tab-worthy
flanked by dr. 19-weeks and dr. 28-weeks in grand rounds yesterday [i love them both, but yeesh], i thought about how much it has helped me in recent weeks to share my story with others. when i have a problem or receive bad news, my go-to coping mechanism is almost always to talk about it with someone — or many someones — rehashing things and telling my story again and again until it starts to sound normal and okay.
i guess that’s one of the reasons that this whole blogging thing has worked out.
but it actually took me well over a year before i felt comfortable opening up about my (unmet) desire for a baby. here, i declared that i wanted to be pregnant by the end of 2010 (umm, great achievable goal, SHU); here i start to discuss the possible contribution of running to my infertility and in this post i am a bit clearer in relating things from the beginning.
however, i do not have a post where everything is clearly laid out. instead, it’s all in bits and pieces, with mysterious acronyms and vague allusions. this is because in the earlier stages, i still had some denial/doubt/shame/guilt surrounding the issue, and i just didn’t feel ready to share. but now i’m over that; i’d probably tell the UPS guy if he asked nicely!
since i know there are some of you who may be going through similar experiences, i thought it would be useful to write a post where i just lay it all out there. (and let’s face it — it’s also therapeutic for me. win/win!)
first: a glossary
have you ever read a blog about someone trying to have a baby only to have your eyes gloss over from all of the weird terminology and acronyms? (i did! and i thought after med school i knew every acronym that had ever existed!)
TTC: trying to conceive
BBT: basal body temperature (referring to charting that is done to help predict ovulation)
BFP/BFN: i hate these acronyms, but they stand for ‘big fat positive’ and ‘big fat negative’ respectively. or, you can insert your favorite colorful “F” word, which seems reasonable in either case to me.
a BFP! but definitely not my BFP
O: ovulate. get your minds out of the gutter.
DPO: days post ovulation.
OPK: ovulation predictor kit = urine test strips that sense LH, which surges 36 hours prior to ovulation. this can be used in conjunction with BBT to predict the most fertile days of the cycle.
HSG: test in which they put a scope into your uterus, squirt dye in there, and watch to see a) filling of the uterus (to check for any defects in the wall, like polyps) and b) spilling of dye through the tubes into the peritoneum (to make sure they are patent and go where they are supposed to). i got to experience this yesterday, and for me, this test was extremely painful. put it off if you can!!
EWCM: yep, there is an acronym for this sign of a fertile cervix!
RE: reproductive endocrinologist (ie, OB/GYN who does an additional fellowship specializing in infertility)
my story
no, i will not be discussing anything related to my own CM (“EWCM” or otherwise) — that’s just crossing the line. but most of the rest is fair game. i think that a chronological organization makes the most sense here, so here goes:
■ january 2009: josh and i feel ready (we think) for a baby, and i had wanted to take advantage of a special ‘newborn month’ built into the pediatrics fellowship — a whole extra 4 weeks at home, mostly with the baby, added onto maternity leave! sounded like a great plan to me! so i stopped my seasonale. i had been on OCPs of some kind at that point for ~7 years.
■ march 2009: huh, no period. interestingly, i noted that i lost a few pounds unintentionally when i stopped taking the hormones. i have to admit i considered this a bonus [for reference, my BMI went from around 20 –> around 19; i was never underweight]. i was running 30ish miles/week, training (casually) for the upcoming charlottesville half. my 2nd niece ellie was born, and i remember thinking about how excited i was for the day we would have our own baby to hold.
■ may 2009: huh, still no period. well, maybe it’s not SUCH a bad thing — after all, i get to drink as much champagne as i please on our napa/sonoma vacation!
■ june 2009: hmm, it’s 6th months post pill, and still no period. i decide to see an OB/GYN to see what might be causing my post-pill amenorrhea. i get my first ultrasound, and my ovaries look like this. i remember crying on the table.
■ july 2009: referred by the OB, i report to the duke fertility center for an evaluation. i have a number of labs drawn, ruling out ‘easy’ fixes: thyroid, prolactin, even nonclassical CAH — all normal. my LH and FSH are normal (6.9 and 7.1, respectively), my estradiol on the low side, and my fasting glucose and insulin 70 and 1.7 (superlow!) respectively. my testosterone level was normal for a female. i remember having these labs drawn at the end of a 30-hour shift, stumbling to the clinic having fasted for 14+ hours.
discussing the results with the RE, she is reluctant to put me in any sort of neat category, but states that with my ultrasound findings and amenorrhea, she would treat me like a patient with lean PCOS. she gave me a course of provera to induce a cycle, and . . . it worked! the plan was to begin clomid soon.
