New Dads on the Block

Baby One:

Baby Two:

The twins were twelve weeks and a couple days along when these sonogram images were taken in Mumbai on Monday, December 4.

From the images, in the bottom right-hand corner, you can see Baby One is 2.6 inches CRL (crown-to-rump length). Baby Two is 2.7 inches CRL.

Those ages you see (12w6d and 13w1d) are estimates based on the size of the fetuses, even though we know they’re 12 weeks and a couple days along in these photos.

The heartbeats are great, and no anomalies are shown in these scans. All things expectant dads want to hear.

On a more entertaining note, Matt and I had a little too much fun with the “ermahgerd” meme that spread like crazy around the Internet and Facebook not long ago, especially the animal “ermahgerd” meme. Matt and I may or may not have pasted a few of these images on each others’ Facebook walls when the meme first came out.

With the new sonogram images of the twins, I couldn’t help but make my own “ermahgerd” image.

And yes, it is now my Facebook cover image.

About 160 days to go….

–Josh

As of this weekend, our surrogate is 12 weeks pregnant with our twins.

From what Matt and I have read, this means our twins are about the size of plums at this point. They’re about 2-3 inches from the tops of their heads to their rumps, and weigh between half an ounce and an ounce each.

Most of their critical systems are formed, and they’re about to enter a big growth and maturation stage where organs and tissue are going to grow and develop rapidly.

They’re able to open and close fingers and curl toes, and their brain development is picking up speed.

About 166 days to go….

–Josh

Good news: Matt and I are eleven weeks along with healthy twins! 🙂

Two healthy babies is wonderful news, of course. However, we were pregnant with triplets initially. Our medical team in India let us know their concerns about the health and well-being of the three babies, and our gestational carrier, due to the multiple pregnancy. Their concern was great enough that they let us know they felt it medically necessary to reduce the pregnancy from triplets to twins.

Matt and I were, of course, saddened by this news, and talked a lot about it. We did plenty of reading and research about the subject and found some important information about reducing a pregnancy from triplets to twins.

Carrying three babies to term would more than double a woman’s risk of developing the most severe diseases of pregnancy, such as preeclampsia. The average triplet is born two months premature, significantly raising the risk of disabilities such as cerebral palsy and of lifelong damage to the infant’s lungs, eyes, brain and other organs. By reducing the pregnancy to twins, [there is a] decrease in the risk of severe prematurity. (Washington Post)

We were also able to find medical journal articles, and studies, about reducing triplets to twins.

First trimester multifetal pregnancy reduction can be performed in order to decrease the risk of complications associated with multiple gestations. These complications include extreme prematurity before 32 weeks, low birthweight infants, fetal death in utero, high levels of perinatal mortality, and high levels of perinatal morbidity, which includes cerebral palsy and necrotizing enterocolitis. (European Society of Human Reproduction and Embryology)

What we read led us to believe that our medical team came to the right conclusion.

On top of all that, our gestational surrogate is five feet tall, which makes it obvious that carrying three babies to full term would be impossible. Not only that, but it could put our surrogate’s health at risk as well, from more minor health concerns, to potentially life-threatening complications. Matt and I are so grateful to our surrogate for carrying our children for us–more than we can ever even express–and it only seems right to do everything we can to assure her health, as well as the health of our children.

Matt and I spent a quiet weekend together, sometimes somber and still doing a lot of thinking, but came to a place of acceptance with what our doctors felt was medically necessary. This week we’re working to focus on the fact that we have two healthy babies on the way. We couldn’t be more thrilled about that, and we’re so excited to meet them this spring.

–Josh

When I was a teenager, I remember making one of those “life goals” lists. One of the items was “Run a marathon before I turn 30.” That list, and that bullet point, stuck with me for years. Since I’m now 29, with the big Three-Oh coming in February 2013, this fall became my last shot to cross that goal off my list.

And, of course, with kids on the way, I had more than one person say to me, “Do it now. Before kids.” Not that it’s impossible to train for a marathon when you have children–hundreds of thousands of parents run marathons every year–but I’m betting it’s a lot easier to train the many hours and miles for a marathon as empty-nest newlyweds than as parents of infants.

I spent the last five months training to run a marathon, clocking more than 400 miles during the training process. You can imagine my heartbreak, then, when I got a terrible case of pink eye, and a nasty chest cold, the Friday before the race. I also had a foot injury that had just healed after three weeks of rest, with not a single mile run during those last weeks leading up to the race.

