oldposts

oldposts, Pregnacy Loss

Relatable Words After a Miscarriage

The article may contain affiliate links. Pregnancy loss, miscarriage, or neonatal loss can be traumatic, life-altering experiences that are tough to truly understand unless you have been there. When someone else puts words to that unexplainable feeling, it can feel like your pain has been acknowledged. We’ve gathered words related to grief and loss—many from people who have experienced the loss of a pregnancy— and hope you see your truth or find comfort in some of these words. Trying to Describe Loss “I held you every second of your life.” — Stephanie Paige Cole from Still: A Collection of Honest Artwork and Writings from the Heart of a Grieving Mother “Baby loss =A million what ifsA billion if onlysA trillion I wishes” Zoe Clark-Coates “There is no greater agony than bearing an untold story inside of you.” — Maya Angelou When you carry a life and it’s there, and then gone, a part of your soul dies. Forever. — Casey Wiegano I didn’t want to kiss you goodbye was the trouble. I wanted to kiss you goodnight, and there’s a lot of difference. — Ernest Hemingway “Before I carried the pain, I carried you. And in my heart, I carry you still.” — Unknown “Any woman who’d ever lost a child knew of the hollowness that remained within the soul.” ― Brittainy C. Cherry in Disgrace “What does a miscarriage feel like? It feels as if you have been short-changed by nature. You will cry for what might have been but nobody will understand because they didn’t feel it.” — Unknown Strength From Loss “We are not broken by our tragedy, our loss, our miscarriages, but made stronger by what we learn from them.” — Dr. Lora Shahine in Not Broken: An Approachable Guide to Miscarriage & Recurrent Pregnancy Loss “Pregnancy loss is not a disease that can be cured; it’s not going anywhere—it is, in fact, a normative outcome of pregnancy. And it is, therefore, a topic we would benefit from engaging in candid and integrating into everyday conversations, devoid of silence, stigma, and shame.” — Dr. Jessica Zucker from I Had a Miscarriage Words of Sympathy “A mother is not defined by the children she can see, but by the love she holds in her heart.” — Franchesca Cox “There is a unique pain that comes from preparing a place in your heart for a child that never comes.” — David Platt Words of Comfort “A life need not to be long-lived for it to be meaningful.” — Unknown “There is no foot too small that it cannot leave an imprint on this world.” — Unknown “Sometimes the smallest things take up the most room in your heart.” — A.A. Milne in Winnie the Pooh “How very softly you tiptoed into our world, almost silently, only a moment you stayed. But what an imprint your footsteps have left upon our hearts.” — Dorothy Ferguson “I’ll love you forever, I’ll like you for always, as long as I’m living, my baby you’ll be.” — Robert Munsch in I’ll Love you Forever “Even those that never fully blossom bring beauty into the world.” — Unknown You were but a drop of rain to the eye but managed to flood my heart with love during your brief time with us. — Amy Hoover Moving Forward From Loss “The way forward is through, not around.” — A McDonald Ace, C. Starr, A.N. Bourbonnais in Through, Not Around: Stories of Infertility and Pregnancy Loss “Some things cannot be fixed; they can only be carried. Grief like yours, love like yours, can only be carried.” — Megan Devine “Sometimes we don’t want to heal because the pain is the last link to what we’ve lost.” — JM Storm “You never arrived in my arms, but you will never leave my heart.” — Zoe Clark-Coates “Grief is not a sign of weakness, nor a lack of faith… it is the price of love.” — Elizabeth I “Some say you’re too painful to remember. I say you’re too precious to forget.” — Unknown “You didn’t do anything to cause your loss. There is nothing you did, didn’t do, or could have done differently to prevent it. As you will continue to learn, the loss of pregnancy and the death of a baby are not discretionary; it can happen to anyone. It just happened to you. — Joey Miller in Rebirth “I am done trying to reason with it. For now, at least. There is no reason. There is nothing to understand. There is no could-have or should-have because there is only what is.” — Nora McInerney in It’s Okay to Laugh (Crying Is Cool Too) Pin Me

