Wednesday, January 30, 2013

The Jargon

Every single community, no matter how big or small, develops its own jargon. Even twins sometimes make up their own language and words for things. So it's not surprising that one big part of the infertility community is actually something small like the language, but it's very confusing if you don't understand it.

At first, when I was learning all of the abbreviations, I thought it was just flat out stupid. I felt like everyone was being 14 year old teenagers texting on their phones that had a 160 character limit. But as I started using it, it's actually become very useful. There are a lot of big words or phrases that are commonly used, and typing an abbreviation is simpler and easier than having to look up a word to know how to spell it, and is a time saver since we say them so often (only once you understand what all of the phrases mean first.) It's so much easier to use abbreviations when chatting with my online support group. Everyone know what it means, so why not save some time? Now I even catch myself having to proofread my blog posts on here to catch any abbreviations I might have used accidentally!

Here are the common ones. There is a huge list, but most aren't used all that often. Here are the very common ones. They probably should be in alphabetical order, but I'm just typing them as I think of them. More like order of importance.

TTC- Trying to conceive (I promised I'd tell what it is!)
IF- Infertility
TWW or 2WW- Two week wait. The wait after ovulation until you can test.
AF- "Aunt Flo," a nicer word for menstruation
CD- Cycle day
O- Ovulation
DPO- Days past ovulation (Counting the days in the TWW)
OPK- Ovulation predictor kit
HPT- Home pregnancy test
POAS- Pee on a stick, taking a pregnancy test.
FMU- First morning urine
BFN- Big fat negative! For when you test for pregnancy and it's negative
BFP- Big fat positive! A positive pregnancy test
BBT- Basal body temperature. The temp that ladies take in the morning to track ovulation.
BD- "Baby dance," or intercourse. It seems less personal to talk about it that way
CM- Cervical mucous. Don't even worry about why women are talking about it.
DH- Dear husband
AFM- As for me
EDD- Estimated due date
hCG- Human Chronic Gonadotropin. You all know that one already.
HSG- Hysterosalpingogram
IUI- Intrauterine insemination
IVF- In vitro fertilization
LH- Luteinizing hormone, the hormone detected by OPKs 
RE- Reproductive endocrinologist
SA- Semen analysis

That's just about it!

Here's an example of how I use them every day.

"Hey [user] congrats on the BFP! I'm so glad you decided to finally POAS even though it's only 12DPO and not let the fear of a BFN get in the way. Did you track your BBT and see the temp dip? Will you get an hCG quant. test soon? What is your EDD?

"AFM: Been TTC since Feb. 2010, so it'll be three years on Valentine's Day. It feels so weird to think it's been that long. CD 3 today, took Clomid. It sure gave me really weird, creepy dreams last night. AF still hanging on but not too bad this time. I'l start OPKs next week and hopefully DH and I will BD at all the right times and finally have our miracle!"

Did you catch on quickly? That actually looks like an average conversation.

You're now ready for a conversation with pretty much every online group talking about infertility, and even those women just talking about TTC. These aren't exclusive to the IF community.

Tuesday, January 29, 2013

My Very First Monitored Cycle

I keep feeling like this post is overshare, and I am a very firm believer in not oversharing. The whole purpose of this blog is to be completely open and educational, and help people understand what I, and thousands of other women like myself, go through when it comes to infertility. That includes treatments, tests, and what is involved with all of that. So perhaps I feel like this is overshare because it's getting really personal now. Perhaps I'm embarrassed to be putting it all out there. But since I feel like it's so important, and I try to be an advocate for the infertility community, I'll share. Like I have said before, please feel free to skip any posts that you are uncomfortable reading. But I promise that I try to keep it basic and definitely leave out the little, icky details.

I finally started my next cycle and could return to the specialist to begin treatment. (There was also some news regarding my blood test. Scroll down to the *** if you want to skip my new plan and just want to see the results.) I had to take Provera, which was a 10 day course of progesterone that simulated the hormones in a typical cycle, therefore making the body menstruate, since my body wasn't doing it on its own. It can take up to two weeks for menstruation to start after taking the last pill. So it took a while and I was getting impatient! My friends and I called it the Worst Two Week Wait Ever. (Typically, crazy women like me call the last two weeks after ovulation and before you can test for pregnancy the "two week wait," or abbreviated, TWW. But, I'll write another post about TTC jargon later. And you can understand what TTC is.)

I went in for a baseline appointment today (cycle day 2), where they just check everything out with an ultrasound to see if everything is quiet and ready for the new cycle. Everything looked good, so we spent the next 20 minutes going over everything I need to know for the next two weeks.

I started Clomid today and will take it till Saturday.

I'll start an ovulation predictor kit shortly after to look for a hormone surge. They will be monitoring with ultrasound, too, but I think the OPK is so I can monitor in case the surge comes unexpectedly and they can change the ultrasound dates around. I think... I'm not actually sure. I'm just doing it because they told me to.

