Pass the Love, Hold the Helpful Suggestions

Dear Friends, Family, and people I only marginally know,

Thanks for your interest in my fertility! I know you are all trying to be supportive, and helpful to me in this stressful time of my life. Can I ask a favor though? I don't want any suggestions from you. I don't want stories about people you know, I don't want you to ask if I've tried the newest fertility treatment of eating raw earthworms.

"Did you hear cousin Suzy got pregnant from doing IUI? And cousin Betsy did in-vitro and now has two little boys! Why don't you try that?"

"Have you tried Metformin? I hear it's a miracle drug! My neighbors daughters friends dog-walker said nothing worked until she went on it"

"Have you seen a naturopath? What about acupuncture? Guided meditation?"

"Wait, what's wrong with you again? Why can't you have a baby?"

"What do you mean you aren't going to do IVF - don't you want to exhaust all your options?"

"You're trying too hard. Just relax! Pretend like you DON'T want to get pregnant - that works for a lot of people!"

"Don't worry, you can still adopt! There are lots of kids that need homes!"

Family and friends, you should know that there is not a treatment out there I haven't researched, no book I haven't read, no blog I haven't followed, no infertile women I haven't hounded for information. I know all the treatments, alternative therapies, drugs, and procedures. You don't need to tell me about any of them.

I really don't care what other people did to achieve a baby. I'm not them.

I know more about the male and female reproductive systems than I ever thought possible. I just don't always feel like explaining the inner workings of my lady parts to you. If you're really curious, get a book. I have a stack by my bed. No, you can't borrow them. I need them.

I have a plan of treatment. My doctor has earned my trust, and he and I are going down the road we have chosen - the road that is right for me. I'm not going to exhaust all the medical options. I'm not a lab rat, and I don't have an endless supply of money. We are pursuing a course of treatment that my husband and I feel comfortable with. Please trust us about that.

I really don't feel like explaining WHY I'm not doing acupuncture, taking Chinese herbs, or snorting Vitex Root up my nose. Please don't ask my to justify why I'm doing what I'm doing, and why I'm not going down other paths.

No, I'm not trying to hard. I'm trying the amount that I'm comfortable with. Relaxing doesn't actually affect my fertility. My endocrine disorder affects my fertility.

Adoption is on the horizon. But we're not there yet. We can't simutaneously put all of our effort into fertility treatments AND researching adoption. We'll do one until we reach the end of the line, then we'll explore the other. We actually don't even want to think about adoption right now. So please, leave the adoption issue alone.

So, what's a well-meaning friend of my aunts florist to do? Send me your well-wishes and prayers. Hope that I find peace with whatever unfolds. Send good thoughts that my marriage stays strong throughout this process. Ask me how I'm doing, tell me you'll support me no matter what I choose. And when the thought of, "Have you tried...." pops into your head, stifle it by giving me a hug.

The Two-Week Wait

Subfertility is an endless cycle of hope and heartbreak. Right now, I'm on the upswing of hope. This month my bloody cysts shrank down and stopped producing estrogen, and I got the green light to start the fertility drugs (technical term: gonadotropin therapy). This included jabbing a needle into my belly every day, and then going in to get an ultrasound every other day or so, to see how my eggs were growing, and to take a blood sample to measure my estriodiol levels (E2, as the cool kids call it). I've heard some women respond to the first round of the treatment in as little as 5 days, but no, I took 13 days. By the end, I was so bloated and uncomfortable I couldn't even bend over ,and even sitting was difficult. I began to see the benefit of having an IUI - sex just didn't sound appealing. Towards the end, the ultrasound technician would really have to jam the wand against my ovaries, causing all kinds of discomfort. If I haven't told you before, this isn't the nice kind of ultrasound where they rub jelly on your belly and move the sensor around. This is a trans-vaginal ultrasound, where they stick a giant sex-toy looking thing up your hoo-ha and look at your insides.

But, after 13 days, they declared me gravid, and told me to take the trigger shot. The trigger shot is basically HCG (the pregnancy hormone) - it's supposed to kick the little eggs of of the ovaries. I took the shot on Wednesday night, and we got busy Wednesday, Thursday, and Friday night (yeah, we were pretty tired of it by Friday night). Then, Saturday morning I started on progesterone suppositories, to keep any embryos that might be forming from falling out. And now....I wait. I wait and wait and wait. I'm supposed to test this Friday or Saturday. Actually, what the nurse said was, "stop taking the progesterone on Saturday, and if you don't get your period, come in for a blood test". Because I'm paranoid about my chronically low progesterone levels, I'd rather not do that, so I'll take a home test on Friday. And probably Saturday and Sunday. The only thing that is keeping me from testing every day is that the trigger shot has the same hormone as the one the pregnancy test looks for, and that shot can take up to 2 weeks to leave the body. So, testing early might give me a false positive, which I'm just not up for.

