Category — Barren Advice

This is the tenth installment of Barren Advice. You can ask questions that are fertility or non-fertility related.

Barren Advice is posted each Tuesday. If you have your own question for Barren Advice, click here to learn how to submit. Please weigh in with your own thoughts in the comment section and indicate which question you’re addressing if there are multiple questions in the post.

Dear Mel:

I’m having a bit of a crisis of confidence, of the how-infertile-am-I-*really* variety (warning – all this may just be the Clomid talking). I’ve always been averse to medical intervention for anything that isn’t a clear and specific injury or illness. In the realm of infertility, there seems to be a lot of ambiguous or conflicting information. For example, take luteal phase length supposedly anything under 10 days is too short, and yet I can plug in “Short Luteal Phase (<10)">

Although I do appear to have ovulation problems and DH’s s/a was less than optimal, we haven’t been trying all that long (about a year), so it’s not clear how much these things are reducing our odds. How do I sort out which reproductive issues are definitely a problem and really do require medical help, versus those that doctors think are probably a problem but don’t really know for certain?

–Kate of “No Blog” Fame

The heart of this problem comes with linguistics. Infertility is a bit of a misnomer. A large portion of those diagnosed as infertile are actually subfertile. After all, if you were not fertile at all, there would be nothing one could do to help you along. It would be like trying to grow a flower in concrete. Some people in the community are the equivalent to concrete (and I say this in the most loving way)–nothing they could do would give them the ability to become pregnant. Either they are completely sterile and do not produce any sperm (and this is different from a low sperm count which also isn’t getting anyone pregnant) or they are missing necessary reproductive organs such as their ovaries or uterus. The rest of us are actually more accurately subfertile. We’re more like poor soil–add some nutrients, change the seeds you’re using, adjust some details–and, hopefully, plants will grow.

And that is what makes this suck so hard.

If we were infertile, we could make neat decisions. We could accept our limitations and we’d know the right time to move on. But we’re not. We’re subfertile and that’s where things get grey and we enter an analogy akin to gambling. How many IVF cycles should you do with your eggs? What if the next one was the one that would have worked? What if we had held off one more cycle before starting treatments–could we have gotten pregnant and avoided all of this? Too many questions linger like that when the boundaries aren’t clearly defined and it’s hard to walk away from the table once you start gambling. Because that’s sort of the allure of gambling–there’s always the chance of the next time.

Therefore, I think a lot of this has to do with what type of stakes you’re comfortable laying on the table: not when life is good and you’re at the casino for a lark; but if you were playing for something really important to you. Are you the type who would rather watch the game for a bit and figure things out and decide if you really want to enter? Are you the type who jumps into the game and places everything you’ve got on the table, even before knowing whether the dealer is working with blackjack or 5-card draw (can you tell that everything I know about poker I learned from Intellivision)?

Let’s strip the analogy away and ask this question: are you the type who feels it’s worth the risk of losing time or chances in order to work on the problem sans treatments? A lot of people feel this way and many are successful. If you try enough times, chances are, you will win. You’re not guaranteed to win because the statistics remain the same each time you try. If you have a 1 in 4 chance, you will still only have a 1 in 4 chance, but you’ll have it 15 times. Please don’t ask me about this fuzzy math.

Or are you the type who needs this to happen for your own sanity. Please do not disregard mental health–your soul, your emotions, your heart need to be given as much care as your body. Separating them is detrimental to your whole. Therefore, if you would treat an ulcer, you should also treat the stress that caused the ulcer (if stress caused the ulcer). If infertility is affecting someone emotionally, I think it’s worth treating all medical issues–the reproductive health and the mental health. Sometimes, treating the infertility by default treats the mental health issues.

