Understanding Semen Anaylsis Results

Time to share the blame! Approximately a third of all fertility issues in a couple are attributed to semen problems. It is easy to assume that if you aren't getting pregnant, it is your fault, but it is definitely beneficial to get your man checked out before starting invasive procedures or taking fertility drugs. In fact, both my fertility doctor and OB insist on a semen analysis before prescribing clomid.

How it works:

• He collects a sample. Depending on distance from lab, you might be able to collect it at home and bring it in immediately (within one hour). They don't want it getting too cold or too hot. It is recommended you hold it against your body to keep it at the right temperature. The lab might insist he provide a sample in their office. They will give him a private room to "collect" himself.


• Your OB or Fertility Doctor can write the orders for the semen analysis. Otherwise, he can see a urologist.


• He might be asked to abstain for ejaculation for 2 to 5 days prior to the test. His doctor or lab will provide specific restrictions. However, they typically want you to have sex within two weeks of the test to insure the sperm are active.

What it shows:

• The results will show if he has a healthy quantity and quality of sperm.

Normal Results:

• Volume of ejaculate (how much semen is present in one ejaculation): 2.0 ml or more


• pH (the acidity or alkalinity of the semen): 7.2-8.0


• Sperm concentration: 20 million per ml spermatozoa or more


• Total sperm count (amount of sperm in 1ml of semen): 40 million per ml spermatozoa per ejaculate or more


• Motility (percentage of sperm that can move forward): 60% or more with forward progression


• Morphology (percentage of sperm that have a normal shape): 30% or more with normal forms


• Vitality: 7 5% or more live,i.e.,excluding dye


• White blood cells (white blood cells normally aren't present in semen): fewer than 1 million per ml

Terms used to discussed results:

• normozoospermia: results are normal


• oligozoospermia: low sperm count


• asthenozoospermia: poor sperm motility


• teratozoospermia: sperm have more morphological defects than usual


• oligoasthenoteratozoospermia: signifies disturbance of all three variables above


• azoospermia: no sperm is semen


• aspermia: absence of semen

Bad results, now what:

• The information from the semen analysis will help your fertility doctor determine the best way to treat. Some situations require surgery, however drug treatments or assisted fertility (IUI, IVF) might just do the trick.

Sources: www.med-direct.com, www.webmd.com, www.wikipedia.com

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Dealing With Pregnant Friends

Never do you see as my pregnant women as when you are have trouble getting pregnant. My big joke is stick with me and you will be pregnant soon because everyone I know is either pregnant, has a newborn, or just announced they are trying for baby #3.



People take different approaches to dealing with this pregnant people everywhere I go phenomena (or what I will refer to as PPEIGP). I personally found handling the PPEIGP was easier for me when people knew my story on my own terms. If I had told them about the miscarriages and surgery, I felt like, okay, it is out there. In these situations I feel mostly at ease.



However, when it isn't on my terms, I want to run and hide under something fertile. Such as last week. I was at my in-laws house for a family get together. I had asked my MIL not to tell the family about my surgery and miscarriages. She forced my hand at telling her sister-in-law. I begrudgingly gave in with the stipulation that her SIL not tell her kids and daughters-in-law. Well it was very obvious everyone knew and no one said anything to me. Awkward. Then my MIL's friend's daughters came in, both pregnant, and the entire focus of the crowd turned to kids and pregnancy. It literally gave me a headache. Everyone was saying how fun for sisters to be pregnant together. Seems my entire family all forgot I was pregnant at the same time as my sister-in-law, 2 weeks apart. This time, I just wanted to bolt.


If you haven't guessed, I am pretty much an opened book. I appreciate that not everyone is the same way. So I would recommend telling people that you feel comfortable with who can help steer conversation in such situations.

For me, it also depends how supportive a friend has been prior to their pregnancy. My best friend has been truly the most supportive friend in the world during my year of drama. She got pregnant her first shot and I don't feel an ounce of jealousy. It is really because I can still say anything to her. I can make comments about everyone in the world getting pregnant on their first shot, how insensitive so-and-so was, and every other thought I should probably keep to myself. She told me within 12 hours of getting her BFP. It wasn't like some dramatic announcement where she was trying to break the news. This I appreciated.


Tips for dealing with PPEIGP:

• Be a hermit in moderation: It is okay to remove yourself from situations that might be upsetting (a girls night in where everyone is pregnant but you) but don't make it a habit. If you just found out your husband has no sperm and you have the eggs of 65 year old, all in the same day, take a breather. Otherwise, don't shut out all your friends because they are happy.
• Think Ahead: Try to remember that you very well could be pregnant next month and then you would feel happy for your friends, so feel happy for them now, and your time will come.
• Enjoy the things you can do and they can't: drink, have caffeine, eat tuna to your heart's content, plan a romantic weekend, sleep in, and enjoy a whole movie without having to take 3 bathroom breaks.
• Stay off Facebook: This one has helped me immensely. People from high school are announcing their second and third pregnancies. Others got married 6 months ago and are already telling 300 of their closest friends that they are expecting. Also, the constant pregnancy symptom updates and polling of other moms for opinions puts me over the edge. One girl posted pictures of herself sitting on a stool in a hospital shower- part of her natural child birth. I am not making this up.
• Fake Fun Till you Make One: When a friend tells you she is pregnant, it probably will sting. Put on a happy face if one doesn't naturally spring forth. Act the way you would want someone to act when you make your announcement. When you have time alone, get upset. Talk to your husband, mom, or your best friend. Is it selfish? Yeah. But is it completely understandable? Of course. And the three people that love you most will get it too. In my experience, moms and best friends understand it much more and I mean much more than husbands.
• If it is too much, say something: If you have a friend that can prattle on about every detail to the point you want to stab her eyes out with an OPK, say something. Just say that you are so happy for her and her husband, but you have been having some trouble and it is a little hard to hear. Obviously you want to be there for her and know all the big milestones, but the daily play by play is a bit too hard to handle. And end with, "I am sure you understand." What can she say to that?
• Awkward is a Two-Way Street: If you have disclosed to your friend that you are having trouble and she has a modicum of social grace, she might feel unsure of what and how much to tell you. You might be fine hearing she and her hubby had a screaming match in Babies R' Us over espresso or white furniture but knowing he is calling the fetus "schmoopie junior" could be a bit much. Have one uncomfortable conversation to avoid 9 months of them. Or just ask specific questions about her pregnancy journey so the information comes on your terms.
• It is Okay to be Sad: You are entitled to be upset. I remember countless times I put on a happy face when hanging out with pregnant friends that had no idea what I was going through. As soon as we got in the car, the sadness would just hit me. My husband didn't get it and thought I was a bad friend. But it wasn't about them. It was about me and things not working out how I had hoped. Take the old dumping standard, "it's not you, it's me" and apply it to the feelings you are having now. In you heart of hearts, you don't really want a friend to be having fertility problems, you just don't want them yourself.
• Keep the faith: Just know your time will come. Even if it means fertility treatments or adoption, you can and will be a mom. It just might take longer than you expected.

While pregnancy is the only known cure for PPEIGP, I am hopeful these tips can help you deal with ever-expanding pregnant population.

Can Cough Medicine Lead to a BFP?

Anyone who is anyone in trying to conceive knows the importance of EWCM (egg white cervical mucus). It is the holy grail of CM because it means you are most fertile. What distinguishes EWCM for other CMs, besides it being well timed with ovulation, is its actual physical properties. It is thin and stretchy, allowing sperm to travel more freely in its journey to your egg.

Some people fret because they don't create enough EWCM. Those who take clomid might notice their cm dries up or becomes thick, making it difficult for sperm to reach the egg. TTCers have thought of any and everything to combat such problems. One of the more interesting approaches is cough medicine.

It makes sense to me. When you have chest congestion or a cough, you take cold medicine to break up the congestion, or mucus in your lungs. There is an ingredient in cough medicine that is responsible for this: Guaifenesin. This is an expectorant that thins mucus in the lungs, allowing you to cough it up. The medicine can't distinguish between lung or cervical mucus. It works systemically, so it will affect all mucus membranes, including cervical mucus. This ingredient causes CM to thin out and become more stretchy, allowing sperm better transport through the cervix.

Not all cough medicines are created equal. Per my research, you want the only active ingredient to be Guaifensesin. I can't stress this enough because other ingredients can actually dry up CM. I looked at a ton of Robitussin and Mucinex products and they are not interchangeable. Some cough medicines don't contain Guaifenesin at all. Some have too many active ingredients that can dry up CM. Others don't contain enough Guaifensin. According to the cough medicine wives tale, you need 600 mg of Guaifensin. I could only find Robitussin up to 200mg, while the Mucinex has 600mg per dose (take 2 a day). Also, Robitussin is a syrup and Mucinex is in pill form. I personally would be more inclined to try the Mucinex for this reason alone.


After researching this, the only product I would recommend is Mucinex Expectorant with 600mg of Guaifensesin. I included a link at the bottom of this entry.

From my reading the recommended dosage is to take Mucinex daily for the 5 days before your expected ovulation and stop the day after ovulation. Typical daily doses are 1200mg for the day.

If you have high blood pressure, thyroid issues, or take medicines you think might have a negative interaction, you might want to check with your doctor before trying this approach. In general, it is a good idea to check with your doctor before taking "unnecessary" medicines.

Where do Babies come from?

I saw this funny video today posted on babycenter.com. Check it out.

The Pineapple Pregnancy Theory

Are we all just grabbing at straws? The things women attribute their pregnancies to is getting crazier the longer I prowl the boards. But by far the most seemingly-ridiculous theory is that of the Pineapple.



It is said that this tasty fruit contains an enzyme called Bromelain, that breaks up proteins that inhibit implantation of a fertilized egg. Now it is important to note that following this pineapple regime is not exclusively centered on the juicy goodness of the whole pineapple, you also have to eat the pineapple core, which contains a higher concentration of Bromelain.



This tentative theory includes specific instructions of when to eat the pineapple based on the method of conception. Here goes.

• IVF: divide a whole pineapple into 5 portions. Eat a portion a day over five days, beginning on the day of your embryo transfer.


