Disclaimer:
I am not a doctor, and none of what follows should be construed as medical
advice. I am simply sharing what I have
learned in the hopes that it may make you more aware of the information that is
out there and that can benefit you on your journey. Any medical decisions should be discussed
with your doctor.
1.
Not
all doctors are the same.
This may seem like
a “duh” statement, but it’s not something I really thought about much during
our first couple of years of trying to conceive.
In traditional
allopathic medicine, many women start with an OB/GYN and then eventually move
on to a fertility specialist who can perform ARTs (assisted reproductive
technologies). The goal in this model is
usually to take the quickest route to a healthy baby, which often equates to
medicated cycles, IUI (intrauterine insemination – also known as the turkey
baster method), IVF (the petri dish method), and possibly even things like ICSI,
sperm donation, egg donation, and surrogacy.
They are not necessarily as concerned with discovering and healing the
underlying causes of infertility as they are with achieving the desired outcome
of a successful pregnancy.
On the other hand,
there are many types of doctors who take the approach of healing the underlying
causes through either medication and surgery or through lifestyle changes and
more holistic treatments. Some examples
of these include OB/GYNs who specialize in NaProTechnology (natural procreative
technology), functional medicine doctors, Chinese medicine practitioners, and chiropractors
who also practice acupuncture and nutrition, and the list goes on. Some doctors practice a combination of those
things I just mentioned.
Even within a
specific field or medical model, individual doctors have different levels and
types of training, different specializations, different experiences, different
goals, and different approaches. Not one
way is necessarily right or wrong, but knowing the differences may help you find
a quicker path to the doctor that most aligns with you and your husband’s
goals, beliefs, and desires.
2.
You
are not married to your doctor.
Having covered
number 1, it’s important to realize that you are free to switch doctors at any
point in the process. If you don’t feel
like you are being heard or if you see that your goals are not lining up with
those of your healthcare provider, you don’t have to feel bad about seeking out
a new one.
3.
The
lifestyle choices you make now will affect your fertility months down the road.
Lifestyle changes
are so important regardless of which medical approach you take for fertility
treatments! When your body is not
healthy, reproductive function is often the first thing to shut down because it
is not necessary for immediate survival.
Our overall health has huge implications for our fertility. One thing I recently learned that shocked me
a little was that the egg that is released this month started developing toward
ovulation about three months ago. That
means that your nutrition, sleep, stress, and exercise habits from at least
three months ago are affecting your current ovulation, and those same habits
today are affecting the egg that will be released three months from now. Also, anyone who has ever tried to lose
weight knows that lifestyle changes don’t change the body overnight. Lifestyle changes are crucial, but time and
consistency are required in order to see noticeable and lasting physical
changes.
4.
Food
is important.
The types of food
you eat are important, and the amount of food you eat is important. Your body needs nutritious whole food in
order to support both you and a baby.
Filling your body with foods to which you may have an unknown (or known)
sensitivity or filling it with processed and sugary foods causes inflammation
that diverts all your body’s energy away from making a baby and toward healing
the inflammation. Here is one good article with a few tips as far as eating habits. My acupuncturist also recently told me that
women who under-eat or frequently skip meals are much more likely to struggle
with infertility. Our bodies recognize
that we won’t be able to provide the nutrition our baby needs when we aren’t
even getting sufficient nutrition for our own bodies.
5.
Exercise
is important.
Intentional
exercise supports blood flow, blood sugar utilization, healthy weight, muscle
building, inflammation reduction, and so much more. Cardio and strength training are both
beneficial for overall health and fertility.
However, it is important to be careful with this. Exercise that is excessive or too intense can
cause extra stress on the body, raise cortisol levels, and mess with your
hormones. At a certain point, your body
doesn’t know whether you are running for pleasure or running from a threat, and
pregnancy is a no go if your body is in fight or flight. Making sure you are eating enough to provide
the energy for the amount of exercise you are doing is also crucial. Anything less can be considered under-eating and can affect you in the ways we discussed in point number 4.
6.
Sleep
is important.
