Fierce Fertility

facing fertility and searching for a balanced life

Post Retrieval Details

probing-questionsI learned so much during my several fertility cycles. Many things I was familiar with and some information was completely new, confusing and surprising. After doing a successful egg freezing cycle, we decided to do embryos for our next round. Not only can you do genetic testing, but embryos are much stronger, so there is a greater chance they will survive the freezing and thawing process. By the time I went through the embryo cycle I had been in the fertility world for about a year so I felt pretty seasoned and informed. I assumed it would be the same as before (besides the addition of sperm of course), but I didn’t think to ask too many questions and I wasn’t given much new information from my doctor.

Unfortunately, during the process, I learned several new things I wish I had known before starting. While going through IVF, every day felt like an eternity. Constantly waiting for results, appointments and green lights to go forward. I’m the kind of person who likes to be in control at all times so I definitely wish I was better educated on the steps that occur after eggs have been retrieved:

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Career or Baby – What Comes First?

I have been so enmeshed in the fertility world for the past year, I don’t think I have careerreally taken the time to realize how much it has changed my life and the impact it is having on other aspects of my life both present and future. Before learning I had diminishing ovarian reserves (DOR), I was 24 and knew I wanted kids, but figured that was something to think about in my early 30’s. I was (and still am) figuring out what I want to do with my life, and assumed I had all the time in the world. Although I know I am still young and I do have time to figure out my career, I have this constant brick weighing down on my shoulders – “will I be able to get pregnant?” I can’t help but wonder and worry about this, despite the eggs and 2 embryos I have frozen away and of course the possibility that I will get super lucky and  get pregnant naturally. Everyday, implanted embryos fail and die off – IVF is not a sure thing and best case scenario is that an embryo has a 60% chance of leading to a live birth. The odds are good, but not great.

Without even realizing it, it often feels like my life is controlled by my ovaries. I feel very fortunate to have found out about my DOR at such a young age, but I can’t help but be angry at the anxiety it has caused. I have recently considered going back to school. If I follow that path I will be 27 when the program starts, which means I’ll be 29 when it finishes and by the time I get some work experience I’ll be in my early 30’s. Normally I never would have questioned this timeline –  early 30’s seems like a good time to have kids, but with this potential ticking time bomb inside of me, it seems like a risk. Do I pursue a career and risk the chance of furthering my fertility issues? Do I have children and then pursue a career? Do I even have to choose? Can I do both at once? Everyday these questions pop into my head and unfortunately I don’t seem to have the answer yet and who knows if I ever will.

As I think about my own predicament, I realize the debilitating aftermath infertility can create for a woman, man or couple. It doesn’t just impact the ability to start a family, but can really shake up other parts of someone’s world. For now, the most I can do for myself is be conscious of my thoughts and acknowledge the different parts of my life that may be obstructed and tackle them one by one. I hope to bring new practices into my daily routine such as meditation, yoga, writing etc. to deal with this new weight in my life, and I hope these small practices can have a big impact on the overwhelming dilemmas I now face.

 

The Power of Small Wins

I 7289f1e6e95d6644492d5e7ed399b971was reading a post yesterday on a really fantastic fertility blog called,  Don’t Count Your Eggs, and I was inspired. Maya, the author,  wrote, It’s somehow easier to be in something– active. By doing shots and being monitored it feels like you’re moving forward.” This statement really hit home for me and I think it is such an important idea. Although a freezing or IVF cycle lasts about 10-20 days, mentally, each cycle is so much longer. Depending on the protocol you are following, you’ll usually spend at least 2 weeks’ prior on the pill, taking estrogen, monitoring ovulation etc, waiting for the cycle to begin. Unbeknownst to me, those were the weeks and the days I was the most anxious. The anxiety became even worse after going through a cancelled cycle. I was so focused on just getting the cycle started, I didn’t realize how tightly wound I was.

A few weeks back I was sitting on the couch with my fiance. We had just finished up the second round of shots for the day when he turned to me and said, “this is the calmest you have been in two weeks! It’s almost as if  the weeks leading up to the cycle are the hardest part, but once you start, you calm down.” I quickly realized that he was completely right, so much more of my anxiety came from just worrying about the cycle, before it even started. Once I was doing it and in something active, as Maya said, I felt like I was moving forward.  

As I write this I can’t help but think about running. For me, the thought of getting on a treadmill for 30 min sounds like complete torture. To get around this, I  have learned to break up my workout into smaller parts and work in intervals. Instead of thinking about getting through 30 minutes, I focus on getting through 5 minutes, it makes the workout so much more manageable.

