Monday, August 31, 2009

OPKS- the Cheap Pregnancy Test?

Looking back at my own experiences, I discovered I was pregnant by getting a positive OPK. I knew it didn't make sense to ovulate so early in my cycle. I immediately took a pregnancy test and got strong positives.

Soon, after I get the doctor's okay, I will be back in the world of trying to conceive and had an idea. Could I use OPKs to test early (i.e. 10dpo, 12dpo) for pregnancy and if it looked promising, I could use a First Response Early Result to confirm pregnancy? Pregnancy tests are expensive. While OPKs aren't exactly cheap, especially the Clear Blue Digitals I use, they are less expensive.

Besides my personal experiences, I wanted to dig deeper to see if there is a reason a test that checks for LH could be used in place of a test the looks for HCG (pregnancy hormone).

  • LH and HCG are both glycoproteins- they consist of a protein with a sugar attached to it. These hormones are comprised of two parts. If you were to break it down (I blocked out anything I learned in chemistry, but let's accept the fact that it can be broken down) the first part, the amino acid chains, are identical. The second part are extremely similiar in composition and function. This explains why some getting fertility treatments are given an HCG trigger shot to stimulate ovulation instead of getting an LH shot.

  • HCG is more complex of a hormone, it has more parts than LH. Home pregnancy tests are supposed to look for these extra things, not in the LH. However, since they are so similiar, in many cases an OPK can detect HCG. However, a pregnancy test cannot detect LH because a pregnancy test is look for that extra part that LH doesn't have.

The experts point out there are reasons not to use OPKs as pregnancy tests.

  • If you get a positive OPK, it is only detecting there is either LH or HCG in your system, you can't clearly distinguish which one is being picked up. I would argue though that if you are monitoring your cycle by temping or a fertility monitor, you would have a good idea.

  • It could lead to false positives because you naturally have LH in your system throughout your cycle. The test picks up a surge of LH, but if the test is more sensitive you might get a false positive.

  • Most pregnancy tests are more sensitive than OPKS so you would get a positive on a pregnancy test sooner than on an OPK.

Overall, experts agree it isn't a great idea to use OPKs as a pregnancy test. In my opinion, and please take it as just that, I think it might be worth testing.

Here is why. I like using First Response Early Result . They have always been accurate for me. Based on my previous post on pregnancy test sensitivity, you can get a positive by 12dpo. But I dread using them because they are costly.

After having two miscarriages, I am not sure I want to make a big deal to my husband or parents before I know this pregnancy is viable. Now that I am working with a fertility doctor, I can get an HCG beta test and get results the same afternoon. I don't want to waste a FRER on 10dpo, but I would like to know if I was pregnant. That way I could go in, get tested, and then retest on 12 dpo to see if my beta was doubling appropriately. If I did get an early positive on an OPK, which is much cheaper than a pregnancy test, I would use my First Response Early Result to confirm immediately. The downside to me is that if the OPK looks positive but is in fact picking up something else in my system.

Although, this all circles back to conversation about whether it is better to know before 14dpo so you don't risk the heartache of a chemical pregnancy.

What do you think? Would you try this approach?


Something is Working- But Not Enough

I am one messed up science experiment. I have so many confounding variables it is impossible to identify which of my many actions should be credited with results.

Since trying to conceive, I haven't had one cycle were I ovulated before CD20. In general, my cycles were 37 days. My doctor said anything over 33 was considered too long.

I started monitoring ovulation in August, my first cycle after fibroid surgery. I got a high on my Clearblue Easy Fertility Monitor or CDs 13 and 14. On the evening of CD14, I got a positive OPK using ClearBlue Easy Digital Ovulation Predictor. On CD 15, I got the blessed Peak on my monitor. To say I was in shock is the understatement of the century. I came out to the living room where my husband was contently engrossed in baseball game and did a happy dance for everyone on our street to see (and we get quite a lot of pedestrian traffic).

I was so thrilled to see I was heading into the normal range of cycles. I felt more confident that I would have what my doctor refers to as "a strong ovulation" resulting in ample progesterone production.

To recap, here is what I have been doing since I last monitored ovulation to help lengthen my luteal phase.

  • Had my Fibroid removed. My doctor said that fibroids don't affect hormones or cycle length. I am not sure I agree.
  • Seeing a reflexologist every two weeks. She focuses on my endocrine systems and tries to bring my hormones into balance.
  • Been on Atkins diet for 4 months which controls insulin which should balance out hormones
  • Take B-6 Vitamin
  • Exercising 5 days a week (with the exception of fibroid surgery recovery for 6 weeks)

  • And clearly something if not the confluence of all these factors worked.

