Are You There God?...

...It's Me.

For the past year or so I have been highly preoccupied with my periods, so much so, in fact, that I feel like I'm writing my own adult-version of a Judy Blume novel.

I guess the good news is that my husband also read the book when he was in elementary school, so he's been totally informed regarding female concerns for most of his life.

The other good news is that I have not yet resorted to chanting, "We must, we must, we must increase our bust."

The fertility diet: myths vs. realities?

When you're trying to conceive you come across a lot of information -- from books, from friends, from the Internet. I am a skeptic by nature, so I have a hard time believing that any single lifestyle choice in general or dietary choice in particular is going to be the secret ingredient for conception. After all, people have been conceiving babies since the dawn of humanity, and most of those people conceived without prenatal vitamins and dietary supplements and even particularly good general nutrition.

So, it can be a little maddening to read about all the dietary choices a woman can try to help her conceive. I'll admit, I've tried some of these, but mostly because I like the food's taste and general nutritional benefits. And, if drinking something or eating something were magically the secret to conception, well, I would have been pregnant in July.

What are some so-called fertility foods?

• Green tea typically tops the list -- I drink de-caf green tea a few times a week now, mostly because I like something warm to drink in the morning, and I've reduced my coffee intake.
• Yogurt and full-fat dairy are also frequently mentioned -- Good news is that I eat yogurt every day at lunch; but full-fat dairy, seriously? I can't stomach whole milk, but instead I go between skim milk and 2% milk. Oh, and I eat A LOT of cheese.
• Folic-acid fortified cereals -- Yup, Kashi, I consume you daily.
• Whole grains, fresh fruits and veggies, and foods with "good" fats, like salmon, have been a major part of my diet for as long as I can remember
• Pomegranate juice has been in the news for the past several years. While lots of women anecdotally claim it helps female fertility, there is one study that links better sperm quality to pomegranate juice (and Lance Armstrong seems to agree). I'll drink some pomegranate juice a couple times a week because I like the taste.
• You can even listen to those who claim consuming cough syrup will help you conceive.
• Eat pineapple core between 1DPO and 5DPO to assist implantation.
• Take any combination of vitamins (B, D and E appear to be popular ones) in addition to your standard prenatal vitamin that already contains plenty of folic acid to help you get pregnant.

The point of everything above is that there may be one or two studies that add validity to claims of linking fertility to these foods. There may be just as many studies -- if not more -- that negate such claims. My belief continues to be that I'll continue to eat a healthy diet overall. Right now I'm probably eating better than I ever have before. One single food is not going to get me pregnant, and the chances of a single food I eat or choice I make increasing my chances of achieving pregnancy seems dubious at best. And, at a time when I am trying to keep as many chemicals as possible out of my body, I will not be ingesting cough syrup.

OPKs: Easier than charting

If and when you read Taking Control of Your Fertility, you'll discover that the author, Toni Weschler, is semi-opposed to ovulation predictor kits (OPKs). If and when you talk to my doctor, you'll discover she's highly opposed to OPKs. But I'm here to tell you that OPKs for me have been a perfectly fine supplement to charting, and I'd even go so far as to say these can be just as helpful as charting.

What is an OPK?
The term ovulation predictor kit is a bit of a misnomer. When I first learned about them, I imagined a small microscope with lots of slides where I could perform my own little biology experiments. While it is true that I often feel like TTC has been a series of science experiments, OPKs are nothing more than little strips you dip in your urine that detect the surge of lutenizing hormone (LH). Your body always has LH present, but the surge in LH typically occurs between 12 and 48 hours before you ovulate.

Why are Weschler and my doctor opposed to OPKs?
In a word, cost. They claim they are too expensive for what they do and that a woman with irregular cycles has lots of difficulty using them correctly. (This assumes, though, you buy them at drug stores.) Additionally, some women test at the wrong time and miss the surge. Also, sometimes the OPK will detect an LH surge and ovulation does not actually occur.

Why do I like OPKs?
I like them because I found the cheap ones on Amazon that work as well as any more expensive ones you could buy in a drug store. When I got my period most recently and I was running low on OPKs, the first thing I did after my temperature dropped was order 120 OPKs and 40 accompanying home pregnancy tests (HPTs). (I did this, of course, because they come in packs of 40 OPKs and 10 HPTs for a little more than $9 total, and I was going for free shipping on orders of $25 or more.) Now, I have the most irregular periods on the planet, but I do not consider these OPKs to be a very significant investment. Additionally, even though I have incredibly irregular periods, I can still use as many of these as I want at a relatively insignificant cost, compared to the 7-20 strips that come in your standard store-bought OPK and cost approximately $24.

