infertility

If you have visited many message boards were women undergoing In Vitro fertilization hang out, you have probably noticed that quite a few are talking about accupuncture.  Some women swear by it, stating that it’s the only thing they did differently from one IVF cycle to the next, and the one cycle that involved getting needles stuck in them (by a professional) was the one that had a successful outcome.  Even some women who are not undergoing IVF treatments are seeking accupuncture as a fertility aid.  So, what’s the deal? Does it help or not?  That’s what researchers want to know.

Do a quick search with “infertility” and “accupuncture” together and see how many results you get. Depending on the search engine you use, you’re likely to find upwards of 7,000 pages.  In this broad mixture of results, you’re likely to see offices which specialize in accupuncture for infertile patients.  Now, these folks had to get this idea somewhere!  Actually, they got the idea from, where else, the Chinese!  Accupuncture has been a staple in Chinese medicine for ages, and it’s becoming increasingly popular here in America.  If this study proves that it does, in fact, improve the statistical success rate for In Vitro Fertilization, you can bet it will be even more popular in the months and years to come.

If you have undergone accupuncture in an attempt to increase your fertility, please drop me a line and let me know.  I am certain that women across the nation will be watching and waiting for the results of this study.  Currently, the study is set to be concluded in August, so we won’t have much longer to wait!

All too often, a couple is hesitant to seek help for infertility simply because of the high price tag that accompanies it.  I, and almost every other woman in the country, can understand that all too well.  Very few insurance companies have a limitless supply of funds to cover infertility, and most will cover diagnostic testing but not fertility treatment.  Even then, you’re still left to pay the co-pay’s and deductibles that come with such coverage.

One possible solution to getting fertility treatments without having to sacrifice your savings and retirement accounts could be to consider volunteering for a clinical trial.  Of course, you would still have to qualify for the study and it would near to be in an area near you unless you can afford to travel for an extensive amount of time.  But, if you qualify and are close, you could receive top-notch fertility care at no expense!

Okay, you’re thinking, it sounds good.  The only problem is, how do you find out about these studies to see if you qualify.  It’s simple.  Two very good places to look online are ClinicalTrials.gov and CenterWatch.com .  Simply enter the keyword, “infertility” in the search box and you’ll have results in a few seconds.  Use the advance search buttons to narrow down the results if you need to.

Participating in clinical trials isn’t for everyone.  Some people would rather live child-free, or be content with the children they have, than to volunteer for something of this nature.  However, just because it isn’t for everyone, doesn’t mean it isn’t for you.  Think about it.  Talk to your partner.  If you feel the matter is worth investigating, do a few searches and see what you find.  You never know — you might just get a baby out of the deal!

When you’re trying to have a baby, few things seem to be more important.  You faithfully keep your appointments with the ob/gyn as you’re starting fertility treatments and tests, just hoping that one day you’ll go in and he’ll tell you the news you’re longing to hear: You’re pregnant.  Unfortunately, sometimes those words just never come, and either you feel it’s time to move on, or he feels he is unable to help you and refers you elsewhere.  Regardless of whose decision it is to move on, you have no choice but to start exploring other physicians.  Before you commit yourself to a doctor, though, do your research and find one you trust and feel comfortable with.  After all, you’re placing your fertility in his or her hands.

If you don’t know many people who have had fertility challenges, it is not going to be easy to get a decent referral from your friends.  You can always get names and numbers from your doctor’s office, and that might be a good place to start.  Also, check with your insurance company.  You’re going to want to know how much coverage you have for infertility (if any) anyway, so get a list of which providers they cover in your general area.  You can also search the internet for forums for those suffering from infertility and ask the people on those boards who they use and what is their opinion of him or her.

Once you have a list of potential doctors, it is time to get down to business and start researching.  See if the doctor has a website, and if so, do you like it? (I know, this seems trivial, but you may just have a gut feeling after looking at the website.) Take a look at your calendar and see when you might be free to talk to some of these physicians.  Most of the time, you will not be charged for an initial consultation but be sure you ask about it when you call to set it up.  Don’t try to schedule all your meetings in one day, or possibly even one week depending on how many candidates you have.  Make sure you take notes at your meeting with all the questions you want answered.  Immediately after you leave the office, take a few more notes on your first impression of the office, staff, nurses, and the physicians.  You must remember that all of these people will be taking care of you to one extent or another, and it’s important that you feel comfortable with them.  If you don’t hit things off with one doctor, don’t immediately dismiss him from your list.  Think about it for a day or two before crossing him off — ask yourself if you were having a bad day, or did something odd happen while you were at the office which could have thrown everyone off.

