Time

Today I am reflecting on time.

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This week I turned 33 years old, and so I decided to celebrate all the threes, 33!  I had a few friends over for an afternoon tea party and we learned how to knit.  Yup….you may have been mistaken into thinking that I was actually having my 65th Birthday Party.  But haven’t you heard?  Knitting is totally hipster.

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This is how I imagined my friends and I to be like at my Birthday party.  Very Cool.

Thinking about turning 33 I realise that I am quickly heading towards 35.  Yeh, yeh, that is two years away.  But 35 is the age that women apparently ‘may find it more difficult to get pregnant’…note – it can be difficult, not impossible.  And that is to be said for a woman who was supposedly more fertile than myself.  So, if the next round of IVF is successful and we do decide to have a second child I would definitely be past 35 if we ever tried to conceive again.  Not exactly what I had in mind!   But time is never going to be on my side and I can’t cheat it!

Today as I did a bit of early spring cleaning, I took down our four photo frames Chris and I put together for our Wedding day.  They were starting to curl and look a bit raggedy.

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Our photo collage we put together for our wedding day…we look so young!

I peeled the photos off the frame and I noticed the lack of wrinkles on my face in some of the photos.  A couple were from over eight years ago when Chris and I first met.  As I look in the mirror today I see my slightly more pronounced furrow lines and wonder how much my life experience impacts these lines.  Often we associate wrinkles with ‘wisdom in life’, and I sure feel like that.  Since I met Chris we have done incredible things in our lives.  If I were to die today I would think I had led a pretty amazing life and would go with a smile.  But experience and wisdom doesn’t simply come from the good things in life, it’s also the bad things.  I think it’s difficult to truly appreciate the good things without experiencing some pain.  So when I see those furrow lines in the mirror I don’t just see time fading, I see time enriching me.

“The more sand that has escaped from the hourglass of our life, the clearer we should see through it.” – Jean Paul Sartre

With infertility, I want time to pass quickly, I’m always waiting. The dreaded two week wait (How many of those have I written about on this blog now??!), waiting to start treatment or waiting to end treatment!  But I don’t want it to pass so quickly that my furrows grow deeper and I realise too late that infertility made me accidentally press the pause button on gaining that life experience and wisdom – the good, bad and ugly.

So as I move forward into 2016, my new year’s resolution is to embrace time and make every bit of sand in that hourglass of life count for something.

IVF Vol 2 begins!

Yesterday my period arrived, just one day later than anticipated, but that’s all good.  I called my nurse and started with the Birth Control Pills (Reclipsen).

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Birth Control Pills (BCPs) – YEY!!!!

I will be on Birth Control Pills for 14 days (1 day longer than last time), then 3 days later we go into the Clinic for my Cycle Day 3 baseline ultrasound and blood tests – this time we won’t need to have all the lessons on injections – but we will need to sign some paperwork and sort out the finances.  Then the next day I get my instructions for injections…and we are off on IVF/ICSI cycle 2!  Here is a calendar of our cycle…

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Planned Dates for IVF Cycle 2.

It is all happening a week later than I expected, which puts me in a conundrum about work travels.  This would mean travelling for work almost the day after I take my first beta blood test.  If it is positive, then I will be flying transatlantic to the UK just 4 weeks pregnant, and have to figure out how I’m going to do these progesterone injections.  Or if it is negative and I am not pregnant, then I will be away from Chris at a sad time. Either way, it kind of sucks.  If I don’t go on this work trip then I will be a real let down to my team.  I’m hoping Chris might be able to come with me on this trip, but it is really hard for him to get the time off work.

Anyway, I am genuinely excited to be starting this cycle, but I had a little cry yesterday.  I think it was all the period hormones running around.  I cried because of the whole situation of fitting everything in life around this IVF cycle.  I’m trying to make it easier for myself by taking some leave off work, but it is a busy month for my team, there is lots of work to be done, I have already had to pull out of one work event (in Switzerland :-|) and so I feel guilty.  Despite feeling like this….I still have hope for 2016 🙂

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2016 is the year I will be stronger, braver, kinder and unstoppable.  This year I will be fierce!!!

For those of you who are new to the whole IVF process or want a reminder of how IVF works you can find a summary on my “What does it all mean?” page here.  Currently I am in Step 1 of the process!

