Murphy Probably Had The Right Of It.

You know that thing you can do when you subtly (or not) induce someone to independently endorse your opinions by spinning them the data in such a format that they think the inevitable conclusion was all their own work? (If you overwhelmingly do not, then you have probably never worked in sales; further, I have just singled myself out as someone whose moral ground just became a leetle stickier underfoot.)

I’m a little anxious that I may have pulled this trick, albeit unwittingly, on my Consultant. I shall s’plain.

The twists and turns to my reproductive history are so myriad that they bore even me: let us simply term my uterine activity a fair personification of Murphy’s law. In précis: I have been pregnant four times in my left uterus and twice in my right – redeemingly, one of which went on to be awarded Star of the Week at school on Friday. (Reason? He finally worked out how to read. Also? It was kinda his turn. The kids haven’t realised there is, loosely, a rota.)

After Harry’s IUGR, I moaned loudly about my perceived poor vascularity of the right uterus, especially after finding that my heart’s aortic/venous plumbing is laid back-to-front through my abdomen, and might not necessarily be on the best of geographical terms with my right uterine artery. I postulated the theory to one and all, but seemed to be rather lone-voiced among my doctors in blaming Suspect Vascular Supply, although they all dutifully wrote it down in my notes.

But here’s the thing: by your 5th failed pregnancy, doctors start noticeably pandering to any harmless bees you might diffidently produce from your bonnet. Thus pregnancy six, Turbo, was duly replaced into my nice, inaccessible, arterial-haemorrhage-menses-producing left uterus purely in order to make me happy. The subsequent violent miscarriage – my body badly wanted those heparin-assisted burrowed-in placental shreds gone – sent everyone’s diagnostic weathercocks swinging round to Immunological. And I’ve been feeling cosmically picked-on about it ever since: Uterus Didelphys coupled to infrequent ovulation is a sufficiently complicating handicap – must I also suffer the indignity of an immune system that can’t read the simple sign on my ute?

Warning: Live Pregnancy. Do Not Extinguish. This Means You.

Anyhoo, when I cited ‘immunological’ in passing discussion with Head Chap earlier this week, I goggled when he said he would be inclined to look no further than poor vascularity associated with my didelphys as the culprit. I did the whole distended-eye-goldfish-mouth impression slightly, so he had time to enlarge upon the fact that the uterine arteries, intended to feed half a uterus each, are obliged to feed a whole uterus each with didelphys (I had known this, John had not) and that this factor could well be expected to have a marked effect on even an early pregnancy.

Say what now? I’ve been banging on and on and bloody on for months about the fact that I thought my right ute was at the absolute end of the radiator system for the hot water, so to speak, and was even humoured to the extent of Choosing My Own Uterus For IVF. It made no difference, as it happens, but no-one has ever so much as hinted before that I might just have had a real point in blaming the physical logistics of blood supply. I remember specifically asking him to keep an eye out for dodgy arterial uterine wiring during my hystero-& laparoscopy, but he said it’d not be visually detectable, and gave no hint that it might be anything other than Ann’s Crackpot Theory. 

So, it essentially felt like he was reading my half of the script, and I’m not quite sure how we got around to switching lines.

Having said that, I didn’t anticipate him taking quite that tack, as the accepted medical wisdom is that Uterus Didelphys, in the lump, is not strongly associated with early miscarriage. Late miscarriage, premature birth, IUGR, lousy presentations: yes, yes, yes, yes; didelphic uteri tend to be small and the cervixes sometimes incompetent. (Mine are both normal-sized, as it happens, and my formerly neat, competent cervixes were only buggeroonied into a pretzel by Harry’s emerging through one of them like Rocket Man, followed by a comprehensive pelvic-floor exhale.) 

But I know, because I read the Mullerian Anomaly message board, that early miscarriage does, in fact, anecdotally seem to crop up fairly often. So do irregular periods, thrombophilias and every other sort of reproductive havoc; it’s the nature of the comorbidity beast. If you have a Mullerian duct anomaly – any of ’em – you have problems. Except for the women that don’t. There are women, particularly with UD, who sail through conception and pregnancy without a tremor. Others – the majority? – have a mixed bouquet of early and late miscarriages, interspersed with premature births, interspersed with full-term uneventful pregnancies.

And no-one knows why the hell.

