The stress of 'trying'

by Real moms

It never fails... when you have a nice night out with your spouse, you end up fighting on the way home. Here is one womans account of an infertility seminar she went to... then her reaction to the stress, and the spat that followed in the car!

I had my infertility (IF) seminar this evening that was given by the Fertility Center I'm going to start going to. It was very informative and interesting. I already knew most of what they talked about from my research, but I think my husband learned a lot... Then dh and I got in a bit of a spat on the way home. I just got very emotional, like it was just all so scary and overwhelming? And it just hit me all of the sudden, and I started crying in the car, and he told me to just quit getting so upset like he usually does. It pisses me off, he just always seems to scold me for getting upset! I can't help being upset, and it's not healthy to let it all build up either. I told him I just have to let it out, I can't just go around pretending to be happy all the time just because he doesn't like to see me upset! Plus I told him that I wish he would be more involved in all this stuff, show a little more interest. Anyway, I think he will be now, he sort of understands what is happening better now. And he did say that he was sorry that I feel like he is scolding me. We'll see if he gets any better though.

Hi Kristin, Sounds like the meeting was definitely worthwhile. I'm sorry that you and your husband had a spat though. All that we have to go through with trying to conceive is so stressful. Maybe it was kind of hitting your husband about all that's involved too and that's why he wasn't more supportive? He could be at a much different spot in the whole process than you are. I know that I think about this stuff way more often than my partner and then have to remind myself that she's in a different place than I am and doesn't know or remember all of the terms that I use. I now write out the days of when things are going to happen (clomid, IUIs, pg testing, etc) so she can keep track and gave her a few books to read. It's helped her be more supportive. Anyhow, I hope that you and DH are able to both deal with all as best as you can. - Karen

As far as your husband scolding you, my partner does the same whenever I get too emotional. She says she is just trying to be strong for me, and trying to not let the emotional situation get out of control. She hates to see me cry, and thinks that's the way to stop me. But of course their telling us off just makes the whole situation worse doesn't it?! My partner is learning, slowly -- hopefully your husband will also. He does sound like a lovely man, and obviously really cares about you, he just needs more educating in how emotions work, about when it's a good time to cry, and how tears are healing. Of course nobody but us women really understand how bad we feel about not being able to get pregnant easily, that's why we need a board like this one. - Jenn

If there's one recurring theme apart from the obvious on these boards, it's that we think our men don't give us the support they always should. They get distressed or even angry when we're upset, and the more unhappy we are the less sympathetic they become, or APPEAR to become. I think they just get more and more helpless and less able to function when we are like that and then they feel scared and in adequate, but they always come up trumps when we really need there support. Emotionally they are SO different to us. So cry your tears when you have to, and discuss the the science bit with your husband if you can, but don't be offended by his wrong reaction. He LOVES you, and so do we. - Jane

I TOTALLY understand the emotions getting to us. I think our husbands and partners want to help us, and they feel helpless and it causes stress. I also know how emotions of "the moment" can get to us also. - Kim

My husband is very similar. The most upset I have ever gotten in this process was when they wanted to start me on FSH. I was just bawling like crazy and he kept saying, "So, what's the big deal?" We even had to go for a "booster consult" so the RE could explain the "risks" of FSH and all. I THINK maybe he got it a little then, but now it's been so long, I guess he has forgotten. I think you are doing everything right though. Hopefully you'll get your positive before the appointment. - Kerri

I wonder if all that info was just overwhelming to your husband, and as a result he took to arguing? I know it's awful, but sometimes I'm convinced men are just clueless! I know whenever I talk about the science behind all of the hormones and stuff (I'm a chemist, he is a words person -- NO scientific understanding), I'm sure all he hears is "Blah, blah, boobs, beer, blah, blah..." But maybe this will help him to understand more of what's going on, I hope! - Jodie

About your husband, they all are like that in the beginning. Firstly, they feel frustrated that they can't do anything. Then they really don't realise how much these hormones affect us. Believe me, they do get educated in the process, and they appreciate what we go through more in time. My husband used to be like that, "scold" me if I got very upset. I've broken down at least a couple of times in the doctors' office, and having the doctor say it's healthy to cry and perfectly normal, he is more at ease about that now. He also did not understand why invitro fertilization was so worrisome to me. He used to say it's not much more than an intrauterine insemination! Until we started the process, and now he is much more gentle with me. He does understand that the hormones wreak havoc with our emotions. And seeing me never complain about shots, he has become more appreciative of things. In this process, I'm glad to say we have become closer than we were before.

