Probably Obvious

So, the meaning of my blog's title is probably obvious to anyone who finds their way here, but I thought I'd point out this related entry on Miss Zoot's blog just to make it clear. Because it's often crossed my mind as well -- would I rather be a repeat aborter or a habitual aborter? They're both so fabulous that it's impossible to choose!

I've always had bad habits... I'm a nail biter, a procrastinator, a lazy housekeeper. I get frustrated with myself over those things, but no bad habit in the world could be as frustrating as my so-called "habit" of miscarrying.

The first time was in October, 2000, when I was 31 years old and ten weeks pregnant. We were one of those annoying couples who got pregnant immediately when we decided to start trying. We were beside ourselves with the happy. We told our families. We told our friends. We went for our first ultrasound and the tech said, "I don't see a heartbeat." Then there was a D&C and the shame and heartbreak of having to tell everyone what had happened.

I couldn't stand for anyone to talk to me about it. I made my poor husband tell everyone that had to be told by phone (our families, mostly). I quit my hairdresser because I couldn't bring myself go back and face her. I felt like quitting my whole life. The due date was in May, so late that fall we planted a dogwood that would bloom in the spring, and surrounded it with tulip bulbs. Nothing helped much, though. It was a very dark time, and I'm still very grateful for my therapist, the anti-depressants, and most of all my husband.

The second miscarriage was in May of 2001. The week before the due date of the first pregnancy. The week before our eighth wedding anniversary. I didn't even think I was pregnant, I just thought I was getting my period. After feeling crampy and weird for a week or so, with no period to show for it, I finally took a HPT and it was positive. Because of my previous miscarriage, the OB/GYN put me on progesterone right away, but the pregnancy was already past helping. The betas started dropping and I was bleeding within a week.

Not too many people knew about that one, which made it a little easier to deal with, for both my husband and me.

Around that time I talked to a friend who had at one time been very involved with RESOLVE. I handed her a list of local REs approved by my insurance company and she told me about this doctor she'd met and liked, Dr. T. He wasn't her doctor, but she thought he seemed great, and besides, he was a specialist in miscarriage at one of the country's premiere fertility clinics. So my husband and I signed up and got an appointment a few months out.

Fall, 2001: testing, bloodletting, sonohystogram, karyotypes, blah blah blah. Everything was mostly normal, although they did remove a small cyst from my uterus. I also take dexymethosone now to compensate for a slightly elevated androgen level. But the real problem, they thought, seemed to be immature eggs producing non-viable embryos. They prescribed Clomid to encourage mature follicles.

Then followed four Clomid cycles with intercourse and progesterone suppositories, but not much happened other than I experienced all the side effects of Clomid and gained about thirty pounds. After a few months of frustration, we decided to take a break and regroup. Then (spring 2002) we got an unexpected opportunity to relocate for 2 years to a foreign country for my husband's job, so the break stretched out to those two years.

I don't really regret leaving. I needed to stop for a while, and come to terms with things. After the first two miscarriages and then the frustrating start to treatment, plus all the depression and weight gain, I couldn't keep soldiering on without doing myself some physical or mental damage. Leaving for two years was probably the best thing that could have happened -- although of course, in the back of my mind, I hoped that we'd have a kid on our own while we were there.

While we were away, I lost all that weight I'd gained, and didn't think too much about the fertility thing. Until January 2004, when I had my third miscarriage. The pregnancy was unassisted (I was charting), and the miscarriage was pretty early, around week 7. And after the time I'd taken away from fertility testing and treatments, it was also a lot easier for me to deal with on my own. Mostly, I was relieved that I could still get pregnant. It had been almost three years since the last time, after all.

A couple of months later, we somehow managed to do it again. This pregnancy is very dear to me because I saw the heartbeat. For the first time ever, I saw a heartbeat! That only made it worse, of course, when I brought my husband to the next appointment (in week 11) and the ultrasound showed that the heart had stopped and the fetus had started to shrink. This was July, 2004, less than a month before we were scheduled to move back to the US. So, a quick D&C in a foreign country, followed by an international relocation.

But this time, after the D&C, they tested the tissue. And they found out what had caused this fourth miscarriage. Trisomy 22. It's not the answer to everything, but it's AN answer. To that one. Of course, through the testing, I also found out that it would have been a boy. I'd never known the gender of any of the others, and that added an unexpected twist of the knife for me.

Just a couple of weeks later, we were back in the US. As soon as we could get an appointment, we met up again with Dr. T, whom we hadn't seen in over two years. He prescribed Femara (letrozole) rather than Clomid this time, but I didn't respond much. The third Femara cycle got converted to IUI (2 days, back to back). My first IUI, January 2005, the month of my 36th birthday.

I held out until 13 days post IUI before testing with HPT. I tried again on days 14 and 15. Then one more time on day 16. They were all negative, so I quit the progesterone. Two weeks later, when I still didn't have my period, the doctor ordered a beta HCG test to be sure I could safely take Provera to restart my cycle. And on that test, my beta came back at 2517. After four negative HPTs.

The thing was, 2517 was way too high if I wasn't pregnant (duh), but it was way too low if I was eight weeks pregnant. So we went for an ultrasound, and they saw something that might have been two sacs (but maybe not). Then they rechecked my beta two days later and it was dropping, and that was that. Again.

So that was the last one so far. But it was also my first IUI, and the first time I ever got pregnant other than the old-fashioned way. Whenever the doctors were watching before, nothing happened. So I'm a little encouraged by that. Now Dr. T thinks I'll respond better to FSH than Clomid/Femara, so next time we're using Bravelle, with Ovidrel to trigger, then IUIs (2 days) followed by progesterone support. I can't help but feel we're getting closer, although it's the same feeling I've had many times over.

Oh, and my friend who originally suggested Dr. T to me? While I was living out of the country, she switched to him herself. Last December she did her first IVF cycle, and it took. I realize that has no bearing on my likelihood of success, but deep down it still makes me feel good about my doctor.

But believe me, miscarriage is one habit I would be so happy to break, if I could. I actually did manage to stop biting my fingernails, so that's a start, I guess.