ADVICE LIST: DO THIS…DON’T DO THAT…blah, blah, blah

I’ve experienced handfuls of well-meaning but ignorant advice. I understand that people are trying to be nice and offer this advice to help me and not harm me, but it still stings deep even though I know I shouldn’t take it personally.

First it was the “Don’t” Advice List. People told me, don’t do this and don’t do that. I’ve been told, “Don’t think about it.” (Well, I’m sorry but I do think about it as there are constant daily reminds everywhere!) “Don’t stress about it.” (I do stress about it because it’s a deep desire in my heart.) “Don’t take it so seriously.” (I do take it seriously because it affects every aspect of my life.) “Don’t worry, you’re young.” (I worry because even though I am “young,” studies show your most fertile age is before the age of 24.)“Don’t be sad.” (And I am sad because all I’ve ever wanted is to be a mother.)

Then it was the “Do” Advice List. They said, “Take a vacation.” (How many vacations does this mean? Because we’ve been on 8 since trying to get pregnant and it hasn’t happened.) “Adopt and then it will happen.” (Statistics show only 1 in 4 will go on to have a biological child after adoption.) “Relax.” (Ha…good one.) “Enjoy your time without children.” (We have…for over 5 years of married life, but now we’re ready for our family.) “Get a pet.” (We gave in to this one. We got a fish. Didn’t work. He died.)

Be careful when giving advice to someone experiencing infertility. Good and honest advice can be hurtful and/or taken the wrong way even with the best of intentions. Maybe offer support instead of advice. After all, we know you don’t have the answers, ultimately, we just want someone to care.

THE DREADED WAITING ROOM FULL OF THE PREGGERS

As I went to my first appointment alone and as I was sitting in the waiting room, I experienced my first public infertility “sick to my stomach” occurrence. Due to the fact that “infertility” is included among the OB/GYN department at the clinic where I live - there isn’t a separation. This means that every time I went in for an appointment, I had to sit in a waiting room full of pregnant women. As I looked around the room, I kept looking back to one young girl with a big ol’ preggy belly sitting next to who I’m assuming was her mother. She didn’t look too enthused to be there and she looked to be around 17years old, at most. I just didn’t get it. Why would God allow her to get pregnant and not me? Couldn’t he just pass her pregnancy over to me? She obviously didn’t want it. Please, someone, pull this knife out from my chest!

During many appointments after, as I’d look around admiring all the preggy bellies, I often wondered if those women thought I was pregnant myself. They probably never knew the hurt inside of me as I looked at them full of jealousy for their little blessing they had growing inside of them! Oh what I’d give to be them! Thank goodness no one ever asked me anything like, “Oh, when are you due?” because I don’t know if I could have held the tears in. I’d page through all the baby magazines and fliers they had laid out to read, daydreaming about how maybe, just maybe, someday I could subscribe to these magazines too!

I had many other experiences sitting in that dreaded waiting room. It never got any easier. But I told myself every time that someday that would be me sitting there with a big honkin’ pregnant belly.

PRAYER SHAWL

Nick and I received a prayer shawl from my mom that she hand crocheted herself as a gift for us. She makes these in a “Prayer Shawl Ministry” group where she lives. This group makes these shawls to bring physical warmth and spiritual comfort. They are intended to be a reminder of God’s ever present love. It is a gift for every time and every occasion – joyful or sorrowful, for easy season and circumstance of life – chosen or unchosen, when you are weeping or when you are celebrating.

We love this quilt and have had it on our bed since the day we received it.

Here is the note she included:

Dear Amy & Nick,

This prayer shawl is made especially for the both of you with lots of love and lots of prayers. Some day you will look back on this time in your life and know some of the answers about a baby coming to share your life and your home. Hopefully and prayerfully this will happen soon for you.

The main color I have chosen is a soft white. White symbolizes peace, spirit, innocence, purity, gentleness, protection, and perfection. A baby is an innocent little person and so perfect to parents, grandparents, and all it’s family. I know you can look at all of the words above and somehow it seems to fit that tiny little person.