Fertility Health, oldposts

Books About Infertility

When the people around you don’t understand your experience with infertility, you can always connect with people who have been there and written about that. Here is a selection of books on infertility and the process of IVF, infertility memoirs, mind-body infertility resources, and childfree, not by choice resources. Books on Infertility & IVF These books focus on explaining the procedural aspects of infertility or IVF. We’ve kept the list to current books to make sure they are still relevant. The Fertility Doctor’s Guide to Overcoming Infertility  Buy on Bookshop This is a current guide (2020) on everything-infertility written by a doctor specializing in the area. Dr. Mark Trolice offers a general overview on topics from ovulation to preserving fertility from cancer. It’s a cross between a self-help book and an encyclopedia that offers practical tips along with accessible explanations. Who is it for: Readers looking for a general overview of many aspects of infertility are open to writing that offers advice. Conceivable: The Insider’s Guide to IVF Buy on Amazon Science journalist Jheni Osman offers an overview (2020) of IVF that extends beyond the medical procedures’ ins and outs. Chapters include how IVF works, choosing a clinic, egg, sperm, and embryo donation, cryopreservation, and when IVF doesn’t work. Conceivable has expert commentary and personal experiences woven throughout and is an easy read. Who it’s for: Readers from the UK who are new to the world of IVF and are looking for an overview from a patient perspective. (The book has a UK angle: resources, prices, terminology, etc.) Get A Life: His & Hers Survival Guide to IVF Buy on Amazon Buy on Bookshop Get a Life (2017) is a casually written field guide to IVF by Richard Mackeny & Rosie Bray that focuses on the roles that both men and women have in the process and the feelings that may come with each stage. The “his and hers” format leads to a few gender stereotypes—but likely also provides insight into what your partner might be experiencing and feeling. It’s UK-focused (resources, terminology), but not in a way that makes it UK-exclusive. Who is this book for? It’s a good book for couples looking to understand their partner’s role and feelings during IVF. The Trying Game: Get Through Fertility Treatment and Get Pregnant without Losing Your Mind Buy on Amazon Buy on Bookshop Part memoir, part how-to guide, Amy Klein writes about the process and emotional ups and downs of getting pregnant through fertility treatments. Drawing on her own experience and framed with research-driven info and expert interviews, she discusses everything-infertility in terms of what you need to know and what your choices are. Who is this book for? This book is suitable for a wide range of readers—anyone who is interested in better understanding the experience of infertility and the realities of fertility treatments. Pregnancy and the birth of a child are discussed. IVF & Infertility-Focused Memoirs These books focus on personal experiences with infertility, and that often include expert interviews and research. The Art of Waiting: On Fertility, Medicine, and Motherhood Buy on Amazon Buy on Bookshop Belle Boggs (2016) offers a series of essays on infertility, IVF, and birth, touching on topics like the two-week wait, seeing pregnancies everywhere, the infamous “just adopt” advice, financial barriers, and the fear of, after everything, bleeding during pregnancy. Who is this book for? This book is suitable for a wide range of readers, particularly anyone looking to help put words to feelings. The book mentions pregnancy and successful IVF after a first transfer. Through, Not Around: Stories of Infertility and Pregnancy Loss Buy on Amazon Buy on Bookshop Edited by Allison McDonald Ace, Caroline Starr, Ariel Ng Bourbonnais This book is a collection of essays (2019) that reflects the emotional ups and downs and physical struggles resulting from infertility and pregnancy loss experiences. Who is this book for? Readers looking to engage with raw and honest first-person experiences with infertility and loss. Some stories end with pregnancy or the birth of a child. The Seed: Infertility is a Feminist Issue Buy on Amazon Buy on Bookshop Journalist Alexandrea Kimball explores the relationship between infertility and feminism, where the right to not have a child is arguably more prevalent than the right to have a child. Who is this book for? This is a short yet dense read for people looking to really engage with how infertility fits into feminist theory, cultural norms, and popular culture. This isn’t a how-to or a memoir as much as it is a deep analysis of an underexamined issue. Conceivability: What I Learned Exploring the Frontiers of Fertility Buy on Amazon Buy on Bookshop Elizabeth Katkin writes about her extensive experience with fertility treatments while examining the often murky ethics involved in the process. Katkin speaks to the range of infertility treatments— from Clomid to egg donation — in a way that reads more like a story than a reference book. Who is this book for? Anyone looking to better understand the big business of assisted reproduction or intense perseverance in trying to have a baby. Mind and Body-Focused Infertility Books These books address how infertility can spill over into every aspect of your life. Buy on Amazon Buy on Bookshop Conceiving with Love: A Whole-Body Approach to Creating Intimacy, Reigniting Passion, and Increasing Fertility Denise Wiesner is a practitioner of Traditional Chinese Medicine with an integrative East-Meets-West approach (think chakra balancing) towards building intimacy and ultimately a passionate sex life. We don’t love everything about the book, but losing intimacy to infertility is a problem, and there might be something in it that helps you turn it around. Who is this book for? Couples looking to re-engage physically who are open-minded enough to work through exercises including breathwork and gratitude practice. Child-Free Not by Choice Books that cover what happens when infertility doesn’t end with pregnancy. Silent Sorority: A Barren Woman Gets Busy, Angry, Lost and Found Buy on Amazon Buy on Bookshop

