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Feature Article #1

Embryology 101

Look, I’m no expert, but I had to make myself understand a few things, so here goes, hope you can take something away from this.
Making heads from tails from my own embryology was a bit of a challenge, simply because I’m no embryologist, but I wanted to understand what’s going on there, so I started [...]

InVivo | May 1st, 2009 | Continued

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Feature Article #2

A Prayer for a Mother in Waiting

This post was inspired by my many friends in the computer struggling to conceive, who have coped with loss upon loss and deal with many heartbreaks and questions on a daily basis, and especially my friend Sam who is on her knees praying for all to go well and Kimbal who has to deal with [...]

InVivo | May 20th, 2008 | Continued

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Feature Article #3

Insulin Resistance & PCOS

Dietary lifestyle change is one of the first lines of treatment for Polycystic Ovary Syndrome (PCOS). A condition that often runs in families and leads to subfertility and sometimes infertility. The article below is a work in progress drawn from my readings on the topic.
What does it mean to be insulin resistant?
In a nutshell [...]

InVivo | January 12th, 2008 | Continued

About this Site

Welcome to Invivo!
This blog is a blogumentary of my journey through the struggles of living with infertility. It’s my connection with many wonderful people that live my reality and share in my joys and pain as we struggle to build a family, by hook or by crook.  For some it takes a little more effort [...]

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A Birth Story

I’ve just extracted my 3AM feed.  I know I have to tell this story,  this story that brings to full circle a three year journey of blood, sweat and tears. I recall a poem I wrote November 2006:

11/28/2006 10:26:32 PM

Afwagting

Die holte brand waar jy moet woon
Jou tuiste wag in hoop
En jy’s reeds hier

Jou trane glinster in die oggend dou
Jou warmte tussen ons vashou
Jou asem in ons gesels oor jou

Jy’s reeds hier
In die vashou en droom van jou bestaan
Jou heenkoms word afgewag
Ons hoop is jou verwelkoming
Selfs voor jou bestaan

Jy vlinder in die onsekerheid
Van die nuutsheid
En in die wonder of die grootsheid van jou drome
In ons huis sal kan woon en leef
Ons sal vir jou moet wag
En hoop dat die liefde en die hoop
Wat jou na lewe lei jou sal omvou
En jou by ons sal hou

I remember the great hopes and expectations that were shattered month after month as we struggled to conceive. I remember fears of the possibility that we might never be able to conceive.  After 3 years of intensive fertility treatments and many hours of personal investment in my own health I tell the story that completes the circle, our birth story.

The last three weeks of my pregnancy were hell, I discovered new depths to the word discomfort.  I lived through what many consider to be equivalent to the worst torture techniques – the pregnancy rash named PUPPS.  The word still stirs terror when I read it ‘cause I know how bad it can get and it’s not a pretty picture.  PUPPS without a doubt is an initiation rite into new levels of pain and suffering, in fact some describe the cumulative pain of PUPPS to be worse than the pain of natural childbirth.  The itch still lingers a week after my C-section.

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Sunday evening of the 28th of March 2010 will remain etched in memory forever.  After a typical lazy Sunday afternoon of watching Idols, of wishing the hours away, the itch came in full force, like it did the past three weeks, every night without fail.  This time I was driven to tears, the discomfort was severe and unrelenting. This time we decided we’ll try something new (one of more than a dozen home remedies I’ve tried), I undressed, waddled into the bathtub and my husband proceeded to dress me in Bulgarian yogurt.  The cool softness brought relief, for a moment to the raw burning itch.  I rested my yogurt dressed self on a towelled recliner, in desperate exhaustion I took a few deep breaths during this brief window of relief.  As the yogurt dried, the itch returned and I decided it’s time to go shower (another method to find a few moments of relief).  Little did I know that the ultimate and only relief was on its way.

I then covered myself in Sudocrem, like every night before, a ritual that sometimes afforded me enough time to fall asleep for an hour, but this night was different.  I couldn’t fall asleep, the raw burning itch was unbearable and my tummy began aching like it was being stretched beyond capacity. I pushed the sides of my belly together to provide some relief to the bruising sensation just below my belly button.  My first thoughts were that one of the babies were probably turning and that the pain will relent once the baby has found a new comfortable position. It didn’t.  A little later I came down with an upset stomach, visited the loo, and back to bed. I had one or two sore contractions, which I believed to be too far apart to mean anything.  Not much later the vomiting started.  At this point (3AM) we started phoning our moms for advice. My mom told me to go to hospital immediately (I wasn’t quite convinced, but decided to go anyway), so we proceeded, all-a-vomitting to the ER.