I chose to use a single stand of color in each group of fringe, three in number to represent the Trinity. I didn’t look at the meaning of the colors until I finished the shawl – fringe included – and it seems that each symbolic word shows what a parent needs to have for their parenting skills and what a child needs to grow. But most of all, and I know you will, teach your child/children about God. The other most important thing you can do for them is to love each other, which I know you already do.

Pink – compassion, sensitivity, generosity, strength, nurturing
Yellow – wisdom, learning, optimism, intuition, well-being, friendliness
Green – healing, prosperity, clarity, sympathy, hope, confidence, growth, life
Blue – healing, meditation, tranquility, honesty, loyalty, communication, judgment, sincerity, wisdom, and self-esteem

I love you guys will all my heart,
Mom

WHY ME?...WHY NOT ME?

I’ve asked this question all too often. Why me? It just doesn’t seem fair. Why can promiscuous teenagers, prostitutes, unmarried women, and ones who can’t afford to have a baby get pregnant? But I can’t.

I know everyone asks, “Why me?”. It’s asked by the 35 year old who hasn’t found a husband yet so desperately wants one. It’s asked by parents who lose their 10 year old to cancer. It’s asked by someone who has been out of a job for over a year. Why me?

Maybe I don’t want to know why. And maybe if I did truly know why, I wouldn’t like what I heard. Or perhaps if God did reveal the answer, would my puny little earth brain even be able to comprehend? Probably not. (That’s why I’ll probably just wait to ask all the “why me’s?” when I’m in heaven.)

Or if I did know and understand it, wouldn’t I lose the whole purpose of this journey? I’m determined to learn something in this process. And if I haven’t learned anything yet, I guess this journey isn’t over quite yet. Maybe it’s a big wake up call that we are all in need of a Savior and Redeemer. We need to realize that we’re not in this alone and we need to lean on God for support and guidance. Maybe it will strengthen my relationship and point others to the same relationship.

I asked “Why me?” for so long that it didn’t even cross my mind to think, “Why not me?” So, why not me? Really? Why not me? I often think I’m taking this burden in the place of someone else – so they don’t have to go through it. It helps me get through. And it helps me stay strong.

I’ve decided to try to not dwell too long on the “Why Me’s?”. So, for today I’m asking, “Why not me?”.

THE ALPHABET SOUP OF INFERTILITY

The world of infertility has many crazy technical terminology (why those words are so long, confusing, hard to spell and even more difficult to pronounce, I’ll never know!) and even more crazy abbreviations. I was thrown into this big bowl of alphabet soup and was immediately overwhelmed. It’s all so complex and confusing!

Most of what I know came from my lovely friend, “google search.” He’s never let me down yet. We’ve become very close and he’s given me lots of good leads on some promising information from both medical professionals and just normal blogs from normal people!

Here are just a few examples of the INFERTILITY LINGO I’ve come all too familiar with:

ART = Assisted Reproductive Technology
BBT = Basal Body Temperature
BCP = Birth Control Pill
BSE = Breast Self-Exam
E2 = Estradiol
EDD = Estimated Due Date
ENDO = Endometriosis
EPT = Early Pregnancy Test
ET = Embryo Transfer
FET = Frozen Embryo Transfer
FSH = Follicle Stimulating Hormone
GnRH = Gonadotropin Releasing Hormone
hCG, HCG = Human Chorionic Gonadotropin
HPT = Home Pregnancy Test
HSC = Hysteroscopy
HSG = Hysterosalpingogram
ICSI = Intra-cytoplasmic Sperm Injection
IF = Infertility
IM = Intra-muscular Injections
IUI = Intra-uterine Insemination
IVF = In Vitro Fertilization
LAP = Laparoscopy
LH = Luteinizing Hormone
LMP = Last Menstrual Period (start date)
LP = Luteal Phase
LSP = Low Sperm Count
MF = Male Factor
O, OV = Ovulation
OB/GYN = Obstetrician/Gynecologist
OC = Oral Contraceptives
OHSS = Ovarian Hyperstimulation Syndrome
OPK = Ovulation Predictor Kit
OTC = Over The Counter
P4 = Progesterone
PG = Pregnant
PI = Primary Infertility
PIO = Progesterone in Oil
PMS = Pre-menstrual Syndrome
RE = Reproductive Endocrinologist
SA = Semen Analysis
SHG, SonoHSG = Sonohysterogram
TSH = Thyroid Stimulating Hormone
TTC = Trying to Conceive
US, u/s = Ultrasound