oldposts, Pregnacy Loss

Best Books to Read After a Miscarriage

This article contains affiliate links. The experience of losing a pregnancy can be hard to process. If you are looking for help understanding what has happened, to hear that you are not alone, or are looking for hope for the future, here is a list of books that may help you on your journey to heal. Themes: We have done our best to indicate the loss-related topics you may encounter because triggers are real. Books to Read After A Miscarriage I Had a Miscarriage: A Memoir, a Movement Jessica Zucker, Ph.D. 2021 Jessica Zucker is a psychologist specializing in reproductive and maternal mental health. After miscarrying at home 16 weeks into her second pregnancy, the lens on how she approached her work and was forever changed. In I Had a Miscarriage. Dr. Zucker candidly offers her personal story and experience as a therapist to reflect on the shame, silence, and stigma surrounding reproductive loss. In an extension of her #ihadamiscarriage movement, this book calls on us to normalize miscarriage and the important conversations surrounding it. Who is this book for? A reader looking for empathy and empowerment after the loss of a pregnancy. If you can associate silence, shame, or stigma with the experience of pregnancy loss, this is a must-read. Themes: Pregnancy loss, pregnancy after loss. Buy on Amazon Buy on Bookshop Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss By Lora Shahine, MD 2017 Dr. Lora Shahine is a reproductive endocrinologist who specializes in the care and treatment of pregnancy loss. Not Broken is an evidence-based guide covering all aspects of miscarriage and pregnancy loss. The book contains the research and information Dr. Shahine wants her patients to access and is delivered in a compassionate and empathetic way. Who is this book for? Anyone looking for evidence-based yet accessible information on the how and why questions related to first-trimester miscarriage and first-trimester recurrent pregnancy loss. This book extends beyond coping and into genetics and treatment options. It would also be a good read for friends and family looking to show their love and support. Themes: Pregnancy loss, recurrent miscarriage. Buy on Amazon All the Love: Healing Your Hear and Finding Meaning After Pregnancy Loss By Kim Hooper, Meredith Resnick 2021 All the Love combines the personal experiences of co-author Kim Hooper and the professional insights of co-author Meredith Resnick. Topics covered include the medical aspects of loss, a prominent focus on grief, reconnecting with your partner, finding a new “normal,” and getting pregnant again. It reads like a grouping of short stories with pockets of information. Who is it for? Some processing the experience of pregnancy loss or stillbirth. Themes: Pregnancy loss at all stages. Buy on Amazon Books for Support After a Miscarriage Not Broken Illustrated: A Gift for Those Who Have Suffered Pregnancy Loss By Lora Shahine, MD 2018 When someone experiences pregnancy loss, it can be difficult to know what to say. This illustrated book is designed to be gifted as an offer of love and support to those who have experienced loss. Who is it for? Someone processing the experience of pregnancy loss, stillbirth, or infant loss. Themes: Pregnancy loss, recurrent miscarriage. Buy on Amazon Buy on Bookshop The Baby Loss Guide: Practical and compassionate support with a day-by-day resources to navigate the path of grief By Zoe Clarks-Coates 2021 In The Baby Loss Guide, Zoe Clarks-Coates walks through a timeline of life after baby loss. She covers treatment, practical considerations like dealing with social media, the many decisions of life beyond loss, and the thread of grief that strings it all together. The book concludes with a guided 60 days of compassionate and supportive journaling. Who is it for: People looking for guidance in moving forward after baby loss with interest in journaling. Themes: Miscarriage, stillbirth, SIDS, neonatal loss, TOPFA. Buy on Amazon Buy on Bookshop Books on Pregnancy After Loss Rebirth: The Journey of Pregnancy After a Loss By Joey Miller, MSW LCSW 2020 Joey Miller is a therapist and social worker with experience in perinatal loss. In Rebirth, she provides a roadmap of the realities of trying to conceive and experiencing pregnancy after the loss of a child. Practical tips are given on ways to approach milestones after loss (the baby shower invite) and how to approach each stage of pregnancy with a focus on advocating for your needs. The real-life experiences of 25 women who have grappled with loss are woven throughout. Who is it for? A reader looking for perspective and tips from a therapist on approaching pregnancy—from conception through delivery and postpartum—after a previous loss of a child. Themes: Pregnancy loss, stillbirth, neonatal loss, pregnancy after loss. Buy on Amazon Buy on Bookseller Books on Personal Experiences With Miscarriage What God is Honored Here?: Wringing on Miscarriage and Infant Loss by and for Native Women and Women of Color Edited by Shannon Gibney & Kao Kalia Yang 2019 What God is Honored Here? is a collection of essays by indigenous women and women of color that reflect on the loss, pain, and trauma of experiencing miscarriage and infant loss. Themes: Pregnancy loss, stillbirth, infant death, ectopic pregnancy. Buy on Amazon Through, Not Around: Stories of Infertility and Pregnancy Loss Edited by Allison McDonald Ace, Caroline Starr, Ariel Ng Bourbonnais 2019 This collection of 22 personal stories reflects the emotional ups and downs and physical struggles resulting from infertility and pregnancy loss experiences. Who is this book for? Readers looking to engage with raw and honest first-person experiences with infertility and loss. Infertility has a significant presence in the book. Themes: Infertility, IVF, miscarriage, second-trimester miscarriage, donor conception, pregnancy after infertility, pregnancy after loss. Some stories end with the birth of a child. Buy on Amazon Buy on Bookseller You Are Not Alone: Love Letters From Loss Mom to Loss Mom By Emily R Long 2016 This simple book contains letters of love and support from moms who have experienced loss to other loss moms.

