There is a sign up north at the cottage that reads,
“If you’re lucky enough to be at the lake, you’re lucky enough.”
I have no idea why, but my immediate family (mostly my brother, Matt) has always made jokes about that sign. I believe it all began when Matt read the sign in a George Bush impressionist voice way back in the day, and it evolved to became one of those “Fill in something funny instead of ‘Lake’ ” sort of jokes. You know, like,
“If you’re lucky enough to have one glove, you’re lucky enough”
“If you’re lucky enough to have a cracked cell phone, you’re lucky enough”
“If you’re lucky enough to be eating Ramen noodles… again… you’re lucky enough”
Bunch of weirdos, right? I digress.
The clinic was packed this morning. It always amazes me how many people I’ve never seen before sitting in the waiting room. I mean, we are all on some kind of “cycle,” you’d think two women’s schedules would sink up at some point! But no. Always new faces. He’s got a great business!
Because Dr. Sherbahn does all of his own ultrasounds once a woman is pregnant (instead of the nurses/techs) we were pleased to not only have him in the room in general, but also so we (…I…) could pick his brain as much as I wanted. (You can ask the nurses on the phone anything you want, but because they are not “Doctor” they are always hesitant to give a straight answer. Makes sense, of course. But annoying.)
Unlike other ultrasounds I’ve had in this particular room, Dr. Sherbahn swung the monitor screen over so that all three of us could look at what was being show on the monitor at the same time. Once the ultrasound started I noticed within 2 seconds that:
#1) There was a gestational sac
#2) It was in my uterus
#3) There was something inside the gestational sac
It wasn’t the most thorough ultrasound I’ve ever had (the nurses always do a super long ultrasound getting many angles and taking many measurements). I mean, I think he took two angles and then quickly froze the image on the screen so he could measure the size of the gestational sac. He didn’t even attempt to see a heartbeat.
The gestational sac measured 4w5d (4 weeks, 5 days). Today I’m technically 5w4d. Do the math, that leaves me 6 days behind.
Before we could question, Dr. Sherbahn quickly told us about his thoughts on monitoring/dating using early HCG level, gestational sac measurement, and embryonic rump to crown/heartbeat measurements. The exact line I was QUITE surprised to hear was,
“My nurses are a lot more cautious/negative with HCG numbers and measurements than I am.”
Apparently (in terms of likelihood of live birth), HCG levels are the LEAST predictive. In fact, Dr. S. told us that HCG is primarily being emitted by the placenta, and not the embryo very early on in pregnancy so using HCG as a predictor of embryonic health is obviously far from related.
What’s considerably better than using HCG is using measurements of gestational sac size. (Now, my own opinion on this? He didn’t try to get a ton of angles here. It’s possible that if he had, the sac would have measured bigger than the measurement he choose to take. But what would that have changed (aside from my mental state)? Ultimately nothing, so that’s probably why he did a quick measurement. Who knows? I’m no doctor…). What’s most important is that Dr. Sherbahn stated that our sac size made him “happy” “not to worry.” (Ha! Okay… I’ll try my best…)
Finally, Dr. S. stated that embryonic rump to crown/heartbeat measurements were the MOST predictive (like, many, many times more than gestational sac measurements) measurements in terms of overall early gestational health. Seeing as our little blob was so small (and without a heartbeat) this measurement was not possible at this time.
Dr. Sherbahn printed out the still frame picture of our blob for us to take home. I asked which part was the yolk sac and which was the fetal pole. He said, “Well I could tell you what I thought, but I’d likely be lying to you.” Apparently it’s too small to know for sure. But some big part of what we saw/see in the picture is the yolk sac for sure.
Additional blood work was taken, and I was told I’d receive a call (as always) to discuss medication changes as well as when my next ultrasound would be (Dr. S said about 1.5 weeks from today). After an hour of total clinic time this morning we finally walked out to the car.
As I’m sure is typical four couples going through IVF, our marriage has been stressed to the max these last several weeks. I’ve got a great guy, but we are both pretty much hanging on by a thread right now. Our usual “downward spiral” includes me “looking sad” (even when I’m not!), Joe thinking I’m sad and trying to make me “happy again” (often using what I consider a “not funny joke” to which I become offended, etc, etc, etc…) Regardless, I’m deeply thankful for my goofy husband who knew just how to make me laugh today when I need it most.
Once both car doors were shut, I hear in an weirdo accent of some kind,
“If you’re lucky enough to see a yolk sac, you’re lucky enough.”