You may be wondering why writing a post about fertility treatment makes me think of running… Well for starters, they both suck (at least for me). Secondly, they both become much more manageable when broken into parts and taken one step at a time. Once I made this connection, it made so much more sense to approach my treatment the same way I approach running. If you go through treatment just thinking about the end result, the process to get there will be so much more torturous than it already is. Create smaller goals throughout the process – it will make getting to the end that much more manageable and it even allows you to have small victories along the way.  

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Exercise & Your Ovaries

When going through fertility treatment, it can sometimes feet like your entire life has workoutcome to a halt and and everything needs to focus on your ovaries. During my first egg retrieval cycle I certainly felt that way. I stopped drinking alcohol so my social life seemed to be cut in half, I was watching my diet so I struggled to go out to eat with friends and coworkers, and my body felt like a a fragile egg shell so I immediately stopped all physical activity.  While I still feel cutting out alcohol and eating a healthy diet are important, I have slowly learned the importance of maintaining some physical activity during the crazy time that is fertility treatment.

Let me preface this by saying it is of course always important to listen to your doctor and follow his or her instruction, but below are few  of my thoughts  when it comes to exercise:

Keep a Routine

Your body is going through so many changes – from sticking yourself with needles to injecting all kinds of hormones – having some resemblance of routine can do wonders for maintaining a level of normalcy. When I exercise I just feel better. I’m happier, I feel better about myself when I look in the mirror, and I feel  more accomplished throughout the day. When I stop exercising and moving, I quickly start to feel really shitty – for me, maintaining some aspects of my normal life really helped to keep my head above water.

Keep a Clear Mind

Getting into your head and becoming overwhelmed and stressed is so easy to do. Moving your body and getting your energy flowing are key in keeping your mind clear, which will keep your stress level down. Even a short 20 min walk will help to relieve some stress.

Keep it Safe

As you, get further into your cycle,  rigorous activity is not recommended (It can cause torsion in your ovaries aka your ovaries can become tangled as they are much larger than normal). Your doctor should be keeping you in the loop about what exercise is allowed, so if he or she doesn’t mention it, be sure to ask! Towards the end of your cycle you may need to get creative in your exercise. Below are some thing I tried that seemed to do the trick:

  • Walking – while I don’t normally just walk for the sake of walking, I found it to be really enjoyable during my cycle. I discovered new podcasts, got outside and explored new areas of my neighborhood.
  • Lifting hand weights – Be sure not to push yourself too hard, but this can be a great way to work out your upper body and not  jeopardize your lower half.
  • Stretching – I started stretching more during my cycle, which not only helped to get my energy moving, but helped me to realize I definitely don’t stretch enough when I’m not doing a cycle and now I have incorporated it into my normal workout routine.
  • Taking the stairs– Normally I may just opt to take the elevator or escalator. Since I wasn’t doing much rigorous exercise during my cycles, I would always keep my eye out for alternative ways to get my heart rate up. Taking the stairs at the grocery store or in the subway were great ways of sneaking this in during the day.

 

 

3 Things to Always Do and the Importance of Advocating

advocatingThe biggest lesson I have learned so far that I would tell any woman or man going though fertility problems is to learn the power of  advocating.  Of course it is much easier said than done considering how intimidating the entire process is. The world of IVF, egg freezing and fertility doctors is like a whole universe of itself. More specifically, it is a universe with a massive black hole in the middle – just a tad intimidating… couple this intimidation factor with the waves of emotion and you have a perfect recipe for feeling completely and utterly in the dark.

The good news is, this initial feeling doesn’t have to overtake you – it can be temporary. The word temporary is key here. It is important to keep in mind that it is impossible to feel positive at all times, and feeling overwhelmed comes with the territory, but the other key  is knowing it doesn’t last forever. Below are 3 tips to help keep you in the know and in control.

  1. Follow up with the nurse or doctor after getting blood work results back. 
    • Results are often given back to the patient without any explanation. It is helpful to know if your levels fall where they should. During one of my cycles that eventually got canceled  my blood work was coming back low, but no one explained this to me so I felt blindsided when they all the sudden canceled my cycle.
  2. Have the doctor explain what they see on the ultrasound
    • Every doctor I saw conducted the ultrasound in a different way. Some are in and out without a word (they don’t event tell you what they see!) and some spend 10-15 discussing the results. It is easy to feel rushed by doctors and forget to get your questions answered. Be sure to ask how many follicles they see on each side and how they look – are they growing? How big are they?
  3. Never be afraid to bug the doctors 
    • When going through a cycle a person is bound to be nervous and will most likely have lots of questions. Fertility clinics are busy places and it often feels like the patients are treated like numbers. It is SO important to remember that you are a person and deserve to feel at ease, especially considering what financial investment this is. Don’t settle with just communicating through the coordinator. If you have a question or concern be sure to ask to speak directly to the doctor. There are no stupid questions.