Once admitted to the maternity ward I was wired to a dopler and a device measuring uterine contractions. The graph spiked off the charts, I was still in denial, believing that what I had was some kind of stomach bug. Maybe from something I ate? Clearly still completely in denial that this was actually happening.  The nurse seemed notably rattled and proceeded to call my obgyn.  All the while I was fighting for my own consciousness as I heard the nurse saying, “No! Don’t faint on me, Maritza! Don’t faint on me, wake up!” I could feel the darkness closing in on me and could see little sparks like stars in the darkness as my eyes closed involuntarily. The IV brought relief and I regained consciousness.  My obgyn arrived a few moments later, frazzled in bed-hair.  He told me: “It’s time”.  I was shocked, and in utter disbelief signed the consent papers to proceed with the C-section. I opted for general anaesthesia as I wasn’t up to coping with any more drama or being traumatised by any more pain. I was so deeply exhausted and had little to no reserve left to cope with more sensory stimulation so I asked them to turn the switch off and make me go to sleep.

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Moments later I woke up in terrible, terrible pain. I huffed and puffed like I was in labour all over again.  The nurse was quietly encouraging me and kept telling me that the pain meds will start working soon.  What I didn’t know when I opted for GA is that I would wake up without any form of sedation or pain relief and would have to fight my way through the first 30 minutes of pain until the pain meds kicked in. It was sore, very, very sore. In all this mess and suffering the theatre nurse kept reassuring me that my babies were doing well and that she prayed for them as they entered the world, I cried and said thank you as I huffed and puffed my way through the pain.  I could hear my husband at the door of the theatre asking for me, but the nurse told him that they are waiting for the pain medication to take effect before I could leave for the maternity ward.  I said some things to people which to this day I still don’t remember, including a phone conversation with my brother.

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Hours later I was fully conscious and wheeled into the NICU on my bed and could have a peek at my babies.   Those moments between the maternity ward and the NICU, on my way to meet my babies were the most beautiful moments in my life.  I was relieved, relieved that I brought them into this world alive, relieved that I was alive and deeply relieved that I would experience motherhood.  Those moments were flooded with joyous perfection.  My life was perfect. I was loved and had two children to consummate that love. I looked at Lize first, her body was covered in patches, all wired up with machines beeping, beeping, her face was covered with an oxygen mask, but I could see her profile and I knew. It was in that moment when I moved into myself and the world felt distant, I felt like I was in a bubble where I knew the truth which no one else seemed to see.  The story of Nella Cordelia (a story I incidentaly stumbled upon via twitter a few weeks before) flashed in front of me and I knew. The emotions that welled within me did not seem foreign, I recognised all of them as Nella’s story flashed in front of me. I knew she had Downs syndrome from the first moment I laid eyes on her, even before my paediatrician knew.  My pead only made comments about her condition days later as the swelling disappeared. All the while I kept asking “Are they both normal” and everyone kept answering “They’re both doing very well”.  It felt too silly to ask out right “Does Lize have Downs?”, what if I were wrong?  How embarrassed would I feel?  I refrained from asking and protected my heart by keeping my feelings distant as I saw the inklings of a tsunami roaring on the horizon.  The nights in hospital were long and tiring as I battled through much left over pain and itch from the rash which still didn’t relent.  My mind was busy, trying to figure out what I would do with the news I was dreading to hear.  Three days passed in a haze. I can remember distinctly, holding her, cuddling her, warming her as she laid on my bare chest with her bare body tangled in wires.  That’s when the aching started, when my heart felt like it was being electrocuted, spasms of pain shot through me as I considered the possibility, the possibility which my heart knew before my mind was sure.  Feelings flooded within me, feelings I couldn’t show because I was too afraid I was wrong.  Three days later I came home.  Babies remained in NICU.

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Friday morning I woke up late morning when my husband came home from NICU walking into the bedroom, his eyes were red and before he could utter the words I knew what he was going to tell me but was too afraid to hear.  First he told me that he loved me, very much, and as he said those words he burst out in tears, and I knew, and I cried, I cried like I’ve never cried before and we held each other as we cried together and wept.  It was the single greatest moment of loss I’ve ever experienced in my life, I felt utterly helpless and sad and angry. I so desperately wanted it to be fixed, to be gone, to be untrue, but I knew.  It felt like someone I loved died.  From that moment for several weeks it felt like someone stabbed me in the heart, my heart was raw and heavy.  Inside I was a teary mess, on the outside I kept going, for their sake, they needed a mother, they needed me to be strong.  The nurses in the NICU ignored my red swolen eyes, never mentioning Down’s Syndrome, as if to afford me some dignity in a very trying situation, knowing full well that it would send me off into tears.