Friends and family asked, “Do you think you’ll still be able to do it?”

Truthfully, I didn’t know. But I put on my best brave face and said I’d be going for it no matter what.

The Friday night before the race I flew to Philadelphia directly from a work trip in Oklahoma City. I spent some time with Matt, and our dog, Butter. My best friend, Josh K, and his boyfriend, Trent, bussed down from New York to root me on at the finish line.

Sunday morning, November 18, was the moment of truth. Josh K knocked on the bathroom door as I pulled on my marathon outfit, long before sunrise. I opened the door. We both laughed.

“Oh no,” he said. “You look terrible.”

“I know!” I said. “Watch what happens when I smile.”

When I did, my red, swollen, itchy right eye closed almost completely. Then my laughter turned to a nasty hacking couch, and I spit up something unmentionable.

I don’t think I’ve ever felt sexier. (Ha.)

But I was determined.

At 7 a.m., when the fog horn sounded and the race began, I hustled off with more than 20,000 fellow runners, some running the full marathon, others the half-marathon.

Four hours, twenty-eight minutes, and five seconds later, I crossed the finish line.

Overjoyed doesn’t even cover how I felt. I was ecstatic. I called Matt and, as we talked, I was so overwhelmed and happy–and just plain relieved–that I cried.

It was an amazing day.

Four days later, it’s Thanksgiving. The cough is fading. Thanks to prescription eye drops, the pink eye is mostly gone, but because of the risk of contagion, we had to cancel our plans with my family in D.C. and Maryland. That was a huge bummer. But it did also open the opportunity for something we’ve never done as a couple: Thanksgiving for two.

This year probably marks the last time Matt and I will ever have Thanksgiving just for two. Next Thanksgiving we’ll have five-month-old babies. And, barring any seriously contagious ailments, we’ll be surrounded by family, which will be great. That will probably be the pattern from here on out.

But this year? We bought a small chicken, rubbed it in herbs and spices, and popped it in the oven. Matt made green beans and croissants, I made Stove Top stuffing (my favorite part of any Thanksgiving meal), and even baked my very first cake. Ever.

It turned out to be kind of sweet, this holiday for two. It gave us time to contemplate the future, and time to think about how much we actually, truly, have to be grateful for.

This Thanksgiving we want to send very special thanks to our surrogate, in India with her family, and to our babies, whom we look forward to meeting (so much!) in six and a half months.

And, of course, a very happy Thanksgiving to you. I hope it’s a great one, filled with great food, family and/or loved ones, and much to be thankful for.

Hugs,

Josh (and Matt!)

A year ago today, Matt and I got married at Bethesda Fountain in New York’s Central Park. Our wedding took place on 11/11/11, exactly three years from the day we first met.

Surrounded by thirty-three people, all dear family and friends, we exchanged vows.

It was such a fun, easy, relaxed day.

After exchanging vows, we had champagne at the Boat House, just steps from Bethesda Fountain, and then had dinner with our wedding guests at Buddakan (at the long table, seen at the 0:14 mark). I travel a lot for work, and saved a lot of hotel points, which allowed got us to get a suite at the Le Parker Meridien that night. After dinner, our wedding guests joined us at the hotel for drinks, coming and going at their leisure, the last of the guests leaving after midnight.

It’s such a cliche thing to say, but it really was probably the happiest day of my life (so far). When else do you get all your friends and immediate family in one place at one time to laugh and eat and catch up and listen to music and harass each other and tell embarrassing stories and stay up late drinking cocktails, toasting to the fact that you just married the person you love most?

The first year went fast, and it was a great first year of marriage. Matt and I started taking serious steps to have kids in May 2012, and by July we were in India, working with our surrogacy clinic to get a pregnancy under way.

Now, on our first wedding anniversary, we’re staring at the second sonogram of our pregnancy, nine weeks along.

We still have three healthy babies, and so far everything is looking normal and good.

At nine weeks, babies in utero are about one inch long–each about the size of a blackberry–with tiny fingers and toes. Hair, fingernails, and toenails are starting to develop.

Matt and I have so much to be grateful for. It’s crazy to think that a year from now, on 11/11/13, our second wedding anniversary (and five years from the day we met), we’ll have five-month-old children (God willing!).

We can hardly wait.

–Josh

Today our pregnancy is eight weeks along. Hurrah!