There are also some “non-technical terms” that are common to the infertiles, such as:

2WW = 2 Week Wait
AF = Aunt Flo (menstruation)
BFN = Big Fat Negative
BFP = Big Fat Positive
BMS = Baby Making Sex
FTTA = Fertile Thoughts To All
ONNA = Oh No, Not Again
CBNBC: Childless But Not By Choice

FEEL WHAT YOU FEEL

I think I’ve felt every emotion humanly possible. And when I thought I had conquered feeling one way once and for all, suddenly it appeared back again to haunt me. I struggled for years with these feelings, trying to make them stop. I tried to convince myself that I shouldn’t be feeling that way. And it seemed that everyone told me to NOT feel a certain way. Give yourself the freedom to feel what you need to feel. Don’t try to adapt your feelings to the expectations of others!

After all, there could be much “worse” things that could be happening in my life, such as a death of a family member or a disease, such as cancer. I remember reading somewhere that you can’t say “someone has it worse” because truthfully, “someone is always going to have it worse.” And who’s to say your struggle is worse than another? In fact, studies show that infertility is oftentimes as stressful and life altering as a death or disease like cancer. Little did I know, I had been minimizing my own feelings for something so heartbreaking and traumatic as infertility.

I thought I needed to stop being obsessed over what I wanted instead of being thankful for what I had right in front of me. And to an extent, this is true. My father always says, “Count your blessings.” And I do, I really do. But what I needed to understand is that it doesn’t mean you need to stop desiring for those other things you hope to achieve in life.

I was so tired of running and hiding from my feelings that I was missing a huge part of the whole process. How could I experience these things and move on if I was holding everything back? I remember driving through town one day, and it literally dawned on me, “Feel what you need to feel!” I finally recognized that it was okay for me to feel how I felt. I gave myself permission to feel. What a relief it was!! I felt an incredible relief. I was so thankful for this epiphany!

I decided that I can be sad if I want to be sad. I can be happy if I want to be happy. Why else did God give us emotion? We have feelings for a reason – both good and bad – they’re a gift from God. We have tears because sometimes, they need to be cried. And there’s nothing wrong with that. I learned not to downplay my feelings and to recognize that it is difficult. So, do just that - feel it, deal with it, and keep moving on. Feel the feelings, but don’t let yourself get stuck on one. Feel it and move on to the next!

Am I proud of the way I’ve acted or all the emotions I’ve had? Not all of them – that’s for sure. But I know they were real and I shouldn’t be ashamed to have felt them. It’s all part of being a human, and as humans we born into sin. I don’t know if there’s anything I could have done differently. I’m far from perfect, but I’m worthy enough to appreciate my feelings.

I was so tired of people telling me how NOT to feel. But please FEEL WHAT YOU NEED TO FEEL! Don’t let anyone tell you HOW or HOW NOT to feel. Don’t hide from your feelings. Feel how you need to feel and always encourage others to let their emotions out.

WHAT IS SPERM WASHING?

This information is taken from: www.fertilityplus.org



Sperm washing is a laboratory technique for separating sperm from semen, and separating motile sperm from non-motile sperm, for use in assisted reproduction (IUI, IVF).


The washing technique for near normal specimens is mixing the ejaculate after liquefaction with the appropriate washing medium followed by centrifugation. (A centrifuge is a machine that separates materials with different densities by spinning them at high speed.) The supernatant is discarded and the sediment (sperm rich fraction) is re-suspended in more washing medium. This process is repeated 2-3 times maximum. In the final wash, the sediment is re-suspended in 0.5 cc of medium, loaded into a syringe and deposited in the uterus.