    A huge benefit that normal-cycled ladies could never understand is not having to wait forever and a day for the next cycle to start. When your cycles are long, it is even more upsetting to get a BFN because you know you have to wait so long until your next opportunity to try. I also can use fewer Clearblue Easy Fertility Monitor Sticks. I only used 7 this cycle (I stop testing once I get a peak).

    I went in 7 days after my initial positive OPK and had my progesterone drawn. I previously had never been above 8.4. A reading of 5 shows some sort of ovulation but weak ovulation. 10 is what the doctors want to see for normal ovulation. I came back at 13. I was triumphant. I just felt everything had fallen into place because of all these steps I had taken.

    Everything was looking rosy until 10dpo when I started spotting. By 12dpo, it hadn't stopped. The fertility doctor told me to come in to get another progesterone draw. I got the results 3 hours later. My progesterone had crashed to 4.8, a level so low, it didn't seem pregnancy could be sustained. I did however, make it to 14dpo, before my next cycle started, which really is great news. My longest cycle since last year had only had an 11 day luteal phase.

    My doctor said that it seemed the corpus lutem gave up to early. She explained that a luteal phase defect can manifest in two ways. The first way is your period starts too soon. The second way is that you progesterone drops significantly, too early.

    Since my ovulation was good, she doesn't want to treat with clomid right off the bat. Instead she wants me to take progesterone starting 3dpo. Hopefully, that will do the trick.

    Anyone use progesterone to keep there levels up throughout the whole tww?

    Exercise, TTC, and Pregnancy

    I had my 6 week post-surgery appointment today and am now approved to work out. I was so eager for this day but when I got back from the appointment I had to mentally force myself to change into my exercise clothes. Well- the exercise reprieve was nice while it lasted.

    This got me thinking. How intensely should you work out when you are trying to conceive?
    Once pregnant, you shouldn't let your heart rate exceed 150bpm. But during the dreaded TWW (two week wait), when you don't know if you are pregnant, should you hold back on exercise intensity?

    First off, studies show exercise is important during pregnancy.
    Exercisers experience:
    • fewer aches and pains
    • lower risk of gestational diabetes
    • less likely to gain excess weight
    • easier labor
    • quicker recovery after pregnancy

    The CDC suggests pregnant woman should exercise 30 minutes a day most days of the weeks.

    My doctor told me that if you had been working out regularly prior to pregnancy, you can keep it up during pregnancy, but you need to keep your heart rate under 150bpm. She also frowned up jumping (sorry Jillian, won't be 30day shredding with you during the TWW).

    From what I have read, it is best to follow the pregnancy guidelines during the TWW. Moderate exercise has not be linked to increased miscarriage. Be sure to hydrate, warm up, cool down, and stretch (but not intensely). A fertility specialist on said that it is safe to exercise during your most fertile days (ovulation).

    So there you have it ladies- we have no excuses!

    Saturday, August 29, 2009

    Chemical Pregnancies- is it Worth it Test Early?

    My mom and mother-in-law love to tell me how back in their day, they didn't even know they were pregnant until they were weeks to a month late. Maybe ignorance is bliss, because what you didn't know couldn't hurt you.

    Today, some people get positive pregnancy tests (BFPs) as early as 8dpo. While it is more common to get your first BFP 10-14dpo, is it worth it to test early?

    I read a statistic that frightened the bejesus out of me. 60%-70% pregnancies are chemical, resulting in an early miscarriage before the fifth week. So that means if 6 out of 10 people were pregnant on 8dpo, only 4 will be on 14dpo.

    I think there are valid reasons to test early. Of course, the suspense is horrible and let's face it, some of us are obsessive. Also, you can get tested early for progesterone levels and get supplements if you need them. You can get your HCG levels tested. They should double every other day, so if you get a BFP on 10dpo, you can get retested on 12dpo and by 13dpo when you get your results, you can tell if your pregnancy is moving in the right direction.

    The cons are obvious-you get an early BFP, are ecstatic, tell your husband, tell your parents and three days later you get your period. Studies show that most chemical pregnancies would not have been detected had the woman waited until her period was due.

    Chromosomal problems in the developing fetus are the most likely cause of a chemical pregnancy and couldn't have been avoided. Other possible causes are inadequate uterine lining or physical problems with uterus, LPD, infections, and hormonal issues. Given that there are these other causes that are treatable, it could be helpful to know so you could begin testing. Also, at least the woman would know she can get pregnant.

    The earliest that I have ever tested was 10dpo and it was negative. Both times when I was pregnant I tested about a week after my period was due. I am not so sure I could be so disciplined now to wait to even 14dpo.

    What do you think, is it worth it to know early?

    What's Her Angle?

    Something very odd is going on - or not going on, to be more accurate. My mom has seemed to remove herself from my reproduction.