 

Preparations for IVF Round 2

This week My nurse ordered my medications in preparation for IVF round 2.    Our doctor did tell us that she might up the stimulation drugs…but I didn’t know it might be DOUBLE 😦 Last cycle I took 300iu Gonal-F and 75iu Menopur.  This cycle I will be starting off with 400iu Gonal-F and 150iu Menopur.

Menopur is the one that frigging burns too 😦  The nurse said to me “Don’t worry, it’s still one injection.”  Well, I guess in that case I should count my blessings!

When I spoke to Freedom Fertility Pharmacy (my favourite people – not!) after telling them I am likely to be starting stims on 7th Jan, the lady on the phone said….”Great, should I schedule a delivery for your medication to arrive the 5th Jan?”.  Ummmm no, that is way too close for my comfort, and after your previous perfomances, I just don’t trust you!! (OK, so I didn’t tell her it quite like that!!).  I don’t need that stress again!

Now….just to wait for my period to start next week!  Fingers crossed all goes to plan.  But for now, this is me signing off the great pudding club hunt for a week of festivities.

Have a very merry and peaceful Christmas everybody!!! XXX

 

How to make big decisions when dealing with infertility

Throughout infertility we are often faced with the kind of decisions that are life changing.  Life changing decisions for the more fertilely inclined will probably involve: whether or not to get married, which house to buy, where their next holiday destination will be, what career to choose, whether to stay or quit a job, and of course, the classic – whether they should tell their best friend that their partner is cheating on them.

For us infertiles it might also include whether or not to re-mortgage the house to pay for another round of IVF treatment, adoption, surrogacy or a.n.other expensive treatment, whether to undertake genetic testing of embryos, which body part to sell for the exuberantly priced hormonal medications we have to buy or whether to terminate a pregnancy to save our own lives.

Ok so I might have trivialised the decisions fertile people make (Please don’t take offense!), but I think you get my point.  Making decisions throughout the process is tough.  Fortunately for me, this is my line of business…I help the military make tough decisions, whether it is on operations or in peace time, I help them to see the wood for the trees.

So there are a few of the more simple techniques that I can show you that you might be able to use to help you when you get stuck in a rutt.  They are also useful to work through with your partner.  In-fact, it is is even better if you do work them through with your partner (or your BFF, sister or other close relative).  Getting an outsider’s perspective from someone who you trust can be helpful (obviously you don’t have to listen to them :-)).

I’ll order the techniques in difficulty, starting with the easiest first…

PLUSSES, MINUSES, INTERESTING (+, -, ?)

  1. Take out a large blank piece of paper and write at the top of your paper the dilemma you are trying to resolve.  For example. Take methotrexate treatment to terminate suspected ectopic pregnancy.
  2. Draw three columns down the page, each with the heading: Plusses, Minuses, Interesting.
  3. Start with the Plusses column.  Think about what the likely positive outcomes would be if you took the action.  Write each point down with a plus sign”+”.
  4. Next think about the likely negative consequences if you took the action. Write each point down with a negative sign “-“.
  5. You may also write down things that are interesting about taking this action – these might be outcomes that you are simply unsure of what the future might hold.  Write each of these down with a question mark “?”.
  6. Simultaneously get your partner to follow the exact same process.  Make sure they write what they feel, not what they think you want them to write!!!  This is a time for honesty.
  7. Now compare your lists and talk about the differences you might have and why.  If you don’t understand something on each other’s list then use the couple’s validation technique (described here) to help you explore each other’s feelings.  It is important to explore your differences and understand why they might exist.
  8. Hopefully a conclusion will fall out of this list writing.  If it doesn’t, then the dilemma you are facing is probably too complex for this technique, you may want to try another approach.

6 THINKING HATS

This is one of my favourite techniques!  You can do this on your own or with your partner, or as many other people as you like (ideally no more than 6 people otherwise it gets a bit chaotic!)  This technique makes you think with 6 different perspectives and helps you to organise your thoughts.  Edward De Bono who created this technique says:

“The main difficulty of thinking is confusion”.

He is quite right, and this technique helps to overcome a lot of the confusion in our minds.