The "Sperm Rise" or "Swim-up" technique is one in which two to five cc of medium are carefully layered on top of 0.2-0.5 cc of semen. Motile sperm cells "swim-up" into the culture medium. After some time (30-90 minutes) the medium (containing motile sperm cells) is carefully harvested and centrifuged. If necessary, fresh medium is layered on top of the seminal fluid again to harvest more sperm cells.



The discontinuous gradient centrifugation technique utilizes a dense liquid phase to separate sperm cells from seminal fluid and debris. There are different compounds commercially available that may be used. Semen is deposited on top of this fluid and subjected to centrifugation. Motile sperm cells migrate to the bottom of the tube, which are used for IUI after further washing.

WHAT IS AN IUI - INTRA UTERINE INSEMINATION?

An IUI -- intrauterine insemination -- is performed by threading a very thin flexible catheter through the cervix and injecting washed sperm directly into the uterus. The whole process doesn't take very long — it usually only requires the insertion of a speculum and then the catheter, a process that maybe takes a couple of minutes (60-90 seconds to introduce the catheter, then sperm injection, and another 60 seconds or so to remove the catheter — going slowly helps reduce discomfort). Sometimes when the cervix is hard to reach, a tenaculum is used to hold the cervix, which makes the process a bit more uncomfortable.



An IUI has 5 basics steps. This information is from www.advancedfertility.com

1. The woman usually is given medications to stimulate development of multiple eggs and the insemination is timed to coincide with ovulation - release of the eggs.

Many doctors monitor follicle development during IUI cycles. Most trigger when the dominant follicle is within a certain size range. While there is always some difference in doctor preference, the norms are unmedicated 20-24mm, clomiphene citrate 20-24mm, FSH-only meds 17 or 18mm minimum, and FSH+LH would be 16 or 17mm minimum. It is possible for slightly smaller follicles, 14-15mm, to contain a viable egg. Also, follicles continue to grow until they release, usually at a rate of about 1-2 mm per day. A woman may ovulate more than one follicle in a cycle, but the releases will occur within 24 hours. When hCG is not used, only follicles close in size are likely to release. The use of hCG induces ovulation in about 95 percent of women, and will get most mature follicles to rupture.

2. A semen specimen is either produced at home or in the office by masturbation after 2-5 days of abstinence from ejaculation.

Usually the semen sample is collected through ejaculation into a sterile collection cup, but it is also possible to obtain collection condoms for this purpose. Most clinics want the semen to be delivered within a half hour of ejaculation, around the time of liquefaction, so if one lives close enough the sample can be collected at home. If not, one has to make do with a room at the clinic, a bathroom, or any private setting.

3. The semen is "washed" in the laboratory (called sperm processing or sperm washing). The sperm is separated from the other components of the semen and concentrated in a small volume. Various media and techniques can be used for the washing and separation. Sperm processing takes about 30-60 minutes.

There is a delay between when the semen sample is dropped off for washing and when it is inseminated. The amount of time depends on the washing technique used, which takes 30 minutes to two hours, as well as on the clinic's scheduling. Most will perform the IUI as soon after washing is completed as possible.

4. A speculum is placed in the vagina and the cervical area is gently cleaned.

5. The washed specimen of highly motile sperm is placed through the cervix into the uterine cavity using a sterile, flexible catheter.

The intrauterine insemination procedure, if done properly, should seem similar to a pap smear for the woman. There should be little or no discomfort. Most clinics offer for the woman to remain lying down for a at least 15 minutes after the procedure.

Ideally an IUI should be performed within 6 hours either side of ovulation — for male factor infertility some doctors believe after ovulation is better, otherwise chances of success are higher with insemination before ovulation with the sperm waiting for the egg. When timing is based on an hCG injection, the IUIs are usually done between 24 and 48 hours later. Typical timing would be to have a single IUI at about 36 hours post-hCG, though some do it at 24 hours, and some clinics are reporting better results when doing the IUI at 40-42 hours post-hCG.

Some doctors will base timing of IUI on a natural LH surge. In that case, a single IUI at 36 hours is the norm, but doing them at 24 hours is also pretty common since ovulation may be a bit earlier. The egg is only viable for a maximum of 24 hours after it is released.

