Fertility Options Coach

Your heart can embrace your baby many years before your body can successfully carry it. This is the story of a mother who would not stop loving her baby although the doctors told her she would never get pregnant.

Nothing strikes fear in the heart of a woman with infertility more than the thought of hearing those words “I am sorry, but there is nothing we can do.” Julia Indichova refused to let those words stop her from her quest to have a baby. She followed her heart–and had not one, but two successful pregnancies after the doctors said it was impossible. Although she had been told that there was no chance of having a baby due as her ovaries were no longer working, her quest for motherhood continued.

Indichova’s path to parenthood will sound familiar for any woman who has experienced the pain of infertility due to high FSH levels–especially those over 40. Indichova tells of her struggles to get past the medical diagnosis of infertility both emotionally and physically. Her eventual success was through a variety of means including herbs (Traditional Chinese Medicine) and acupuncture. No matter what path you choose, her words are inspirational.

This is not a “How-To” manual. She provides few specifics about how she achieved her successful and healthy pregnancies. It is not her intention to tell you how much of this and what of that to take or do. This is instead a personal tale of pain and hope and finally, triumph over the odds. It is an inspiring and hope-filled book for any woman suffering from infertility. If you are facing an apparently hopeless fertility journey, Indichova’s story can help restore your hope and give you a window into how one woman changed her medical destiny and made motherhood a reality.

The hysterosalpingogram or HSG is often ordered as part of an infertility workup to show the shape and condition of the uterus and fallopian tubes. If there are blockages in the tubes sperm can’t find their way to the egg. If there are abnormalities in the shape of the uterus it may be difficult or impossible to carry a baby to term. Your doctor may order an HSG to help rule out physical abnormalities as the cause of infertility.

An HSG is an xray of your uterus and fallopian tubes done with a “contrast” dye so that the shape of these organs will show on the xray (normally soft tissues such as muscle and skin don’t show on an xray). The HSG must be done on days 7-10 of your cycle to rule out any chance that you might be pregnant.

About half the women I talk to say it is no big deal, the other half said it was very painful. I took two ibuprofen and two acetaminophen two hours before the test to be on the safe side.

When I went in for an HSG, I was very upset to learn that at this hospital they don’t allow spouses to accompany women through the procedure. I could have rescheduled for a different hospital since many do allow spouses to come along for moral support, but I decided I just wanted this done. The technicians were super nice and explained everything they were going to do.

As with most gynecological procedures, I was on my back with my feet in stirrups. The radiologist used a larger than usual speculum so he could get a good view of what he was doing. He then threaded a small catheter with a tiny flat balloon on the end into my cervix. This wasn’t as bad as I expected but there was some cramping. He then inflated the balloon slightly and began injecting the dye.

The catheter slid right out. This time my cervix had moved and he had a lot of trouble getting it back in. Worse, now I was cramping as bad as my worst periods and the muscle contractions didn’t help him in getting the catheter back in place. He started apologizing for the intense pain he was causing, but the catheter just wouldn’t go in. He turned the speculum a few times to get a better view. THAT was even better. He did eventually get the catheter in and said “This is one of the worst I have ever done! I do twelve of these a day and this was really difficult.” Trust me to be the one with the extra long cervix!

He explained that my cervix was more than twice as long as normal, likely from all those years of not having periods (I have polycystic ovarian syndrome). Once he had it in place and began inserting dye, it got even more painful as my cramps got worse when the dye pushed in. The good news is that most women don’t go through this much. The even better news is that my tubes both showed clear and my uterus is normal. This was a huge relief after so many years of worrying about it.

Having an HSG can often clear any debris or mucus blocking the tubes, so many women actually do get pregnant after an HSG. For most women it is not a terribly painful procedure, I just got lucky again. Both the radiologist and the technician complimented me on my pain tolerance and apologized for how unusually difficult my procedure was. I asked them if this was supposed to change my mind about wanting to go through labor. The laughed and said, “No, this is supposed to make labor look easy!”

If the HSG shows that you tubes are blocked, it is important to understand that this can be a false reading if your tubes are spasming they may appear blocked but not actually be blocked. It is also possible for mucus to block the openings. If your tubes appear blocked your doctor can often open themby inserting a small catheter into the opening of the tube.

That bagel you had for breakfast just might be one of the reasons you haven’t been able to get pregnant. A hidden sensitivity to a protein in grain can cause infertility, depression, diarrhea, constipation, anemia and fatigue. This protein, called gluten, is present in wheat, rye, oats, triticale, spelt, kamut, and other grains. Gluten sensitivity is related to celiac disease, but it is much more common.