    If you have been keeping up with my blog, you can understand why this is so eerie. See, my mom has no boundaries. We are very close so she really doesn't bother to take the time to think her intrusive questions are crossing a line. She speaks about my husband's sperm, inquires if we are bedding, asks when I think I will ovulate, asks me "how are you feeling?". And when I respond "fine" she says, "well what about your stomach" and walking into her trap I say, "my stomach doesn't hurt" and then she will deduce "so you haven't gotten your period yet?" I am not kidding, that was a real conversation. She is the Sherlock Holmes of my procreation.

    But now, all is quiet on the overbearing front. She doesn't ask when we will start trying again. She'll ask how a doctor's appointment went or my HSG. She is very vested, but reserved. I did tell her I feel pressure from people knowing that I once I am cleared to try again, that the family will be waiting for a happy phone call from me and that is stressful. I just didn't expect her to take it her heart. Generally, she feels like these boundaries don't apply to her.

    Lately, I have been wondering what would happen when I got pregnant. Would I blurt it out as soon as I heard her voice as is my typical M.O.? Or would I wait to confirm a heartbeat? She is in a Catch-22 that she doesn't even know she is in.

    If I told her early that I was with child, she could either be cautious (which would make me think she thinks something would go wrong) or excited (which would me nervous if something did go wrong she would be disappointed again and sad for me). And I, in turn, am in a Catch-22. If I don't tell her right away, she will be pissed and likely hurt. Even if I waited 2 weeks for the first ultrasound, she would be upset. She would expect that I call her the second the line appears or as I am waiting the three minutes for the test to display results.

    As my dad would say, these are good problems to have. I am sure I wouldn't be able to keep it in for ten seconds anyway, so this stream of maternal consciousness is probably moot.

    Thursday, August 27, 2009

    The 411 on Clomid

    With Clomid being dangled in front of me like a baby-making carrot, I set out to learn more about it. Here is some information about what it does, how you take to, side effects, risks, and success rates. I would love feedback from past users to hear if it was successful for you and any side effects you have had.

    What is Clomid:
    • The most commonly used fertility drug that stimulates ovulation about 80% of the time
    • It works by stimulating hormones that cause ovulation

    How do you Take Clomid:

    • Pills are taken orally early in a woman's cycle (Typically CD 3-7 or 5-9)
    • Typically, you start off with the lowest dose, 50 mg. If this proves unsuccessful in achieving ovulation or pregnancy, the doctor may increase the dosage all the way up to but not exceeding 150mg
    • Often used in conjunction with IUI treatments (artificial insemination)
    • Some doctors monitor your follicles to see if quality eggs are being produced, others do not
    • Many doctors have patients do what is called the Clomid Challenge. This is used to evaluate a woman's ovulation and egg quality or ovarian reserve. Clomid increases FSH levels after 5 days of use. On the sixth day, the FSH blood level is drawn. It it drops back to normal levels, then ovarian reserve is normal. If it is high, it indicates a low ovarian reserve (your body is working harder to ovulate)

    Who should take Clomid:

    • Clomid is administered when there is a known problem with ovulation, but no physical problem, i.e. blocked fallopian tubes
    • People with irregular cycles or anovulatory cycles (don't ovulate)
    • Woman with PCOS have had good success with Clomid
    • Used commonly for people with unexplained infertility
    • People with Luteal Phase Defect may take to achieve a strong ovulation and produce more progesterone to lengthen the luteal phase

    Side Effects from Clomid:

    • Nausea
    • Bloating
    • Dizziness
    • Blurry Vision
    • Breast Tenderness
    • Hot Flashes
    • Moodiness
    • Ovarian Hyperstimulation Syndrome

    Risks of Taking Clomid:

    • The risk of multiples is exponentially higher on Clomid than natural conception. The twins rate is 10%
    • Triplets and multiples of higher order are much more rare, with a 1% chance
    • Clomid can decrease the amount of cervical mucus present and makes transporting the sperm to your egg more difficult
    • Potentially, Clomid can thin the uterine lining, making implantation harder to achieve
    • It is not recommended to take Clomid for more than six cycles

    Success Rates with Clomid Use:

    • 80% of users will ovulate
    • 30% of users get pregnant their cycle of use
    • 40-45% of women using Clomid for 6 cycles will achieve pregnancy


    Tuesday, August 25, 2009

    The Sperm Meets Egg Plan

    Over the last year, I have periodically come across the "Sperm Meets Egg Plan" as a method of getting pregnant. It is a combination of doing the deed every other day and using ovulation predictor tests. Each time I have come across it, there is always the short plan and long version. I am pasting this verbatim from a post I came across.