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My birth story, I suppose, is nothing like the typical birth story, seeing that I was unconscious during the birth.  It’s also nothing like the ordinary birth story because it was fraught with difficulty, with challenge, with emotional pain, with loss.  I lost a daughter the day another was born and needed to fall in love anew. Amidst all of this lay a little boy that needed to be celebrated, fully, a normal boy which made me feel so much joy that I refrained from feeling it too much because it felt too wrong to be so sad about one child and so happy about another.  The deeper the happiness for one, the deeper the sadness for the other.  So I waddled emotionally on the tightrope of remaining in control.  The problem with “remaining in control” is that it wells up emotion until it wells up too high and somewhere something gives.

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The twins spent 21 days in NICU. 21 Long tiring days of commuting between home and hospital, 3 hourly breast milk expressions and the emotional burden of learning about Lize’s condition all took its toll resulting in what I now believe to have been an ulcer.  Luckily my recovery was swift and the stress gradually wore off relieving my morning stomach cramps.

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The hardest thing about learning about Lize’s diagnosis was the conflicting feelings, feelings I dare not admit to others, feelings I am ashamed of having felt.  My world of perfection, my world of “only the best” of “fast” and “achieve” and “intelligence” did not have room to accommodate “slow” and “challenged” and “retardation”.  This tragedy could not be happening to my daughter, to my angel daughter for whom I had the highest hopes and dreams.  I wanted to lift this veil from her face and see who she was supposed to be, who she would’ve been if she wasn’t born with one stray chromosome.  So many scenarios flashed in front of me, of experiences I probably would never be able to share with her, the pain of not being able to bear children or live completely independently.  The pain was intense and numbing and after a while I forced myself to not think about these things because it was burning a hole on both my soul and my stomach.  It was here where I truly started to live one day at a time.

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I still hurt, sometimes, when I hold her close and I recognise features of my own face when I was her age, and I wonder, what if.  Swiftly however those thoughts are replaced by pure love and thankfulness, thankfulness that I get to hold her, thankfulness that I get to know her, thankfulness that I get to teach her and guide her and protect her, and thankfulness that she gets to teach me what it means to truly love, without exception, without condition, without expectation. Just to be, and to love.

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The complexity of the feelings tied up with Lize and her diagnosis has made it difficult for me to truly come to grips with motherhood, to drink it in and soak it up, but I’m getting there and can’t wait for these two little angel faces to speak and interact and understand when I tell them how much I love them.  For their sake I have to calm my heart and learn to accept the way things are so that we can all grow and learn together.  I enter motherhood with a multitude of questions, of not knowing and having to learn to put my need to know on the back burner and accept that some questions will remain unanswered indefinitely.

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Here begins a new journey of not knowing when or why or how, of self acceptance, of other acceptance, of being more forgiving and learning to find perfection in every imperfect moment.  Joy amongst uncertainty. Enter motherhood.

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P.S. To all who held my hand to this point in time (you know who you are). Thank you muchly.

Welcome 2010!

It’s 3.46 am 1 Jan 2010, I’m 23 weeks and 2 days pregnant with twins. I’m sleepless and simply can’t get over how HUGE I’m feeling. I’m praying for sideways expansion ’cause seriously any more forward expansion and I’ll be tumbling over real soon.  Below, a pic of myself on Christmas day seated on my Christmas presie on which I’ll probably be spending a lot of sleepless nights like these, at first nursing my increasingly unmanageable tummy and later nursing two anxiously awaited little creatures. B.t.w Don’t be desceived by how small the lounger makes my tummy seem, it’s HUGE and soon I’ll update you with another sideways shot to evidence the point.

Lounging

I bought myself a dress yesterday, to see if perhaps it’s not the wiser choice in my current condition, I ended up laughing myself in a state of near shock. I refuse to show anyone what it looks like.  You’ll have to take my word for it. It’s a sad, sad little picture.  Fashionable will have to escape my vocabularly for a while.

