IVF in Kerala - Triplet Pregnancy

We did IVF- ICSI and conceived!. Read here about the IVF

Then started the OHSS symptoms.

It's TRIPLETS!!!

Well, facts are always more complicated than fiction, no doubt. In the last two weeks, especially on one particular moment today morning, my life changed entirely. Whatever I was, whatever I was planning for myself, whatever I was expecting in the future..everything changed so drastically..I am yet unable to believe, and I am exhilarated, I am scared, although what can be the consequences and implications of it all I may not fully grasp until after many years.  

After coming home on 5^th, my parents went to their house to fetch the things for a stay that might be little longer than expected before. When Ramesh left for office, I sat alone. I felt very nervous about my P.G. course. If I do not go to complete the course, then it might become a problem (as described in the post 'Post Graduation'). Besides I did not want to waste the first two semesters of hard work, good fun and good marks. So just to make myself believe that I would be going, I booked train tickets to Chennai, on the 11^th July evening train, for myself and Ramesh. Then I called up my friend and P.G. classmate Sari and transferred the next semester’s tuition fees of around Rs.45,000/-.  

The next couple of days I spent reading something and worrying about everything. On 10^th my parents returned, and my mother took over cooking from the maid. Mily, our pet dog was allowed everywhere inside the house before, but since my parents were worried about pet allergy to pregnant women, she was now allowed only inside the sitting room.

On 11^th  (Monday) morning we went to the hospital, got the blood check done and found that Beta hCG doubling rate has reduced. I was very anxious, and my face showed the anxiety while waiting outside DrTC’s room. He saw me through the half door and we were called inside. He said the Beta hCG rate will get reduced as time passes, and later it will stop entirely. There is a  chance of increased hormone production by body at the end of the gestation period, and a very remote chance of recurrence of OHSS, but it will not be nearly as severe as the one before. He said that the ultrasound scan report says that it was multiple gestation, and he confirmed it by doing a vaginal scan. I told him that I was planning to leave for Chennai that evening, and he said outright that I should not go. There would be another scan on 19^th, and once it was done we could take a decision. If it is indeed multiple gestation, then I would have to take bed rest. I got very agitated by this. We left the hospital, and I cancelled the tickets. The waiting started again. I was too anxious. Anyway, I spent day and night lying down, reading and watching TV. In between we also went to watch ‘Salt n Pepper’ and ‘Harry Potter VII’. ‘Salt n Pepper’ talks about food and the opening scene song sequence features a lot of mouth-watering delicacies. But my stomach was still tight, no trace of hunger, and I missed feeling hungry watching those scenes. HP-7 we watched on 18^th  -a late night show (somewhere deep inside I knew I would not be watching another movie in a movie theater for a very long time to come). Ramesh was tired from office, and he generally disliked HP movies ("books are so much better!”), so he started snoring loudly. People in front rows turned around and laughed. I felt so embarrassed, but there was no way to wake him up.  Gradually he stopped snoring, still slept through the movie.

Today morning I had yet another ultrasound and vaginal scan. My father came along with us as he had a body check-up (after the angioplasty a few months back) at another hospital on the way. We dropped him there and went to our hospital. This ultrasound was done in the main block of the hospital, in the main scan room. The lady doctor with the accented Malayalam did the scan and she gave her findings to the person typing the report. (Online I have read many stories of pregnant women talking about their scans etc. where the doctors show them the monitors and discuss the results. But here it is not like that. We are considered ignorant, delicate weaklings with whom the important medical information about our own body cannot be shared). She was telling something and I noticed her saying ‘triamniotic’. A mild anxiety crept through me. Really, it can’t be triplets... My mind went numb. I could not pray for anything except that all was well. Even if it was triplets..well, whatever God gives, I should happily accept..after all these years..I closed my thoughts and concentrated hard on praying all was well…

