Naturally Getting Pregnant

I find myself here…again.

I’m having a miscarriage, but it may be worse – yes, there is a worse – it could be another ectopic pregnancy.

My HCG values which should be going down since I am miscarrying have decided instead to stay the same. On Monday the value was 125 and on Wednesday it was 142. So actually it went up slightly but my gynecologist said that she considers the values to be the same since HCG is normally measured in the thousands and the slight difference in the hundreds is outside the measurement’s precision.

Originally, I was scheduled to have my HCG values tested on Thursday but the terrible cramps that woke me up in the middle of the night on Tuesday prompted me to reschedule my appointment for Wednesday.

Wednesday’s visit didn’t provide me with any new answers though, just a prescription for pain medication. Since then I’ve been bleeding and each night I have terrible cramps. The pain medication certainly helps but could this please just come to an end. My frustration is building and my sense of relief that I spoke about in my last blog is dwindling.

My next appointment is set for Tuesday. She’ll be checking my HCG values and probably doing another ultrasound.

I hope my body figures this out on its own. Luckily, I have a gynecologist that also wants to give my system a chance to short this out. Until then I have a winter wonderland to look out the window at and two cats that think it’s cool I’m lying on the couch. Friends have invited us over for an evening of cooking and a movie this weekend. Hopefully, I feel up to it because an evening with friends couldn’t sound any better than right now.

My digestive system has quite a personality. And I mean that literally. When it’s not working right, it influences my mood drastically. I’ve been known to head into the bathroom in the morning in a foul mood emerging a short time later with my hands in the air and a smile on my face screaming, “Wahoo!”

This sounds ridiculous, but that’s my life.

My bowels get slow sometimes. I’ve gone days before without relief, which not only puts me in a bad mood but over the last couple of years has left me wondering, “Is this affecting my fertility?”

Julia Indichova, author of two books on infertility and director of the Fertile Heart™ Studio in New York, in working with infertile couples has noticed a link with the observation, “…a large number of these people had digestion-related complaints” (1).

This isn’t a total surprise though since we know that the digestive system plays a crucial role in our overall health. Our digestive system is responsible for breaking down and absorbing the nutrients, energy and water we need to live from the food we eat. If all goes well, the body gets everything it needs and the waste products are ushered out the back door.

So how do we know if everything is indeed working well? According to Dr. Oz and Dr. Roizen in their book, YOU The Owner’s Manual, an important diagnostic for measuring your digestive health is, yep you guessed it, how shall I say it – your poop.

Let’s not try and make this sound scientific: let’s be direct. Dr. Oz and Dr. Roizen give the following criteria for healthy poop:

• banana shaped (not pellets)
• attached to you when it hits the water

Or as Foxx-Orenstein, president of the American College of Gastroenterology, stated, “An ideal stool looks like a torpedo—it should be large, soft, fluffy and easy to pass.” What isn’t good is a stool that is hard and dry, liquidy, pencil thin, grey or black, floats and smells or is bloody (2).

And with regard to regularity, Foxx-Orenstein says that although bowel movements should be regular everyone is different. Regular can mean as few as three bowel movements each week and still be healthy. What isn’t good is diarrhea or constipation (constipation being defined as too much straining with bowel movements, passage of small hard stools or a sense that the bowels have not completely emptied) (3).

So what have I done about my digestive health?

Well, initially I did what all the experts recommended: I ate lots of fruits and veggies (easy as a vegetarian at the time), got plenty of exercise and drank plenty of water. This didn’t seem to be the solution to my problem, though, so I did a colon cleanse. Although the cleanse helped, I still had bouts of constipation.

More recently, I eliminated all cheeses and increased my vegetable intake further, especially including regular servings of parsley and the green leafy vegetable called rocket or arugula. This wasn’t enough so I traded my regular morning breakfast for vegetable soup. This helped quite a bit, but it caused a new problem – too much weight loss.

Then, ironically, in an effort to meet my other diet principles I added something that seems to have solved my digestive problems: poultry (see my blog: Vegetarian no more…).

This seems so odd, but I haven’t changed anything else in my life over the past several weeks. I’m thinking the poultry did something. There is one other possibility though. I stopped eating gluten about two months ago – suspecting it as a culprit to my digestive woes. So, it’s also entirely possible that the gluten free diet has slowly taken hold (more about gluten and fertility in an upcoming blog). Right now, I’m going to celebrate my happy digestive system, “Wahoo!”

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To say the least, things have been bumpy lately.

