Forewarned is forearmed, so walk away now if you don’t want physical details.  We went back to the fertility specialist today for a follow-up and a next step discussion.  We were supposed to see another doctor tomorrow who might have taken a different tack, but her office called Friday to tell me she had resigned.  So no appointment tomorrow; we may wait a while and see if she turns up somewhere else, but I wonder if maybe God just shut that door to leave just the one open.

Today was largely what I expected: based on the hcg level last week, they drew more blood; the doctor reviewed the results of trying lovenox; and he recommended IVF based on the idea that maybe our embryos aren’t implanting in the right place.  Before I explain the blood work, we are going back in October to start the tests needed to begin IVF, which would put us somewhere in January starting the first cycle.  Given that our most recent loss isn’t really completely over yet, we would have to wait another month to start the process, and that would have put us waiting for a pregnancy test right before Thanksgiving if we started the IVF procedures as soon as possible.  We could end up pregnant anyway, but I’d prefer not to intentionally schedule a potential pregnancy (which I mostly see as a potential miscariage) at the start of the holiday season.  Christmas sucks enough for me without scheduling potential disasters to happen at the same time.

Now the blood work: I went last week for a repeat hcg check to make sure that the level was dropping.  It should be below 5 to be considered negative for pregnancy; anything over 25 is considered positive for pregnancy.  It was 46 last Wednesday.  That was slightly less than half of the highest level I had, but it was 54 the week before, which means it barely dropped over that week.  I’ve never had the level not drop to negative a week after a miscarriage.  It is not really unusual for it to take several weeks to drop back to negative, but it is unusual for me, and most of the people whose levels remain elevated for a while had hcg levels well over 1000 when they miscarried.  We won’t get results from today’s blood work until tomorrow because the person who processes the lab work was out of the office and will return in the morning.

Before anyone goes nuts and thinks that the hcg level remaining elevated could be a good thing, it’s not.  Remaining slightly elevated without going away is often called a missed miscarriage; in clinical terms it means that some “products of conception” remain somewhere in the body, which can cause a lot of fairly disgusting complications, infection and internal bleeding being among them.  So continuing to show positive on a pregnancy test does not mean we may still have a viable pregnancy.  There are plenty of chat room stories of women who had miscarriages but discovered several weeks later that they were still pregnant, but even they point out that the hcg numbers then continued to rise dramatically like they should have to begin with. All things are possible with God, so I can’t say he wouldn’t do that, but I can tell you I will be furious with him if that were the case for us right now.  I’m very sure it’s not because of the next explanation.

This is the part that I warned you about, so you have one more chance to walk away.  I have been bleeding for three weeks at this point.  I started bleeding lightly about a week before we got the news that my hcg levels were dropping.  The day after that news, I began what I assume to be the miscarriage, which was much heavier bleeding and cramping.  It slowed down after several days, and I expected it to stop in about a week, which is what I have done all but one time a few years ago.  That time I continued spotting (different from bleeding), but we had a negative hcg level.  I am still bleeding, and it even picked up the pace yesterday.  The doctor would like to watch this for another week or two to see if it resolves on its own.  The alternative is moderately invasive surgery.

I am SOOOOOOOOOOOOOOOOO frustrated right now, and I have no idea what to pray for.  I find that I am once again almost hoping that there’s a problem.  Surgery would mean a d&c and laparoscopy to try to find the pregnancy, and that is obviously not an ideal situation.  But surgery could possibly mean that they find the pregnancy, which might be useful in determining a definite course of action.  If it’s in the uterus, it would tell the doctor that IVF is not a good idea; if it’s outside the uterus, it would tell him that his hunch is right and we stand a pretty good chance of success with IVF.  While a natural resolution is obviously better, I have no words to describe what the potential for another two weeks of bleeding does to me.  Because of the low hcg level numbers, there’s really nothing to see by doing an ultrasound or pelvic exam, so the only option is to wait and watch.

If the hcg level has continued to drop based on today’s blood draw, then by next week it should be negative, and maybe this will end soon.  So I guess that would be the best news tomorrow.  I suspect that it will not be the news I get tomorrow, but that may just be the crazy hormones talking.  If the hcg level continues to hover for the next week or two, or if I develop any symptoms of a complication, then we will definitely be doing the d&c.  I just really want this to end immediately.  I started typing that sentence with “need” instead of “want,” but I realized that the only thing I need is to let go of this and wait and trust God to keep me sane.  Far easier said than done.  I’ll let you know what we find out tomorrow.