IVF 6w2days+-5days, 2 implants, no detectable heartbeat. Did we lose one?

[JLaSalvia]

Hi we are new on this forum, but my wife and I went through IVF before (1 ovary and infertile only because of blockage) and had twins (3 "A" grade specimans, one was lost at 16 weeks) and 2 cryo froze "B" grade specimans that were left. Recently we attempted again (it is not emotionally or financially inexpensive) but neither cryo embryos survived the thaw. Thus the start of the emotional rollercoaster:
My wife is over 36 now and we decided to do the whole IVF fresh this time right away after the news of the cyro failure, but this time with insurance benefits (it helps). For some reason when we breezed through the twins (although high risk) we took for granted that this would be as easy.

We realize age has an affect and were recommended to do PGD to test for chormosome abnormalities and favor a girl if possible (we have the near-3 twins and a 19yr old from my wife's previous). But this time it took more meds and yeilded more follicles and eggs, but the PGD yielded only 2 candidates, a boy and a girl, the rest determined chromosomally abnormal of different kinds. It made the implant/moral questions/issue non-issues (other big reliefs) because the abnormal chromosomal embryos would have aborted (PGD checks only life-sustaining, not whole chromosomal spectrum).

Because of the PGD and IVF, the hcg levels were about 41.4 and 84.5, 10 and 12 days post ET.

We went for the 1st u/s today, and viewed one with a wonderful heartbeat although not quite completely audible. It was obvious that the nurses felt pretty obviously optimistic/confident.  Officially they gave the age at 6 week,2 days plus or minus 5 days. But the other, although present, and appearing pretty similar in size was darker and not as regularly shaped as the other had no detectable heart rate and it was noticeable that the nurses focused on the one with the heart rate.

Although we are blessed with the children we have,  we did not get the warm and fuzzies we experienced from the 1st IVF experience especially not a very good feeling/vibes from the nurses who performed the 1st after-blood determined pregnancy u/s regarding the embryo with the non-detectable heartrate. Next week is another scheduled u/s and it, as everyone else going through the trials and tribulations of IVF and pregnancy can relate to, is a true test of patience, hope, desire and fear of the unknown. I am an very optimistic person, but am coming to the realization of the miracle of life is truly that, whether natural or medically helped. (It makes for a helpless feeling while waiting for the next u/s.)

Looking at the other forums and questions, it seems early and I want to be remain optimistic, but realistic:

Is 6wk, 2 day (IVF estimate) plus or minus 5 days too early to give up on the second one (probably the girl since she was a class "B" implant) although similar size than the visibly beating one, but darker and irregular shaped, without a detectable heart rate (the other was barely detectable audio-wise, but you can see visibly)?

With all our hearts, we reach out to you. With all our wishes we wish well the others we've never met, but know that they are experiencing similar uneasiness (along with all the harmonal changes and emotions that go along with it).

I remain hopeful, but would appreciate any realistic comments.

[40smama]

I firmly believe that our re's office too was understaffed which drove me nuts especially in regards to nurses.  I'll never understand why my re does that except there may be a labor shortage.  You've raised some interesting points.

[JLaSalvia]

Thanks for the support. My wife is computer phobic and really doesn't like to know details; just the bottom line. The shots and pills (projesterone and estrogen) and not knowing, just stress her and she tends to think about it, but not deal with it. So I think about it for her, trying to make any sense with it all, whatever time it is. We were only given the 2 hcg records that supported my theory that they were on the PGD, which takes one cell in 6-8 has an affect on the levels/growth so the stats I see doesn't take into account.

The next u/s is Thrusday (a week from the last). I figure twin b is there, but just behind because the grade was initially lower and it had the 6 cells upon the PGD (biopsy), which would explain the growth difference. But I also looked at the PGD and compare it with the oocyte data record myself to find that the doctor may have given us a "white lie" when she said both were chromosome damage free (which is true) but the boy was an "A" grade and the girl a "B" to find out that the girl was a "C" and had less cells when biopsy for PGD was made. Also, I cannot find any statistics that combine IVF with hcg count but also take into account PGD which takes out a cell when the embryo is only 6-8 cells (12.5-16.6% of total cells at this early stage - seems to me would have an effect on growth & quality affecting both hcg and stage relative to the normal and iVF stats)....And the bedside manner of the nurses was apparent they were not hopeful of twin b, by side-stepping the issue (I think protocol is to have the doctor give the straight facts - and she wasn't there. Leaves me to wonder, do they consider these things or not. The office is to busy to return promised calls on everything from why they bill as if they are not on the list of providers (with some fertility coverage) to why the meds is different cost than what they tell you at the first conference, to list of prescripts to keep the pharmacy (who is getting $2000+ of our money after pharmacy benefits) honest. To understaff a fertility office (by splitting into 2 separate at 2 sides of town) tends to change the 1-on-1 feeling we got 4 years ago into a lower quality rotating-door feeling. I guess this is makes me uneasy. It counteracts the general progress on fertility and spreads it too thin, injecting doubt, deceipt and non-pesonal although (not so positive) though as we all know, is closest to the heart.
A tangled web indeed.

I am thankful for your comments and hope that the twins in both your cases become as rewarding as our twins (which were triplets until 16 weeks). One is blonde and blue-eyed (athough only my father and my wife's grandfather are the only blue-eyes we know in the family; the other small, curious-and-mischievous-while-smiling with big brown eyes having very long eyelashes.

[40smama]

Your story touched me also.  I would expect that a u/s in one week time would determine the outcome of twin b.  Are you scheduled for one anytime soon?  Good luck!!!! - jennifer (15w2d)

[dsmommy]

Your story touched me b/c we went thru IVF to conceive this time as well and are now preg. w/ twins.  I know how challenging and stressful the whole process can be and also how rewarding.  I know you are thankful for even just one baby but the unknown is SO hard.  It would have been nice for the dr or nurse to give you some insight to the other baby. Did you ask any questions about it?

Could go either way.  If you saw two and only one heartbeat then it sounds like the other one implanted and either stopped growing or may be a day or two behind the other one and they just weren't able to detect the heart beat yet.  One of mine obviously implanted later than the other because it has consistently measured two days behind the other one.  Have you had any other blood test/hcg levels tested?  I have read other post where a heartbeat was not detected until around 7weeks so keep your fingers crossed.  When is your next u/s?   Also, I'm posting my hcg levels just to give you some comparison since that part drove me crazy and hopefully they will test again soon.  Did they also test progesterone or are you (your wife) taking any prog.?  Keep in mind everyone and every situation is a little different.  I wish you the very best!!  Keep us posted.

5day transfer on 8/21
8/30 hcg 326
9/6 hcg 3950
9/13 hcg 22985

Good luck and try not to worry yourself silly over the weekend!
Dottie
14wks 1day (twins)