I have another appointment next Wednesday for a water ultrasound (the test I talked about in number two on this list) to check for cysts and other similar fun stuff. At that time, the doctor will also look at and measure my follicles to see if the Clomid helped them grow. If they aren't mature, I go back two days later for another ultrasound to check again.

When they are big enough (measure at 18mm or larger), I will use an hCG trigger shot if I don't get a positive OPK. That trigger will release the eggs and force ovulation to occur. The only problem that we could see is if I have too many mature follicles, they would all release and have a very high chance of multiples. If there are three or more mature eggs that would release, we will not trigger and wait until the next cycle.

Two days after triggering, it's time to start the progesterone.

Then, it's just waiting. They are going to tell me to absolutely-do-not-under-any-circumstances test before my period is due if I use the hCG trigger. It's extremely easy to get a false positive and think you're pregnant when the test is just picking up residual trigger. That's going to be fun. Some women like to "test out the trigger." They will test early and watch the tests slowly turn negative as the trigger goes away, then continue to test to see if the test turns back positive. If you see a negative test and then the ones after are positive, you can be pretty sure it's a real positive. But a lot of women get their hopes up and disappoint themselves that way, or don't do it right and think a false positive is real.

***After a few hiccups on the lab's part, I finally got the results of the blood test I took to look for any sort of clotting disorders. The results came back borderline. That means that my blood clots faster than 95% of other people. There is an anti-coagulant medication that they put people on that combats it, but since I was just borderline, they instructed me to take a baby aspirin every day. That should help with keeping my blood thin.

I'll be keeping busy, and hopefully the time will go by quickly. I know this isn't anything close to what women do for an in-vitro cycle (those women go through A LOT), but it sure seems like a lot to me, especially since this is the first time that I've actually done some real treatment! I'm so grateful we were able to finally save up just enough for this!

Tuesday, January 15, 2013

Why "Obsessed" Is Normal

I just read a short and amazing article, "10 Reasons Why 'Obsessed' is Normal" on This applies to everyone, so please take the time to at least skim the list! For my infertile friends, this will help comfort you and make you realize that you are not alone in feeling this way! And for my other wonderful friends who take the time to come here and check up on me, I hope this can help you understand a bit what it's like month to month.

Feeling A Bit Obsessed With Having a Baby? Welcome to the club!

Your dreams of motherhood may go back as far as you can recall. It was never a question of "if" you were going to have a baby, but rather "when." You may have felt  great pride for being responsible and doing it all just right:  school, marriage, and a career. You and your husband chose a home with a spare room, perfect for a nursery, decorated in a palette of soft colors.

What happens when trying to conceive becomes a roller coaster filled with great hope and excitement only to be followed by increasing disappointment &despair?

You are ready to take action but what no one tells you is that infertility can bombard your thoughts, your time, your body and your emotions. If you are feeling obsessed, you are not alone! Join the club!

Here are 10 reasons why feeling obsessed is normal!

1.There are those daily, inescapable reminders of a very fertile world.  Around every corner lurks a pregnant woman, a cooing infant, or an adorable onesie!  (You can run but you cannot hide.)
2. For half of every month you are hoping to be pregnant so you carefully monitor what you eat, what you drink, and what medicine you can take. (No hot tub for you!)
3. Instead of escaping into mindless novels about love, travel and friendship, you find yourself scouring the internet, educating yourself about the causes and treatment of your infertility. (Not exactly Jodi Picoult's latest best seller.)
4. Your whole life has been separated into 2 week anxiety producing segments of waiting, watching and wondering. Am I ovulating? Am I PMSing? Am I pregnant? ("Am I going crazy?")
5. Before trying to conceive you may have been fairly oblivious to your monthly bodily functions, but you are now scrutinizing every twinge and secretion. (Do you recall the days when going to the bathroom just meant going to the bathroom?)
6. Playful and intimate moments with your husband have been replaced by carefully timed, "on demand" encounters. ("I don't care if you do have pneumonia, get over here!")
7. Your head is spinning as you try to schedule infertility tests and procedures around your work and home life, all the while, you're desperately hoping to maintain a tiny bit of privacy. ("I need time off work again because now my other great-grandmother died.")
8. Your mind is always racing one step ahead! What is our next option if this treatment fails?  (When you got married you never thought to include infertility treatments into your budget along side your mortgage and electricity bill.)
9. Your two closest friends have just announced that they are pregnant with their second babies. (You have most likely run out of kind and appropriate responses to the ever present question, "So, when are you going to start your family?")
10. Finally, the thought of never being a mother and going through life childless brings you unbearable and inescapable fear and grief.

So you're feeling a bit obsessed and overly focused?
Of course you are! Because you're NORMAL!  Hear me:  really, really normal.