Poor quality or
quantity of sleep compromises your immune system and makes you more prone to
getting sick, which is not productive for fertility. Lack of sleep also aggravates stress levels,
which can then in turn affect sleep, and we can get into a vicious cycle of
sleeplessness and stress. Again, this
type of cycle doesn’t signal to the body that now is a safe time to have a
baby. Our bodies also work on healing
while we sleep, so depriving yourself of sleep could mean depriving your body
of the healing it needs to be healthy enough to support a pregnancy. If all that isn’t enough to convince you,
sleep deprivation also contributes to decreased libido – which unquestionably
puts a damper on the trying to conceive process.
7.
Stress
is bad.
Stress comes in
multiple forms, such as physical stress from over-exercising, sleep
deprivation, or mental and emotional stress from everyday internal and external
factors. Stress is characterized by an
increase in cortisol, which affects your reproductive hormones. Stress can cause things like delayed
ovulation, compromised immunity, decreased libido, inflammation, and other side
effects that are problematic for fertility.
We can’t get rid of all the stress in our lives, but we have to learn to
manage it well in order to achieve optimal health and fertility.
8.
Community
is crucial.
Living with
infertility can feel extremely lonely – but it doesn’t have to be that
way. Our journey was so much harder in
the first year before we shared with anyone that we were having a hard time
building our family. The well-meaning,
hurtful comments were much more plentiful during that time. Once we decided to open up about it, the
comments all but stopped, and we found ourselves being loved and supported in
very tangible ways – from hearing the stories of those who have walked the same
road to having friends bring us meals through surgeries and pray for us and cry
with us through each difficult decision and everything in between. Being open has also created ministry
opportunities for connections and conversations with people that would never
have happened otherwise. Not everyone is
comfortable sharing this part of their lives with the whole world, and that is
absolutely understandable. However, I
think everyone struggling with this should open up to at least one other
trusted person or couple. God created us
to walk through life together, and we place ourselves in real danger when we
try to face something like infertility alone.
I highly recommend being open with friends or family you can see in
person, but if you’d like to start with joining a Facebook group where you can
find community outside of your immediate circle, encouragement, and answers to
questions, check out Moms in the Making!
9.
Pain
and PMS aren’t normal.
For the longest
time, I thought severe cramps and half a month of things like backaches, sore
breasts, wild mood swings, and fatigue were just part of being a woman. Everything from sex education in the school
to movies and commercials seemed to communicate that these types of symptoms
were just to be expected. There were
pills you could take to help manage it if you were one of those weak, dramatic
women who just couldn’t deal, but it didn’t mean that anything was really wrong
inside your body. Now I know that period
pain can be a sign of something like endometriosis and that while one or two
days of PMS might be normal, one or two weeks of it indicates that your
hormones are probably off. If you
suspect something might be wrong, don’t be embarrassed or think that you are
just being overly dramatic or sensitive.
It’s not all in your head.
10.
Not
all women who have PCOS are overweight.
Polycystic Ovarian
Syndrome (PCOS) is one of the primary contributors to infertility in
women. It is diagnosed when at least two
of the following three criteria are present: elevated male hormones (which can
cause acne, excessive facial or body hair, etc.), many cysts on the ovaries or
enlarged ovaries, and irregular or absent periods. One common symptom of PCOS is weight gain and
difficulty with losing weight; therefore, this condition is often associated
with women who are overweight. A quick
Google search reveals this information pretty quickly, but the part that I
didn’t know for a long time is that there are different types of PCOS, and one
of those types is found in lean women. I
have been around 110 lbs since middle school, and I was still diagnosed with
PCOS. I also have hypothyroidism
(another condition that is often associated with weight gain). Don’t assume if you are at a healthy weight that
it’s impossible for you to have these types of conditions.
11.
Mindset
matters.
