Venting

[VolvoFan]

Not sure if this should be in 'AIBU?', but it's about conception, so thought best to put it here.

It's a long one, sorry.

I'm 36, DH is 35. Two years of trying for a baby. I was 34 when we started trying. We want two babies, even three would be nice. But we can't even seem to get one. We know we left it a bit late, but not that late. We cracked on.

First year of trying was natural. My cycles can vary between 32 and 35 days long, so I track them. No stress. Just pee on a stick, take a photo and check reading. Then if LH is high/peak, DTD. I got pregnant on the first month of trying after getting to grips with LH testing. My period came two days later.

Got pregnant again 6 months later, my period came about 3 days later. I turned 35 a few months later.

We find out DH has low sperm, about 11 million per millilitre, but above average in other metrics like morphology, progressive motility etc My AMH came back decent for my age and I have 'a beautiful uterus' according to my fertility consultant. I am very socially awkward and almost said "Thanks, you too." during the consultation. Let's face it, it's not an everyday kind of compliment, but I felt very reassured none the less.

Second year we started IVF. January 2023 I had my eggs harvested. 30 or so eggs collected, good number they said, about half of them immature which is normal. Seven made it to 5 day blastocyst, but two were discarded because they weren't good enough to survive being frozen. Five embryos, 1st transferred in March, implanted but pregnancy test came back with a weak positive, lost it at about 2 weeks. 2nd transferred in around June time, no implantation and negative pregnancy test. Took a break from IVF and tried naturally for a while.

3rd and 4th transferred in October, one failed right out of the gate, the other implanted but died at about 3 weeks. It became an MMC and I now have retained products for which I'm going to my local EPU to get sorted out after Christmas.

I have one more embryo left in the freezer (that sounds so odd to say out loud).

I'm going to get some tests done in the New Year to see if I have any disorders that could be preventing implantation and/or killing the embryos.

We do still want children, I don't quite know about DH, but my longing is gone. I am fed up. I don't get jealous of other people's babies, pregnancies, scan pictures and people at work going off on maternity leave anymore. If I do get another positive pregnancy test, we'll be so happy, but we'll also be terrified of losing it again. I want to get pregnant again asap, but I'm terrified of another loss.

Am I being unreasonable for feeling this way? These days two years doesn't seem to be all that long, but we feel like we've been trying forever.

Thank you for taking the time to read if you got to the end.

@VolvoFan wow that’s quite a journey you have been on hun. I really feel for you. I’m 37 & just starting my journey for baby number 1 & god knows where it will take me! The way you are feeling is completely valid & absolutely not unreasonable. It sounds like you are going into protection mode by becoming a bit numb to it all…maybe protecting yourself from getting hurt again which is a completely normal defence mechanism.
I don’t really have any advice for your situation apart from to stay strong & get as many tests done as quickly as you can do you don’t end up another 2 years down the line & learning of issues. I wish you all the luck 🍀 x

You sound very reasonable and level headed -especially considering all you've been through. I think posts are like these are also helpful to those stressing over their TTC circumstances that often pale in comparison to one's like yours.

I'm sure you've had every advice and researched all the relevant things, so I'll avoid regurgitated.

I do hope that 2024 brings you much much closer to your aspirations. The fact that you have been able to conceive on the past does indicate to me there's certainly hope. Best of luck

@4LeafCloverBaby @Outliers thank you both xx

I'm in the expectant management phase of this latest loss. I don't think it's going to come out without help so I'm expecting to have to go back to the EPU. But we shall see. It honestly is so horrible, but so common apparently. We'll get through this, I know we will.

Update with prelude:

In the early hours of 7th and 8th December I passed big clots, and I was in agony, but nothing I couldn't manage at home. For just over three weeks after that, I had continuous brown spotting, so I went to the EPU and they saw there were signs of RPOC or at least what they found was 'in keeping with RPOC'. They sent me home and told me to get in touch in two weeks' time if I'm still testing positive.

Sunday 31st December I was at my in-laws for a New Years' meal and without any warning, I started passing more massive clots, absolutely no pain. I had to go home and ended up sat on the toilet for a little over 5 hours. No pain, just continuously passing clots.