■ december 2009: PR marathon! but because both josh and i were starting to get nervous about what would happen with his career (there was a period when we didn’t know if he would be able to find a local fellowship), i decided not to start right away on the clomid. (after the withdrawal to provera, i was still cycle-less.) by this point, i did start to wonder whether my mileage/lifestyle was contributing to the problem. i hoped that everything would sort itself out after the marathon, though i planned to continue running ~30 miles/week. (after all, the RE would have told me to stop if she thought it was a problem, right?)
■ january 2010: niece maelie (#3) is born. i am excited but i have to admit there were pangs of envy, too. i had started TTC before she was conceived, and now she was here.
■ april 2010: we find out that josh will be going to duke for his vascular fellowship! still no period. i am (almost) ready to start the clomid, although i am nervous about the possibility of twins.
■ june 2010: we get genetic counseling. because we both have ashkenazi judaism in our genetic pedigrees, combining of our DNA means there is risk for a number of recessive conditions, none of them good. luckily, i tested 100% clean (so josh didn’t even need to have his blood drawn).
■ september 2010: i begin adjusting to life in fellowship and i finally get my act together, starting my first cycle of clomid at the lowest dose. according to the mid-cycle ultrasound, i respond to this beautifully. i am not sure whether to be thrilled or crushed when my cycle arrives right on schedule 30 days later.
■ oct – december 2010: the RE increases my dose, hoping to stimulate even more follicles to reach the finish line. however, each cycle is a failure. i never got the follicular growth that would have been expected, and a blood test confirmed LACK of ovulation in cycle #3. at this point, josh laid down the gauntlet and after reading papers like this one he basically decided that i needed to essentially stop running. he also felt i should gain some weight. i did not like either of these ideas one bit.
■ december 2010: i finally agree to cut my mileage — drastically — while working on my nutrition. i wrote about it a bit in this post — talk about an unusual resolution! i also saw an RD for the first time, and she really encouraged me to work on bringing my body fat up a little.
■ january 2010 – february 2010: i have two ‘successful’ cycles on the highest dose of clomid. ‘successful’ here means that my ovaries responded well. each time, i was prescribed injectible HCG to help precisely time ovulation. however, neither cycle ended in a BFP. i am sure the effects of the medication on my mood probably are not helping, but each time i was hit pretty hard.
■ meanwhile: i am still running only 11ish miles/week, supplementing with (a fair amount of) yoga and weight training. admittedly, i’ve even added in a bit of elliptical on the days that i do lift weights. with these changes, i have gained probably around 5 lbs in just 2 months, bringing me up to a BMI near 21. this does not sound huge, but it was FAST, and this is bigger than i have ever been in my life. as i mentioned before, my clothes are not working so well for me right now and i have to admit i am pretty uncomfortable with the changes. even the RD agrees that it would be fine for me to shift my focus to stabilizing at this size. [translation: no more coconut milk ice cream ‘just because i can’! and i have to say i’m oddly relieved by this.]
■ to be continued: i am on an unmedicated cycle right now, which will be an interesting physiology experiment for me, as it will be the first time i get to see what my (less athletic) body does WITHOUT an extra push from hormones. i am not sure what the next step is going to be after this, but will find out at my next RE appointment in march. i am still working on taking this whole thing more in stride, capitalizing on the time and freedom we have right now. but in truth, i’m still really, really hoping for a BFP.
and i’ll keep you all posted! although i will say that when it does finally happen for us, i am not sure when i will reveal it in this forum. part of my feels like, “well, if i can share all of THESE details, what’s the difference?”; however, others have urged me to keep things quiet for the first 10-12 weeks. i think i will leave it up to josh — after all, at that point, the story will be ours, not just mine.
if you’re still reading,
thank you! and another special thank you to those of you who have written in to share your own TTC stories — it always feels good to know that i am not alone in a lot of this. as always, please feel free to comment, or to email me if you have any questions or suggestions!