So far, these cheap OPKs have perfectly caught each of my LH surges. At first I was using the OPKs only in the morning, and then I read that they do a better job detecting the LH surge when used in the afternoon -- for some reason, 3-5 p.m. appears to be the average woman's best time for detecting the LH surge.  A positive test has a test line that is as dark or darker than the control line. This the one downside to this particular OPK: you will almost always have two lines present, but the test line will only achieve proper darkness when you're about to ovulate.

The first time I used these strips I got a positive reading one time, even though I was testing daily. Most recently, after I learned to test in both the morning and afternoon around the time I think I might be ovulating, I got three positive tests and one almost-positive test (one afternoon positive, still positive the next morning, still positive the following afternoon, and close-to-positive the following morning). So, with these tests I recommend testing in morning and afternoon around the time you think you could be ovulating. Of course, for me, that means testing for about 20 days, but with these super-cheap tests I really don't mind.

My verdict? If you decide that charting is too complicated or too crazy for you, you can get the same, or very similar, results by using these cheap OPKs.

Why I don't trust Fertility Friend VIP

So yesterday when I introduced you to my charting world, I told you about a free site called Fertility Friend where you can enter your daily BBT and other fertility signs. What I didn't tell you is why I've learned to beware of the VIP site.

When you first sign up for Fertility Friend, you are automatically offered 30-day free access to the VIP site. This site includes a number of special features, including a fertility analyzer -- a little stop light that pops up next to your calendar and tells you that you are "most likely not fertile" (which totally freaked me out when I signed up -- I'M INFERTILE???!!! FYI, that's not what it means) or "possibly fertile" or "most likely fertile." This feature, while a little silly, is not the big problem. The big problem is the Pregnancy Monitor. This thing is such a pot of bullshit.

Here's how the Pregnancy Monitor works. After ovulation has been detected and you've entered your luteal phase (LP) the Pregnancy Monitor kicks in. (Side note: this time is also known as the Two Week Wait [TWW] between ovulation and your period during which you've hoping you'll be able to get a big fat positive pregnancy test [BFP]). The Pregnancy Monitor compares all your symptoms to the symptoms of all the other charts on the site where women have achieved pregnancy that cycle. So, if you had cramping on 5 days past ovulation (DPO) and lots of pregnant women also had cramping at 5DPO, you essentially score points on the Early Pregnancy Signs chart.

The Pregnancy Monitor also scores your Intercourse Timing, looking at whether or not you had sex three days before, two days before and one day before ovulation as well as on the day of ovulation itself and even the day after ovulation. If you have sex two of those days you've rated as having a "good" chance of having achieved pregnancy this cycle.

This all sounds like it could possibly be useful information, right? I thought so too. Last cycle, I eagerly entered my symptoms each day during my LP. I had 70 points out of 100 in the Early Pregnancy Signs scale. My temps were high and even seemed triphasic (where after the initial post-ovulatory spike you have a second spike of temps that may indicate implantation and pregnancy). And, according to the Intercourse Timing analyzer, I had a "High" score.

This is why, when my period came 12 DPO, I felt especially crushed. We had "done everything right." I even had the "scores" to prove it this time.

The ray of sunshine in this experience is that my 30-day free trial of the Fertility Friend VIP site ended while I was in the middle of my last period, and I gladly refused all the site's attempts to sign up for the VIP membership at a reduced price. Now I simply have the basic site access for free, where I can still enter my temps and signs, but I don't have the luxury of comparing all my signs to all the other charts. And I am much happier.

Learning to love charting

Back in the days before my neighbor (and good friend) knew I was TTC, she recommended I read the book Taking Charge of Your Fertility. My friend kept telling me it was full of useful information that -- as the name suggests -- allows you to have a better sense of what goes on inside your body every cycle. I kept thanking her for the suggestion, saying, "Yeah, I'm not quite there yet," honestly figuring that I'd be pregnant within the next month, so why bother with the investment and add another thing to the list of items that could potentially stress me out. In hindsight, I was totally wrong, and I wish I had read the book several months before we started TTC.

