"...Now hope that is seen is not hope. For who hopes for what he sees? But if we hope for what we do not see, we wait for it with patience."
Romans 8:24b-25

31 July 2011

Pregnant Until Proven Otherwise-PUPO

The first time I heard that acronym, PUPO, and learned what it meant, I found it incredibly adorable!  What a great way to honor the blossoming life a woman just had placed inside of her!

This is a picture of the two embryos
we transferred on Day 3 of our IVF
The first time I was PUPO, we had two little lives placed inside of me.  They were 8 cells (really 7, growing an 8th).  They were beautiful, they were living, and looking at their picture, our hearts were filled with hope for the first time in a very long time that we may actually become pregnant and eventually become parents.

For nearly two weeks, I walked around the house, spontaneously grabbing my husband's hand, placing it on my belly, and saying, "Let's pray for the embryos."  We stopped about a dozen times a day in the middle of sentences and activities to pray for those two precious lives we hoped were still growing inside of me.

At the end of the first week of waiting, we got a call from the embryologist.  Of the 15 embryos that had developed from the 19 healthy eggs retrieved and injected with sperm, two had been transferred on day 3, leaving 13 embryos, and only one of those 13 made it to the stage of being viable to freeze.  Four had made it to the blastocyst stage on day 5, and would have been candidates for a day five transfer had we not had a transfer on day three, but those four quit developing by the time day six (the freeze day) rolled around.  So, between the final possible day of transfer and the next day in which they'd be frozen, four healthy-looking embryos stopped developing.

I knew, when he told me about the four blasts that stopped growing on day 5, I knew the two inside of me had not made it.  I don't know how I knew, but I did.  I knelt down on the floor in the corner of my bedroom and cried over the lost lives.  I cried for those 14 embryos that never had a real chance.  I wept over the two that were placed in me and begged God to please let them live, but deep inside I knew they were gone.  

As I knelt there on the floor, weeping, the phrase running through my mind over and over again as my heart cried out to God was, "You know."  And that was what I clung to.  I knew that He knew my heart's desire, the longing DH and I have for children from our own bodies; He knows how many cells each one made it to; He knows why they didn't survive; He knew if the two inside of me at that time were still living; He knew how losing them would affect DH and me; He knows each life that He created, why He created it, and what became of each one; He knew my heart was broken and how to mend it.  There were so many other things, and for me what mattered in that moment was that He knew.

I picked myself up off the floor, went downstairs and asked DH to hold me (he had gone downstairs before I started crying and had no idea I had been up there weeping).  He held me gently and asked me, "Are you crying because we only got one?"  I responded through my tears, "No. I'm crying because we lost the others."

Part of what I love about being "PUPO" is the fact that for at least a week, if not even two, I have the privilege of having another life living, and potentially growing, inside of me!  That's exciting!  It's also scary.  

There are so many "what if's" to consider when one is PUPO.  Although there is life, a confirmed growing embryo, there is the question of, "Did it implant?" or, "Is it still growing?"  "What if pineapple core doesn't help implantation at all?"  "What if that tiny nibble of chocolate jeopardized it's chances?"  "What if I stood up too long on the way to the bathroom?"  "What if pushing to pee is as bad as pushing to poo?"  "What if my 15lb cat falling asleep on me while I was napping killed the embryos?  What if struggling to get him off of me did?"  "What if this? What if that?" "What if...what if...what if..."

This time around, it's not the "what if's" that are getting to me, it's the "could this be's".  Last time, after I grieved the embryos, I was fairly convinced I wasn't pregnant.  I didn't notice any symptoms other than the fact that my breasts weren't quite as swollen, I didn't have to pee all the time anymore, and I generally felt normal.  

This time, I'm noticing tiny cramp-like twinges near where I usually have major cramps, and I think, "Could this be the embryo growing after implantation? Or is it simply the progesterone, or the two whole red-bell-peppers I ate today?"

