Thursday, August 20, 2009

Our New TTC Protocol, Part One: Yes, Women ARE Complicated!

I’ve often heard men say that women are complicated. Men, you have no idea! So read on.

There are basically four levels of assisted reproductive therapy ("ART"): (1) a medicated cycle, (2) intra-uterine insemination (“IUI”), (3) in-vitro fertilization (“IVF”), and (4) intra-cytoplasmic sperm injection (“ICSI”). Because timing, and everything after intercourse, relies so much on the woman’s body, medicated cycles alone can help women who have unexplained infertility, irregular, or unpredictable cycles. The medication also has a higher occurrence of more then one egg being released, increasing the opportunity for a sperm to fertilize an egg.

The average woman’s menstrual cycle is 28 days long, and she will ovulate (“O”) usually on cycle day (“CD”) 14. Ovulation refers to the release of a mature egg from an ovary. Cycle day one is the first day of a woman’s full-flow menstruation. These are the dates that conception, and therefore assisted reproductive therapies, are based on.

My cycles are rather predictable, with O arriving on CD 14 like clockwork (unless I get sick earlier in my cycle). They are a little on the shorter end, at 24-25 days long, but this is not short enough to be diagnosed with a defect because of it. Since we have moderate male-factor infertility (“MFI”), the least-invasive step that could help for my husband and I is IUI. In proceeding with IUI, many fertility specialists like to have the woman on medications also to make her cycle extremely predictable, stable, increase the number of eggs released to increase the odds, and make her as fertile as possible. It made me feel like a bionic baby-making machine!

Anyhow, I liken IUI to the turkey-baster method. This seems to be a working metaphor, and it sticks in my friends’ and family members’ heads so I don’t have to repeat the descriptions over and over again! It also contrasts nicely with the next step, which is IVF, or what I refer to as the petrie dish method. A quick description of IVF and ICSI: For IVF, the sperm are donated and treated as in an IUI, and mature eggs are extracted from the woman’s body, then the two are put in a container together, and hopefully, sperm meets egg there. ICSI is IVF with the sperm being injected into the egg(s). We have been told that if IUI doesn’t work for us after about three times, ICSI would be the next step.

So, back to our current cycle, new protocol and IUI. It all starts with me taking Clomid on CDs 3-7. As it was explained to me, Clomid acts like a little general in your brain telling it to stop listening to certain hormones and to listen to the Clomid instead, which mainly tells it to mature extra follicles (in which eggs are maturing). Side effects that I had from it included hot flashes, bloating, headaches, and blind spots (like stars you see when you get a concussion or a migraine). I have heard from other gals that modd swings are also very common, and the doctor warned me that the Clomid could thin out the uterine lining and decrease cervical mucus (which is an important fluid present around O that helps the sperm swim through the cervix and into the uterus). Because of the last couple of side effects from Clomid, the next drug is Estrogen, or Estradiol, which I took on CDs 8-12. The bloating continued, but the other side effects subsided. Starting on CD 11, I had to use an ovulation predictor kit (“OPK”) first thing in the morning, and as soon as we had a positive, call the clinic and go in for an intra-vaginal ultrasound (“IVUS”) to see how big my mature follicles are and how thick my uterine lining is, and from that, predict how close I am to O. We also had to abstain starting on CD 9 until the insemination, so that my husband could build up a good store of soldiers before making his deposit! They start you on CD 9 in case you have to get the IUI on CD 12, so that you have three days of storage, but I didn’t O until CD 14 (as usual), so it was a long time, I tell ya! And mind you, those days are your most fertile, so for the last two years, that’s been baby-dancing time! What a switch…

Next post will continue at CD 13 when we went in for my IVUS to check out the follies. Make sure to check back!


Monday, August 3, 2009

Misconceptions about Infertility (no pun intended)

Please let my lawyer-self come out for a moment and make this disclaimer: I am not a doctor or any sort of medical professional. The information I share in this blog is from my reading, experience, and layperson opinion. I will try to cite reputable sources as often as possible.

I want to tell you about our new plan/protocol that is now underway, but before I do that there are a few more general issues I’d like to opine about. In particular, I want to dispel some of the more common misconceptions about infertility. One of the reasons I think this is important to do is because I know I may have some friends and family members reading this who are unfamiliar with infertility.

Infertility is not rare. In the United States, ten to 15 percent of couples are infertile. (Mayo Clinic, at According to the Mayo Clinic, infertility is the inability to get pregnant despite having frequent, unprotected intercourse for at least a year. (Ibid.) Several papers I have read from various clinics and sources define infertility more specifically as the inability to get pregnant despite having regular, unprotected intercourse for at least a year under the age of 35, or for at least six months if 35 or older. If the man or woman is diagnosed with a fertility-impairing condition prior to that time, they also may be considered infertile. I have noted that the population usually tested consists of married couples in which the woman is of “child-bearing age”, or 15-44 years of age.