I moved across town. I’m totally excited about the move but whether I’m happy about it or not, moving is considered to be a major life event – or in stress terms: a major external stressor (not to mention that it was postponed by a week due to my miscarriage). On the day we moved things also got a bit hectic – can moving day go any other way? I tried to eat well and stay relaxed. But, no, it did not work.

For lunch I threw some chicken in the oven to go with the potato salad my mother-in-law made. Being in the hectic mode I was in, I forgot to ask what was in the potato salad. Well, it turns out she put in some sunflower seeds – seems harmless but, they are the bag of sunflower seeds I gave her because I couldn’t eat them with a clear allergy warning on the back that they may contain gluten. Yes, I told her they contained gluten when I gave them to her. But apparently, she forgot, and fed them to me.

After we finished hauling in the last boxes, we stood in our new kitchen with friends and toasted with our Champagne glasses bubbling with…water. No, water just didn’t seem to represent celebration, so, I raised my glass full of Champagne just like everyone else.

Stress, gluten and alcohol. These things have never equated to fun for my body. Why should now be any different? I got my acne back, my hair started falling out again, I lost weight that I didn’t want to loose, and I’ve been pretty exhausted. I finally started feeling better last week (the move was over four weeks ago). All I can do is hope that this episode is coming to an end and that I’m recovering.

So what about the probiotic bacteria?

Well, in the same haphazard fashion of the move: I didn’t stick to my plan. The plan was to first introduce probiotic bacteria naturally with fermented foods and then, if necessary, add probiotic supplements.

That’s not what I did. Instead it was like this: I’m standing in my new kitchen with my body totally peeved (acne, tired etc.) and I saw the gluten free probiotic supplements sitting in the middle of the otherwise empty fridge. I thought, “Oh, what the hell.”

I took them for two weeks every morning with my mid-morning snack and except for a little bit of a butterfly feeling in my stomach sometimes, there’s not much to report. My bowels were actually a little slower during that period but since everything was out of whack it’s really hard to say how my body reacted specifically to the probiotics.

I’ve stopped taking the probiotics and I am also feeling better. Connection? No idea. My head is on straight now, though (I think) and I am going back to food sources to get my probiotic bacteria. Here’s what I’ve chosen:

Probiotic Food I’m including:

• Organic Raw Sauerkraut – I sprinkle this on my salads.
• Organic Vinegar – I use vinegar to make a simple but yummy salad dressing (2 Tbs olive oil , 2 Tbs vinegar, 1 crushed garlic clove, ½ tsp Dijon mustard, salt and pepper: shake in a jar and enjoy).
• Miso Paste – I found some that’s gluten free and I use it to make miso soup. Yes, this is a product made from soy, which I avoid because several studies suggest that too much soy can lead to infertility. So why do I eat miso if I’m avoiding soy products? Fermented soy products offer the benefits without the drawbacks of non-fermented soy. Soybeans are high in phytates and enzyme inhibitors which cause gastric distress and can bind to minerals like zinc, calcium, and iron in the digestive tract and prevent their absorption. Fermented soy contains only low levels of these culprits.
• Tamari Sauce – This is like soy sauce but is gluten free. I use this sauce along with ginger and olive oil to bake my chicken. I also add it to steamed vegetables. Yes, this is a soy product that I allow because it is fermented – see Miso Paste above for why I allow fermented soy products in my diet.
• Organic Pickles – I eat this as a snack but I’m careful to buy the truly fermented ones: not in vinegar but listed on the package as fermented.

Probiotic Food I’m not including and why:

• Fermented Dairy Products like cottage cheese, kefir and yogurt – dairy products remain controversial in their role in infertility and most experts recommend keeping them to a minimum, add on to that I don’t digest them well.
• Tofu – several studies suggest that too much soy can lead to infertility
• Soy sauce – contains gluten
• Tempeh – again, several studies suggest that too much soy can lead to infertility
• Beer & Wine – some studies suggest it may not be good for fertility and it’s dangerous to a developing fetus, not to mention that it throws off my digestive system.

And in my diet I also include the following foods that contain prebiotics (food for the probiotic bacteria):

• Asparagus
• Chicory
• Chinese chive
• Eggplant
• Garlic
• Fruit – I only eat fruit in small amounts so that I don’t spike my sugar / insulin levels
• Jerusalem artichokes
• Leeks
• Legumes
• Onions
• Tomatoes

Here are the prebiotic food items I don’t eat and why:

• Burdock root –  I have no idea what this is or where to get it
• Peas – never really liked these little green pellets
• Soybeans – several studies suggest that too much soy can lead to infertility
• Sugar maple – can spike sugar levels / insulin

So, I’ll keep eating my probiotic foods and I’m even thinking about making some of my own sauerkraut. We’ll see in the next few weeks how my body likes the new critters in my digestive system.