My husband isn't very supportive, and he gets mad when I get upset. I know how frustrating that is. It's normal to cry and you would have issues if you hold it all in, so I don't think that your response was anything but normal. - Sara

Bottom line is I KNOW our husbands and partners love us. They just don't know how to make it better for us, hence their "odd" reactions! But believe me, they are always there for you when you need them! - milli

Thanks everyone, you are all such great friends! Don't know what I would do if I hadn't found this board, honestly I think they would have carted me off with a straight jacket on by now! I have been really down and emotional today, and I have tears in my eyes from reading all your messages! What a sap I am! And I know that my husband loves me dearly, I should be happy that he is so strong and positive in all of this and doesn't break down all the time like I do. But sometimes I feel like he is too sure that it will just be an easy fix, and he won't look ahead to the future and think about the "what if's". I suppose it doesn't help to dwell on that stuff, but I want to be realistic here and think about how far we are willing to go and how much in debt we are willing to sink. I guess I just have to take things one day at a time. That's what he always says... perhaps just once he is right! - Kristin

Motherhood after breast cancer?

Research Australia

A quarter of young breast cancer sufferers have reported no discussion of fertility issues at the time of diagnosis, despite the possibility of infertility after treatment.

"Timing is everything," said Belinda Thewes, a UNSW PhD candidate in the Faculty of Medicine. "These women need more information when they are diagnosed about the effect that treatment could have on their fertility, so they can take appropriate steps to preserve it, if they want to."

The paper acknowledges that breast cancer in women who are childless at diagnosis is becoming more common. 10,000 women are diagnosed each year with breast cancer. Between 6 and 7 percent of those are under 40.

"Being diagnosed with a potentially life threatening illness is bad enough, but when you're younger there are other factors which need to be considered," said Ms Thewes. "The treatments that are used can affect a woman's fertility and this can be exceptionally distressing, especially for women who may not yet have children, but want to do so."



The research Fertility- and Menopause-Related Information Needs of Younger Women With a Diagnosis of Early Breast Cancer has just been published in the international Journal of Clinical Oncology.

"When I first started doing this research there were no younger celebrities who were diagnosed with breast cancer," said Ms Thewes, who was based at the Department of Medical Oncology at the Prince of Wales Hospital. "Since then, Kylie Minogue, Belinda Emmett and Jane McGrath have all been diagnosed. These women have raised awareness that young women do get breast cancer and that fertility may be an issue." The options for younger women who may still want to have children after successful treatment include using IVF prior to chemotherapy and using more experimental techniques such as freezing the woman's ovary tissue. A woman may not become infertile after treatment, but if she does, she may choose to adopt or use donor eggs or embryos. 228 women who were 40 or younger, with a diagnosis of early-stage breast cancer, took part in the study. All completed the questionnaire 6 to 60 months after diagnosis. The paper found that 71 percent of these women had discussed fertility-related information with a health professional, while 86 percent of them discussed menopause.

"While oncologists have extensive knowledge about cancer, they might not have similar levels of knowledge about fertility," said Ms Thewes. "We need to encourage a multidisciplinary approach."

The team is now developing some tools for younger women with a diagnosis of breast cancer to help inform and educate them about fertility preservation methods following diagnosis and the management of menopausal side-effects of breast cancer treatment. This multi-centre research was a collaboration between the Dept Medical Oncology Prince of Wales Hospital and researchers at 19 oncology clinics in NSW, Victoria and the ACT.

Midlife moms: How to conceive in your 40s

Joanne Kimes

Unless you're a high school virgin having sex for the first time under the school bleachers with a boy who claims he loves you but will never acknowledge you again after this encounter, getting knocked up can be an enormous challenge.


