I’m Still Pregnant, But…

There isn’t much in the way of hope. This can only end badly: in miscarriage or in urgent treatment.

I had a scan yesterday because my hCG hormone levels are continuing to rise. It didn’t show anything, but the doctor was expecting that, because the embryo is usually only visible once hCG levels reach 1,000 or more. However, the fact that they’re increasing shows that something is still growing, so she thinks this is a failing or an ectopic pregnancy. I’m being scanned and tested again next week, and in the meantime I’ve been given 24-hour contact details for the local gynae ward in case anything happens.

I am eight-and-a-half weeks pregnant. There should have been a heartbeat weeks ago. Instead I am carrying a child that will never be born.

Delayed Reaction

My hCG levels aren’t dropping. I’m definitely not viably pregnant – they should be at least 8,000 by now, and mine are hovering around 130 – but nor am I moving towards a place where we can try to conceive again. A not-pregnant level is < 5 and my body is unlikely to ovulate until it reaches that point.

I had no idea this could happen. I thought once they started to come down, they would continue to fall. I didn’t expect that a week later they would have risen slightly. No one told me that after a miscarriage it’s normal for it to take up to six weeks for hCG to return to normal, and I still don’t know whether what my body’s doing is normal.

It feels like the final straw. I kept it together during the bleeding, the initial too-low levels, the day where I was told the pregnancy could still be viable in the morning and found out it wasn’t in the afternoon, but this is too much to take. I’m grieving too much to be functional. I thought I was aware of my loss before, but it feels like it’s only just hit.

I think the failure of my hCG to come back down does make it all worse. It’s not just that I’m impatient to try again, it’s the horrible feeling of being in limbo. I can’t move on from the miscarriage while I still feel nauseous and have sore boobs and have to report to the clinic for weekly pregnancy tests. I can’t come to terms with what’s happened when no one will yet tell me what has happened (I’m referring it to a miscarriage for the sake of simplicity, but I guess it could still be a failing or ectopic pregnancy). I can’t draw hope from thinking about our next cycle of treatment when no one can realistically tell me when that might be. I’m stuck in some sort of no man’s land that I had no idea existed, and my body’s failure to either sustain the embryo or miscarry it properly makes me feel like a freak.

I’m also frustrated at how little information I’ve been getting from the nurses in the clinic. With the obvious exception of my levels, all the facts in the first two paragraphs have come from my own internet research. To be fair, I think the fault is with the system rather than individual nurses: results become available an hour before the clinic closes, the lines are usually busy and the nurses understandably have other patients to talk to. I get a far better response if I ask my questions when I go in for blood tests, but then a few hours later the result comes back and the answers are out of date – hence Rollercoaster Wednesday.

At least I have a slightly better idea of what to expect now. I know the levels could do anything next week. I know they might take another three weeks to come down, and if the clinic then makes me wait for a period before trying again, the earliest our next cycle of treatment could be would be mid November. I know that “waiting and seeing”, if it works, is better for my fertility than drug or surgical interventions. And I’m going into the clinic next week armed with a list of questions. I hope I get a receptive nurse.

“Are You Pregnant?”

Every time I visit my dentist, I have to amend my details on the medical history form they hold for me. One of the questions is, “Are you pregnant?” and the available options are yes or no. Until this month, I would have thought those two tick boxes were perfectly adequate.

They’re not. Right now, I need a box for “It’s complicated”. And that’s the short version.

The long version is that on 14 August, I had my first cycle of IUI (intrauterine insemination, in our case using donor sperm). The treatment itself posed no problems. I couldn’t feel the very fine needle when I had to inject myself with Ovitrelle the day before. I was a little freaked out to discover that I had to go onto the ward and don a surgical gown for a procedure that had been described as “a bit like a cervical smear test”, but you know what? Once I was in theatre it was a lot like a smear test, except that it’s far less unpleasant when you’re holding your partner’s hand and grinning and thinking, “We could have a baby!” as opposed to “Oh, my God, what if I have to go to the Colposcopy Clinic of Doom?”

We had a really nice lunch at the nearby Pride Café while I had sperm swimming around in me for the first time ever, and then began what’s known in fertility circles as the Two-Week Wait.

Nine days after fertility treatment, I started to feel nauseous. This is not normal for me, so I headed straight for Google and found that it’s not unheard of for women to experience morning sickness that early on, though it’s more usual to develop it at around week 6. I also noticed that my boobs were tender, which again isn’t something I normally get – they tend to get slightly larger and sometimes ache before my period, but they’re not usually tender to the touch. The following morning, after checking that the Ovitrelle would be out of my system, I did a First Response pregnancy test (the most sensitive I could find) and was rewarded with a very faint, only-just-noticeable pink line.

The next few days were a rollercoaster. Typically, the cats would wake us at 4am, I would need a wee, would not want to waste that early-morning urine, so would pee on a stick before dawn and be unable to get back to sleep with the excitement. Confusingly, that faint pink line just wasn’t getting any darker and the Clear Blue Digital test I tried (which is slightly less sensitive) resolutely said that I was Not Pregnant.

12 days after treatment, I had a little bit of spotting. Although this would be common in early pregnancy, I had a really bad feeling about it, to the extent that I couldn’t face going to church and hid under the duvet instead. On day 13, it continued. On day 14, when I was due to have the official test at the fertility clinic, I woke up to find I’d been bleeding more heavily. I wasn’t surprised when the  results came back showing an hCG level of 12, where they would expect it to be at least 50. It looked as though I was having a very early miscarriage.

I want to be clear here how OH and I experienced this. I think a lot of people assume it’s a minor disappointment: “Oh, how frustrating, I thought I was pregnant and I’m not.” Some people call it a chemical pregnancy and consider that there was never really a baby, just a few cells. That’s not how I feel about it at all. From my point of view, an embryo, a blastocyte is our child and it doesn’t matter whether it was never a viable one, or how common this might be – I was pregnant, I felt pregnant, I lost the baby and that is something I need to grieve. Not such a devastating loss as a later miscarriage would be, but a loss nonetheless.

So, I bled for a few days (it was bright red – something else that for me reinforced the fact I was having a miscarriage and not a period) and then OH and I went on holiday for a week. It was really helpful to get away, relax in the sunshine, eat lots of Camembert and come to terms with the fact that I was not pregnant. Except that as the week went on, I realised I still felt pregnant. I was still nauseous in the mornings and my boobs were getting bigger. Could this all be psychological?

Back in the UK, I had another blood test which showed my hCG had  gone up to 140. On Wednesday morning, we were told there was a chance – a small chance – that I was still pregnant and it could come to term. It could also be some tissue remaining from a miscarriage, a failing pregnancy, or an ectopic pregnancy. On Wednesday evening, we got the results of a second test and were told the pregnancy was not definitely viable. The hCG is finally starting to come down but I will need to be followed up and monitored and there might be a delay before we can try again.

Am I pregnant? In terms of having a baby at the end of it, unfortunately, no. In terms of symptoms and a positive result if I pee on a stick, yes. Like I said, it’s complicated.