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  1. I like to have 6 separate blank pieces of paper ready. 1 for each of the 6 hats.
  2. Take your first sheet of paper, and write at the top: THE WHITE HAT – FACTS & INFORMATION.  The white hat makes you think about data and information.  It is used to record information that is currently available and to identify information that may be needed to help with your decision.  I.e. questions you may need to ask your medical practitioners.  Now think about all the facts you have about the problem you are facing.  For example, costs $$, available budget $$, dates, times, who is involved, who is not involved – any other facts or information you may have.  Write all these down.  Don’t forget to add any questions you may have that you simply do not know the facts of at that very moment – this is important!  Once you have run out of facts and information…move onto the next step.
  3. Take your second sheet of paper, and write at the top:  THE RED HAT – FEELINGS.  The red hat is associated with feelings, intuition and emotion.  this hat allows people to put forward their gut feelings without justification or prejudice.  Now write down your gut feelings you may have.  For example: “This drug is going to kill my immune system so I know I’m going to be sick for a long time after I take this injection. I don’t want to be sick anymore, I’m sick of being sick”.  Once you captured your feelings move onto the next step.
  4. Take your third sheet of paper, and write at the top: THE YELLOW HAT – BENEFITS.  The yellow hat is for a positive view of things.  It looks for benefits in a situation.  This hat encourages positivity even with people who tend to be more critical.  Now write down all the benefits you can think of.  Try to see the positive light when ‘wearing’ this yellow hat.  Once you have run out of positivity (!!) move onto the next step.
  5. Take your fourth piece of paper, and write at the top: THE BLACK HAT – CAUTIONS.  The black hat relates to caution.  It is used for critical judgement.  Sometimes it is easy to spend a lot of time focusing on this hat.  Now write down all the issues or downsides you can think of.  It is often easy to be the critic.  So for every negative, try to match it with a positive (using the yellow hat list and add to the yellow hat list if you need to).  Once you have finished being negative, move onto the next step.
  6. Take your fifth piece of paper, and write at the top: THE GREEN HAT – CREATIVITY.  The green hat is for creative thinking and generating new ideas.  This is your creative thinking cap.  Review your list so far.  Try to think about how you might want to overcome some of the negatives on your list – think creatively!!  You could try writing something crazy or wacky down to start with, then try to turn that crazy idea to something more realistic.  This can be difficult to do on your own!  Get some thoughts from other people!!  It is important at this stage to not immediately put down any idea your partner may make.  All ideas are good ideas when ‘wearing’ the green hat.  When you are ready move onto the final step.
  7. Take your sixth and final piece of paper, and write at the top: THE BLUE HAT – CONTROL.  The blue hat is the time to think some more about the thinking you have just done!  The blue hat reviews, summarises, concludes and makes decisions.  Now is the time to review your other 5 sheets of paper, add any last final ideas (it is OK to go back and look for any gaps in any of your 5 hats)…and time to discuss with your partner, similarly to the +, -, ? technique resolve differences in opinions and make some decisions.

Hopefully this technique will help you consider all sides of an argument and help you find some alternate points to your specific dilemma you may never have considered before.  The thing I love about this technique is that you can do this with your partner without worrying about ending up arguing.  Only negative things can be said when wearing the black hat…!!!  Use that to help you get things out on the table.  You can download a blank template here: http://www.slideshare.net/zhigangfang/six-thinking-hats-worksheet But I would highly recommend doing the YELLOW HAT BEFORE THE BLACK HAT!!! Sometimes you can do the BLACK HAT before the YELLOW HAT, but it really is up to you 🙂

It is simple once you have done it once, and after you remember the 6 hats, you can apply this as a mental model to any decision you want to make.

MAKE A DECISION!!!

This isn’t really a formal technique per se, but it is something I came across a while ago when I was making a decision about whether or not to take methotrexate to terminate my suspected ectopic pregnancy.

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I used this notepad to help me make a decision whether or not to take methotrexate

I bought a pad of paper that had blank lines to fill in anytime you want to make a decision.

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It nicely mixes up the two techniques I have already explained, and it is quite funny.  You can buy these ‘Knock Knock’ notepads from amazon here.

OK this post is long enough already….I’ll write about some more decision making techniques another day 🙂

‘Tis the season…Pt 2

‘Tis the season to be jolly.  True.  But my feelings can’t help but be a bit up-and-down like a see-saw.  So I decided to split my post into two.  Depending on how you are feeling this season, you may only want to read one or the other.  Maybe you feel a little bit like me, so read both!