In my experience, people often blow off infertility as insignificant, something that only rarely happens, and not to them. But if ten to 15 percent of couples are infertile, that means that more than 1 in 10 of the couples you know have, are, or will be struggling to bear a child. Infertility has been a taboo subject for far too long, leaving these people feeling isolated, unsupported, and misjudged.

Another broadly misunderstood aspect of infertility is that “it’s a woman’s problem.” In this day and age, I haven’t heard anyone actually use this phrase, but it is inherent in the assumption that people make that if a couple is infertile, there is something wrong with the woman.

Numbers vary on the exact percentages of the frequency that infertility is caused by a woman’s problem, a man’s problem, both, or is unexplained. Personally, I believe part of this problem in getting an accurate representation is simply that, if a couple is having trouble getting pregnant, the woman is far more likely to go see the doctor about it and get tested. Also, many symptoms or signs of infertility in women are more easily noticeable than in men. The National Women’s Health Information Center stated: “About one-third of infertility cases are caused by women’s problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture of male and female problems or by unknown problems.” (

The third misconception I want to mention here about MFI (male factor infertility), is that a man’s fertility depends simply on his sexual performance, such that, if he has a fertility problem, he must not be a great performer in bed. On the contrary, all the stories I know about MFI entail men between the ages of 24 and 50, who have low sperm counts, morphology or motility, and are stallions in bed! (Their wives or partners have provided me with this data.) This includes my own husband. Enough said about that.

Watch for my next entry, which I plan on being about our new protocol.

Thursday, July 30, 2009

The Ups and Downs of Infertility

Today is the first day of a new chapter for my husband and I. Today I started the medication to prepare for assisted reproductive therapy, or ART. It has been a long road to get to this point, but, fortunately, not as bumpy as it is for some. Some people go through multiple miscarriages as they try to conceive. Not us. At least, not yet.

Two years ago, we decided we were as ready as we’d ever be to be parents, so we set aside the birth control and got down to business. We were 31 years old, and wanted to have two kids before we were 35, so I looked up what I needed to know so we could be as effective as possible at our “baby dancing”.

For those of you who don’t know, there is only a period of time of about 4 days, give or take, during each menstrual cycle, that baby dancing (BD) can result in a pregnancy. The window generally consists of the three days before ovulation (O), and the day of O. With busy lives, it can be easy to miss that precious window.

The average woman of child-bearing age ovulates on about cycle day (CD) 14, but it can vary. The average woman also has a menstrual cycle of 28 days, but this can vary, too. To establish her particular fertile window, a woman can take her temperature every morning with a special, sensitive thermometer, and she can use ovulation predictor kit tests – or “pee on a stick” (POAS).

I did all this, and continued doing it off and on for the past two years. My own cycles average 25 days long, so they go faster than a month, but there were multiple times when we had to take off from trying to conceive (TTC). First, because I had to get an MMR vaccine and a TDAP vaccine, and then because I donated blood for my Dad’s surgery.

In the summer of 2008, we started talking to our doctors about fertility, and both got certain tests done. It turns out we have low sperm morphology, creating mild, male factor infertility. That’s the only diagnosis we’ve been able to get. It’s not that we can’t get pregnant, it’s just that we have a lower statistical chance.

So, we spent 22 cycles trying, then hoping, praying and waiting, for the wonderful news. Each cycle, counting down the days, getting negative pregnancy tests, crying when that time of the month came that “Aunt Flo” showed up with her cramps, bloating, backache and all, until I felt like I was going insane.

Today, I had lunch with a good friend and colleague, and we caught up on our TTC misadventures. I mentioned to her that about 16 babies had been born around me, to friends, family, and physically near acquaintances, during the time we have been trying to have a baby of our own. After I got home, I sat down and actually made a list. The total count of babies born or currently pregnant mothers in my world in the last two years is actually 32. And four of those are to two women. The same two women I jealously watched have their first children almost two years ago are already having their seconds.

Please don’t misunderstand me. I love all these parents, whether as friends, family, or just through the love of humanity, and I would never, ever, want to replace their joy with sorrow. I am happy for them. But I am also sad for myself and my husband. I would like more people to realize that every belly pic, every joyous, “it’s a boy!” every baby shower, and every adorable photo of their little ones brings tears to my eyes, and rips open a hole in my heart. Maybe it will help them better appreciate the challenges that kids bring. Maybe when the kids are screaming, and the baby’s crying, they’ll realize that it could be worse – they could have never had those beautiful babies. Moral of the story: Take nothing for granted, including the ability to get pregnant.

Albert Einstein is attributed with the quote, “Insanity: Doing the same thing over and over again and expecting different results.” I definitely reached that place. I thought, well, maybe we’re not meant to be parents. Maybe God has another plan for us. But, really? How could that be possible, when I can feel with all my heart and soul that there’s supposed to be a baby in my arms? I struggled with the idea that we should just give up, but I couldn’t do it. My whole life, I’ve been taught, and lived by, the concept that I must never give up.