Fertility Health, oldposts

Understanding Male Infertility

Although fertility problems have often been considered a female problem, both men and women can contribute to infertility. In the United States, around 9% of men and 11% of women of reproductive age experience fertility issues. With couples experiencing infertility issues approximately one-third is related to male infertility, one-third female infertility, and one-third combined male/female or no answer. Infertility should be seen as a shared challenge, no matter where the diagnosis lies. The Male Reproductive System The testes are the most important part of the male reproductive system. This is where the sperm are made and stored, as well as the site of testosterone production, the hormone that gives men their masculine characteristics and helps sperm development. The testes are made up of very small tubules called the seminiferous tubules where the sperm mature. Nature has designed the anatomy of a man so that the testes are kept suspended away from the body; this is to keep them approximately 1 degree cooler than the rest of the body. In colder weather, the scrotum contracts to pull the testes closer to the body to maintain a constant temperature. As the sperm mature, they pass from the testes into the epididymis, a tightly coiled tube at the top of the testes (stretched out it would be approximately six meters — about 19 feet — long!). Here, they further mature and develop their ability to swim. It takes approximately 12 weeks for the full cycle of sperm development and 10 to 15 days for them to travel to the end of the epididymis before entering the vas deferens. The vas deferens is a long curving tube that carries the sperm from the epididymis up into the groin. pouch-like glands called seminal vesicles at the far end of the vas deferens produce most of the fluid (semen) in the ejaculate. A man who has had a vasectomy can still produce semen because the vas deferens has been cut close to the epididymis so that the seminal fluid can still leave the body, but the sperm stay trapped. The prostate gland is the largest of all the male reproductive glands and lies just below the bladder. The prostate gland also produces some of the seminal fluid discharged into the urethra during ejaculation. This fluid helps to change the pH of the semen, which neutralizes the acidic environment of the vagina. The Role of Sperm in Fertilization After ejaculation, the sperm swim through the cervical mucus and enter the uterus. They then swim up into the fallopian tubes where they meet an egg at the far end closest to the ovary. Although millions of sperm are deposited in the vagina, only a couple of hundred reach the egg, and only a single sperm is needed for fertilization. The sperm binds with the outer shell of the egg and enters it in a process called the acrosome reaction. As soon as this happens, the shell of the egg changes to stop any more sperm from entering. The DNA is then released from the head of the sperm and combines with the DNA of the egg to form the embryo. Causes of Male Infertility Sometimes the male partner is found to have a problem with his sperm. A semen analysis will identify problems involving the sperm count (numbers) and morphology (the shape and size) or motility (the movement). If a specific problem is identified, then the cause can be investigated by a specialist. Most often the only advice is to change environmental and lifestyle factors that may be contributing to a low sperm count. But occasionally further testing is needed to eliminate underlying health conditions or undiagnosed genetic disorders. Causes of fertility problems in men include the following: Obstructive problems (blockages in sperm-carrying tubes) Testicular injury and disease Varicocele (a varicose vein in the scrotum) Sperm disorders Genetic disorders Problems with erections and ejaculation Hormonal problems General medical disorders that reduce fertility Drugs that reduce fertility Environmental toxins and radiation Sperm Quality Factors in Male Infertility Sperm quality influences not only rates of fertilization but also subsequent embryo development. Remember, half of the genes come from the father. The male partner may carry a chromosomal abnormality that is responsible for him having a low sperm count and that increases the risk of implantation failure and miscarriage. A standard semen analysis usually tests sperm count, motility, and morphology. Several tests that are more advanced can be carried out if the sperm count is low for no apparent reason or if several treatment cycles fail without explanation. Several studies have shown increased sperm quality when a man takes vitamin supplements for a prolonged period. This is especially true if the supplement contains vitamin C, zinc, and folic acid. Eating a balanced, healthy diet with plenty of fresh fruit and vegetables, along with good quality proteins and healthy oils, has also been shown to improve fertility in men. Interestingly, most of the sperm found in a man’s ejaculate is actually abnormal, even in men with normal fertility. This is a case where the body is focused on quantity rather than quality. Semen Analysis One of the first investigations done by a fertility doctor is a semen analysis. This is done by the man producing a semen sample through mastrubation into a sterile container. This may be done at a clinic in a special room or potentially at home if you live close by. The clinic will supply you with a container and sperm-safe lubrication, so don’t use any household products or this may affect the results. Getting the sample When you get your semen assessment done, your doctor will receive a report from the lab with all the findings. The following table shows the normal ranges for sperm count, motility, and morphology. Normal Value Sperm concentration 2.0 mL or more Concentration 20M per mL or more Count 40M or more Total Motility 40% or more Progressive Motility 32% or more Morphology 4% or more Vitality (% alive) 58 Interpreting a