Pt 1: ‘Tis the season to be jolly

Pt 2: ‘Tis the season to be not so jolly


‘Tis the season to be not so jolly

I already blogged about the difficulties of the holiday season for those of us struggling with infertility (my post is here), so I won’t cover old ground.  But this isn’t always the season to be jolly.  And as much as I have equally had lot’s of jolly things going on, I have recognised that life isn’t always quite so jolly at this time of year.

1. Gift Shopping.  I hate shopping at the best of times, and shopping with the Christmas crowds – my worst nightmare – I’ve written about this before.  Shopping for baby gifts – EUGHHHH.  I am an emotional roller coaster with this one!  I love buying cute baby stuff, but when I see cute baby Christmas stuff – especially adorable onesies with “My 1st Christmas” I’m a wreck.  I don’t think I need to say anymore about this one.

2. Distance.  I am a few thousand miles from some of my greatest friends and of course my family.  So when my mum told me she had received my Christmas Parcel and cried, I cried.  Damn it.   It’s not easy being far from loved ones at this time of year.  We have had lovely offers from friends inviting us over to theirs for Christmas Day, but in fact this is something we just can’t do this year.  We are going to start our own family traditions – I wrote about that already – we are excited to do this, but it’s not easy to do.  Some people may say that we are lucky we don’t have to deal with ‘forced family reunions’ with nosey inquisitive family members; but even if we were back in the UK we are lucky that we have the most supportive family that this wouldn’t happen for us.

3.  Trying to Conceive.  Officially we are allowed to try to conceive again, but I have mixed emotions about it.  I wrote a separate post about it so I won’t repeat it, but this has been playing my mind this week.

4. Facebook.  A friend posted on facebook what seemed to be a pregnancy announcement, until you get to the bottom of the long carefully written post and realise they are just talking about santa clause.  It was poor taste for someone like me struggling to get pregnant…but even more so because I felt sad that this couple may just find them selves to be one of the “1 in 8 facing infertility” one day.  I wanted to tell them it was in poor taste, but then realised that I would just come across as a scrooge bag as so many people had already commented how funny it was.

5. Money worries.  As my credit card bares the scars of many swipes this holiday season and our bill from the infertility clinic shows up with a surprise payment from September, I have the constant feeling of every penny counts.  Actually, we are very fortunate to be in a comfortable financial position, but I want to keep our options open for the future and don’t want to close a door because I didn’t keep control of our outgoings.  But Christmas is a time for giving, so in general I don’t feel guilty for the gifts I purchase or the charities we give to – it’s just the gifts that Chris and I give each other and the seemingly endless nights of eating out that make me feel guilty!!!

6. Coping with loss.  This applies to anyone who has lost a loved one, not just those who have had to deal with losing a child, as well as anyone who has experienced loss of something of their physical self.  Ultimately the Christmas holidays plays heavy on the heart of someone who has lost their hopes and dreams.  As I sip my cup of tea in my new mug “When it rains look for rainbows” this reminds me to remember the positive things and love that I have been lucky to have experienced and made me a richer person, and “When it’s dark look for stars”, this reminds me to look up and remember our dreams are still out there and we are being watched over.  It’s still difficult, and gets harder getting closer to the big day itself.

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Everyone you meet is fighting a battle you nothing about.  Be kind. Always.


We have far more jollynesss to keep us going for the festive season  but it’s these kinds of things that remind me it isn’t easy for everyone, and even more so for many more people who don’t have the jolly things I described in my earlier post.

On the subject of coping with the festive season.  Resolve has an excellent fact sheet about coping with the holidays (here) – it provides a collection of great articles I recommend for reading over a cup of tea.  You may need some tissues to go with that too.

O-Day

Chris and I shower together – we have a bath that has two shower heads at either end, so we share.  It’s impossible to switch either one off, so we have to shower together to save on the water!!!  It was a bit weird at first, but we have discovered this is the one time of day that we can have a conversation without interruptions.  Today, as we were getting in the shower together Chris asked me

“when will it be baby making time?”.

I knew it was today.  Today is ovulation day.  I don’t need an ovulation predictor kit to tell me this.  I am just so experienced at it, I just know when it’s going to happen.  All the signs and symptoms are here.  O-Day.

