Fertilomat.com – an experiment

At first I wasn’t  sure how I felt about this website: Fertilomat.com Initially, I was mad about it.  I was mad because I believe it was just targeting vulnerable women who are concerned about their level of infertility.  But then I thought, well it appears to be combining a whole bunch of medical research and turning it into a user friendly format for women to interact with, that’s got to be a good thing.  This website has developed a ‘predictive’ model that combines data from various research areas into fertility, such as effect of BMI, alcohol and caffeine.  But the big problem I have with this website is that they are not transparent with how the model is developed or what the potential error is.  This makes me suspicious.

Plus their business model sucks.  They charge women 19 Euros to view a two page personal report based on 23 questions about lifestyle.  The questions are very simple, such as weight, height, age, alcohol intake, caffeine etc. Although I can see that this model may have taken many hours of research and cost them a bit of money to develop, I feel conned because the research that they do cite is free to download anyway.  I also wonder how the authors of all the various research reports being used feel about their data being used to make money from women in this manner?  The website could have chosen a different approach and made money in other ways, by advertising on their website, or charging medical practitioners to use their model.  Maybe I am just biased…

So as a matter of interest I paid for the two page personal report providing me with my fertility score.  Quite frankly I was very disappointed.  First of all because for some reason the form I filled in reset to my height as 4ft and weight as 55lbs.  I am 5’8″ and 130lbs, so the output was useless anyway.  Here are the two charts that were included in my 19 Euro report…

Depressing...

Depressing…

Of the two pages of My ‘personal’ report, I actually received 1 1/2 pages of report. 1/2 page was dedicated to repeating back my answers to the 23 questions, the other 1/2 page were the two charts above.  Then the last 1/2 was some text pointing out that my BMI was far too low (of course it was because the interface was CRAP and assumed I was 4ft and 55lbs) and my fertility score is below average, and next year it will decline.  It also told me that it was good that I was avoiding alcohol because 1 litre of wine in a week can decrease fertility by 60% (thanks, I read that in the free research report you cited).  It told me: ‘the fact that you don’t smoke increases your chances of getting pregnant’.  Ummmm no that’s not how it works!!!!  Then the last paragraph filled up space telling me that If I want to know more about my fertility I should see a doctor/gynaecologist to check for further tests such as ultrasounds.  And that was it!!!!

Simply put people, and as I suspected, this is a CON: Fertilomat.com But I am glad I spent the 19 Euros because hopefully now I can share this so other women won’t!

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Infertility Awareness: Sharing our Journey

It’s national infertility awareness week soon, 19-25 April 2015.  The theme is “You’re not alone”.  There is a blogging challenge under this theme which I have been thinking about writing.  I asked Chris if he thought it would be a good idea for us to write a joint blog post under this theme and post it onto our personal facebook pages.  After all, it is the making people aware of infertility week – how better to make people aware than to share our journey so far?  But Chris quickly pointed out that this would be too much to share.  We would get more questions like, “Any news?”, we would be asked about our troubles at times when we just don’t feel like talking about it, we would also get the unintentional insensitive thoughts, ideas and suggestions (a great post about this “Pardon me whilst I burst into flame” I re-blogged here).

This all makes me so sad.  Sad because I feel like we should make people more aware of the statistics (how common it is), the hidden suffering, the variety, complexity of infertility problems and the many options/choices of treatment.

Our journey is getting a bit rocky

Our journey is getting a bit rocky

The infertility journey is a rocky wild path, that will throw all types of extreme weather at us, it’s physically exhausting and mentally draining.  We know the peak is high, we may come across false summits.  Some of us may fall down, some of us may find shortcuts (we always hope to find shortcuts!) and sometimes the path simply becomes longer and windier than we ever imagined.  We can ask directions from the experts along the way, they help us to see the path as a gentle winding pleasant route, but they can rarely help when nature creates that avalanche and cuts you off.  If we have our friends with us, they can help us round and scale the new challenges that pop up…they  don’t need to be there all the time, they can relay it up the mountain with us, but surely we are better off not going it alone?

via ferrata2In some ways this journey reminds me of the play we saw last year, K2.  This is a story of two climbers who scale K2 but come across difficulties in their climb, death is near as they fight for survival together.  The two contemplate the meaning of life, family, friends, God and our existential existence.  Ultimately, if there had been at least one other person with them, they all may have survived.  Is our infertility journey like this?  If there were more than the two of us, if we fall, will it be easier to get up and keep going?  Movies often portray climbers that find themselves like the K2 scenario as egotistical and selfish.  But climbers are misunderstood, climbing is more than adrenaline or ego, big climbs are often an exercise of self examination, a chance to get away from the daily grind. I am not saying that in this case infertility sufferers are like climbers.  But what I do wonder, is that we similarly are misunderstood.  We are misunderstood because no one knows we are out here on our journeys.  Should we make more people aware?  How can we do this?

We are out here on this journey because the top is going to be beautiful, it will be worth it in the end, worth the financial burden, the mental exhaustion, the physical pain.  I’ve heard it is amazing up there.  I just don’t want to be alone.  But I’m not sure we are ready to invite everyone to join us on our journey just yet.