My Magic 8 ball says ‘Cannot Predict Now’. His said ‘Outlook Not So Good’. He said he thought the odds were against me, but not stacked against me so badly as to render it all pointless.

Anyway. I could well have immunological issues, too. I asked him about the shiny-new-uterine-biopsy they are offering for Natural Killer Cells, but he gave us the strong impression that he, personally, thought that NKCs were the stuff snake oil is made from. So, given that I was supposed to be taking prophylactic steroids next time anyway, I’ll probably pass.

I explained my quantity over quality preoccupation. He agreed that replacing cleavage-stage embryos would probably give us more bites of the pregnancy cherry.

Him: ‘Should we replace one or two?’

Me: ‘Oh, God. Definitely one.’

(My last frozen 2-embryo cycle resulted in a twin pregnancy of sorts. Do Not Want. However, I have since noticed the £750 price tag attached to frozen transfer cycles, and I’m thinking I might need to reconsider.)

I asked about my weight (‘you don’t look to have a significant problem’) and age (‘I wouldn’t say you’re at an age-critical stage yet’). Which is odd, because I sat cringingly in front of this chap 7 years ago, a stone and a half lighter than I am now, and he told me my weight wasn’t helping, and that I was too obese for NHS IVF. Of course, I’ve been pregnant 6 times since then, so he’s possibly not sweating the small stuff anymore.

After recently learning that elevated levels are associated with recurrent miscarriage, I told him I would like my prolactin level looking at; apparently it’s never been checked. I don’t know if I ever posted about it, but I was still fairly full of milk a year after I’d finished breastfeeding. I had eventually dried off (John suggested a diet of sawdust and straw) by my last pregnancy – but by the time I miscarried at, what – 9 weeks? my milk had come in. Properly come in. Which was nice. He said it wasn’t desperately unusual, but  he agreed it was worth checking, and sent me off for a blood test immediately afterwards.

I suppose I should have walked out of clinic depressed. I think John did. But I actually felt as if a small weight had been lifted from my shoulders. If it isn’t immunological after all, if it’s just (just!) the didelphys, then at least I have one less thing wrong with me than I thought. 

Now: to lose some weight. I have abducted my in-law’s Wii, bought the Zumba fitness game+belt, and tomorrow the floors will begin to shake with my frantic gyrations. I will be whippet-thin by June.

Here. The sun’s been beaming, and it’s been lovely. Have some pretty flowers.

Eggs

Thank you all very much indeed for your response to my previous post. Your comments: the insightful, the sympathetic, the kind – and the, ummm, not quite so kind – were all appreciated. You are, as ever, my sterling Internet of Phenomenal Greatness.

I have tried to answer the questions commenters raised about the Whys & Wherefores & Whats in the aforementioned comments section, so I will simply move briskly onwards and say that John has agreed to continue paying out assisted reproductive rope for me to hang myself with, simply because he doesn’t want a crushed and malfunctioning wife.

The gameplan is that I take until the end of Spring to get myself lighter, fitter, healthier, and thus give myself the best possible chance of success, and the fewest possible If Only We Hads. I also have IBS with an assortment of delightful gastric complications, and a torn-during-last-viable-pregnancy-and-not-healed-at-all abdominal muscle, neither of which I’ve been quite organised enough to actually tell my GP about, so I am planning to see if he can improve my quality of life a little.

I have wangled an appointment with my original consultant tomorrow (who is now the hospital Medical Director-type and, I am sad to hear, retiring this month) in whose opinion we both place some faith. I was profoundly disappointed that my previous IVF cycle yielded no frozen embryos, and, among other things, would like to discuss ways in which I can, within reason, prioritise a degree of quantity over quality – without landing myself in OHSS territory again. Tall order, I know: maximum bang for your buck. Or… something.

John is 40 in May, and last year I miscarried on his birthday. Ehhh. My absolute unwitting bad. This year, I am insisting he parties in some fashion, ergo: I must generate hospitality not hospital visits. But if I start a cycle immediately after his birthday, and it’s successful, that puts my ~8-week Maximum Miscarriage Danger Zone smack bang across Harry’s birthday, for which I also have plans. And leaving it any longer makes me feel twitchy. The calendar is already dog-eared from my feverish attempts to work out just when I could miscarry with minimum family impact. Apparently, some people just use a calendar to work out holidays. Fancy.

