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

March 30, 20158 Comments

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.

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

March 26, 2015March 26, 20156 Comments

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 🙂 /\/\/\/\/\/\/\/\/\/——

IUI #2 off to a better start than #1

March 15, 20154 Comments

Intrauterine Insemination (IUI) round 2 is off to a better start than the first one – we think anyway.

A matter of timing

The first round of IUI was, of course, all new to us. I had taken an ultrasound on the Friday (Cycle Day 11), took an Ovidrel Shot to stimulate ovulation on Saturday evening, and had IUI on Monday (CD 14). At the time we wondered whether the IUI procedure too late because my clinic are not open on Sundays we could not do IUI that day, the Doctor had indicated that I needed the IUI procedure early on Monday, rather than later as my follicles were rather large. I had a positive result from my ovulation predictor kit on the Sunday morning, the day BEFORE the IUI. I simply thought that this was the Ovidrel in action, and the doctor had everything timed well. But now we are suspicious that all this meant is that the IUI was too late….

THIS time around for cycle 2 it was a slightly different story. I had my ultrasound on the Thursday (Cycle Day 11) and I had slightly smaller follicles, but big enough to go ahead with the IUI. I took the Ovidrel shot on the Thursday evening, and had IUI on Saturday (CD 13). This time, I got a positive result from my ovulation predictor kit on the morning of the IUI, Saturday morning. This makes me believe that we were too late last time around as it seems that the Ovidrel doesn’t interfere with ovulation predictor kits. This cycle I decided to monitor my Basal Body Temperature (BBT) for the first time ever. Today, Sunday (CD 14) I got a spike in my temperature confirming my suspicions that I most likely ovulated yesterday. Woohooooo! This cycle, it feels that the IUI procedure was better timed. I was also having horrible ovulation pains on the way to the clinic and all day yesterday. A good sign?

The sperm stats low down

Another excellent sperm sample Mr C!

semen volume: 1.2mL
Sperm Concentration: 129 million per mL
Percent motile: 51.9%
Number of motile sperm: 80.3 million
After washing (centrifugation)
Number of motile sperm in vial: 72.5 million
Motility: 86.8%
volume of vial: 5mL
recovery rate for processes sample: 90.2%

The IUI procedure

As we were a bit more knowledgeable about the whole procedure this time around so the whole appointment took about 20 minutes, of which 15 minutes I was laying down on my back resting whilst the sperm figure out which direction they need to swim in. Chris joked we knew that about 15% of the sperm were just swimming around in circles, confused, not knowing what to do with themselves.

The doctor was a new one for me – a sweet lady who seemed very happy for an early Saturday morning! I asked Chris later if I had just been treated for the first time by someone younger than me. Eeeek we are getting old! But he believed she was actually in her mid thirties, so not much older than us. The doctor was very kind and kept apologizing for any pain she might cause. She told me she would use the smallest speculum and the smallest catheter possible so it wouldn’t hurt. This made me wonder whether all this time other doctors purposefully use big speculums and catheters out of choice! She was good at explaining everything she was doing. She put the (smallest!) speculum into my vagina (No lubricant because this kills sperm). She told me she was going to open the speculum up and I might feel some pressure. Which I did, but it did not hurt. After this she inserted the catheter into my uterus via the cervix and the sperm was injected via the catheter directly into my uterus. I barely felt a thing and it was over with in less than 2 minutes. I had no cramping until later in the day.

Here is a short 2 minute 3D animation of how IUI works.

The nurse set a 15 minute timer and I lay down on the bed feeling a bit surreal. This time the 15 minutes went much quicker than last time because we spent it talking about our next holiday – a road trip to the West (Las Vegas, Grand Canyon, Bryce Canyon, Santa Fe etc). We have been planning on going in October, but have been waiting for the last 4 months to see if we were pregnant before we book anything. This will be the last cycle we wait before we book it. No more holding off!

Naughty Gift – no not that kind of naughty

The morning of the IUI I decided to give Chris a gift I bought him a few weeks ago. I have declared before that I believe it is unlucky to buy baby name books, pregnancy books, baby clothes etc before actually conceiving. But seeing as we have been unlucky so far I thought we cant possibly have any more bad luck so what the hell, I bought a pregnancy book for men. It’s a slightly funny book with interesting facts about pregnancy. I couldn’t resist! But I won’t buy anything else. I just wanted to get him something we can share together along this journey.

My naughty gift to Chris

2 Week Wait and greasy progesterone suppositories here we come!

I need my safe place today

March 2, 20158 Comments

14 days past IUI round 1 and I have one negative pregnancy test in front of me….we were good and didn’t test until day 14. But I’ve known since Saturday it would be negative because I have been having those well known period pains. But maybe, just maybe I was confusing them. But no. I was not.

