Still here

Yep, I’m still here. Still pregnant. If I make it through the day, then I will have exceeded my first and longest pregnancy. So that hurdle is within reach! Otherwise, not much to report on. I’ve not been sick, really. Though I do feel a bit bad in the mornings. I can only stomach about 1 cup of coffee, maybe a little more. Which is ok, because I don’t need much more than that anyway (no more than 3 is recommended by most docs, haven’t asked mine about it). Still tired a lot. Going to bed around 9:00 pm! I know crazy early! 😉 But I’m waking up before the alarm most days, which annoys me still. Today wasn’t too bad though. I slept til 5:45, so only 15 mins. before the alarm. Yesterday I was awake at 4!

I thought I’d link a couple of other places I go for support. You know, other than blogging and talking with friends who know. One is the sheknows Femara board. I’ve not really hung around the other boards on sheknows, but I’m sure they’re all just as supportive as the Femara board has been. The other place I like to go is Babyfit.com‘s mommyteams Infertility team. Again, I haven’t poked around the other teams there, but I’m sure they’re all great!

And in closing, I will leave a new ticker. This is the same one as before, but with the “humor” version instead of just the developmental. The humor saying for week 5 really cracked me up!

pregnancy

Ultrasound Atlas

Ultrasound Atlas

I thought it might be useful to show what sorts of things I see when I get an ultrasound done at the RE’s office, and I found this great resource for ultrasound photos, linked above, since I do not have copies of my own ultrasounds. I’ve pulled a few photos for illustrative purposes here.

The first is what the uterus looks like in an ultrasound:

uttrans.JPG

Here you can see the “three-layers” of the uterus. You can see tickmarks where the ultrasound tech is doing some measurements. Early in the cycle, the distance from top to bottom through these layers should be thin. By mid-cycle, this distance should be 7 mm or greater in thickness. This is how they measure the uterine lining. I’ve linked a thumbnail here because the full size was too large, in my opinion.

Next, we’ll look at an ovarian follicle on the ovary:

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Here you can see the shape of the ovary, and a large dark mass. This is an ovarian follicle! Early in the cycle, these follicles are very small, and there are usually several of them. Leading up to ovulation, typically one follicle is selected to be the dominant one and it will grow much bigger than the others, before releasing an egg at ovulation. Again, you can see tickmarks where they are measuring the size. My largest follicle this last go round was 19 mm. But, they can be larger than that! This site talks about the typical size of ovarian follicles in natural and medicated cycles around ovulation. This ultrasound image of an ovarian follicle is of a normal one. If I had PCOS (which I don’t, but just for the sake of interest), my ovaries might look like this:

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Here you can see the shape of the ovary, and several small follicles. These small follicles are often described as looking like a “string of pearls.” You can read more about PCOS here.

So, now you know what my doctors are looking at and for when I go in for ultrasounds!

must read blogs?

I’m slowly building up my blogroll. I’m only adding a few at a time just so I don’t get people mixed up! What I want to know is what are you favorite infertility blogs? Are there any that I don’t have in my blogroll that you think is an absolutely must read? Or, are there any new ones that is looking for new readers, just like me? Don’t hesitate to leave your own blog as a suggestion. I’m open to any infertility blogs, including adoption, pregnant or parenting after infertility. So give me all you got!

Temperature Charting

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Today I’ll talk a little about temperature charting. I’ve linked above an image of last month’s chart from fertilityfriend. At the top you see the date, the bottom you see the Cycle Day number. I usually end up only paying attention to the Cycle day number. The CM line stands for Cervical Mucus. The Test line shows the many pregnancy tests I took that were all negative. And the Meds Line marks FE on the days I took the femara. You can see a few other things here. The dotted line on Day 4 means I didn’t record a temperature that day. Open circles usually mean that I slept too long. Fertilityfriend gives open circles anytime you enter something that may mean the accuracy of the temperature is off. Sleeping in, getting up too early, and not sleeping well (marking sleep deprivation) are all examples of cases when the temperature accuracy may be questionable. The red crosshairs marks where ovulation most likely occured. I take my temperature as soon as I wake up in the morning before getting out of the bed. This is important. Your body temperature may change once you get up. So to accurately get your basal body temperature, it has to be as soon as you wake up before getting out of the bed.

