Wednesday, January 8, 2014

Trying to Conceive Tools

Since my "Harmless but Hurtful" post about the struggles of trying to conceive, I've talked to so many friends, family members, and acquaintences about their past, present, and ongoing battles with infertility or just thoughts on conception in general.  I am truly amazed at the support and positive feedback I've received since that post, and it's really inspired me to continue to share some of my personal experiences in the hopes that it will keep these lines of communication/support open.  This post won't be nearly as raw or heartfelt, but probably just as helpful.  I've tried to compile some of my go-to references, tools, and sites that have helped me along the way in trying to conceive.  It's truly a world all its own, including acronyms, definitions, and expenses you would never imagine when starting this journey.  Looking back, I can't believe that I wasn't taught more about this stuff in health education in high school or even my 6 years of pharmacy school.  But these self-taught lessons have given me a greater appreciation for the process of conception and made me a better pharmacist along the way.  Since then, I've counseled numerous patients on things like basal body temperature and ovulation kits that definitely would not have come first nature to me right out of school.  A silver lining perhaps?

Before I get into the details, a quick disclaimer:  This is by no means "the best" or only way to conceive.  Many, many people get pregnant without these tools - this is just what worked for us.  If it seems like too much pressure/stress/work, forget it.  Stress has been one of my biggest opponents these past few years, so I get it.  For my type A personality, I loved that these methods made me feel more in control of my cycle and timing, and it helped me to learn more about myself along the way.  So, if you and your partner have been trying for several months with no luck, why not educate yourselves a little more and decide if some/all of these methods are right for you?  I also included some helpful tips for those of you who are maybe not quite ready to start, but beginning to think about family planning in the near future.  It's a lot to prepare for and hopefully this list will help.

WHERE TO START???

Pay attention to your menstrual cycle - Take note of the first day of you period (the first day of bleeding) and about how long they last.  This will be handy when calculating your due date, since most physicians count from the start of your last missed period.  You will also use this cycle length to help calculate when you should start using ovulation predictor kits (OPK's) if you choose to do so.

Prenatal vitamins - In pharmacy school, I had a professor who had been a practicing physician for longer than I've been alive and he insisted that all women of childbearing age should be taking a prenatal vitamin.  As he put it, those "little parasites" will leach calcium and vitamins from you so quickly that it's good to have it stored up before even starting to try to conceive.  And why not?  If you're taking a vitamin already, why not switch to an over-the-counter (otc) prenatal that's higher in folic acid or even have your doctor write a prescription for one.  There are several that are only $4/month here at Kroger, so it's not going to break the bank.  Start taking them now, because once you are pregnant, you may find it hard to stomach/keep them down for a few months.  (If that's the case, try taking two chewable Flintstones type vitamins daily until you can stomach the others.)  Which one do I use?  The Nexa Plus, because it has all the vitamins I was looking for plus plant-based DHA (important if you can't tolerate fish), and a small amount of docusate (a stool softener) built in - yea, trust me, you'll want that in the first trimester.  As with most brand-name meds, there are money saving offers on the website, but again, I'm not saying this is the perfect vitamin for everyone. It's just what worked for me after some trial and error.

Be sure your vaccinations are up to date - Again, even if you're not ready to start trying, this is always something good to check in with your family doctor about.  Vaccinations such as MMR, Tdap, Chicken Pox, and Hepatitis B are all vaccines to look into at this time.  Be sure to check before getting pregnant, as there are a few vaccines not recommended during pregnancy.  Once you're pregnant, your OBGYN will probably keep on top of all the recommended vaccines to receive during pregnancy (like the yearly flu shot, Tdap, etc. as indicated).  Even if you've had a baby before, be sure to check with your OBGYN or family doctor as guidelines and recommendations are changing all the time (for instance, since Annalyn was born they've now changed the recommendation on Tdap to give the mother a booster during each pregnancy).  Your partner will want to be sure to have his/her vaccinations up to date, too; especially the flu shot and Tdap so they don't pass the illness on to the newborn.  I even asked my parents to make sure theirs were up to date since my mom spent the first week with us- keeps my parents and my baby safe = WIN/WIN!

Talk to your doctor about any medications - While looking into your vaccination history, be sure to ask your doctor about any medications that you are taking regularly, since many are unsafe to use during pregnancy.  By doing this ahead of time, your doctor can work with you to get off any unsafe meds or make a plan for switching to a safer one before you get pregnant.  Be sure to tell your doctor or pharmacist about any over the counter medications as well since some pain relievers, acid reflux, and cold/allergy medications are not recommended during pregnancy.

A healthy diet/exercise - Pretty much recommended for anyone, but especially during conception, this is important.  Studies have shown that losing weight can increase your chances of getting pregnant (if you're overweight to begin with), and being active will help strengthen your heart and muscles to get them ready to handle the extra weight and changes in pregnancy.  Try to maintain a balanced diet, high in calcium to build up those bones.

Stop smoking, limit alcohol - If you need help quitting smoking, let me know - I'd be glad to help you make a plan.  I'm sure any doctor would love to help you as well.  It goes without saying, but you definitely want to quit before pregnancy and before caring for a child, but stopping smoking will also help you get pregnant faster and improve your overall health.  Same goes for limiting alcohol.  I know this can be a little harder knowing that you will have to completely cut it out for 9 months, but cutting down to the occasional glass of wine of will actually help the cause.  Same goes for your partner for all of the above - have to think about those sperm counts!
 
