Wednesday, December 23, 2009

What's The Plan, Stan?

I had my post- MFM consult visit with Dr A this afternoon. He hadn't yet received the consult report, but I told him basically what Dr C had told me- that my risk of preeclampsia was double the average, that I should take a baby aspirin daily during pregnancy, and that my autoimmune issue should be suppressed during pregnancy, and flare afterward, if it decides to flare.

He was very relieved. I think he said, "I feel a lot less worried" at least 6 times. Goes to show that not every RE deserves that "rogue money-grubbing cowboy" description. Dr A's approach is pretty cautious when it comes to mom/baby and avoiding multiples is a definite goal.

The plan did slightly change, in that he is wanting to do monitoring to make sure the Femara is actually helping me ovulate, but we are still starting at the 2.5mg dose. I am a little worried about how to approach my new boss about flexing time for the day 3 and day 12 monitoring. This new company that has taken over is much less flexible, we are entering our busy season, and therefore PTO is already blocked in the month of January, and there are many rumblings among the nurses in my area- we are expecting to all be laid off once the busy season is over.

Another change is that, should we end up having to try follistim, my dose will be increased "because of my age". I turn 32 in March, and do not quite feel that old- but I guess if my ovaries were dusty and grumpy at 27, when we started, 4 more years more may not necessary find them springtime fresh.

Wow, four years. Four years, 30 cycles, and one pregnancy. Not very fertile at all.

Monday, December 21, 2009

Perfect Moment Monday- Solstice Musings


Being infertile is so much about being set apart from the rest- and set apart from the joys of raising a child.

My perfect moments this week are brought to you by my son, J.

* Saturday morning, 5 AM. Mr S and I are bone tired, sleeping soundly. I wake up from a dream to hear "Mommy! Daddy! Mommy! Daddy!" I stumble into my son's room, and he is standing in his crib, clutching his blankie and ginormous stuffed Thomas the Tank Engine. I do not want to be up, and decide to bring him to bed. I lay him between us, and he reaches over to Mr S's side of the bed. "Daddy?", he asks, then, "Yes, dat Daddy." Satisfied that his world is all aright, he snuggles up next to me and falls asleep. I feel rich. Not everyone gets to be this lucky.

* Saturday night, 6:30 PM. We drive an hour north for an extended family Christmas party at an uncle's house. My mother, a person everyone says was "meant to be a grandmother", opens the door for us. J's face lights up, as does hers, and they run with open arms to each other. My uncle, a stern police officer who happens to be very good with toddlers, carries him around all night. I know, we should have some flavored coffee to go with this cheesy scene, but to me it is an illustration of how our family has moved from loss to abundance. Infertility isn't just about the loss of the parenting experience, but a loss that can touch the whole family.

* Sunday morning, 8 AM. I open the mail from the day before. It is full of Christmas cards, most of them photo cards. Nearly all of them have pictures of children. There is not a single painful stabbing in my heart, not a single whisper in my mind of what could be. Our own card hangs on the fridge with the others, and next to it is J's birth announcement, and the ultrasound from 5weeks 5days, when we saw the first flickerings of his heartbeat. Our fridge is a constellation of children's faces, family, friends in real life, and now virtual friends as well. Many of those children were long-awaited, and these cards are the photographic equivalent of a yule log, burning bright against the winter darkness, " Our barren season is over. Let the sun shine in our lives again."

More Perfect Moments can be found here.

Thursday, December 17, 2009

Show and Tell- Japanese Finds and Green Gifts

I bought another 5-pack of Envirosax for Mr S's truck, this time in manly monochromatic black and white designs. I'm happy to report I am so good with using these bags that we often have none of the required paper bags to put paper recycling in.


Using a 25% off coupon, I also went to reusablebags.com and got the Kleen Kanteen sippy above, and Kids Konserve stainless steel containers. We pack breakfast, lunch, and two snacks to go to day care every day, so these are well used.


My sister Noonie visited sister K, who has been teaching English in Japan these past few years. She came back with a load of goodies for us. J now has a cute little rice bowl that uses for his hot dog and "dip"- AKA ketchup.

Sister K was also kind enough to feed my addiction for Kirin Gogo no Kocha, a cold milk tea. When I went to Japan at age 17, my friends and I would drink a liter of this a day.