Fertility Health, oldposts

Understanding Blocked Fallopian Tubes

Getting pregnant is a complicated business. The egg and sperm have to meet and fertilize and the resulting embryo has to grow and implant in the uterus. Most of this early part of conception takes place in the fallopian tubes. These thin tubes, around 8-10 cm long, stretch between the ovary and the uterus. After ovulation, the egg is picked up by the open end of the fallopian tube which is close to the ovary, where it begins its journey towards the uterus. Millions of tiny hairs called cilia line the end and the inside of the tubes. These cilia beat hundreds of times a second and help to catch the egg and move it through the tube towards the uterus. The cells lining the fallopian tubes provide lubrication for the egg on its journey and nourishment for the sperm, egg, and developing embryo. If sperm is present around the time of ovulation, the egg and sperm will meet in the second portion of the tube known as the ampulla. The egg and sperm combine to form the embryo, which starts its life as a single cell for the first 24 hours and will then continue its journey through the fallopian tube to the uterus. Fallopian Tube Disorders You can imagine that any serious dysfunction of the fallopian tubes will prevent conception, in which case in vitro fertilization (IVF), which bypasses the fallopian tubes, may be needed. As well as acting as a transport system for the egg, sperm, and embryo, the tubes are the site of sperm capacitation and storage, fertilization, and early embryo development. The tubes are an important contributor to the nutrition and development of gametes and embryos. Any changes in the delicate cells lining the fallopian tubes can affect a woman’s ability to conceive. In addition to being patent (open), the tubes must be healthy and disease-free to allow normal function. Identifying tubal occlusions, or blockages can be done using ultrasound or radiological imaging of the tubes after filling them with saline or a special dye. This investigation is usually done soon after you visit your doctor to discuss your fertility because the results will determine whether a couple should continue trying on their own or if they need surgery or the help of IVF. HSG: Diagnosing Issues with Fallopian Tubes A hysterosalpingogram (HSG) is a common test used to determine whether the fallopian tubes are patent (open) and if the uterine cavity is normal. During an HSG, a catheter is placed through the cervix into the uterus, and a contrasting dye is injected into the uterine cavity. Several X-rays are taken of the pelvic area to identify if the dye is traveling through the tubes, indicating that they are clear and whether there are any uterine abnormalities. An HSG is preferable to a sonohysterogram (which uses saline) because it provides more detailed information about the reproductive system, including the fallopian tubes. An HSG is part of the basic testing done in the early stages of diagnosis. It is performed between Days 5 and 11 of the menstrual cycle, and a woman can attempt conception in the same month. This test is typically performed by a radiologist in the X-ray department of a hospital or clinic and usually takes 15 to 30 minutes. You may feel some cramping similar to menstrual cramps during the test and for a short time after. Most women with blocked fallopian tubes do not have any symptoms. If only one tube is blocked, a woman can still get pregnant naturally, although usually only in the months when she ovulates on the side with the open tube. In rare cases, women have gotten pregnant when they ovulated on the side with the blocked tube, so it’s still worth trying every month if this is the case. It is also possible for a tube to be partially blocked, this increases the chances of an ectopic pregnancy, so it’s important to have a full investigation done if you are trying to conceive and have a history of pelvic infection. What Causes Blocked Tubes? The most frequent cause of blocked fallopian tubes is pelvic inflammatory disease (PID) which is usually the result of an infection. Salpingitis is the medical name given to enflamed fallopian tubes. Here are some of the common causes of blocked fallopian tubes and their symptoms: Salpingitis This inflammation of the fallopian tubes is usually caused by a bacterial infection and is one of the most common causes of blocked fallopian tubes. Salpingitis is sometimes called pelvic inflammatory disease (PID), although PID can also refer to inflammation of other parts of the reproductive tract. Salpingitis may have no symptoms. In other cases, signs may include abnormal vaginal discharge, spotting between periods, painful periods, pain during ovulation or sex, and lower back pain. Treatment options include prompt antibiotics when an infection is identified. Infection of one tube can easily lead to infection of the other tube because of their proximity. Diagnosing salpingitis involves several tests, including: General examination: to check for localized tenderness and enlarged lymph glands Pelvic examination: to check for tenderness and discharge Blood tests: to check the white blood cell count and other factors that indicate infection Mucus swab: a test to identify the type of bacteria causing the infection Laparoscopy: a way to view the fallopian tubes with a slender instrument inserted through abdominal incisions Sexually transmitted diseases, especially Chlamydia and Gonorrhea, can cause the tubes to become blocked. If you have a history of STDs and are having trouble conceiving, talk to your doctor about testing to see if your tubes are healthy. Uterine infections caused by pregnancy termination, surgery, or miscarriage can also lead to blocked tubes so make sure you mention any relevant history to your doctor. Hydrosalpinx A hydrosalpinx is a blocked fallopian tube filled with clear fluid; this is usually in response to an infection or other cause of PID such as endometriosis or surgery. Symptoms vary. Some patients have low, recurring abdominal

oldposts, Trying to get Pregnant

Best Ovulation Tests

If you are looking to get pregnant quickly (and both partners have no underlying fertility issues), timing is the key. The optimal time to conceive is called your fertile window. Peak fertility or ovulation is not standard across all cycles. This means that accurately predicting ovulation is individual. Even those with regular cycles can have highly variable timing of their fertile window. Because of this, determining ovulation based on a calendar method or calculations (assuming ovulation is day 14 or dividing the length of your menstrual cycle by two) is not necessarily accurate. Monitoring physical symptoms can provide you more information about the actual timing of your fertile window. This is where an ovulation test kit can be useful. To understand precisely how ovulation tests help, it’s helpful to understand what exactly is meant by your fertile window. Identifying Your Fertile Window There are only certain days of a menstrual cycle where conception is possible. This 6-day timeframe is referred to as a “fertile window” and includes the five days preceding ovulation and the day of ovulation itself. This time period is determined by adding together the maximum possible viability of both the sperm and egg. When an egg is released, it must be fertilized within 12-24 hours, or it is reabsorbed back into the body. Sperm can live inside of the female reproductive tract in the right conditions for up to 5 days. Together, the possible range for fertilization to occur becomes this 6-day fertile window. Which days are you most likely to get pregnant? While pregnancy is possible over these 6 days, it is most likely to occur during the two days preceding ovulation and the day of ovulation itself. In a study of 221 women, couples who had sex once during this three-day timeframe had a 27% to 33% chance of becoming pregnant. The study reported that the likelihood of becoming pregnant if you have sex during the fertile window was as follows: 5 days before ovulation – 10 % 4 days before ovulation – 16 % 3 days before ovulation – 14 % 2 days -before ovulation 27 % 1 day – 31% Day of ovulation – 33% Another study shows that sex on the day before ovulation is most likely to translate to pregnancy and that chances of conception drop dramatically to almost 0% after ovulation. Bottom line: There is a 6-day window that consists of the five days before ovulation and the day of ovulation itself for the fertile window where pregnancy is possible. Of these days, the final two days and the day of ovulation have the highest probability of conception. (Read about fertility-friendly lubricants) Don’t I Ovulate on Cycle Day 14? The clinical guidelines have long been that a median menstrual cycle is 28 days with a steady 14-day luteal phase (number of days after ovulation until the next period), meaning that ovulation is generalized to occur on day 14. There is much more variation among cycles, meaning that this would not be the most accurate way of determining your fertile window. In a large study, the mean menstrual cycle was 29.3 days, and follicular phase length, or ovulation date, was 16.9 days. Only around 13% of cycles were found to be 28 days long. One study found that women seeking treatment at fertility clinics had attempted to identify their fertile window, but few could do it accurately. The researchers concluded that a lack of fertility awareness can cause problems when trying to get pregnant and might be a contributing cause of infertility. Online Ovulation Calendars What about those free online ovulation calendars? Most online ovulation test calculators that “calculate” your fertile window with only your cycle length likely use the day 14 assumption. We know that not everyone ovulates on day 14, making these results not accurate for many people. More accurate results come from interpreting signs from your own body through fertility awareness or luteinizing hormone (LH) ovulation tests. Read: Implantation Calendar: What is Happening During the Two-Week Wait? What is an Ovulation Test? A basic ovulation test can be done at home and will help you predict when your body will release an egg through the process of ovulation. By identifying when you ovulate, you can time sex for the best chance of getting pregnant. How Do Ovulation Tests Work? Most urine-based ovulation predictor tests work by detecting the amount of luteinizing hormone (LH) present in urine. A surge of this hormone triggers a follicle to release an egg, and detecting this surge can be used to predict ovulation. A surge of LH means that the chances are high that ovulation is coming up. Standard LH Ovulation Tests The majority of tests on the market fall into this category. They are either a strip (or dip) test where a test strip is dipped into a cup of urine or a midstream test where a test stick with an absorbent tip is held in the urine stream (think pee-on-a-stick). All of these tests are qualitative or threshold, which means that a certain hormone level will trigger a positive result. The threshold is often 25 mIU/ml or 40 mIU/mL (mIU/mL is the abbreviation for the measurement milli-international units per milliliter.) Because they are threshold-based (yes/no), these tests don’t work well for people with atypical hormone patterns, including polycystic ovary syndrome (PCOS), symptoms of menopause, or those taking some fertility-enhancing medications. The user interprets the results by how dark a line is compared to a test line. The more of the hormone present, the darker the line will appear. The tests tend to be in a lower price range. Digital Tests With digital tests, a test stick is inserted into urine and then entered into a mini-computer that analyzes the sample and displays the results. The main advantage of digital tests is the results displays on a screen, and there is no interpretation involved. Even though these tests are more sophisticated, they are still qualitative/threshold and are triggered by a certain

