Thursday, March 28, 2013

It's complicated

[WARNING:  PREGNANCY, CHILDREN AND NEGATIVE THOUGHTS MENTIONED AND DISCUSSED.  FEEL FREE TO SKIP THIS POST IF THOSE TOPICS ARE SOMETHING YOU DON'T WANT TO READ ABOUT.]

I went to the OB's office this morning and saw two of the nurse practitioners.  They did an ultrasound and confirmed that there is a single yolk sac in my uterus.  Which is good for two reasons: one, I'm not having an ectopic pregnancy, and two, there is only ONE yolk sac = one embryo.

After years of infertility, it would never have occurred to me that seeing a second line on a HPT would ever induce any feelings in me but happiness and excitement.  Those feelings aren't what I've been experiencing over the past 24 hours, though.  My feelings have been quite a bit more complicated.

My first, and still my chief, feeling has been surprise/disbelief.  I have long thought that the odds of our ever conceiving naturally were extremely low and getting lower every month.  I mean, why else would we have used fertility treatment, donor eggs in fact, to achieve pregnancy?

A quick internet search will tell you that the "average" 42-year-old woman has about a 3% chance of conception each month. . . and even that chance would be premised on the notion that she actually had sex during the "fertile window" of her cycle.  The NP at my OB's office confirmed that the odds of conception for a woman my age are 2-3% and agreed with me that those odds are likely even lower for someone like me with a history of three years of unsuccessful TTC.

Since our sons were born, MM and I have been lucky if we have s.e.x once a month some months.  Two or three times in a month would be a banner month for us.  What are the odds that one of these rare episodes that always occur on weekends (which is the only time we have both the time and energy) would fall on a fertile day?

Frankly, I'm also a little annoyed.  I mean, MM and I resorted to EXTREME measures to become parents.  We spent over $30K over three years before finally having AJ and MJ via donor egg IVF.  If we had had even an INKLING that there was even a HOPE of ever achieving pregnancy on our own, would we have gone to the lengths we did?  Maybe we just needed to keeping TTC for five years instead of three?

Of course, we did not have a crystal ball and had no way of knowing that sometime down the road something like this could happen.  Now that we have AJ and MJ, of course we cannot ever regret the measures that brought them into our lives, whatever the cost.  We love our boys for the unique people they are. . . people they wouldn't be if they had been conceived in some other fashion.

I also feel embarrassed.  In my mind, unplanned pregnancy is generally something that happens to women who are immature and irresponsible (apologies to my readers who have had an unplanned pregnancy).  Neither MM nor I is either immature or irresponsible.  We simply felt that, if the odds of a pregnancy happening through intercourse were probably 2% or less, that meant that there was a 98+% chance that it wouldn't happen.  I think (thought) those were good odds. . . more effective than most forms of birth control claim.

Since my sons were born, I have told everyone who has ever asked whether we would ever have another child that I would never, ever go through another pregnancy.  I meant that.  The thought of enduring another pregnancy fills me with dread and, honestly, fear.

I have some very real concerns, both about my own health and about the health of the potential future baby.  My previous pregnancy was far from uncomplicated.  In addition to the "inconveniences" of extreme fatigue, all-day nausea for the first two trimesters, constant heartburn and the like, I also developed life-threatening complications.  I delivered pre-term.  I had a very significant post-c-section hemorrhage.  I literally could have died.

Obviously this is not all about me, but I don't want to die or become disabled because of an accidental pregnancy.  I have two young children already whose needs I must consider, and more than anything, they need a mother who is present and healthy.

I wasn't in prime physical condition when I embarked on my last pregnancy, but I had lost some weight and spent a couple of months getting in better shape before our cycle. Now, in addition to being two years older, my body is shot.  I live with some kind of pain somewhere daily.  I still get charley-horse-type cramps in my right lower abdomen on occasion, so I know that my abdominal muscles are not normal post-twin-pregnancy and post-c-section.  I don't have half the muscle tone generally or the cardiovascular endurance I had before getting pregnant with my sons.

There is also a real risk of miscarriage: 50% at my age.  I am only about 5 weeks pregnant, give or take, so it is very early, and there are no guarantees.

The odds of chromosomal abnormalities are higher for a baby conceived via 42-year-old eggs.  Plus there is a real risk that I will once again deliver pre-term, and depending upon how pre-term that happens, even a healthy, normal child could end up with long-term problems as a result of premature birth.  These things concern me greatly.  As much as I find it hard to wrap my mind around the idea of adding a third, healthy child to our family, I think it would be doable.  Difficult but doable.  A child with significant health challenges?  I honestly don't know how we would do it.