I came out, saw Ramesh waiting there and told him that there might be some unexpected news. He frowned, but kept quiet. Then we went to DrTC’s room. The senior nurse was standing outside the room. She called me aside and said ‘Hey, it’s triplets!!’ I smiled, but it was forced. ’ Really?’ I said. ’Yes, Congrats! And now you take good care of yourself’. With that she went inside. I came back and told Ramesh what I was just told. He smiled, but I could not really make out if it was real, or forced. Then we were called inside and DrTC was sitting with a huge smile. He did not know that I was told, so with all the air of breaking a life changing news (which it was), he said, ‘You know, it’s triplets!’ ’Yes, we heard’ I said. The first thing I wanted to know was if I could go back to Chennai. He said, yes, I could, but then if there was some mild problem, or if there was a spotting (bleeding during pregnancy which to some extent resembles a period, but much less in quantity. It is a common occurrence, nothing serious most of the time, yet scary enough), then I might have to visit a hospital there, and as soon as they found out about the multiples, they’d make me stay in the hospital. Unknown hospital, unknown people, unknown city. And if there was any serious problem, then every single person in the family would blame me for going. So, really it was up to me to decide, and yet I had no options. I said I had a comfortable room to stay, good helping friends around. He laughed at this and said I was saying all these because I had no idea how complicated and difficult life could become during pregnancy. Ramesh offered that he could come and stay with me, and again doctor said, the problem was that things were unpredictable. If something happened then all the effort, all the sufferings, all the money, all the prayers and hope everything would be wasted. And so, finally I had to face that tough moment of actually realizing that I was not going anywhere for the next year. I could not believe it.

Then we talked about the babies. Doctor explained that I might have to stay in bed at least in the last trimester, and he would prefer if I stayed in bed during the whole time. Since the first day of my last period was 2^nd June, my due date for delivery, that is 40 weeks completion, was 8^th March. It might not go full term, but it would be very good if I could carry on till 37 weeks or 36 weeks, or at the very least 33 weeks when babies' lungs would be mature enough to breathe. I looked at the calendar and wondered if I could carry on till 14^th February- Valentines day, that is one day before 37 weeks complete. I felt strong and willful, and somehow felt I could carry my babies full term. We discussed many things, like other couples with triplets, the possibility of my continuing the studies later etc. Then DrTC said in a serious tone- ‘It is not going to be easy, carrying three babies, and going full term. You have to rest completely. Then after the babies are born, it will feel like a kindergarten at home. You will need a lot of patience. You have a choice to do selective reduction, that is, there is a procedure in which the weakest foetus is identified and reduced, so only twins will be there. You can opt for it, but then I would advise against it. Because of all the complications, there is a good chance that if we do this procedure, the other babies also might get harmed.’  ‘Oh, We are not planning any reduction’- Ramesh said quickly.  I had read that sometimes when there is a triplet pregnancy, and there is a health issue, then in that case it is better to do selective reduction so that at least the two surviving babies are healthy. So I wasn’t very sure, and remained quiet and listened to the doctor. He said, ’I am not advising selective reduction for two reasons-one, you both hoped and tried so much, and when you got such a blessing, it is not right to do such a thing when you actually can afford to not do it. You are well settled, you can afford three babies. Then you have the support of the whole family. People do selective reduction when they can’t afford to raise multiples due to financial problems, or because they don’t have enough help. Your case is different. I agree that it will slow down your career growth for may be a few years, but well, it will also enrich you in many ways. Second reason is that the process itself needs to be done expertly. And it is not something we have a lot of experience in. Anything can go wrong, it can affect the other fetus also, I am not saying it will, but it can. Also it is not necessary that the fetus that gets reduced was the weakest. It is just an assumption after studying certain characteristics. So, now the decision is up to you. Think about it, and decide wisely. Your decision, whatever it is, is right’

We came out, and I said, ‘In a way it is good now that we know where all the three transferred embryos are, because otherwise I would have wondered where the third embryo went, whether it is in the tube or something..but then the three frozen embryos, what will they do to them?’ Well, we may never find out.

Much later, experience made me wonder about selective reduction, the technique of identifying the embryo to remove if we so decide-in case of multiple pregnancies. If the criteria for selection is weight, then what we find from experience is that the baby born with the least weight is the smartest one. If the criteria is survival instinct, well, how do they identify if an embryo has more survival instinct? Anyway, that is for experts to think and decide. 

As we started back, we discussed selective reduction. Ramesh would not hear of it. I also did not want to do it, now that the doctor assured that if I could carry at least 35 weeks, then the babies would have no major health or developmental issues. So, no selective reduction for us. We picked up my father on the way, told him the news and he got very excited. We reached home, told Amma. She got thrilled too, but also very worried about the health risks for me and for the babies. 

We are planning to go to my parents’ place and stay there for a few days, to get things settled there and my parents can come with us for a longer stay. I am doing a lot of internet research on pregnancy, especially IVF, that is how I read about ectopic pregnancy, where the baby can get stuck in the tube. Also I read about birth defects when it is a multiple pregnancy. The possibility of autism and other developmental problems due to pre-term delivery. I am having all kinds of bad thoughts these days. I am inventing all sorts of reasons to worry.

I was worried about many things at the time and I could not really appreciate the abundant blessing I was provided with. But later we realized the dedication and expertise with which DrTC and the rest of the doctors and nurses approached each case and the care they give to each one.

NEXT...First trimester