At yesterday’s scan, they saw the gestational sac clearly in my tube.  I don’t remember which tube.  I have had only the very occasional twinge on either side, no pain, no spotting or anything.

I’m supposed to go back on Thursday for another scan.  This is to make sure that the other embryo doesn’t magically show up in my uterus as a second sac.  Since I was 5w2d at this last scan, it’s a long shot but not a total fantasy.  This would be heterotopic pregnancy, supposedly rare but not so rare with IVF.  Chances of a heterotopic: as high as 2%.  Chances of an ectopic in an IVF: 2-4%.

If no second embryo, then I’m going to be encouraged to take methotrexate, an injection, to "resolve" the ectopic and make it stop growing.  If there is a second embryo, then I’ll have no methotrexate – surgery to take out the tube.  I need my tubes like I need an 8-track player, so I’m better off than lots of other women in that respect.

While an ectopic pregnancy can be life-threatening, the doctor thinks we have until the end of the week to decide how to deal with it.  I would be 6 weeks on Saturday but I probably won’t get there.  Since I have no ectopic symptoms, and the sac in the tube is still small, the danger to me is pretty minimal, especially since it’s now diagnosed.

Meanwhile my betas continue to double.  I’m in the 3000’s now (can’t remember the exact number).  With the increasing beta came the longed-for morning sickness.   After a few hours of refusing to throw up last night, I gave in and barfed.  I have always been scared of throwing up, even though when I do, I usually wonder what the big deal was.  I was afraid I’d continue to feel sick but I felt better immediately.

Last night, after a day of crying, the nausea seemed like an unbearable irony.  Today I feel better about it.  I always wondered / worried about how I’d handle that part of a pregnancy, and I did want to get far enough into pregnancy for it to be, well, real. Even though ectopic is an outrageously sucky outcome, at least it’s not the tentative, ephemeral non-result I’ve had before.  So far the nausea starts up in the evening – I woke up with a very empty stomach and feel just fine.  So far.

I’m curious (and would love to hear from anyone with experience) because I have read that after methotrexate, I might have to wait 3 months to try again.  This might be more about conceiving "naturally" or with one’s own eggs, neither of which applies to me.  I have also read that it may take many weeks for the betas to come down, so that I’d have to wait quite a while anyway.  My doctor also tells me that methotrexate doesn’t have a lot of side effects.  Naturally I’m skeptical.

I am wondering if I shouldn’t just ask my doctor to do the surgery anyway, and at least get a look at my endometriosis, and maybe take care of some of it.  I have never had a lap.  I’m secretly hoping I’d be able to try again sooner and that my betas would come back down more quickly if the Wanderer were removed surgically rather than killed slowly with the methotrexate.  Not a good choice either way.

Getting the betas back down was not something I’d thought I’d ever be concerned with.

I have run out of almost all my meds at this, the worst possible time; I will have to get refills and end up with leftovers of everything, which I hate, even though I will certainly need them next time.

What else?  Yesterday was very intense.  Shock and numbness followed by a day of crying which is probably just the beginning.  I didn’t want to hope for the second embryo to show up, but of course I do.  It’s just so strange that in the midst of all this tragedy I am still pregnant, and feeling it more every day.  The perfect timing of this pregnancy is now perfectly awful – I was going to be able to tell my parents at Thanksgiving and the rest of the family at Christmas.  Now I’ll just continue to be Aunt Joy, who seems to wants kids but never has any, is sad a lot, and gets older and fatter every year.

My focus during this time is a kind of submission.  I know it’s okay to be angry at God, but I also think I have to accept that God has allowed this – but God is still good –  if I’m going to recover.  I was thinking about this when I was so worried about the betas and the scan.  Every mother says that the worrying never ends, and I have to figure out how to survive it.  For me that means accepting God in the good and the bad, otherwise I live in fear.  Probably will anyway but I need it to be less.

I also want to be more willing to hope, even for things that are unlikely.  Especially for those things.  I was doing well with hope leading up to yesterday’s scan, and even though I got blindsided again, I think hoping was still worth it.

The comments and emails have been life-giving.  When I’m feeling detached they help me to cry.  The prayers help too.  Thanks so much.

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