So, that’s background on what you see. Why does a woman’s temperature change after ovulation? Progesterone in the bloodstream is the key to this chart. Early in a cycle, estrogen is the dominant hormone (this is the follicular phase). After ovulation, the Corpus Luteum (what remains of the follicle after it releases the egg) takes over hormone production causing progesterone to rise, and estrogen declines (also known as the luteal phase). Progesterone will remain high until right before menstruation, where it will drop and estrogen will take back over. If pregnant, the corpus luteum will continue with progesterone production through the first trimester, at which time the placenta takes over.

Progesterone is what causes your temperature to rise. So, temperatures should be relatively low, then right after ovulation, your temperature will rise due to the rise in progesterone. My chart I linked above shows this temperature shift. I’ve found that most anything can affect the BBT. If I wear warmer PJ’s, then my bbt may be slightly higher. If you sleep with your mouth open, it may be off a little bit. And so on. But you can see in the chart I included here, that while it is not perfect, and the conditions weren’t always ideal, you can still see the temperature shift.

Charting is good to see if you are ovulating. But, ovulation is confirmed after the fact, so it is not great for timing things just right. Fertilityfriend won’t confirm ovulation until you have 3 consecutive days of high temperatures. FF will also use the other signs, such as cervical mucus, to determine when you ovulated. It takes all of the information you give it and tries to cross-check everything. There is other charting software out there, I’m sure. You could also do this by hand, but I find it very easy to enter into the website every morning.

I also like to chart because that helps me figure out whether I could be pregnant or not. Last month, when my temp dropped, I had a hint that the cycle probably didn’t work out. When it continued to go down, I pretty much knew that it was over at that point. Also, while a woman may not ovulate on the same day every month, usually her luteal phase is pretty constant. I know if my luteal phase goes beyond 14 days, then something’s up! Most pregnancy tests are reliable at 14 days past ovulation, so it helps with timing when to test as well. So, while I don’t have to chart my temperature according to my RE I continue to do so anyway, because it gives me some extra cross-checking points.

Resources:

ABCs of Basal Body Temperature Charting

Fertility Plus: Hormone Levels and Fertility Bloodwork

Fertilityfriend.com

Caffeine and Miscarriage

Caffeine, Miscarriage and Fertility – Conception

I will admit that I’ve not cut my caffeine consumption down much. I still have 2-3 cups of coffee most mornings. I don’t have much more than that throughout the day, because I usually drink water the rest of the time. I may have another cup in the afternoon as a pick-me-up on a really long day.

So, to cut caffeine or not? The studies are so ambiguous. Some say that it can cause miscarriages, others say no, not really. I think likely I will never completely cut out all caffeine from my diet. I can get the daily consumption down. I’ve done that before, but the holidays kind of reversed that for me. But I find it pretty unlikely I’ll ever get that down to zero. Reasonably, I think that’s ok. If I go to 1-2 cups a day instead of 2-3 that would be an improvement.

Herein lies the part where you see inside my head more. Often I think, “Is there something more I could do?” When in reality there probably is not. I was honest on my infertility paperwork on the amount of coffee I have each day, and my RE doesn’t seem concerned. That probably should be enough to comfort me. However, I think it is common for women going through infertility to wonder what else they could do. Hey, I’ve even considered switching us to an all organic diet (at home anyway)! We try so hard to put the burden on ourselves–to fix ourselves so that we can get pregnant, because there must be something I’m doing wrong–something I’ve messed up and need to fix. Even if we know rationally that’s not true, it’s hard not to get into these pitfalls. Plus, there’s the engineer in me still trying to tweak the system to see if I can somehow over time locate where the problem is and fix it.

So where am I going with this post? I’m not sure. I’m just letting my fingers type. I wanted to give some resources on the supposed caffeine-miscarriage link. I think the above article summarizes my feelings well. Moderation is key. Moderate caffeine intake shouldn’t do any harm. I fall into the upper – end of moderate on most days, and some days I exceed that. But I rarely get to the 600+ mg of caffeine that the one study supposedly found as the dangerous amount.

So there you have it! I don’t plan on changing my habits much. Just little tweaks here and there… 😉