Now, I have a new protocol, something different that my dear husband and I can do to have our babies. For the first time in months, I feel cautiously optimistic, like my head is starting to come out of a fog. I can physically feel depression lifting, despite the additional hormones and chemicals that are starting to course through my body. I’m ready, so bring it on.

Tuesday, June 30, 2009

I'm a big flake, and I hate the new ATMs

Yes, I know, back in February I said I'd come back and write about my own personal love story, but then I stayed away for four months. What can I say, I'm a big flake. I'm sorry. I am now trying to be more consistent, so hopefully it won't be four months before I'm back again.

Today, my focus is on the new ATMs my Bank has installed. When they first put them in some months ago, I thought, "Hey, these are great, no envelopes to cause litter and waste paper, and I can get a little miniature scanned copy of the checks I'm depositing - nifty!" I think I even told my husband how happy I was about this, because it meant I could take my business checks straight to the ATM to deposit and didn't need to scan them in at my home office first. Then yesterday happened.

On Sunday, the 28th, my dear husband was obviously stressed about how low our checking account was, since he had automatic billpay set up to come out of the account on the 30th. I told him I probably had a check sitting in my P.O. Box that I could pick up and deposit on Monday morning, and another check already in hand. He instructed me that it needed to be done right away.

On Monday afternoon, at about 4:30 and on the other side of town, I remembered this needed to be done. I made it across town, picked up my mail at the Post Office, and made it to the ATM at 5 minutes to 5pm. I thought that I had to get the deposit in before 5pm in order for it to count that business day.

Superbly pleased with myself for my speed and efficiency, I inserted my ATM card in the machine and pushed the required buttons. Then, the slot popped open and the machine asked for my check. I carefully slipped the edge of the first check in, and it grabbed it from my hand and sucked it inside the machine. Then it spit it back out. So I tried again, with the same result. "OK," I thought, "maybe it doesn't like that check because it had been folded in half and had a crease in it I couldn't get rid of. At least it's the smaller check, so I'll try the other one that's so nice and flat."

I again pressed the demanded buttons, the machine grabbed my check out of my hand, and then try to spit it out without the slot fully opening. The check jammed up against the "lips" on the slot, and as I tried to reach in and grab it, the machine continued to suck it in, spit it out, suck in, spit out, and so on, making the jam worse, but slowly getting enough of a corner to stick out so I could finally grab it and pull it out. At this point, the check was torn and crumpled, and there was no way I was going to try that check again.

"Well, maybe it's just this particular ATM." So I tried the one next to it. No luck. At that point, the branches were closed, so I couldn't walk in to make the deposit, and since the ATM change, we no longer even have the option of using an envelope. Poop. I was just so pissed that after all I did to try to get the deposit it on time, the stupid machine wouldn't let me. So, I called my husband and told him about my adventure and apologized for not being able to get it deposited, and could we reschedule the payments so that we aren't overdrawn. Then he tells me we aren't going to be overdrawn, just low on cash. Great. Thanks for clarifying that before I had a freaking stroke!

I think I can reliably say that I will not be using the ATMs for my deposits any longer. Add to these problems the fact that there are no longer any mirrors for me to be able to watch the scary person who is wandering around behind me, and I doubt I will be using the ATMs at all. Hey, maybe I can help keep a human being employed. Silver lining!

Friday, February 13, 2009

Day One - Part One

OK, so this is my first blog post, and I've already had it disappear on me three times! Ugh. Not a good start! Lesson number one: Write your post in a word processing document first, then post it!

This is my first real attempt at blogging. I've never been good at keeping a journal or diary, but at this point in life, I finally decided that enough has happened to me, and I need to write about it!

My name is Jamie, I'm 32, female, white, born and raised in the United States. I’m married, no kids, college educated with a Bachelor of Arts, a Juris Doctor, and over $100,000 in student debt to show for it. I am an attorney, although I haven't been practicing law for profit for a few months and I’m not sure if I’m technically unemployed or self-employed. I spend most of my time these days as a homemaker. I am lucky that my husband is gainfully employed, and we live in a two-story home in a Northern California suburb.

I have many interests and things I'd like to write about, so it's possible this could turn into several blogs. Some subjects close to my heart include: relationships and psychology, religion, politics and government, work-life balance, infertility, family, cancer, organic food and cosmetics, pets, philosophy, history, books, science-fiction, law, gardening, traveling, clothes and jewelry, business and financial planning. So we’ll see what pops up!

I am interested to find out if anything that has happened, is happening, or will happen in my life resonates with anyone else out there, so please, feel free to post your comments. I apologize ahead of time if I offend anyone, but please, stay cool-headed and don’t flame. Kindred spirits are preferable.

I think that with St. Valentine’s day tomorrow, my love life is probably a good topic for discussion. But this has taken so long, I need to go get my workout done before lunch time, and take care of some of my housekeeping duties before it gets too late in the day. I’ll be back later.