Monday, April 8, 2013

The Other Two-Week Wait

Ignorance is bliss, yet wisdom comes from experience.  The million dollar question is - would you rather be wise or happy?  I have come to the conclusion that this is the question that Adam and Eve answered incorrectly when they opted to try to know more than they needed to.  But in my case, it's not exactly my "fault" that I know what I know.  The experience of a previous pregnancy loss, however early on, plus the knowledge of what can happen based on all of my online buddies' experiences, keeps my pregnancy bliss at bay.

People who have never had to struggle to get pregnant find it hard to understand why I can't just rejoice, why I have to be so pessimistic.  But I think I'm being realistic.  In reality, the statistics say that not every embryo conceived is born.  There isn't a magical point at which the risk is turned off.  Rather, it's a gradual change over time, with the greatest risk of miscarriage passing with the first trimester.  This is why women are advised to wait until the end of their first trimester before announcing their pregnancy, since at that point their risk of miscarriage drops to below 2%.

In the case of women who used artificial reproductive technology, there are additional questions forming a whirlwind in our minds as we anxiously await that first ultrasound. The first milestone to pass once a pregnancy is confirmed is to eliminate the possibility of a chemical pregnancy.  This is where an embryo burrows itself into the uterine lining but then calls it a day.  The initial hcg level in the blood may be lower than expected or it may be normal.  The second beta blood draw will show that the hcg level has dropped or is not doubling according to plan.

Other times, the embryo burrows and grows just fine, but the location of implantation is such that the baby is unable to grow, develop, and be born.  This is an ectopic pregnancy, or one where the embryo implants in the fallopian tube (most commonly), or anywhere else outside the uterus (on the ovary, in the cervix, or even in a cesarian scar).  The likelihood of bringing a baby to term is almost entirely impossible.  I believe the few instances of it happening have either been due to an initial misdiagnosis or the location of implantation being less than ideal but still such that the baby was able to grow within the womb (as opposed to trying to grow in a fallopian tube).

There are also instances of a blighted ovum, where the blastocyst implants and the placenta grows and secretes the hcg needed to signal the existence of a pregnancy, but upon ultrasound viewing, it becomes evident that there is no embryo inside.Only an ultrasound can establish a) that there is indeed an embryo growing, and b) where the baby is growing.

This is the second milestone that I am currently waiting for.  In a little over a week, I will be able to rest a lot easier knowing that all is well.  Until then, I simply know too much to relax.

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