MY FIRST IUI: UNEXPECTED TORTURE

My first IUI (Intra Uterine Insemination) was anything but normal. In fact, I would say, it went horribly horribly bad. It’s supposed to be a quick, easy, painless procedure. But apparently, my cervix wasn’t opening correctly so the doctor had a hard time getting the catheter passed through. It lasted a long time when it’s only supposed to last less than 30 seconds. He finally got it through, but I started having the most intense cramps I’ve ever experienced.

Now I must tell you that throughout my life, it is common for me to experience horrible menstrual cramps every month, especially on the first day of my cycle. The pain can become so intense that I vomit. In high school, I would miss school and sometimes in my adult life, it caused me to miss work. I’m used to it, and yes, it totally sucks, but I deal with knowing that if I can just take enough drugs and fall asleep, I can hopefully get through the worst of the pain. I’ve always thought that since I’ve had to deal with this every month, maybe, just maybe that means that when it comes time to deliver a baby – that little bugger will just pop right out, as simple as that!

After the IUI, you are required to lay there for 15 minutes or so. As I was experiencing these horrible cramps, I compared it to combining the worst 5 months of cramps I’ve ever had, putting them all together, and giving me that pain all at the same time. I thought my uterus may just explode right then and there. I ended up vomiting 3 times. (A beautiful mix of my breakfast of orange juice and a banana. Yuck!) Now keep in mind that vomiting is extra difficult to do when you need to stay laying on your back. I started becoming extremely hot and sweaty. My vision started getting fuzzy and I also started shaking. I thought something was seriously wrong and that this just might be the end for me. As ridiculous as that sounds, it was true. I knew something was wrong and I was fearful. The doctor came back in to check on me. My heart rate was really low and he explained that I was experiencing a Vasovagal Response. It’s the central mechanism leading to the loss of consciousness. There are many different things that trigger this, but in my case it was a result from experiencing intense pain from the cramps.

Naturally, after this was over, I thought to myself, hey, this pain is worth it and it must mean that this HAS to be THE TIME WE GET PREGNANT. But, of course 2 weeks later, here comes the heartbreaking moment when I get my period. Defeated once again…frustrated once again…angry once again…

INFERTILITY ETIQUETTE By Vita Alligood

Yet another wonderful article by Vita Alligood!

INFERTILITY ETIQUETTE By Vita Alligood

Infertility is, indeed, a very painful struggle. The pain is similar to the grief over losing a loved one, but it is unique because it is a recurring grief. When a loved one dies, he isn't coming back. There is no hope that he will come back from the dead. You must work through the stages of grief, accept that you will never see this person again, and move on with your life.

The grief of infertility is not so cut and dry. Infertile people grieve the loss of the baby that they may never know. They grieve the loss of that baby who would have had mommy's nose and daddy's eyes. But, each month, there is the hope that maybe that baby will be conceived after all. No matter how hard they try to prepare themselves for bad news, they still hope that this month will be different. Then, the bad news comes again, and the grief washes over the infertile couple anew. This process happens month after month, year after year. It is like having a deep cut that keeps getting opened right when it starts to heal.

As the couple moves into infertility treatments, the pain increases while the bank account depletes. Most infertility treatments involve using hormones, which alter the user's moods. (That statement is like calling a lion a cat-my husband would tell you that the side effect is insanity!) The tests are invasive and embarrassing to both parties, and you feel like the doctor has taken over your bedroom. And for all of this discomfort, you pay a lot of money. Infertility treatments are expensive, and most insurance companies do not cover the costs. So, in addition to the pain of not conceiving a baby each month, the couple pays out thousands of dollars, depending upon the treatment used.

A couple will eventually resolve the infertility problem in one of three ways:
• They will eventually conceive a baby.
• They will stop the infertility treatments and choose to live without children.
• They will find an alternative way to parent, such as by adopting a child or becoming a foster parent.

Reaching a resolution can take years, so your infertile loved ones need your emotional support during this journey. Most people don't know what to say, so they wind up saying the wrong thing, which only makes the journey so much harder for their loved ones. Knowing what not to say is half of the battle to providing support.