Thalia's fertility journey

Fun in the middle of the night

I seem to be suffering from early morning insomnia. I wake up some time between 430 and 545 and can't get back to sleep. This morning I woke up on the early side, but managed to get a comfortable nest set up on the sofa, and dozed off again around 6. Only to be woken by a loud crash at 630. It took me a while to figure out that what had happened was that a picture had fallen off the wall above our coffee machine, bounced off the coffee machine and slammed onto the floor. Nice. Luckily the coffee machine is working, albeit with a broken lid, because not being able to get cofee at this point would be a total disaster.

So I haven't had much sleep. Luckily I'm not going to work today or tomorrow, so I can nap at various times which will really help. Off to see Dr OB later this morning, I don't expect him to say anything interesting other than 'get a scan next week' given the baby hasn't moved and I'm still feeling fine, albeit with swollen ankles (not fingers), and plenty of heartburn and general grumpiness. Having a baby's head shoved into your ribs is not a very comfortable thing to live with. Bending forward is no longer even a vague possibility.

It still hasn't sunk in that we could have a baby in as little as 2 weeks time. The house is an utter mess as the basement still hasn't been re-waterproofed since the flood, and Pob's room has just been painted, so the furniture for her is just sitting in boxes in the hall. We got a new printer, that's still in a box. We had to move all H's camping and golfing stuff, our shoes and coats out of the basement so those are scattered over our living room. The study floor is covered in paper as H tries to sort out his filing system. My papers are in piles all over the house as I wait for him to find some space in the filing cabinets for me to file them. I still have books in boxes from when we moved house, but there are no bookshelves for them. We've had mice so there is poison and traps under the units in the kitchen. You get the picture. None of this is life threatening, but I'd love to be more organised. I'm not a tidy person, but from time to time am good at doing a massive spring clean, often around the jewish new year. But work has left me so knackered that I've done very little in the house for the last few months, and it shows. Luckily we have a cleaning lady, so it's not too disgusting, but she doesn't get to the big stuff like cleaning bookshelves, stairs etc. We're getting a cleaning service in for 2 days next week to do a thorough spring clean, but they can't do the paper filing for me...

Anyway, it will all be fine in the end. I either will or won't sleep, the house will or won't get tidier. I will or won't have time to finish those posts I've got brewing about my antenatal classes, and a couple of scientific publications that have come out recently. But either way, we'll probably have a baby home with us. In 29 days at the latest. Wow.

Away in the frozen north

Apologies for lack of update, as previously mentioned it's been busy at work, plus we're trying to get stuff in our house sorted (I never told you about our flood, did I?). We were planning on leaving on holiday on Friday night but had to delay til Sunday just to get stuff done in the house on Saturday. It was a long drive north, but we arrived late on Sunday night and immediately felt more relaxed. I'm working very hard not to think too hard on the fact that it was probably while we were here 16 months ago that our first pregnancy ended. This is the first time we've been brave enough to return. It's a lovely place, and I don't blame the place for the miscarriage. I know it's an association rather than anything more. Hopefully this visit will kill that ghost. I have, of course, checked which local hospital we need to go to if I start to bleed or if my waters break. There's a good consultant-led unit about 20 minutes away, and we both know the route to get there. What me, suddenly become an optimist? Surely you jest.

I do have work to finish up - hence turning on the computer this morning, but we've also visited our favourite gardens, cooked a Roast Chicken dinner, watched The Bourne Identity, I've started and finished my first book of the holiday (highly recommended, especially if you used to be or are now a scientist), and I had a 2 hour nap yesterday afternoon. It's good to have a break. There's really no signal here to speak of, so I'm hoping this post doesn't get eaten by the system when I try to post. I'll keep hoping.

All is well with the Passenger. I had a horrible dream last night that she had died inside me. I kept trying to find her heartbeat with the doppler but secretly knew it wasn't there. People kept coming in to use the room I was in and I was getting increasingly desparate and started getting quite rude as I tried to make them go away. At one point I saw her projecting out of my right side, and I tried to push her back in. She did go in, but I still knew she was dead. As you can imagine, when I woke up from that one there was no going back to sleep. I got up and ate some breakfast to try and get her going. And within about 15 minutes she was wriggling away, thank goodness. It was horrible while it lasted, but I suppose it's a normal anxiety dream at this stage.

The 'projecting out of the right side' thing is probably related to my worries/discomfort with her position. Having been breach, she moved to obliquely transverse about 2 weeks ago. Her head is under my right ribs, her bottom is down by my left hip (best guess, I haven't had another scan, although the doc agrees). In this position they won't even attempt an external version as apparently it rarely works on transverse babies. So the next step is a scan at 37 weeks, and then we make a decision. If she is breach or transverse, and if an external version doesn't work if she's breach, then we schedule a c-section, they won't do a vaginal delivery if she's not head down. We'll see what she decides to do. I'm still doing ok - blood pressure is a very healthy 105/60 at the last check, last week. Bump measures the right size, urine is fine, she moves around quite a bit, etc..

