I can not control reproduction and conception.
I can not control reproduction and conception.
I can not control reproduction and conception.
I can not control reproduction and conception.
I can not control reproduction and conception.
I can not control reproduction and conception.
I can not control reproduction and conception.
I can not control reproduction and conception.
I can not control reproduction and conception.
I can not control reproduction and conception.
Monday, October 25, 2010
Thursday, October 21, 2010
Clomid or Femara?
In my last post I mentioned my barely 3 day period, how my acupuncturist believes a light period suggests a thin uterine lining and blood deficiency and how my RE says these qualities are within normal range. The possibility of a thin lining makes me anxious about my IUI + clomid cycle coming up, so I called the nurse coordinator to express my concerns.
She explained their protocol for first time IUI cycles for a patient with unexplained infertility:
Empiric therapy: treatment before diagnosis. level one for unexplained infertility: IUI + clomid. We are unexplained until a diagnosis can be made during treatment, if treatment fails, or (if my lining is too thin like my acupuncturist suspects) if they discover my lining is too thin via ultrasound--during treatment. The other part of empiric therapy: even if my lining is too thin now, we would still proceed with IUI protocol and monitoring and add progesterone mid cycle. If that doesn't work then adjustments would be made.
My other option for IUI (before injectibles) is to take Fem.ara instead of clomid, which doesn't have the same side effects such as scant cervical fluid or thin lining. She said this was my choice so I decided to do some research.
Why does this have to be my choice! I get anxious about taking drugs and this decision is especially difficult. I don't have any research studies to cite or reference here but this is what I found when I peeked at some online literature about Fe.mara:
I visited Femara's website to check out the Fe.mara Car.es Program that offers a prescription discount to users. I left as soon as I read that Fema.ra should only be used by post-menopausal women. I read elsewhere that Fe.mara is not approved by the FDA for use in the treatment of infertility. Further, Dr. Liccardi from the Infertility Blog writes in a post that he does not use Fe.mara.
When I talked to the nurse coordinator at my clinic, she described a study that found higher incidence of birth defects in babies conceived with the help of Fe.mara, but quickly followed that the study was later refuted and subsequent studies did not find the same data. She also explained that Fe.mara is flushed from the body very quickly. Still, Dr. Liccardi does not prescribe it as a precaution.
I am sure many of you have already come to this decision, maybe you were just prescribed Fe.mara, or chose it over clomid. Please do share your experiences, thoughts, info you've gathered, your RE's opinions, and all your additional wealth of knowledge about infertility drugs. I would really love to hear what you think.
She explained their protocol for first time IUI cycles for a patient with unexplained infertility:
Empiric therapy: treatment before diagnosis. level one for unexplained infertility: IUI + clomid. We are unexplained until a diagnosis can be made during treatment, if treatment fails, or (if my lining is too thin like my acupuncturist suspects) if they discover my lining is too thin via ultrasound--during treatment. The other part of empiric therapy: even if my lining is too thin now, we would still proceed with IUI protocol and monitoring and add progesterone mid cycle. If that doesn't work then adjustments would be made.
My other option for IUI (before injectibles) is to take Fem.ara instead of clomid, which doesn't have the same side effects such as scant cervical fluid or thin lining. She said this was my choice so I decided to do some research.
Why does this have to be my choice! I get anxious about taking drugs and this decision is especially difficult. I don't have any research studies to cite or reference here but this is what I found when I peeked at some online literature about Fe.mara:
I visited Femara's website to check out the Fe.mara Car.es Program that offers a prescription discount to users. I left as soon as I read that Fema.ra should only be used by post-menopausal women. I read elsewhere that Fe.mara is not approved by the FDA for use in the treatment of infertility. Further, Dr. Liccardi from the Infertility Blog writes in a post that he does not use Fe.mara.
When I talked to the nurse coordinator at my clinic, she described a study that found higher incidence of birth defects in babies conceived with the help of Fe.mara, but quickly followed that the study was later refuted and subsequent studies did not find the same data. She also explained that Fe.mara is flushed from the body very quickly. Still, Dr. Liccardi does not prescribe it as a precaution.
