What's a Beta test?

Some of you have asked me about beta numbers and what they mean.  Most (fertile) women who suspect they are pregnant will take a home pregnancy test and call their doctor to let them know.  Their dr will usually have them come in for another urine test or blood work (qualitative beta - explained below).  When you are dealing with infertility, you will always have a quantitative beta blood test.  It's always about the numbers when it comes to infertility.  I found the following explanation on line and thought this would be helpful for those who are unfamiliar with infertility.    

Explaining a beta test:

There are two basic types of pregnancy tests -- blood and urine. You will use a urine pregnancy test at home (and even sometimes in your doctor's office) but to get a blood test you generally need to see a healthcare provider or have your blood drawn in a lab on doctor's orders.
 
The pregnancy hormone, hCG (human chorionic gonadotropin), is what both of these types of tests detect. A urine test will tell you that you are or are not pregnant, but a beta hCG blood test can actually give you a number. To muddle the matter some more, there are actually two different types of beta tests -- the qualitative beta hCG is more of a yes or no test, like a urine test, but a quantative beta hCG will give you and your provider a number. Some women have a very small amount of hCG at various points in her cycle but in order to be considered pregnant the number must be above a certain number. This number may vary from lab to lab (or office to office) but often a level above 5 is considered positive.

Who gets a beta?

Not all expectant mothers get a beta hCG test. Many offices do not even require an in-office urine test if you've tested for pregnancy at home, and blood tests are not common in many practices. Some providers only do them in emergencies, such as vaginal bleeding or unusual cramping in early pregnancy.

On the other hand, women who have been working closely with a fertility specialist (called a Reproductive Endocrinologist, or an RE for short) will often have beta tests drawn routinely at the end of a cycle to test for pregnancy. Other women will be a patient in a medical practice where betas are used or can be requested, so it really depends on your medical provider and your insurance policy.

What does the number mean?

By itself, a beta hCG number can tell you if you are pregnant or not. What it cannot tell you is how pregnant you are, such as how far along you are and if everything is growing as it should. What a provider will often do, then, is do a repeat beta test in two days. The comparison of the two numbers will help you and your healthcare provider how your pregnancy is progressing.

Generally, in a healthy pregnancy, the beta hCG number will double itself every 48 hours. This is known as doubling times and can tell you a lot about how your pregnancy is going. For example, if your first beta is 40, your second one two days later should be around 80. A lower number can alert your provider to a possible problem, and a number that is where it should be can help reassure you and your partner that everything is progressing as it should be for now.

It can be hard to not get caught up with the numbers game, particularly if you have experienced one or more losses in the past, but taking it easy and reducing stress should be a high priority for an expectant mother, so try to do your best to think positive thoughts!

(This information was taken directly from this source).

The hCG hormone is measured in milli-international units per milliliter (mIU/ml).

Guideline to hCG levels during pregnancy:

hCG levels in weeks from LMP (gestational age)* :

3 weeks LMP: 5 - 50 mIU/ml

4 weeks LMP: 5 - 426 mIU/ml (I think I was at 4 weeks when I had my first beta of 761 last week. I need to confirm  the dates with the nurse). 

5 weeks LMP: 18 - 7,340 mIU/ml

6 weeks LMP: 1,080 - 56,500 mIU/ml

7 - 8 weeks LMP: 7, 650 - 229,000 mIU/ml

9 - 12 weeks LMP: 25,700 - 288,000 mIU/ml

13 - 16 weeks LMP: 13,300 - 254,000 mIU/ml

17 - 24 weeks LMP: 4,060 - 165,400 mIU/ml

25 - 40 weeks LMP: 3,640 - 117,000 mIU/ml

Non-pregnant females: <5.0 mIU/ml

Postmenopausal females: <9.5 mIU/ml

* These numbers are just a GUIDELINE-- every woman’s level of hCG can rise differently. It is not necessarily the level that matters but rather the change in the level.

(This information is was taken directly from this source).

I hope this information was helpful.  I will post results of our third beta tomorrow once I hear from the nurse. 

What Should We Do When We Don't Know What To Do?

(I love this little girl to pieces.  Just the thought of her puts a smile on my face).

I'm feeling better today (the sun is out and it's suppose to be a beautiful day).

Since the last IVF in January, I've been praying for direction on what to do next.  Do we adopt, try another cycle, or just give up on having children of our own? I haven't really received an answer. 

Then I was reading the Ensign (church magazine) and came across an article titled, What Should We Do When We Don't Know What To Do?  Sometimes God doesn't tell us what to do, He leaves it up to us to decide and go to Him with faith.  And if it's not the right decision, He will let us know. 