I'm going to test again on Thursday, and if it's still a strong positive, then it's back to the EPU with the potential for looking at having surgical intervention 😩

I just want this to be over so I can move on.

@VolvoFan so sorry you are going through this. I had RPOC with my MMC in September and ended up having it removed via MVA under local which was generally a positive experience. It feels so unfair to deal with when you just want to move on. I hope it's cleared itself and that you don't have to go through more intervention. Sounds like you've been through so much and I hope this year is more positive for you.

Update with prelude:

I had another big bleed with big clots in the early hours of yesterday (Tuesday 16th).

My PT was lighter today, though I have a scan booked at my nearest EPU tomorrow morning to see what's going on.

Recap:

• FET 18th of October 2023 - private fertility clinic
• Positive PT 31st of October 2023 - private fertility clinic
• Missed miscarriage discovered 20th of November 2023 - private fertility clinic. Sac was measuring 2.5 weeks behind on a 7 week scan. No fetal pole, no heartbeat, no yolk sac, just a blood clot in a collapsing gestational sac.
• Massive haemorrhage in the early hours of the 7th of December 2023 - 1 hr on the toilet
• Massive haemorrhage in the early hours of the 8th of December 2023 - nearly 3 hrs on the toilet
• Sporadic brown/red spotting up until 21st of December when RPOC is diagnosed and blazing positive PT - private fertility clinic
• Had scan at EPU and found no sac but vascular tissue, no measurements taken - NHS clinic - still spotting
• PT next day still very strong positive - still spotting
• PT a week later begins to lighten - still spotting
• PT a week later same as week prior
• Another enormous haemorrhage on the afternoon of New Years Eve - 5+ hours on toilet, very ill the next morning but back to my usual self by the evening
• Sporadic bleeding ranging from coffee grounds brown spotting, stringy, bright red fresh blood
• Massive haemorrhage in the early hours of 16th of January 2024 - 1 hr on the toilet

Now have what appears to be a normal period . PT taken today (17th of January 2024) much lighter. Scan booked at EPU tomorrow - NHS clinic

Two months of this hell. Two stinking months.

Hopefully tomorrow brings some answers.

So I got more answers today.

Sadly while the hCG is declining, there is still a 50mm x 17mm x 9mm cystic mass that has a blood supply. The mass will pass on its own, but it's a matter of when, and in such, how much more bleeding and random gushing I'm willing to endure in the meantime.

They've suggested a D&C because that's the procedure done under GA. As I've never given birth before, they recommend the one with GA due to pain from widening the cervix.

The EPU will phone me on Monday to see how I'm feeling and book the D&C. Alternatively I can just phone them up and book it. Then I can be closer to ending this nightmare.

I had a little cry in the nurse's office before I left the hospital because I felt so overwhelmed. The nurse gave me a big hug. It's not fair. None of it is.

Very sorry to hear about this. This all sounds gut wrenching and unfortunate.

I have no wisdom or knowledge to offer, but I wish you much strength during this challenging time. Totally agree, it's unfair.

@13lucy thank you lovely xx I'm sorry I haven't responded to you yet. I've been a mess lately. I am hoping it'll just come out on its own, but I'm starting to get so fed up that I'm thinking of just going for the surgery.

@Outliers thank you lovely xx It is really, really unfair and I wouldn't wish it on my worst enemy.

@VolvoFan I totally empathise with you and was in a similar position to you. I opted for surgical management via MVA just because I wanted to draw a line under it all and couldn't deal with the uncertainty. I haven't given birth before but found the MVA very manageable and it meant I could have it done more quickly. Sorry you're in this position, it's really horrible but you will get through it and I hope you get it sorted soon.

My EPU rang me up today to check in with me, my PTs are getting much lighter now and I'm free to wait another week. I'm testing once a week and the one I did this morning is as light as a PT from a chemical pregnancy I had in April last year.

6 weeks, 4 haemorrhages and 3 scans later, I'm nearly back to normal. I will get through this.