• IUI: divide a whole pineapple into 5 portions. Eat a portion a day over five days, beginning on the day of your IUI.


• Old-fashioned Intercourse: divide a whole pineapple into 5 portions. Eat a portion a day over five days, beginning on the day after ovulation.

Apparently, it is important not to eat pineapple prior to ovulation because it is acidic and can affect your CM.

I couldn't find any scientific studies centered around the pineapple-pregnancy link, but did discover yet other uses of the multi-tasking pineapple. It may induce labor, clean wounds, and tenderize meat.

I am all for non-invasive ways to help TTC but this sounds like an old wives tale. If you swear by the Pineapple Pregnancy Theory or have tried it and alas, the spiky fruit didn't result in a baby, I would love to hear.

What the Heck is an Instead Cup?

I keep seeing on babycenter.com that people are using Instead Cups to get sperm closer to the cervix in the hopes of conceiving. I hadn't ever heard of an Instead Cup.

Turns out is is a feminine hygiene product (ala tampons and pads) but it looks more like a condom with a plastic rim on it. The intended use is to insert it during your period to collect blood. You can leave it in for 12 hours.

However, industrious conceivers have found a new use. After sex, you insert the Instead Cup by squeezing the ends together it pushing it back (versus up, like a tampon). Hours later, you remove the cup. Apparently it is ridged so there is something to grab on to when removing it. Taking it a step further, some TTCers fill it will Pre-Seed to help the sperm get where it needs to go. Also, I have read people use it when they have hostile CM, to help the sperm move more freely.

I have seen the costs range from $6.75 (see below) to $12.00 for 14 cups. You would seemingly need 4 cups per month, one a day during your fertile window.

Newbies tend to border on panic attack before using the Instead Cups, because of the fear of how to get it in and even more alarming, how to get it out. Veterans say it is so easy. It might be worth a practice run. I did a brief Internet search to find first hand experiences. Someone posted that they have used it for all three pregnancies, clearly worked. Another avid fan advises that after sex, lie with you feet up for 5 to 10 minutes, then grab the cup and insert it while still lying down. Then when you wake up in the morning take it out. If you are using during the day, some advise it is only necessary for 2 to 3 hours, but no harm in waiting the full 12 hours. Another veteran added that you should insert it while still lying in bed, get up and go to the bathroom (to avoid the dreaded UTI) and then get back in bed.

As with most products, there is a slew of people saying they tried unsuccessfully to get pregnant for many months, used the Instead Cups, and got pregnant their first shot. Just another weapon in our arsenal against a BFN.

The Cost of Doing Baby Business

The birds do it. The bees do it. So why does it cost me so much to try and do it? This is alarming and may my husband never see this post. I decided to calculate what it costs me to try and conceive each month. A conservative estimate is $405.

Calculation Notes: this is based on where I currently am in my quest for baby. At times, I was using 20 sticks a month for my monitor given my long cycles but now I am basing on 10 since my cycle is short. However, now I will be using progesterone and will be getting multiple blood tests at the doctors, not covered by insurance. Previously I was seeing the Reflexology 2 times a week at $65 a piece, now I see her every 10 days. Also, I am using supplies I had previously bought, but have since found better prices on products (that I have shared on links throughout the site) so in the very unfortunate event that I would need to try again after this cycle, I will have some savings there.

Costs:

• Prescription Pre-natal vitamins: $10


• Prescription progesterone 20 day supply: $20


• Home Pregnancy Tests (2): $20


• Clearblue Easy Digital Ovulation Kit: $39


• Clearblue Easy Monitor Sticks (10 of 30 used monthly): $14


• B6 Vitamin: $3


• Calcium with vitamin D: $2


• Baby Aspirin: $2


• Reflexology (3 Sessions): $195


• Blood tests at Doctor (haven't seen bill for 3 tests last month so estimate): $100


• TOTAL: $405

This comes out to almost $5,000 a year. I certainly have paid more than that considering my HSGs, MRI, countless blood tests, doctor appointments, costs associated with surgery. This doesn't even take into account costs that I might one day need to pay for IUI, trigger shot drugs, and monitoring. I am so incredibly hopeful it won't come to that.

I never really sat down and thought about the actual dollars it was costing us to try to conceive. We have definitely paid an emotional toll and made concessions in our lives about things we won't do (travel) or for me eat/drink (diet coke with lots of lemons, bad carbs, and anything that could remotely give me a buzz).

Looking at my list of expenses, I am not willing to give anything up. I could forgo the OPKs since I have the monitor, but I like to make sure I know when I am ovulating. I could cut back on the reflexology, but I do feel like it is helping.

The conclusion- I should buy stock in ClearBlue Easy and shield my husband from the reality of what it is costing us to get pregnant. I could just use one HPT a month, but who are we kidding, there isn't a chance in hell I could hold out until 14dpo. I might have to make a trip to a Dollar Tree. I hope there is one within city limits. I guess TTC is good practice for having a kid- they are expensive and what a bonus when I actually am pregnant. We can sock all this money away for the Pottery Barn furniture I have been using to decorate the nursery in my mind for the last two years.