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.