Then, in case you wondered, little Lulu is still the sunshine in our lives. She’s undoubtedly the cutest dog ever.  She loves meeting and greeting every single dog and man she runs across on the beach and has no fear of water whatsoever which normally results in daily baths during the holiday season to wash off sea and sand.  She has an obsession with fetching balls and digging holes in the sand.  She also loves chasing after her own breed, especially Pesto (her imaginary boyfriend) who lives two houses from our beach house.  Unfortunately he has been neutered so it will have to remain what it is, a summer romance.

Lulu

P.S. This is a rather untypical picture, normally she’ll be looking much more grungy and grimy, her most joyful state of being. This was taken a few hours after a bath.

She’s beginning to look just like her mom, only her mom has a better hairstyle ’cause she probably isn’t a hardcore outdoorsy dog that gets things stuck in her hair on a daily basis.

lulu-mom

2010 is going to be a year of huge change for us and will be ushered in with great discomfort (already struggling not to keep my hands raised behind my head to ease my cramped breathing space).  Can’t wait to put the pregnancy phase behind me and get on parenting, it has undoubtedly been one of the most uncomfortable things I’ve ever experienced and is testing my patience and endurance on a daily basis.  Each time however I feel the little buggers moving and kicking, I’m reminded what it’s all about and feel deeply thankful to be able to experience this rite of passage and this very special and intimate bond. Simply can’t wait to meet them!

In the meantime I battle to stay sane and keep them safe and sound for another 14 weeks. It’s going to be a tough three months!

A little Update from Fat-Belly-Ville

Testing, testing…testing 123.

I probably don’t deserve the title of “blogger person”, more like “lame ass non-blogger who refers to herself occasionally as a blogger”. Anyhow, let’s forgive and forget and move on to more important bits.

Did I mention I’m 21 weeks pregnant! Whoop! Whoop!

I will relieve you from your suspense and reveal to you my first open-to-the-public belly pics:

Just to put it into perspective, especially those who think I’m still small. This was April 2009, 7 measly months ago:

See what I mean? Yea? No? Oh well, whatever!

So what has happened between 12 weeks and now?

Well, our 17 Weeks fetal assessment showed no abnormalities, which came as a great relief!  After that I suffered a terrible bout of Flu, which had me staring blankly at the ceiling for about a week.  Full recovery took about two weeks (after a good dose of Augmentin).

Our 21 week assessment went fine as well.  Boy twin seems like an avid boxer and girl twin jawned twice during the scan (she clearly finds our keen interest in her wellbeing very boring and over rated). The day after our 21 week assessment the little buggers gave us a terrible fright by pushing down too hard on my bladder (which resulted in a little involuntary spill, which I thought to be amniotic fluid).  I was admitted at the Medi-clinic and they had me stay for the night to monitor for any further leakage. In a nutshell, I was admitted to hospital for peeing in my pants! Wonderful! Seems like motherhood seems to make fools of us all! An internal exam the next morning showed no evidence of amniotic leakage.  The little incident however shook us up a bit and made me realise just how important the next 7 weeks were and that I probably should be more careful and take extra precaution during the next few weeks (as opposed to waiting till I can barely stay on my two feet).

My feet and back are killing me and I’ve gained about 12kg’s!  Frik, I don’t know how they’re going to make space for another 4 months of growth, but I’m preparing myself for a LOT of discomfort and time spent on my beeeehind.

Hope to update you soon on more of Fat-Belly-Ville!  Have to go take a shower, the heat is killing me!

Dreams

Been a long time since I’ve posted.  Been a long time since I’ve felt well enough to have a free minute to think and write, every other productive minute has been filled with work and settling in in our new home.

Despite all the busyness I’ve been thinking a lot about my life and what I want to do with it (I normally overthink things, hence the magical balance that my husband brings to our marriage, he does first then thinks). Anyhow, we were having a braai the other day and my husband asked one of our guests what she would do with her life is she had no limitations, that is if she did not have to support herself financially with what she chose to do. It struck me how clear she was on this, I envy that type of clarity.

At university I used to be so clear about what I wanted to do with my life that I couldn’t imagine doing anything other than what I planned at that stage (being both a counselling and research psychologist).  Life happened in between and I became less sure of what I wanted to do and now that I’m in a position that I really have many options to explore, I REALLY don’t know what I want to do.  Seems like the more freedom you have the more difficult decisions become.   Maybe then limited choice is a blessing in disguise?  In a sense I’m crippled by too much choice and a hashmash personality that doesn’t like to be pinned down to one thing.

