Last Appointment with Victoria Fertility Centre, Ultrasound, Prenatal Testing, and 11 Weeks Pregnant Tomorrow

Current mood . . .

This past week I've spent in various states of hope and despair. With my husband away and the house quiet, except for a yowling cat who protests his absence, I've had an inordinate amount of time to ruminate, catastrophize, and get stuck inside the scary confines of my mind.

The week went from mild end of November to a frosty start to December. It made for beautiful opportunities to photograph the changing weather, a handsome crow, and I gathered some blue spruce and a lone rose to make an ikebana arrangement earlier in the week.

This crow has his beak full of breakfast. The Mexican mock orange bush is in bloom despite it being autumn and not spring.

Not bad for the end of November.

I don't claim to know the art of Ikebana, but I do enjoy arranging flowers and plants with antique ikebana vessels and kenzans.

December started with beautiful frost in the morning sun.

My follow up appointment with Dr. Down, my maternity GP is scheduled for December 14th. This will be a full physical. After reading the materials provided by both Dr. Down and Dr. Hudson on prenatal screening tests, my husband and I decided to go with the publicly funded prenatal test, IPS, which consists of two blood tests during different weeks of gestation (my first one will be this coming Monday when I'm getting blood tests done for both lithium level and thyroid levels- why not get it all done at once? The second blood test must be done between December 29th and February 1st- these are time sensitive blood tests that must be done in certain weeks) and an ultrasound (Nuchal Transparency Test or NT) that measures the fluid behind the nuchal area of the fetus or nape of the neck (excess fluid can indicate conditions like Down Syndrome). The NT is supposed to be done between week 11 and week 13 of pregnancy (as is the first blood test), so I'm waiting for the screening place to call me with a date. The IPS test is somewhat less accurate than the test that one can pay for privately (NIPT which just has one blood test done from 10 weeks gestation forward), but after just spending over $15,000 on IVF, we're not really in the mood to spend another $600 (and yes, we're still fighting with our insurance company to try to recover the drug expenses that they said were covered in our policy and which they now claim were only covered up to $2,500 total instead of up to $2,500 per drug, which would have meant that our entire $9,000 claim should have been covered).

Dr. Down told us that if the IPS test (the publicly funded one) looks abnormal then the medical system will generally fund the normally privately funded test (NIPT). Then if there is an abnormality found on the NIPT test, there is the amniocentesis test that is done in the second trimester and has the highest rate accuracy (but also a risk of miscarriage as a needle is inserted through the abdominal tissue into the uterus to sample amniotic fluid and test for genetic abnormalities). Amniocentesis is only publicly funded and done for women over 40, high risk pregnancies, people with a history of certain genetic disorders, and for people who have been flagged in the previous prenatal tests (like IPS or NIPT) as having a fetus with a genetic abnormality.

I went to acupuncture on Monday for continuing support of my pregnancy and treatment of some of the symptoms including anxiety, stiff back and neck, digestive system chaos, headaches, and nausea. But really, nothing can help me with my biggest problem, uncertainty. Only time can deal with that.

Before acupuncture . . .

During acupuncture . . . (these are just some of my many needles in my chest and head)

Hand needle and forearm tack for nausea.

After acupuncture (in the awesome lighting of the medical building bathroom) . . .

On Tuesday, I went to the chiropractor again for more adjustments. My neck and back are torturously stiff and sore. I don't think that the anxiety is helping and obviously with my long absence from the chiropractor things shifted out of place and it will take time to put them back where they belong and for the muscles to settle down from being splinted and stiff. Also, pregnancy leads to many changes in a woman's body, including the enlargement of breasts, which puts stress on the back and neck, the hunching forward of shoulders, and the pelvis expanding to accommodate the enlarging uterus with accompanying back changes and hip changes.

The appointment this week that I was most terrified about was today. It was my final appointment with Dr. Hudson at the Victoria Fertility Centre. I emailed the clinic yesterday to ask if there would be an ultrasound at the appointment today. With all of the anxiety that I've been experiencing about the fetus being dead and me having a second miscarriage this year, I felt that if I could see that the fetus was alive and hear its heartbeat, I might feel somewhat, though not totally, reassured (I'm still not out of the riskiest time, the first trimester). The nurses told me that there would be an ultrasound today.

