Sixth month of Pregnancy

Journey into Parenthood Part 13 :

June 1st was when the 6th month began, and after complete bed rest for the last few months, just walking around in the house, coming and eating at the dining table with others, made me feel much better. 

But I consciously avoided going out or eating outside food as ours is a twin pregnancy and I didn't want to do anything that would cause strain or worry, which might result in a premature delivery.

Just by sitting around with Amma and my house help we cleared wardrobes and made space. This in itself was exciting. I was in touch with Harini who was recovering from child birth and enjoying her mother hood experience. She would keep giving me courage and lists on Whatsapp on how to be prepared for the babies’ arrival.

One Thursday I started jotting down a list. Though there is still a long way to go making these lists makes you feel positive. Going through the online shopping sites and making a budget for this keeps you occupied!

One more exciting development was I started practicing Carnatic Music with a portable tambura! I sang daily for about half an hour. I am just a passionate singer, definitely not the professional kind! But for me music is one way of getting closer to God .

Sixth month Check-up:

Our 6 th month check-up was on June 23rd. After we reached the hospital, my initial BP and weight measurements were taken and I was given 2nd dose of TT injection. We met Dr. Manu who told us that so far all was fine, and asked me to check GTT, thyroid and haemoglobin levels in the upcoming weeks. Dr. Manu interacted with us, removed the fear of premature deliveries, and advised us to take things lightly and be happy. The same advice was repeated by Mohanapriya! It was lovely interacting with Dr. Manu for few minutes and looking forward to taking care of ourselves and going in for the next check up!

Fifth month anomaly scan and check-up:

Journey into Parenthood Part 12 :

We were advised to take the anomaly scan at Scan India in TNagar. Both Harini and Mohanapriya had warned me that though people were friendly there will be a crowd and it is better to go very early.

So with packed breakfast, lunch, drink and fruits we reached the scan centre. That day my sister in law Ms. Priya also joined us. Initially she helped Hari to park the vehicle and then spent the whole day almost upto 3pm with us at the centre. She was a big help and company, brought me yummy hot capsicum rice and Hari some fruit juice.

This anomaly scan is combined with fetal ECHO for twins. I was extremely nervous, as this scan will give us complete details about every organ of the babies.

Till now, because of the rules, Hari had never seen our babies on the monitor. He was longing for it but we didn't expect his wish to come true at this centre. 

This scan centre was very systematic; first my scan was done by a doctor assistant. Thankfully from now on a full bladder is not required. As soon as she started scanning she asked me if my husband had come and asked the assistant to call him in. This made me terribly nervous. I thought something was wrong. When Hari came in he was asked to sit on the sofa.

    Madam did my scanning very patiently and showed us the different organs of both the babies. Hari was just super thrilled and followed the doctor. Maybe because of nervousness, I couldn't really enjoy the moment.  Madam patted me and said the babies are fine and I don't have to be so worried. Once again I appreciate the doctor's gesture – previously I have experienced such painful scans, that too TV scans, where the doctor will sigh if we have tears because of the pain! I am thankful to God for these nice doctors. 

Hari spotted one baby even sucking his / her thumb in a cozy position and the other one in Namaskaram position! After the 1st round, a senior doctor, Dr. Sathya did a complete anomaly scan. Hari was inside for that too. Dr. Sathya said that everything was fine, the placenta position was better and it had moved away from cervix. She wished us good luck and asked me to take care and wait for the cardiologist for the foetal ECHO.

It was a long wait; when I called Mohanapriya to inform about the delay she gave some very happy news-- Harini had delivered and she and her son were doing fine. I was thrilled! She had a normal delivery post IVF.

Finally our cardiologist arrived and did the foetal ECHO. We saw the functioning of the tiny hearts ♥ and heard their heart beats too! The doctor said all was fine with both the babies and wished us good luck.

We collected our reports and rushed to meet Dr. Manu. My initial weight and BP check-up was done. She saw all the reports and assured us that all was fine and told me I can walk around the house but not strain too much. When Hari, Mohanapriya and I at the same time sighed in relief Dr. Manu started laughing. She told me not to be nervous about every scan! She told me I can sing! She did the usual heart beat check-up, reduced my injection schedule to once in two weeks and told me to include proteins and take care and meet her in the last week of June. An additional bonus for us was meeting Harini and her little one. I was so happy to see her- it was an emotional moment for me.

I came back home relieved, maintained minimum movements and started singing for the babies. I also started feeling the movements of the babies predominantly.