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2.22.11
workout: 30 minutes elliptical, levels 9 – 11 + weights (NROL4W phase 1, workout A, week 3):
— 2 x 12 squats (bar + 20 lbs, up from 15)
— 2 x 12 pushups (regular pushups)
— 2 x 12 seated rows (50 lbs, up from 45)
— 2 x 12 each leg – step-ups (high bench, holding 10 lbs total)
— 2 x 10 jack-knife crunches on ball
tv dinner: for the first time in years, josh and i enjoyed dinner while watching TV (come on, glee was on!!)
this real simple recipe was a step up from your standard tv dinner.
roasted tomatoes, swiss chard, raisins, and chickpeas with brown rice
(i added that little bit of goat cheese for good measure and it worked!) i won’t say this was the most exciting dish i’ve ever had but it was easy and healthy.
27 Comments
Sarah thank you so much for sharing with us all that you have been going through. I hope you know and recognise that many of your readers (myself included) find you inspiring and admire the courage you have to share your TTC story with us all. I remember you in my nightly prayers (to send some positive vibes) and I am truly hoping that everything works out for you.
thanks for sharing. my fingers are crossed for this cycle!
i have a few friends that seem to be going through something much like this right now, with all the fun of lots of tests and lots of questions without answers. although i’m not quite there yet, i know that the having (or starting to try to have) a baby isn’t THAT many years away and there is a small part of me that is already worried.
p.s. i can’t believe that you are encouraging putting off a test!!!
to clarify: of course, if the doctor says it’s important to get right away, i definitely think one should get the HSG! my RE posed it as an ‘option’ at first, saying that i could wait to see what happened after a few cycles. but if it’s an option to wait and the RE doesn’t feel it’s high yield, i would say that’s the way to go — just because of how unpleasant it is — plus, it’s radiation exposure, even if it’s just a small amount.
Thank your for sharing your story. I just know that it will happen for you soon!
I think it takes great courage to write about something like this, and really admire you.I am hoping and praying that this important change comes in your life at the earliest.
Best of luck Sarah. Stay positive and I am sure things will happen for you and Josh. Know that many women go through this.
Although I’ve read most of it on the HA board, thanks SO much for sharing your full story. My story is very similar, and it really helps to know that I am not alone. This whole process is beyond frustrating, and but hopefully it will only make us better, stronger mothers in the end.
I admire your courage to post the complete story. Only my mom and best friend are aware of my situation. I just haven’t gotten there yet in terms of sharing with everyone. That, and I think I would start crying uncontrollably when I start telling someone.
My fingers are crossed for you that you cycle successfully on your own this March!
Thanks for sharing Sarah. I really enjoyed reading 🙂 Stay positive!
I really enjoyed reading your story, especially since I am still a relatively new reader. I don’t know if this will encourage or scare you, but my aunt and uncle tried for 5 years before having their first baby, now they have 4 (ah! but not all at once thank goodness) amazing kids. I know the waiting and wondering and stress is awful, but it will all be worth it in the end 🙂
Thanks for sharing this. I was diagnosed with the more common variety of PCOS a very long time ago. While I’m not TTC yet, my period is mostly MIA (wow, I’m acronym happy today). I think it’s great that you’re not staying silent about it and I hope to have that courage too!
This has certainly been a long process! I hope it all works out soon. I’m sorry you’re feeling uncomfortable too. I know what 5 pounds does to us small peops, but you probably look great!
thank you for sharing your story – it showns tremendous courage on your part! Stay positive and things will happen, one way or another. All the best to you and Josh!
I would not suggest putting off the HSG. I have seen maybe a dozen cases over the years where once the tubes were blown out during laparoscopy BFP!!
In my thoughts and prayers
thanks, lac. maybe the tube ‘flush out’ was what i needed! i guess we’ll see. i was patent on both sides. (i’m lucky they were even able to finish the test – i practically had to make them stop. don’t know how well i’m going to with the actual childbirth part if that was so bad!! but at least in the latter case, you can get an epidural . . .)
wow, thanks for sharing your experience. i haven’t been a reader since you started ttc, so i really had no idea what you had gone through before i started reading. i’ll hope for good news for you and josh soon!
Thinking of you!! My HCG test was very painful as well, they couldn’t get through my cervix at first and had to remove everything and start again – OUCH!! I’m glad you have this over with, it was the most painful thing of my whole TTC journey, IUIs were pretty much a breeze (if you ever go that route).
