Friday, August 25, 2017

Weeks 10 - 12 #pregnancyDiary

Week 10 thoughts

This morning I had my ten week appointment at the doctor. It was early so hubby was able to come by for most of it before going to work. I was finally given the elusive Mutterpass (translation: mother passport), which is a booklet pregnant women in Germany get which contains all their relevant information for doctors. This has been categorized as a "high risk" pregnancy due to it being IVF and my 'geriatric' age of 35. That's a joke by the way. 35 is the new 25 don't you know? Anyway, the doctor spoke to us about pregnancy in general, what to avoid doing, what's ok. A lot of stuff I already knew. Some things which are relevant to how things are done in Germany, I didn't. For instance there's an optional test for Toxoplasmosis which health insurance here doesn't cover. It only cost something like 30€ though so I asked to get it done.

Regarding gene defects the doctor said, because I'm 35, the health insurance would pay for an amniotic fluid sample to be taken around week 14 or 16, can't remember now. However he advises against it as it carries risks. He even said that you can end up with a 'dead baby' that could have been perfectly healthy. He certainly doesn't mince his words! I'll be avoiding that test for sure, not taking any unnecessary risks. There is a blood test and based on that plus other factors (my age) will assess the risk of the baby having any gene defects. If it comes back as high risk, such as 1 in 50 then we could consider whether to get another blood check done (this is called the harmony test) which wouldn't be covered by insurance and costs around 450€. The doctor wasn't going to give me a scan at all today as I'd had one recently when I had the scare but I asked nicely! Well I said it would be great just to make sure everything is still ok. Unfortunately hubby had left at that stage as he had to get to work so he didn't get to see it. This time the baby didn't just look like a blob like last time haha! It was great, I could see the tiny little hands and feet moving around!

Oh man, I have so much love for the little baby! I wonder if it will be a boy or a girl. I guess I would have a slight preference for a girl, but honestly either is great! I think hubby prefers the idea of a boy but I also know he would be a great Dad to a daugher. We would like to find out. I'm not sure whether we would tell everyone else or not. Though probably we'd find it hard to keep a secret! I'm delighted to have gotten to the ten week mark. It's definitely starting to feel like a strong pregnancy now!

From around week six I did notice some very mild nausea but not bad at all. Since week nine though it got a lot worse! I also started having a lot more food aversions. The best way to help against the nausea has generally been to eat something pronto, although eating while feeling queasy isn't that pleasant, and it has been hard to figure out what I even feel like eating. Several times I've gagged but not thrown up, but I did end up having to get sick once after brushing my teeth. I've also gone off avocados which I used to love, I hate the idea of fish at the moment plus the dairy free vegan yogurt and ice cream I used to eat a lot of (it's made from a lupine plant) doesn't appeal to me at all anymore. The best food I've found is popcorn! So I end up snacking all day long basically to try to keep the nausea at bay which means I only have an appetite for small portions at meal times. Anyway, overall it is manageable. Being in the office has been a bit challenging as I just get so tired in the afternoons but hopefully it'll be better in a few weeks.

I'm planning to tell my boss and HR manager once I get to the 12 week mark if everything goes well at my check up. I googled something like "when to tell your work you're pregnant" and the first result said not to tell till weeks 16-20 at the earliest and then talk about all the great projects you did recently! I thought, wow, that must have come from a US site. No offense meant to any of my friends from the US. The article basically gave the underlying impression that your job is at risk if you are pregnant. I looked up some German sites and the message there was to tell your work at 12 weeks and the health of you baby has priority. There are lots of great laws here to protect pregnant women in the workplace. For instance you are not allowed to work more than 8.5 hours per day or be expected to carry heavy things or to be on your feet for more than four hours.

The doctors here have no problem giving pregnant ladies sick leave when needed. Sure, there may be women who abuse that for instance I have heard of one who got pregnant and didn't feel like working anymore and asked to be written off for all nine months, but in general that's not common and I think it's great here how the emphasis is placed on keeping you and baby healthy. Your boss is also not allowed fire you until at least four months after you've had given birth. And in Germany there is 14 months parental leave which you can share with your partner. Anyway, there are a lot of benefits to working in Germany! That's not to say that sexism in the workplace doesn't exist here, that's a topic for another day but there is good support for employees. Even when I do tell my boss and HR, I will still tell them that I would like to keep this pregnancy discreet. I would prefer to wait another month or so before other colleagues find out. I'm not sure how feasible that is since people can gossip and maybe I'll start showing at that stage. Right now I'm just really bloated but I think I have the beginning of a tiny bump too! Under all the bloat that is.