 

 

P.S. More to say on Advocating so keep in eye out for future posts

Think Dirty to Live Clean

I always strive to live an overall healthy life, but let’s be honest, it’s really hard to do. Especially when it feels like so many of the things that are out my control. There’s pollution, chemicals in furniture, mold, second hand smoke, chemicals in food, chemicals in products, the list goes on and on. I have always wanted to gain a better understanding of the bad things that go into the products that I should avoid, but the second I begin to look into it, I become discouraged by the overwhelming amount of words, ingredients and chemicals I don’t recognize, let alone pronounce.

When I began going through fertility treatment, I was even more conscious of what I was putting in and on my body. I definitely wasn’t perfect all the time, but I tried. I even started carrying around a laminated list of all the chemicals I should avoid so when I went to the store I could cross reference. Of course I was usually in a hurry and only pulled out the list a small handful of times. It wasn’t until my mom introduced me to a new app that everything changed and it became 100 times easier.

The app is called ThinkDirty and it has literally changed my life. It allows you to scan the bar code on a product and it will tell you where it falls on a scale of 0-10. 0 being the cleanest and 10 the dirtiest. It also tells you the exact ingredients in it that are bad and what they can do to cause you harm. The minute I downloaded it I went all around our apartment scanning everything I could find. I was pleased to see that our shampoo and conditioner were a 3 (0-3 means it is clean!). Unfortunately my toothpaste and hand soap didn’t  come out as well. Fortunately, the app as another great feature – it suggests similar products that are cleaner than the one you searched. I immediately went online and ordered new toothpaste and soap. 

I was also surprised to learn that a lot of the products I was using that I thought were clean weren’t at all! Brands like Kiehl’s, Tarte and Aveda all scored very poorly. After doing some research, I discovered that the Honest Company has some really great products that are clean. I have since replaced many of my products and I’m loving it.

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Deep Breaths

An awesome reminder to take a deep breath once in awhile!

 

 

Mastering the Communication Game

effective-online-communicationIt is amazing to me how much
my mental state has changed over the past year. There is something about the possibility of infertility that will send your mind into a tailspin. No matter what your specific situation is, or how long you’ve been going through it, your emotions and thoughts are bound to fluctuate. That is where communication is key. Communication is important in all aspects of dealing with fertility problems, from communicating with your doctor  and nurses (more on this later)  to communicating with your partner. One thing that many people forget or struggle with, is communicating with others, such as family members, friends, or even strangers who are going through a similar experience.

When I was first diagnosed, I was confused and embarrassed. No one seemed to talk about fertility, especially at my age. My first thoughts were “how will I go through a cycle and not have my co workers notice?” or “what will I say to my friends when I can’t go out since I’ll have to be at home for my shots?”.  All of the sudden you are carrying around the biggest, heaviest news and you’re “not supposed” to tell anyone.

For me, it was time that allowed me to let go of some of this fear, and if I could go back in time, I would tell myself to step out of my comfort zone and open up, people will be a lot more receptive and understanding than you think. As I slowly came to accept my diagnosis (after months of random, middle of the night cry sessions – although let’s be honest, those still occur from time to time), I slowly opened up to people around me and it was the biggest relief. For so many months my friends would ask me how I was doing and I would force myself to say “great!” or “all is good”, while inside I felt absolutely terrible and like everything was wrong.

As I learned more about my own fertility and the problems I was going through, I realized how many women are going through this and how many feel so alone. I also realized it was a gift that I was diagnosed so early on in life, and I’m sure there are many women who would benefit from getting tested in their 20’s instead of waiting. As this new mindset began to sink in, I started to feel more and more comfortable with my situation. Instead of the worst thing in the world, it became a hand that I was dealt and something I needed to work through and deal with. I slowly started to tell me friends what was going on, not only to have someone to vent to, but to help spread the word.

I knew I had really made some progress when I had accidentally scheduled dinner plans with friends during a night when I had to do my shots during my latest cycle (March 2016). In the past I would have cancelled in a heartbeat to avoid the awkwardness of leaving early or explaining our situation, but for some reason I felt different this time. I was really excited to see our friends and I didn’t want my “situation” to get in the way of my life. I quickly decided to put my meds on an ice pack, grab some needles and bring it all with me! When we arrived I quickly explained the situation and that Jason (my fiance) and I would have to step away for a few min to do the shots. Not only did they totally understand and support us, but they were glad we told them and decided to come.