I once asked my RE how my mother got pregnant with me when she couldn’t get pregnant with treatments (yes, I’m an off-cycle baby) and he explained it this way. Every subfertile woman creates perhaps one or two good eggs every once in a while. They may have happened before we started trying or they may happen when we’re 41. We just don’t know. It is the perfect cycle where egg quality and uterine lining come together. If you are having unprotected sex every single cycle around ovulation; never taking a month off, you will hopefully catch that egg and have it fertilized and implant. And you will carry it to term. That’s how people become pregnant after adoption or how they become pregnant after stopping treatments. Or how they become pregnant naturally after 8 failed IVF cycles.

Some people are willing to wait for that cycle. Some people luck out and inadvertently find that cycle. And other people are not willing to sit around for something that may or may not occur. I didn’t fall into the first category, I am here on this earth due to the second category. But my heart feels best (and this is personal for me) with that third category. That’s how I chose treatments. I don’t know if it’s helpful to hear how someone else reached the decision to plow ahead.

No really, the beauty of a blog advice column is that you get to weigh in with your two cents too. Let the questioner know if you support the advice, add to the response, or dispute it completely. I would love people to add how they decided whether or not to enter treatments.

Leave a comment in the reaction box below–only keep in mind that conflicting advice is embraced and rudeness is not. Want to ask your own question? Click here to see what you need to send in order to be included in a future Tuesday’s installment of Barren Advice.

This is the ninth installment of Barren Advice. You can ask questions that are fertility or non-fertility related.

Barren Advice is posted each Tuesday. If you have your own question for Barren Advice, click here to learn how to submit. Please weigh in with your own thoughts in the comment section and indicate which question you’re addressing if there are multiple questions in the post.

Dear Mel:

Today I had my embryo transfer for my first IVF cycle, after 6 years of TTC, several years of alternative treatments like acupuncture and herbs, 8 prior assisted cycles including 6 IUI’s, 1 miscarriage. Normally I am very good about refraining from urine pregnancy tests and waiting for the blood test results. This cycle, though, my husband and I will be travelling during the week when I was scheduled to have my blood test. Because of the difficulty of finding a lab to do the blood test in our destinations, the RE decided to postpone the blood test until I get back, almost a week after I was originally scheduled for the test.

My question: Should I do a urine test on my own, or wait for the blood test?

Pros of testing myself:
-During my one pregnancy which led to miscarriage, each day that I was pregnant was among the happiest of my life. I wouldn’t want to miss out on any joy that may be coming to me, especially after the hundreds of days of non-joy over the past 6 years.
-If the urine test is positive but then I miscarriage by the time of the blood test, it might be good to know about the miscarriage for diagnostic purposes and the next IVF cycle.
-2WW becomes 3WW! I am patient, but there are limits.

The big con:
-Our week and a half of travel involves visits to multiple family members including staying in their houses. No family members know anything at all about TTC, IF, etc. We do not plan to announce a pregnancy, if there is one, for at least a couple of months, due to a combination of miscarriage concern and weird family dynamics. If the test is negative, I would have a hard time concealing my disappointment and/or making up an excuse about why I am so upset. If the test is positive, neither my husband nor I have a good enough poker face to hide our excitement. We don’t want anyone to know anything at this point, but I’m not sure if I would be able to keep positive or negative test results a secret.

I know that you and most of the rest of the IF world are far less secretive than I am, but we definitely want to stay in the IF closet. That said, if you were in my situation would you test or wait?

–Anonymous

There are going to be people who write in the comment section to wait and they will also have good reasons. And therefore, I’ll start this off by saying that you should read through everyone’s thoughts and then weigh each one, choosing the one where you have no argument to make inside your head to the contrary. My advice is going to be to test.

Unless you are the type who can truly compartmentalize, you will still be experiencing emotions over infertility and the cycle regardless of the outcome. Sometimes, the waiting is the worst part. No one wants to go into a cycle thinking that it won’t work, but it sounds like you have looked ahead and know what happens next, therefore, though a negative will sting like the dickens, you do have a goal of picking yourself back up and giving yourself emotional Benadryl even if you don’t necessarily know how you will reach that goal from this vantage point. I think having that in your pocket, knowing you will get there even if it is simply a matter of putting foot over foot for the next few weeks, is a huge source of strength. By which I mean that you should notice your own internal strength that you can plan for the future, accept multiple possibilities, and have the sense to think ahead. Those facts alone point to a person who has internal fortitude.