    Short Version:

    • "Try" every other night starting Day 8

    • Buy 10 ovulation predictor kit sticks Begin ovulation testing on Day 10

    • When test is positive, "try" that night, plus two additional nights in a row Skip one night, then do one last "try"

    • Take a home pregnancy test 15 days after your ovulation test was positive, if your period has not begun

    • If your ovulation test never goes positive, continue "trying" every other night until Day 35, then do a pregnancy test if your period has not begun.

    • Statistics coming in from the bulletin board show that about 40% of post-miscarriage women will get pregnant on the first try if they are faithful to the plan, about double the number of the normal population who are not on the plan. This assumes, of course, that you waited for a normal cycle to begin after your loss, and did not begin trying before having a period after a miscarriage. Many women do not ovulate in that first cycle.

    Detailed Version:

    • On day 8 of your cycle, counting from the first day you bled, begin "trying" every other night.

    • Begin taking Ovulation Predictor Kits (or continue with your Ovulation computer) on Day 10. To make sure your OPK is working well, take your test in the afternoon or after work and do not drink any liquids or go to the bathroom for at least four hours prior to testing. (Morning is not a good time for OPKs, which look for the LH surge, which usually happens during the day.)

    • When your OPK turns positive, begin trying every night for three consecutive nights, skip the fourth night, and then once more. Then stop! The waiting begins. Take a home pregnancy test 15 or 16 days after your OPK was positive if your period has not begun.

    • Should your OPK never become positive, keep the every other day trying going until day 35.

    • Remember that not every women will ovulate every month.

    • As you are trying, make sure to "release" the sperm in your partner at least once during the gap between ovulation and new cycle Day 8 so that no more than 10 days elapse without new sperm production. Sperm is also a cause of genetic damage, not just eggs, so keep it fresh

    Apparently, a blogger named Deanna created the Sperm Meets Egg plan in 1999 ( Average Janes have generally positive comments about the method; many saying it worked their first month. Others say they like it because they don't have to chart temperatures. Detractors say it causes you to think about TTC too much and the stress is bad for baby-making.

    I think it is a good plan for a woman who doesn't want to hassle with constantly monitoring her cycle and whose husband is willing to bed her every other night on command in order to get the baby. From conversations with friends, the stereotypical male who wants it all the time, if he even survived the first few years of marriage, is pretty much MIA once he is told when he needs to do it regardless of how long their day at the office was. So for those blissful bunnies - I say go for it!

    First Response Fertility Test- worth the money?

    You may have seen ads for the First Response Fertility Test

    on TV. I was curious as to what the test actually tested and if it was accurate. It seems so daunting to get that information at home.

    Here is what I could dig up.

    The Basics:
    • It costs about $25 for two tests
    • Must be done on day 3 of your cycle
    • It tests a woman's FSH (Follicle Stimulating Hormone) level, a sign of egg quality and quantity, a leading indicator of fertility. FSH helps regulate your cycle and signals the ovaries to ovulate.
    • You are born will all your eggs and each month an age matures in preparation for ovulation. With each month, the number of good eggs and fertility decreases.
    • Hold one of the sticks in your urine for 5 seconds and then wait 30 minutes for results
    • Shouldn't be used by pregnant woman or woman going through IVF or on the pill. PCOS will affect results too.
    • First Response claims the test is 95% accurate


    • If your ovarian reserve (eggs) is low in quantity or quality, your FSH level (early in the cycle) will be higher than normal because you are producing more FSH to try and stimulate your ovaries to produce a mature egg. This means your fertility potential is below normal.
    • To determine your results, you need to compare the test line to the control line
    • If your control line is darker than your test line, FSH levels are normal
    • If your contol line is lighter than your test line or the lines are similar color, FSH levels are high and you may have more trouble getting pregnant. In this instance call your doctor to set up further testing. This does not mean you can't or won't get pregnant, but it might be good to get yourself checked out.

    My take on the test-

    I haven't taken it but the price seems right. It is cheaper than getting a Day 3 FSH test at the doctor. My concern is only that if you did get a negative result, you might jump to the conclusion that you can't have kids and that isn't the case. Also, this only tests one aspect of fertility, FSH levels. It doesn't look at prolactin, thyroid levels, progesterone, and physical issues like cysts, fibroids, or determine if you are ovulating, but it is a good starting point. I have heard from people that use it that it brings them a sense of relief when the get good test results.

    Monday, August 24, 2009

    Baby Aspirin: The Fertility Wonder Drug?

    I first heard about the use of baby aspirin and pregnancy through the TTC boards. I am not big on taking medicine, so didn't start popping pills myself. I know, shocking, since I am pretty much always looking for the quick fix to get pregnant.