There is a very good list of questions you might want to ask each doctor at http://infertility.today.com/wp-admin/post-new.php.  Who knows, if you are in Florida, you might consider using that fertility clinic!  You will find a few pages that you can print and make copies if you want so you can be sure to remember the questions you want to ask.

Making the decision to move to a more advanced doctor is a big step.  Everything doesn’t need to be so scary, though.  Just make sure you do your homework, and keep searching until you find someone you’re comfortable with.  You absolutely must be able to trust this physician, and you will be working closely with him and his staff.  Do all of you a favor and make sure you pick the right group to be associated with.  Your future fertility could depend on it!!

Because yesterday’s topic was the negative emotional aspects of infertility, I thought that today I would try to lighten things up a bit.  Even though sometimes all we want to do is just sit down and cry, it usually doesn’t help too much and we’re left with swollen eyes and a bright red nose! So, instead of just trying to cheer myself up all alone (and lets face it, after fertility treatments, who can afford retail therapy??), I generally go to some of my favorite forums and read some jokes.  I thought I’d share a few with you today, and hopefully, you just might think about these the next time you’re feeling down, too.  (Oh.. and feel free to share your favorites with me, too!)

The Hormone Guide
Women will understand this and the men should memorize it!

Every woman knows that there are days in the month when all a man has to do is open his mouth and he takes his life in his own hands! This is a handy guide that should be as common as a driver’s license in the wallet of every husband, boyfriend, co-worker or significant other!

DANGEROUS:/ SAFER: / SAFEST: / ULTRA SAFE:

What’s for dinner?/ Can I help you with dinner?/ Where would you like to go for dinner? /Here, have some wine.

Are you wearing that? / Wow, you sure look good in brown! / WOW! Look at you! /Here, have some wine

What are you so worked up about?/ Could we be overreacting?/ Here’s my paycheck. /Here, have some wine.

Should you be eating that?/ You know, there are a lot of apples left./ Can I get you a piece of chocolate with that?/ Here, have some wine.

What did you DO all day? /I hope you didn’t over-do it today. /I’ve always loved you in that robe! /Here, have some wine.

13 Things PMS Stands For:

1. Pass My Shotgun
2. Psychotic Mood Shift
3. Perpetual Munching Spree
4. Puffy Mid-Section
5. People Make me Sick
6. Provide Me with Sweets
7. Pardon My Sobbing
8. Pimples May Surface
9. Pass My Sweat pants
10. Pissy Mood Syndrome
11. Plainly; Men Suck
12. Pack My Stuff
and my favorite one.
13. Potential Murder Suspect

One ovary says to the other ovarie, “Hey, did you order any furniture?”
The other ovarie says, “No, why?”
“There are a couple of nuts outside trying to shove an organ in.”

Two women dealing with infertility were walking down the street together. Suddenly they saw I stork carrying a baby fly by. They looked at each other and one women said, ” What do you think that was?” The other woman took out a handgun and said, “Opportunity knocking.”

Don’t Kick Anything
A little boy came down to breakfast. Since they live on a farm,
his mother asked if he has done his chores.

“Not yet,” said the little boy.

His mother told him that there’s no breakfast until he does his
chores.

Well, he became a little pissed off, so when he went to feed the chickens,
he kicked a chicken. When he went to feed the cows, he kicked a cow.
When he went to feed the pigs, he kicked a pig.

When he went back in for breakfast, his mother gave him a bowl
of drycereal.

“How come I don’t get any eggs and bacon? Why don’t I have any milk in
my cereal?” he asked.

“Well”, his mother says, “I saw you kick a chicken, so you don’t get any eggs for a
week. I saw you kick the pig, so you don’t get any bacon for a week either. I
saw you kick the cow, so for a week you aren’t getting any milk.

Just then, his father came down for breakfast and kicked the cat half way across
the kitchen.

The little boy looked up at his mother with a smile, and said “You going to tell him, or should I?”

Okay.. hopefully I’ve give you all a little laugh.  Just try to remember, there will be dark days, but there will be sunny days every now and again, too.  Don’t get too hung up on those dark days that you stay in bed with the covers over your head when it’s nice and sunny.