Fourth month into Pregnancy !!!!!!!

Journey into Parenthood Part 11 :

Fourth month check-up:

Fourth month check-up was on 21st April. First Dr. Manu's assistant Dr. Rekha did a check-up and told me both the foetuses were fine. Madam was also very kind and explained everything in detail like Dr. Manu. She felt the placenta was still lying low but to confirm I underwent an ultrasound again with Dr. Ravichandrika. In the 4th month a scan is usually never done, but since I was very anxious they did the scan with special concern and I wasn’t billed for it.

      Placenta had not moved. Dr. Manu told me all other parameters including the double marker tests were normal. My HB was also fine and I was put on iron supplements. She told me not to worry and expected the placenta to move by the next month. She asked me to come by the end of fifth month with anomaly scan reports. I was a little impatient so I kept asking her whether I can sit and sing? Sit and work on my laptop? Dr. didn't want to disappoint me but asked me to be careful. But when Mohanapriya came in for injections she talked to me like I was a small child and made me understand and asked me to be patient for few more months. She told me to take this as a deserved Holiday! I felt truly better!

 

Early stage of Placenta Pervia -challenging bed rest times !!!!!!!!!!

Journey into Parenthood Part 10 :

As usual I googled enough to understand my situation and I understood that when it happens at an early stage of pregnancy there are bright chances of it altering later on.

One big change after the first trimester is that your check-up will be only monthly once. So only one outing a month! Thankfully by God’s grace I didn't have morning sickness. In the first trimester I used to constantly feel hungry which settled down in the second trimester. Otherwise, frankly by God’s grace, I had the fullest support of my parents, who take charge of home; Hari would buy everything and take care of grocery and vegetable shopping; every day I would get calls from some close friend or my cousin or relatives and to top it all I was blessed with lovely neighbors especially my dearest friends Jerine and James Sir who dedicated their evening time to give me laughter therapy and to keep me pepped up! So I have to say I didn't feel the real pinch of bed rest.

I must specially mention little girl Judith, Jerine's daughter who played monopoly and other board games with me. She would stay with me whenever Amma went down to the temple and never move away till my mother came back. Hari and I are touched by their love and care and are happy that our little ones already have a caring and loving elder sister!

The First Trimester !!!!!!!!!!!!!!!

Journey into Parenthood Part 9 :

Generally the first trimester is taken to be between week 1 to week 12 in pregnancy. In normal pregnancy one would realise and test for pregnancy only around 6 weeks. But when we get pregnant through IVF, we know our pregnancy at a very early stage and our motherhood fears and anxiety begins from then. After about 35 days I noticed a small red thread like particle in my urine. I was worried but thankfully there was no vaginal bleeding. I immediately called Ms. Mohanapriya in the night and she checked with the doctor and told me to start susten injection twice a week.

               Ms. Mohanapriya administered my injections till almost the end of my delivery without expecting anything in return. Hari and I will be eternally grateful to her not just for administering the injections but also for the complete pep talk to make Amma, Hari and me extremely comfortable. She would leave our place only after the injection and the morale boosting talk. I respect and adore her for her professional commitment.

After the injections started, I reduced my movements a little but that small discharge occurred about 3 times in my first trimester. Ms. Mohanapriya checked with the doctor and reassured me to stay calm.

Our first scan was on February 18^th and I was very nervous. Hari was excited as he was eagerly expecting twins. It was very crowded at the hospital. Finally my turn came--to wait with a full bladder is real challenge-- our sonologist Dr. Ravichandrika madam is a senior doctor and looked serious. I felt like a student having my paper corrected by a strict HOD! She very patiently did the scan and I just closed my eyes and kept praying. Finally madam told me all parameters are good and I am pregnant with twins! I immediately came out and Hari was thrilled to know the results. For the first time we saw the pictures of the gestational sac on the report- yet another emotional moment indeed! Dr. Manu explained the scan reports and told us the EDD (expected due date). It is 7th October 2017, and when Hari asked her if it would be earlier she said yes because twins generally come out sooner! 

We were asked to continue with the same medication and come back after two weeks for a check-up. 

In the first trimester our doctor’s visits was every two weeks to monitor our foetuses’ growth. So I had 2 more scans-- one on March 3rd, and the next one on 16th March. Both were to check if the heart beats were good and the foetuses were growing well. The 3rd scan was done by Dr. Manu and she said one of the babies was happily doing somersaults!!!! She did show me the screen but what thoroughly excited and moved me was the happiness she showed on seeing the movements. It showed how passionate Dr. Manu is about her patients. We were truly blessed to be in the care of such a passionate doctor.