Top of the world

Top of the world

The big question – What if we can’t have children?

As we were about to head to bed for the evening, Chris quietly asked “What if we can’t have children?”.  This is a question we have discussed before – several years ago in fact.  It’s the kind of question you ask just after your boyfriend/fiancee asks you to marry him.  It’s one of those BIG questions.  And we had much time to talk about it back then.  Chris proposed to me just 1/2 hr into our 4 day hike in the remote Italian mountains, the Dolomites.  Of course I said yes when he asked me to marry him (If I had said no it would have been a rather awkward four days in the mountains 😉 ), but this left four days of ‘just us’ to talk about ‘the big things in life’, to double check that we were in fact right for each other.  Well probably more of me doing the double checking, after all, he had been planning to propose to me for months, he had all that time to think about it.  We concluded that love conquers all, you couldn’t really argue with that logic.  Oh so naive?

This time around, Chris asked the question with a genuine sadness in his eye.  With a little bit of wine in me, my eyes welled up instantly and hit some kind of nerve.  Because yes, love does conquer all, but it hurts to think that this could be a reality in the not so distant future.  I have thought about it a bit, but I haven’t really looked into it in depth.  We discussed potential future options of donor eggs. donor sperm, gestational surrogacy, adoption and being ‘child free’.  These discussions were brief and emotionally fuelled, with neither of us having much understanding about any of them.  We concluded that we do not both agree on each of these options, we have our differences of opinions, however we recognised that these feelings are likely to change dependent on our situation and once we have done more research together.  We did agree on one thing – that we would use all of our savings if we had to, but we would not get into debt.

The discussion was brief, we were tired and emotional, it was not the best time to ask this BIG question.  But it is a question we need to be prepared to think about more if round 3 of IUI does not work.  This doesn’t mean we are not hopeful about round 3, far from it, it’s just something we might want to start smarting up about.  Education certainly never hurt anyone.

Lost: one unopened clear blue digital pregnancy test

Today was meant to be the day that I unwrapped the ‘highly Gyn/Ob recommended’ Clear Blue Digital pregnancy test.  But it’s currently ‘Missing In Action’, I couldn’t find it…I know it’s in the house somewhere, I just can’t remember where I hid it from myself.  Incidentally, I bought it about 7 months ago.  Do these things go out of date?  Oh well…it doesn’t matter because Aunt Flo arrived anyway.

I would like to thank Aunt Flo for the big glass of Wine I shall enjoy this evening and the trip to Busch Gardens now planned for tomorrow – and I am going to go on ALL the rides, many times over, probably until I am sick and dizzy.

Infertility, you sure do suck, but today I am not pregnant and I am going to enjoy this short time of drug free freedom (except the good good Ibuprofen to help alleviate my period pains).  Yes I cried with Chris early this morning, but now I am more determined than ever – whatever is stopping us from getting pregnant – we will overcome it, together.  Round 3 – Ding Ding!

TTFN X

(TaTah For Now)

Reflections upon being pregnant in a war zone – what scares me

The big question: why did I write about something that happened way back in 2007?  Why did I open up some old wounds by writing and thinking about when I was pregnant in Iraq? For the most part, it’s because I drove for four hours on my own, so I had plenty of time to think.  Very dangerous, I know!  Thinking AND driving!  But actually, it is because I have a fear, a fear of being pregnant again.  It sounds rather silly writing it down on an infertility blog. But of course I want to be pregnant more than anything in the world, but this fear is about suffering the ‘side effects’ of severe morning sickness like I did before in 2007.

Hypermesis Education & Research Foundation

Hyperemesis Education & Research Foundation

Last time I was pregnant I suffered severe morning sickness (also known as Hyperemesis gravidarum) and horrific abdominal pains (compared to my normal Irritable Bowel Syndrome (IBS) pains, these were what I considered to be horrific anyway!)  The worst of the symptoms lasted for over three weeks and the nausea continued until the end of my pregnancy of 10 weeks.  There was no way I could have worked during this period.  But to what extent were those symptoms as a result of the environment and conditions I was experiencing at the time – heat, exhaustion, stress, poor food quality and choice?

When Chris and I first met with our Reproductive Endocrinologist (RE), Chris asked her if my previous pregnancy could be a clue as to why we were not pregnant yet.  I didn’t think it would be so I hadn’t mentioned the severe morning sickness in my questionnaire.  The RE did confirm that it was not likely to be associated.  But, now that I think about it, perhaps it wasn’t such a silly question after all.  Because quite frankly, any explanation to our fertility troubles would be nice right now.  I’m quite bored of asking ‘Why me??’

Today I am 12 Days Past IUI number 2 (12DPIUI#2), and so far potential symptoms of pregnancy:

  • Short sharp cramps just around both sides of my ovaries
  • Sharp cramp like pains under the left side and right side of my ribs.
  • Sore boobs, but not tender to touch, just achey.
  • Today I have felt a little nauseous, but Chris has had a funny tummy today, so potentially we ate something funny.