I am sure many of you have already come to this decision, maybe you were just prescribed Fe.mara, or chose it over clomid. Please do share your experiences, thoughts, info you've gathered, your RE's opinions, and all your additional wealth of knowledge about infertility drugs. I would really love to hear what you think.
Tuesday, October 19, 2010
I Drew a Picture of My Period
F and I waited over a year before we made an appointment with an RE and began diagnostic testing for the cause of our infertility. Because of my age, (still young but at the age where fertility begins to dramatically decline--did you know that age is younger than 35? I didn't) and lack of insurance coverage for infertility, we decided that we could do some testing, continue to try naturally (maybe it will just take a really long time because of that age and decline thing) and then make some decisions if we approach the two year mark. This decision to wait was part practical (financial, logistics, etc), part denial and part overwhelming fear of treatment (failure). As we approach our two year mark of ttc, I am in the midst not of conventional treatment (though I will be next cycle), but acupuncture treatment. And I am fixated not on numbers and monitoring, but on the length of AF, the color, the quality, the amount...mostly due to the conversations I have about the subject of my period with my acupuncturist.
Today I had one of those conversations. I even drew a picture to show my acupuncturist how much of a pad I filled up in four hours on cycle day 1, cycle day 2 and cycle day 3. Barely any on, cycle day 3. AF was light this time, maybe the lightest ever. It makes sense to me that light periods would suggest a thin endometrium. It makes sense that my acupuncturist would consider a light period a symptom of something in TCM called a blood deficiency and treat me accordingly. It makes so much sense that it worries me. Does it make so much sense because it is so simple (no negative value attached to the word simple here)? Because what I have learned from infertility and lack of conception (which seems equally simple and effortless) is that infertility treatment and diagnosis is not simple.
Is a light period a symptom of an inadequate lining? It sounds so clear cut, so black and white--if only cause and effect could explain or solve my unexplained infertility.
The things is, I believe in acupuncture and herbs. At least I get answers and explanations and treatments that actually treat something. A diagnosis of a blood deficiency +/- some other deficiencies and damp cold feels so much better than being told, "everything is normal, you're perfect; try again."
So here is my treatment, in addition to weekly needle sessions, until ovulation--a list of my pre-ovulatory herbs ( I am on cycle day 8).
Dang Gui/Angelica-- a common herb for both fertility and menopause with possible hormone regulating qualities and effects on the uterus similar to estrogen. It nourishes and invigorates the blood.
Bai Shao/White Peony--also nourishes the blood and liver and is used to treat night sweats and uterine spasms.
Bai Zhu/Atractylodes--is used to treat fatigue and spleen deficiency
Du Zhong/Eucommia and Tu Si Zi/Cuscuta-- yang supplements that may lower FSH in women with blood and kidney yang deficiencies. Du Zhong treats cold patterns and promotes circulation.
Gui Zhi/Cinnamon Twig-- has warming qualities that promotes circulation of blood
Huang Qi/Astragalus root--treats weakened immunity, stress and is used to help the body repair tissue and organs and is often used on patients with blocked fallopian tubes
Fu Ling/Poria--treats fatigue, strengthens the spleen and relaxes smooth muscles
Gan Cao/Licorice--also has warming qualities, is thought to be anti-inflammatory
Herbs also have added effects used in formulas and in combination with each other. This information was taken from the book, The Infertility Cure and from Yin-Yang House, which provides an online herbal database.
Today I had one of those conversations. I even drew a picture to show my acupuncturist how much of a pad I filled up in four hours on cycle day 1, cycle day 2 and cycle day 3. Barely any on, cycle day 3. AF was light this time, maybe the lightest ever. It makes sense to me that light periods would suggest a thin endometrium. It makes sense that my acupuncturist would consider a light period a symptom of something in TCM called a blood deficiency and treat me accordingly. It makes so much sense that it worries me. Does it make so much sense because it is so simple (no negative value attached to the word simple here)? Because what I have learned from infertility and lack of conception (which seems equally simple and effortless) is that infertility treatment and diagnosis is not simple.