This time, my prenatal vitamin makes me feel sick when I take it, and I think, "Could this be the nausea I hear about from pregnancy? Or is it simply that this company maybe changed its formula, or I'm suddenly reacting to the iron in the supplements?  Or could it be that I just need to eat?  But my sisters could only get their pregnancy nausea to go away when they ate something and that's what makes my queasiness go away, so could it be???"

And I haven't even mentioned yet the fact that for several days post transfer, I didn't feel a thing.  Not one single symptom.  Not a period symptom, not a pregnancy symptom, not even a symptom of being myself.  I was kind of like a machine, I suppose.  I was fully composed, not at all stressed, just super chill.  It was weird and out of character for me.

Well, actually, truth be told, there was one symptom.  I was weepy.  But there you have another "Could it be?"  I wasn't sure if I was weepy because of the hormones I am taking, because of extra hormones my body might be producing because of a growing baby, or extra hormones my body might be producing in preparation for a period and in rebellion to the intentional prevention of it's arrival.  I eventually decided that it was most likely my body reacting in relief, even if my mind was not telling it to, consciously.

For example: The day before the transfer, a good friend of mine commented on how calm I was and how good I seemed about everything, even though I had verbalized concern that our frozen embryo might not survive the thaw.  The morning of the transfer, I was still in that calm mental state, but my body pushed the "override" button and started showing all the classic symptoms I get when I'm super nervous about something (let's just say, it's not pretty).  My assumption is that I was weepy after the transfer, not so much because of hormones, but because my body finally was able to express relief, but my mind was still in denial that it was ever under any stress.

Regardless, my point is, being PUPO is a wonderful, wonderful thing, but it is also a very maddening state of being.  It's wonderful because you have two glorious weeks of believing that there is a life blossoming and growing inside of you.  Hopes are high and the world is grand!  But it's maddening because doubt creeps in quickly and robs you of some of the hope and steals bits of the joy.  An unavoidable self-preservation kicks in that we infertiles know all too well.  We begin, in this PUPO state, to talk ourselves down from the ledge of hope, to a safer place known as "maybe, but probably not."

The embryo we transferred this
cycle. The dark circle in the
middle toward the top is what
becomes the fetus, the lighter
part becomes the placenta.
I must admit, I am head-over-heels in LOVE with this embryo inside of me!  I got to see which part will become the "fetus" and which part will become the placenta.  I was privileged to witness the fact that after it was thawed, this little embryo began to hatch before it was placed inside of me.  I can only imagine how dreadfully painful it will be to have to let go of this one, too, if it isn't clinging to life and growing inside of me.  I don't even want to think about it, but it's there in my mind.  What I want to think about is how neat those little twinges feel and how nice it would be if my queasiness is from the little life inside of me.

I have two and a half more days of being PUPO.  I'm going to do my best to enjoy the possibilities and not talk myself off of that ledge of hope.

Thank you all for your thoughts and prayers of support through this past week.  It's helped tremendously!  I am so thankful for my Twitter/Blogger support system.  I pray that I will have good news to share in a few days.  It may be a while before I blog about the results, but you'll probably hear on Twitter fairly soon after we know.

Praying for this life inside of me,


  1. Hoping for you! I also mourn the loss of the other embyos xoxo

  2. Thank you! I appreciate your thoughts, prayers and support so much! And it's nice to know I'm not the only one ;-)

  3. What an awesome post!! I will be praying for you!! Your strength and faith are inspiring!! xx

  4. Thank you! I greatly appreciate your prayers :-) I'm glad my story can be an encouragement as well. <3

  5. Hang in there - I've been PUPO too and it's crazy. There's nothing like praying that your blast sticks, praying that it makes it, praying that there's an end to the madness that opens the door to a whole new mission

  6. Thank you! I'm hoping we get to pursue that mission soon! :-)

  7. I have been thinking about you Julie and praying for you! Thank you for being so transparent in your posts - it is a blessing to many!

  8. Thank you, April. That means a great deal to me! <3

  9. Saying lots of prayers for you and yours!


I would love to hear from you! The subject matter of this blog can be very sensitive. This is intended to be a place of encouragement and to be uplifting. It is never my desire to cause pain through what I write here, so please keep that in mind as you share your thoughts. Thank you.