I slept fitfully last night imagining what I would do if there was no heartbeat. My  husband would not be at this ultrasound and I didn't want to ask anyone else to go along with me in case the worst occurred. I could not stand the thought of anyone else watching me fall to pieces.

I drove out to the Victoria Fertility Centre this morning trying to breathe.

In the car.

I waited for my appointment after having emptied my bladder (at this stage it's still an internal ultrasound, not an external one as it is for later pregnancy ultrasounds where they do require a full bladder).

In the waiting room.

 Dr. Hudson was waylaid in a procedure and I had to wait longer than anticipated. I could feel my bladder rapidly filling back up and worried if it would be too full for the ultrasound. My husband and I texted while I waited. He had boarded his plane and was about to take off. We were both very anxious. I could barely breathe as I stared up at the ceiling tiles and forward at the beige curtain.

In the examination room before ultrasound.

Beige everywhere.

Ceiling tiles.

Dr. Hudson joined me with a nurse and started the ultrasound (luckily my bladder wasn't too full). As usual, he turned the screen so that I could take a lot of pictures for the blog. I couldn't believe it when he pointed out the fetus.

The fetus can be seen as a grey mass in the middle of the black amniotic fluid. The head is to the right (about 50% the length of the whole fetus at this point). The rump and leg below are to the left.

38.4 mm in this measurement head to rump of the fetus.

This cloudy mass is apparently my cervix and the line across is Dr. Hudson's measurement of it. 

The round grey mass in the middle of the black mass of amniotic fluid is the fetus' head.

Another shot of the fetus with the head on the right and rump and leg below on the left.

This measurement of the baby head to rump is 40 mm.

This image shows the fetus' head to the right, its arm in the middle, and rump and leg below to the left.

43.5 mm head to rump measurement in this shot.

It's amazing to think that this fetus is just reaching the size of a fig.

It was kicking. It was alive. I was most definitely ten weeks and six days pregnant. I blinked in astonishment and then quickly took a video of it kicking, so that I could show my husband. He was very disappointed to have to miss this appointment and I knew that he would want to see it (at this stage the fetus is much too small for a woman to feel it kicking, but it's in there moving around all the same).

I took more pictures as Dr. Hudson measured the length of the fetus head to rump several times (see above). It was about 39 mm (1.5 inches) up to about 43.5 mm (1.7 inches), so the fetus is making its transition from green olive (week 10 fruit size or about 31 mm) to fig (week 11 fruit size or about 41 mm). He said that the fetus is a totally normal length for 10 and a half weeks pregnant. I let out a little sigh of relief.

Then he let me listen to the heartbeat.

My eyes welled up with tears as the sound of the steady heartbeat filled the little examination room. It was normal. I took a video of that too to show my husband when he arrived home later tonight. I couldn't believe it. It was alive, it looked normal, it sounded normal, and Dr. Hudson said that he couldn't be happier with how things had turned out. He asked if I had thought of any names yet. I told him that I was still too afraid of think of names, because I was worried that I would have another miscarriage. He assured me that with each passing week, my risk of miscarriage decreases. He said that since everything looks normal, he doesn't need to see me anymore and he is turning over my care completely now to Dr. Down (maternity GP), as well as my endocrinologist (thyroid), and my perinatal psychiatrist.

Dr. Hudson gave me a printout of four of the images from the ultrasound (below- the second image has the heart rate graph on it). I quickly texted my husband, who was still waiting for takeoff, to tell him that "the thing," as we have been calling it, is alive, and to send him some pictures and tell him that I had a video of it kicking and the heartbeat. He was so relieved to receive this fantastic news before taking off on his cross Canada flight to come home for the weekend.

I went down to the drug dispensary in the clinic and gave the lovely technician my leftover items for the demos that they do there for other patients, as well as my full sharps box for disposal (and no, I do not miss shooting up 2-4 times a day). I told her that I would be 11 weeks pregnant tomorrow and that this was my last appointment at the clinic. She gave me a warm hug since as she said I was "graduating" from the clinic. Everyone that we dealt with at the Victoria Fertility Centre (VFC) was a complete joy, competent, and I feel so fortunate that we had this clinic in our city, so that we didn't have to travel to get IVF as many people do (I can't imagine the expense and stress that this adds to the process and I marvel at all the strong people on the IVF.ca VFC forum who are travelling from all over Canada to get fertility treatments done at the VFC). She told me to keep in touch and to send pictures when we have the baby.

I certainly hope that we do.