I was at the dentist this week.

Exciting?

No.

But while I was sitting in that oh-so-comfortable dentist’s chair I was confronted with the fact that I have been trying to conceive for over three and a half years. Let me repeat that in case you skimmed: over three and a half years. All I could think about was the fact that three and a half years is a long time – almost ten percent of my lifetime so far.

So why did this dismal thought come to me while a guy in a white coat was trying to see how many sharp objects and mirrors could fit in my mouth at once? Because the fact that I am trying to conceive weaseled its way into the discussion I had with my dentist and now I was sitting back with nothing but my thoughts to distract me from the poking, pushing and drilling that was taking place in my mouth – which I consider a very small place for all that activity.

The discussion my dentist and I had started out simply. He informed me that one of my two amalgam fillings had to be replaced and that a few of my other teeth will probably develop cavities if they are not sealed soon. So replace it and seal em’ up, right? Not quite so fast.

For someone who’s trying to conceive the decision to replace an amalgam filling is a bit more involved. I wrote about this in my blog last fall: Dental Fillings with Mercury: In or Out.

In a nutshell: mercury is toxic and although organizations such as the U.S. Food and Drug Administration, the World Health Organization, and the Center for Disease Control currently agree that there is not enough evidence to show that the fillings are a health risk, the FDA states on their website, “Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses.”

The greatest exposure to the mercury in these fillings comes when the fillings are placed or removed. And since the body needs months to eliminate mercury, women trying to conceive could have elevated mercury levels at conception which presents a potential danger to the fetus. This is why I decided last fall to leave them in.

Now it’s different. One of them has to come out. Does this mean I should postpone trying to conceive even longer than the two cycle wait I’m in right now from my miscarriage to allow my body to eliminate mercury? After talking to my dentist I decided no.

He said the fact that the filling is so tiny combined with the special equipment he uses to remove the filling means there will be virtually no mercury exposure to my body. Sounds good. Sounded so good that I thought while he is in there he might as well remove the other amalgam filling. Because while there are no studies that show these fillings cause infertility there are some anecdotal stories out there from women who attribute the removal of their amalgam fillings to becoming pregnant. Totally weak to base a decision on anecdotal stories but it was somehow enough to tip the scale. I mean, I have to get one of them replaced anyways so why not wipe the whole issue from the table by replacing the other one too?

For my next appointment he’ll finish sealing the rest of my teeth and replace the other amalgam filling. When I’m reclining in the dental chair next time, I plan on thinking about the fact that I’ll be mercury free instead of dwelling on the three and a half years that I’ve been trying to conceive.

Mercury free. I like it.

I thought the expense of having a baby would come after conception.

Turns out – I’m wrong.

Cost of Assisted Reproductive Technology

For those of us struggling to get pregnant, sticker shock hits even before we get a positive pregnancy test. Many of us head to an infertility clinic in the hopes of getting pregnant. But the exorbitant price tag on technological procedures make having a baby seem out of reach – even for those of us with insurance.

According to RESOLVE, an infertility patient advocacy organization, most insurance policies don’t cover most assisted reproductive technologies. So when you’re struggling with infertility and you go to your doctor for help, you’ll probably need to have your wallet ready. The average costs of infertility treatments look like this (1):

IUI cycle: $865
IVF cycle using fresh embryos (not including medications): $8,158
IVF Medications: $4,000
Average additional cost of ICSI procedure: $1,544
Average additional cost of PGD procedure:  $3,550

Who has $12,158 to hand over to give IVF a try?

Not too many people, which is why infertile couples often take out loans to finance their hope of having a child. Some can afford only one attempt and others have to turn away before the first consultation.

Fortunately, banks, institutions and some clinics have developed financing programs specifically for infertility and a few organizations are awarding infertility scholarships. This is a good start but not everyone is in a position to take out a loan – especially in today’s economy – and the winners of scholarships are limited to just a few couples.

So the decisive factor for many infertile couples is money.

Unfair? Yes. Wrong? Absolutely.

But that’s the reality right now: in the US there are only fourteen states that currently have laws that require insurers to either cover or offer to cover some form of infertility diagnosis and treatment (2). And within those states self-insuring businesses do not have to implement these regulations at all (3).