In other news – God, yes, let’s have some other news! – I bought two new hens yesterday, neither of which I actually needed, as such. One never needs hens. One simply chooses to suffer the mild dementing effect associated with them. I brought them home at lunchtime in a cardboard box, and ejected them straight into the darkness of the henhouse to settle and orientate themselves. Except they both summarily decided that Out was better than In, and avian chaos followed.

The home contingent consisted of two cockerels (one of whom was actually already on death row for the heinous crime of being sold to me many weeks earlier as a point-of-lay pullet, and having proved impossible to give away) and 4 brown, quarrelsome, endearing ex-battery hens. Gertrude the Chick, the chick I suffered over, was eaten by a buzzard on Christmas Eve. (Goddamn it, nature! Still, at least the buzzards had a nice chicken Christmas dinner hor d’oeuvre.)

My new Black Rock hen is evidently Head Girl material, and she joined in the general troughing (I had brought food. With hens: always bring food. I have read my Du Maurier, and have a healthy respect for beaks. Also, no open-toed shoes if you require feet-assistance for base 10 numeracy.) with such gusto that she temporarily passed as a ringer amongst the other girls. The two cockerels, unfortunately, had spotted Fresh Meat; both crowed Dibs! together, and Ugliness ensued between them. 

My other new purchase, a White Star (a breed known to Hairy Towers as Pterodactyl Hen, due to distinct predominance of beakiness & scrawniness) had already warmed up beforehand on an entirely unscheduled, and inconvenient, circuit of the Domestic Fowl Trust’s checkout area before being inserted firmly into the box, so she exploded out of the henhouse like an agitated feathery missile sat on a firework. Everytime the shiny-white little idiot blindly scuttled past the feeding area at warp speed, the cockerels would break off their ferocious attempts to murder one another in order to set off in hot, lust-driven pursuit – but there was no catching her. I took the adult course of action and stood mithering for a while, before somehow managing to divert the neurotic white blur back into the henhouse, and hoofing the Black Rock in after her. I slammed the door shut.

The alpha cockerel – the one I actually intended to own – took up station outside the door, expectantly.

He looked at me. I looked at him. His wants were fairly transparent.

I let the ladies out at dusk for a quick look around – by which time, the beta cockerel was no more, John having finally neatly and swiftly despatched him at my fervent request – and the yampy bloody White Star took off around the paddock again. If you ever felt the need to watch me thundering about, waving a garden fork and muttering: last night was your missed opportunity. Whilst I was trying to re-corral the pterodactyl, Black Rock fell victim to the cockerel’s determinedly amorous advances, which is my euphemism for violent rape. The poor girl eventually just let him get on with it, but he persisted in waltzing frantically until I shooed them all into the dark for a well-needed rest.

I can only assume he’s compensating for something, because even in undisputed possession of his flock, this morning was a Trying Time for Black Rock. I stood in the howling wind and freezing cold watching glumly as, riddled with male insecurity, and ignoring the ex-batts completely, the cockerel leaped on the suffering thing every 5 minutes, chasing her dutifully around the run while in full courtship display, sporadically leaving her be in order to chase pterodactyl hen – whom, btw, he is never, ever gonna catch in a flat race. That girl has Pace.

This afternoon, the White Star has mainly been visible as a nervy pale gleam at the far corner of the hen run,

 rummaging among the undergrowth, keeping a weather eye out for the cockerel – who is still assiduously, although happily less violently, courting Black Rock, whom I feel is trying to find somewhere discreet in order to lay the egg I’m sure she has been nervously retaining since yesterday – but as anyone with a young family who has tried to locate a nice quiet toilet cubicle in time of acute emotional and physical need will testify, peace is always at a premium in busy communities. Having said that, she has just launched a squawking, unprovoked, beak-extended attack on the White Star, emerging triumphantly wafting white feathers – so perhaps she isn’t clenching awkwardly and shifting uneasily from claw to claw after all. The ex-batts, mightily offended to a woman at the disruptive arrival of such irresistible shapely scarlet-black allure in their midst,

 are all gathering around the cockerel, trying SO HARD to flutter their feathers winningly at him. I am no expert on hen behaviour, but they look Jelus As Hell to me.

 All human life is here! And I bet I have no more eggs this week.

This week, in which I turned 37. I hope my ovaries are doing better in that department.

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