Matt and I are especially thrilled because reaching the eight-week mark means that our chance of miscarriage drops from 15% to 3%. It’s a nice (small) sigh of relief as we make our way through the first trimester.

Our babies are now the size of raspberries. They are 3/4 of an inch from the crown of their head to their rump (what they call CRL, or crown-to-rump length) and can now kick. All major organs, muscles and nerves are present.

Keeping our fingers crossed! Likely less than 200 days to go.

–Josh

Last weekend Matt’s mom flew into town for a couple days so we could celebrate her very recent birthday, and also to toast to the baby(ies) on their way. We knew that by Monday morning, at the close of our weekend, we should have the first sonogram of our pregnancy, six weeks into things.

Our merry trio went out for drinks, took in a Broadway performance of Evita (Ricky Martin was the best part, and not just because he’s not hard on the eyes), and went out for a dressed-up dinner at Del Posto afterward. Matt and his mom are true foodies, so it was a lot of fun to watch them savor the delectable dinner.

On Sunday we caught the great, smart thriller Argo, and spent some wonderfully lazy time at our apartment, just hanging out together.

But by Sunday night, it was in the air: We were all a little restless, on pins and needles to get the sonogram results from the clinic. Matt kept refreshing his e-mail inbox as we headed to bed after midnight, knowing Monday morning business hours had begun in Mumbai.

No luck.

In the morning, Matt’s mom showered and packed her bags, getting ready to fly back home. I packed my bags, too, preparing to fly out to Houston for the week for work. We both looked at Matt, who looked at his phone, and then back at us with a shake of his head.

Still nothing.

A Town Car took me to Newark Airport, and I kept looking at my phone, making sure the ringer was on, waiting to hear from Matt.

Forty-five minutes later, as a United machine spit out my plane tickets at the airport, my phone rang.

“Are you ready for this?” Matt asked.

“Yes! Tell me!”

“It’s triplets. We’re pregnant with triplets.”

I stopped dead in my tracks. “Are you serious?”

“Yep. I just e-mailed the sonogram to you, along with the official report. We have three healthy, normal heartbeats right now.”

Blown away doesn’t even cover it. It was the most wonderful, surreal experience. Matt and I laughed, excitedly parsing all the details we’d been sent.

“Triplets?” I asked again.

“Well, here’s what I learned: a lot of twin births actually start out as triplet pregnancies. The body often reduces a triplet pregnancy to a twin pregnancy, all on its own. So we have triplets right now, but we shouldn’t necessarily expect to end up with triplets in the end.”

We knew the next big sonogram would happen at 11 weeks, wherein we’d have a battery of genetic tests, thoroughly examining the health of each fetus and looking for any concerning irregularities.

The clinic also let us know that if the health of the babies, or the mother, were in danger due to the triplet pregnancy, that they would need to reduce the pregnancy to twins. Twins come early as it is, we learned, and triplets come even earlier, especially when your surrogate is barely five feet tall and can’t accommodate three full-term babies in her small body. Triplets increase the odds of early birth, low birth weight, with potential fatal risks for the babies. Having to reduce is wrenching, of course, but we want everyone healthy and safe when delivery time comes, and that very likely means twin  births at most. Our doctors will be monitoring things very carefully in the coming four-plus weeks, and their medical determination will be the final word on that front.

With all of that in mind, that’s why the title of our post reads “TRIPLETS*!” with an asterisk. We’ve been prepared for the high likelihood that we’ll have a twin birth in late spring of 2013. It’s also good to keep in mind that we’re still early on in the pregnancy, too; one or zero babies are still possible at this point. However, we’re hoping for the best, and for textbook, low-risk births next year.

Matt and I have been poring over the sonogram images of our babies (“Baby A” is above, on the right), and the official reports.

Our estimated delivery date falls around June 12-16, 2013. Of course, knowing we have a multiple pregnancy, the babies are virtually guaranteed to come earlier than that.

Three well-defined gestational sacs are seen in the uterus, our report reads. They show a good chorio-decidual reaction around them. A fetal pole is noted in each sac. Fetal heart activities are present. 125-133 beats per minute. There is no evidence of subchorionic bleed. The lower uterine segment appears normal. Bilateral adnexa are normal.

(Click below to enlarge the report)

There’s a little surprise at the bottom of the report: A small vanishing sac is seen in the uterus. There is no fetal pole in the sac.

