We are pregnant!!!

If you are still wondering after seeing the image and the title of this post, yes we are PREGNANT 🎉🎉🎉

Let us start back from waiting after the transfer. The stakes seemed higher and we waited very anxiously for day 10 test. Considering what had happened in the previous transfer attempt, we did pretty well to manage ourselves by keeping busy. Day 10 has finally arrived on a Friday. The results came back with hCG (Human Chorionic Gonadotropi) level indicating we were pregnant but this is a very early sign. But we were cautiously optimistic, this is as far as we have come in the process. The next test will be on day 14 to check rising hCG level. Four more days of waiting. Then there it was, hCG level rose perfectly to 6.5x higher than day 10 scan. During early stages of pregnancy they expect hCG level to roughly double every 24-48 hours. We grew very hopeful and felt such joy. We were advised based on results there won't be any additional blood tests until early pregnancy scan. The early pregnancy scan was scheduled in 3 weeks time. After counting day by day, 3 weeks of no test sounded absolutely crazy. Can we really survive three whole weeks without new information?!

Soon enough the early pregnancy scan date arrived and this was at just about the 8 week's mark. We had researched that during this scan we may experience fetal heartbeat. That was what we hoped for to hear and see. The scan was spectacular and we saw this blueberry sized blob in the image. But then we also noticed a smaller blob and thought uh oh do we have a twin?! We thought it was nearly impossible for the embryo to split as the embryo was day 5 blastocyst. Are we the exception? What must only have been 2 seconds, the doctor told us that's the yolk sac and how it provides nutrients to the baby until placenta is formed. We had absolutely no clue there was such a thing. This later resulted in a lot of research into yolk sac and size of yolk sac can indicate problems with pregnancy. We were good at doing just in time research and finding all things that could go wrong, thanks Dr. Google.

Then we saw the flickering in the blueberry sized blob. This was the heartbeat! It was going so fast, estimated 150+BPM. This is all starting to feel real and we couldn't believe our eyes. Then I had to ask the question: can we hear the heartbeat? The answer was no, that would cause too much heat and would be a risk to the fetus and we did not want that. We had equated heartbeat to sound but safety first!

This early pregnancy scan was to be the last appointment at the fertility clinic. The doctor congratulated us on the pregnancy and officially declared we were pregnant. So what's next? She talked through a number of factors and strongly recommended we have an obstetrician as lead maternity care (LMC) rather than a midwife. We had started to talk about the LMC option but it was more focused on where the midwife would be based and hospital based vs self-employed. Obstetrician option was given too much thought and was going to be considered as a needed basis. She then let us know urgency on the LMC decision including which OB clinic as they do reach capacity quickly. This wasn't quite the decision we were expecting to make on the day but we were now experts at just in time research. We made a decision and OB as LMC it was and decided on a clinic too.

We were then "discharged" at the fertility clinic with a congratulation and a gift box with items for pregnancy and for the baby. When we saw the dummy in the box it suddenly felt very very real that we are indeed pregnant. This has been 3.5 years in the making at this point and to realise that we are pregnant was an incredible feeling. We are pregnant.

Moving on from fertility clinic to obstetrician was a big shift. Can't say it enough but that means we are pregnant! Filling out the forms and booked in for the first obstetrician appointment at 12 the week's mark. Four whole weeks without an appointment was a little too much to take and as we couldn't get an earlier appointment with an obstetrician we booked in for an additional scan on week 10 scan at Fertility Associate.

The first surprise at the week 10 scan was that it was abdominal ultrasound, we had graduated to abdominal ultrasound. Three of us were not expecting it and it was a pleasant surprise for us all, the baby is already at size that we could see via abdominal scan. What appeared on the screen was not the blueberry sized blob from 2.5 weeks ago. What we saw was a baby! A baby with head, body, 2 arms, and 2 legs. It was a fig sized baby now. We were amazed how quickly the baby is now growing. Just as we were about to wrap up the scan and take the last photo the baby started to move. A lot. Wiggling, turning, moving arms and legs. We watched affixed to the screen and the only thing we could utter was wow, wow, wow.