I turned to Chris and said that I am not sure I want to try this month.  (For some quite selfish reasons I’ll go into a minute.)  He said “Maybe if we are not trying our hardest, we are not ready to become parents”.  I told him that is a perception not a fact….  I was pretty mad at him for saying that.

….And then I just burst into tears.

I can tell you that being in the shower whilst crying is a great place to be.  You can cry your hardest and it just doesn’t matter where the tears and snot roll down you face.

Let me tell you why I cried.  I cried because I do feel selfish.  I thought about not trying this month because my period is due on my Birthday, a few days after Christmas.  Between O-day and then (the dreaded two week wait) I would feel guilty for every sip of alcohol I drink. Which will mean I will not want to drink.  But I LOVE Christmas drinks – mulled wine, bubbly, mimosas, red wine, hod toddies, baileys coffee, port. I’m not an alcoholic BTW!! Last year, I had a couple of Christmas drinks knowing there was a chance I could be pregnant.

I am also going to be in the 2 week wait worry – and I am out of practice of this.  The last time I was in the 2WW worry I remember feeling incredibly emotional.  I have just got over being sad about the way things worked out after IVF 1.  I want to be emotionally sound going into IVF 2.  If I get a negative test (which will happen to be on my Birthday by the way) I get yet another punch in the stomach that I can’t get pregnant on my own.  To which I already know this.  Why do I want to mess with my sanity when I am in a good place right now?  I would love to not go through another round of IVF.  Seriously, it would be the best thing in the world.

Unexplained infertility leaves you with feelings of ‘There is nothing stopping you get pregnant’.  Maybe we could get pregnant without medical intervention.  So I then have a huge rack of guilt.  Surely if I want a baby then these things all shouldn’t matter – I should just suck it up.

Chris says he understands.  But honestly, I don’t think he understands how I truly feel, it is difficult to understand unless you have felt it.  Yes, he feels the pain of this too.  But it’s not his body that wakes up everyday in the two week wait, hoping – losing hope with every twinge your body makes.  It turns your inside out, it makes you feel sick, it makes you well up on the verge of tears, it eats you alive.  Infertility does this.  It puts you in position of feeling guilty for not trying your hardest.  But sometimes you want to screw up that infertility and throw it in the “just fuck-it bucket”.

I haven’t decided yet.  My feelings are mixed and confused right now.

3 months post Methotrexate

Today marks the day that 3 months ago I took the methotrexate shot to terminate my suspected ectopic pregnancy.  Today is an important day for Chris and I because we are officially allowed to try to conceive again!  Woohoo!!!  We were on a ban from conceiving just in case I got pregnant and the methotrexate was still in my system causing damage to the embryo.

Three months has flown by…I have kept myself busy with work travels and finishing off various projects at work before the end of the year.  Also preparing for Christmas has been a nice distraction too.  Now all that is left to do is make some time for a few parties to see in the new year.

You cannot believe how much I am looking forward to 2016 and our next round of IVF treatment 🙂 yup….this craazy lady here is looking forward to being stabbed in the tummy with needles.

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Effects of flying and jet lag on fertility pt 2.

In my previous post I described some research that indicates fertility may be effected by the disruption to the body clock as a result of travelling across time zones (or any other job that requires shift work).  There is one hormone that may be taken as a supplement to help overcome and regulate the problems our bodies face as we fly in to different time zones – melatonin.

Melatonin is not new to me.  Some of my US colleagues have told me about the use of Melatonin to help them overcome their jet lag quickly when they are in Europe.

Last year I landed in Germany with a terrible headache that had lasted more than two days, pain killers just didn’t touch it, and I couldn’t sleep – which was probably perpetuating my headache.  So my US colleague suggested I took some melatonin to help me sleep and kick start my body into a natural rhythm.  He warned me that melatonin can have side effects, such as vivid dreams.  I already dream a lot normally, and I had problems in Afghanistan with Anti-Malerial drugs causing vivid dreams and hallucinations; so I was very cautious of taking melatonin.  But I was willing to give it a try as by my third night in Germany I was consistently unable to fall asleep until about 5AM, then working all day with this awful headache.  So I took two of the little melatonin pills, and they helped me to fall asleep before midnight.  Bliss.  I did have some vivid dreams, actually they were more like nightmares, but at least I got some shut eye!  My headache didn’t disappear though, so I decided not to take any more melatonin. I was more afraid of my dreams than my headache.