Modern choices

Getting a sperm and egg together may seem like a simple feat, but it requires the split second timing of a NASA moon launch. Plus, if you take that same high school virgin, tack on about twenty-five years, the "challenge" of conceiving becomes more like a miracle.

Generations ago, when Mother Nature had her way, girls would start popping out babies in their teens and continue to do so until they reached their forties. That's when either their aging reproductive organs would make conception difficult or they'd die of a toenail infection that went horribly awry. But now with the advent of birth control and antibiotics, women live much longer and can choose to delay having children for decades.



The aging paradox

Unfortunately, Mother Nature hasn't had time to adapt to these changes so a woman in her 40's faces unique challenges that can make conception difficult. For one, her cycle is irregular which means ovulation is more unpredictable. Also, her eggs are less viable which leads to more miscarriages and chromosomal abnormalities. And, she's had more time to develop conditions such as cysts, endometriosis, and fibroids that can add even more obstacles to the already overwhelming challenge.

But, that doesn't mean that a woman in her forties can't conceive and give birth to a beautiful baby. It just means she has to fight Mother Nature as she does with other aging dilemmas like covering her stubborn grays and smoothing out her wrinkles with Botox. On that note, here are ways to give Ms. Nature a run for her money so that you'll be swaddling your baby in no time:

Action plan!

1. See a fertility specialist as soon as you're ready to conceive. That way you'll know where you stand in terms of your overall reproductive health and your fertility level. Your partner should be checked out as well since it takes two to tango, as well as get knocked up. While you're there, learn about the available treatments such as hormone shots, artificial insemination and IVF so you can make an informed decision if need be.

2. Since a woman over 40 can have more hormone fluxes which can lead to an irregular cycle, it's more important than ever to know when you ovulate. To do so, get an ovulator predictor kit so you can predict your fertile days.

3. Keep a positive attitude and don't focus on the negatives. For instance, yes, you may have an irregular cycle, but it's also more likely that you'll release more than one egg each month doubling your chances of conception. And true, the odds of miscarriage and chromosomal problems are higher than when you were younger, but the odds of everything going right is still higher than anything going wrong.

Keeping the spark alive

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How many times should you DTD on your fertile days

Mark Kan, MD

Making a baby can take a little more time than we might expect, so when do we know when it's time to seek help from a specialist? Obstetrician/Gynecologist Mark Kan explains. (Have a question for our fertility expert or another advisor? Send it to us here!)

Your question:
I checked an ovulation calendar and it said I was most fertile during 2 consecutive days. Should we try numerous times throughout those 2 days, or just once per day or what would be best? I heard that you shouldn't have sex everyday when trying to conceive. Does this stil apply during those ovulation days?

The expert answers:
Studies have shown that the best time to attempt intercourse for conception is the just prior to the release of the egg.



Ovulation occurs approximately 36 hours from the onset of the LH surge and 12 hours from the peak of the LH surge. When using home electronic ovulation monitors, the last day of HIGH fertility to the first day of PEAK fertility is best.

The egg may live up to 24 hours and the sperm up to 3 days.

Attempting conception every day or every other day will give you a good chance around those times, provided you try before the egg is released.

Boxers or briefs - does it make a difference?

Wanda Steele, RNC

Does the type of underwear your partner wears have any real bearing on whether or not you will be able to achieve pregnancy? Obstetrical Nurse Wanda F Steele has some information.

Your question
We have been trying to conceive for seven months now and no luck. My husband asked if it could it be due to the fact that he wears briefs. Does this really matter? - Lyn

The expert answers
Hi, Lyn -

I know seven months may seem like a long time but when you are talking about infertility problems, but I'm afraid it isn't. Most doctors recommend that you start checking for a problem if you have not become pregnant after a year of "trying." When you consider everything that has to occur in the proper order at the proper time, etc., it is amazing that any eggs get fertilized!



