Sunday, 12 November 2017

A few words about how we got pregnant (and at least as many in caveat)

Sprite and I are entering the third trimester, with no known complications so far other than mild gestational diabetes (I might write about that in another post, although there's not much to tell). So I feel mostly OK about writing a post about our success getting pregnant.

A few things you won't find in this post:

  • Advice on how to get pregnant unassisted. I'll say what worked for us, but I'm not claiming it will work for anyone else.
  • New scientific information. I wish I could give you the science of why conception happened this time, because that might be useful, but I don't know unfortunately, and neither does anyone else.
  • Trying to conceive woo (I don't believe in it, and I don't practice it.)
  • Lifestyle advice (again, I'll say what worked for me, but it isn't anything special)
So what's the point? Well, first I assume people are curious. I'm curious about other people. Secondly, there might be readers out there in similar circumstances who will find this information useful, anecdotal as it is. Lastly, perhaps it would be helpful to read someone be very matter of fact about how they beat the odds of infertility, which is what I intend to be. Don't get me wrong, Sprite and her older sister, AJ, are miracles that rock my world and my whole perspective on the universe. But that's a topic for another post, or several over a lifetime.  Lastly, as I move through this pregnancy, I'm thinking about ceasing to try to conceive, permanently. Part of this involves revisiting pieces of the odyssey, honouring them, and hopefully giving them their permanent place in the past.

Here is the summary of our fertility status. According to the doctors, both Mr. Turtle and I are infertile, but having achieved two pregnancies after our diagnosis, I think subfertile is more accurate. It's the word I use however, not the one our doctors use.

  • I was diagnosed with severe premature ovarian failure by our fertility doctor, Dr. Cotter. In her words, at age 33 my ovaries were functioning "like those of a 45 year old woman." The implication being that things would only get worse with age. After we had AJ however, she added "Clearly there are some young eggs in there."
  • Mr. Turtle has sperm counts that fluctuate from very bad to not so bad. He has Crohn's disease (currently in remission) and takes an immuno-suppressant medication. Either the disease or the medication or something about his current health causes a genital lymphedema that flares up periodically especially when he is sick. He has observed a drop in sperm count/quality when the lymphedema is bad, although Dr. Cotter said it shouldn't affect the sperm until 3 months later.
  • We have been trying to have children since the fall of 2011. There were periodic breaks, particularly right after Mr. Turtle was diagnosed with male infertility (which happened before my diagnosis) and for about 6 months after AJ was born. Other than that we've been trying pretty continuously on or own or with treatments (IVF in January 2014, and Clomid from September-December 2016). We haven't undergone that many treatments because Dr. Cotter did not see promise in many of the options. IUI was not initially recommended because of poor sperm count. IVF was tried once, but without great hopes, because my high FSH/low follicle count meant that my ovaries wouldn't stimulate (and they didn't).
So, with that information, what did I do?

  • I trusted my instincts. More or less. Even without the results of the medical tests, I could see that I did not ovulate all the time. My cycles tend to be around 24 days, and they can go as short as 15 days or more rarely, drag on for two months or more. However, I'm still more regular than not, and I have fertile signs such as stretchy mucous and ovulation pain maybe 60% of the time. When I temped, I got a rise in BBT on probably 2/3 cycles. I did get positive OPKs.  I'm definitely not optimally fertile. But I couldn't quite believe that I was completely infertile, either. It felt like my body was trying to do the right thing; it just didn't succeed a lot of the time.
  • I have used the OvaCue fertility monitor periodically, although I've found it less useful in the past couple years, for whatever reason. The OvaCue was how we timed sex to conceive AJ. But more recently I found I was getting very wonky readings and they were not so useful. So I did not use it for the cycle where we conceived Sprite or several of the ones preceding it. 
  • OPKs. I had the most success  with the non-digital kind. I liked to see the lines getting slowly darker as the fertile window approached. I would usually continue testing a few days after seeing the first positive, to see how long it stayed positive and when it went back to negative. Usually the test would stay positive for 2-3 days. I tested around noon. There were many days at school I'd go around with an OPK hidden in my pocket, trying to find a convenient time to sneak a peak. I dreaded leaving it somewhere accidentally and people starting rumours (because they couldn't tell the difference between it and a positive pregnancy test).
  • I took a daily prenatal. I've been on those things for most of the past 3 years. Prior to conceiving AJ I took only folic acid. Sometimes I'd get tired of them and go back to only folic acid.
  • In the summer of 2016, I started DHEA supplements and CO Q10 again, with Dr. Cotter's agreement. I took 75mcg of DHEA and 300 of CO Q10 until I think about January of 2017. At some point, I forget exactly when, I decided to reduce the dose. I had no very logical reason for doing so; I was just tired of taking pills three times a day. I went down to 25mcg of DHEA and I think 30mg of COQ10.
  • I took baby aspirin off and on. I did this because it was prescribed for our IVF cycle and I figured if it helped with implantation during IVF, it might help with natural implantation too. Sometimes I took if for the whole cycle, sometimes I only started after I confirmed ovulation. Sometimes not at all. I did take it for the cycle we conceived Sprite, but I forget when I started exactly. I stopped a few days after the first pregnancy test, on the recommendation of my family doctor who said he saw no point in continuing it.
  • I would usually take my BBT until I confirmed ovulation. For a few cycles I took it the whole time, but I found I was getting stressed about it particularly after confirming ovulation when I would start obsessing over the temperatures wondering if they showed conception or not. It started interfering with my sleep patterns. So I stopped taking it after 2-3 days of a confirmed rise.
  • I tracked changes in cervical mucous, as I found this a pretty consistent indicator of fertility, though not 100% consistent, of course.
My chart:

Summary in words:
  • Positive OPKs on days 10 through 12
  • Sex on days 7, 9 and 11
  • Temperature rise on day 10, with a dip on day 11, then another rise on day 12 and a fairly constant slow rise to day 17 when I stopped temping
  • Tender breasts days 11 through 18 (at least that's when I remembered to chart it)
  • High temperature recorded on day 29, when I figured I was a few days late. This followed by the first positive pregnancy test.
On Mr. Turtle's side, he had had one test in the fall of 2016 showing very low sperm count. Due to gaps in our appointments, we didn't know the results of this test  till January, but the sperm situation may have had something to do with why we didn't conceive on Clomid, as my ovulation was confirmed 3/4 times. However, I also had a very short luteal phase on Clomid, for whatever reason. In the spring Mr. Turtle re-tested and the sperm counts were much better, good enough for Dr. Cotter to recommend IUI as the next step. We were supposed to start that in June. I conceived Sprite in May.

And that's about it. We did much the same things on this cycle that we did on a dozen other cycles. But this time, it worked for some reason.


I was average weight, on the slender side. I generally eat a healthy and balanced diet, but I'm pretty relaxed about it too. There are no foods I avoid and no foods I eat especially for fertility. Stress affects my eating habits (I eat less). My job is fairly stressful, though usually manageable. I don't recall having high stress when we conceived Sprite. My stress was definitely much lower, for example, than when I was trying to adjust to my new job and being a working parent, and dealing with my dad's illness and death, etc. Our outlook toward trying to conceive was more positive then than it had been in a while, due to hearing about Mr. Turtle's improved sperm counts and having a treatment plan again.

I did not completely avoid caffeine, though never imbibed excessively. I had one cup of instant coffee most mornings (anything more made me feel sick).  I drank alcohol, mainly wine, periodically, once a week at most, often less. I generally avoided drinking when I figured I was in my luteal phase, but there were certainly days when I was like, screw it, a little bit won't hurt. Everybody has their limits, and one of mine is alterations in my diet. Trying to conceive means performing a lot of ritualized behaviours. Some of these I was OK with (to a point): Charting, taking pills, taking BBT, etc. Allowing ritualized behaviour to infringe on my food and drink choices, including my small pleasures such as a cup of coffee or a glass of wine, felt like a bridge too far. When I looked at it analytically, I felt there was no hard evidence it made any difference at all, at least not to me. So since I didn't want to change my diet anyway, I didn't. I share this in part to validate that it's OK to have boundaries around what you are willing to do when trying to conceive. Everybody has different ones, but whatever they are, my advice is to know and respect them. This shit can take over your life and drive you crazy. Don't let it.

That's about all. Why were we able to conceive? Here's my theory of subfertility:

  1. some people are fertile all or most of the time
  2. some people are infertile all or most of the time
  3. some people are infertile much of the time, but are occasionally fertile
I think we fall into group 3. Most fertility tests would put people in either group 1 or 2. Group 3 is hard to diagnose because they would have to be retested constantly to find the "fertile windows." The only way to know if you are in group 3 is by experience. Two pregnancies in 6 years does not = great fertility, but qualitatively and quantitatively, it's a helluva lot more than zero.  We are extremely lucky.

As always, love and light to all who stop by to read.