Why test–for the very reason you state as a pro in your question. I believe wholeheartedly that we should grab happiness where we can. Some would rather not know about a chemical pregnancy, and in some cases I agree that ignorance is bliss. But in most, I believe when you are going to be unhappy anyway, to grab the five minutes of happiness passed your way. To turn it down gains nothing–it doesn’t lessen the unhappiness on the other end. If the cycle doesn’t work, you are going to be sad. If the cycle does work and it turns out to be a chemical pregnancy, you are going to be sad. If the pregnancy continues for a bit, whether or not you tested will have no impact on how you feel later on with whether you reach term or not because new information will be added to that emotional path. So, in terms of immediate reaction, I would take 5 minutes of happiness and 71 hours and 55 minutes of unhappiness over 72 hours of unhappiness. But that is just me. Some feel that the sadness on the other end is even worse when you swing down from great heights. But, in my world, sadness is sadness and the shade of it doesn’t really matter.

There are plenty of non-conception reasons you might be sad or anxious or in a bad mood and needing space. Problems at work, a fight with a friend, debating a career change. You may not be able to hide the feelings, but you may be able to explain them away.

And if it is positive and you’re giddy, there are excuses galore you can use. You can pretend you received a call from a friend who is pregnant which allows you to gush about “her” pregnancy (and later gives you the opening: “remember how I told you about my friend that day…”). It could be something good happening at work or just that you’re in a sunny mood in general.

I hope that is what happens on your trip–that you’re too happy and people get suspicious that something good is happening.

In Eat, Pray, Love, Elizabeth Gilbert closes off the first section–Eat–with an explanation for why she took four months out of her life to only seek happiness. She explains: “But I felt a glimmer of happiness when I started studying Italian, and when you see the faint potentiality for happiness after such dark times you must grab onto the ankles of that happiness and not let go until it drags you face-first out of the dirt–this is not selfishness, but obligation. You were given life; it is your duty (and also your entitlement as a human being) to find something beautiful within life, no matter how slight.”

I read into your question that you want to feel okay with testing. That you want someone to tell you that it will be okay if you test–that you will get through the day regardless of whether you are circling the bottom of despair or bubbling over with happiness. You will get through the day. It may n
ot be perfect. It may be messy and emotional and full of excuses–but I don’t think that a day where you don’t test will look that much different. Infertility doesn’t simply hang out, sipping a cappuccino while you navigate a visit and wait to test. Those emotions–those fears and hope and excitement and anxiety–are there anyway. At least test and see what you are facing.

No really, the beauty of a blog advice column is that you get to weigh in with your two cents too. Let the questioner know if you support the advice, add to the response, or dispute it completely. I would love people to add to my argument, but I’d also love to hear the opposite side: why she shouldn’t test.

Leave a comment in the reaction box below–only keep in mind that conflicting advice is embraced and rudeness is not. Want to ask your own question? Click here to see what you need to send in order to be included in a future Tuesday’s installment of Barren Advice.

This is the eighth installment of Barren Advice. You can ask questions that are fertility or non-fertility related. But today, I am turning the tables on you.

Barren Advice is posted each Tuesday. If you have your own question for Barren Advice, click here to learn how to submit. Please weigh in with your own thoughts in the comment section.

Dear You:

Rather than answer advice today, I am asking advice from you. An etiquette question on correcting your elders. I have a friend who is considerably older and wiser who has two facts wrong about me yet keeps repeating them every time she introduces me to a new person. The first one, that I have “incredible blue eyes” is clearly wrong if I’m being introduced to the person face-to-face. Usually the person nods, peers at my eyes, gets a confused expression on their face, and we move on. No one has said to her, “but she doesn’t have blue eyes!” Yet.