“When you are living worthily and your choice is consistent with the Savior’s teachings and you need to act, proceed with trust,” said Elder Richard G. Scott of the Quorum of the Twelve Apostles. If we are sensitive to the promptings of the Spirit, Elder Scott added, “either the stupor of thought will come, indicating an improper choice, or the peace or the burning in the bosom will be felt, confirming that your choice was correct. When you are living righteously and are acting with trust, God will not let you proceed too far without a warning impression if you have made the wrong decision.”

So we are thinking about doing another IVF cycle. I feel like we need to give it one more shot. I am putting my faith and trust in God to let us know that this is the right decision for us right now.

Wanting it and Feeling it, Two completely different things.

I meant to post this morning, but got so busy at work that I am just now getting around to it.  We went in yesterday for our 7th and final beta.  This was to confirm that the number went down to negative, which it did.  The dr spoke to us for a few minutes to go over what our options are.  We could wait for my next period and start another cycle or start TODAY on birth control and get a cycle in before the end of the year.  They do not do egg retrievals and transfer the last week in December, between Christmas and New Years.  So if we were going to complete a cycle by year end, we would have to start now!

Part of me wanted to go ahead and get in one more cycle, but then the other part of me wanted to just take a break and enjoy the holidays, then start in January (or start taking the BCP in mid/late December).  Steve wanted to wait, hoping for a miracle that we would get pregnant on our own in the next two months and then we could get our money back (since we're in the shared risk program).  Given my history of miscarriages, I'm not very optismistic about that scenario.  But of course, he said it was up to me and he would support me either way. 

I prayed really hard so that I could make the right decision.  I WANT to jump right back in and start the next IVF cyle, BUT, I FEEL like we should wait.  And that was the war that was going on in my head all day yesterday.  Should we do it?  Should we wait? What do we have to lose? Let's do it!  No, let's wait! Ai-yah!

As much as I WANT to do it, I'm just not FEELING it. So....we are going to wait for now.  We will use the time to heal emotionally and try and get fit physically (although that will be twice as hard since the holidays are sneaking up on us!).  I called the nurse today and told her our decision.  She was super nice, as usual, and she totally understands. 

We still have our post IVF appointment with the dr next week to go over all the details of this past cycle and the protocol for the next cycle. 

I am looking forward to a little mini break from all the shots and meds (especially the progesterone!). 

***As a side note, I have really enjoyed 'meeting' new people this month through ICLW.  You guys are all wonderful and I pray that you will all have many blessings poured out upon you!

Tentative Transfer Date

The nurse called and said we now have 11 embryos.  We are on the schedule for a tentative transfer tomorrow at 11:30 am.  She said there's a posibility that they might move me to day 5 transfer on Thursday.  The Embryologist will let her know tomorrow morning. 

This kind of makes planning a little bit hard for us since we have such a long commute in.  So, we will just prepare to come in to work tomorrow and if I don't hear from the nurse by 10:00 am, then she said to just come in.  I've told my boss what my tentative schedule is for tomorrow.  If the transfer does happen tomorrow, then I will work from home the rest of the week and take it easy.  Oh and I'm instructed to come in with a full bladder.  Uh, I hope I don't pee on the table.  How embarassing would that be!

Wow, seems like it's really going to happen.  Keep the prayers coming!!

Egg Retrieval update

The Embryologist called and of the 17 eggs retrieved, we have 13 embryos!  The nurse will call us tomorrow to let us know if the embryos are maturing and will let us know if we are going in for day 3 or day 5 transfer.

Egg Retrieval

Okay, so the trigger shot wasn't as bad as I thought it was going to be.  It was quite nerve racking leading up to it though.  But it was over quickly.  We had our retrieval this morning.  Our appointment was at 11 AM, but we had to be there by 9:30. We got there a little earlier so Steve wanted to grab breakfast.  I was instructed not to eat since I was going to be under anestesia.  Wouldn't you know it, there was a Panera right by the office in Rockville! 

When we arrived, the nurse took us immediately back and explained what was going to happen and we had to sign the release papers.  Then the Anesthesiologist came in and explained what would happen and hooked me up to an IV.  We waited for a little bit and I was brought back to the retrieval room. 

Here I am in my pretty gown and hair net. 

Steve waiting patiently.

In total, 17 eggs were retrieved.  The Embryologist will call us tomorrow to give us a report. I'm still a little sore and will just be resting today and tomorrow. Please say extra prayers for us!  We will need lots of prayers in the next few days. 

We May Have A New Tradition

What do two people do while waiting for an early morning U/S BW appointment? What better way to kill some time than to have breakfast together at Panera! It's starting to be a regular thing now. Our RE has three offices (Rockville, Annandale and Leesburg). Two of the three offices are right by a Panera Bread! How convenient!