My problem is mainly that most things end up boring me, I set out in a direction and once I get a feel for the subject area I become bored. I also have multiple modes of functioning. Part of me likes to manage crises, run around, problem solve, another part is obsessed with the aesthetic, part of me can mull over practical and abstract systems and concepts (I love seeing order emerge from chaos), another part of me is poetic, artistic and a little deranged, part of me even likes working with my hands (to much of DH’s frustration seeing that I always want to fix things myself instead of hiring people to do it).

What complicates things most that I need an emotional connection to what I choose to do to make it sustainable, so I continuously keep asking myself, what do you want to do with your life?

Here are a few of the options:

I take up my studies again and qualify myself as a psychologist and specialise in the development of personality, including childhood development and helping parents identify emotional and intellectual strenghts to develop their children optimally with programmes aimed at educating adolescents on career options that fit their strength-profile.

I coordinate the writing of a book on above said topics by engaging experts without actually slugging my way through a masters and doctorate degree.

I become involved in the development and upliftment of informal childhood development projects (like play groups in disadvantaged communities).

I raise awareness on parenting skills, especially aimed at the optimal emotional and intellectual development of children.  Structured play etc.

Set up computer literacy training centres for children, teaching them how to research, learn and communicate with technology.  Learning them through play projects to collaborate and work in groups.

Start my own ceramic studio.

Set up a practical and useful online social community for my area, to encourage community engagement and connecting of women and indirectly families.

Set up a second hand bookshop/coffee shop that will draw people in to relax and socialise, with book readings, book clubs etc.

Be ubermom.  See where motherhood leads me and serve the needs as I see them arrive.

Become a psychologist specialising in Infertility.

Get myself so far as to fire up online projects I’ve started in the past, that have fallen by the wayside.

Refine my cooking skills by completing an advanced cooking course.

Refine my photography skills by completing more projects and speding more time behind the lens.

As you can see, I have enough to keep my dreamy hands busy for a lifetime, and a lot of it is tied up in motherhood and things you get closely involved with by being a parent (hence my deviance from those fields since my struggle with infertility).

For now however, these things mull in the back of my mind as I try and push myself (and our two babies) safely into a new era of our lives, continually made aware of the fragility of it all and terrified by how suddenly it may change.  I try to focus myself on today and tomorrow and try not to push myself ahead too far into the future becuase now there is nothing more important than the treasures I carry and transporting them safely into this life.

What are your dreams, and what would you do had you had the freedom to pursue anything regardless of financial security or gain?

Fetal Nuchal Translucency, Down’s Syndrome, Chorionic Villus Sampling (CVS), Amniocentesis

Been going through a terrible time of late after we got a “upper end of normal” result at our 11w2d scan.  The result for both fetuses was 2.5 mm.  After discussing the risk factors and stats we decided we didn’t want to pursue further testing as we felt that there was no need to pursue invasive testing (CVS) if we didn’t intend to terminate under any circumstance.  I then went for another scan 12w5d at another gynie, the result of which is currently unclear (more on that later), but which seemed to my untrained eye to be 4.5. It also seemed as if the nucal was visible from the top view of the baby, which caused great alarm on my part.  He only mentioned that one seems to be normal and the other not. After scanning I asked the result from the Dr. who responded that he will forward a report via fax to the sonographer that will perform further testing (fetal assessment center), at which point I realised I will not get along with the Dr. I was emotionally drained and didn’t have the energy to have the “I am entitled to my results” talk, and very politely said my goodbeys and paid my bill.  Very few things in this world infuriates me more than a medical practitioner without emotional intelligence who believes that patients are incapable of mastering medical information.  Apparently you need a medical degree to understand a bell curve *shrug*.

Anyhow, I left his consulting rooms confused, rattled and anxious and immediately followed up by arranging a fetal assessment at Kingsbury Fetal Assessment Center in Cape Town – Tel: 021 683 4653 (which was going to happen just the NEXT day).  After much discussion and tears we decided we could not buy our own peace of mind at the risk of our babies (should a CVS be performed) and I proceeded to cancel the appointment that was so kindly arranged by Elizabeth at Kingsbury at such short notice.  They were extremely kind in their response and I was choking as I said goodbey on the phone, trying to gulp down my tears.  The pressure of HAVING to do the assessment (because the expert assessor Shannon Morris was going on leave) on such short notice just broke me and I had to go with my gut feel and cancel.  The screening would have involved last minute travel arrangements to Cape Town and a lot of stress after an already long day of emotional upset and just did not feel right.