The other fact, that I play violin, is not immediately apparent. Though I took one violin lesson during college, I’m not sure where this idea comes from, but she thinks it is one of the most interesting things about me and therefore adds it to every introduction. Every once in a while, the person turns out to be an violin player too and asks me a question but for the most part, this fact is simply noted and we all move on in the conversation.

I’ve gently corrected my friend via email and in conversation, pointing out that my eyes are hazel and I don’t play violin at all. Yet by the time we see each other again, she has forgotten this and adds these two incorrect facts into the next introduction. How hard would you push to have these facts corrected? Would you send another email or make a phone call about it or correct her in the moment when she is making the introduction? Would you simply allow legions of people to walk away from a conversation with you believing they are colour-blind if they see my eyes for what they are (hazel) or that they’ve just spoken to a violinist?

So give me advice today.

Want to ask your own question? Click here to see what you need to send in order to be included in a future Tuesday’s installment of Barren Advice.

This is the seventh installment of Barren Advice. You can ask questions that are fertility or non-fertility related.

Barren Advice is posted each Tuesday. If you have your own question for Barren Advice, click here to learn how to submit. Please weigh in with your own thoughts in the comment section and indicate which question you’re addressing if there are multiple questions in the post.

Dear Mel,

I have just found out I am pregnant (naturally after IF!) but am wondering what to tell the doctor about my cycle dates. You see, I didn’t ovulate until CD25. So the typical week count from Day 14 will not be accurate to measure growth and predict due dates. But we all know how well doctors listen to what we have to say. In my experience they usually decide (in a somewhat patronizing way) that I am mistaken but I know I’m not. I temp every day and am very aware of when I ovulate. Also, I use TCOYF software.

I suspect that the Doctor will still want to count my 40 weeks from my CD1 which was April 19. This will throw off calculations by almost 2 weeks. Should I fudge my dates? Should I tell them that CD1 was April 29 in order to reflect CD14 ovulation date which is how they calculate the 40 weeks? Would there be any harm in this? I just don’t want to go through the next 40 weeks explaining to every nurse and ultrasound tech that I actually ovulated on CD25. (Assuming that my pregnancy lasts that long.) I know that this seems like a trivial problem to have but I really don’t want to have miscalculated times the whole way through.

–Skygirl at Chasing Blue Sky

My gut says to work from a place of utmost honesty. State the start date of your cycle and the date you ovulated. A doctor who is not willing to work with you to calculate the correct due date and trust that you know your body is not a doctor you want to remain with during the duration of the pregnancy. Switching doctors is easier said than done, but problems can actually arise that go beyond the panic you’ll feel when you hear your embryo is measuring behind.

Not using the correct date of ovulation can throw off all testing that is time sensitive–CVS, amnio, AFP tests (alpha-fetoprotein). You may be induced early believing that you’ve reached your due date–and induction does carry more risk and a higher chance for a c-section than natural labour. It’s one thing when induction is unavoidable, it’s another when it’s being done simply because a doctor will not listen to you when you know your ovulation date.

Back up your words with evidence such as the TCOYF software and a copy of your chart. And truly, a doctor who is rigidly set on Naegele’s Rule and can’t listen to facts or wishes is giving you a sign that they most-likely will be inflexible later on when you decide you do or do not want other changes to standard protocol.

Another route is to ask your doctor to do a series of ultrasounds early in pregnancy to help determine the correct due date based on growth. The ultrasounds are most accurate before 12 weeks. There is a margin of error as there is with any ultrasound, but you will still be able to get a better sense of the correct due date once you bring together all of the information you have on hand (LMP, the ovulation date, and ultrasound findings).

Stand your ground and put on some ass-kicking shoes before that first appointment just in case you need to kick a little ass in order to have reality heard.