As it is my first time on all these hormones it has been a very confusing month. My right breast grew significantly larger after I took the Letrozole (and it’s stayed like that); I’ve had horrible ovary pain around ovulation and a swollen abdomen; then after the IUI, sharp pelvic pains that stop me in my tracks, aching lower back, swollen breasts and nausea. Damn you drugs.

But now I’ve figured all that out this time, surely, the second time round will be easier and less confusing?

Chris was dying as much as I was to take the test, but I knew already and woke up crying this morning because I just knew. So Chris made me take the test to resolve it once and for all. I’m not going to put all my thoughts down about how I feel right now, it would not make for good reading. Maybe later this week when I’m a little more composed.

My safe place is my ‘anchor point’ I developed on a ‘Presentation Skills’ course. We were taught to have an anchor point that reminds us of our safe place. Some people on my course thought it was odd and just didn’t get it. We were made to sit down on the floor and meditate, thinking of a place that makes us feel warm, safe and happy. Whilst thinking of this happy place we were asked to hold our thumbs to our middle fingers. We were guided through this meditation to visualise this happy place, smell it, listen to it and feel the warmth of it. By associating this happy place with this action of holding our thumbs to our middle fingers, we can easily calm ourselves before giving a presentation. I learnt this ‘skill’ almost 9 years ago and still use it today when I feel anxious. Today I’m walking around with my thumbs to my fingers, a lot.

IUI round 1: My Big Fat Negative

What is the probability of IUI success?

March 1, 20153 Comments

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?

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!

Do I spend more $$ when I am my most “fertile”?

February 25, 2015February 25, 20152 Comments

Do I spend more money when I am my most “fertile’? Probably seems a bit of a strange question coming from someone who has been diagnosed with ‘unexplained infertility’. But never the less, assuming my most fertile period is when I ovulate (give or take a few days either side), do I spend more on ‘discretionary’ items?

Yesterday I heard on the radio that a Texas university discovered that ladies buy more things when they are in their fertile period of their cycle. Well this caught my attention considering not long ago I wrote a post on the weird science of ovulation. So yesterday I started to look at my own spending habits, and of course I have my credit card data, and my ovulation data from the 15 months, what do they look like together overlayed? Is there any possible correlation? I plotted ‘discretionary’ spending, which is basically any type of spending where I had a choice (I excluded groceries, bills, fuel and work expenses), against ‘peak ovulation’ days. Ovulation day is the highest orange peak, with 2 days either side of ovulation day. Here’s what my chart looked like….

Nope…doesn’t look like much of a correlation! But it was interesting to see my ‘waves’ of spending habits! This analysis is really rudimentary. What was the radio show really talking about? There must be some particular way I need to look at spending v ovulation or perhaps I don’t fit the profile because I am actually infertile?? Haha. OK, I’m being mean to myself here.

So this evening I hunted down the source of the research…Asst. Professor Kristina Durante from University of Texas. Here is her webpage, it has a link to all her research papers on it. She has done a lot of interesting social science research on ovulation and social effects. She has even given a TED Talk – Fertile, Flirty & Feisty (I love TED Talks by the way!) her approach is all related to evolutionary theory.

It turns out her research is in fact far more in depth than the radio makes it out to be…Chinese Whispers etc. Indeed, the paper merely discussed that ovulation affects women’s preferences, which might contribute to spending on positional goods such as cars and jewellery. Well the majority of my ‘discretionary’ spending included decaf skinny vanilla lattes and cookies so I think we can safely say my chart is null and void. But it was interesting anyway whilst it lasted 😎 One way to keep me busy in the 2 week wait and distract from horrible cramps and leaky vaginas – geek out!

Abstract from: Money, Status and the Ovulatory Cycle*

Each month, millions of women experience an ovulatory cycle that regulates fertility. Previous consumer research has found that this cycle influences women’s clothing and food preferences. The authors propose that the ovulatory cycle actually has a much broader effect on women’s economic behavior. Drawing on theory in evolutionary psychology, the authors hypothesize that the week-long period near ovulation should boost women’s desire for relative status, which should alter their economic decisions. Findings from three studies show that women near ovulation seek positional goods to improve their social standing. Additional findings reveal that ovulation leads women to pursue positional goods when doing so improves relative standing compared with other women but not compared with men. When playing the dictator game, for example, ovulating women gave smaller offers to a female partner but not to a male partner. Overall, women’s monthly hormonal fluctuations seem to have a substantial effect on consumer behavior by systematically altering their positional concerns, a finding that has important implications for marketers, consumers, and researchers.

* Durante, K.M, Griskevicius, V., Cantu, S.M. & Simpson, J.A. Journal for Marketing Research, 2014

Purple sperm and a painless IUI#1

February 17, 2015February 17, 20154 Comments

Today Chris and I tried to make a baby without touching each other (well later on we will try the normal way too!!). Totally weird.