And that is it, not much to go by, but the sharp pains reminded me of my previous pregnancy so I have been more positive about this cycle so far.  Just two more days to go til the big test.

I am afraid to be pregnant but want to be pregnant more than anything.

And that sums up my emotional roller coaster right now 🙂 /\/\/\/\/\/\/\/\/\/——

A new day, a new cycle and new worries!

Yesterday sucked.  Today sucks still, but not quite as much as yesterday.  Cycle Day (CD) 2 and tomorrow is start of Letrozole!  Wait – tomorrow??!?! Wow, where is the time to breathe?  I don’t even have a prescription yet.  The nurse didn’t mention anything about my medication for a new cycle.  She just told me that if I was pregnant I was to call in and arrange a blood test and keep taking the progesterone, but if I was not pregnant, to stop the progesterone and my period would come (late, not to worry, that’s normal because of the progesterone) and then we would follow my doctor’s plan.  At the time, this all made sense.  But my period came full flow three hours after I took my pregnancy test (seriously, what a waste of a test!!!).  My period wasn’t late, and suddenly I realised I don’t have my prescription ready for CD 3.  In addition I realised that CD11 for my first ultrasound was due the day I was planning on returning from Paris for a work trip. Uhoh.  And if all went to plan as the last round of IUI, we would be doing the IUI either the Saturday that my brother is visiting from the UK (sorry bro, you’ve come all this way and we just got to pop to the doctors for half a day) or potentially the day I will be travelling to DC for work (sorry bro, was supposed to be taking you to DC with me for some site seeing). Aghhhhhhh!  Too much to think about. How much of my best laid plans could I reschedule?

All of this came quickly.  I thought about it yesterday, but was in no state of mind to deal with it.  So I dealt with it all today…I decided to still go to Paris, just come back one day early (fingers crossed my flight isn’t delayed by more than 24hrs), we have a plan for when my brother is visiting, and I can delay my DC work trip (My boss has been helpful in this respect).

Today I called the clinic to schedule my CD11 ultrasound, check about medication, how I go about refills and to check the status of them passing on our medical records to our insurance company.  It turns out some of my prescriptions were on refill, but not the Letrozole (the nurse asked me if I still wanted to carry on with it – I guess so??).  The nurse said she would arrange it immediately.  However, when it came to my medical records, there was no note to say that my medical records had in fact been sent to my insurance company.  However, there was a note to say that they needed to do it… But not to worry, because I can always check again when I come in for my CD11 ultrasound.  Well I do worry because I still do not have approval from my insurance company to have IUI treatment – and there is nothing I can do but let them figure it out together.  We can afford the IUI, we have the savings for it, but we would rather know now than later down the road what we do and don’t have to pay for.

On a more positive note, today is our 3 year wedding Anniversary.  We celebrated this evening and I enjoyed a lovely big glass of Merlot.  Good timing 🙂

Happy Anniversary Mr F!

Happy Anniversary Mr F!

What is the probability of IUI success?

Our Doctor told us that we have a 20% chance of success with our IUI treatment (Letrozole Day 3-7, Ovidrel trigger 36 hours before IUI procedure and progesterone suppositories (50mg) for two weeks after IUI).  After three rounds, that would be a cumulative chance of success of 60%.  But this probability is a calculated estimate based on many factors that our doctor knows about us.  For example, if you were diagnosed with unexplained infertility the probabilities of success are lower than if you have been diagnosed with an ovulation related dysfunction.  Age, number of years trying to conceive and sperm quality are all examples of other factors that will influence your probability of success.

Success rates for IUI?

Success rates for IUI?

There are many predictive models out there to determine likelihood of success of IUI.  Each model seems to be slightly different, but in general they tend to range between 9-23% success for unexplained infertility, and the important factors that determine this success also seem to vary from model to model.  This is probably the real reason why that if you were to google ‘the probability of IUI success’, you won’t find much of a straight or clear answer.

Why do I care?  The difference between 10% (a one in ten chance) compared to 20% (a one in five chance), is psychologically different and I’d like to prepare myself for these seemingly different odds!  I trust my doctor, but I want to know more about why it’s 20%.

I spent several hours trying to find something useful that explained the most recent stats.  But the website with the most useful statistics explaining the different probabilities is www.advancedfertility.com.  However, the website is confusing, statistics are hidden away in text paragraphs that require reading several times, multiple hyperlinks to different pages that break up ease of understanding, how recent is this information and it is not always clear where their statistics have come from.

If you google ‘the probability of IVF success’ there is a plethora of useful information and supporting data (because the govt mandates the data is collected by clinics), also there is a really good resource, Society for Assisted Reproductive Technologies (http://www.sart.org/) who summaries the most recent data at the clinic level and the national level.  They even have a patient level ‘Predict my success’ interactive tool.

So, I herby call for greater transparency and clarity on IUI success rates, similar to what can be found online for IVF success rates.  I’m not looking for exactness, just more openness.

If you know of good resources to help understand success rates of IUI, please comment below and share!