Here is J playing with his new favorite toy, a wooden ring stacker doo-dad.

It has a funky face painted on it.

Best of all are the Japanese T-shirts for J with English phrases only a crazed monkey can come up with.

"How are you? I am champion." I think that might be a dung beetle. He has to keep those muscles strong for lifting those turds.



"Rainbow is symbol of peace. Natural Feeling. Like a heaven."

Who else is Showing and Telling? Pop over to Mel's for the master list.

Do Infertility Treatments Cause Birth Defects?

There's a post today on Our Bodies, Our Blog linking to a recent study in Fertility and Sterility that, I think, still leaves this question unanswered.

The study compared rates of birth defects between women who conceived spontaneously and women who conceived using three different methods: ovulation induction, IUI, and IVF.

The results:

" The prevalence of birth defects with AHR procedures was 2.91%, which was 1.55-fold higher (95% confidence interval [CI], 1.03–2.38) than in the non-AHR population (1.86%). Specific anomalies that increased with AHR were gastrointestinal (odds ratio [OR], 9.85; 95% CI, 3.44–28.44), cardiovascular (OR, 2.30; 95% CI, 1.11–4.77), and musculoskeletal defects (OR, 1.54; 95% CI, 0.48–4.94). The risks of birth defects by types of AHR were 2.35% for ovulation induction, 2.89% for IUI, and 3.45% for IVF."

At first glance, it seems that treatments could have a higher risk of birth defects- however, I don't think this can be inferred at all.

The results were adjusted for maternal age, smoking, infant gender, gestation, and parity- but the control group consisted of normal, spontaneous pregnancies in non-infertile women. There were no comparisons between infertile women, like myself, who conceived spontaneously, and those who conceived via treatments.

The study only tells us the rates of birth defects per method used to conceive. It does not distinguish between the many causes of infertility. Does advanced maternal age, and therefore egg quality, factor into this? Do poor sperm and egg quality overall have higher rates of birth defects? Do couples who require IVF for blocked tubes alone have the same rate of birth defects as couples who require it for severe male factor infertility or premature ovarian failure? Does a poor sperm morphology issue have higher rates than for men who have a count issue alone? Does the use of ICSI have higher rates of defects than the typical IVF? Does IVF with egg donation have lower rates than IVF with ones own eggs, if there is an egg quality issue?

Until studies distinguish between causes of infertility, we can't truly point the finger of blame. Just like last year's study concerning Clomid and uterine cancer, it leaves us with more questions than answers.

Tuesday, December 15, 2009

Pediatric H1N1 Vaccine Recall

This is not a safety recall, rather a concern about the effectiveness of the vaccine. Sanofi-Pasteur is recalling 800,000 doses, most of which have been given, including to my son, noting the potency is slightly less than desired levels. So, they aren't harmful, but may not protect as much as they should.

So far, the CDC does not feel children need to be revaccinated. Swine Flu appears to be declining, as it is. Click on the above link for the full article.

Friday, December 11, 2009

19 Months

Today The Boy is 19 months.

A few things going on with him now:

* The day care director made a point of seeking out Mr S today as he went to pick him up, to tell him how much J loves music and delights everyone with his dancing.

* He uses just about every toy as a gun now. We have no gun-style toys in the house, we never play shoot 'em up, and we don't watch violent TV in front of him, yet he still picked it up from the other kids.

* Mr S does yoga every night in the family room. J imitates him, and has learned to do a Cobra and Downward Facing Dog. He calls it a "down dog".

* We tried putting him on toddler formula to help him gain weight, buuut...he's reacting to it. His cheeks are bright red with eczema, so we have to reevaluate and shell out the money for more goat's milk.

* He likes using names for people now, but gets confused. Every older man with gray hair is "Grampa".

* He is in a huge "mommy" phase now. At home, he will only eat for mommy, only sleep for mommy, and beg mommy every 20 minutes for an "owie kiss".

* There is a life-size, mechanical, singing, dancing Santa at day care. J loves to sing and dance with Santa, but you better not walk too close to that big, scary Santa, or he holds on as tight as he can and gives you one of those, "Aw, hell naw, bitch" kind of looks. I can't say I blame him. That Santa scares the shit out of me.