on Advanced Fertility Center of Chicago's website with respect to HCG values in early pregnancy:
HCG is first detectable in the blood as early as 7-8 days after ovulation by very sensitive HCG assays (research assays). In real life, blood pregnancy tests will be positive (> 2 mIU/ml) by 10-11 days after HCG injection or LH surge.
In general, the HCG level will double every 2-3 days in early pregnancy.
85% of normal pregnancies will have the HCG level double every 72 hours.
HCG levels peak at about 8-10 weeks of pregnancy and then decline, remaining at lower levels for the rest of the pregnancy.
There is a large variation in a "normal" HCG level for any given time in pregnancy.
Pregnancies destined to miscarry or to be ectopic (tubal) pregnancies tend to show lower levels (eventually), but often have normal levels initially.
Some normal pregnancies will have quite low levels of HCG - and deliver perfect babies. Caution must be used in making too much of HCG "numbers". Ultrasound findings after 5-6 weeks of pregnancy are much more predictive of pregnancy outcome than are HCG levels.
It was that last line that stood out to me, and also the 3rd to the last about there being a lot of variation in HCG numbers. So there is a sliver, just a teensy sliver, or hope. Four women on that betabase site had numbers around 3 on the same day that I am testing. I've always been a bit of an oddball. Maybe I'll be on the fringes of this bellcurve as well.
Labels: IVF1
Comments on "Crash and Burn: On the Fringes of the Bell Curve"
I tested and it came back as 7 and then dropped to 6 . I was told that sometimes it does increase and I'm not too hopeful. let's see Beta hcg to come in friday. In the meantime I've run out of progestrone and I'm in US and my Fertilty doc is in canada. damn it! where does one get progests?
I wish you all the luck and hope that you're numbers increase. I
ve also heard that sometmes numbers double every 4-5 days and not the usaul 36 -48 hours. So goodluck