oldposts, Trying to get Pregnant

Ovulation Tracking Charts

A BBT chart is used to track fluctuations in basal body temperature (BBT), which is your body’s temperature at rest. Because a slight rise in temperature occurs at the time of ovulation, tracking BBT over time helps identify low and peak fertility. (Check out our intro to BBT charting.) Digital tracking with the use of various apps has become a popular way to track BBT, but for some, the traditional paper and pen method of tracking is the way to go. If you have determined that pen-to-paper is your method, finding a paper chart with the ideal layout for you is next. Here is a selection of BBT charts that might do the trick. Free Printable Ovulation Chart Options Source: Taking Charge of Your Fertility Source: MyMonthlyCycles.com Source: TheBabyCorner.com Source: BabyCenter.com Download BBT Charts Fertility In Focus available on Etsy $3.00

Fertility Health, oldposts

Cervical Position and Fertility

In addition to the commonly charted cervical mucus changes and Basal Body Temperature (BBT) changes of the menstrual cycle, cervical position, texture, and openness can be a useful guide in identifying the fertile time. Below is a guide to using cervical observations to chart your fertility. Where is the Cervix Located? While the cervix is often referred to as if it is a discreet thing, it is actually the name given to the lower portion of the uterus. It is the part of the womb that extends into the vagina and can be palpated with your finger. It is also the passageway that a baby must pass through when being birthed vaginally. When unaroused, a vagina is typically 3-4 inches long, with the cervix located at the end. The cervix can be easily palpated with an index finger. It should feel like a “snout” at the end of your vagina. How Does the Cervix Change During your Cycle? The cervix, as part of the uterus, is affected by the dozen ligaments that suspend it in the pelvic cavity. Levels of relaxin, a hormone, fluctuate throughout the cycle and influence how the ligaments hold the uterus within the pelvis. This can cause the uterus (and cervix respectively) to raise and lower within the vagina. In turn, this changes the angle of the cervix within the vagina. The opening to the cervical canal, the “tunnel” between the vagina and the uterine cavity, is called the “os.” The os must open in order to allow cervical mucus out and to allow sperm in. For this to happen, the entire cervix softens. When the cervix is soft it feels like the texture of your lips. When it is hard it feels like the cartilage in your nose. Why Does Cervical Position Fluctuate? Cervical changes serve several functions: An open os allows the release of cervical mucus, which is pivotal to supporting sperm survival in the vagina. An open os also allows passage of sperm into the cervix, so they can make their way through the uterus and into the fallopian tubes. A high cervix facilitates deeper penetration during intercourse, increasing pleasure for both partners and increasing the chance of orgasm and pregnancy. A cervix that is directly in line with the vagina increases the chances of sperm getting into the cervix (bull’s-eye!). After ovulation has passed, the os closes, the cervix hardens, and the uterus shifts down. The closed os prevents bacteria from entering the uterus, thus decreasing the chances of the uterus being infected with a virus. Cervix During a Fertile Time At ovulation, the cervix should optimize the chances of conception. This means: Open – The cervical os should be open, to allow sperm transport into the uterus and to allow cervical mucus out of the crypts and into the vagina. Soft – The texture of the cervix should be soft, like your lips. High – Ideally, the cervix will be high, however, there may be many reasons why it is not (see below.) Straight – The cervix should be directly in line with the vagina. Cervix During Low Fertility At times of low fertility, the cervix should protect the uterus from infection. This means: Closed – Considered to be the least open position. Hard – A hard cervix is normal between menstruation and the onset of cervical mucus, which marks the shift into the fertile phase of the cycle. The cervix is also hard after ovulation and up until menstruation when it softens and opens again to allow menses to flow out of the uterus. Low – Typically, a low cervix indicates a time of low fertility. Tilted – The uterus should be resting fairly horizontally, just above the bladder, meaning the cervix should be tilted towards the rectum. However, this can vary by individual based on the unique alignment of the pelvic organs within the pelvic cavity How to Perform A Cervical Check Be sure your nail is short and not freshly cut to avoid scratching yourself. For hygiene purposes, be sure to perform your cervical check using clean hands, and be certain you do not leave soap residue that could cause irritation. Get into a comfortable position (squatting or having one foot up on a toilet are ideal). Insert an index finger gently into your vagina. Feel for a “snout-like” protrusion at the end of your vagina. Press lightly on it to ascertain whether it is hard or soft. Feel for the small hole in the center. Does it feel open or closed? Lastly, notice whether your cervix feels directly in line with your vagina (e.g., right at the tip of your inserted finger) or whether it feels angled to the front or back (e.g., the front pad of your finger). These distinctions—hard/soft, open/closed— are easiest to make when you have experienced the full spectrum of changes, so observing and charting through one entire cycle is usually necessary before being able to differentiate with any level of confidence. Be sure to sit or stand in the same position whenever doing your cervical examinations as your cervix will feel different depending on how gravity is acting upon your organs. Individual Variation in Cervical Position The most important aspect of charting cervical changes is determining what is fertile for you. This requires charting for a full cycle and comparing observations against other primary fertility signs. Variations in pelvic floor health, amount of relaxin production, previous pregnancies, individual anatomy, and obesity can all impact the positioning of the reproductive organs within the pelvis. For this reason, identifying the change that marks the shift into fertility is what is important, more so than the individual position.