Is a light period a symptom of an inadequate lining? It sounds so clear cut, so black and white--if only cause and effect could explain or solve my unexplained infertility.
The things is, I believe in acupuncture and herbs. At least I get answers and explanations and treatments that actually treat something. A diagnosis of a blood deficiency +/- some other deficiencies and damp cold feels so much better than being told, "everything is normal, you're perfect; try again."
So here is my treatment, in addition to weekly needle sessions, until ovulation--a list of my pre-ovulatory herbs ( I am on cycle day 8).
Dang Gui/Angelica-- a common herb for both fertility and menopause with possible hormone regulating qualities and effects on the uterus similar to estrogen. It nourishes and invigorates the blood.
Bai Shao/White Peony--also nourishes the blood and liver and is used to treat night sweats and uterine spasms.
Bai Zhu/Atractylodes--is used to treat fatigue and spleen deficiency
Du Zhong/Eucommia and Tu Si Zi/Cuscuta-- yang supplements that may lower FSH in women with blood and kidney yang deficiencies. Du Zhong treats cold patterns and promotes circulation.
Gui Zhi/Cinnamon Twig-- has warming qualities that promotes circulation of blood
Huang Qi/Astragalus root--treats weakened immunity, stress and is used to help the body repair tissue and organs and is often used on patients with blocked fallopian tubes
Fu Ling/Poria--treats fatigue, strengthens the spleen and relaxes smooth muscles
Gan Cao/Licorice--also has warming qualities, is thought to be anti-inflammatory
Herbs also have added effects used in formulas and in combination with each other. This information was taken from the book, The Infertility Cure and from Yin-Yang House, which provides an online herbal database.
Monday, October 18, 2010
Why would you test after your period?
after my period?
I have no idea. What a silly thing to do.
Reasons to test after your period:
1. To be absolutely sure that the last 3 days of bleeding were the real thing.
2. Because AF showed up before my test date.
3. Because until I see that BFN on a stick I am not entirely convinced that I am not pregnant.
See? Now I am (convinced).
I have no idea. What a silly thing to do.
Reasons to test after your period:
1. To be absolutely sure that the last 3 days of bleeding were the real thing.
2. Because AF showed up before my test date.
3. Because until I see that BFN on a stick I am not entirely convinced that I am not pregnant.
See? Now I am (convinced).
Friday, October 15, 2010
National Pregnancy and Infant Loss Remembrance
Today, October 15, is National Pregnancy and Infant Loss Remembrance Day.
Many of my fellow IFers have experienced miscarriage and my heart goes out to you all today.
Please visit the October 15th website
Okay, I just can't end this post. I feel utterly compelled to add something completely inappropriate and selfish. I have sat here for 5 minutes trying to resist, but I have to get these feelings out, right? Please forgive me.
It is troubling that I have had 20 BFNs (yesterday being my 20th) and never, not one BFP, not even a hint of pregnancy, chemical or otherwise. Sometimes I feel like a a miscarriage would be a (devastating) step in the right direction. At least I would know I could get pregnant. I know this is a common feeling, however insensitive it may seem to say or think, especially today. A year ago I said this to my CNM. She looked at me and replied, "No, not getting pregnant month after month is hard, but now, miscarriage, that is a real loss." I still feel hurt by what she said, a real loss, and think it was way out of line. Was what I said out of line, too? The context is different, right? A pregnancy is considered a success for someone who is infertile whether or not she miscarries or delivers. If I do an IUI next cycle and I get a BFP that results in miscarriage I will feel like we are making progress, HUGE progress. That doesn't mean I wouldn't be devastated by the loss of a pregnancy, even if it meant progress.
October 15th is remembering a different kind of miscarriage, but also the same. The thought of losing a pregnancy at 20 weeks is too scary to even think about. And the loss of a pregnancy for an infertile couple comes with a much more complicated set of circumstance, context and affect. My point is, I don't think any of us who have struggled with infertility begin a pregnancy without already having some of the emotional space reserved for the loss of it, at least in the first term.