The annoying thing about the progesterone suppositories is that they mimic pregnancy symptoms - cramps, bloating, exhaustion, sore breasts, and nausea. So, we'll see. Three days until I can test. I hope my fingers don't develop gangrene from being crossed for this long.

PreConception You vs Subfertility You

What a difference a year (actually, 13 months) makes!

13 months of trying to make a baby. You've changed so much in this year, and I'm not sure if it's for the better. Let's take a look back at the happy carefree Preconception You, and the slightly jaded and still not pregnant Subfertility You.

Preconception You LOVES to talk about getting pregnant. Good people to pump for information are hair stylists, as they are cutting your hair. You shyly tell them that you are planning on starting a family soon too. They tell you all about their 5 kids, and wish you luck on your impending conception.
Subfertility You doesn't go to that stylist anymore.

Preconception You blows her nose, and throws away the tissue
Subfertility You examines the contents, and wishes your cervical mucus looked so good. Subfertility you is also obsessed with pretty much anything that shows up on toilet paper; always on the lookout for good cervical fluid or the elusive implantation spotting.

You go for a run on the trails by your office. The secretary warns you not to go, as there is likely a rapist behind every tree.
Preconception You blows off her warnings, because she is an alarmist and a conspiracy nut.
Subfertility You thinks, "A rapist? Do you think his sperm is any good?"

Preconception You loves to coo over other people's babies. You love to hold them, cuddle them, and ask their mothers all sorts of questions about conception, labor, delivery, appropriate times to introduce the bottle, maternity leave, and their opinions on pacificers.
Subfertility You doesn't want to talk to anyone about their baby. Because, it will lead the the question of, "are you going to have one?", and you like to avoid that conversation now. You don't even like to hold people's babies now. Probably, because you know you are likely to steal the baby, and you need to practice a measure of restraint.

Preconception You has a bunch of baby-planning books that other people have given you, as well as baby toys and clothes. They say, "just tuck this away for someday".
Subfertility You has only read the first chapter of each of these books (the one about pre-conception and conception). It's too depressing (or it feels like you might jinx yourself) if you read any further. The Baby Naming Book is under the wobbly leg of the table. All the baby toys and clothes are now molding in the basement, far out of sight. Sometimes you even give them to other people, as they have their babies, or second or third babies.

Preconception You thinks it would be fun to have an "oops" baby, preferably in the summer, when your work load at your job is the lowest. Subfertility You will take any kind of baby she can get, at any time.

Preconception You assumes your husband masterbates from time to time, but doesn't want to know about it. Preconception You also has no interest in sperm, other than the fact it is messy. Subfertility You is obsessed with sperm numbers: motility, morphology, volume, live sperm per volume, fragmentation, healthy tails. You also demand that your loved one jerk off into a cup while you wait with the car running, so you can transport it (in your armpit) to the clinic within an hour of emergence to be analyzed.

Preconception You likes to say, "oh, I'm so against using drugs for anything. I'm an all-natural kind of girl." Subfertility You will swallow, inject, or shove up your hooha any drug your Reproductive Endocrinology tells you too. You'd even inject it into your eyeball, if the RE told you it might help.

Preconception You drinks because there is no baby.
Subfertility You drinks because there is no baby.
(hey! I guess not everything changes!)

X will make you fertile! Y will make you infertile!

If you start hanging around fertility boards, you get a lot of advice on what enhances fertility, and what hampers it. You get some good suggestions, such as:

Losing weight will help your fertility!
Okay. I buy that.

Going off birth control will make you fertile!
Yeah. That makes sense.

Having sex will help make a baby! If you don't have sex, it's harder to get pregnant!
Got it. Sex = baby.

If you don't have sex during your fertile period, you won't get pregnant!
Right. No egg = unemployed sperm.

Then you get into the realm of "alternate therapies"

Acupuncture will make you more fertile!
I don't know about this one, but it's been around for a while, and a lot of people put stock in it. I'm not going to discount it.

Sugar will make you infertile!
I guess I can kind of see that, if you have PCOS and blood sugar issues, then cutting out sugar will stabilize your blood sugar levels, disrupting the negative feedback loop between insulin and low hormone levels....okay....

Use Instead Softcups! They'll hold the sperm up near your cervix - it will have no where else to go but into your egg.
Maybe if you plan on doing Jazzercize right after you have sex...