NT scan and double marker tests:

This test is a combination of an ultra sound scan and a blood test. It is called a Nucal translucency scan where the thickness of the neck of the babies is measured by an ultrasound probe. A full bladder is absolutely mandatory for this scan, and along with this measurement, cervix position and placenta placement is checked. The thickness measurement checks the probability of occurrence of Downs Syndrome. Along with this scan they will also do a blood test which will screen the blood for other genetic abnormalities in the body. Scan results are obtained immediately but blood tests take a weeks’ time.

                     By God’s grace our NT scan was fine. This time the pictures given were very cute. Hari spotted both the babies and he observed it so keenly that he could make out some facial differences too! 

        We went to meet Dr. Manu. She was happy about the scan but said there is one thing to worry -- placenta was covering the cervix. She explained that any strain or pressure might lead to bleeding. So she recommended complete bed rest except for using the rest room. She told us that when babies grow the uterus will expand and the placenta will move away but till then we need to be very careful especially since it is twins. But she reassured us that if I took care I need not worry much.

The next interesting part of the check-up was that we got to hear the heart-beat of our little ones for the first time! Yet another golden moment!  Dr. Manu said everything is fine. She stopped estrogen, the progesterone gel and ecosprin. Susten was to be taken twice -- morning and night -- and injections became weekly once. 

But I was upset as I expected Dr. Manu to tell me that I could go back to my normal activities. I thought I can manage on my own. Neither my parents nor Hari agreed to such an idea! Dr. Manu told me clearly the placenta position had nothing to do with IVF, and generally after the first trimester an IVF pregnancy is considered equal to a normal pregnancy.

           The word strict bed rest did upset me for a couple of days, but with a lot of motivation from family, Hari and Ms.  Mohanapriya, I got into a new routine. I started watching a lot of web series and stand-up comedy. Every week during the injection Mohanapriya used to tell me to be relaxed and there wouldn't be a problem if we took proper care.

The Test Day: beginning of a new journey

Journey into parenthood Part 8 :

February 1st 2017 was our scheduled day for beta HCG blood test. We reached the hospital by 8.30 am and as always I felt a positivity as I reached the hospital. I gave my blood sample to the lab technician Mr Pandian, who probably withdraws about 100 samples a day. Despite that, he told me to be calm and find out the results by calling the hospital. I was touched by his way of handling patients.

Hari dropped me at my moms’ house and left for office; both of us definitely nervous. Our family was gearing up for my cousins’ wedding and I had already expressed my inability to attend. My parents and Hari took turns and attended the function. As I said before my extended family only wished we get through this procedure successfully and prayed for us- a true well-wisher will not want to ponder on the finest details. In fact, my family gave me updates of the wedding through whatsapp.

●      At about 11.00 am I got a call from the hospital and thanks to true caller I identified the number and quickly attended the call. I recognized Ms. Sangeetha’s voice; she immediately verified my name and said -Congratulations! - tests are positive- my beta HCG value is 4969 , which is a good value and asked me to be happy and report on the 3rd for the second blood test which will help us confirm pregnancy. This was one of the most emotional moments for me- I actually didn't know how to react! I told Hari, my parents, in laws, my cousin and Saai Harini.

●      The next day went by and on Friday, February 3rd we went to the hospital for our second blood test. We decided to stay back and meet Dr. Manu.

●      Meanwhile my father sent me to the hospital and quickly rushed to the wedding. Everyone in the first family circle was praying for me during the wedding!

●      At about 11.30 am we received the 2nd value. This has to be double of our first value to indicate that pregnancy is progressing. By God’s grace it was 11, 232- far more than double.

●      Our nurses were very happy and we met Dr. Manu. After going through the values she said they were positive, but it was too early to even feel symptoms. She asked me to avoid raw white sugar in any form (to prevent gestational diabetes) and very spicy food. Of course as always no outside food is preferred.

●      She asked us to continue all medications and get back on the 50th day for the scan. I sincerely appreciate our doctor’s professional way of handling us at every stage. She was practical and not emotional. I find it funny when I see advertisements of Fertility Centers where everybody hugs the doctor and cries when a blood test turns positive.

●      A positive blood test is definitely a great beginning but the journey of pregnancy has just begun and we have a long way to go.