Not that loss is measurable or one outweighs another...
Many of my fellow IFers have experienced miscarriage and my heart goes out to you all today.
Please visit the October 15th website
Okay, I just can't end this post. I feel utterly compelled to add something completely inappropriate and selfish. I have sat here for 5 minutes trying to resist, but I have to get these feelings out, right? Please forgive me.
It is troubling that I have had 20 BFNs (yesterday being my 20th) and never, not one BFP, not even a hint of pregnancy, chemical or otherwise. Sometimes I feel like a a miscarriage would be a (devastating) step in the right direction. At least I would know I could get pregnant. I know this is a common feeling, however insensitive it may seem to say or think, especially today. A year ago I said this to my CNM. She looked at me and replied, "No, not getting pregnant month after month is hard, but now, miscarriage, that is a real loss." I still feel hurt by what she said, a real loss, and think it was way out of line. Was what I said out of line, too? The context is different, right? A pregnancy is considered a success for someone who is infertile whether or not she miscarries or delivers. If I do an IUI next cycle and I get a BFP that results in miscarriage I will feel like we are making progress, HUGE progress. That doesn't mean I wouldn't be devastated by the loss of a pregnancy, even if it meant progress.
October 15th is remembering a different kind of miscarriage, but also the same. The thought of losing a pregnancy at 20 weeks is too scary to even think about. And the loss of a pregnancy for an infertile couple comes with a much more complicated set of circumstance, context and affect. My point is, I don't think any of us who have struggled with infertility begin a pregnancy without already having some of the emotional space reserved for the loss of it, at least in the first term.
Not that loss is measurable or one outweighs another...
Thursday, October 7, 2010
my new acupuncturist (and my cold thin-walled uterus)
Love her. And, she works with other patients of Dr. A, my RE, so she knows his practice and protocols. She also works with pregnant women, and one strolled past me in her healthy glow as I sat waiting.
Yesterday my pulses were weak. I am approx 7 dpo and my blood should be flowing strongly, right? She thinks I may have a blood deficiency and put me on post-ovulation/miscarriage preventative herbs that relax the uterus for implantation, support the uterine lining and increase heat and blood flow.
I'm thinking this is not my month. I'm just too cold.
I need to get my progesterone levels checked again--last time they were at 10, border line low.
Yesterday my pulses were weak. I am approx 7 dpo and my blood should be flowing strongly, right? She thinks I may have a blood deficiency and put me on post-ovulation/miscarriage preventative herbs that relax the uterus for implantation, support the uterine lining and increase heat and blood flow.
I'm thinking this is not my month. I'm just too cold.
I need to get my progesterone levels checked again--last time they were at 10, border line low.
Tuesday, October 5, 2010
Am I finally ready?
This morning I finally built up the courage to call the RE's office to check in, like I planned to do since I returned from Texas (I've been home for a month). I don't know exactly why I get so overwhelmed about committing to treatment. I cried at my first acupuncture appointment. When the appointment-making-nurse pulled up my chart, she said, "So, you need to speak with the nurse coordinator to make plans for your IUI," as if I knew what the plan was. Tears immediately filled my eyes but I pretended, "Yes, that sounds right." And it was/is correct, I knew this would be the next step, I knew this in June, wait, I knew this in February. But somehow I was surprised and taken aback when she used the letters I U I; and I finally realized the extent of my denial and fear of infertility treatment this morning when I got off the phone and sobbed.
I'm just not really sure where the denial and fear come from or why I feel them.
---
A few minutes ago, the nurse coordinator and I did make a plan: I will continue with acupuncture and herbs for 1 more cycle. If I am not pregnant after this next natural cycle, I call her on cd 1, start clomid on day 3, call by 5:00 pm when I get my first + opk and then go get INSEMINATED!!!
This plan means IUI #1 sometime around the first week of December.
This plan means that IUI# 1 will happen less than one month shy of our 2 year anniversary of trying to get me pregnant. Writing this sentence now, I can't believe we waited so long.