I know that not getting pregnant when you want to be is not a laughing matter, so let's talk about your husband's underwear. It has been shown that men who wear briefs may have a possibility of a lower sperm count than men who wear boxers. The scrotums and testicles of men who wear briefs are at or are near body temperature, and they can produce a few less sperm. The reason for this is that the scrotum, by design, was made to hang down and not be up against the body, thereby keeping the testicles at a lower temperature than the rest of the body. Boxers allow the scrotum and testicles to be in the proper anatomical position for optimum sperm production.

I am certainly not advocating the use of any one style of men's underwear. After a proper sperm count is done on your husband and you have been thoroughly checked out, then the matter may be worthy of further consideration.

Good luck,

Timing of pregnancy may predict baby's gender

There's still no way to choose the sex of your baby, but Dutch researchers say they have found a way to better predict whether an expectant mom is having a boy or girl by looking at the timing of her pregnancy.

"Some people really want one or the other," says Patrick Weix, MD, obstetrician and gynecologist on the medical staff at Baylor Medical Center at Irving in Texas. "We obviously don't make any promises, but we just do our best to see if we can tell accurately what they're having," says Dr Weix.

A new study by Dutch researchers found a mother may be able to look at the timing of her pregnancy to predict whether it's a boy or girl well before an ultrasound can.

"In the study, if it took the woman longer to get pregnant then they actually had a higher percentage of boys being born," notes Dr Weix.



More specifically, the researchers found that for couples conceiving naturally, each additional year of trying to get pregnant was associated with a four percent increase in the likelihood of having a boy. Why? The answer is complicated, but it has to do with the differing swim rates between the male and female sperm.

"If there is a difficulty, if this becomes sort of the rate-limiting step, if there's a little bit of a hurdle than it's going to favor the male sperm," Dr Weix says.

Previous studies have also supported the results of this most recent research. Experts remind parents that a four percent increase in the likelihood of having one sex or the other is still very small.

When trying to get pregnant, how long is our window of opportunity?

Jane Forester

If you're trying to conceive (TTC), you probably wonder when is your most fertile time -- and how long does that "magic moment" last? Family Physician Jane Forester has some information for you.

Your question
When you're trying to get pregnant, how long is the "window of opportunity" in terms of conception? How long can the egg live, and how long can sperm survive? - Joyce in Englewood,Colorado

The expert answers
To determine your "window of opportunity" for conception, you must individualize your own menstrual cycle.

For several months prior to wanting to conceive, you need to track your length of menstrual cycle. Whether 24 or 32 days, it doesn't matter regarding fertility, it just helps with planning. Besides the easiest way to determine ovulation, which is with an ovulation predictor kit, you can also count backwards by 14 days from your period and that is a close approximation to your ovulation date. So in a 32 day cycle, that would be day 18. This information is then useful in subsequent months.



Now for some more facts and more planning. The date of ovulation has a small variation with each menstrual cycle. The hormone called LH (leutenizing hormone) is what triggers ovulation and helps prepare the lining of the endometrium for implantation. Many infertility concepts are based on tracking the LH surge, since this heralds the release of the egg, and is your fertile period. The average egg lives only 24 hours, so it needs to be quickly after its release from the ovary. If an ova is to be fertilized, it is usually within 12 hours of ovulation, so the sperm must be ready. The average male ejaculate contains 200-300 million sperm, 60-90% are physically normal -- fewer than 200 of these sperm even get close to the egg, and only one sperm fertilizes the single egg released at ovulation. Sperm can live up to 72 hours once ejaculated. Sometimes the egg is found within 45 minutes for fertilization, while sometimes it can take as long as 12 hours. If the egg isn't yet released from the ovary, it is thought that the sperm can go into a holding pattern for about 24-48 hours while awaiting release of the egg.

In general, if conception is going to happen in any given cycle, it will probably be within the first few hours after intercourse. The plan of attack to achieve pregnancy is to have intercourse starting every other day after the completion of your period. This would assume with a seven day period, intercourse would take place on days 9, 11, 13, 15, and 17. Normally you can rest assured that this method best increases your chances for pregnancy in any given cycle, barring any other factors suggesting either a male or female factor preventing pregnancy to easily occur.