Pregnancy tests and ovulation predictor kits - There is a certain excitement and thrill that comes with going to the drug store to buy that first pregnancy test when you first start trying to conceive.  You will likely be greated with a whole shelf full of options ranging from two pink lines, to plus signs, to little digital smiley faces or "pregnant" readings.  Likely, you will splurge and go for the easy to read and fun to take pics of digital tests and spend something like $14.99 for 2 of them.  But hey, what's $15 compared to the excitement of getting to read "pregnant"?  Well, after a few months, that excitement and thrill turns to dread as each time you test, you are met with the inevitable "not pregnant" or lonely single pink line.  And you can't use just one test each month, so you buy multiple and pretty soon, you've added a substantial monthly expense.   Then after a few months of trying, you might decide to try the ovulation kits to make sure your timing is right (especially if you've experienced erratic or long cycles).  These range from about $18 to $28 for a box of 7 tests, and if you still don't get a positive, you have to buy a second box.  Talk about expensive and frustrating!

Well, somewhere along the way, I discovered early-pregnancy-tests.com, a site that sells both pregnancy and ovulation tests in bulk for a much lower price. You can buy either the test strip kind (where you collect urine in a cup then dip the strip in it) or the traditional midstream kind like you buy in the drugstore.  The more you buy, the cheaper they are, and they also have "conception packs" that come with both pregnancy and ovulation tests.  They also offer same day shipping (usually arrives in about 2 days) for orders over $14.95.  Personally, I've had great luck with these tests and don't buy the fancy expensive ones until I have a definite positive and want to take a picture.  To give you an idea of pricing, they have a bundle that contains 15 ovulation strips and 5 pregnancy strips for $16.95 (about the price of 2 digital pregnancy tests).  Much more cost effective if you're in it for the "long haul."  Once you get that faint positive, it's also fun to take one a day to watch the line get darker and darker.  I say it's my way of making up for all the negative ones... but maybe that's just my crazy self.

First four testing days with baby #2 - see how it starts super faint and darkens each day? I like to keep testing every few days until it's as dark as the control line. 

Conception Combo #1 - Test Strip "Value" Pack
"Conception Combo #1 - Test strip value pack"

Books/references - After 5-6 months of trying for baby #1, I came across the book Taking Charge of Your Fertility.  Funny title, but it's very informative.  The book has a lot of basic information about the menstrual cycle and the process of conception, but also about natural family planning - a method that utilizes subtle cues from your body to help chart specific parts of your cycle such as ovulation, fertile times, luteal phase, etc.  This book taught me how to chart my cycles using my basal body temperature (basically, you take your temperature at the same time every morning before getting out of bed).  This basal temperature peaks just after ovulation, so along with ovulation predictor kits, makes it much easier to confirm that ovulation took place.  Over several cycles, you will soon be able to nail down a more specific few days that you are likely to ovulate and start to see patterns in terms of what might be delaying ovulation (stress, lack of sleep, alcohol, sickness, etc.).  As I was saying, the basal temperature peaks a day or two after ovulation and stays high until menstruation when it drops again.  If you get pregnant that cycle, the temperature stays high and may even rise a little more.  This is a very basic, watered down explaination, but it's really quite amazing to read about and see.  That being said, don't get too caught up in every little temperature because what you are really wanting to see in the overall trend.  They sell all kinds of fancy basal thermometers, but one that reads to the tenths (i.e. 98.7) is just fine.  Here is the one that I use, but not for any particular reason other than it's just the one that I bought. 

         

Taking Charge of Your Fertility also has a website (tcoyf.com) that allows you to chart online, share/view other people's charts, and discuss common issues/questions in forums.  Using this tool, you can enter all your past history and menstrual cycle trends and it will help you identify when/if you've ovulated.  It's really helpful when you first start charting and kind of fun to look at and compare charts with other users. 

Two other sites that I've used both while trying to conceive (TTC) and while pregnant are babycenter.com and whattoexpect.com.  Although they have more information about pregnancy and early childhood, they do have some good articles on getting pregnant and what to do leading up to that positive test.   

And of course, "there's an app for that!"  The Attain Fertility Planner is the one that I used to chart my cycle with this baby.  This free app is very similar to the tcoyf.com site and is easy to use.  It helps track ovulation, set the cover line, etc. just like the online tool. 


Whew!  Anyone else overwhelmed yet?!  I know, it's super overwhelming to look at it all in writing, but just remember, you don't start at the bottom of this list.  This takes several months of preparing to start trying, trying for several months with just the typically recommended every other day intercourse, and then starting to look into other ways like OPKs and charting to help.  The general recommendation is for couples under 35, try for a year, then look into possible infertility causes (assuming something like a miscarriage or other complication doesn't come up first to initiate testing). I started OPKs after 3 months, and charting after 6 months.   Frustrating?  Absolutely.  Seem like it takes forever?  You betcha!  Make you feel like a lottery winner just for being born?  Not really, but it probably should.  My point being, there is so much more than this involved for a lot of us.  Testing, fertility drugs, lots and lots of blood tests...  but this is a good place to start for anyone wanting to conceive a baby.  A little planning and a little knowledge go a long way.  Even if pregnancy just happens for you without much thought or trying, I really hope you will take some time to look at the first few bullet points and cover all your bases to ensure that you get your body prepared to take on the amazing and really hard task of making a baby.  Sending lots of love, luck, and baby dust your way!  Happy baby-making ;)

Love,

Mama


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