I was also referred in July 2009 to the Duke Fertility Clinic, didn’t know we were there the same month; I started treatments in August 2009.
I can’t wait for the blog entry where you let us all know that all your hard work and the long wait has paid off. I have complete faith that it will happen and can’t wait to celebrate from far away for you and Josh. You’ll make wonderful parents for whichever little soul is out there waiting for you. I understand the waiting for second trimester to announce, since that’s what we’ve always done. However, the really selfish part of me wants you to yell it out to the world ASAP because I’m so excited for you! Either way, best of luck to you and Josh.
Also, I’m all for buying nice clothes that fit your current body and will continue to fit for first trimester and postpartum. There is a lot to be said for feeling good about yourself and your body–and the amazing things it can/will do for you. It made a world of difference for me when I’ve had trouble dropping the extra 15 (!) pounds from having Henry. I took myself on a moderated shopping spree to Banana and haven’t looked back. You should do the same with Anthro!
Thanks for sharing, Sarah! I know that when it affects you, it seems that no one else have that "issue," but it’s amazing how many people actually have trouble TTC. I must admit that, though I’m (unfortunately) no where near even TTC (no man in my life right now!), I have fears that it will be difficult for me to conceive. Don’t know where that fear comes from, but it’s there. I hope that all of your efforts prove to be beneficial in your desire to have that baby! You never know, I’ve known people to "take a break" from the medications and…surprise!
thanks for sharing your story, Sarah! What a roller coaster you’ve been on – TTC is so hard for some people, and I think having someone like you to relate to is so important. I do foresee myself having similar problems like you when I’m ready, and it’s so scary to even think about, let alone go through. But I know it will happen for you – wishing you continued luck and well wishes 🙂
Wow, thanks for being so open and honest with a very emotional issue.
I am definitely commenting as an outsider in terms of trying to conceive. However, I work at a place that is experiencing a major "baby boom" among faculty and staff. I think – no, I know – that there are 2-3 women pregnant every year. That’s a rough estimate, but I always joke that I’m not drinking the water. I’m actually the only married woman of child-bearing years who has NOT had a kid in the past 5 years.
However, I do know that this environment can be hard on those who are trying to conceive. It’s a small community so there is much hoopla when a woman is pregnant and/or has the baby, which is great on one hand. On the other, I know that other people have struggled with it, and I do feel for them.
i love how honest you are! and brave in sharing what is an emotional issue for many people. thank you for this post. it might not have been meant for a reader like me (not trying to get pregnant in any way) but i loved it anyway. i’m someone who benefits from talking about things that are bothering/stressing me so i totally understand why you wrote this post. i totally am sending good vibes your way! fingers and toes crossed for you.
It seems like there is such a big group of women and bloggers who are TTC right now…I’ve already come across several. I can’t say I can relate as I don’t ever want children, but I understand the desire and the frustrations that come with it. I also know many couples who are very hush-hush about this, and I commend you for being so open about your struggles.
definitely tab worthy. hang in there!
Thanks for sharing your story…
I was thinking…that right around the time we met you guys for brunch in July 2009, I had no idea what was going on with the ttc stuff, but I remember talking to you about ttc and I want to apologize for any insensitive comments I may have made. I think I was thinking that it would be easy for you guys and it would happen soon…
I now never ask anyone whether or not they are ttc, because it could be a sensitive topic. Or should I?
I’m way to young to even think about kids, but I pray that conceive soon!
Your journey has been amazing so far, and it’s wonderful to read your optimistic tone throughout..
As a side note, your blog is such a joy to read! I truly admire your organization/cooking/writing skills.
Best wishes to you and Josh!
KT
I am catching up on posts – thank you for sharing this story. I do not know much about TTC other than it can be a roller coaster of emotions, tests, hormones, and disappointments, and your post has given me new perspective on your situation specifically and TTC generally. Thank you for having the courage to share more on such a personal topic.
As a med student (2nd year) who also has PCOS, I want to thank you for your blog. I love all your posts and appreciate how much you’ve shared. I was wondering if you saw the Today show last week where they discussed infertility. A really interesting part to me was how women who joined infertility support groups had higher rates of getting pregnant. This was the best link I could find to it. http://www.parenting.com/blogs/show-and-tell/mela…