I’ve put up
several posts on my personal Facebook and Instagram lately about how I’m learning how closely the mind, body, spirit,
and emotion are connected. What we think
and feel does affect our bodies. A few
techniques I’ve been learning to work on my own mindset include deep breathing,
practicing awareness of how stress is affecting my body, celebrating successes,
and pursuing faith and gratitude. Deep
breathing is pretty simple. When I feel
my stress levels rise, I consciously breathe in through my nose for about 4
counts, hold it for another 4 counts, and then let it out slowly for 4 counts. There are several more ways you can do this
(find what works for you), but deep breathing helps bring your body back down
from a stressed state. When I am
stressed, I’ve also started paying attention to where my body feels like it’s
reacting. For me, a lot of times it
shows up in clenched teeth, shoulder tension, and tightness in my stomach. Once I notice that it is happening, I can
intentionally relax those muscles. Celebrating
successes in the area of infertility means celebrating the progress you’ve made
on lifestyle changes, the improvement in hormone levels, the return of
ovulation, etc. It means refusing to see
each month as a failure simply because the end goal of becoming pregnant has
not been achieved yet. Finally, pursuing
faith and gratitude reminds me that no matter what the end of my journey looks
like, I am still loved and valued by God and that I have been incredibly
blessed. It keeps me from sliding down
into dark despair, or lifts me back up when I have fallen there again.
12.
You
don’t have to take every single piece of advice that comes along.
There will be a
lot of it. It can come from anywhere,
and most of the time the source has good intentions. Choose to see it as a sign that they care and
just want to help you, even if the advice itself is unhelpful, something you’ve
already tried before, or just a plain terrible idea for your particular
situation. Be grateful for their heart,
but research any advice before diving into it, and don’t feel like you have to
try everything that everyone suggests.
There isn’t enough money or time in the world – which brings us to
number 13.
13.
There
is no magic pill.
There are hundreds
of pills that people will recommend.
Supplements and herbal remedies can be helpful, but they can also be a
waste of money or even detrimental to your health and your goal to become
pregnant. The fact that they do not
require a prescription doesn’t mean that you can try whatever you want without
the guidance of a healthcare professional and expect that they won’t have a
huge effect on your fertility, possibly in a negative way. Don’t just trust your own research. There is a reason that healthcare
professionals spend years in school.
Don’t think that you can gain the same knowledge from a few Google
searches. Some supplements are fine and
useful short-term, but can have bad effects if taken long-term - but this
doesn’t always show up in the research.
Also, it is highly unlikely that any one supplement or herbal remedy is
the key to finally getting that baby in your arms anyway. They are simply tools that can work alongside
lifestyle changes and medical treatments to create a healthier, more fertile
you.
14.
Each
woman’s body has its own unique needs.
Speaking of
supplements, herbal remedies, and advice – don’t assume that just because
something worked for your friend, your co-worker, your favorite online blogger,
or even your sister that the same thing will work for you. Our bodies are so very unique, and we all
have our own set of health, history, and lifestyle factors coming into the
equation. Infertility does not have a one-size-fits-all solution or even really
a one-size-fits-most solution. Each
woman needs her own individualized plan for testing and treatment. Again, depending on what all is going on,
something that may have been beneficial for your friend might actually
aggravate things that are going on in your body. Do your own research, but also talk to your
doctor.
15.
Podcasts
are one helpful source of information that won’t turn you into a screen zombie.
If you’ve been on
this journey for any time at all, you know how easy it is to get sucked into
the vortex that is Google. I researched
everything in the beginning – causes of infertility, treatments for
infertility, earliest symptoms of pregnancy, symptoms of underlying
infertility-causing disease, chances of having a false negative pregnancy test,
baby names, herbal remedies, and so on.
My eyes and my head would ache, but I wanted to know more. In the past year or so, podcasts have become
one of my new favorite sources of information.
Books are good too, but those cost money (or an awkward trip to the
library), and finding current infertility literature that doesn’t feel like
reading a textbook or swing to the other side and have very little scientific
information can be a challenge. Podcasts
are audio recordings that you can listen to as you do the dishes, drive to
work, fold laundry, or get ready for the day.
They require minimal screen time, and they are free! Here are some of my favorites (there are many
more out there!):
16.
There
will be needles. Lots of them.