    At my consultation with the fertility doctor 2 weeks ago, she recommended I take a baby aspirin a day. She said that even though I had tested negative for the blood clotting disorder, there are some minor disorders that aren't tested and baby aspirin can help treat them. This is often recommended for people who have had unexplained, recurrent miscarriages.

    I went to purchase the baby aspirin and found it doesn't exist anymore. I remember baby aspirin from my youth. I think Tylenol has cornered the baby pain market. I asked the pharmacist and she said I need a "low dose" or 81mg aspirin. It is a tiny pill and I started taking it daily with my vitamins.

    I have done more research since leaving the fertility doctor and some studies suggest baby aspirin might actually help you get pregnant. Supposedly, baby aspirin increases ovarian activity and increased blood flow to the uterus. This creates a thicker and healthier uterine lining for the egg to implant in and allows more blood flow to help create placenta.

    Here is more information on baby aspirin and fertility.,,midwife_46td,00.html

    Please speak to your doctor before starting aspirin therapy.

    Sunday, August 23, 2009

    Resetting the Clearblue Easy Fertility Monitor

    With more and more people buying their Clearblue Easy Fertility Monitor
    used on eBay or borrowing from a friend, I thought I would post the instructions on how to reset the monitor so it wipes clean the memory. As you know, the monitor stores the users information for months, so you want to make sure someone else's information is removed.

    I have used it to reset after a miscarriage made my cycle length wacky and didn't want the monitor to think that long cycle was normal for me. However, I had only been using the Clearblue Easy Fertility Monitor
    for one month prior. I don't recommend resetting for yourself if you have months of data stored.

    A third reason to reset might be if you have taken years off between kids and your cycle is different than when trying to conceive for the first time.

    Below are the instructions. They are somewhat hard to find, because Clearblue Easy doesn't want to encourage people buying used monitors.

    1. With the monitor off, place a clean, unused test stick with cap on in the monitor. Make sure you hear the snap.

    2. Press and hold the “M” button on the right side of the monitor.

    3. Turn the monitor on.

    4. You will get the “Remove Your Test Stick” sign. Keep pressing the “M” button. In about 20 seconds you will see a screen full of symbols, i.e., a telephone, a brush, the remove the stick, the insert the stick, you get the picture the screen will be full.

    5. Remove the Test Stick and release your finger from the “M” button

    6. Your screen should display an “M” in the lower right corner and to – - in the top right corner. Your monitor has been reset and all the info has been wiped from it’s memory.

    Friday, August 21, 2009

    Pregnancy Symptoms- how do you know when you are pregnant?

    There is nothing more fun or shall I saw, all-consuming, for a TTCer than over-analyzing her alleged pregnancy symptoms. We have learned to skillfully harness the energy we once used to over-analyze everything our boyfriends and husbands said, did, and thought and now use it for the power of pregnancy prognostication. We rely on these happy harbingers to answer the monthly questions - am I or aren't I pregnant?

    I have compiled a bunch of symptoms from several lists. The big caveat is that a lot of people don't feel anything for weeks into their pregnancy. But what fun would it be to think the reason we are tired is because we didn't get home until 2 am when you could easily attribute it the fatigue you feel in early pregnancy?

    Happy obsessing,

    1) Swollen or tender breasts
    2) Implantation bleeding
    3) Delayed or no period
    4) Fatigue or being tired
    5) Morning sickness
    6) Frequent urination
    7) Headaches
    8) Backaches
    9) Areolas darken
    10) Food cravings
    11) Cramps
    12) Heartburn
    13) Feeling faint
    14) Mood swings
    15) Abdominal bloating

    The Lingo- the meaning of trying to conceive language

    If you are new to the world of trying to conceive social media, you might find that droves of women are speaking an unfamiliar language of abbreviations, acronyms, and phrases that normal people don't use. Above is a list to help you navigate these waters with more confidence. I have created my own acronym with my husband (DH) which is BFPP, big fat positive present. I thought he had agreed when the time comes to get us a new, bigger car. I really thought he agreed. He told me to get that out of my head, but I might get the La Mer moisturizer I have been coveting like it is my job. Since we seem to be the only two people use the catchy acronym BFPP, I will leave it off the list.

    Thursday, August 20, 2009

    B6 Vitamin and Your luteal phase

    Big caveat- I am not a doctor and don't pretend to be one on a blog. I have, however, read an awful lot about how to get pregnant. One common problem (which I might still have, we will see after charting this cycle) is a Luteal Phase Defect.

    Essentially, the time between Ovulation and Menstruation should be 14 days, but really needs to be a minimum of 11 days in order to sustain a pregnancy. If your Luteal Phase is short than 11 days, you might not be able to get pregnant or if you do, there is an increased chance you will miscarry. Basically, your uterine lining sheds to quickly, starting your next cycle.