And then you get into the sphere of Crazyland. And granted, I fully understand why people want to visit Crazyland. It's lovely this time of year. And in Crazyland, the following things make you fertile:

Fertility stones, fertility candles, yams, sleeping with the lights on, crazy nasty herbs , soy, maca root, baby aspirin, chiropractors, vitamin B6, Red Raspberry Leaf tea, green tea, tea tree, lavender, dextoxing, oil pulling (swishing oil in your mouth), Chaste berry tea, yoga, meditation, robitussin, royal jelly, uterine massage, lunaception, Fertibella, Tulsi tea, iodine, melatonin

And the following things make you infertile:
Coffee, Tea, alcohol, high heels, hot tubs, peas, soy (ha! it's on both lists), stress, dairy, gluten, too much sex, not enough sex, low iron, antihistamines, microwaves, cell phones, radios, air pollution, NSAIDs (IBproufin)

To simplify things, I've made my own list of what helps fertility:

Being fertile

You're welcome.

THE PRECONCEPTION CHECKLIST (and why it's a terrible idea)

Thinking about having a baby? How exciting! All the books, websites, and well-meaning people give you a list of things to do before you get down and dirty. I wanted to go through some of these, and give my feedback on them.

1. Go see your doctor for a preconception exam!
I'm not sure what OTHER people's doctors do, but my doctor did exactly squat. No tests, no pelvic exam, no blood work, no ultrasounds. I practically had to force my history on her, she didn't seem to care. When I told her my concerns about going off birth control, she told me, "just try to get pregnant right away". As irritating as this is, I think that most doctors would probably say something like that, and tell you to come back in 6 months or a year if things aren't going so well. So, save your money, start trying to make a little bean right away, keep a calendar, and go in after 6 months

2. Start taking prenatal vitamins 3 months before you want to start trying to conceive.
Sounds like a good idea, no? Let me tell you something about prenatal vitamins. They constipate you like a motherf***er. At least they did to me. I asked a nurse about it, and she said, "no, prenatals don't do that. Progesterone from pregnancy does that". Since I wasn't pregnant (and still am not), I'm pretty sure it was the iron. After 2 weeks on the prenatals and eating a bag of prunes a day (no, really), I decided that I couldn't actually go without pooping for a year. So, I'm on regular ol' multi-vitamins. Sometimes when I remember, I take extra Calcium and B-complex.

3. Go see the dentist
Well, you should go see the dentist anyway. But for the love of god, don't tell them you're trying to get pregnant. Because they'll make a little note in your chart, and then they'll ask you every 6 months if you're pregnant. And eventually, you'll want to either find a new dentist, or just let your teeth rot out.

4. Stop smoking, drinking, and having caffeine.
When you first start TTC, you cut way back on alcohol and coffee, and everyone assumes you must be pregnant. A year later, when you look the same, they just assume you're weird. There's some folks out there that think alcohol and coffee will make you infertile. But it won't. Infertility makes you infertile. So I still drink the coffee, and the whiskey, and sometimes whiskey in my coffee. I try to knock it off during the two week wait, but honestly, even if I were pregnant during that time, we don't share blood supply yet. Cutting out coffee and beer doesn't help your chances of conception, it just makes you sad. And smoking? I don't think anyone should smoke, regardless of whether they are TTC or not.

5. Review your medications with your doctor.
I've been on prozac for a long time, because it makes me a nicer person to be around. For the past 5 years or so, everytime I saw a doctor, I would ask them, "should I go off prozac while pregnant?" And I've gotten about 5 years worth of very different answers. I did try to go off prozac, but you know what? Subfertility is very stressful. And I honestly don't know if I can make it though the process without my happy pills. So, I'm staying on them.

6. Get your finances in order.
You know the great thing about subfertility? It gives you lots of time to get your finances in order! It will also suck them dry, if you let it. We've decided the only thing we are willing to do that ISN'T covered by the insurance is IUI. We waited until we were settled to try to start a family - we're not going to now blow it all on non-covered procedures that may or may not work. And honestly, how many young fertile women have their finances in order before they get knocked up?

7. Take a trip together!
Yes, you should do that. But don't expect to come back pregnant. But, on the plus side, you'll be able to take lots of baby-free trips, because you aren't pregnant yet!

8. Reduce stress in your life.
You know what's really stressful? Trying for a long time to have a baby, and then not having a baby. Charting your temperature, analyzing your cervical mucus, breaking down in tears when your period comes, having lots of crazy invasive tests to try to figure out what's wrong with you, shooting yourself up with drugs, crying when your period comes, getting more and more irritated with with people's stupid questions, your friends going to to have their second and third baby, did I mention crying when your period comes...?

So there you have it, the pre-conception check-list debunked. Really, don't do any of it. You'll already be giving up any sense of decorum and decency, as you discuss your estridiol levels with strangers in the line behind you in Starbucks. Don't give up the Starbucks too. And put a little Jim Beam in that coffee. It will lessen the sting of that negative pregnancy test.