1st U/S & Peri Appt - The Details

Some of you asked what made me decide to ask for the MTHFR test. After being in the world of infertility for quite some time, I've pretty much seen a lot of devastation. I've read way too many stories of women having recurrent m/c and then finding out they had MTHFR.  Once they were put on prescription strength folic acid and maybe blood thinners, they went on to have a successful pg. Such an easy fix to avoid the devastation of a m/c.  Now of course I'm fully aware that their m/c could have been completely unrelated to MTHFR and also that someone with MTHFR can have a completely normal pg without treatment.

I'm one who likes to be proactive and leave no stone unturned, which I believe is one of the reasons that I am finally where I am today. I've asked for the MTHFR test a few times in the past, but had always been told, oh you don't need that, we only test for that in someone who has had recurrent m/c.  Well as many of you know, lucky Seven was my last embyro. I couldn't afford to m/c first.  So I insisted on being tested.

I never imagined that it would actually come back positive. My ob/gyn immediately referred me to a perinatologist for a consult as she knows how important this pg is to me. The peri wanted me to have an u/s prior to the consult, I guess to make sure that I was pg before getting into any kind of treatment.

Kerry and I arrived for our surprise 1st u/s at 6w1d. We were both pretty anxious and trying to believe for the best. I peed and then headed into u/s. I first had the transabdominal u/s and immediately I exclaimed, there's a sac!  She then told me to go empty my bladder while she went and got the peri.  I had just gone! If I haven't mentioned it before, I have major frequent urination going on.

The peri and sonographer returned. The peri introduced himself and said "I've seen your ovaries several times". I said "well it's always nice to finally put a face with the ovaries". He's super nice and we both really liked him.

We got started on the intravaginal u/s. She first measured my cervix at 3.1cm, we're hoping this will lengthen some. They reassured me it would as pg progresses. She then removed the wand and said, go pee, your bladder is full again. 3rd pee in 15 mins! We were all cracking up.

Next we got to the exciting part, seeing our little bean. It measured 3mm. I addressed my concern that I thought it should be 4mm by now, they both laughed and said that's only 1mm difference. Thanks to those that pointed out that the gestational age varies during this time and 2 or 3 days off is totally normal. They use the CRL (crown to rump length) to determine GA (gestational age). 3mm put us at 5w6d, so just 2 days off, but totally within range.

Next they had me hold my breath while they looked for a heartbeat.  There it was, a blinking light on this tiny little 3mm baby! We couldn't hear anything, but the sight of it was beautiful. It measured 117 bpm, I love how Seven keeps running into the number 7.

They continued to look around and I about freaked. To the lower left of the sac was a 2nd smaller sac!  I was like, please tell me it didn't split! He said no, that's a hemmorhage.  It's actually a SCH (subchorionic hemmorhage) where the placenta separates a little from the wall of the uterus. He said it's small (5mm) and should not pose a problem and should go away on it's own. This is one of the main reasons for early pg bleeding. I told him other than around beta, I haven't had any bleeding. He said I probably wouldn't then.

If you look at my u/s in the previous post, you can see this white mass to the lower left of the baby. In a different plane of view, this area contains the 2nd sac, the SCH. It's pushing into the fetal sac causing it to look funny shaped.

After the u/s, we had our consult.  I addressed my concern that due to the MTHFR, I was terrified that my baby hadn't been getting any folic acid and how that causes things like neuro tube defects and spina bifida. The peri explained MTHFR to us as an illustration. He said that each gene is like a two lane highway. With being heterozygous, one lane is blocked and the other is open, so a car can just drive around the roadblock and keep on going. The condition would be much more serious if it was homozygous where both lanes were blocked.  He said because I had no family history of blood clotting issues or strokes, he didn't think this would cause me any problems except maybe a slight increased risk of preeclampsia. I asked that since my normal BP is very low at 100/60, would that be in my favor to not get preeclampsia and he said no, my current BP doesn't change my risk either way. He really felt that there was nothing that needed to be done differently as I was already on baby aspirin and extra folic acid.

He said that we would know how much the MTHFR was affecting me when the Homocystine level came in. If it was elevated, we would need to make sure I was put on Folgard and if it wasn't elevated, I could just continue on as if I didn't even have the MTHFR.

Well my Homocystine came back normal!  The normal ref range is 3.7 to 13.9 and mine came back 7.7.  Notice the sevens?  I think that was Seven's way of saying "chill out mom, I'm ok in here".

I asked if there was anything else I needed to be tested for. He said no, that even if something came back positive, he wouldn't change anything I'm doing, so why stress me out.

I then discussed my concerns of being at risk of incompetent cervix due a short cervix due to having a leep in 2004. He really didn't feel like 1 leep would cause me any problems. I asked if we could keep an eye on it anyway and he said absolutely.

I asked when my next u/s would be and he said 18 weeks. I about fell off the table and exclaimed, are you serious???  I let him know that I will go nuts if I have to wait that long.

After I got dressed, the peri suprisingly came back to my room to discuss the hemmorhage.  He said after looking at my chart, he noticed my last few estrogen levels went from 1163 to 3022 to 798.  After seeing that, he wondered if that 2nd sac was in fact a 2nd fetal sac, as in the embryo split but 1 didn't make it. He then said he still really thinks it's just a hemmorhage. I start asking a million questions and then he smiles and winks at me and says "I'm just finding an excuse to get you another u/s in 2 weeks".  How cool is that!

So my 2nd u/s is scheduled for Nov 10th at 7w6d. Afterwards I have my first prenatal appt.

I've been on bedrest for the last 2 days due to spotting.  It's either from the u/s or the hemmorhage.  As long as I stay off my feet, it goes away. If I'm up and about too much, it picks up.  Today it seems to have stopped, so bedrest works!