No really, the beauty of a blog advice column is that you get to weigh in with your two cents too. Let the questioner know if you support the advice, add to the response, or dispute it completely.

Leave a comment in the reaction box below–only keep in mind that conflicting advice is embraced and rudeness is not. Want to ask your own question? Click here to see what you need to send in order to be included in a future Tuesday’s installment of Barren Advice.

This is the sixth installment of Barren Advice. You can ask questions that are fertility or non-fertility related.

Barren Advice is posted each Tuesday. If you have your own question for Barren Advice, click here to learn how to submit. Please weigh in with your own thoughts in the comment section and indicate which question you’re addressing if there are multiple questions in the post.

Dear Mel:

Okay, this is a pregnancy mentioned question. I am finally out of the closet about this pregnancy. So, now that everyone knows, the stupid advice has started flowing in mass quantities. It has barely begun and I am already going crazy.

Everyone wants to know if I am taking the right kind of vitamins and whether I know not to eat soft cheeses and sushi. My mother-in-law just told me that I have to stay away from cats because they kill unborn babies. I have yet to receive any actual, true advice. Not a single person has told me a real fact yet. And the next person who emails me that cell phone story will not find out about any future babies until they can talk well enough to announce themselves.

I am smart enough to do my own research (especially being that no one has even been right yet). I majored in psychology in college and I spotted every error in that cell phone study before the authors of the study themselves announced that it proved nothing and the media was blowing it out of proportion. The worst part is that everyone means well and it’s just because they care and are really excited. (This is the worst part because I have to bite my tongue on all the sarcastic comments that are dying to slip out of my mouth. Plus, I am too nice to actually be mean in return.)

My question is does anyone have any good ideas of things to say that are polite but might get my point across? I need a few answers that I can memorize, so that the polite answer can come out of my mouth while my brain processes the sarcastic things I would like to say. I will also take funny stories about things that other people said to you, so that perhaps I can begin to laugh about this and it won’t bother me as much.

–Jen from Here We Go Again

See, that’s the whole problem, the person means well and is giving the advice because they love you and they desperately want to be involved. There’s not a lot they can do when the child is still in your belly. Sure, they can help you shop or set up the room, but for the most part, they’re left standing around staring at your belly, throwing out whatever small tidbits they’ve managed to collect since the last time you spoke.

Advice you can’t use is the worst kind of advice because you can’t get angry–the person meant well–but you get angry because they are inadvertently calling into question your intelligence and judgment.

Barring that the person is speaking from a place of animosity, make your first response sweet and kind. Make your second response firm. If you have to get to a third response, I give you full permission that it can be a free-for-all. So, what are some sweet responses you can practice?

• Wow, I didn’t know that.
• That sounds like a very interesting study.
• Thank you for letting me know that!

And then change the subject to make it clear that you are done with that topic. If they keep coming back to it, you’ll need to ramp it up to firm. Or, if the same person keeps coming back with more and more advice, you may need to jump immediately to a firm place:

• I know you mean well, but we’re only taking advice from our doctor.
• Thanks, we heard the same study but our doctor told us not to worry about it.

Lastly, you may need to be a little more pointed in your response to get the advice to stop.

• I know you’re saying these things because you care about us but do you really think we’re not capable to taking care of ourselves?
• We really need a moratorium on the advice; all of the stories are simply giving us more stress than helping.

And if it continues after that point, a hearty, “shut the fuck up!” always stuns the crowd.

Er…um…oh, this was Grandma giving the advice? Then maybe a “shut your piehole!” is better?

No really, the beauty of a blog advice column is that you get to weigh in with your two cents too. Let the questioner know if you support the advice, add to the response, or dispute it completely. And you heard the girl: she wants the best assvice ever given to you.

Leave a comment in the reaction box below–only keep in mind that conflicting advice is embraced and rudeness is not. Want to ask your own question? Click here to see what you need to send in order to be included in a future Tuesday’s installment of Barren Advice.