okay, i am not pregnant yet, but i feel like i know a lot of stuff about trying to conceive at this point, & maybe some of it will be useful to others. i’m also going to write about all the different stuff i have tried so the next time someone says to me, “you should really try fertility charting,” or, “ovulation tests really helped my grandma’s best friend’s neighbor’s daughter,” i can just point them to this entry so they’ll shut the hell up.
charting this is pretty much the first thing people try when they are trying to get knocked up. i started charting back in 2001 in order to avoid pregnancy. it’s a system of noting your body’s fertile symptoms in order to avoid or maximize your chances of pregnancy. you take your temperature first thing every morning, make a note of what’s happening with your cervical mucus, note the texture & position of your cervix, & check whether your cervix is open. at peak fertility, your temperature will be low, cervical mucus should be relatively copious, clear, & stretchy, & the cervix should be high (difficult to reach), soft, & open. the day after ovulation, your temperature should start getting higher, the cervix will drop & become firm & closed, & cervical mucus should dry up or become creamy. i charted for years by printing out the sample form in the back of taking charge of your fertility by toni weschler, which provides a gazillion times more info about fertility symptoms & how to chart. when i got serious about getting pregnant, i started using an online tool at fertilityfriend.com. i signed up for a VIP membership so the website remembers my info & creates algorithms to help predict my most likely fertile time. it also runs my luteal phase symptoms against the info provided by other members so i know how my experience stacks up against women who have managed to get pregnant.
charting is important because every body works differently. if you’re just having sex/inseminating on or around cycle day 14 & wondering why the hell you’re not knocked up, you need to chart. lots of women ovulate sooner or later than that, & if you’re not timing the introduction of sperm properly, there’s no way you’re going to get pregnant. don’t bother with online ovulation predictors–they seriously just tell you to have sex fourteen days after your last period. that doesn’t help anyone but the few women with textbook perfect cycles.
ovulation tests it took me a few months to come around to the idea of using ovulation tests. i figured i was charting my fertile symptoms & that was good enough. & for some women, it is. but ovulation tests can help take the guesswork out of things. they test for luteinizing hormone, which spikes 12-48 hours before ovulation. when the test line is as dark or darker than the control, it’s positive. these things can be spendy, so my method is to use the cheapo tests made by formosa medical. they’re called wondfos & you can pick up a bag of fifty for like $12 on amazon.com. when my fertile signs start picking up speed, i like to test four or five times a day, & i can do that with the wondfos because they’re seriously like twenty cents per test. an ovulation test from a drugstore is considerably more expensive, which would encourage a budget-conscious lady to maybe only test once a day, which could cause her to miss her surge.
once i get a positive result on a wondfo, i like to back things up with a clearblue easy digital test. these things are very expensive. at target, a box of twenty costs $35. but there’s no question with them: if a surge is detected, a smiley face pops up. if there’s no surge, you get a blank circle. if you’re only using them to back up the wondfos, you’ll only need two or three per cycle, so a box of twenty will last ages (though hopefully you won’t need them that long, because you’ll get pregnant first!).
once you get a positive ovulation test, it’s important to NOT STOP HAVING SEX OR INSEMINATING! so many women seem to think that a positive test means they have ovulated, all done, now they just have to wait for a positive pregnancy test. NOT TRUE! the ovulation test looks for LH, which surges right BEFORE ovulation! the ovulation tests should become negative again before ovulation happens. so basically, keep having sex/inseminating as much as you can for three or four days AFTER getting a positive test. the ultimate goal is to get a fresh batch of sperm in there the day before, the day of, & the day after ovulation. charting can pinpoint the day of ovulation (you know it’s happened once your temps go up & stay up, creating a biphasic temperature pattern), but not until AFTER it happens. so just keep boning, okay?
clomid it seems like some women don’t realize that regular ob-gyns can offer infertility treatment. you don’t need to start seeing a reproductive endocrinologist (which can be considerably more expensive, depending on what your health insurance covers) right away. an ob-gyn can order basic fertility bloodwork (checking LH, FSH, progesterone, etc), prescribe fertility meds, order an HSG, etc. most women have an ob-gyn anyway because they’re getting regular pap smears (RIGHT?).
my ob-gyn ordered all my basic bloodwork, & based on the information i was able to provide her through my charting, she prescribed clomid & progesterone support for me. clomid is basically a starter fertility drug. women do three to six rounds, perhaps of increasing dosages. they take it for five days at the beginning of their cycles & it works to promote ovulation–to help a non-ovulating woman release an egg, & to help an ovulating woman release more or better eggs. some women report certain side effects on clomid: hot flashes, headaches, nausea. i haven’t really experienced any of that, but then, being the child of two of the biggest drug addicts east of the mississippi has instilled in me a certain natural tolerance for drugs. i almost never get side effects from anything. taking clomid closer to ovulation (ie, cycle days 5-9) supposedly helps create one more mature & well-developed egg, & taking it earlier (cycle days 3-7) helps create more eggs. it’s a quantity versus quality issue. i ovulated on my own without clomid, so i am now experimenting with taking it earlier. more eggs means more chances for fertilization…although it also means a slightly increased risk of becoming pregnant with multiples.
it’s also worth noting that clomid is pretty inexpensive. a five-day treatment at 50mg (the usual starting dose) is only $9. so there’s really no reason for anyone to drive to mexico for black-market clomid. doctors can’t wait to prescribe it, & it’s very affordable.
progesterone my charts made it obvious that i have a luteal phase defect, most likely caused by low progesterone. this is one of the most easily treatable fertility issues a person can have. it just means that the latter half of my cycle (ovulation until my next period) is short. the average is twelve to sixteen days. mine was nine or ten. after an egg is fertilized, it takes about a week for it to journey down the fallopian tube & implant in the endometrial lining. if a woman’s luteal phase is too short, her endometrium will have started to break down already by the time the fertilized egg has arrived, & it won’t have anywhere to implant. i could have been fertilizing eggs every month, but my luteal phase was too short to give them a chance to turn into anything. progesterone supplements are used once ovulation has been confirmed (it’s important not to start them too soon because they can prevent ovulation altogether or create mucus that is hostile to sperm) & support the endometrium for longer, giving a fertilized egg a fighting chance of turning into an embryo.
i’ve tried two kind of supplements, crinone & prometrium. crinone is a gel & it is pretty fucking disgusting. once it’s been in the body for a while, the gel breaks down into these tiny plastick-y balls that are horrifying. it’s also crazy expensive–$250 for two weeks of treatment, if you don’t have insurance. prometrium is also expensive, but not nearly as bad a crinone. $250 gets you a 30-day supply, & there’s a new generic available for $200. it’s a capsule suppository. far less disgusting, & it worked better for me. with crinone, my LP was extended to twelve days. not bad, but not great. with prometrium, i got up to twenty days. some women have to get a shot of provera to bring their periods on after doing progesterone support, but not me. mine always comes once i stop using the progesterone.
(to be continued!)