Best of luck trying, and remember -- try to have fun!

Jane Forester
Family Physician
Glencoe, Illinois

Before pregnancy: What you can do to prepare your body

Whether it's your first pregnancy or you have had a child before, there are some smart ways to prepare yourself to give your baby a healthy start. Here are two answers to common questions about preconception health.

Before you conceive

Your question: "I'm thinking about getting pregnant sometime in the near future. What should I do to prepare?"

The answer: That's smart -- what you do before you are pregnant can affect your pregnancy! In addition to eating right, exercising and getting plenty of rest, there are five things you can do before getting pregnant to have a healthy pregnancy and to reduce your risk of having a baby with a birth defect.

1. Start taking 0.4 mg (400 mcg.) of folic acid every day now, because it takes some time for your body to build up proper stores of this important B-vitamin. It is important to take it before conception and early in pregnancy, since these defects occur in the first month of pregnancy before most women realize they're pregnant.

2. See your health care provider for a check-up, and make sure you've had all your immunizations, especially for rubella (German measles). If you're taking a prescribed medication, be sure your health care provider and pharmacist know that you're planning to become pregnant.



3. If you smoke, drink alcohol, or use drugs, STOP! These substances can threaten the health of your baby, and your own health too.

4. Stay away from toxic chemicals at home and at work--including insecticides, solvents (like some cleaners or paint thinners), lead, and mercury. Read the labels before using chemicals, and don't be afraid to ask your health care provider if you have questions!

5. If you have a cat, don't handle the cat litter--it can carry "toxoplasmosis" which can cause birth defects. If possible, take a break from this chore while you're pregnant! Also, wear gloves while gardening in areas cats may visit and while handling uncooked meats.



Pregnancies differ

Your question: "I didn't do those things before and my other children are just fine. Why should I worry now?"

The answer: Each pregnancy is a unique experience. While women who have already had children with birth defects may be at higher risk than others, most birth defects occur in pregnancies of women who haven't had an affected pregnancy before. Three to four percent of all babies are born with a major birth defect. And while only some women will ever have children with birth defects, we have no way of knowing in advance which women these will be. That's why it's so important that all women stay as healthy as possible, even if they haven't had any problems before. If you have already had a baby with a birth defect, consult your doctor before trying to become pregnant again.

The preconception diet: Eating right before pregnancy

Nancy J Price

Everyone's heard the adage, "You are what you eat." Well, during pregnancy, your baby is what you eat, too! If you're trying to get pregnant, you want your body to be as healthy as possible so you can start off your pregnancy on the right foot. Get some nutritious tips here!

Preparing to conceive
Every mother wants her baby to be as healthy and strong as possible. Well, the best way to do that is to start at the very beginning: before conception.

Not only can eating the right foods (and avoiding the wrong ones) help you to have a healthy baby, it can actually make pregnancy possible.

So where to begin? Experts agree: Get your folate!

Folic acid
Kelly Shanahan, MD, a board-certified obstetrician/gynecologist, says that even before conception is confirmed, women can start implementing a healthier diet containing essential vitamins and nutrients, such as folic acid. Fertility specialist Mark Kan, MD, agrees that when it comes to preparing to conceive, "Folic acid is the most important dietary subject."

Folic acid, also known as folate, is necessary for proper cell growth and development of the embryo. According to nutritionist Martha Belury, PhD, RD, "Folic acid in a vitamin supplement, when taken one month before conception and throughout the first trimester, has been proven to reduce the risk for an neural tube defect-affected pregnancy by 50 to 70 percent."

If you're trying to conceive, the March of Dimes recommends taking a multivitamin supplement containing 400 micrograms (mcg) of folic acid every day. It's also important to have a healthy diet, which means eating food that's rich in folic acid, which include leafy green vegetables, avocados, peanuts, fortified cereals, breads and orange juice.

Building healthy eating habits
Belury says, "A wise approach to good nutrition habits during pregnancy is to consider choosing foods with high nutrient density. The same concept holds true for choosing beverage foods." A nutrient-dense food is one that provides a high amount of nutrients (e.g., vitamins, minerals, protein) relative to caloric content.