I had to phone the immune doctor to ask why my new treatment plan hadn't arrived yet. Turned out it hadn't even been sent! The receptionist sounded embarrassed and said she would remind the doctor and asked if I'd like her to scan the documents and send them by email to me first. I can see why this particular doctor gets such bad reviews, the main complaint seems to be that people are fed up with how slow everything takes! Anyway once the email arrived I had a look. Most things were clear and expected, it gave details on how to reduce the steroids and Granocyte injections. The baby aspirin tablets I'm meant to keep taking until at least week 24. This seems long to me but it's not such a big deal, just taking the tablets so whatever. Two things bothered me. Firstly it said that I have to get my blood checked again to look at the natural killer cell levels. If they are too high still then I would need to keep getting the Intralipid infusions for longer. That is such a pain. I'm so ready to be done with the intralipid infusions! Also I only have one bottle of the stuff left. They only sell it in boxes of ten and it costs about 200€ altogether then about 50€ per doctor visit to administer it not to mention the time it all takes. And the second thing was that it recommended I get a pre eclampsia test at week 13 since I am higher risk due to my missing KIR genes apparently.

I got a little upset about the email. As I was saying to hubby, I just want to have a normal pregnancy like most women and not to be so highly medicated and high risk and have all this extra stress! The thing about all the extra immune stuff is I don't know for sure if it is the reason this IVF and pregnancy is working or not. It could be the thing that made it work or maybe it would have worked anyway. I'll never know for sure. Obviously on the off chance that the Intralipids, granocyte, steroids and baby aspirin are the magic ingredients keeping the pregnancy going, then of course I'm going to keep them up! Anyway a while later I felt better. Getting the preeclampsia test shouldn't be a big deal. I'll show my doctor the letter from the immune doctor and even though preeclampsia itself sounds scary as long as the doctors catch it in time, it would be fine. And the fact that I have to send my blood off to get tested again is a pain but I'll just do it and hopefully the results will show everything is ok and I can stop the Intralipids finally.

My usual gyno is away on holidays for the month of August which was has been awkward. There are two doctors' practices that are helping out. Both aren't that handy to get to from where I live. I phoned them and neither had heard of Intralipids or wanted anything to do with them. It's not an easy thing to explain in German! So neither practice will give me the 12 week intralipid. I phoned the fertility clinic and they agreed to give me the 12 week one no problem so that's great but like I mentioned before it is really far from where I live. I'm going to have to talk a half day off work. The intralipid will be administered by dr. Peppy though, and I'm looking forward to seeing her again!

Week 11 thoughts

It feels like a long wait till the twelve week scan. I've been trying to think positively though and not let myself get too carried away with worries. At ten weeks I realised I am already one quarter of the way through the pregnancy which is a crazy idea! I have also been thinking recently about how lucky we are. I came across some statistics for IVF and the odds of it leading to a take home baby are really surprisingly low in general. It's still early for me and I don't want to count my chickens before they have hatched, but I am so grateful to have gotten this far. This was our 7th embryo. Six other perfectly good embryos were placed inside me over the past two years. One took for a few weeks but sadly wasn't to be and the rest just didn't implant at all for whatever reason. What made the 7th embryo implant and keep growing into a tiny human I have no idea! I wish IVF would work for everyone though. This is most likely going to be my last pregnancy too. Provided it works. I have no idea what we would do if the worst happens. Hubby and I both agreed we wouldn't want to go through IVF again. For many reasons. We have both accepted the fact that we will most likely just end up with one child and we have come to terms with that. Only children are very loved and I have no doubts that our single boy or girl will be happy!

I have a pregnancy app on my phone. It was fun to read today that the baby is the size of a fig now! On my gyno's advice I went for a teeth cleaning at the dentist. I actually always dread it a bit. I was scared of going to the dentist when I was a kid. It's gotten a lot better as I've gotten older but I still don't particularly like the experience. I hate all the noises in the dentist office, like the drill, ah! Anyway the teeth cleaning is normally not too bad just mainly uncomfortable and long. I have sensitive teeth too so some bits like when cold air is blasted on my gums is very unpleasant. But anyway it went fine. And I reminded myself that I'm doing it for a baby. Thinking about the little one moving around in there and growing is a really nice thought. This morning I also feel fine, not nauseous at all! Of course then I started to worry that it could be a bad sign but I googled it a bit and some women's pregnancy symptoms can start to ease off in week 11, so it's probably just that. A lot of women on the forums mentioned their nausea came and went a bit too. Like they'd have a good few days and bad few days again. According to my pregnancy app, you don't look pregnant at this stage just bloated and as if "you've had too much to eat" haha! If I pull in my bloated tummy I think I can still see a tiny bump. Otherwise I haven't noticed any other body changes really. Instead of my hair getting glossier, it's gotten frizzier. I think I'll need to use the de-frizz serum more often!

