Our retrieval was on Thanksgiving and the transfer 3 days later. We made the decision to put back 3 embryos, the same thing we did the past two IVFs. This decision was based on the advice from our RE, our past history of putting back 3, and the fact that this cycle required more and more stim drugs meaning it was getting even harder for my body to produce eggs. This was our last chance. All was going well and I felt some slight tugging and pressure a few days after the transfer, exactly as I had felt with my DS. Maybe this might work.
I went in 8 days after the transfer and my HCG level was 94! A positive result is anything over 20. But we're not out of the woods yet, it has to approximately double every 48 hours. Sure enough, 48 hours later it was 346, the next one was 1373 at 12 days past transfer. For perspective, with my DS on 12 days past transfer my HCG was at 326. My mind went into overdrive, uh-oh, I think we have multiples. I checked out betabase.info and while my numbers fell into the range of a singleton and twins, I knew something was up. DH and I started to prepare ourselves for having twins. Three days later, my HCG shot up to 4378. We had an ultrasound that same Monday at 4.5 weeks, but it was too early to see anything. I went back on Friday and we saw 3 gestational sacs - yes, 3. All 3 embryos that we put back had implanted. I cried right there on the table.
What had happened? Over the past 3 IVFs we've put back 7 embryos and only had 1 baby. How could all 3 have implanted? What were we going to do with 3 babies? The nurses all assured me that it was really early and a lot can happen. Something like 40-50% of triplet pregnancies lose one by 11 weeks. I turned to my Resolve chat boards, poured my heart out, and received amazing support from the ladies on there. We have all been through so many ups and downs together, and these ladies were able to share their own personal experiences around this and talk me down a bit. I started checking out tripletconnection.org to read about families with triplets. How many medical problems were there at birth, how do families cope day to day, what types of developmental delays, etc.
We were thinking that the first ultrasound would show twins and we would be able to say we were pg with twins. But with triplets! How do you even say that? We knew we couldn't look at people and show genuine happiness, we were scared to death, overwhelmed with emotion, financial thoughts, our lives completely turning upside down. I would have to quit my job and stay home. So I took the cowards way out and just posted that we were pg on this blog for those of you that were following the IVF, then remained silence. We had nothing more that we wanted to share at that time. I called family to say that we were pg, but avoided questions of "how many" by saying it was too early to tell.
At 6 weeks, all 3 were growing on track and we could see heart flutters. With Christmas approaching and the RE office closed for a few days, I was given a prescription for nausea since I would have triple the hormones and could have triple the morning sickness. I never filled that prescription. Other than exhaustion, I've felt fine. At 6.5 weeks, they were all growing on track and while we still couldn't hear their heartbeats, we were able to measure them between 104-133 beats per minute (bpm). At that point, the doctor told me he was just going to look around a little bit and make sure we weren't missing another one that might have split. While my feet were in stirrups, my leg started to shake. Another one? Sigh of relief, nothing more was found other than my still massively swollen ovaries producing triple the hormones.
At 7.5 weeks, I went to the OB for my first visit. All 3 were growing on track with heartbeats in the 160-168 range. I asked if my OB could handle this pregnancy. He's delivered hundreds of twins, but only 4 triplets. I was referred to a Maternal Fetal Medicine (MFM) specialist in the Medical Center. My OB told me that he takes a conservative approach to multiples and would recommend bedrest at 19 weeks for triplets, and if we lost one, it would be 24-28 weeks for twins. It's not medically necessary or proven, but the thought is that by staying off your feet and taking pressure off the cervix, pre-term labor can hopefully be avoided. We were all for that plan. After my whole almost dying incident while giving birth to DS, we want to be cautious. But wow, that meant I didn't have a whole lot of time left.
Later that week I saw the RE again, everyone was growing. I started researching the leave of absence and short term disability programs at work. If I stopped working before the babies were born, I would use up all my FMLA and only have 8 weeks after the birth for STD from a c-section. That's not enough especially if they spend time in the NICU. Instead, I'm going to cut back my hours to 25-30/week while on bedrest and hope to reduce some stress. It will be a pay hit for a few months but I should keep all of my benefits, accrue vacation time, and keep my STD and FMLA time for when they are born. The next step about my job won't be decided until after they are born.
At 9 weeks, saw the RE and they were all growing. One nurse in particular has been so supportive during all of this. Talking me through my overstressed and overwhelmed tears, providing the name of a counselor, and just patiently answering all of my questions. At 9.5 weeks, I saw the MFM and we talked about risks. We also talked about my MTHFR (I don't absorb folic acid and can have blood clots). He said that staying on my normal 3 doses of folic acid with B vitamins a day is enough to counteract the MTHFR, and that I no longer need to take the Lovenox blood thinner injections. Woo hoo! That was definitely positive and I stopped that very day. I still will take baby aspirin the whole way through for my own peace of mind.
Another RE visit, but since I was already being seen by the OB and MFM, this was to be my last appointment. I do recall taking a last look back at the office while I walked out the door, thinking that I would never be back. Whatever happens with this pg, I am done. Even if we lose them all, I am just done, I can not go back and do this again. The amount of physical and emotional pain, and the volume of tears that have been shed while trying to build a family had definitely taken their toll. I knew that if we lost them all, we could potentially try naturally, but I would never be back and we would most likely stay a family of 3.
Over the next few weeks we saw the MFM a few times and baby C was was not doing as well. With my age, the fertility drugs, and seeing baby C, we decided to do CVS (chorionic villius sampling) testing on baby A and B to see if they would be ok. It is a painful procedure. We were supposed to have results in 48 hours, but because of baby A and B's placenta being close to each other, the doc wasn't able to get enough tissue for the fast test. In fact, he thought he might have to go in again to get more tissue. Mine was transabdominal and they essentially take a large needle, stab it through your skin, fat, muscle and uterus to get tissue from the placenta to test the DNA cells. It literally took my breath away. Luckily I've learned a lot of coping skills over the years for dealing with physical pain and I used them to get through it. The thought of it being done "again" to get more tissue was agonizing. We waited an hour to see if the lab had enough tissue, which they did.
We waited 2 weeks to get the results. During that time we didn't have anymore ultrasounds. Even with it looking like we were losing baby C, there was nothing that could be done. It was definitely a mixed feeling. We've known all along that we had no idea how to handle triplets, and losing one makes everything more manageable (not that twins and a toddler won't be challenging enough), but we'd seen baby C on the ultrasound a number of times, wiggling and moving. It's heartbreaking to think that we'll never meet our child. The doc told us to take a break from all the appointments and wait for the results. We finally got the tests back on baby A and B and they are both genetically normal (no Down's Syndrome, Cystic Fibrosis, etc) and at this point we're not at risk of losing them. They are also both males. While we were thrilled to hear that they are healthy, DH and I were both a little sad that we wouldn't be having a little girl. We've shed another round of tears over the last few days, losing baby C and wondering if that would have been our little girl. Baby C's picture will be added to our infertility album, which holds pictures of all of our past embryos that never made it.
Here's the last picture we have of the 3 of them together. Baby A is on the far right with hands on his head, baby B is in the middle, upside down with feet at the top. Baby C is on the left/bottom, already looking a little smaller than the others.
But now we are ready to move on! I'm 14w2d, starting the 2nd trimester and ready to be excited about our growing family. I want to enjoy this pregnancy, my last one, be amazed by the kicks in my belly and keep these babies inside as long as possible. We'll be re-using all of DSs bedding, clothes, etc, but just today went out and bought a 2nd set of boy bedding. We're having twin boys, exciting and scary all at the same time!