If you've got any knowledge of the TTC world, you've no doubt heard of -- or, even more likely, read -- this book. If you're brand new to this game, though, I'll offer a quick summary. (If you're already familiar with this information, you should skip down to the My Experience subheading!)

Crash course:
The premise of the book is that women can use basic physiological signs to keep track of where they are throughout the course of their monthly cycles, from menstruation to the fertile phase to ovulation and then to the phase between ovulation and menstruation called the luteal phase. Here's the most important disclaimer: this book is NOT about the Rhythm Method, a totally outmoded and completely ineffective method for those practicing birth control and those hoping for pregnancy achievement alike. The Rhythm Method follows the premise that all women have 28-day cycles, with ovulation occurring like clockwork at day 14. This is false for the vast majority of women, which is why Taking Charge of Your Fertility preaches an entirely different gospel based on a woman's individual physiological signs.

There are two main signs women can track: basal body temperature (BBT) and cervical mucus (or, more preferably, as the author points out, cervical fluid, which sounds a lot nicer). We'll stick to CF for that one.

Your BBT changes during the course of the month: traditionally we have low readings during menstruation up until ovulation (97-97.8 degrees), and then at ovulation most women see a spike in temperatures that remain high (97.9 and up) until the day that your period is destined to arrive, when temperatures typically plummet again. Your CF also changes accordingly, with it being most present and sperm-friendly when you are in your most fertile phase.

The trick to using this Fertility Awareness Method (FAM) for pregnancy achievement is to time intercourse during your most fertile phase based on your CF. You use your BBT, and its spike around ovulation time in particular, mostly as proof that you are in fact ovulating and not having anovulatory cycles. Once your BBT has spiked, the egg has already been released and your chances of fertilization are incredibly low, so if you wait for your temps to change to help you time intercourse, it won't work. (And, if you follow this FAM process religiously, you can also use it as fairly effective hormone-free birth control if you simply avoid intercourse during the window in your cycle when you are close to ovulation -- though I have no experience with that.)

You're supposed to take your BBT each morning when you wake up at approximately the same time while you're still under the covers. You're also supposed to do this for a few cycles to notice patterns and help you determine when you're ovulating. Of course, this is way more tricky when you're like me and have highly irregular periods, so your charts from one month to the next are not that helpful in allowing you to predict ovulation. You're also supposed to start charting on cycle day (CD) 1, the first day you get your period, but really you can start at any time as long as you know how many days you are into your cycle.

My experience:
After almost five months of actively deciding not to read the book, I ordered it on Amazon and devoured the entire thing in a few hours. I got out my trusty digital thermometer and gave it a new home next to my bedside table. I signed up for a free account on fertilityfriend.com. (There's even a mobile site that allows me to enter my temps from my phone while I'm still in bed.) I started charting in the middle of my last (really long) cycle, and you know what? It really works. Like clockwork. I could see exactly when I ovulated based on BBT, CF and my ovulation predictor kit (OPK) to boot as double back-up proof. The upside to this is that my husband and I timed intercourse as well as we possibly could. The bad news is that after 11 days of high temperatures after ovulation the next morning I woke up and my temperature plummeted to my pre-ovulatory temperatures. And I started crying as soon as I put the thermometer down -- I had been convinced this would be the month that it worked.

But then I got out of bed and put on my big-girl pants and I realized, hey, now that I know I am going to get my period today, it won't be such a shock. A few hours later when the dreaded period arrived, I simply shrugged and thought, "I was expecting you."

Even though my irregular periods make my charting experience less than ideal, I will say that there's a sense of empowerment that comes along with knowing that despite all the uncertainty I'm dealing with, at least I know I'm ovulating, and at least I know when my period is going to arrive. Although I'm resigning control to determining when my body will allow me to get pregnant, I now at least know when to throw some tampons in my purse.

Really hungry: blood test edition

Yesterday I told you about the planning I went through leading up to going off birth control, and now that I am past the six-month mark of TTC, clearly things have not been moving like clockwork. Today I am going in for a blood test (finally) to figure out what's going on, and I'm really hungry because I normally eat a big breakfast every morning when I first wake up. All in all, though, I'm thrilled to be getting blood drawn today.

Here's what got me to this point.

I went on birth control in March 2004, and up until that point in my life I had pretty normal periods. No, I wouldn't get my period every 28 days, but so few women actually do. I fell in the "normal" range because I would get my period every 30-35 days. In college I was definitely influenced by the hormones of all the girls I'd live with -- I was clearly not the alpha female -- so my body and my cycles would naturally adjust to the bodies of the women around me.

