Maybe you can’t be a little bit pregnant, but the constant testing rigamarole of infertility treatment sure left me feeling like I was a little bit pregnant, with just enough information to do days’ worth of ill-advised internet searching, but not quite enough to feel settled.
For instance, my initial HCG level was 27, and anything above 5 technically indicates pregnancy. If I hadn’t had that number, I actually might have been calmer. Instead, I obsessed.
The way it works is that in early pregnancy, your HCG doubles about every 48 hours from the time it can first be detected in your blood. If it doesn’t start doubling, it usually means the pregnancy is doomed. The doubling rate is a big deal.
But there’s also some indication that the number itself can be an indicator of pregnancy outcome. That numbers on the very low end of the range tend to predict pregnancies that won’t last. And 27? It was on the very low end of the range, which I knew because thousands of other women just like me are on the internet at all times of day and night sharing their HCG beta numbers.
Nevertheless, the doubling rate is way more important, and mine was fine! In fact, I was more than doubling every 48 hours. In a test two days after the first one, my HCG was up from 27 to 124. Three days after that, 658.
Yet, I was like electricity searching for the fastest path to the ground, rapidly finding new ways to worry. After days of reading horror stories about low initial HCG levels, I switched up and started googling “HCG rising too fast.”
Another thing keeping me feeling like I was still infertile was the fact that I had to start taking more shots. Worse ones, in fact.
In early pregnancy, your body produces a lot of progesterone; without enough, a pregnancy can’t survive. IVF disrupts the usual mechanism by which this progesterone is produced, and so IVF patients are put on progesterone supplements, often pills or suppositories. According to my test results, my level was still low, and the best way to jack it up was to start mainlining the stuff for a few weeks.
It was something I had read about on the message boards, and I was dreading it. Injectable progesterone comes suspended in oil. Thick, viscous oil that has to be injected intramuscularly (by Sandy, into my hip), through a huge needle.
The first progesterone shot was pretty traumatic. We rewatched the instructional video we had watched the last time Sandy had to give me an intramuscular shot, and Sandy got the needle in fine using the recommended quick dartlike motion, but this time, when he had to pull back the plunger to check for blood, there was actually blood. So he had to pull the needle out, causing a tiny blood geyser, which was really scary and gross.
Like everything else in IVF, though, we got used to it quickly and by the third night, we were old pros. It wasn’t terrible, just inconvenient, but it kept me from feeling like I’d graduated out of IVF treatment.
I started to pin my hopes on the ultrasounds. Seeing everything in plain view was going to make this pregnancy feel real. At about six weeks pregnant (so, about four weeks after egg retrieval), you can usually see a gestational sac, a yolk sac containing nutrients for the tiny embryo, and the embryo itself (referred to at this stage, somewhat creepily, as “the fetal pole.”) If you can see the fetal pole, you can usually see the heartbeat. You can’t hear it, but you can see it, and once it’s been seen, the miscarriage rate drops drastically.
A week and a half after getting our initial positive pregnancy test, we headed to the clinic for the ultrasound. Now, there are two kinds of ultrasound. The one Sandy had seen already, the one at the embryo transfer, is the kind you’re picturing, that you’ve seen on TV shows. For that one, they put the ultrasound sensor on your tummy and look in from the top. Most fertility ultrasounds aren’t done that way. They’re done with what the ladies on the message boards call “the dildo-cam.” Officially, it’s called a transvaginal ultrasound. I’d been getting them all the time for six months, but Sandy had never witnessed it, and he found it extremely creepy.
I took deep breaths and held Sandy’s hand, while she poked and twisted and scanned. She pointed out the gestational sac (yes!) and the yolk sac inside it (yes! yes!). No baby though. More twisting, some pushing on my abdomen, a few held breaths. Eventually she gave up. My heart sank.
She entered some measurements on her computer, and once again gave me just enough information to start worrying about. The sac was measuring small. Not small enough that she was worried, but a few days behind what she expected. They told me to come back in a week and try again.
Nobody was worried but me. I was well within normal growth variation range and the fact that they could see the yolk sac was a great sign that everything was fine. And yet, I spent another week feeling terrified and googling.
Sandy’s patience was wearing thin. I had promised that I would start believing I was pregnant if my HCG levels were doubling, but I hadn’t. I had promised to start believing if things looked good at the first ultrasound, but I reneged on that too. I negotiated again: I would definitely believe I was pregnant if I could just see that heartbeat.
The next week, we were back. The tech took a look and then turned the screen so we could see it. “There’s the gestational sac, there’s the yolk sac, and that’s your baby. See the flickering? That’s the heartbeat.”
That’s our baby. And it has a heartbeat.
That’s our baby.
[Next: Part XI]