Fertility Treatment, oldposts

Preparing for Your IVF Egg Retrieval

In vitro fertilization (IVF) can be overwhelming, but the egg retrieval, also known as egg harvesting or egg collection, doesn’t have to be. After all the preparation with the appointments, pills, shots, and ultrasounds, you’re finally getting ready to see what happens next. Here’s what you can expect from an egg retrieval procedure. What is an Egg Retrieval Procedure? The IVF cycle is basically a zuped up menstrual cycle. What exactly does that mean? In a natural menstrual cycle, hormones called gonadotropins are released from the pituitary gland and help recruit one egg to mature over about 10-14 days and then signal ovulation (egg released from the ovary into the fallopian tube where hopefully it meets sperm). The medications in an IVF cycle are simulating the natural recruitment process with the goal of recruiting more than one egg. Retrieving multiple eggs increases the likelihood of having high-quality embryos to transfer back to the uterus. Essentially, the egg retrieval is like ovulation; however, there are more eggs involved and they are retrieved out of the body before they would ovulate on their own inside the body. If a patient does not have a fresh embryo transfer, they can expect a menstrual period about 7-10 days after the egg retrieval and the ‘cycle’ is then complete. Preparation for IVF Stimulation Most IVF stimulation protocols start with some sort of medication to prepare the eggs and the most common is the birth control pill. Patients are often shocked when I tell them that the first step in IVF is taking birth control pills and they often say, “Isn’t that the opposite of what we’re trying to do here?” I then joke, “We need to re-brand them, no one would hesitate if I call them ‘IVF prep pills.’ The birth control pills are meant to prepare the eggs for recruitment. I describe it as getting them on the starting line for stimulation so that they all develop at the same rate and most of them will be mature and ready for retrieval at the same time. Other ways to prep for the stimulation phase of IVF can be: Estrace (estrogen-only pill) Lupron (a daily shot) Sometimes your provider may recommend stimulation without preparation. This can mean starting daily stimulation shots with the onset of a period and can be called a spontaneous start IVF cycle. Suppression Check and Breakthrough Ovulation Before you start the stimulation medication, you’ll have an appointment (often called a suppression check) to check that you are ready. This usually involves an ultrasound and a blood test for estradiol (an estrogen that your ovaries produce). Occasionally people breakthrough birth control pills and other preparation medications, and if so, we do not recommend starting the cycle. Breaking through birth control pills means recruiting an egg while on birth control pills and we can tell this happens if there is a large follicle on the ultrasound in combination with a higher than expected estradiol level on the blood test. It is very frustrating to be ready for your IVF cycle and have it delayed but it’s the right thing to do. If we started the stimulation shots when your body has already selected an egg to start recruiting, then that is the only one that would develop to maturity in that cycle and the whole point of IVF is to recruit more than one egg. If the ovaries are quiet and the estrogen level low, you are ready to start the stimulation phase of the IVF cycle! Stimulation Phase of IVF Let’s take the mystery out of the IVF cycle — it’s not magic recruiting eggs—it’s science. Every menstrual cycle women may ovulate one egg but many more eggs are lost (this happens every month whether or not we are having menstrual cycles). Our eggs are constantly trying to develop and then the vast majority die off (I wish we could put a pause button on this process!). Of all the eggs that we lose each month, a small group of them are recruitable (able to respond to stimulation medication, if given). In a natural cycle, the pituitary gland makes enough gonadotropins, mostly follicle-stimulating hormone (FSH), to recruit one egg and when the ovaries make enough estrogen to signal that the egg is mature the pituitary gland produces a surge of another gonadotropin, luteinizing hormone (LH) which induces ovulation of that mature egg. We are mimicking this process in IVF with the goal of recruiting more than one egg. We give gonadotropins for 10-14 days in the form of shots to recruit the eggs that are available. These shots are the same hormones a woman’s body makes each month, just in higher doses. It’s important to know that every woman is different, and every cycle is different. The same dose of medications can produce a different number of eggs in different women and even in the same woman but over different menstrual cycles. Women are followed closely throughout the cycle with ultrasounds (follicle sizes increases as eggs mature) and blood tests (estrogen levels increase as eggs mature). Ovulation Suppression The medications you take in your IVF cycle are not all stimulation. Another medication will usually be given to prevent ovulation before the egg retrieval. This medication is either leuprolide (Lupron) or an antagonist medication (Ganirelix or Cetrotide). Daily Lupron shots are started before the stimulation medications and given throughout the cycle while antagonist shots are usually only taken 4-5 days before the egg retrieval. The goal of IVF is to retrieve the eggs when the majority of them are mature and so it is a balance between stimulation and preventing ovulation. Ready Set, Trigger Shot Time! When your doctor feels that the majority of the eggs are mature and you’re ready for retrieval, you’ll do one last shot to trigger the final maturation of the eggs. This ‘trigger shot’ is mimicking the LH surge that occurs in the middle of a natural cycle once the ovaries give the signal that the egg

