Posted by: DD | June 21, 2007

no. 472 – The Silver Lining

Most of you have read the statistics: as many as one in five known pregnancies will end in a miscarriage and usually within the first trimester. With that said, the likelihood of a woman who has had one unexplained miscarriage going on to a subsequent healthy and term pregnancy is 60 – 70%, if not better.

After we lost Vivienne in 2004, that information was my silver lining in my dark cloud for over a year even with the troubles we were having getting pregnant. Eventually that silver lining received a spit-shine when we saw the RE for the first time and the genetic testing on both my husband and I confirmed that Vivienne’s trisomy was a fluke – not a gene passed on from either of us.

The embarrassing enthusiasm I wrote with when our beta numbers came in after the first IVF is painful even now, 18 months later, to think about. But that enthusiasm was fueled with the naiveté that comes with believing that statistically that particular IVF should have been my swan song.

When the beta didn’t double within 48 hours, that silver lining lost its sheen, scratched by disillusion and tarnished by bitter tears (if I was to wax poetic).

The bad news to which there is no good is that since my subsequent pregnancy to my first miscarriage ended in yet another miscarriage, statistics start tilting against me. Less than 5% of women have more than two miscarriages, and once a woman has two, her chances of having that healthy pregnancy start falling from that nice cushy 60 – 70% range.

Who could blame me then when I struggled to find some bit of happiness with my brief and odds-defying pregnancy with Wolf? When we found out that even that one was doomed, I blamed myself more than usual for not having optimism or faith and instead a premonition of what turned out to be the worst possible outcome: miscarriage number three.

Wolf threw me into the less than 1% of women who are jumbled into the three-or-more-concurrent-miscarriages basket. They (Researchers) don’t have information that outline specifically odds on the fourth, fifth, sixth, seventh, eighth, tenth, or eleventh iscarriage. Three becomes the “magic” number. After that, it doesn’t really matter to ASRM if I’ve had three or thirteen.

The fear of getting pregnant again has finally outweighed the fear of not getting pregnant again. I’m trying hard to remember that using donor gamete/egg gets me a statistical reprieve because the number one cause of Early Pregnancy Loss (poor egg quality due to age and chromosomal defects) has been eliminated. Unfortunately, the little testing we’ve had (genetic analysis and clotting disorders) have not indicated what our…excuse me…what my problem is. The tests have only ruled out what it is not.

So here I sit with a rather misshapen cloud, rimmed with tarnished and dented silver, and imagining it in its former glory. I try not to get too close for fear of seeing myself reflected back in the few remaining spots not marred by anger, depression and reality.

Since we don’t have any known medical reason for my miscarriages, I cannot safely bring myself to hope again that donor egg will be the answer to our presently unanswered prayers. I will try to polish up that silver lining again but it won’t be with the enthusiasm I had before. This seems like a good place to end with a riddle: “Fool me once, shame on you. Fool me twice, shame on me.” What happens when I let a pregnancy fool me for the fifth time?

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Responses

  1. I wish that there were some happy snappy statistics out there to make you feel a little better about polishing up that silver one more time. I want so badly for that cloud to go scudding off into the far far distance for you.

  2. Dear DD, you were not “fooled.” You had hope and it got crushed, time and again — but there was nothing foolish about the hope at all, and there will be nothing foolish about hoping again, even if it’s done with a much heavier heart.

    Starting once more with donor gametes won’t give you any guarantees, but it does give you a whole new chance.

  3. First, Happy Belated Anniversary.

    Second, that’s a lot of introspection for someone beginning a vacation.

    Third, I kept waiting on the punch line that you’re not going to blog anymore. I know it’s your decision, but I couldn’t bear the loss.

    Fourth, bearing losses is never easy and this has been so hard on you. I am glad to see you stepping back and looking at the whole dynamic, painful as it may be. You are a pillar of strength, not of failure. No fools here.

  4. Hello

    I should seriously bookmark this article

    http://tinyurl.com/24ahgp

    from my clinic, and in particular this table

    http://tinyurl.com/yvq5gr

    from my clinic, which although not mega encouraging, makes you see that things don’t nosedive quite as fast as all that. This is for idiopathic recurrent miscarriage, which I think you’d fall into (I don’t think “being old” counts as a “known reason”).