Last night I had killer ovulation pain. Both my ovaries were painful when I went to bed – the timing seemed to be just right, 12 hours before the scheduled artificial insemination procedure. Thankfully, I woke up this morning with just a dull ache in my ovaries rather than a sharper pain.

Chris worked from home today and I had a day of leave planned. We headed out to the clinic for our 10AM appointment and we were out of there by 12PM (with a short interlude to Starbucks). First of all Chris gave his sperm specimen for washing. He didn’t take long at all! Then we headed to Starbucks for a quick coffee and catch up on a bit of work. Chris collected his washed sperm sample and we waited in the waiting room with his purple sperm for about 20 minutes. Yup it was purple!

Chris’s purple sperm

The specimen that Chris gave was excellent according to the doctor:

semen volume: 1.7mL

Sperm Concentration: 12.45 million per mL

Percent motile: 64.3%

Number of motile sperm: 13.6 million

After washing (centrifugation)

Number of motile sperm in vial: 6.6 million

Motility: 95.7%

volume of vial: 5mL

recovery rate for processes sample: 49%

It seemed a bit weird sitting in the waiting room whilst Chris held his sperm…but then again I am currently blogging about his sperm, so we are not prudish about it. It was just weird and I can’t put my finger on why. We did get a good giggle though from the diagram on the results form. It was more of a cartoon than a diagram because I don’t think it accurately represents a medical procedure of washing sperm. But perhaps it is, and this is how they wash the sperm, in a nice warm bubble bath.

A highly technical diagram on how sperm are washed

I wasn’t nervous about today, just more excited to get it over with. I was called into the examination room with Chris and the nurse briefed us on the procedure. Very simple. A speculum is inserted, without any lubrication (because that kills sperm), then a catheter is inserted through the cervix to the womb. The sperm are then slowly injected into the womb. Actually it wasn’t very slow and was over within seconds. Apparently the doctor pulled a funny face after she removed the catheter. I didn’t notice as I was concentrating on the picture taped to the ceiling of a happy place – a tropical island beach. The face was one of puzzlement. Chris wondered if she was going to say that something didn’t work. But no, that was it, over and done with in less than 2 minutes. It was painless and hurt less than a pap smear test. I was asked to lay down for 15 minutes, and the nurse left a timer. We laughed about bun making, ovens and timers. All in all, the process was very easy. I’ve had cramping for most of the day, but I’d rather that than the sharp ovulation pain I was having any day of the week.

We are now into the two week wait and I have told Chris if he asks me one more time ‘Do you feel pregnant yet?’ I’ll punch him in the face. Luckily he doesn’t really mean it and we can have a bit of a giggle about it. No point in stressing, my glass is back to being half full again 🙂

The beginning? Or the beginning of the end?

January 25, 2015January 26, 20152 Comments

Is this post the beginning of my hunt? No. But it feels a little bit like the start. This is my first blog post, and the first time I am sharing with the world that we are on the hunt for the pudding club. But this is by no means the true beginning of our journey.

Our journey began a long time ago. It started in 2011 with a trip to the Dolomites, Italy, where Chris romantically proposed to me at the top of a mountain. He proposed 2 hours into the start of our four day hike into the remote mountains. A very risky proposal considering I had been giving him signals that I was not interested in getting married (mis-read signals, I will add!). It could have been an awkward four days if I had turned his proposal down. But it was after accepting his proposal on this four day trip, that we spent quality time discussing our future together. As you can imagine over four days in the wilderness, it was many hours of discussion. But it was clear that we had similar dreams, goals and desires in life. Including having children. I think this was the true start of our journey, our hunt.

We married in 2012 and moved to Virginia USA in 2013. I had my birth control IUD removed in 2012, but the real deciding moment to make our family bigger was in December 2013. This was the defining moment when we realised we were on the right path, and this was our greatest dream. Life since then, for us both, has been amazing, and blessed in many ways. Our journey has been beautiful, but it is getting tiring. I am a glass half full type of girl, and recently my glass has been looking a little half empty.

Last week our doctor diagnosed us with ‘unexplained infertility’. This was a huge relief to both of us. We have no serious ailments preventing a natural conception. However, this is a diagnosis given to almost 30% of infertility cases and often all this means is that there is some other unknown cause of infertility. Pinpointing exactly the cause is very difficult for medical professionals. The art of conception is an amazing feat of nature. So the doctor recommended that we focus on treatment rather than causes. Chris jumped straight in – when can we start? The answer, was right away.

So is this the real beginning of our journey? Actually, this blog post is the beginning of our journey, for what I hope is the start of my glass returning to being half full. Maybe the hunt will be over next month, and this is actually the beginning of the end. But the turns keep coming at us, and so our journey continues for now….