DRMom
Two in Blue
Member since 5/05 20223 total posts
Name:
Melissa
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Soem good info on infertility from fertilethoughts.com
I decided to post this on the "Just starting" bulletin board, and now on the "I wish someone had told me" board, because trying to understand the IF world has been like a second career for me. I thought if I could put a post together that explained a lot of the surprises I encountered along the way, and what I learned about from others' experiences, maybe someone (or lots of someones) could save a lot of time, energy, and heartache. This collection below takes the average IF patient months or years to find out!
Here are some key ideas that we IF women have learned along the way:
* there is no such thing as unexplained infertility... just IF that hasn't been explained YET.
* if you are working with an OB/GYN and are having fertility issues, NO MATTER HOW NICE/INEXPENSIVE/CONVENIENT/FAMILIAR, etc., your OB/GYN might be, bid him or her farewell and start working with an RE immediately. IF is a specialized field and working with an OB/GYN to diagnose and treat infertility is like working with a family physician to diagnose and treat cancer. These boards are filled with women who waited months or years to make the switch, all of whom regret the valuable time lost with their (often beloved) OB/GYN. I have NEVER seen an exception to this rule.
* you have the rest of your life to make money, but a limited amount of time to make babies. Get creative with your financial resources.
* love your DH extra much during this time because IF takes an emotional toll, is hard on the pocketbook, and kills some marriages!! Remember your priorities and that there is more than one way to be a parent.
* the standard tests (HSG, FSH, PCT, CBC, endometrial biopsy, SA) barely scratch the surface of IF testing. If those tests come back normal for you, and that's all your doctor wants to test, GET A NEW DOCTOR.
* don't be afraid to switch doctors if the office staff keeps screwing up important things, or if your doctor doesn't return your calls, etc. Time is of the essence, and accurate, prompt treatment is critical. So is your sense of worth, so if they don't treat you with courtesy and respect, find someone who does.
* once you receive a diagnosis, that doesn't mean you've solved the problem. PLENTY of women have multiple challenges going on and their doctors waste time just sitting around and treating the first one they find out about. Know that many IF factors are interrelated, so you quite possibly have more than one and, if so, they'll all need to be treated.
* don't overlook immune issues, especially if you have experienced multiple miscarriages. See the immune issues bulletin board for more information or http://www.repro-med.net
* if you have irregular cycles, no periods, or your OPK doesn't ever show that you ovulate, you may have PCOS. Interestingly, you can have PCOS even if you aren't overweight, don't have issues with insulin, you do ovulate regularly and you have basically regular cycles. The way to diagnos PCOS in these cases is via ultrasound on CD2 (the day after you start your period.) The doctor should look for antral follicles (teeny immature follicles inside your ovaries at this very early point in the cycle). Lots of antral follicles = PCOS. Treatment can include Metformin, usually prescribed for diabetes patients. Check out the PCOS bulletin board for more information.
* if you have painful periods (cramps), changes in your bowel patterns (constipation, diarrhea) related to your cycle, or pain at ovulation, these are indications of endometriosis. You can have endometriosis without having any symptoms. The severity of symptoms does NOT equal the severity of endometriosis.
* endo women have FAR WORSE chances than other IF women when it comes to IUI. However, their chances with IVF are the same as other women. This is especially true if they've been tested and treated for immune issues.
* if you have endo or PCOS, it's actually likely that you have them both, and very likely that you have immune issues as well http://repro-med.net/info/cat2.php , http://repro-med.net/tests/pheninfo.php
* there is a 3-6 month window after a surgical lap (tx for endo) in which a woman is more likely to conceive. See the endometriosis bulletin board for more information.
* consider alternative treatment such as acupuncture. You'll find many, many western medicine doctors who believe in combining their medicines, surgeries, and other procedures with acupuncture. Acupuncture can improve FSH and help thicken the uterine lining. Be sure to work with an acupuncturist who specializes in fertlity issues.
* acupuncture takes 3 months of treatment before the body is "in balance". Don't just plan to find an acupuncturist a week before your prodecure. Locating an acupuncturist can be made easier through this site: http://www.acufinder.com/
* it's possible to have miscarriages so early in the pregnancy that they don't even show up on HPT's.