Week 12 thoughts

Before my appointment I felt a little nervous but not too bad, I had a good feeling that things would be ok. This time we went to a different doctor as my usual one is on holidays and this one was standing in for his patients. I had to do a pee test, have my blood pressure checked and get weighed. Then we went into the room to wait for the doctor. Once he arrived he asked what he can do for us today. I said, well I'm here for my 12 week scan! He looked at my Mutter pass and asked some questions about the pregnancy. I got another prescription for my thyroid meds. I asked about the pre eclampsia test which the immune doctor recommends. He said it's too soon and I can get it done at my next appointment.

He asked about whether we had done the first trimester screening (where they check for gene defects). We said we had done a blood test but then our doctor went on holidays and we hadn't gotten the results. He explained that the blood test alone doesn't mean anything without measuring the baby's neck which hadn't done as far as I'm aware. So that was annoying. The substitute doctor said he would take measurements today. We'll have to wait two weeks till our doctor is back from holidays to ask about the blood test results though. We asked this doctor his thoughts on flying to Ireland around six months and he said it's absolutely fine so that was nice to hear since my usual gyno is against flying altogether. We are still considering whether we might go to Ireland for a week around November.

Anyway then I had the scan. This doctor was a lot more thorough which was great! He showed us the baby, commenting on how great everything looked then proceeded to point out things like the spine and brain. At one stage he said something like "do you see that black dot there?" in a serious voice and in my head I thought, "oh God, is it a heart defect?" but then he said, "it's the baby stomach"! Then he showed the kidneys. He made a joke at one stage about the baby being a girl because she's so "sensitive" (eye roll) but then he said you can't actually tell yet, it's too soon. We'd like to find out the gender but I'm not in a huge rush, I can wait until the next scan. He measured the neck and said it was 1.5mm which is good, they want anything under 3.5mm. That shows a 70% odds of the baby not having down syndrome. You need to look at the blood test results too in order to say with 90% certainty. At one stage he commented that the neck was a little schrag which means crooked or bent! That made me worry as you can imagine. He said that the baby was in an awkward position and sleeping and he would try to wake the baby up to get a better look at the neck. He then proceeded to tap on my stomach! Then we all saw the baby start to move around! It was incredible. He said at that age they sleep every half hour. I felt protective of the baby already and didn't like him disturbing him or her. But I also wanted to get the measurements to make sure everything is ok.

Once baby was in a better position he measured the neck again and it was fine so that was a relief. He/She was also measuring perfectly for 12 weeks. Then baby fell asleep again. So precious! The doctor commented that while 95% of the placenta is in the right position, 5% is a little low so I might experience some bleeding again. He said if that happens, get it checked out of course but not to immediately panic about a miscarriage. He probably noticed I was still a little anxious because at the end of our appointment he told us that the odds of something going wrong are only 3% at this stage which was nice to hear. I then got the confirmation letter for work to say I'm pregnant. It continues to feel surreal that that there's a little baby growing inside me. Still a dream come true! Despite having some nausea bouts and the anxiety, I do love being pregnant and I am trying to enjoy this whole experience. My next appointment isn't for four weeks, crazy! but I guess at this stage everything is ok. Next week I'll get my 12 week intralipid done and then send my blood off to check the natural killer cells again.

Week 12 - later that week

It was strange making my way to my fertility clinic. It's only been six weeks since I had been there last but it felt like so much has happened since then. As I sat in the waiting room, I looked around at all the other couples and really hoped that things would work out for them. My fertility doctor, Dr Peppy set up the intralipid for me. It was really nice seeing her again. She said that the previous intralipid I had gotten at 10 weeks would have taken me to week 12 and I didn't really need to get another one (but I could). I told her that the immune doctor wants me to send my blood again to re-check the NK levels and she said that there is no need to get any more Intralipids done after 12 weeks. By this stage the placenta has already formed. As usual different doctors saying different things! I trust her though and it made me think that unless the NK cells have gotten really bad again that maybe I would choose not to get any more intralipids done.

A few days later I went to my GP to get my blood taken in the vials provided by the immune practice. Then I hurried to the post office and sent it all by express post. A few days later I asked hubby to phone to check my blood vials had arrived at the immune practice and to ask how soon I would get the results. The results were already there! My NK levels have gone down from 18.4%to 14.7%. They are still "borderline" but ok. I can stick with the current treatment plan, meaning I don't need to get any more intralipids. That's a relief! I was a little disappointed that my NK cells haven't gone down even more than that but anyway I'm not going to let it bother me. Some paperwork was missing, I was meant to send a referral in order for my health insurance to cover the blood test costs. I wasn't sure which doctor would give me one since my gyno is on holidays and the substitute doctor had mentioned he doesn't believe in all the immune stuff. Hubby phoned his practice and explained the situation and he sent the referral no problem though so that was a relief. It's nice the blood test is covered 100% by my health insurance this time.