Throw into this difficult situation an economic crisis that caused the loss of 2.6 million jobs in 2008 (the worst year since 1945) with many more fearing the loss of their income this year. It’s not a bright picture but there is a bright side for those of us suffering from infertility and willing to try something else: natural infertility treatments.

Fertility Treatments – Free and Effective

Many natural fertility treatments are not only proving to be effective but they are also considerably cheaper than assisted reproductive technology – costing near next to nothing.

Diet and exercise are two of the most thoroughly researched – and cheapest – natural fertility treatments.

Dr. Jeremy Groll, an expert in fertility treatment and author of Fertility Foods, noticed the effectiveness of diet with one of his patients who had been trying to conceive for two years with an irregular cycle. He had her change her diet and, after two months, she lost eight pounds and achieved a successful pregnancy. This was just the beginning though; he has since gone on to help countless women realize their dream of having children with his diet and exercise program that is, “low-cost, painless and free of detrimental side effects” (4).

Published research results are also beginning to pile up in support of effective and free natural fertility treatments.

In 2007, scientists reviewed published research on the effect lifestyle factors have on reproductive health (5). They concluded from the evidence that a program to encourage and facilitate the necessary lifestyle changes will improve couples’ chances of successful pregnancies, “minimizing the need for costly and invasive infertility treatment.”  More studies are needed on the effects of lifestyle on fertility but there was enough evidence to support the recommendation of a lifestyle intervention program that includes exercise, a healthy diet, no smoking, caffeine reduction and stress reduction.

A group of researchers from Australia went as far as conducting a cost savings analysis of a weight loss program for obese infertile women (in Australian dollars) (6). Their results show that weight loss results in improvement of reproductive outcome for all forms of fertility treatments and costs considerably less.

Before the program, 67 women had two live births with infertility treatment costs totaling A$ 550,000, a cost of A$ 275,000 per baby. The same women went through a 6 month weight loss program (losing an average of 10 kg or 22 pounds) which resulted in 45 babies (18 of the pregnancies were spontaneous, i.e. natural) and A$ 210,000 worth of treatments, a cost of A$ 4,600 per baby. This shows that weight loss is very effective in boosting fertility and much cheaper with a savings of A$ 270,400 (or over US$ 180,000) per child.

Let’s not pretend like weight loss is easy but, this study shows that with support and the right diet, it can lead to a priceless reward.

There are other inexpensive and effective natural fertility treatments other than just diet and exercise. I’ll be covering them in detail on a naturally getting pregnant page soon (there’s that ‘s’ word again). But right now my stomach is grumbling for a snack, so I’m going to go eat something healthy and improve my fertility without having to break the piggy bank.

I’m wide awake. Staring into the darkness, I have no idea what time it is. I fell asleep so early last night it could be as early as 4am. Quietly, I try to get out of bed and head to the bathroom. My roommate is apparently also awake because she asks me if I need a light. I’m relieved that I don’t have to feel my way through the darkness.

I settle back into bed waiting for the time to pass. Breakfast eventually comes. The nurse comes in to check our blood pressure. Then a doctor comes in to take blood. I think, due to my apparent health, that I’m not going to be subjected to his basket full of needles. I’m very wrong. Sitting down on my bed he reaches for the biggest bundle of vials. Then it hits me. I’m scheduled for surgery on Monday. They’re doing all this blood work in preparation.

The hours go by as I stare at the pages of my book thinking I will be able to concentrate if I try hard enough. Guests for my roommate come and go. The phone rings for her several times. I start to feel a little abandoned. When is the doctor coming? When will my husband be here? It’s 11:00 already. I head out into the stairwell to escape the lonely feeling in my room and to use my cell phone to track down my husband. The nurse stops me to tell me that the doctor just called and that I shouldn’t go anywhere. He’s on his way in. Good. Let’s get things going. As I start dialing my husband’s number from my cell phone he comes up the stairs – with some extra clothes, a bag from the bakery and bouquet of flowers. He gives me a hug and apologizes that it took him so long. My emotions make an instantaneous recovery.

We are back in my room when the nurse tells me my single room is ready. Things are getting better and better. It’s a cozy corner room with a round sitting corner flooded with light. The bed is electric which I realize if I do have an operation will be a god send. Richard sets my flowers on the counter and then I see it, a baby changing station. “That has to go,” I say like a general. Richard grabs it and stuffs it in a cabinet before I can even get teary eyed. Lunch is delivered and Richard and I chat while I try to eat the horrible meal of odd tasting potatoes and overcooked vegetables that taste like water. Just as I decide I’m done eating, the phone rings. It’s the nurse telling me the doctor is ready to see me.