Fertility Health, oldposts

Should I Donate Eggs Again?

You made it through at least one egg donation cycle and now you’re thinking about doing another—but you likely still have questions. How much time does my body need to recover? Can I increase my fee or negotiate new contract terms? Will I run out of eggs? Can I freeze some eggs for myself? Does doing multiple cycles increase the risk to my health? These are all important questions, and things you will likely want to investigate before undergoing multiple egg donation cycles. If your last donation cycle was successful—for example, if you produced a lot of high-quality eggs that became embryos and the intended parents (IPs) reported a positive pregnancy—it is likely your egg donor coordinator will contact you again soon to schedule your next cycle. They may even provide you with birth control pills as you leave the clinic, so you are ready to go for another cycle, or they may ask if you’re interested during a follow-up exam (and yes, it is in your best interests to have a follow-up). You may feel elated if and when you find out your IPs are pregnant—or need the money to pay bills—but whatever the case, it is likely best to step back; it might be beneficial to see how your body recovers and take stock of your experience rather than immediately agreeing to do another cycle. Deciding to donate eggs again is entirely up to you—but it is typically in your best interest to not agree to do more than one cycle at a time. Here are some things to think about when considering another egg donation cycle. How did my body respond to fertility drugs? The first thing to consider before deciding to do another cycle is how your body responded the first time. If you experienced extreme discomfort or bloating—an indication of ovarian hyperstimulation syndrome (OHSS)—you are highly likely to have the same or worse experience on the next cycle. This is especially true if the doctor uses the same medication protocol he or she used during your last cycle. Some medications are more likely to cause OHSS, and others have different effects on the body. Some people are more sensitive than others. If you had no negative side effects throughout the process, and it went smoothly for you, hopefully, that will still be the case for your next cycle. But every cycle is different and there are no guarantees. Read: The Egg Donation Medical Process: For Egg Donors How much time does my body need to recover? Many donors report feeling pressured to do another cycle right away. Sometimes there are recipients anxiously waiting for a donor to be available, and this time that donor is you. Yes, it may feel good to know people want you, but this is your body and your first commitment is to your own health and well-being—and taking time for a full recovery is important. The length of time it takes to recover is different for everyone. Some women feel back to normal within a few days, and others may still be sore, bloated, and uncomfortable for months. A good rule of thumb is to wait for at least two or three menstrual cycles before undergoing another donation cycle and surgical procedure. Your ovaries were most likely quite large and need time to settle down to normal size. You will also want to make sure you have normal periods before proceeding with another cycle. Give yourself time to observe your body and make sure you’re not having any lingering pains in your abdomen or ovaries. Will I be able to ask for a higher fee? Or negotiate my contract? Every egg donation cycle will require a new contract. If there was something you didn’t like about your last contract, this is the time to make sure you negotiate better terms for yourself. You can also ask for a higher fee—especially if your eggs produced a pregnancy. Read: What Egg Donors Should Know About Egg Donation Contracts If you are working through an agency it is likely that you will be sent to different clinics and different doctors on subsequent donations. This also means you may be given different medication protocols than you had on your last cycle. If you had a protocol that worked well for you, ask the new doctor if you can use that one again. If your other protocol did not work well for you, ask to have it adjusted. This is a whole new cycle, and since you’ve donated before you have a pretty good idea of how everything works. Use the knowledge you’ve gained to advocate for yourself. Will I run out of eggs? Every female is born with about two million eggs and they do not make any new eggs during their lifetime. Every month some eggs die off. By the time a girl reaches puberty she has about 400,000 left and by the time she reaches thirty, that number is about 100,000. Of course, every woman is different, and some suffer from premature ovarian failure (POF)—meaning they entered menopause before they were supposed to. During an egg donation cycle, the fertility drugs increase the number of eggs that come to maturity in that cycle, but this does not necessarily mean that you are losing eggs faster by being an egg donor. However, that said, some egg donors do go on to face their own infertility. With the lack of research, no one really knows if being an egg donor increases a woman’s chance of becoming infertile. Can I keep some of my eggs for myself? With recent advances in egg freezing a lot of donors are asking: Can I save some eggs for myself? At many fertility clinics, the answer to this is “no.” However, there are some fertility practices that are now offering donors the ability to “freeze and share.” This means that during an egg donation cycle you will give half of your eggs to an intended parent, and keep

Scroll to Top