We usually just get bagels and hot chocolate. They have yummy hot chocolate! (We don't drink coffee).

Steve enjoying his cinnamon crunch bagel.

Me getting ready to enjoy my apple raisin cinnamon crunch bagel.

Our U/S BW appointment this morning was pretty much the same. Lining looks good, 8 follies on left side, 10 on the right. They're still too small to measure right now. We continue with the same dosage of meds. Return on Saturday morning for another U/S BW. So much for sleeping in! At least I have Panera to look forward to.

Grow follies! Grow!

Labor Day U/S BW

AF showed up on Saturday so today was my day 3 ultrasound and bloodwork. My regular RE office (45 mins away) in Leesburg was closed so I had to go to the Annandale office (over an hour away). Which meant I had to get up at 6:30 AM, to leave by 7:30 am, to get their by 9 am. I was so tired! What a way to spend my Labor Day morning.

At any rate, the u/s went well. I have eight follies on the left side and 9 on the right. Grow follies, Grow!

Tonight we start 150 units of Bravelle and 75 units of Menopur and reduce the Lupron to 5 units. Then we go in on Thursday for U/S and BW.

Grow Follies! Grow!

Lupron week

I begin the Lupron injections tomorrow morning (20 units). This means I have to get up on time so we're not late for work. We have an hour and 15 minute commute in to work, now with some schools back in session, traffic can be a nightmare!! And it only gets worse after Labor Day. So, I HAVE to make sure I get up at 5 AM and out of the house by 6:00 AM.

This is also the last week for the BC pills. I have three days of it left. I'm glad because since I started taking it (three weeks ago), I have not been in the "mood" at all!

By the end of this week, we are expecting AF to show up, then we go in for the Lupron eval.

Here's hoping everything goes according to plan (but does it ever?).

Injection Class and Li.quid G.old

We had our injection class today and it took an hour and a half! There were two other women in the class with us (Steve was the only spouse who came along). We had to sit through each person's instructions, that's why it took so long. I kept wondering why the two other ladies didn't bring their spouses. Maybe they were going to be injecting themselves? Who knows! But I'm glad Steve was there with me because there was a lot to remember and my memory is terrible when it comes to instructions!

It wasn't all new to us since we did four previous IUI cycles. We've had plenty of experience with the subcutaneous shots (in the belly). The only thing we really needed to learn was the inter muscular injection (aka, the shot in the butt)! The nurse told us to carry around a Sharpie in my purse because when it's time for me to take the trigger medicine, they will draw a circle on my butt so we know where to inject the shot. Nice! (Side note, I recently went back to school shopping for Abbey and had a coupon for Sharpies for a penny! I bought six of them! Needless to say, I won't have a shortage of Sharpies).

When we got home tonight, we had a special delivery (no not that kind). There was a box left at our front door. And this was what's in side:

All of our meds for this first cycle!! We found out that the insurance covers up to $2,500 a year for IVF drugs (but they don't cover the procedure, go figure). So our copay for all this loot was only $224.49. That's a steal for all this li.quid G.OLD! But we figured we probably came close, if not maxed out on the allowable $$.

So, when I'm done injecting myself (or more like Steve injecting me) with all this li.quid g.old, hopefully it'll pay dividends!

Textbook!

We went in this morning for our mock transfer/sonohysterogram. It wasn't as bad as I thought (a lot easier than an HSG). What I didn't expect was the gushing of water that came flowing out as he removed the transducer thingy. I couldn't help but think, 'Is this how it feels when your water breaks??'....uh, I have no clue.

At any rate, the Dr. said everything was 'textbook.' Which made me laugh to myself because being a Psychology major (long ago), I sometimes analyze Steve and tell him he's classic 'textbook.'

Now let's pray that everything else in the cycle will be textbook!

Shared Risk

There are two big fertility centers in the Washington D.C. area. We chose to go with Shady Grove Fertility. They have a program called Shared Risk. The program costs $20K (upfront) and that allows you to do up to six IVF cycles (excludes the cost of meds). And they call it shared risk because if you do not deliver and take a baby home, they will refund 100% of your money. You do not have to do all six cycles and can stop treatment at anytime.

The average costs for an IVF cycle is about $6,500 (plus meds, which can run $2,000-$3,000 a cycle).

Why didn't we pay per cycle?? Well, given my history of miscarriages, we figured this was the best plan for us. And if we get pregnant on the first cycle, then that's one expensive baby! (And that's the risk we take). That's why I secretly pray for twins so I can get my monies worth. But I know that the Lord has a plan for us and we will be blessed with those special spirits waiting to join our family.

Aside from being financially draining, Infertility is also physically, emotionally, and spiritually draining. It really tests your faith. And reality sets in and you just have to really trust in the Lord and know that He knows whats best for us.