Considering that I’ve been finding myself in a funk lately, I thought a good topic to address would be one that’s often overlooked through the course of fertility treatments.  The emotional toll that infertility can take on a couple can be intense, especially for the female partner.  Unfortunately, most fertility doctors spend their precious (and often expensive) moments discussing test results, upcoming tests and possible options with their patients instead of asking a heartfelt, “How are you doing, really?”

The range of emotions felt by a woman undergoing fertility treatment are often extreme and can change at a moments notice.  Hormone therapy can play havoc with the natural balance, and the men around us often think that PMS is no longer a temporary issue.  I remember one of the first months my doctor had me on Clomid. I cried about everything. Taking the puppy to the vet and having to leave her for 2 hours had me in tears. My boss mistakenly accused me of something and I was a sobbing mess.  And, what made matters even worse is that I knew I wasn’t able to hold it together, but I also knew that there was nothing I could do about it. The meds were already in my system, and there just wasn’t a way to get them out.  And, through all of this, I kept thinking that maybe, just maybe, it would be worth it in the end because I might get that precious baby I was longing for.  Nope. No such luck.

My days of dealing with the “Clomid Crazies” are over.  The medication just wasn’t what I needed, and Lord knows I don’t need anymore help losing my mind! Unfortunately, just because I left the bizarre mood swings behind me, the depression has held on — actually, it’s worse.  At the time I was seeing the infertility doctor, at least I felt like I was doing something to move forward.  Now, I don’t.

If you, or someone you know, is experiencing depression while undergoing fertility treatments, it is very important to speak to the doctor about this.  Studies have shown that women who are depressed have an even harder time conceiving than those who are less stressed.  No, don’t worry. I’m not trying to tell you to “relax and it will happen” (after all, I’d like to be alive to write this blog tomorrow).  However, it may be possible for your physician to give you a mild antidepressant or to put you in touch with a counselor who can help you with your emotions.  Depression, grief, jealously, outrage, betrayal… these are just a few of the emotions I, and thousands of other women dealing with infertility have dealt with on a daily basis.  Don’t feel as if you are alone if you are feeling these same things.  As “unnatural” as infertility seems, it would appear that these feelings are, well, natural.

Women have complained for years that following acts of intimacy, their husbands almost immediately roll over and fall fast asleep. They seem completely spent — even when they didn’t have to do the work!  Although research has shown that endorphines released in the brain after orgasm are generally responsible for the groggy headed male, you might be surprised to learn that he has another reason for being so tired! 

Semenal fluid is composed of many vitamins and minerals, and a deficit in these components can cause infertility.  Don’t underestimate the value of a good multi-vitamin for your man.  Every baby making attempt robs his body of things such as Zinc, Calcium, Vitamin C, Vitamin A and B-12.  It’s important to replinish his body so that the sperm have a healthy environment in which to grow and function.

Before you start adding extra items to your man’s diet in hopes of improving male factor infertility, make sure you give him the best possible start.  A good multi-vitamin doesn’t need to be expensive, and you shouldn’t automatically jump up and spend a lot of money on specialized “fertility” vitamins.  Most everything he needs can be purchased separately at less than half the cost of those products, and simply adding extra servings of orange juice can be helpful.  Now is the perfect time to get your man healthy — just remind him to take his vitamin everyday when you take your prenatal and folic acid!

Each time a man experiences an ejaculation, he actually depletes his body of vitamins and minerals — almost a whole day’s supply worth!!  No wonder they are so tired afterward!

Sometimes, regardless of how hard they try, a couple just doesn’t get pregnant.  The woman may be recording her basal body temp and every other possible fertility sign, having sex on the appropriate days, and yet - nothing.  Sometimes, it’s just not an issue on the female side.

When there is no apparent problem with the female cycle, many physicians will request a semen sample so that the male factor can be examined.  Although the specimen will have to be examined in the lab, sometimes the sample can be produced at home and transported to the lab.  If you live more than 30 minutes away from the laboratory, though, this may not be possible.  Your physician will give you instructions regarding when and where to take the sample.  Most doctors will agree that it is best to abstain from intercourse (or any sexual activity) for three to five days before the test.