I thought I could
get away with minimal needles when I started – even though I read online that I
basically had no choice but to get over my aversion to them. I thought I’d be one of the exceptions. Don’t we always think that? I’ve lost count of how many times I’ve had my
blood drawn. One month I had to get it
drawn about every other day for the entire month. Then, after we discovered my PCOS, I had to
do a fun little test for checking my insulin resistance that involved getting
it drawn four times in one day. I had
IVs with my surgeries (along with more blood tests) – these were by far my
least favorite needle experience so far.
I’ve done acupuncture with little thin needles all over the place,
at-home intramuscular progesterone injections (which require a needle the size
of Texas injected in a “dart-like” fashion into your rear end), and recently
switched to at-home HCG injections (a much smaller needle to the thigh, arm, or
stomach – I chose the arm). All this and
I haven’t even done IUI or IVF at this point – both of which typically require
lots of needles. There will be needles –
but you will get fairly used to them.
17.
When
you go in for testing, be prepared to be asked (possibly multiple times) if you
are currently or have ever been pregnant.
They have to
ask. Knowing that they have to ask
doesn’t necessarily take away the sting each time you have to say, “No, I am
not pregnant,” “Yes, I am sure,” “No, I have never been pregnant before.” The time that cut me the worst was when I
went in for my HSG (the test they use to see if your tubes are blocked). I expected the question when I went to my
initial visit with my OB/GYN, but then I thought it would be recorded in my
paperwork, and they wouldn’t have to keep asking. My HSG was performed by a different doctor I
had never even met before – that fact alone threw me off a bit. Then the questions were asked by her young
assistants as I sat exposed in my breezy hospital gown with all the fear and
anticipation of both the test itself and of what the results might be shaking
up every nerve in my body. I just wanted
to scream, “OF COURSE I’M NOT PREGNANT – THAT’S WHY I NEED THIS STUPID TEST!”
and “NO, I’VE NEVER BEEN PREGNANT – THANK YOU FOR MAKING ME SPEAK THAT
DEVASTATING TRUTH OUT LOUD.” Of course,
I didn’t. I just responded flatly with a
blank face and felt like I was dying a little inside. Just know that that those questions can and
will come and not always at expected times.
Along the same lines, if you have to have a surgery, they will likely
want to test you for pregnancy beforehand.
It can feel like a cruel joke when you haven’t been able to conceive for
years, but it has to be done.
18.
Testing
too early only creates more stress.
I couldn’t resist
in the earliest months. Online, I read
stories from women who got positive results just 8-10 days after
ovulation. I usually didn’t test quite
that early, but I did often test before my period was really due. Part of me irrationally hoped that I could
sneak a positive in and somehow that would stop my period from coming. Testing early always came up negative for me,
and as a result, I would start mourning prematurely while also trying to convince
myself that false negatives happen all the time. I’d obsessively look even more for any tiny
symptom that might indicate the test was wrong.
I stressed out so much worse and grieved multiple times – with each
negative test and then again when my period started. It isn’t worth it. I know you’ll still test early anyway – at
least for a while – but I had to say it.
19.
You
can have all the signs of ovulation without actually releasing an egg.
You can have
regular periods, the correct cervical mucus pattern, a BBT chart with a
distinct shift, and positive ovulation tests and still not release an egg. I don’t think it’s very common, but it is
possible – it happened to me at least once.
Instead of releasing an egg, the follicle forms a cyst (sometimes a
fairly sizeable one) called a luteinized unruptured follicle. Your hormones still do their thing, so your
body still looks like it ovulated, but the only way you can know for sure that
you’ve ovulated is through an ultrasound.
If I understood this sooner, I may have made some different decisions
along the way.
20.
You
will have uncomfortably specific conversations about awkward things – like
cervical mucus.