These thoughts don't even approach the topic of adding a third child to our family.  Honestly, my mind hasn't really gone to that topic much yet.  If this pregnancy continued to term, AJ and MJ would be only 22 months old when the baby is born.  I have posted often here about how overwhelmed I have felt juggling work and home life with young twins, and I have mentioned the strain that having two young children has placed on our marriage.  At this point, I really can't fathom how we will possibly manage having a third child.  Anyone can also imagine the financial and logistical challenges that would stem from having three children under 2 instead of two.

Anyway. . . I know I sound like a real Debbie Downer here, but that's where I'm at.  I am not assuming that this pregnancy is going to continue, because whether or not it will is basically the flip of a coin.  I am trying not to dwell on the risks and challenges that lie ahead if it does continue.

Given that my main focuses are the notion that I may miscarry at any time and the potential difficulties I will face if I don't, I guess it's not too surprising that I'm not feeling excited or happy yet.

I will be going back to the OB in a little less than three weeks for another ultrasound, and if the pregnancy is then still progressing, I will have a consultation with the high-risk OB group who followed me during my last pregnancy and delivery to get some more concrete information about the risks are in continuing this pregnancy.  Although I can't control much of what will happen, I want to be as well-informed as possible.

20 comments:

  1. Wow. You feel like I would feel except that you actually have legitimate concerns. I recently dreamed that I was pregnant and was devastated. I felt like I had failed my sweet baby girl who I want to be the sole center of my universe. I would swear off sex forever to ensure this never happened, if I thought that somewhere down that road I wouldn't lose a spouse. I don't know what I hope for you, but I'm staying in tune and following along and in your corner regarldess.

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  2. I am so amazed at your honesty and willingness to post this to the internet. I think it's to your credit. Thank you for your bravery.

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  3. What I will say is this:

    A singleton pregnancy is an entirely different beast than a twin pregnancy. It just is. Which is not to say that if you have some underlying problem (like, say, how my uterus contracts every few minutes when I'm pregnant, from 20 weeks on) that it won't happen again. But your body is under a lot less strain and much better equipped to handle one baby than two.

    A baby with challenges is still a baby. And if it happens (and if you choose to keep the pregnancy, I don't know your feelings on that), you find that you are SO much MORE capable of coping than you think you are. It's there, inside of you. It just hasn't been asked (and hopefully won't be) to come out. But if it happens, it is still a baby - YOUR baby - and you CAN do it and love that child with more than you thought you had inside of you.

    I won't lie - three kids can often feel like a zoo. It brings twins to a whole new level. But also? It's a different, very special, sibling relationship. It's a different relationship for YOU with a singleton. And it's all doable.

    Lots of time to go, lots of hurdles to cross, but I just wanted to say it - if this baby sticks around, you DO have it in you to take care of it, no matter what.

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  4. Oh S, I have been obsessively checking for an update. All of your concerns are valid. It must be SO incredibly shocking. I think that all you can do is take it day by day. It is impossible not to think of all of the what ifs but try to be present. I hope beyond hope that you do not start to feel nauseated and that if this baby continues to thrive that he/she is healthy. Much love and support coming at you.

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  5. Oh My God.
    Oh My GOD!!!!! I can't believe that yesterady was the ONE DAY that I did not read your blog -- thus didn't know this news until just now.

    I know it is slightly different, becasue you used donor eggs, but I have FOUR girlfriends who went through years of infertility -- unexplained -- and ultimately IVF, only to "accidentally" get pregnant in short order with less-than-one-year-olds. They just never thought they had to worry about birth control, or at least worry about it much. Both due to previous infertility and also because they were new parents thus having infrequent sex.

    Your post above is so honest. You are 100% entitled to all those feelings! But please don't feel embarrassed -- nobody would ever judge you as "irresponsible" for having this happen.

    I'm thinking good thoughts and sending you good vibes.
    (And I'm getting induced tonight!)

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  6. I've been waiting eagerly to read your reaction to this news. I just want you to know that I am here to listen and everything you are feeling right now is so very valid. This is a very complicated and PERSONAL matter and I frankly am amazed you had the balls to put it up here because I'm not sure that I would have in your shoes. And also here's a HUG. And another HUG!!!

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  7. Your feelings are all totally valid. Hoping everything goes as well as possible for you. Please know you will get through any challenge that may come your way. Sending lots of supportive thoughts!

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  8. I missed your last post. Holy crap!! I appreciate this post and all of your honesty. Everything will work out the way it's meant to.

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  9. I delivered my twins at 36 weeks and had developed sever preeclampsia. I delivered my singleton 26 months later at 39 weeks with zero issues. The differences between a twin a singleton pregnancy are dramatic. I will say that I was exhausted the majority of it but having twin toddlers is exhausting.

    Of course your concerns are valid. Having three under three is exhausting and I went for treatments to have a third. I'm three months into the chaos and some days I feel like I'm just waiting for the year to pass so the boys will be three and she'll be one and that it might get easier. But some days we have these awesome moments when the boys tell me they love there sister and it is all worth it.

