Wednesday, March 14, 2007

A Fine Question

Anonymous writes:
Is it only the implantation that has been causing the bleeding? Might you have had multiple implantations and losses early on in the other pregnancy? What information are you being given about the bleeding?

This is a great question. And the answer is, I don't know. One theory is that I could be bleeding from implantation , but I gotta say... I don't have a lot of faith in that theory. There's an awful lot of bleeding, in my admittedly uneducated opinion, to blame only on implantation. Beyond that, who knows?

Could I have had multiple implantations and losses early in the other pregnancy? It's doubtful because in my last pregnancy, I literally had ONE mature (16mm) follicle and nothing more. All the others had shrunk away to unmeasurable levels. This pregnancy there was a maybe-leader and a whole lot of close followers (16.4, 15.4, 14.2, 14.2, 14.0). Gosh I feel really stupid now. We should have just cancelled the cycle. In the case of the last pregnancy, multiple implantations and losses definitely doesn't cover it, because I had consistent bleeding for 12 weeks. Had there been other implantations that I was losing, they would have shown up on ultrasound.

But as for what information I'm being given on the bleeding... not much. Not any actually. Just the possibility of implantation bleeding, which doesn't make enough sense to satisfy me. They can't find a reason for the bleeding on ultrasound and they are therefore unconcerned. Easy for them to say. I'm the one dealing with it.

What else? A couple people have asked me how far along I am... I'm at about 6 weeks gestation, with variances depending on who you ask. Another popular question is when is my next scan? I don't have to go back in until Tuesday, but I'm going in on Friday so that I don't spend all weekend assuming that life is all doom and gloom. I don't expect Friday's scan to yield any interesting results. I don't expect fetal poles or heartbeats by then, but I expect there may be something more interesting to see on Tuesday. If not, that's when I'll worry. Not that I'm not worrying now.

My question is... at what point do I mention this little predicament to my OB? And will he be able/willing to see me if this stays triplets? I'd feel stupid calling now only to find out I'm down to one or two by the time I "graduate" from the RE's office. But I wouldn't want to not have a plan in place for my next appointment once I graduate from the RE's office either. Decisions, decisions.

On another note, a small part of me is really irrationally angry with Shady Hell right now. I know that IUI made the most medical sense in terms of avoiding costly, invasive procedures if we could... but if someone had just let me have my way and went straight to IVF after the miscarriage.... the odds of triplets right now would have been infinitessimal. We never would have transferred three embryos and we would have had to have a very, very good reason to transfer even two. This is not Shady Hell's fault. They did do the responsible thing in giving me the guidance that they gave me. But I'm still upset about it.

6 comments:

Anonymous said...

From my research on bleeding in the first trimester I found some other theories:
1 - left over blood in the uterus just wanting to come out
2- could be brought on if you have cysts

Of course the medical field doesn't really have any concrete answers. It's all a guessing game. Good luck on the Friday sono.

Anonymous said...

Wow, Karen. I don't blame you for being confused, upset, terrified.

I really hope you won't have anymore bleeding.

There isn't much I can say at this point, but know that I am hoping for the best for you.

Anonymous said...

About the OB thing; it may help you to take this into account: I understand that you want the most "normal", low stress pregnancy you can have, and that a MF specialist or high-risk doc doesn't seem like they would be. However, in my personal experience, OB's get very, very nervous with multiple pregnancies, and may be quicker to intervene than an experienced hig-risk doc. In fact, for them, multiples are among their "best prognosis" cases. I went into things with my twins wishing I could work with the midwives, but they wouldn't let me. When things got rough, my OB group was arguing over what to do and giving me all kinds of conflicting information, while also refusing to give me a realistic idea of what to expect because they were so scared of liability. When we finally got an ultrasound at the high-risk clinic, the doc there was the first to really be straight with us, offer statistics and such. He was also much more comfortable with the protocal he prescribed than my nervuous OB's, and could offer statistical evidence of why it made sense. I really wish we'd have gone there to begin with. Best of luck, whatever happens.

Anonymous said...

One more thing: in retrospect, I guess I think that midwives are the ideal choice for a low-risk pregnancy with a woman who wants to minimize intervention, that OB's are probably best for women who want pain relief or have somewhat higher risk, and that maternal-fetal specialists are probably ideal for multiples and other high-risk situations. It just makes sense to me that you want the type of professional that's most trained to deal with your situation. If you end up gestating and giving birth to triplets, you WILL have lots of monitoring, as well as lots of intervention during the birth. Even with twins, I had to have an epidural to even attempt a vaginal birth, and had to be on my back in the operating room "just in case". So you probably won't cut down on that by going to your OB anyway, and you might just have more monitoring and intervention because an OB more used to dealing with high risk situations wouldn't need as much reassurance. Ok, that was 2 more things - feel free to ignore me. I just really wish I'd understood that. All the nurses on the antepartum ward sure did! My OB's drove them crazy.

Baby Blues said...

I'm sorry Karen. I really don't know what to say either. Just know I'm here hoping for the best.

Anonymous said...

Your anger does not seem irrational. It's been pretty clear that one of the reasons IVF would be more appealing to you was that it would provide a clearer sense of the status of the situation from day to day and more control over it.