Monday, October 4, 2010
Nobel Prize for Infertility
Congratulations to Dr. Robert Edwards, who won the Nobel Prize in Physiology and Medicine for his research in fertility and in-vitro fertilization.
NPR has a brief post about it here. And as always, don't read the comments.
NPR has a brief post about it here. And as always, don't read the comments.
Friday, October 1, 2010
Sometimes I Feel Like We are Pandas
or a tomato plant in growing on the northwest coast. My tomato plant looks great (appears healthy, grows and flowers, etc), but due to the air and weather patterns on the coast, tomato plants do not produce fruit here. I am my tomato plant, except if we moved to another climate, nothing would change, would it?
This metaphor has suddenly made me think of acidic and alkaline environments. Since starting acupuncture and TCM in August, I have cut way back on coffee and sugar (both acidic) and started taking a teaspoon of Carlson's cod liver oil (don't worry, it is the one that is low in Vitamin A) daily (alkaline). I have actually noticed a difference in my fertile cm.
Now that I am back home with fertile cm and in the midst of a natural cycle, maybe I am less acidic. Maybe something will be different this month. Maybe it is after our ttc break that I feel different, mostly emotionally. I don't feel infertile. By that I mean I am less focused on our infertility, things feel less urgent, I feel more positive and patient. I don't want to make an appointment with my RE. I do want to continue acupuncture and TCM for at least 2 more cycles.
Or maybe it is that infertility takes so much work and so much time, and I enjoyed those months when we didn't have to try so hard and be so disappointed. And lately I haven't had the time to think too much about infertility. I've been temping and charting and having sex and that is about all I've had time to focus on. Next steps (IUI) just seem too overwhelming right now, maybe December when my teaching term ends and F has winter break...we'll see.
Maybe, maybe, maybe...
And my cousin is pregnant, after trying for close to a year, experiencing an early miscarriage and trying again for 6 months. I am so excited for her. It gives me naive and desperate hope that I am next, that I can do this naturally...because...why? not sure--I am less acidic? Acupuncture is working (no more clots!)? I feel positive? F has been taking fertilaid? oh, maybe the castor oil packs?
Whatever I am feeling and wherever it is coming from (denial? sex endorphins?), I'm sure it won't last. I'll be back to my infertile self in two weeks, just wait.
This metaphor has suddenly made me think of acidic and alkaline environments. Since starting acupuncture and TCM in August, I have cut way back on coffee and sugar (both acidic) and started taking a teaspoon of Carlson's cod liver oil (don't worry, it is the one that is low in Vitamin A) daily (alkaline). I have actually noticed a difference in my fertile cm.
Now that I am back home with fertile cm and in the midst of a natural cycle, maybe I am less acidic. Maybe something will be different this month. Maybe it is after our ttc break that I feel different, mostly emotionally. I don't feel infertile. By that I mean I am less focused on our infertility, things feel less urgent, I feel more positive and patient. I don't want to make an appointment with my RE. I do want to continue acupuncture and TCM for at least 2 more cycles.
Or maybe it is that infertility takes so much work and so much time, and I enjoyed those months when we didn't have to try so hard and be so disappointed. And lately I haven't had the time to think too much about infertility. I've been temping and charting and having sex and that is about all I've had time to focus on. Next steps (IUI) just seem too overwhelming right now, maybe December when my teaching term ends and F has winter break...we'll see.
Maybe, maybe, maybe...
And my cousin is pregnant, after trying for close to a year, experiencing an early miscarriage and trying again for 6 months. I am so excited for her. It gives me naive and desperate hope that I am next, that I can do this naturally...because...why? not sure--I am less acidic? Acupuncture is working (no more clots!)? I feel positive? F has been taking fertilaid? oh, maybe the castor oil packs?
Whatever I am feeling and wherever it is coming from (denial? sex endorphins?), I'm sure it won't last. I'll be back to my infertile self in two weeks, just wait.
Subscribe to:
Comments (Atom)