Throughout my life I have never had any gynecological problems -- no STDs, no pregnancy scares, no abnormal test results. I also have a clean bill of health -- I have no known diseases, regular blood pressure, ideal BMI. I've never been hospitalized. I have been on antibiotics twice in my life, once for a wisdom tooth that got infected and once when I got a big splinter. Besides that, the only medication I've ever taken is birth control. I've never smoked or done drugs, I drink both alcohol and caffeine moderately, I eat a well-balanced diet with lots of delicious and healthy home cooking, and I get moderate exercise. I even go to the dentist every 6 months.

So, after I went off birth control in July 2010 and got the bleeding (a.k.a. "fake period") that follows finishing a pack, I was a little surprised that it took me 45 more days until my next cycle began.

Then cycle 2 was never ending.

On day 60 of cycle 2 in late October I called the nurse at my doctor's office. I told her I'd been concerned that I was neither getting my period nor did I appear to be ovulating.

The first nurse I talked to asked, "Oh my, now are you sure you're not pregnant?"

"Well, five negative pregnancy tests and no symptoms would suggest that I'm not pregnant," I said.

She still said she thought I should come in immediately. "Can you be here in a couple hours?"

Well, no, my job is totally inflexible, so that wasn't happening, but I told her I could come in tomorrow late afternoon. She said she would have another nurse set up the appointment and call me back.

Twenty minutes later when nurse number 2 called, she asked, "Are you running many miles a week? [No.] Are you drinking daily? [No.] Did you have abnormal periods before you went on birth control? [No.] Are you sure you're not pregnant? [Yes.]." And then, the real kicker, "Honey, you're young and you have nothing to worry about. It can take up for a year after going off birth control for your cycles to regulate themselves."

I expressed dismay, seeing as this was not the same information my doctor shared with me in August 2009 when I did my pre-conception visit. Pretty obnoxious. I knew, based on some research, that it could take a few months for my cycles to be more normal, but even then I felt I was way outside the normal range. The nurse did tell me, though, that I was overdue for my annual appointment, so she scheduled me for one in early December. (Funny side note: when the OB thinks you might be pregnant, they can get you into the office that day, but for any other concern you have to wait six weeks.)

Fortunately, my ovulation predictor kit indicated that I finally ovulated on day 69 of cycle 2, and I got my period on CD 76 (which also indicates a short luteal phase, but I'll take it for now....more on that later.)

Cycle 3 lasted 65 days and I ovulated on day 54 (meaning I achieved an 11-day luteal phase...go me!). Cycle 3 is also when I got serious about fertility charting. (That's the subject of a whole different post.)

In the midst of cycle 3 I had that annual exam in early December. My doctor assured me that I needed to time sex appropriately for pregnancy achievement. Well, duh. Trust me, we are. Then she instructed me to email her as soon as I got my next period and she would be able to somehow miraculously pinpoint the 10-day window during which I am most fertile and therefore, according to her, we should be having sex every other day (we were already having sex every other day, and every day during my most fertile phase around ovulation). Somehow someone with a 45-day cycle, followed by a 76-day cycle, followed by a 65-day cycle could be told what days to have sex and it would magically work? I internally rolled my eyes and promised to email. In the meantime, she told me it wouldn't hurt to check my thyroid function just in case, so she ordered up the blood work and I headed down to the lab. Good news: normal thyroid function.

So, a week and a half ago when cycle 3 ended I emailed my doctor my cycle history since going off BC pills. She wrote back and told me, somewhat to my disbelief, that we need to get to the bottom of what is causing me to have such irregular cycles. FINALLY. So, she ordered up some blood work and told me to go to the lab as soon as I could.

That brings me to today, waiting here for the lab to open so I can get my blood drawn and then eat. I feel like today is a bit of a milestone in the TTC process because my doctor has actually acknowledged that something may be wrong. Yes, I've been a little annoyed that she hasn't taken me too seriously up to this point, and I'm still considering switching OBs, but perhaps showing her that I have been charting my information has convinced her that I mean business. Maybe, in small way, I've managed to take back a little control.