Random tidbit - discovery of Pregnancy+ app (thank you to the person who introduced me to it at first aid training!) made it so easy to find out milestones week by week and with 3D rendering and actual size option making it all so real. Highly recommend the app!

We were buzzing with excitement for days and days with what we saw during the scan. The first obstetrician appointment at week 12 confirmed we have a viable and ongoing pregnancy and the baby was growing well. A set of blood tests prior to the appointment, a quick ultrasound scan, OB and health history and we were done.

We opted to take a Non-invasive prenatal test (NIPT) that screens for certain chromosomal abnormalities in a developing baby. During pregnancy, some DNA from the placenta crosses into the woman’s blood. NIPT tests these cell-free DNA fragments. This test can be performed from 10 weeks onwards, and involves a simple blood test from the woman.

Next was scheduling a Nuchal scan (12 weeks to 13 weeks and 6 days) at imaging and radiology. Again just in time research and googling helped us figure out what it is! Nuchal scan is an early anatomy scan that includes the brain, stomach, spine, bladder, limbs etc.

We are officially pregnant and amazing to be in the second trimester of pregnancy now. Now we are starting to feel all the things we need to prepare for including part 2 of Oranga Tamariki visits and assessments, things to purchase, names, and so much more! We couldn't be happier that we are pregnant. Thank you to our amazing surrogate Wendy, her priest Sarah, and everyone else who has supported her family and us.

Resources

1. Human Chorionic Gonadotropi (hCG) is often called the pregnancy hormone because it is made by cells formed in the placenta, which nourishes the egg after it has been fertilized and becomes attached to the uterine wall. Levels can first be detected by a blood test about 11 days after conception and about 12-14 days after conception by a urine test. Ty The level will reach its peak in the first 8-11 weeks of pregnancy and then will decline and level off for the remainder of the pregnancy.
2. Yolk Sac A yolk sac is a structure that develops inside your uterus during early pregnancy. It provides an embryo with nourishment (food). It helps circulate gasses between you and the embryo. The yolk sac also produces cells that turn into important structures, such as the umbilical cord, blood cells and reproductive organs. The yolk sac is one of the first structures a healthcare provider can see during prenatal ultrasound. It can help confirm pregnancy, along with other factors, such as a missed menstrual cycle and levels of certain hormones in the mother’s blood.
3. Lead Maternity Care (LMC) - A lead maternity carer (LMC) is responsible for your care throughout your pregnancy, labour and birth. They also care for you and your baby until your baby is six weeks old. They have the legal, professional and practical responsibility for making sure you and your baby receive appropriate maternity care. An LMC can be any of the following: A self-employed midwife, Hospital employed midwives, A private obstetrician. Your chosen LMC may provide all maternity care, or may share care with one or more practitioners.
4. NIPT (Non-Invasive Prenatal Testing) Non-invasive prenatal screening (NIPS) is a way of determining the risk of the fetus having certain chromosomal abnormalities. Small fragments of circulating DNA in a pregnant woman’s blood are analysed. These fragments are free floating and not within cells, unlike most DNA, which is found inside a cell’s nucleus. They are therefore known as cell-free DNA (cfDNA). During pregnancy, a mixture of cfDNA from the woman’s cells and cells from the placenta are found in the maternal blood. Evaluation of the cfDNA from the placenta allows screening for certain genetic abnormalities. NIPS can be performed from the 10th week of pregnancy. NIPS can be used to screen for chromosomal disorders such as trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome) and trisomy 13 (Patau syndrome). The accuracy of the test changes depending on the disorder in question.
5. Nuchal Scan A nuchal translucency scan is an ultrasound scan that measures your baby’s nuchal translucency — a fluid-filled space behind your baby’s neck. This measurement can help your doctor estimate the risk of your baby having a chromosomal abnormality such as Down syndrome.
6. Pregnancy+ App (iOS, Android) is an amazing app featuring information for all stages of pregnancy. 3D model rendering to zoom in/out to see details and see baby's development week by week.