I am increasingly uncomfortable - breathing is hard sometimes, it's hard to sleep as my hips start to ache after an hour or so in one position. Turning over in bed is quite a palaver. Getting up and down from sitting is hard, and I feel like a barrage balloon. I can't walk very fast, and have a lot of heartburn - both when I eat and when I don't, which seems a little unfair! Until this week I'd enjoyed being pregnant so much, I wasn't sure I was ready to give it up. But now I can see that after another 5 weeks (or, most likely, less) I will definitely be ready to meet her properly. When I do I think I'll still miss the bump, miss seeing her move under the surface of my skin, miss that feeling of the utter miracle that she has grown inside me all this time, that all my organs have moved aside to make sure she has enough room. H and I have barely stopped marvelling at how lucky we are, how extraordinary this is. Pob* will be here, all being well, within 5 weeks. It's hard to imagine what that will be like. But yesterday we bought her a little stuffed eiderduck (native of this area), just one more thing we're doing so that she knows how much we were thinking of her before she even got here.

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* Pob is the nickname we've been using for the passenger. It stands for 'passenger on board' which is what the drivers who regularly pick me up for work say a lot. It's also the name of a character from children's television back in the 1980s. It seemed to fit.

Coffee, nectar of the gods

A long time ago, when we first started trying to have a baby, I gave up coffee. It nearly killed me. I love coffee with a firey passion. I drink it black, and I savour every mouthful. I never drank more than 2, perhaps 2 and a half cups of black coffee a day, and I enjoyed every bit of it. I was quite fussy about what quality of coffee I drank. No instant coffee, no bad meeting-room coffee, no Americanos unless I was absolutely desparate. The only coffee chain in the UK which actually brews coffee rather than giving you an Americano is Starbucks, so that's where I went. At home we drank single-source coffee, from beans roasted the day you order them.

Initially I cut back a little by ordering a half-decaf, half-normal brewed coffee at Starbucks on weekdays. Then Starbucks stopped brewing decaf coffee in the UK so that was out. Around this time a study was published which showed that consuming levels of caffeine above 300mg a day was associated with an increased level of miscarriage. We'd been trying for about 6 months. I wasn't consuming that much coffee, but I figured that if 300mg caused a problem, why was I tempting fate by consuming any coffee at all? So I went cold turkey. I also gave up diet coke, mostly because of the aspartame, but I could not countenance giving up chocolate, so that stayed on the cards. So I was getting some caffeine but not much. I substituted funky teas for coffee, and I missed it, particularly at the weekend when H would brew up a pot of lovely smelling coffee and I'd be there with my cup of green tea.

And then I found out that green tea can reduce absorption of folic acid. Which I'm already prone to be deficient in, given my MTHFR homozygosity, so green tea was out. I switched to the Tazo tea, Calm, but clearly it wasn't the same. No jolt of energy, no lovely complex smell to inhale.

This went on for some time. Gradually I started to feel resentful. I'd had enough of deprivation. Two years of failed cycles and miscarriages made me feel I deserved to eat the things I liked. And given everyone around me seemed to get pregnant happily on a diet of coffee, wine, and rich food, I didn't see why I had to suffer. So the coffee started to sneak in. At first it was just off-IVF cycle, while I was on zoladex anyway, so no chance of conception. And it was half a (small) cup of coffee, at the weekends, at home. And then sometimes on weekdays too, if I wasn't rushing off to work. I still hadn't picked my Starbucks habit back up.

And then we went on holiday to Morocco for my birthday. And we know now that I was already pregnant. And I had wine every evening for dinner, and coffee, plenty of it, for breakfast. And somehow, not that miraculously, this embryo hung on despite me creating what Zita West would term a 'toxic uterus' for it. Given this, even once I knew I was pregnant, it was hard to justify being that abstemious again. Of course I stopped drinking alcohol again. To be honest, I can take or leave alcohol anyway, so that hasn't been too much of a hardship. I've allowed myself a few sips of H's wine at dinner, and that's been mostly ok. But the coffee? No, that's a different story. I stuck to the 'coffee at weekends' rule for a while. And then I had a less busy period at work so I was able to have a bit of coffee at home on weekdays. And that turned into most weekdays. The passenger was thriving anyway. I kept going, limiting myself to only drinking coffee from our home brewing, not buying it elsewhere.

Until last week. Last week was very very busy at work. I had to work til 10 a couple of nights (normal in my job, but not normal for me recently). By Thursday morning I felt really really rough. So I went to Starbucks. And I ordered a tall black coffee. Which I drank about 3/4 of. Oh baby, forgive me. But it was good. I haven't been back. But I worry I've now crossed the Rubicon and I'll find another day when I need that weekday cup of Starbucks. And there won't be an obvious reason to resist.

Anyone got any suggestions for how to wean babies off their caffeine addiction?

You know all that debate we had about vaginal birth versus C-section?

I have two baby updates to do. This is going to be a pretty happy clappy post, so if you are not in the mood I totally understand. Also, there are pictures at the end. I've made them small enough I think you'll have to click on them to see them, but just so you know before you get there.