I didn’t know much about melatonin at that time; I didn’t really look into it.  But since suffering from infertility I have been educated more into melatonin and its purpose.  I came across it in the book “It starts with the Egg” by Rebecca Fett, but I didn’t pay it much attention.

So what is melatonin?  It is a hormone that helps regulate many other hormones in the body and helps to maintain our body clocks (or circadian rhythms).  During light hours of the day, our natural melatonin production drops and when it is dark, the body produces more melatonin.  If we are not exposed to enough light during the day or too bright artificial light in the evening this can disrupt the body’s natural melatonin cycle.

What does melatonin have to do with fertility?  Melatonin is produced by the pineal gland in the brain, but it is also produced by the follicles within an ovary, the mass of cells that surround the follicles, and in the immature follicle itself.  It is here where melatonin acts as an antioxidant which supports cellular health and protection of the immature egg from oxidative stress, especially at the time of ovulation.  Melatonin has beneficial effects not just on eggs but also on embryos.  Mouse embryos grown in a lab with melatonin showed an increased rate of forming bastocyst-stage embryos [1].  As a result of this success, clinical trials were undertaken.   A study of 115 women showed that melatonin may increase egg quality by reducing the level of one oxidising agent called 8-0HdG in the ovum, which is a natural product of DNA oxidation [2].  Women who were given melatonin had a fertilisation rate much higher than their previous cycle and nearly 20% of the melatonin treated women became pregnant.  Whereas only 10% of the non-melatonin group became pregnant.

Melatonin also helps to control body temperature, the timing and release of female reproductive hormones and possibly egg quality.

Finally, melatonin is known to act as an antioxidant during early pregnancy.  In addition, melatonin in the mother’s blood passes through the placenta to aid the creation of the fetal suprachiasmatic nucleus (SCN) where the central circadian regulatory system is located.

Melatonin levels decline with age, and as a result the ovaries lose their natural protector against oxidative stress; hence could be an additional contributor to age-related infertility.

If you are going to consider taking melatonin as a supplement when trying to conceive you need to be careful and should ask your doctor, because the melatonin supplement may disrupt the natural hormone balance and interfere with ovulation.  If you are going through a controlled hormone cycle with IVF this is less of a concern.  In addition, melatonin can cause side effects, such as daytime droziness, dizziness, and irritability and may worsen depression.  Melatonin can also interact with other drugs, so this is why it is important to check with your doctor before taking it.

If you are going to take melatonin as a supplement whilst travelling it is also important to know what time to take it.  You should take the supplement after dark the day you travel and after dark for a few days after arriving at your destination.  In addition, taking melatonin in the evening a few days before you fly if flying eastward.  Again, there is caution to be made here because the long term effects of taking the supplement are unknown.  Therefore this is not overly helpful for airline attendants or shift workers, and only for those who travel infrequently.

For me, personally, I am undecided as to whether or not I will take melatonin as a supplement for either my next IVF cycle or when I am on my next international trip.  But I will certainly be asking my doctor next time we speak.

Have you taken melatonin as a supplement? What are your experiences with it?

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[1] The effect of melatonin on in vitro fertilization and embryo development in mice.  Available here: http://hera.ugr.es/doi/15015646.pdf

[2].  The role of melatonin as an antioxidant in the follicle.  Available here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296634/

Effects of flying and jet lag on fertility pt 1.

I am just returning from yet another trip to Europe, Belgium this time!  This has been my 9th transatlantic trip this year.  Last year I made 10 trips, and the year before that 11.  With an average of a trip every 6-8 weeks I spend a lot of time either sat in a plane or at an airport or, trying not to fall asleep in meetings whilst I try to get over the jet lag!!

Travelling like this is stressful.  I always have a connection to make in the US because I do not live near an international airport, and sometimes I have another connection in Europe as I travel to cities that do not connect directly with the USA so I can often end up with 2 transfers…it can be very stressful making these connections when flights get delayed or security lines hold me up.  For example on this particular trip to Belgium, due to a series of unfortunate and unrelated disruptions it took me 9 hours longer to reach my destination (on top of the planned 14 hours of travel).