It’s All in the Levels

When it was first recommended to me that I get my fertility levels tested, my first question was, “what the hell are my levels?!” Until this point in my life, the only fertility education I had had was either in health class or from my parents during puberty. When I first started having sex, I was constantly paranoid about getting pregnant. Did anyone see the episode of Girls when Hannah freaks out about “the stuff that gets up around condoms”? Well, I definitely had that identical freak out. It wasn’t until I was about 23 that I learned a woman can really only get pregnant during about 5 days of the month. I was always careful about birth control, but still constantly worried.  It wasn’t until I was faced with fertility problems that I realized I knew almost nothing about my own reproductive system, let alone getting pregnant. The best thing I did for myself when I was diagnosed was to learn as much as I could in order to become my best advocate (more on advocating for yourself later).

Until last year, I had no idea my level of fertility could be determined by two  very simple blood tests. I realized that in today’s world, fertility is  something women only think about when they were ready to get pregnant, even though the “ticking biological clock” always seems to loom in the background. By the time many women look into their own fertility it is often too late. The biggest advice I can give to anyone whether they are actively trying to have kids or not, is to get your levels tested and not to wait! There is no harm in knowing where you stand.  The two most important tests you can do are:

Follicle Stimulating Hormone (FSH) – FSH is a hormone that helps to regulate the production of follicles. It is important to know that this test must be done on the 3rd day of your period for the best results. As a woman gets older, her FSH level rises as her egg count decreases. It is important to note that your FSH can vary from month to month so if it goes up one month, it doesn’t necessarily that your egg count/quality is decreasing. For a woman between 25-35, a normal FSH is around 5. Since being diagnosed with diminishing ovarian reserves, my FSH has ranged between 15.5 and 20 mIU/ml. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples, so definitely keep that in mind!

Anti-Mullerian Hormone (AMH) – AMH is a substance produced by cells in ovarian follicles. Every month follicles grow in your ovaries and in each follicle there is an egg. So, the more follicles you have in a given month, the more eggs you have. Although it can’t predict egg quality, the number can shed light on quantity. A normal AMH is anywhere between 1.5 and 4 ng/ml. When diagnosed, my AMH was .8. The AMH test can give done on any day of the month.

Facing my Fertility

Growing up I always imagined my future a certain way. I would leave my childhood home, enter the workforce, find a husband and have kids, or some variation of that. I have always wanted kids and always assumed it would be easily attainable. I was well on my to keeping on track with my goals. I graduated college, found a job and was in a long term relationship with an amazing man I hoped to one day marry, all at the age of 24. Although I thought about kids, it was definitely not at the forefront of my thoughts, it was easily 5 years in the future. Unfortunately, the reality of fertility problems hit me in the face much earlier than I ever expected.   Women are given no reason to question or explore their fertility until they are faced with the inability to conceive, I feel luckily that it is a misfortune I discovered early on in my adult life. At the age of 24 I was diagnosed with Diminishing Ovarian Reserves (DOR), after it was suggested by a doctor that I get my levels tested after my sister was diagnosed. In short, the diagnosis means I have far fewer eggs than I should for someone my age, and unfortunately no one seems to know why. After getting a few different opinions, it was clear, across the board, that I either had to try to have children right away (definitely wasn’t going to happen!), or freeze me eggs. If I didn’t do one of these two things, there was no way of knowing if I would have any eggs left by the time I was ready to have children. This is such a complex issue and so much goes into the steps following a diagnosis like this one. I wish I knew what I know now going into the process and I feel it is only right to share my experiences and findings with others going through this. The issues and questions that arise seem to be unlimited, but a few of the many I hope to touch on range from, understanding how your lady parts really work (I had no idea until I was diagnosed), to finding the right doctor, to learning the right questions to ask, to dealing with the massive sticker shock, to mentally preparing to give yourself shots everyday, to changing your diet and embracing holistic medicine and dealing with the complete emotional roller coaster that is infertility. 


Infertility and fertility problems are complicated and uniquely different for everyone impacted. It is scary, emotional, stressful and overwhelming (just to name a few).  I hope to add to the momentum put in place by bloggers, writers and public figures, and help to normalize infertility so woman don’t have to go through it alone and confused. Through this blog I hope to talk about my journey and offer support and suggestions for people going through a similar experience, the nuts and bolts to infertility. I will also incorporate my passion and interest for nutrition and integrative health and offer ways to add them into your life, something that is key when facing fertility head on.

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