●      At this point we were definitely happy. Because of the wedding, our inner circle was aware about this positive result but everybody respected the sensitivity of the issue and told us to be careful till we complete the first trimester and of course continue to pray.

Embryo Transfer Cycle

Journey into Parenthood Part 6 :

On January 1st 2017, just like on every New Year we prayed as the day dawned. Both of us felt a special joy -- by God’s grace if IVF works out we will able to experience our dream parenthood this year !!!!!! I got my periods on 1st itself.

●      So on 2^nd when we visited the doctor, she did a scan and told me the uterus had shrunk well and we can proceed with embryo transfer as planned.

●      I was given Progynova estrogen medicine to be taken orally two times a day and ecosprin which is a blood thinner. This is to create an endometrial thickness to support the embryo.

●      No injections were given to me and on the 8 th day I was asked to come back for a check-up.

●      On the 8 th day after a scan the doctor told me endometrial thickness was developing.  I had two more scans on the 10 th day and 12 th day.

●      The dosage of progynova was made thrice a day along with perinatal multivitamin tablets and ecosprin.

●      On the last day of scan the doctor showed me on the screen three lines in my uterus wall, which means the endometrial thickness was as expected. 

●      On the final day a blood test was taken for the progesterone level checking.

●      I was prescribed two medicines susten and crinonine gel both to be taken vaginally. These are progesterone supplements, and they are mandatory in an IVF treatment. 

●      In normal pregnancy our ovary releases the egg with a shell, this egg then undergoes fertilisation. The shell left behind releases progesterone and supports or facilitates pregnancy till the placenta takes over.

●      In case of IVF, since we surpass this step we are given external progesterone support. Many centres do prescribe susten injections too but our hospital prescribes that only when there is a need. No unnecessary medication is ever entertained by Dr. Manu!

●      A small suggestion-- these progesterone, estrogen medications are very important in aiding the implantation of the embryos. So please take it at proper time intervals and maintain a specific time for each dosage. It really helps.

●      After prescribing the medicines and instructing me on how to use them, I was told to come at 11am on 17 th January 2017 for embryo transfer.

How I prepared myself for embryo transfer

As I mentioned before no specific arrangements were required for egg retrieval. But before embryo transfer it is important that you make a few arrangements even though Dr. Manu told me clearly that being on bed rest will definitely not assure pregnancy. 

But I was anxious and I felt I should slow down after embryo transfer. It is the best time you can give to yourself to relax and do what really interests you. 

We decided to ask my mother to stay with us to ensure I eat healthy and not strain much. I got my wardrobes re-arranged so that I don't have to bend much, managed to stock up for the next month. Loaded up some interesting movies and music on the phone and VCR! 

I am passionate about our mythological stories and love to visit temples and spend some quiet times there. During the treatment many people suggest for you to chant a sloka or go to a temple.  I felt God definitely knows when and what to give so I followed my usual routine with firm faith in God. I did visit a couple of temples for inner peace before the transfer.

Embryo Transfer:

My embryo transfer was around 1 PM, and we reported early to hospital. Generally no anaesthesia is required for the transfer; it is just a 5 minutes procedure and it is done when we have a full bladder. But I was worried I would get too rigid and not cooperate so I requested for a mild anaesthesia which Dr. Manu accepted. I was taken inside by 11 am and started on with IV procedure. My nurses were very friendly and helpful. Ms. Mohanapriya ensured I was ready and I got to the theatre by 12.45 PM, but our embryologist was delayed and arrived only at 2.30 PM. 

●      The embryologist arrived with his assistant Ms. Sangeetha. My nurses were ready and the embryos were thawed.

●      Dr. Manu entered the theatre and started the preparations. Ms. Mohanapriya asked me to be calm and said my embryos were fine. Dr. Manu also reassured the same.

●      They told me they will be placing 3 embryos.

●      Amidst lovely music-- a divine song on Garbarakshambigai -- the embryos were placed in me. I was very much conscious but did not feel much pain. Immediately after the transfer Dr. Manu placed a susten medicine.

After the transfer 2 hours rest is recommended after which we can go home. I chose to stay a couple of hours more, as my house was far and we wanted to avoid the traffic.

●      My mother had brought food so I took my dinner and then returned home.

●      I was given a HCG injection and one susten injection and told to continue my medication and report exactly after 15 days for beta HCG blood test. I was also asked to take a HCG injection after 5 days.

●      I was told to take normal non spicy diet with lot of water and no bed rest was required. 

All of them wished us good luck; we reached home safely and retired to a peaceful night’s sleep