Like needles, you
will need to get over any embarrassment about talking about awkwardly private
things – at least with your doctor. Your
doctor isn’t embarrassed and likely talks about these types of things every
day. It’s their job, especially if they
specialize in fertility. Depending on
how public you have been with your struggle, various people (family, friends,
friends of friends, acquaintances, etc.) will also ask you questions. Sometimes they are completely unaware of how
awkward the answer may be for either you or for them or both. You don’t have to answer all the questions if
you don’t want to – you still have a right to privacy. Being open doesn’t suddenly mean that every
person has a right to hear every single detail of your story. For those that you do want to answer, you’ll
learn how to gauge your answers so as not to completely shock your listener
while also giving them just enough information to answer their questions. Or at least you will try and hopefully get
better at it over time.
21.
Speaking
of conversations about awkward things – lubricant matters.
Many lubricants
either kill sperm or make their swim significantly more difficult. There are already enough obstacles stacked
against the little guys – you don’t want them to be essentially trudging
through mud. If you need it, swap
whatever you’ve got out for Pre-Seed or something similar. It is specifically formulated for couples who
are trying to conceive. For some people,
this one change was enough to result in pregnancy; however, remember there is
no single cure-all for infertility. Some
people don’t have any other issues at play, and this was their only
obstacle. For many others, this is just
one of many obstacles. Regardless of
which camp you end up being in, it will be beneficial to switch; just don’t
expect it to be a miracle cure.
22.
It’s
possible to celebrate life while also allowing yourself room to grieve.
Pregnancy
announcements, baby showers, gender reveals, and birth announcements will
continue to pop up throughout your journey.
Life doesn’t stop for everyone else even though it can feel like you are
frozen in time. For me, the hardest part
is the first time I find out that another baby is on the way, particularly when
it is a firstborn. Depending on the day,
I find that my initial reaction is usually a strong emotional upheaval – not
against the new life, but bubbling up from my own sad, unfulfilled
longing. This reaction is normal, and we
can’t deny it or feel guilty about it.
However, we also have to learn to move through our own grief to the
other side and refuse to feed any thoughts or feelings of jealousy and ill will. For me, these don’t always come up, but they
can, depending on the circumstance. In
the context of temptation and sin, one of my Bible teachers said, “You can’t
help it if a bird flies over your head, but you don’t have to let it build a
nest there.” It’s not wrong to feel sad
for yourself, but it is wrong to dwell in bitterness or to become angry because
in your pride you feel like you deserve what the other person has more than she
does. It’s easy to fall from grief to
sin, but one preventive measure you can take is to celebrate the new life once
your initial response has calmed down.
You, more than many, know and understand the miracle that is required each
time a baby is conceived. Choose to celebrate
that miracle regardless of the circumstances surrounding it. Praise God, and ask Him to do it again. And take a break from social media if you
need to.
On a side note, my
younger brother (my only sibling) and his wife chose to write a letter to me
when they found out they were pregnant for the first time. That letter was such a gift both because of
the written record it is of their sweet care and thoughtfulness and because it
allowed me the time to process that initial wave of grief on my own without feeling
like all eyes were on me or like my sadness was detracting from the joy of
their main announcement. It was such a
selfless and grace-filled act on their part and one that they were in no way
obligated or expected to do. One of my
friends asked me what the best way is for me to find out about a new pregnancy,
and I told her about what my brother and sister-in-law did. Later on, she too used a letter to inform me
of her own pregnancy. While I don’t think
it’s reasonable (or even necessarily desirable) to expect this type of special
time and care with every pregnancy announcement, in these cases it was a sweet
gift for me. If someone close to you asks
you the same question (someone you’d rather not just find out about on social
media), I’d recommend the letter method – but keep in mind that it would indeed
be a gift and recognize that they are free to celebrate and announce their news
however they would like.
23.
Your
husband can’t read your mind.
This point could
just be for marriage in general, but for infertility in particular, communication
is so important. Just because your
husband is walking through infertility with you doesn’t mean that he experiences
it the same way you do or that he automatically knows exactly how you are
feeling or how to help. Let him in to
your grief. Let him take care of you in
the ways he knows how, and tell him specifically how he can support you. Talk to him about medical decisions, and
wrestle through those together. Ask him
what he thinks and feels (you can’t read his mind either, no matter how well
you think you can) and how you can support him.
