Our Long Journey

So I haven't posted since Adelyn was a baby. Last post was about teaching her how to clap her hands. Amazing what going back to work will do to your motivation to keep up with a blog! Well, Adelyn is wonderful, but this is a baby blog, and while she will always be my baby, at almost 3 years old, I'm not sure she qualifies that way to most people. So I didn't really come to talk about her. I came to talk about our quest over the last year and a half to further expand our family with baby number 2.

We got pregnant with Adelyn fairly quickly and really expected it to go the same way the second go around, which it did... and didn't.
Our First Pregnancy After Addie
In December 2011, we found ourselves pregnant, almost by accident. We were almost ready to start trying again, so we were a little nervous, but excited. Time plugged along, we were getting used to the idea, but I guess given my profession we didn't "go public." I had some kind of idea in my head that if there was a problem, I wasn't sure I wanted to air my dirty laundry for the world to see. So, we shared with family and close friends, but nothing more.
My first sono was scheduled for February 13th, I think. But Jordan was going to be out of town. I called a friend and my mom to see if I could find someone to go with me, but after thinking through the reason I wanted someone with me in the first place (in case something awful happened), I decided it was best to reschedule for the next day, when Jordan would be back. This happened to be Valentine's Day. I was 9 weeks pregnant.
The minute they pulled the image up on the screen I started searching for the fluttering heart beat... nothing. No movement either. The tech confirms the date of my last period (making sure I'm as far along as I think I am). She measures the little bean that's in there...it measured 9 weeks, but no heart beat. At 9 weeks, there should be a heart beat. The doctor comes in and explains that we are having a miscarriage. The baby is dead. There isn't anything that can be done about it. The whole thing was as awful and painful as you might imagine. I was far enough along they recommended a D&C rather than waiting for it to pass on it's own, which could be painful and take many weeks. We were scheduled for the procedure in the next week or two. This followed by blood tests to make sure everything cleared. We met with the doctor again and she showed us sono pictures and explained that the nuchal translucency (thickness at the back of the neck) was larger than you would expect, likely the baby had some kind of chromosomal defect. I knew all of this. Miscarriage is common. It happens in 30% or more of pregnancies. I wasn't surprised, even if I was sad. I was mostly wanting to move away from the whole terrible experience and start trying again.
Our Second Pregnancy After Addie
We were told to wait two regular periods before trying again. This took two and a half to three months. Then we were pregnant right away. This time they brought me in for early beta HCG levels to monitor my progress. We found out pretty quickly, around 6 weeks that my levels weren't doubling like they should. While this was a much less devastating way to find out about an impending miscarriage, the shock of having two in a row added a whole new layer of sadness. I could see my self becoming a statistic. We miscarried beginning of June, after 7 or 8 weeks of pregnancy. Luckily this time we were early enough into the pregnancy that I didn't need to do a D&C. Natural miscarriage wasn't so bad... like they say, an intense period... except with heart break. 
Testing
After two miscarriages, my OB wanted to do some basic lab tests just to make sure that there weren't any obvious and fixable problems. These tests can't be done when you still have HCG in your system, so we waited a month and then went in. Several weeks later, the results are in and everything is normal. I'm a carrier for an MTHFR mutation, but who isn't really. With just one, that shouldn't increase risks. Still, she says she wants me to take progesterone and aspirin with my next pregnancy. Just in case.
Our Third Pregnancy After Addie
Since we didn't have to have a D&C and with waiting for all of the tests, we were cleared to start trying again. Again, we got pregnant quickly. I went in immediately for blood tests, and knew immediately it was no good. The pregnancy was non-viable at 5 weeks and I miscarried at 6 weeks.
Three consecutive miscarriages is multiple miscarriage. 1% of people have multiple miscarriages. We are the statistic all of a sudden. We were referred to a reproductive endocrinologist, my OB said this was beyond the scope of what she could manage.