A friend of mine lent me her fetal doppler. That's a device you can use to pick up the heartbeat at home. For some women they can get it to work as early as about nine weeks though others take longer. In my case I finally got to hear baby's heartbeat at 12wks2 days. That was amazing to hear and reassuring. I tried again a few days later. It took longer and I was only able to hear it for a few seconds but it was there. Then at the beginning of week 13 I had been feeling anxious and I tried that night and this time I couldn't find it at all! Hubby tried too but no luck. I started getting anxious but he said baby was probably in an awkward position and not to worry. I tried again the next morning before and after breakfast and still nothing! I found a heartbeat which was probably my own as it didn't sound fast enough to be the baby's. I was sorry then for using the fetal doppler at all. When it works it is very reassuring but when it doesn't it can be scary! Anyway, I tried again that night and finally I was able to find the baby's heartbeat for a few seconds. This time it was on the right hand side instead of the left, so many the baby has been moving around! I put the doppler away and I have decided I won't use it again for at least a week.

Now that I have reached the 12 week mark we are gradually starting to share our news with more people. Telling people makes me a little nervous. I guess it's difficult to feel totally at ease with this pregnancy after the long journey to get to this point. I still have a fear of it all being taken away. However, I have also been making an effort to enjoy each day instead of anxiously awaiting the next scan. I have been trying to stay as calm as possible and I keep telling the baby how loved he/she is! When I told the HR manager at work she gave me a big hug and was delighted for us. That was really sweet. Hubby has also been really happy about this pregnancy and it has been a sweet time. We were joking since the last scan that our baby loves sleeping just like his/her parents! I'll ask hubby "what do you think baby is doing now?" and he jokes back "probably sleeping!". I have also been sharing with him some of the facts from my pregnancy app. Like, I read that starting from week 13 the baby can start to hear things outside the womb! And they can also differentiate between light and dark. I am so amazed that from a bunch of cells a tiny person is now forming and growing. I pray that in six months time we'll get to meet our little one! In the meantime baby can stay put and keep growing and being loved.

Tuesday, August 8, 2017

Infertility in the news

Since infertility has been a big subject in my life the past few years, whenever I see things in the news about it, it peaks my interest. Recently a study has come out about men's declining sperm count. "Sperm counts in the West plunge by 60pc in 40 years as 'modern life' damages men's health." The decline shows no sign of stopping either. That is crazy when you think about it!

The article also said that poor sperm can be an indicator of other health problems; Aside from the obvious implications for reproduction, the researchers said the declines were consistent with reported trends in testicular cancer, the number of children born with one or both testicles missing, the onset of male puberty and total testosterone levels. This is not something that should be ignored. There were several possible reasons given in the article; chemicals... BPA... processed meats... but I got the impression they don't really know for sure. If there are chemicals in the food that we are being exposed to that are causing problems like this (plus who knows what other issues could be attributed to it such as cancer), something needs to be done.

The same study was also covered in the Daily mail, which is a tabloid paper. They commented about how women are typically "blamed" for infertility when often it is the man at fault. I really wonder when the blame game of women "being career women" and "waiting too late" is going to stop. Anyway, the article mentioned that maybe men and women will have to start freezing their sperm and eggs when they are young for future use! This is not an ideal solution for numerous reason. It's an interesting idea though. I'm currently reading "The handmaiden's Tale" for my book club and articles like this make the book seem not all that far fetched!

The comments under both articles (there and on the facebook pages) were despicable though. Firstly there were lots of people blaming "feminists" and "feminism". That made my blood boil. Come on! Some people seriously think that women having equal rights and being allowed to work and vote for instance is causing men to feel so threatened that their bodies produce less sperm?! Give me a break! The other most prevalent comment was about "overpopulation" and that this sperm issue is hence "a good thing". That also upset me. I can see how over population can be a problem is certain countries especially with poor access to family planning and contraceptive measures but in the western world we have the opposite problem. Germany has an aging population for instance. Many couples these days only have one kid on average, or none at all! And people not being about to have the choice to have children is in no way a "good thing". I wouldn't wish infertility on my worst enemy! It is heartbreaking to go through.

By the way I wanted to add that by using a picture of the manly Jon Snow from Game of Thrones I'm not in any way suggesting that there might be any issue with his swimmers... But if there were, it wouldn't make me think any less of him!