In the fuss of arrangements (trying to get my blood group from Vitalab) for the Kingsbury scan I spoke to one of the nurses at VL and she asked if I was aware of Prof. Nicolaou Tel:011 883 3070 at Morningside Medi Clinic and that they performed a bunch of non-invasive tests, I wasn’t and decided to investigate.

The nurse (Sharon) at Prof. Nicolaou’s rooms was extremely helpful and talked me through all my options and was equally infuriated at the Dr. who refused me my results. I requested that his report be sent through to Prof. Nicolaou’s rooms.  Interestingly Sharon said that most of the time amnio is better with twins as the positioning can be problematic with CVS, she also mentioned that they now have software and updated stats that improves the efficacy of blood results on twin pregnancies. I sighed a sigh of relief to finally hear a person speaking a language I could understand.

I now have a 17w appointment where they will perform all the available tests and allow us to decide based on the results of those tests if we wish to proceed with an amnio.

So, we now wait for 17 Nov when we’ll know more about the status of the twins.

I think the message that needs to be put across very clearly is that Fetal Assessment does not necessarily HAVE to involve invasive testing and that Obgyns are responsible for communicating risks in a sensitive and clear manner.  No one should be manipulated emotionally into going for further testing by ANY means.  The work of a physician is to put the facts on the table and help patients to navigate their way around the implications of those facts.

Some useful info:

What is fetal nuchal translucency?

Abi Berger, Science editor

In the fetus fluid collects behind the neck, much like it does in dependent ankle oedema in later life. This occurs partly because of the fetus’s tendency to lie on its back and partly because of the laxity of the skin of the neck. As with ankle oedema this accumulation of fluid can represent the end point of several pathological processes, including heart failure. Fluid collecting behind the neck can be detected as nuchal translucency by ultrasound scanning, and it can be measured. The more fluid that has accumulated, the greater the risk of an abnormality being present.
Chromosomal abnormalities—for example, Down’s syndrome—can cause fluid accumulation. Chromosome 21 contains the gene that codes for type VI collagen. In trisomy 21 one subunit of this collagen can be overexpressed, resulting in connective tissue that has a more elastic composition.
Failure of fetal movements is also likely to cause nuchal thickening. Neuromuscular abnormalities can cause poor breathing and body movements, both of which may lead to fluid collecting as happens in peripheral oedema. One example is arthrogryposis, which causes contractures and flexion deformities and can be fatal. Other causes are intrathoracic and extrathoracic compressive syndromes. If the thoracic cage is abnormally narrow or an intrathoracic lesion is present (such as a diaphragmatic hernia) the vessels in the fetus’s head and neck become congested and oedema occurs. Likewise, if heart failure occurs (due to congenital cardiac abnormalities or cardiac dysfunction) more extravascular fluid will form.
There is a brief opportunity between 10 and 14 weeks’ gestation (when the fetal lymphatic system is developing and the peripheral resistance of the placenta is high) to detect abnormal fluid collections. After 14 weeks the lymphatic system is likely to have developed sufficiently to drain away any excess fluid, and changes to the placental circulation will result in a drop in peripheral resistance. So after this time any abnormalities causing fluid accumulation may seem to correct themselves and can thus go undetected by measuring nuchal translucency.
About 90% of fetuses with a nuchal translucency measurement of 3mm (“high”) at 12 weeks’ gestation are normal at birth, while 10% have major abnormalities. Only 10% of babies with a measurement of 6mm (“very high”) at this time will be found to be normal. In centres that perform nuchal translucency measurements, once a fetus has been identified as having a high nuchal translucency, mothers are usually offered chorionic villus sampling and a repeat scan about two weeks later to exclude chromosomal or major physical abnormalities.

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114626/

Other Sources:
http://en.wikipedia.org/wiki/Nuchal_scan

Chorionic Villus Sampling (CVS)

Amniocentesis

A Dedication

I read a post on Fertilicare the other day, a post that moved me and touched me, like so many others who express their deepest pain and fear so eloquently and so real. I think it speaks of the heart that we cherish on the forum, and I thought I’d post it here to remember, remember the hardest times. Makes me so proud to be part of such a deep and caring community.

My DW – by Darlinghusband

Another week goes by my angel with many more to go
How can I get you through it?, I wish I could make the pain go
Your tears are drowning you, you can’t even breathe
All this pain and waiting just so that you will conceive

Your time has become about moments with every tear you shed
My time for you is now about how much blood I have bled.
I can hurt for you ,hurt like you , even be hurt by you
But I cannot be you , be what you are or make you new

Your pain and sadness has become so great and powerful
If only there was some way for me to make you less tearful
I’m watching you sleep now while my eyes fill with water
TELL me someone why is my wife been taken to the slaughter !