    In a weird way I feel like our marriage got better after our third. I feel like our family is solid and we both just have to jump in to control the chaos.

    I'm sure you are terrified. Just take it one day at a time. I like your honesty. I feel like we as iF survivors feel like we should always be grateful, but this parenting thing is hard and it is okay to be scared.

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  10. I also applaud your large balls for posting this. If feel like this is a similar (yet of course very different) version of the reaction I had to finding out I was pregnant with the twins after L. And yeah, we did treatment for that pregnancy! So I felt even more ridiculous for having the "nerve" to feel so disappointed that it was 2 when I sat there in my RE's office well aware of what 3-4 mature follicles meant. Your feelings are very valid, and I don't blame you at all for feeling the way you do. A singleton pregnancy is definitely easier though! (hugs)

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  11. I know you usually don't have men commenting, but I do have relevant experience to offer. My wife had twin girls at the age of 38. We weren't particularly careful with birth control afterwards, and she got pregnant again and had our third girl at 39 (our "Irish Triplets"). Her experience with the pregnancy with the third child was totally different. With the twins, she was on bed rest for the last 2 weeks of her pregnancy and had bad abdominal pains due to strained ligaments. She also had gestational diabetes. With the last child, there was no diabetes and she was able to be active with caring for the twins until the day of delivery.

    It's not always fun to deal with the "triplets", but there really isn't a lot more effort required for the third child, especially when they are infants. My friends and colleagues seemed to think it was a lot harder to go from 1 to 2 kids than it is to go from 2 to 3 kids. It may seem overwhelming, but this is survivable.

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  12. Wow I missed wordless Wednesday! Good on you for writing such an open honest post, I love that. I can't give advice or anything, but As an older mum I understand some of those fears., I just hope and pray that whatever happens either way you'll be fine and ok. And I wish we had a crystal ball! X

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  13. I can totally sympathise with your feelings and I'm really pleased you felt able to share them. Am emailing a longer reply.

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  14. As a single woman who used DE in her 30s, I have (differently) complicated feelings reading all this.

    But, bottom line, all this makes sense to me. And even if it didn't, you're entitled to own every one of your feelings. And put them out there. Thanks for your honesty.

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  15. It is amazing that you got pregnant! My husband and I haven't used birth control for 13 years, and if I should get pregnant naturally now at 42 I think I would just drop dead from shock. So, congrats on still being able to think past the OMG I'm pregnant part of all this :)

    I wish I could say that being pregnant with a singleton is automatically easier than a twin pregnancy, mine wasn't. But I can say that parenting a singleton after having twins, even if your twins are toddlers, is a BREEZE. I hope that your mind and heart are able to settle down and face your future, whatever happens or whatever you choose. Myself, I would still be in a corner right now going blub blub blub blub blub.

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  16. I totally understand your reservations. This is a big deal, and you're taking it very seriously. It makes plenty of sense.

    Sending hugs and warm thoughts your way!

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  17. I understand your reaction. Remember? I posted "what". I have wrestled and wrestled w having 2 vs 3. Once I made up my mind, if it was changed for me I think I would freak out.

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  18. Wow, I didn't read for a few weeks, and I have to say, this is the last thing I expected! I totally understand your reaction, and I have some of the same misgivings myself about possibly having a third child, something I haven't decided about yet. I am younger than you (going on 35), but I feel that I am reaching the end of the years in which I want to bear children, and my husband is four years older than I am, plus if I want any more, I don't want him or her to be TOO much younger than my almost-three-year-old twins. But I don't know if I want to go through it all again. I AM starting to feel old(er), and my husband is from Italy so we have to travel internationally to see his family (MUCH easier with two than with three, I'm sure). My husband is not on board. We are both happy after several years of infertility to have moved on with our lives, and I'm not sure I want to put us back at square one. Neither of us wants fertility treatment, and we're not sure we could get pregnant on our own, but we have no idea since we never got a diagnosis other than unexplained, which is why I'm on birth control. Sometimes I wish it would just happen, so the choice would be made for me. That being said, I totally understand how you aren't thrilled. If we had ended up doing IVF, especially with donor eggs, I would feel exactly the same. And if I were just a bit farther in my life, with no plans for another kid, I would definitely feel the same. In fact, in another year or two, I think I'll be in the same place and would probably not want another one. So I'm sorry, and I hope you make peace with however it works out.

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  19. (((Hugs))))I I wondered how you were processing this. I felt excitement and also a big ol WTF on your behalf. I'll be following along, and always wishing you the best, along with some semblance of peace.

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  20. I keep trying to post but have had so many problems commenting on blogger blogs lately. :-( Anyway, I just wanted to say that I understand (and think I would share) so many of these feelings, and I just hope that all works out in a way that is best for you and your family. Crazy stuff, this life, crazy stuff...

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