Azoospermia is a condition in which there are no sperm cells seen during the testing procedure.  This is a severe male factor issue, and further testing will be required.  Oligospermia is a condition which is often referred to as “low count”. There are insufficient sperm cells to likely produce a pregnancy.  This condition is confusing to many couples because, after all, it only takes one!  A low count isn’t the end of the world, and it can be overcome in most situations.  There are many reasons why a man may have a report of a low count.  For example, if all of the ejaculate wasn’t in the container, the ratio of sperm to liquid will be altered.  In addition, if the specimen wasn’t tested within the necessary time frame, counts and motility will suffer greatly.

If a semen analysis result comes back less than glowing, don’t worry.  Most doctors will ask that the test be repeated in a month or so just to double check the results.  In the world of fertility testing, one bad test doesn’t signal the end of the journey.  Repeated testing is needed to verify the results.  There are many holistic approaches to dealing with semen issues.  In a future blog, I will detail some of these possibilities.

Most literature will dictate that a woman should wait at least one year before seeking help in getting pregnant.  I, personally, have talked to many women who say that the first question the doctor asks is, “How long have you been trying?”, and if her answer is less than 12 months, she’s told to return when it has been a full year of negative tests.  Of course, if a woman is over the age of 35, the year long waiting period is lessened to six months, but that can still seem like a very long time when the sound of your heartbeat is drowned out by the ticking of your biological clock.  There are ways to “beat the system” so to speak, when it comes to getting a doctor to actually help you before this seemingly mandatory time period is up.

The first thing a woman should do is to begin taking her basal body temperature and recording it faithfully.  It is also helpful to note cervical fluid (or lack thereof) on the sheet with the temperature.  Going into the doctor’s office with one chart isn’t going to help you much — going in there armed with five or six charts, though, is a different story.  In addition to the cervical fluid, you should be noting the dates which you have intercourse.  This is important so that the doctor understands that you are, in fact, having sex at the right time.  Noting the results of any ovulation predictor kits is also beneficial.

Although not all doctors will veer away from this year long time frame for letting nature take its course, some will be a bit more helpful.  My own doctor spoke with me about this recently, and he helped me understand the “professional” viewpoint.  Typically, when a couple decides they want children, they simply think that throwing out the birth control is the answer.  If a few months go by without positive results, they may decide then that they just aren’t having enough sex.  A few more months go by, and the couple may or may not have been successful.  If they haven’t, this is the point where a woman will mostly begin to do research about the intricate details of exactly how to get pregnant.  Armed with the information, she begins to record her cycle data (via BBT) and/or use ovulation predictor tests to pinpoint ovulation.  If the couple is still unable to conceive after several months of trying during the peak times of the month, then they will seek help.  Usually at this point, almost a year has passed since the couple has decided to start trying to conceive.  The physician is then in a better position to help with the use of blood tests, and possibly clomid.  It also makes it easier to see if there are any oddities in the cycle data by looking at the series of basal body temperature charts.  In short, it’s easier for a physician to help you get pregnant sooner when you come into their office armed with information, and a woman who has been trying for a year or more with no success will almost inevitably have been doing research on her own.

So… how can you get your doctor to help you without having to wait so long?  It’s simple.  If you haven’t already, start taking your basal body temp.  Although it won’t tell you anything right away, it will give an overall picture of your cycles when you look at it as a whole.  Write down dates of ovulation tests, sexual intercourse, cervical fluid, and anything else that you think may be related to your cycle. It can be important to note times of stress or sleep deprivation as well.  Once you have accurately charted all this information, call your doctor and make an appointment.  If nothing else, ask for a “pre-conception appointment” so that he might go ahead and give you good prenatals so that you’re as healthy as you can be while you try to conceive.  When you go in for your appointment, make certain that you take your charts with you. Simply telling him or her that you’re doing it probably won’t be good enough — they need to see that you are seriously trying and doing things at the right time.  Generally speaking, any person who has not conceived within six months of unprotected intercourse at the proper times in the cycle should be seeking help for infertility.  Arm yourself with your data and simply ask for help. 

Many women who go to the doctor to seek help getting pregnant are often told to “go home, take your temperature every day and call me in two months”.  Well… that’s not much help, now is it?  The Basal Body Temperature (BBT) isn’t hard to understand once you have someone explain it in plain English.  Some women today still use their BBTs as a way to prevent pregnancy!