More Testing
We met with the reproductive endocrinologist (RE) at the end of October. It was an hour long appointment, and he basically spoke with us about multiple miscarriages. He said that if you think about how common miscarriages are, you would expect people to have three in a row just by chance, and shared the statistic of 1% of all people having multiple miscarriages and how, that's really a lot of people. He's right. If it was a genetic variant in 1% of the population, we would call it a benign polymorphism. Given my age and that two of the pregnancies were "only chemical pregnancies" (I could've punched him in the face for how he diminished my experience like that) I should expect to be able to have a live birth even with everything we'd been through. Still, he wanted to do some other testing. He sent some blood work that day, and told me to schedule some uterine imaging with my next period. They called me with results in a week, mostly normal. Maybe I have low ovarian reserve, but basically normal. Oh, and your progesterone was high, so maybe you were ovulating. No, actually, I was pregnant!
Our Fourth Pregnancy After Addie
Since they hadn't really done anything at the RE office, they said we could monitor the pregnancy there or with my OB, our choice. I was more comfortable with my OB, so we held our breath and got my HCG levels...everything was good. They scheduled an early sono for 7 weeks. But 6 weeks in I started experiencing some cramping and panicked. My wonderful OB worked me in and did the sono herself with me in tears through the whole thing. There was a flickering heart beat. Everything was fine. I was measuring a few days later than I thought I should, but everything seemed fine. I was elated... and began to actually hope that this would be the one. I kept the scheduled sono appointment for the next week, because I'm a panicked freak of nature at this point. My mom went with me as Jordan was again out of town. I thought I was safe with the normal sono the week before. Alas, no. No heart beat this time... not even a recognizable fetal pole... just a mess. I met with the doctor to talk options. It was the week before Christmas, so if we were going to do a D&C, it really had to be the next day. I really didn't want to go through that again and my other two natural miscarriages hadn't been so bad, so I decided to just deal with it.
It was the most awful Christmas. I got the flu on Christmas Eve and ran a fever until December 27th. We then went to Beaumont as I was beginning to recover, to see my family. I began to miscarry on December 30th. It was awful. Nothing like the other two. It was miniature labor. I was having actual contractions. **Warning, this is graphic** At my grandfather's house I went to the bathroom...and passed the baby. I couldn't see anything, there was too much blood. But I felt it pass. And then there wasn't anything to do but flush it down the toilet. So. Awful.
I continued to have contractions and intense pain for the next few days. I had pain medication, but it was really just awful. After the flu, I was exhausted. I think I spent the whole Christmas break curled up in a ball in all the guest bedrooms of everyone in our family. I went back to work on January 3rd and felt mostly back to normal. I was seeing patients and went to the bathroom. **Warning, this is also graphic** I had still been bleeding, but nothing more than a period. When I went to the bathroom I passed a clot, and then the blood started gushing. This was one of the things they told me to be worried about...continuous and unrelenting bleeding. I couldn't even leave the bathroom I was bleeding so heavily. I freaked out. Thank goodness I had my cell phone with me. I called Jordan and he navigated getting me in urgently to see my OB. He came to pick me up, by which time the bleeding had slowed enough that I thought there was a possibility I might not bleed out onto the floor. Thank goodness my OB is close to my work. She examined me. I had passed a clot. I guess what happens is your uterus works on passing the clot by squeezing and contracting and squeezing and contracting. If it passes, great, but if not, it just keeps trying. This amounts to squeezing a cut and making it bleed and bleed...except inside your uterus...behind a giant clot. When the clot passed, all of the blood that had built up behind it for the last couple of days came rushing out. Scary! I still had a few clots. She prescribed me something that should help with passing them (makes your uterus contact stronger) and told me if I bled again like I had, I needed to go straight to the ER. It's too much blood to lose twice like that.
**Safe for squeamish again** Luckily there were no further incidents. I finished having the miscarriage, but did retain some tissue that took months to pass. We went back to the reproductive endocrinologist and he did his imaging, nothing abnormal (except the tissue from that miscarriage).
He sat there and told us that they had come up dry. No answers. No cause. No idea what the problem is. Four miscarriages in a year, and no reason. He said we could either keep trying without intervention and we would likely get pregnant and eventually succeed in carrying to term. The only other option had limited evidence of utility, but he offered to do fertility treatments, with the idea that if the problem is poor egg quality (something you can't really test) then the fertility treatments will beef up the quality of my eggs and hopefully give us a better chance at success. Well, we were done trying naturally. My New Years resolution for 2013 was no more miscarriages. So, after being pregnant four times in one year, we entered into the realm of fertility treatments!