    Doctors tend to want to treat Luteal Phase Defect with Clomid. Clomid is highly effective, however, for those not willing to risk the chance of multiples or feel uncomfortable jumping to fertility drugs without trying less invasive approaches, you answer might be in the form of a super vitamin- B6.

    B6 has been shown to lengthen the luteal phase. Reports vary about how much you need, 50mg - 200mg. Most pre-natals have some B6 in them, but not enough to lengthen your Luteal Phase. Stand alone B6 vitamins are available and are relatively inexpensive (less than $10 for 100 capsules). B6 is also found in foods like yeast, whole grains, eggs and meat.

    If you suspect you have a Luteal Phase Defect, you should chart your cycles. Once ovulation is detected, make sure you have at least 11 days before your next cycle starts. If so you are probably in the clear. If you notice it is at least 11 days but have spotting prior to that, you might want to consider taking a B6 vitamin supplement.

    I personally was taking 50mg a day in conjunction with my pre-natal. When I ran out of vitamins, I bought a new bottle with 100mg of B6 a pill. Since I haven't charted since my miscarriage in April, I don't know if it has been affected, but will be sure to report back to you. I did not take B6 prior to my second miscarriage.

    HSG - Part Deux

    I had my second HSG today to make sure I didn't have scar tissue from the surgery and that my tube was no longer blocked (which the doc suspected was originally blocked by the fibroid). I have to say, even though I didn't think it was awful the first time, I was nervous.

    In the waiting room, I met two women going in for the same thing- they were HSG virgins. I was telling them about it when the first girl got called in. The second girl and I were talking for a while when she revealed the same doctor was doing her procedure, which meant two things. One- the doctor was running late and two- she would be taken before and I would be alone with my thoughts and overactive imagination.

    Finally they came to get me. It was much better than the first time. She got the liquid in on the first try, whereas the first time it took several tries. My tubes are clear, both of them! And my uterus went back down to size.

    So all in all great news. Except while I am lying there, the fertility doctor told me she reviewed my blood levels run by my OB and that something looked high, even though it was in the normal range. So now I have to have another battery of tests. Unbelievable.

    Anyone know where I can go and buy a baby?

    Wednesday, August 19, 2009

    Pregnancy Test Sensitivity

    I came across a listing of how sensitive pregnancy tests are (not all tests are created equal). Sensitivity means how much HCG hormone do you need to produce to get a positive test.

    It might be worth checking out. There are a tons of people that use "dollar store cheapies" while others swear by the First Response Early Result (my test of choice). First Response might be a little more sensitive but the dollar store tests seem to be at the top of the class. I was surprised to see that digitals aren't as sensitive. I figured since they were so much more money they would be better. has a list of people that reported when they got their BFP-so based on true accounts. The results show the First Response Early Result might not be as sensitive as we might think. It shows the earliest positive for FRER was 10dpo and all showed positives by 13dpo.
    To me this proves that you can definitely get an early positive (before 14dpo), but is that best? What if it is a chemical pregnancy, is it better not to know?

    Monday, August 17, 2009

    Not following rules

    I know that the Clearblue Easy Fertility Monitor instructions tell you not to read the sticks, but I was alerted to this website that shows pictures of the sticks at low, high, and peak times in the cycle. There seems to be a consistent pattern

    This is great news for people like me that have had a couple cycles where you don't get a peak, the beloved egg, on the Clearblue Easy Fertility Monitor. In those months, I charted and had a clear temperature shift, so I know I ovulated.

    Check this out and let me know what you think. I am going to pay attention to the sticks now.

    Saturday, August 15, 2009

    Check this out- Comedian making fun of TTC

    Someone referred me to this link of a comedian talking about his wife's efforts for trying to conceive.

    Friday, August 14, 2009

    The Fertility Doctor- A Ray of Sunshine

    I heart my fertility doctor. I even granted my mother an "I told you so". Let her have her moment of maternal glory, she was right, I should have been dealing with a fertility doctor.

    I got to the office which was actually inside the hospital. I can't say it is the swankiest office but the staff was nice. I notice people of all ages in the room. While I was at the front desk, a woman walked in who looked 48 came in and the receptionist asked how her baby was. So seems like they are having lots of success.

    The doctor met me and took me into a room to talk, not an exam room which I appreciated.

    Reasons I heart the fertility doctor:

    1) she was the first person that admitted she thinks the fibroid was my problem, she said we don't know for sure but it majorly distorted my uterus.

    2) she wants me to started getting my progesterone levels tested 7 days post ovulation and if it is low she will give me supplements to help support a pregnancy if indeed I were pregnant. She said there is a small subset of people that do need progesterone supplements. No more arguing this point.