@VolvoFan sounds like you've really been through it! Good to hear that you're almost there now - you will definitely get through it.

@13lucy yep, it's been rubbish 😩I still have sporadic brown bleeding. I did a PT this morning and the line is practically a shadow now, it's very, very faint and much lighter than last week's PT.

I've now had some clear watery discharge mixed with brown blood, so I think my body is trying to ovulate. hCG doesn't have to be zero to be able to ovulate, and the brown blood is the old lining breaking apart under its own weight.

I know it's generally a bad idea to Google stuff, but I was so curious as to what the cystic mass was. I thought it was like a placental scab or something, but I was told the gestational sac had stopped growing at 5 weeks, which is far too early for a placenta to have even formed. What's happened is that the lining has got so thick that it's turned cystic, like a sort of hyperplasia. It also has vascularity, ie blood supply, which is a result of hCG being present. My body still thinks it's pregnant, so it's still supplying blood to the implantation site.

Provided I don't develop symptoms of an infection, I reckon another 2-3 weeks and I'll get my period. It'll be very heavy and painful, but my periods have always been somewhat like that anyway.

I have finally stopped bleeding. So from the day the sac passed to today has been almost 6 weeks. My PT is still positive, but only very faintly, and it's continuing to lighten.

So I started bleeding again. It started last night in drips and drabs, and then I got a heavy flow this afternoon and passed a small stringy clot. It has now stopped. I'm hoping it was the remainder of the lining shedding in response to there being very little to no hCG in my system anymore. I haven't ovulated, so this isn't a new cycle. There was virtually no cramping either, which I can only attribute to there having been no progesterone to hold it in place, so it's kind of coming out under it's own weight with very little input from my body. The blood was a mixture of fresh red blood and old brown blood which is indicative of an old, degenerated lining. So hopefully this is the start of a brand new cycle.

I realise some people are probably thinking "Why didn't you just have the D&C? You'd have been over all this by now and already be trying to get pregnant again." You're right. However, the pregnancy ended at 5w3d in a blighted ovum. There was no placenta, no foetal pole, no yolk sac and no heartbeat. There was a gestational sac measuring about 1cm with nothing but blood in it, thus the risk of infection and uterine scarring was very low, and based on when my hCG started to fall, I passed the sac on Boxing Day last year. Waiting this out has given me a break that I didn't realise I needed.

I bled again this afternoon, heavy and passed a slightly bigger clot. I'll test my hCG tomorrow morning. It should be lighter or negative.

@VolvoFan hope you're doing ok. Sounds like it's been going on for a while now. Did EPU say whether you should speak to them if you're still testing positive?

Hi @13lucy xx I'm okay. Thank you for looking out for me. My HPT is now a very, very faint positive and I got my period yesterday. I reckon it'll be negative this time next week. I spoke to the EPU today and they were happy to discharge me and wished me better luck in the future.

I didn't need surgery in the end, and as much as it was gruelling to let my body deal with it, I prefer it that way. I can now move on and start trying again.

For anyone coming across this thread who might be in the same boat:

I had an IVF pregnancy confirmed on the 2nd of November 2023 and had a diagnosed MMC on the 20th of November 2023.

Two weeks after I withdrew the eostrogen and progesterone, hCG fell slightly and I had two random spontaneous haemorrhages and passed massive clots, one on the 8th and one on the 9th of December, both times I was in a lot of pain. I then passed the sac on Boxing Day 2023 with no pain and my hCG started falling a lot more the week after that. From the week it began to plummet, it took 8 weeks to get my period back (at the time of writing), so about 9, maybe 10 weeks to test negative. During that whole time, I had 4 random haemorrhages with massive clots (the last two with zero pain) and spotted with old brown blood every day.

TL;DR: Resolution of an MMC at 7 week scan with an anembryonic pregnancy that died at 5w3d. 3 months from the time of diagnosis to the time I got my period back. My hCG began to drop like a stone a month after the diagnosis, and then another 2 months and I'm essentially testing negative.

Today also the day I find out that my local EPU is closing down for good, so I have to go tp another one about 30 minutes drive away. Not the end of the world, but sad news none the less.