We head over to the doctor’s office like we are going out for coffee: chatting, joking, and laughing. The doctor has me up on the table for another ultrasound. “Any pain?” he asks. “None,” I report proudly. He inserts the ultrasound wand and starts the usual exploration. He settles on my right ovary. Moving the wand back and forth he says, “See this mass? This was not here yesterday. See how it moves independently from everything else when I move the wand back and forth? I believe this is the pregnancy in your right fallopian tube.”

The final verdict: I have an ectopic pregnancy.

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It’s Monday and the doctor who conducted the surgery for my ectopic pregnancy is back. He calls Richard and me into his office, and we settle into the chairs across from him like a couple of regulars. In my hand is the print out of my surgery photos – not for the faint of heart. It shows everything: my ovaries, my uterus, and there in the center of one the photos is a large grey glob being pulled out of my right fallopian tube with a pair of extra large tweezers.

I spent much of this morning examining the photos and Richard has already briefed me on everything the doctor said after my surgery on Saturday. I’m anxious to hear everything he has to tell us so when he starts by saying that the surgery was “very interesting,” I move to the edge of my seat.

“During the laparoscopic surgery I found stage one endometriosis, one cyst and two myomas,” the doctor says with compassion. He rotates his computer screen so we can see the surgery pictures in high resolution. “The surgery went great,” he proudly announces. “I removed the endometriosis, the cycst and one myoma. The other myoma was attached to the outside of your uterine wall, which I can not touch during pregnancy due to the high risk of bleeding.”

He brings my attention to the pictures on his screen again by pointing out my fallopian tube prior to surgery. The tube is stretched so thin by the mass growing underneath that it’s transparent. The grey color shines through providing a stark contrast to the deep pink color the rest of the fallopian tube has. “We did the surgery just in time,” he says matter-of-factly. Although, I have no idea how much pressure a fallopian tube can hold, the picture creates an eerily convincing case by itself. Lastly, he points out the empty fallopian tube and the stitches. “It’s still so stretched out,” I remark. He reassures me that it will shrink back to its normal size. The stitches will dissolve on their own.

Now comes the interesting part. He turns to us and begins to talk about our desire to have children. Somehow, he knows that despite this dramatic experience we are not deterred. Or shall I say: I’m not deterred. Richard is still so shaken that his enthusiasm to try again is noticeably absent. The doctor explains that we do have an increased risk of another ectopic pregnancy. He goes on to recommend that we continue trying again as soon as the waiting period is over since the endometriosis may come back and the most likely time to get pregnant is directly after the removal of endometriosis.

Wait a minute. “Waiting period?” I blurt out, surprised. Obviously, I have not given this one ounce of thought because had I thought about it, I would know that my body needs time to recover and at a minimum my tube needs to heal. How is a fertilized egg going to make the trip through a tunnel under construction?

“Three months,” the doctor says sternly. It seems like an eternity. Three months of lost time. “Why so long?” I plead. He explains all the medical details of how my body needs this time to get back into equilibrium and heal. The look on my face must have revealed my disappointment because he said, “Well, the third month is mostly for the emotional aspect.” “So, two months,” I say completely oblivious to the feelings I’m harboring and have yet to deal with. I suddenly realize that I am trying to negotiate the waiting period: totally ridiculous but I stick with the two month reply. It still sounds long but much better than three months.

For the next hour the doctor continues to answer our questions and provide emotional support and guidance. I feel lucky that we ended up in such good hands. Lucky is not something I thought I would be feeling after this surgery. But at this moment I feel lucky and decide to savor it.

The only follow-up I need to do is to have my HCG value checked weekly to make sure that it goes back down to zero. Then I’ll need to see my OBGYN for a post-op check up.

As Richard and I walk out of the doctor’s office and head back to my room, I ride an emotional rollercoaster. My feelings are so mixed. I’m sad thinking about what could have been had the egg traveled just a little further. I’m happy my endometriosis has been removed. I’m frustrated the doctor could not remove the second myoma on my uterine wall. I’m thankful I could keep my tube. I’m scared that my tube may not heal properly. I sigh and bring my attention back to my loving husband walking next to me. Holding is hand right now is helping me heal already.

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