    3) she made several comments that given my age (31) she didn't want to jump to drugs or more aggressive treatments- meaning I am young.

    4) they have screenings and blood tests between 7 and 8 in the morning so you get same day results so they can take action right away, like progesterone and HCG levels, which works out perfectly since I am impatient. They are open 7 days a week. When I had the first pregnancy I had took a beta test on friday and didn't get results back until Monday and couldn't get the second round results until Tuesday. I was so anxious.

    The Plan

    1. She told me to start taking one baby aspirin a day. Some minor blood disorders aren't picked up on a panel test and the aspirin will help.
    2. She had me give blood for genetic diseases, a screening I didn't have yet
    3. I have to schedule another HSG, ugh, as soon as my cycle starts so that we can see if that tube is still blocked post surgery and if the surgery caused scar tissue. Not looking forward to this but at least I know what to expect this time.
    4. I will track ovulation and come in to get my progesteron measure, I will also chart to track my luteal phase.
    5. Assuming LP and HSG are normal, I will try on my own to get pregnant for three or four cycles.
    6. If not pregnant on my own, I will take clomid and be monitored. You go in on CD3 and get an ultrasound, take pills days 3-7, and get monitored a week later, get a trigger shot, and then can either get IUI or given my exceedingly young age (I know I am pushing it) go home and have "timed intercourse" for three days in a row. Then they monitor you after.

    I left feeling very hopeful that she thinks I am going to get pregnant on my own and even if I can't she will get me pregnant. She didn't say as much, but she did say most people they do clomid for three months before moving on but because of my history of getting pregnant and age, she would go to six if I didn't want to try more aggressive methods. Also, I don't have fertility coverage through insurance, so we would rather try natural/clomid before tons of money for IUI, IVF.

    Wednesday, August 12, 2009

    RE-garding my appointment

    Tomorrow is the big day- my first official appointment with the RE. While I don't think it is going to be a typical first fertility doctor appointment (since I haven't been classified as infertile and we don't know if I will have issues getting and staying pregnant now that the fibroid is gone), I do have a bunch of questions.

    From what I have read, the hours of a fertility office are critical, because if you are taking a drug that needs monitoring and you ovulate on Sunday, well you are screwed. Also, sometimes they need to monitor you several times a week to look for follicles which means then need long office hours so you can go before or after work.

    I also want her take on progesterone to get and sustain pregnancy and how she approaches Clomid. How many times will she give you Clomid before they trying something more serious? Will she make me get another HSG and have my husband tested before giving me the pills? Is she willing to do progesterone draws post ovulation to evaluate my numbers?

    Finally, I want to understand better how the relationship works between an RE and your OB. When do you stop seeing the RE and going to OB?

    If you have any other suggestions for questions, let me know!

    Friday, August 7, 2009

    Getting Back to Good

    I still contend that it takes the precision of a rocket scientist to get pregnant (unless, of course, you are a teenager and scared to death of having a baby). Despite the work involved (temping, charting,OPKs, fertility monitoring, and let's be honest, doing the deed as a command performance) I kind of missed it.

    The last time I new everything anyone would ever want to know about their own cycle was March-the month I got pregnant. After the miscarriage and my doctor's edict "do not get pregnant", I found it liberating not to set my alarm to 5:30am seven days a week to temp, not to pee on a stick 20 mornings a month, and not to date rape my husband after an uneventful and not particularly romantic dinner.

    But now that it has been 5 months, I kind of miss it. I want to know if all my efforts have paid off. And let's call a spade a spade, I didn't take my fertility efforts in moderation. To recap I am seeing a reflexologist about 2x a month (though we will up once I can start TTC again), I am taking B-6 vitamins in an effort to lengthen my luteal phase, I started Atkins to help regulate hormones and hopefully help my long cycle, I started exercising 5 times a week without fail, I lost a bunch of weight and I had the mutant fibroid extricated from my body. Now, with the exception of fibroid, these other efforts have been consistent for 4 months and no longer a shock to my system.

    I am seriously looking forward to setting the alarm early for my temp (though I got a 20 minute grace period from my DH, he agreed to never set his alarm before 5:50am), using my overpriced but well-worth it monitor, tracking my luteal phase, and of course inviting daydreams of my BFP back into my every day life.

    I guess you don't appreciate what you have till it's gone.

    Well I'll Be...

    I guess my doctor didn't like being on a break either. While yesterday I made peace with going to the fertility doctor, she was reconsidering. Turned out she called the Fertility doctor (the main guy not the one my appointment is with) and asked his take on my progesterone request.

    He told her that he agrees that LPD (luteal phase defect) should be treated with clomid, but if I am insistent on progesterone supplements than "it isn't worth arguing about". He said it wouldn't do any harm and if it brought me peace than go for it.

