7w2d: Introducing.... Blueberry!

I'm sorry if my comments have been sparse lately. I'm trying to catch up with everything, mostly real-life stuff.

I haven't told you guys our nickname for the embaby: he or she is called Blueberry. I think the name came up on the day of the ET; I was looking at pictures of 5 day blastocysts online and we were trying to think of a name, and that's what stuck! Maybe we were influenced by pictures of the day 4 morulas (aka raspberries); I don't know. Anyway, I've really liked how so many of you have had nicknames (Scrappy and Doozer come to mind), and it feels really good to be able to call him/her by name without assigning a gender and still staying a tiny bit detached (see below).

My two readers with a medical background may recall that there is a scary syndrome known as a "Blueberry Muffin Baby." Which is not a good think, as it signifies congenital rubella, CMV infection, etc. I refuse to give up our cute nickname because of that!

Chicago was fun but exhausting. There were about 33,000 (or more) people attending this conference, so it was crazy. I was listening to lectures about breast cancer pretty much 8AM to 4 or 5PM every day, and I learned a lot. It is always inspiring to hear about all of the new therapies and hopefully tests that will help predict which patients will benefit from these therapies. I also realized that unless I start focusing more time on work, I'm unlikely to ever get my name on even a tiny abstract.

The fun part of the trip was that I had the chance to stay in a hotel room with my friends K (wonderful friend since 7th grade, high school, college, and residency; also a Heme/Onc fellow and the mother of an adorable 9 month old boy) and A (friend from residency, also a Heme/Onc fellow at the same institution as K, and 17 weeks pg). We enjoyed talking about everything: pregnancy stuff, career issues, and reliving the laughs, odd personalities, and horrors of our stressful Inter.nal Medicine residency program. It definitely helped the days pass quickly up until today's ultrasound:





The great news is that Dr W is thrilled about Blueberry's progress. His/her crown-rump length is 9.9 mm, right on target. The heart rate was a perfect 148 bpm, and this time we not only saw the flicker of the heartbeat, but we were actually able to hear it (via transvaginal Doppler). Absolutely amazing!

I would be lying if I didn't admit to you all that I am still incredibly nervous, though. Blueberry's gestational sac is only 17 mm in its longest dimension. The mean gestational sac diameter would certainly be even smaller. 17 mm corresponds to about 6w3d or so, ie about 6 days behind. I've spent hours googling this topic, and this pretty much summarizes my current angst:

1) I asked specifically, and Dr W is NOT concerned about the sac size. She says it is completely fine, and she assures me that if she did have any concerns, she would let me know. I don't know why this isn't enough for me.

2) most websites, scientific articles, and textbooks do not really talk much about sac size or the variation thereof, and it is most frequently mentioned referring to badness such as having a certain-sized sac without a visible yolk sac or embryo

3) there was one (and only one) study in 1992 which found that if the difference between the gestational sac size and crown-rump length was less than 5 mm, the chance of miscarriage was 90%. If it was 5-7.9 mm, it was 26%, and above 8 mm, it was 10%. In my case, the difference was 7.1 mm (17-9.9 mm).

4) The sac should increase in size by about 1 mm/day, and the average is 1.1 mm/day, I believe. An increase of under 0.6 mm/day is a poor sign. Mine did increase by 1mm/day since 6w0d, so I guess I'm on-track there.

5) I read a blog in which the author had a normal sized embaby and a small sac, raising her OB/GYN's concern. Unfortunately, the blogger's embaby stopped growing soon thereafter (at about 8.5 weeks). Other blogs described twins in which the smaller sac embaby did not make it. A few other blogs had cases in which everything seemed to turn out fine, but somehow these did not completely reassure me.

Oh please, please don't let Blueberry run out of space to grow!!

My mood varies from elation to dread, depending on if I am thinking about the beautiful heartbeat or the petite sac. I will probably see Blueberry next on Tuesday, June 17, at 9w0d. Our other option was 8w3d, but that is Friday the 13th, and I guess I'm feeling a little superstitious. The main consideration, however, is that S will be coming to the next ultrasound, and I figure that we might as well see as developed of an embryo as possible at that visit. So, 9 weeks it is! Today's ultrasound was great, but I couldn't make out what was head/yolk sac/body/limbs, and I'm looking forward to being able to see a bit more detail.

I am truly sorry if all of my whining and worry seems frivolous to anyone out there who is still TTC. I don't know, I think I am kinda scarred from the entire IF experience, and I can't believe that this will really work for us.

Please keep growing, Blueberry!