Last Thursday we had a regular check-in with Dr OB. Blood pressure is 110/65 so that's all going well, no protein etc. in the urine. He couldn't be sure of the baby's position but thought she might be breach again. He did, for the first time, measure my fundal height with a tape measure - usually he just uses his hands. He commented that I seemed to be a bit ahead for dates, and that we should check to see if the baby was measuring big and if so, perhaps repeat the gestational diabetes test. I had booked a scan for Monday at our favourite clinic, where we did the 12 week and 20 week scans, so that was just something to put on the list for them. I do wonder about this fundal height thing. I have a bit of belly fat at the bottom of my bump, doesn't that distort the measurement? If he's never measured it before how does he know what's me and what's baby growth?

He also repeated the induction conversation, and it became clearer that they really won't let me go much beyond 39 weeks. He said they'll take it on a week by week basis - if I come in at 38 weeks and the head is engaged and the cervix feels soft, it's time to induce. If the head is still high and the cervix closed, well then they may wait a bit longer. We'll see. We left feeling quite calm and optimistic for a change!

Yesterday's scan was quite miraculous. The first thing that happened was that the sonographer exclaimed how the baby was in a great position for a 3D picture. Before we knew what was happening, there was the passenger's face in front of us. Just the most extraordinarily wonderful thing. She looks like a person! We got two great shots of her, which are below. She was busy yawning and swallowing. It's always utterly miraculous to see her swimming around in there at every scan (and, gulp, she's been scanned 11 times so far in this pregnancy. Please no one tell me scans are bad for them), but to see her in 3D is a whole 'nother level of miracle. I don't know who she looks like, it doesn't seem to be much like me, but she looks amazing. And real - so real!

The rest of the scan went well. She is pretty much average size for this stage of pregnancy, slightly longer femur, slightly shorter humerus (short arms? No good at tennis, then, H will be disappointed), big on one head measurement, average on another. Perhaps she has a funny-shaped head. She also has a big nose and long mouth (my observation, not the sonographer's measurements!), but I will love her regardless of mishapen heads and funny noses.

The only bad news from the scan is that yes, she is breach again. I personally have no faith she will turn given she's been in this position at every scan bar one of this pregnancy, although everyone says it's possible. if she doesn't turn, the whole induction thing becomes moot and we'll have to schedule a c-section. Which, despite me writing ambivalently about birth earlier in the pregnancy, I really don't want. Aurelia really helped me want to give birth vaginally, with her discussion of how wonderful it felt to be able to push those babies out. If I don't get to do that, it will be ok, but it will be a little loss. Not a big one, just a little one. We'll see.

Pictures below, look away if that's the best answer for you.

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This one will stir it all up

This morning a cross-party committee which has been reviewing the government's draft Human Tissue and Embryos bill has reported their findings. Some of these findings support the scientific community - for example, relaxing the ban on hybrid embryos for research. Some are structural or political and I'm not sure are a big deal for patients, such as suggesting that the proposed merger between the HFEA, which regulates fertility treatment, and the Human Tissue Authority, which governs research and the storage and use of human bodies, organs and tissues, does not go ahead.

And then there's the one that I can see a LOT of debate about. And it's the recommendation that donor conceived children have this on their birth certificate.

As you probably know if you read any UK-based in/fertility blogs, last year the government introduced legislation that said that donation of sperm or eggs was only allowed if the donor was prepared to be contacted by any resulting children when they reached 18. That is, the end of anonymous donation. This led to an immediate shortage of sperm donors in UK clinics, which almost matched the extreme shortage of egg donors which has been there for years. The responses to this have included campaigns for donors to come forward, and, I presume although I've not seen any figures, an increase in people going abroad for treatment. My clinic, for example, has no egg donor list, but cooperates with a Spanish clinic which can organise anonymous donors.

If I understand this suggestion, and I haven't read the report itself so I could be wrong, even those who conceived via an anonymous donor in Spain would have to record this information on their child's birth certificate. That's a big change.

The debate about what to tell a child of donated gametes, and what to tell, is a really tough one. Personally, particularly having read the blogs of children and young adults in that situation, plus all the long-received wisdom about adoption and how much better children cope when they know they are adopted as part of their life story (and yes, I am well aware that donor conception is NOT like adoption in many ways), I would want to tell my child. I don't know how I'd tell them or when, given that they'd likely start asking around 2 or 3 and heaven knows how you turn donor conception into an understandable story for a 3-year-old, but I'd want to tell them. For me it would be dishonest otherwise (one of the arguments being made by one of the MPs involved is that NOT putting this information on a birth certificate is tantamount to the state lying to the child), and just setting up the family for later trauma. I don't think it's possible in this day and age that the child would not find out at some point. What happens when they do the genetics part of biology in secondary school and come home to ask mum and dad if they can smell fresias or if they can roll their tongues, or if their ear lobes are attached? What happens when they need a blood transfusion and find out their blood type? There are just too many opportunities for your child to feel you've lied to them. I don't think I'd be able to do it.

Let's be clear, I say think here. I haven't had to be there, so I don't know for sure. But I do think that's what I'd do.

But putting it on a birth certificate I imagine is a huge deal for the parents involved. Birth certificates don't come up at family occasions, as a rule, but it does remove any element of choice from this big, big decision. Is this right? Who should get to make this decision - the tell/not tell decision?