First the info about my blood work...

The hormone they were measuring was at 27 when they took my blood on Thursday.  The midwife had told me that she expected them to be above 10 for this stage of my pregnancy.  When they took my blood yesterday it went down to 22.  So, this was a decline which was what they were expecting.  That if my pregnancy was moving towards being a miscarriage we should see the levels declining.  However, I guess it didn't decline what they considered to be a lot.  I have no idea what's "normal."  But they said that sometimes at this point in the pregnancy the hormone level will level off and that the decrease that they saw wasn't truly definitive.

Next was some additional info about the ultrasound...

She said that when she looked at the ultrasound she did in her office and when she spoke with the technician on the phone who did the second ultrasound at the hospital, all indications were that there was no fetus.  However, upon further reviewing the actual images and file and report etc., they did see a fetus/embryo that measured 6w 1d.  They said it measured .5 cm from crown to rump.  This was pretty amazing to hear (is amazing the right word?  surprising, confusing....) since before I was under the impression there was nothing there at all.  There was no heartbeat however.  So at this point we would no longer call this a blighted ovum but a missed miscarriage.  However, since they did not know this before, they now want to do another ultrasound Thursday to check one more time for a heartbeat.  I will then have a follow up appointment Friday.  All indications are still that this is going to be a miscarriage.  But obviously we all want to be 100% sure not just 99%.

Oh, the other thing is that when they looked at either the gestational sac or the yolk sac, one or the other (or both??) was misshapen.  This concerned me greatly - she said that it could actually be a cause for why the fetus was not developing.  And my greatest worry was why did that happen!?!?  Was it just a fluke or was it something that might happen to me again?   Was there something about ME that made that happen??  She said no, that just because that happened this time didn't mean that it would happen again and that it didn't have anything to do with my not being able to have another healthy pregnancy.

As for how I'm feeling, I'm hardly feeling any nausea any more at all.  I had definite cramping last night and off and on today.  But I also know that I am definitely constipated and have had a lot of gas this whole pregnancy.  So it's really hard to know for sure, but I am fairly confident these are cramps indicating I will soon have a miscarriage. I have a ton of Tylenol (to take for cramping if I don't have bleeding) and a big jar of ibuprofen too.  If I start bleeding at any point I will feel confident in switching to the ibuprofen.  I guess I am prepared as I can be for a miscarriage to happen if it happens naturally.  If the results of the ultrasound on Thursday show no heartbeat I am sort of leaning towards having the D & C.  Not completely, entirely sure, but more sure now that I know there is actually something there vs. nothing at all.  I am still trying to weigh the risks vs. benefits about that.  But if I do decide to go that path, which I'm sort of leaning towards now, it would likely be Tuesday morning. 

As for fertility treatments/options etc.  We had an appointment originally scheduled for the end of this month, so we will have that appointment.  However, the midwife and the doctor she consulted with both agreed that an HSG would be unnecessary.  That is where they inject the uterus and fallopian tubes with dye and do an ultrasound to make sure there are no pathways blocked.  They said that since I got pregnant that this would be unnecessary.  That certainly was good news.  I don't want anything invasive I don't have to have.  Regarding sperm analysis, she said that we could go ahead with it if we wanted.  It certainly wouldn't hurt anything to do that but again that since we got pregnant that things were probably fine as far as that goes.

I think I would be scared to death if there were a heartbeat on Thursday.  Because what would that mean??  That would mean that development would be about two and a half weeks behind?  I'm sure of when I ovulated because of taking the OPK tests and all the tracking I did etc.  I just don't know what that would then mean if there WAS a heartbeat.  I would be terrified that I would have a baby not developing normally. 

Lastly, as far as the cyst they found - they will look at that again on the ultrasound they do on Thursday.  But they would probably be doing yet another one once the pregnancy was resolved and my hormones came back down to 0.  She said the hormones involved with the pregnancy could have an impact and wanted to wait until that was resolved before they made any decisions about how to move forward with that. 

So that's the news.  I just keep praying that I will be healthy again.  I don't know what else to pray for.  I pray that I make the right decisions about surgery vs. no surgery.  I pray that if they do see a heartbeat that I will somehow have a healthy pregnancy.  I pray that if I have a natural miscarriage that I will still be healthy.  All my prayers are just revolving around health because I don't know exactly what else to pray for because I don't know what God has planned.