Introducing me, planning to TTC

OK, now for the real back story:

I'm a hyper organized person, so I thought I could approach TTC with the same gusto I approach most projects in my life: make a careful plan, reap the fruits of my hard work. Everything in life has been ths way for me. I worked hard as a child, got excellent grades that got me into excellent schools, where I got more excellent grades and internships that resulted in an excellent job. I work hard and excel in my job, make decent money, found an outstanding man who became my husband, and together we bought a beautiful house and have raised two adorable dogs. I have so much going for me in my life, and I am a great example of how those who work hard can achieve success.

Sound familiar? Chances are, if you're reading my blog, you are also probably a person who has controlled much of your destiny up until this point.

So, in August 2009, 11 months before my husband and I were planning to start TTC, I used my annual OB appointment as an opportunity to drill my doctor on everything I should know/should be doing before we started to TTC. I'd already read What to Expect When You're Excepting back in 2008, so I came armed with questions. She told me that because I'm young (I'm now 29 with a 30-year-old husband) with a history of perfect health, I would get pregnant immediately after I went off birth control. This is, of course, in retrospect now in the Hall of Fame of Worst Advice I've Ever Received. She added that I should finish my last pack of birth control pills, and then I could start TTC immediately -- she did not recommend any wait time as some other doctors recommend because, in her words, I would be most fertile right after ditching the BC pills.

Oh, and she said I should cut down on alcohol, caffeine and mercury-laden fish, which is simply her generic advice she gives all women. I do not consume a ton of any of those items, so I didn't need to make much in the way of a lifestyle adjustment. And, in keeping with her generic advice, she also told me to start taking a prenatal vitamin three months before I started TTC.

During that August 2009 appointment she did decide to have me run down to the lab to have my blood drawn to test for Cystic fibrosis, and the test revealed I'm not a carrier, so the odds of my husband and I having a child with this disorder are exceptionally low.

After the appointment I planned our big summer trip around my periods and the date that I wanted to ditch my birth control. My husband and I picked the date we wanted to start TTC around the date that I wanted to give birth, figuring (so shockingly naively) that I would get pregnant on the first try because that's what the doctor told me would happen.

I marked my calendar religiously: start taking prenatal vitamin on April 1; finish BC pills on July 15. Then, of course, have a baby born in March or April. I started imagining the conversations I'd have with coworkers when I'd announce in October that I'd be giving birth in March, the time of year that my job becomes most insane. Frankly, I couldn't wait to abandon my work and take care of a newborn.

As you can imagine, October (and November and December and now January) came and went with lots of big fat negatives on the pregnancy tests, and lots of other annoying surprises about my body to boot.

I've named this site Resigning Control because that's been the biggest lesson I've had to learn in the six months so far my husband and I have been TTC. Up until this point, I have controlled everything in my life and gotten everything I've ever wanted. Clearly the process of having a baby is something I cannot control, no matter how much I would like to.

Deciding to share my story

When my husband and I decided a year and a half ago that having kids would be in our not-too-distant future, I decided we wouldn't tell anyone. What if we found out we were infertile? How embarrassing would it be for so many people to know that about us?

Then, about a year ago, I decided to tell one of my best friends when we were out to lunch. She was thrilled and eager to know more since she also has not had any children.

Then I told a few of my best friends from high school.

Then I told a close co-worker.

Then I told a neighbor.

By this point, some of the closest women in the world to me knew about this latest project my husband and I had decided to take on.

Finally, I had to rein myself in. Although I do not any longer view infertility as something anyone should be embarrassed about -- and I frankly have no idea right now if my husband and I are truly struggling with infertility or not -- I felt like I needed to stop telling my friends that we were TTC. I don't want to be annoying and self-centered. Perhaps more importantly, though, I don't want people at work to even suspect that I might be TTC and therefore treat me any differently. (In a perfect world a woman would not have to worry about discrimination in the workplace, and while I have not experienced overt discrimination, I know too many instances of women who've faced subtle discrimination when it comes to their choice to have children.)

So, I decided this blog could be a place for me to (mostly) vent my frustrations and share my story in hopes that anything from my experience could potentially help someone else. For a while there (aka last month, and the month before that, and then earlier in the fall...) I was spending entirely too much time scouring the Internet looking for answers my doctor seemed incapable of providing. I do not claim for this blog to possess medical wisdom, but I do think that when you're faced with TTC, something you've never worried about in your entire life -- except those times you prayed you WERE NOT pregnant -- it's good to know as many stories as possible to arm yourself with knowledge, however anecdotal.

I give you my personal story, nothing more, nothing less, and I hope the window into my world will open doors within your own. Good luck!