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?

(source justmommies.com)

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 babycenter.com said that it is safe to exercise during your most fertile days (ovulation).

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

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.

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

Sources: infertility.about.com, webmd.com

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 (http://pregnancyloss.info/sperm-meets-egg-plan/). 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!