  5. I think we’re all fools to keep trying anyway so you may as well let yourself go and be foolish a fifth time.

    I’m no expert but your silver lining seems shinier to me when you speak of donor eggs.

    I think only the very strong are foolish, the very weak are not strong enough to be!

    XXX

  6. What happens? That is up to you. What do you think you are capable of handling?

    But I think you know there is nothing foolish or shameful about dreaming. At least I HOPE you know that.

  7. I’ve spent a lot of time thinking about — actually obsessing over — similar kinds of statistics.

    The chances of a stillbirth — maybe around .5%. Or, put another way, there’s a 99.5% chance of *not* having a stillbirth. The chances of neonatal death — about .05% Which means a 99.95% chance of *not* having your baby die shortly after being born. Those numbers didn’t exactly help my twins. Bitter much? Why yes, yes I am.

    I guess what I’m saying is pretty much the same thing you are: that statistics, good or bad, don’t mean too much when you end up on the wrong side of them. And that it’s not just you who got fooled and are contemplating getting fooled again. It’s a sign of hope, not of stupidity. At least that’s what I keep trying to tell myself.

  8. I don’t think it’s foolish to feel scared adn anxious, or to feel like the statistics have betrayed you. The big problem with statistics is that they’re good for 10,000 women as a group, not for one individual. They can make us feel comforted and then totally betrayed when they don’t bear up for us. We’re already on the wrong side of the statistics when we’re infertile. It seems like they just get worse and worse from there.

  9. Hugs DD. Donor egg, although not a “cure all” is something to have some hope with. If you look at statistics from clinics that use donors who are mothers themselves, those statistics are better than for women of any age who do own egg IVF. In fact, the stats are better for those over 40 (like me) than they are for the 20something using own egg.

    Hugs again.

  10. I personally hate those statistics… and I understand your feelings. I personally hate being unique and well falling into that group of 1% makes it so.

    As for donor egg/gamete – from my experience while limited I’ve heard more good than bad. Same goes for donor embryo… most of the women in both categories I’ve read/emailed with etc have found that elusive silver bullet rather than the blank.

    Ultimately I think hope helps us all get through what we’re going through at that particular time. We all hope we fall on the “good” side of stats rather than the “shitty” side no matter how long a shot it is. My hope for you is that the good side finally wins out.

  11. Silver lining shmining…. Number 1 was bad luck, number 2 (bad luck), number 3 (bad luck – one of those things), number 4 – wow, you guys are the unluckiest people on the planet….

    Number 5? I can’t even think about going there…

  12. DD,

    Have you read “Coming to Term?” It has a lot to say about miscarriage, statistics, and hope. I would highly recommend it as it really helped me gain a better understanding of the whole miscarriage process(es) and what science can and can not do.

    Liz

  13. DD,

    Something to remember about those stats is just how poorly they are gathered. I’ve ranted on about this before, but since no country properly tracks pregnancies and losses under 20 weeks, much less causes…we may not be very rare at all. Like the myth of the uberfertile teenager with perfect eggs? Not quite, it turns out they have an extremely high rate of pregnancy loss. And the myth of the old eggs causing trisomies? It turns out that women over 35 are more likely to demand that Dr.s look for causes for their losses. Almost all Down’s babies in Canada for example are born to women under 35.

    Let go of the guilt. We have no idea if we are rare or not because the medical profession doesn’t give a damn about us. Please don’t blame yourself for their pathetic ineptitude.

  14. I’m so sorry you’re in this sad place right now, wish I had enough words to help you feel better. I know you feel that the failed pregnancies fooled you, but hope is a very strong contender, and it will not be fooled. Hope is stronger than anything we know, it carries us through when no sane human being would carry on. One day at a time, and never give up hope!

  15. You know I’m in the 3 or more miscarriage category but there is hope…Hailey waS lucky number 4. I want you to have a lucky number too. Sending you good thoughts.

  16. thanks for sharing all of your thoughts and fears…your courage is an inspiration to me…as for your poll about asking your niece…even though i think you should, it’s not something i could bring myself to do…partly because they are VERY religious but partly…hmmmm…i don’t know….
    i’m wishing you the courage to hope again….
    peace
    shlomit

  17. Here’s hoping the next baby will be asking for the car keys before you are ready…

  18. thanks for your posting. i just suffered a chem preg and then a m/c (iui) all right in a row, after ttc 1yr. i’m a bit lost, but reading about your journey helps a little bit.


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