In order to begin recording the temperatures, you must have a chart.  While some people find it easier to keep a chart handy beside the bed everyday, most of us with computer access tend to lean toward online charting software.  There are many websites which will offer you the ability to chart for free, however if you want to share your chart with other women who are trying to conceive, you may have to pay for that.  Two sites that I highly recommend are Ovusoft and Fertility Friend.  I believe that both sites will offer you a free trial period before you must purchase any software.

It is also recommended that you purchase a special basal thermometer.  These can be found in most drug stores, or you may order them online. In my opinion, any digital thermometer that shows temperatures in tenths of a degree will work just fine, but you should use whatever you feel comfortable with.  The most important thing to remember about your thermometer is that once you start a cycle using one, you shouldn’t switch thermometers mid-cycle.  Each thermometer may not be calibrated the same way and swapping could throw off your chart.

It is very important that you take your temperature at the same time every morning. This MUST be a resting temperature — no getting out of bed, no kisses to the hubby, no talking! The alarm rings and you grab the thermometer (this is why I always laid mine on top of the alarm clock so I’d have to feel it before I could turn off the alarm!!).  Once you have taken the temperature, you are free to do whatever you want to do at that point.  A digital thermometer will record the last temperature taken (read the package insert for details), so there is no need to record your temp right away.  Although most women choose to take their temperature orally, some women prefer vaginal temping.  The reason being that sometimes you might sleep with your mouth open and this could affect the temperature.  It’s completely up to the woman to decide how she will temp.  If you aren’t comfortable with the idea of temping vaginally, try it orally. In a month or so, if you see that your temps are all over the place, try switching to vaginal or rectal temps and see if that corrects the problem.

Once you’re up and out of bed, you can then record your temperature on your chart.  At first, it isn’t going to make much sense to you, but don’t worry.  The whole basis for temperature charting is to get an overall picture of your monthly cycles. One temperature does not tell a whole lot about anything, honestly.  A whole month’s worth of temperatures, though, is a completely different story.

If you want to learn more about basal body temps and charting, I strongly urge you to get a copy of Toni Weschler’s book, Taking Charge of Your Fertility and reviewing the websites I mentioned above.  Charting is simple once you get the hang of it — and it can tell you much more about your cycle than you ever thought possible!

When a woman decides that she may need help getting pregnant, often the first stop is the gynecologists office.  After all, most gynecologists are also obstetricians, so it makes sense to consult with them.  However, many women will later find that there is only so much the gynecologist can do, and they will sometimes be referred to a Reproductive Endocrinologist (RE) for further treatment.  Most doctors (regardless of specialty area) will agree that there are basic fertility tests which need to be performed.

Determining ovulation is almost always the first step.  While some women have a perfect 28 day cycle, not all women can so routinely determine when their next cycle will start.  It is a popular myth that ovulation usually occurs on the 14th day of each cycle.  Each woman is unique, and our bodies respond to stimulus differently.  Simply determining when ovulation occurs can help a couple conceive.

One popular way to determine when an egg is about to be released is by using over the counter ovulation predictor tests, also known as ovulation predictor kits (OPK).  These handy test strips come packaged just like a pregnancy test and are used in the same way.  Chemicals inside the test stick measure the amount of lutenizing hormone (LH) which is the chemical which stimulates release of the egg. Either urinating on the test strip or dipping it in a cup of urine will activate the chemicals inside the stick.  Generally, one line will appear to show that the test strip was activated and it will be used as a reference line.  A second line will appear when the test strip determines that there is a high level of LH, indicating ovulation within the next 24 to 48 hours.  An ovulation predictor is considered positive when the test line is as dark or darker than the reference line.  Some women will be able to see a fade-in pattern in the darkness of the test strip, while others will not even see a second line until the test is positive.  Couples should plan to have intercourse until a few days after the positive test. 

Almost all ovulation predictor tests will be packaged with instructions on which day to begin testing for ovulation.  The date one should begin testing is determined by the length of days in an average cycle.  The first cycle in which a woman uses the OPKs, she might plan to use more than one box of test strips in order to accurately record ovualtion. After all, it is better to continue testing until you see a positive test than to stop and miss the event all together!

Certain drugs, like Clomid, can interfere with the results of the test.  Most fertility experts recommend that a woman not begin using OPKs until approximately ten days after the last Clomid pill.  Using the tests within ten days of taking the pills can result in false positive results.