* multiple m/c's, even ones so early on that you don't know about them, actually CAUSE immune problems. Check out http://www.repro-med.net
* normal numbers today aren't normal numbers for our parents' generation, such as sperm count (normal = 100 million thirty years ago; normal = 30 million today). An astute doctor may inform you of problems that DH didn't appear to have, because the RE understands that the "acceptable range" of numbers listed on your lab paperwork isn't so accurage. Your doctor would be right. Think of it like the ever shrinking clothing sizes (I am NOT a size 2, no matter what the tag says!!)
* a common cause of miscarriage is blood clots in the teeny, tiny veins of the uterus, or even in the umbilical cord. This can be detected with proper testing of inherited thrombophilias, including a test called Leiden Factor V, Protein C deficiency, and the MTHFR test, and treated with baby aspirin, Folgard (prescription folic acid and other B vitamins) and possibly Lovenox throughout the pregnancy.
* if there isn't at least 12 days between your ovulation and the first day you start spotting for your next cycle, you have luteal phase defect (LPD) and need progesterone.
* progesterone suppositories or injections are far superior to pills.
* if you are prescribed Clomid, YOU SHOULD BE MONITORED VIA U/S. Ultrasound lets your doctor know about:
- number of developing follicles (too many, or none!)
- size of follicles (too small? your doctor needs to know that)
- development of your lining (should be at least 8.0mm and triple-stripe)
- potential cysts from the previous cycle (in which case NO Clomid that month!)
* Clomid's estrogenic properties can thin your lining, causing implantation problems or even m/c. This doesn't happen to everyone. Once it happens to you, there's no more Clomid in your future, and you'll switch to injectables.
* if your one or both of your tubes is blocked, you'll need to have it/them removed before IVF, due to the danger of hydrosalpinx (tube filling with fluid and destroying the growing embryo).
* male factor infertility can be overcome with ICSI and TESI http://www.goivf.com/about_us/breakthroughs-icsi.php4
* a great product for improving sperm quality is Fertility Blend for Men, invented in Stanford's School of Medicine http://www.fertilityblend.com
* excellent guided meditation CD's can be found on http://store1.infopac.net/anji/Sear...ory=Infertility
* normal lubricant (KY, etc) is fine for people without IF issues, but if you have them, you NEED to be using either no lubricant (yikes!) or Pre-seed, which isn't as harsh on your man's little swimmers. http://www.preseed.com/
* the learning curve for IF is steep, steep, steep. Befriend with women on this site. Forgive yourself for your age, your previous mistakes in life, your mixed emotions toward other people's joyous and easy additions to their families. Did I mention LOVE YOUR DH???? If you need a break from ttc, take one. If you prefer to become a parent a different way, fantastic. Life is short and no one can make your choices for you.
* Remember that DH's love to be able to help and solve problems. Feeling helpless is just about the worst thing for the average guy, and feeling helpless about his woman is unbearable. Whine and weep to the board; we're all here for each other. If DH is interested in being involved, give him statistics and data. Let him wrap his mind around the science of it all. I'm generalizing here of course, but from months of reading DH postings, I do believe that's the way to go.
* can you imagine what it would be like if you had to go into some strange and sterile room in a doctor's office and have an ******? and then give them a container full of what you managed to secrete during that ****** for them to see if it was "good enough"? and you had to walk out there with your little jar in front of a lot of medical assistants who probably were of the opposite gender from you? Women always complain that guys barely have to do anything compared to what we go through, and that their tests aren't invasive; heck, they're even pleasant! But remember how totally exposing and embarassing their procedure can feel. How the one thing that's supposed to be most private is judged and tested. How much their "manhood" can be affected by bad results. A realistic attitude would be to avoid getting in that testing situation to begin with. So don't be surprised if your DH behaves in uncharacteristic ways when it comes to SA, and try to understand.
* in terms of negative emotions, the most common emotion I've seen described by women on these boards is "SAD" and the most common emotion described by men is "ANGRY." In terms of positive emotions, women often say "HOPEFUL" and men say "INFORMED." Remember and respect these gender differences. Let yourself be sad; let your DH get all ****** off (at IF, not at you!) Find reason for hope. Help your DH to find information.
* direct your anger where it belongs -- at IF, not at each other. IF is behind everything, no matter what either of you did on a particular day or earlier in life. Kick IF's butt!!! Love each other.
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