Your heart and your soul cry out for our child we have never seen
Just what is it with life sometimes that it has to be so mean?
I will now love you in ways that life simply cannot stop
Because from now on I will carry your pain and your tears until I drop.

Like I said before, soon we will meet the child we have yet to conceive
Of that I am certain no matter how long we bereave
I will always be there for you as you climb, no matter how steep
Sleep well my angel ,sleep well , I am watching over you as you sleep
Sleep well
DH

To all those in the trenches of infertility, living with the pain and uncertainty of never knowing, of living on the shifty sands of waiting and wanting, a dedication:

Wait it out – By Imogen Heap

Where do we go from here?
How do we carry on?
I can’t get beyond the questions…

Clambering for the scraps in the shatter of us collapsed
that cuts me with every could-have-been

Pain on pain on play repeating
with the backup, makeshift life in waiting

Everybody says time heals everything
but what of the wretched hollow?
The endless in between
are we just going to wait it out?

There’s nothing to see here now,
turning the sign around
We’re closed to the earth ’til further notice

A stumbling cliched case,
crumpled and puffy faced
Dead in the stare of a thousand miles

All I want, only one, street level miracle
I’ll be an out and out, born again, from none more
cynical

Everybody says time heals everything
but what of the wretched hollow?
The endless in between
are we just going to wait it out?

And sit here cold, we will be long gone by then
In lackluster, in dust we’ve layer on old magazines,
fluorescent lighting sets the scene
for all we could and should be being
in the one life that we’ve got

Everybody says time heals everything
but what of the wretched hollow?
The endless in between
are we just going to wait it out?

And sit here
Just going to wait it out
And sit here cold
Just going to sweat it out
Wait it out

The Day when Triplets became Twins – 9w2d

Nature has taken its course and the embryo with the weaker heart has fallen away, measuring 8w6d. (If you look back to the scans you will clearly notice one weaker heartbeat)

Our embryo triplets are now twin fetusses.

Don’t want to say too much about this, ’cause I don’t want to take away any of the joy we feel for the two remaining ones.

The two remaing embryos are 100% on track, limbs are now visible and both are active and moving about.

The loss no doubt stings, but we’re so very grateful for the two remaining babies.

So very grateful for their tiny little wiggly bodies, bless them.

Almost Nine Weeks – 3 Weeks to Target #1

Tomorrow we’ll be pregnant 9 weeks, horay! So far so good. Scan#2 Friday morning.

Current topic of stress:

Will all three heartbeats still be there?

Funny how what began as, “May there please be A heartbeat” now suddenly morphed into, “Please don’t let one of them fall away?” It’s in our nature, we want to nurture and protect what we have, want to keep our own out of harm’s way.  Gone are the days of triplet panic, it seems almost natural now, like it’s supposed to be, but the fear and dread of losing one or all is ever present.

Somehow I’ve got to let go and let be ’cause no amount of fretting will change the outcome which is already determined.  Can you imagine that? The joy and exhilaration which we feel now can in a second be replaced with loss and grief, and in the future I’m already grieving or celebrating, I’m just not privy to that moment yet because time, like a thick curtain separates me from tomorrow, protecting me from experiencing too much life in one moment. Keeping the future secretly brewing, like the life within me.

Despite all the fear and uncertainty, I have a deep hope and trust that we’ll be ok. The future will be ok. We will create joy and love and happiness whatever the circumstance, that my friends is within my reach today, THAT I can hold close and nurture, tomorrow is simply an extension of that which I nurture today.

So today I choose to nurture hope and certainty and happiness. Hope to see you all in that future!

In the words of a good friend: “Rainbow farts to all!”

Early Pregnancy is hard work! Not that I’m complaining of course…

So I’m a little surprised that I’m not exactly the poster kid for a glowing pregnancy, or maybe the best is still to come?  Here are a few things I was rather unprepared for:

  1. The paralysing nausea
  2. The breathlessness
  3. The exhaustion
  4. The hot flushes & feeling of burning up
  5. The heartburn, O dear! the heartburn
  6. The inability to sneeze without feeling like I’m ripping apart
  7. The chronic stuffy nose
  8. The bloating

It’s not exactly a picnic in the park, in case you were wondering. A little tougher than I imagined.  Like having the flu, going on three weeks…

I have a hair dresser appointment today and dread having to sit still for that amount of time, dread the nausea, dread the need to urinate every 30 mins.  Really hope I survive!