The weight of this journey is lessened when you make sure you are on the
same page as a couple, when you hope and grieve together, and when you work
together toward making difficult decisions.
24.
Mother’s
Day may catch you off guard.
We were only a few
months into trying to conceive the first time that Mother’s Day changed for me. I didn’t even think about the fact that it
was Mother’s Day when I woke up that morning.
I had seen the church tradition many times before: mothers were asked to
stand up so that children could bring each of them a flower as the pastor spoke
about the high calling of motherhood.
This time was different. This was
the first year that I wanted so badly to stand, but instead I was sinking into
my chair and hoping I might disappear. I
hoped and prayed the longing and ache of my heart wasn’t written across my face
as I avoided all eye contact and wished for the whole thing to be over. I’ve been more prepared in the years since
then. I still would rather fade to into the
background; motherhood should be celebrated, and I don’t ever want to take away
from that.
25.
While
motherhood is a high calling, that doesn’t mean that your calling for your
current season isn’t just as valuable.
I’ve really only
ever wanted to be a stay-at-home wife and mother. I do believe it is a high calling, and it is
a calling I greatly desire. It is a
calling for which I feel I was made. Even
so, it is not my calling for right now.
That doesn’t make me any less of a woman, any less blessed by God, or
any less valuable. God just has a
different job for me right now. Part of
that job is being a part-time nanny for two sweet little girls. Part of it is giving myself more fully to
ministry than I could otherwise. Every
season of life is valuable, and as long as I’m following my Savior, I’m right
where I’m supposed to be. If you are
following the Savior, you are right where you are supposed to be too. Motherhood is a great gift, a great service,
and a great honor, but it is not the only great gift, service, or honor. Don’t think that you can’t be whole until you
become a mother – you can’t be whole with children if you aren’t whole without
them. Seek Jesus first and His calling
for you today. Don’t give up hope, but
don’t let your satisfaction and healing rest on your future children. They can’t live up to that, and you will miss
out on so much in the meantime.
26.
Toxins
are real, they are everywhere, and they do affect your body and fertility.
This is still a
fairly new subject for me. I recently
learned that a huge percentage of whatever I put on my body is absorbed through
my skin and into my bloodstream in less than thirty seconds. I also learned that a product’s availability
on a store shelf is not an indicator of the product’s safety. Many current products have ingredients that
are known to cause or contribute to all sorts of problems, including infertility. Some of those products look to be “clean” but
actually have sneaky ingredients hiding under terms like “fragrance.” This podcast from The FU Project was
eye-opening for me. I’m working on
switching out skin and hair care products, hand soaps, and more. If you know you have high levels of oxidative
stress or inflammation, think seriously about the products you use.
27.
Even
perfectly healthy couples have only a 15-25% chance of conceiving in any given
month.
Even with the
perfect lifestyle and no underlying disease, conception is still a miracle. It can still take several months to conceive
naturally even once everything is as healed, balanced, and optimal as possible. You cannot try something for one month and
assume it doesn’t work or that it isn’t helping just because you didn’t get
pregnant that month. Pregnancy can take
time even in the best of circumstances.
28.
This
journey WILL affect your relationship with God, your marriage, and your
relationships with others. HOW it
affects those relationships is largely up to how you choose to respond.
You can become
bitter, angry, and isolated while blaming anyone and everyone for your plight. Or, you can grow into a stronger faith, a deeper
love, and a richer community than you ever could have otherwise. Choose to be grateful and see all that you
have been given instead of allowing what you don’t have to consume you. Pull your spouse closer instead of pushing
him or her away. Pray for, protect, and
pursue your marriage. Cry with God, and
allow Him to comfort you. Believe that
you are loved. Allow people to help and
encourage you. Accept that your life is
not your own, and don’t cling quite so tightly to the specific dreams and
expectations you had for yourself. Come
to God with an open hand, and a submissive heart, and see that He will fill
your cup to overflowing. It may not be
in your time or in your way, but He is and always will be enough.
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