I am simply sick and tired of it.  Yes, I get to go visit some cool cities, I am grateful for that opportunity, but it is physically disruptive to my life.  As this is my last trip of the year and I already have 7 trips planned in the first 5 months of next year :-s I am beginning to wonder whether it is such a good idea to do all this travelling.  I am not sure how many of these I will be able to commit to with my next round of IVF coming up.

This got me thinking about how little I know about the effects of flying on my fertility.  Is it even an issue?  Should I be concerned?  So I did a bit of research and here is what I have found so far:

There is currently no overwhelmingly strong evidence that flying has a direct cause of reduced fertility.  However, there are a few studies that indicate that there may be some correlation.

One study I found to be compelling used mice to investigate whether shifting the body clock has an effect on their fertility [1].  The results of this study showed that there may be serious implications for a woman’s reproductive health if her work involves shift work or time zone changes.

To understand the outcome of this study, you need to understand the body clock.  Our body clocks are called circadian rhythms, these are physical, mental and beahvioural changes that follow a roughly 24 hour cycle, responding primarily to light and darkness in the environment.  Your circadian rhythm is produced by your body, but it is also influenced by the environment.  Light is the main thing that influences circadian rhythms – it turns on or off genes that control your internal clock.  Your circadian rhythm can change your sleep-wake cycles hormone release, body temperature and other important bodily functions [2].  (I know travelling certainly screws up my body temperature because I discovered this last year when we were trying to conceive the good old way and I was actually bothering to monitor my temps.)

The researchers of this study found evidence suggesting the severity of circadian disruption may be linked to the severity of pregnancy disruption: mice subjected to advances of the light-dark circle had greater circadian clock disruption and lower reproductive success.  This group’s pregnancy success rate was only 22% compared with the control group of 90%.

WOAH. That’s quite a difference!

So what does this mean?  This means that if this affects mice, there is a good chance it affects humans too – but to what extent remains unknown, more research is needed before conclusions can be made confidently. ….but I couldn’t find anything taking this research further forward.

Now, there have also been a large survey study of flight attendants to examine fertility….there are two interesting conclusions, first that flight crew were found to be more likely to suffer from irregular periods, and also more likely to suffer a miscarriage.  But I find the study designs less compelling, so I’m not even going to write about this in much detail (but you can judge for yourself here).

So is there something that can be done to prevent suffering from the effects of flying and jet lag?  No one knows for sure, but we do know that Melatonin is an important hormone that regulates other hormones…this can be taken as a supplement, but it can also have negative effects on fertility too when taken as a supplement.  And this is what I will talk about in some more detail in Part 2 later this weekend!

flying.jpg

Am I less fertile because I travel trans-Atlantic a lot?

[1]  Summa KC, Vitaterna MH, Turek FW (2012) Environmental Perturbation of the Circadian Clock Disrupts Pregnancy in the Mouse. PLoS ONE 7(5)

[2] Circadian rhythms fact sheet on the National Institute for General Medical Sciences website

Period after HSG and miscarriage

If you are not into reading about periods and period blood you should stop reading this now and come back tomorrow when I will be talking about less gross things in life 🙂

This is my first period since my recent Hysterosalpingogram – HSG – test.  This is also (probably) my second period since my miscarriage.  And it’s a weird one!!  It is on schedule – for which I am truly grateful for (isn’t it funny how we celebrate the little wins on this journey!!).  But this period is weird so far.  The pains are different, I cannot explain what is different about them, they don’t hurt so much, but the pain ‘rumbles’ inside me rather than the typical’radiating’ and ‘sharp’ pains I get from my normal period.  The blood is a heavy watery-pinky-mucusy mix.  Normally I get dark brown or red, thick and clotty blood.

So I got onto my friend google (like you do in a situation when weird stuff happens to your body).  I extensively searched for possible causes and whether this is normal or something I should call the nurse about.  My biggest concern is that my uterus lining won’t be up to scratch in preparation for our next round of IVF.

The best and corroborated explanation for this unexpected weirdness is that it may be an indicator of anemia or low iron stores and/or unbalanced diet/suffer from poor digestion.  Both of these things are plausible in my case, but can be easily resolved with some supplements.

I was worried it could be associated with the HSG procedure or the miscarriage, but it seems to not be the case.  So nothing to  worry about or to call the nurse about specifically, but I will mention it when I speak to her next.

Crisis averted, thank you google!  Now….pass me the liver and spinach 🙂