What does that mean? It means that all four implanted embryos actually latched in the womb. The fourth embryo stopped multiplying, and did not develop into a fetus, but it’s still latched to the womb at the moment. The remaining three embryos have become fetuses. It’s crazy because in our first round of IVF we had three implanted embryos, and none latched. Zero percent. This time we were four for four, a perfect 100% for latching.

So, what now? We wait and watch. Right now we have three fetuses, each about the size of a snow pea. Tiny eyelids are forming and hand plates are appearing. We have three sets of heartbeats. At eleven weeks (around Thanksgiving), we’ll know if we need to reduce from a triple pregnancy to a double.

Most importantly, God willing, we’ll be dads before summertime.

We couldn’t be more excited.

–Josh

On Thursday I got off the subway in Soho, on my way to work, and happened to pull my phone out of my bag.

I saw that I had three missed calls from Matt and right away my brain went to one thing: bab(ies). Could this be the big news, if we were pregnant or not? We didn’t think we’d know until the weekend. But with three missed calls from Matt, all right in a row, I figured something was up, one way or another. I hoped against hope for good news and called him back.

“Guess what? We’re pregnaaant!”

I almost walked into a tree.

“I thought we weren’t supposed to know until at least tomorrow!”

“I did, too,” Matt said. “But then this text came in. And we’re pregnant!”

He read the text message to me. It was such a surreal moment, walking down Prince Street on my way to work, and hearing that, via text message from 7,000 miles away in India, our surrogate had tested positive for pregnancy.

Matt and I traded ridiculous little text messages back and forth during the day.

“You’re gonna be a daddy!”

Needless to say, we were thrilled, especially with one round of surrogacy behind us that hadn’t worked out. I think having gone through that experience made us even more grateful to have a positive pregnancy test confirmed.

The clinic e-mailed us the beta hCG test results shortly after we got the text message. I did a little reading online to find out more about hCG, wanting to understand more about what the results meant.

The hormone human chorionic gonadotropin (better known as hCG) is produced during pregnancy. It is made by cells that form the placenta, which nourishes the egg after it has been fertilized and becomes attached to the uterine wall. Levels can first be detected by a blood test about 11 days after conception. (Read more here)

Our beta hCG results (shown on the right–click to enlarge) show that our surrogate’s levels at 1.7 weeks were at 581.22 mlU/ml.

Below that, there’s a chart showing that 1.3-2.0 weeks in the hCG levels are often in the range of 16-156. (Before we got our results, the clinic told us that they ideally wanted to see a number over 120. Last time, when we had our failed first round of surrogacy, our hCG number was 4.)

As you can see, our number is more than three times higher than the high range listed in the chart. So, what could that mean?

As I learned online: possible multiple pregnancies.

Yes, that was the sound of our jaws hitting the ground.

Indeed, as we called two of our friends who were recently pregnant and told them our hCG results, they both said right away, “Oh wow, sounds like twins.”

Of course, we’re still early in the process. All we know at this point is that we’re in business, and not if we have one baby, or multiple babies. It’s the first trimester, too, and obviously a lot can happen. We learned that 10-15% of pregnancies end in miscarriage, so obviously we’re keeping our fingers crossed, and we’re aware that we’re not out of the woods for a little while yet. (After an ultrasound confirms a heartbeat at eight weeks, the risk of miscarriage is only about 3%. The risk falls even lower–1%–after a normal ultrasound at 16 weeks.)

It also helps that our surrogate has had a baby before (all surrogates at our clinic must have at least one child already), and relatively recently at that. (Her son is now two.)

We started making our phone calls, telling our friends and family the good news (with the asterisks, of course, that we were early into the first trimester, but still excited, and sharing because we promised to share, etc.).

Matt’s mom was thrilled. She called back several times during the day to chat more about the news. When I told my grandparents there was so much happy yelling that I had to hold the phone away from my ear for a moment.

“What great news!” My grandpa said. “You brought tears to my eyes!”

It’s been so fun to call and share the news with people. We’re definitely feeling the love from the friends and family in our lives.

So, what’s next? We have our first ultrasound the week of October 22. That’s when we’ll be able to tell if we have a single pregnancy, or multiple pregnancies, and we’ll get a little more news about the health and development of the fetus(es).

Needless to say, that date is circled in bright red in our minds. We’ll try not to chew our nails (too much) before then.

–Josh