For most of us, becoming a mother feels like a need as fundamental as breathing and eating. Even your critics would certainly feel a bit "obsessed" about air and food if it was withheld from them.

Saturday, January 5, 2013

"Beating" Infertility

My mom decided to do a little remodeling of her house. There was a giant built in entertainment center taking up a large portion of the living room, and she had really outgrown it. There wasn't any storage space, it had a large and deep hole big enough for an old projection TV and really wasn't a proper space for their flat screen, and was completely hollow. A big waste of space!

Since it was so outdated and kind of a nuisance, it was time for it to go. And I was lucky enough to be around to see it happen, and even help out! We pulled out a Sharpie marker and a giant hammer, and went to town on the drywall!

It's not often that one gets an opportunity to take out his or her anger on an inanimate object, especially a wall. So, with all of the frustration and emotion attached to infertility, I felt this was a perfect opportunity!

It was very therapeutic, and a lot of fun! Plus, I was able to get out all of the desire to smash a wall after watching so many home-improvement TV shows on HGTV. 

Friday, January 4, 2013

What Causes Miscarriages?

John and I had an amazing visit this week with my new doctor. He was so kind, and patient, and hopeful. We talked about my history, and he helped me understand something a bit more.

Statistically, I most likely had three miscarriages. However, because I did not have an early ultrasound with any of them, it's possible that one or more could have been ectopic pregnancies. Those occur when the egg implants somewhere else other than the uterus. It's possible that, especially since I have one blocked Fallopian tube, that the egg was fertilized but didn't make it down to the uterus. But, since we don't know for sure, we are assuming they were all implanted in the uterus, and would be miscarriages.

Besides having really, really bad luck (by luck alone, the chance of a woman having three consecutive miscarriages is 0.8%), there are five main reasons for a woman to suffer from multiple (three or more) miscarriages.

  1. Low progesterone. I have already discussed this a bit in the past. If there isn't enough progesterone produced, the egg will be vacated from the body because it's not being supported. He said my level was good in a sense that it showed I ovulated, but doesn't know much more than that. Every body is different, and perhaps that level was low for me specifically. We are not doing any tests for this, and I'm just going to be put on progesterone supplements. He said it's cheaper and easier to just prescribe it than to test the levels every month. Thank you!
  2. Cysts, polyps, and fibroids.  Sometimes there are little growths growing on the uterus or ovaries. These make it hard for embryos to implant and grow. Next month I will be going back for a water ultrasound. They will inflate my uterus with water and do an ultrasound to look for any of these growths. If there are some, usually a simple outpatient surgery will get rid of them. Sometimes it's a chronic condition, like polycystic ovary syndrome, or PCOS, that we'd have to work around with hormone drugs. 
  3.  Autoimmune disorders. Some women have a disorder which forms antibodies that think fetuses are foreign invaders in the body, and don't belong there. So these antibodies will attack the tissue until it leaves the body. The solution for this is simply taking an immune suppressor so the antibodies won't attack and leave the baby in peace. 
  4. Blood clotting disorders. This also has to do with the immune system. Some women have immune systems with antibodies that attack anticoagulants in the blood, causing the blood to clot more easily. The blood can clot in the placenta, not allowing proper blood flow to the growing fetus. There is a drug that a woman can take that will prevent the blood clotting so easily and allow blood flow to the fetus.
  5. Genetic disorders. I have not studied genetics passed what I learned in high school biology (this would be more of John's area of expertise), so this is my very, very basic understanding. If anyone has more info, please comment! Sometimes two people's genes just won't mix right. Without proper genetic information and instructions, a healthy fetus can't grow. There is a really cool test they can do on each person to get a map of all their genes. They would take a sample from me and a sample from John to see if our genes are compatible. If there is some problem, the solution is to do in vitro fertilization. They would fertilize the eggs and do testing on those embryos to see which ones are viable, then place the viable ones into the uterus and hope they implant.
After the doctor explained each of those to me, the first thing that went through my mind is that there is a solution for each one of those problems. I'm just so relieved that a solution is right in front of me. Before, my problem seemed endless. Now, we just have to test and play around with the first few options to see if we can diagnose what it is. As for numbers three and five, we are going to wait on those. The tests are really expensive, and it's a lower probability that those are the cause. We are on a tight budget, so we're just going to test for the affordable ones. So, if after working on the other three I get pregnant and miscarry again, we'll do tests for the last two and see if those are the culprit. We're just hoping it's not number five, because in vitro is expensive!

In addition to taking progesterone, I will also be going back on 100 mg of Clomid. I thought I was done with it because I have been ovulating on my own, but at my ultrasound this week, we saw that I did not this month. Clomid can have a brief lasting effect after you stop taking it, but that effect wore off on me. 

It's all so close now that I can almost see it!