So now, more than ever, it's time to rethink your food choices. To start:

• Look for foods with plenty of vitamins, minerals, protein and fiber
• Cut back on fat, extra sugar, preservatives and other additives
• Go organic -- buy products that are pesticide-free
• Look for hormone-free dairy products (such as those not containing Bovine growth hormone: rBST)
  

Steering clear
In addition to the foods you should eat, there are also certain foods you should avoid. These include (but aren't limited to):

• Raw or undercooked fish (including sushi), shellfish, eggs, meat or poultry
• Swordfish, shark, tilefish or king mackerel -- however, other fish may be consumed in moderation
• Unpasteurized milk and any foods made with it
• Soft cheeses like Brie, feta, Camembert, Roquefort and Mexican cheeses such as Quesa Blanca
• Raw egg -- including that in homemade cookie dough and batters
  

As additional precautions, be sure to wash raw vegetables and fruits thoroughly. Cook ready-to-eat meats (like hot dogs) and leftovers until steaming hot.

Drinking to your health
Water should be your number one beverage before - and during - pregnancy. The human body is mostly composed of water, so consider it a vital nutrient. Drinking plenty of water, that is, a minimum of eight 8-ounce glasses each day, also helps flush your system of toxins. Belury notes, "Water is a very important beverage to consume in ample amounts before, during, and after pregnancy."

When you've had your water, Belury says that fruit and vegetable juices can provide ample amounts of vitamins and minerals with minimal to moderate calories.

And even though they can taste great, soft drinks offer empty calories, so consume them in moderation. Diet sodas, in addition to not being a positive contribution to your nutrition, have an artificial sweetener (such as aspartame, saccharin or acesulfame-K) in place of the sugar. In general, and in the absence of any maternal health problems, the March of Dimes and the American Dietetic Association agree that aspartame (also known as Nutrasweet) and acesulfame-K are safe to consume during pregnancy. However, the American Dietetic Association notes that saccharin can cross the placenta and may remain in fetal tissues, therefore, you should carefully consider your use of saccharin during pregnancy and while trying to conceive.

Caffeine
An ingredient in sodas, coffee, tea and even chocolate, caffeine is a stimulant (which means it can keep you awake or make you jumpy) and a diuretic (which means it stimulates urination, thereby reducing fluid levels in your body at a time when you want to be adequately hydrated).

According to the International Food Information Council Foundation, some studies have suggested that high levels of caffeine intake may actually extend the time it takes to conceive. However, when other lifestyle variables (smoking, for example) are considered, these findings are inconclusive. More recent research from the Centers for Disease Control and Prevention (CDC), Harvard Medical School and the University of California at Berkeley show that moderate caffeine consumption does not reduce a woman's chance of becoming pregnant.

During pregnancy, however, studies have shown that caffeine may cause a miscarriage or could slow the growth of your developing baby if you consume more than 300 mg (an amount equal to three cups of coffee) per day. If you have concerns about your caffeine intake, be sure to talk to your caregiver.

Alcohol
If there is any one beverage type to avoid while trying to conceive, alcohol -- in any of its forms -- is it. Why? First, birth defects associated with prenatal alcohol exposure can occur in the first 3 to 8 weeks of pregnancy, before you even know if you are pregnant, according to the National Center on Birth Defects and Developmental Disabilities. And although early pregnancy is a particularly vulnerable time, damage to your baby can occur throughout pregnancy as a result of continued alcohol exposure as organ systems grow to maturity.

Furthermore, if you are trying to achieve pregnancy, beer, wine and other spirits may hamper your efforts. The American College of Obstetricians and Gynecologists (ACOG) says that women who drink alcohol may have a harder time getting pregnant.

Smart for you, smart for baby
Without a doubt, the human body is an incredible thing. The things you eat recombine in an amazing way to create a precious new life. Making wise, informed decisions about your food and drink now -- even before conception -- will benefit both you and your baby for the long term.