    So that means we aren't on a break! She said if I get a BFP I should come to her not the fertility doctor and I should cancel my fertility appointment.

    But here is the catch, if I cancel that appointment my mother in law will personally drag me out of the house by my hair (making note not to hurt my healing uterus) and then my mom will roll over me in a semi truck. They are both thrilled that I am "finallllly" (to be read exasperatingly) seeing an expert.

    What I realized is I don't know if I have LPD because I haven't tracked my cycle since my miscarriage in April and now I don't have the mutant fibroid. So all I want is to try the first cycle on my own, if I do get a BFP, bring on the progesterone need be, and if I don't I will take the clomid.

    I am going to keep my appointment and at least get a game plan in case I do have LPD. And this way my mom won't live with the guilt of maiming her daughter.

    Wednesday, August 5, 2009

    Well that didn't go as planned.

    Back from the doctor's office. She came in and looked at the incision and said it looks good.

    I mustered up the nerve to confront her on the progesterone issue. She said, studies show that it doesn't do anything. And I said well I have friends that have had 3 miscarriages and then they take it and have healthy babies. She said, and they would have been fine without it. I said my friend was spotting for days and took it and now she is fine and she said and your friend would have been fine and the spotting would have gone away on its own.

    I asked can't you budge on this, it makes me so nervous. She didn't budge. So then I mentioned the fertility doctor said people with luteal issues might need it and my LP has been bad since last year. She said I think it is good idea if you set up an appointment with her. She can look into the luteal phase issues.

    A minute later she something about clomid. So I should, well should I just forgo trying on my own and go straight to clomid? She smiled and said, I think you need to speak to the fertility doctor. I asked who would be doing my next HSG and she said either one of us can.

    I've been dumped. She wasn't pissy. She said if I had trouble getting an appointment call her and she would make a call to get me in right away. She told me what to do to get my file copied. And she was like, "alright my dear, I will see you in 4 weeks." Oh also I said who would be my doctor if I got pregnant (since I was being dumped) and she said the fertility doctor would monitor me for a while.

    I set up the fertility appointment for next Thursday morning. I asked the doctor if I would be starting back at square one and she said now they will have your file.

    I feel a bit defeated by this. It makes me think I can't do this on my own, that nobody thinks the fibroid was an issue at all and I have even more fertility problems than the mutant fibroid.

    I feel like crying (which is out of character for me) and the Noah Wylie commercial with the endangered polar bear didn't help at all.

    Progesterone Supplements-is it too much to ask?

    Today is a big day for me. I have my 2 week post-op appointment with my OB/GYN. My doctor and I have a fundamental difference about the use of progesterone in getting and sustaining pregnancy. I think it works and she thinks it doesn't.

    Granted, she has an MD and I get squeamish at the sight of blood, but I have access to and have learned from other TTCers that progesterone helps.

    Here is my case for why I want this magical elixir.

    1) Your body needs progesterone to have a normal leutal phase (14 days but at least 11)
    2) Your body needs progesterone to support the pregnancy
    3) When I would have progesterone draws 7 days after a positive ovulation test, they were always so low it shouldn't be able to support pregnancy
    4) With both failed pregnancies I had bleeding immediately which later subsided, pointing to the fact that I didn't have enough progesterone
    5)I haven't had a normal leutal phase since 11/08
    6) My friend just had spotting at 6 weeks and got on progesterone, she is now 8 weeks and her HCG is going up appropriately, meaning the progesterone saved her pregnancy
    7) Some friends from lost 2-3 pregnancies, took progesterone and now have babies

    My Doctor's Beliefs
    1) Studies show progesterone doesn't do anything
    2) If you have a strong ovulation, you will produce enough progesterone
    3) Progesterone just prolongs an unviable pregnancy
    4) Progesterone has proven effective for people that have fertility treatments because there hormones have been manipulated so much but not others
    5) Clomid (i.e. twin maker) can give you a stronger ovulation and then you shouldn't need progesterone

    So before I left the hospital, the Fertility Dr came by to check on me and I asked her about this. She said in most cases my doc is right, but there are people with luteal issues that need progesterone to sustain pregnancy. LIKE ME!

    I have been pumping myself up to be my own advocate with the doctor today and say I don't want to lose a third baby which could have been prevented by taking progesterone. Hopefully she will agree to either test me repeatedly for levels and if it looks borderline, give me the supplements. I don't want to say in an annoying way that the fertility doctor said I might need it but I want to make it known.

    In other news, it has been two weeks and two days since my abdominal myomectomy (fibroid removal surgery) and I am feeling great. Not 100%, but have very limited pain. I am still not allowed to do much for 4 more weeks, but I feel strong.