I’m 8 Weeks today. 4 Weeks left to the all important 12 week mark, so far, so good.

Thursday I’m off to George for the weekend and hopefully will have some energy to buy some basics for our house i.e. Bed, fridge/freezer, washing machine, microwave, TV, PVR, cutlery, bedding & towels. O the pain of starting all over again!

9 week scan next Friday, hoping for good news, then 11 week appointment with a multiples specialist Obgyn and then 12 weeks appointment with Obgyn in George 19 Oct.

So far I’m not really so fond of the pregnancy experience (yes I can say that!) as much as I want these babies, I dread having to go through months and months of this feeling of sickness and increasing pain as these three litle buggers squeeze me out of space. Nevertheless, if all goes well I probably will only have to be pregnant once in my life. (Unless that one little icebaby has ideas of its own…) I’m nauseous and breathless as I’m writing this and it seldomly relents, ever present, all the time, feels like I’m breathing hot stuffy air all the time, sometimes it makes me feel a little panicky, like I’m going to suffocate, or like my heart’s going to fail. Luckilly there are moments of relief, where I catch my breath and see through the fog of illness.

Trying to keep my eyes on the prize. I might only have 6 months left to go!

Thankfully I don’t need to do much work at the moment, just some bills to sort out and the move to George. I don’t know how you working folk cope?! I really don’t know. (hats off)

My biggest challenge, to keep these babies safe and sound and growing for as long as possible. The first prize, full term triplets! (yes, it’s been done before…)

Really hoping the symptoms will ease up a little after 12 weeks, otherwise there’s a looooong 7 months ahead!

It’s Triplets! – 7 Week Scan

Thursday 10 September 2009 will remain in memory forever. It was the day we saw the heartbeats of three little creatures fighting their way into life, a momentous day on a three year journey of LOTS of hard work and persistence. It was the day I finally believed we could do it, we could conceive.

It’s rather shocking to find out that your first pregnancy, which you thought would be impossible, turns out to be a triplet pregnancy. The feelings leading up to the scan are terrifying, to say the least, and your mind plays tricks on you round every turn.  You would not believe it, but on our way to the clinic we even discussed how odd it would be if there were nothing, then all my symptoms would have been psychosomatic, a phatom pregnancy. DH said he would not be appreciative of the many runs he had to make to shops and restaurants and midnight snacks if the scan turned up nothing. Knowing the sheer strength of my imagination this thought struck me with fear and horror. Maybe it was indeed all in my mind…

Enter into Evidence – Ultrasound One – Week 7

Babies

Yay! I’m indeed not insane.  As you can see, three babies create a hefty amount of paperwork.

Baby1

I could not believe how quickly Dr.V picked up this little bugger, the embryo is hidden away on the backside of my uterus and only faint lines and a beating heart was visible, a little smudgelet of white noise beating away.

Baby1

Babies no 2 & 3 were clearly visible and were pretty easy to find and measure.

Baby2

Baby2

Baby3

Baby3

I immediately spotted three dark spots and initially thought that maybe it was something else, they’re a lot like follicles, big and black.  When I realised they were actaully the embryos, I noticed the one sac was empty and immediately thought, ok, twins, but Dr.V kept screening, somewhat concerned by what he was seeing, perhaps panicking that he might discover yet another. But that was it, four sacs of which one was empty.  They all measured on target for 7 weeks (10mm) and heartbeats were 150. So far so good.

The day was exhausting, especially taken the fact that I barely slept the night before and the many phonecalls and sms’s that begged our attention.  What started as a joke amoungst our friends and family became reality and now we really need three of everything, all at the same time!

I’m exhausted & hungry & nauseous! Pretty much all of the time. But very, very thankful. Thank you Lord, we prayed so long and hard for this.

My next scan is in two weeks with Dr.V and I have an appointment with a multiple pregnancy specialist in four weeks (6 October).

All on track and very, very pregnant, hard to believe but my tummy is already buldging!

Hoping to take these three all the way.

  • The Short Version


    2 Years 9 Months
    Clomid Timed x 2 (BFN)
    IUI x 4 (BFN)
    IVF #1 (BFN)
    IVF #2 (BFN)
    FET #1 (Cancelled)
    FET #2 (BFN)
    GIFT #1 (Cancelled)
    GIFT #2 (BFP)

    Journey to Here

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