While celiac disease affects approximately 1 in 133 people, hidden gluten sensitivity may affect as many as 1 person out of every 2. Celiac disease has dramatic symptoms including rapid weight loss and severe anemia. Hidden celiac disease or gluten sensitivity can remain hidden precisely because the symptoms are not apparent. Gluten sensitivity can be determined with a blood test, but if it is still in the early stages it may not show on a blood test.

Melissa Diane Smith is a nutritionist and health educator. She is also the author of Going Against the Grain, an explanation of how a sensitivty to gluten can ruin your health and what you can do about it. Smith spoke at the After the Diet PCOS conference in April 2006 where she talked about the infertility and gluten sensitivity. She stated that gluten sensitivity is a leading cause of recurrent miscarriage.

Symptoms of gluten sensitivity can include anemia, abdominal pain, bloating and gas, depression, fatigue, diahrrea and constipation. Gluten sensitivity is associated with a variety of other disease including infertility, autism, autoimmune diseases, frequent headaches, psoriasis and skin conditions as well as other problems. Women with celiac disease who do not follow a gluten-free diet have been found to enter menopause 4-5 years earlier than other women.

In addition, up to 39% of women with celiac disease have been shown to have periods of amenorhea (no periods). Clearly, if you are sensitive to gluten it can negatively impact your reproduction. Men with celiac disease have also been shown to have reduced fertility. While gluten sensitivity is not different than celiac disease, it only makes sense to investigate gluten sensitivity while battling unexplained infertility.

Smith said that 85% of her PCOS clients test positive for a sensitivity to gluten. When these women remove gluten from their diets they often see a marked improvement in their PCOS symptoms. She has also seen dramatic improvement in cholesterol levels, thyroid function and weight loss in women who have changed their diets to avoid gluten.

Smith recommends that women who suffer from gluten sensitivity avoid gluten containing foods including hidden gluten such foods as soy sauce, teas and foods containging barley malt, vegetable protein made from wheat gluten, and beer. Don’t just replace the high glutne grains with more starchy or sugary foods though or you run the risk of developing insulin resistance. Instead, focus on fresh vegetables.

For more information about gluten sensitivity read Going Against the Grain: How Reducing and Avoiding Grains Can Revitalize Your Health

There are a lot of good things about having an IUI or intruterine insemination. You know the sperm is getting where it needs to be. You know the timing is right. You are avoiding all the issues with a difficult cervix or having the wrong vaginal PH. On the other hand, you just don’t expect to be trying to conceive a child with your feet in stirrups and two other women in the room.

I will never forget my first IUI. My doctor assured me that it would be much, much easier than the HSG (hysterosalpongogram) they had used to check for blockages in my tubes. I told him the HSG tech said my cervix was difficult. He said they’d use ultrasound to guide the way and that it would not hurt as much. Mostly he lied.

For one thing, my doctor didn’t perform the procedure. It was performed by two super nice nurses. They asked me to identify the donor sample we were to use. I said I’d never seen it before, but hey, looks like sperm to me. They asked me to check the numbers on the syringe and the numbers on the form I had to sign. Yup, looks like sperm to me.

They didn’t use ultrasound either. Don’t know if that would have helped, but for me the worst of it seems to happen when they are trying to find the opening to my cervix. Seems mine is never in the right spot. It took a long time for them to get the right size speculum in the right spot to see where they were going. I don’t want to scare anyone, because from what I hear mine was far, far worse than average (as usual). But this was not fun.

Once they figured out where to go, the insemination itself was a breeze. Then the cramping started. I had to stay on my back for 20 minutes while “gravity” did its thing. They tilted the edge of the table up in the air and left the room. I shifted, squirmed, cried, and tapped my feet for 20 minutes while I begged these anonymous sperm to swim the right direction despite my cramping uterus. My husband said, “Don’t worry, labor will be a lot worse.” He is a very, very lucky man. If I had not been afraid of losing $300 worth of donor sperm I might have broken my vow of non-violence.

Since that first time, I have had three more IUI. None of them have worked for me, but at least the next three were much more comfortable. I had a different doctor and she actually did the procedure instead of passing it off to nurses.

Studies have shown that IUI in conjunction with other treatements can improve your odds of conceiving.

Human chorionic gonadotropin (HCG) is a hormone produced during pregnancy. HCG is the hormone measured in pregnancy tests. A level less than 5mIU/ml is considered negative for pregnancy and anything over 25mIU/ml is considered positive. Urine tests for HCG (home pregnancy tests) are able to detect different levels of HCG. The most sensitive tests can detect levels as low as 25mIU/ml and can be effective as early as 11 days after conception. Blood tests are more sensitive than urine tests and can detect pregnancy sooner.

Your doctor can order two different types of HCG tests. A qualitative HCG test is usually used to determine if you are pregnant. A quantitative HCG test is used to determine how much HCG is present which can help determine the viability of the pregnancy. HCG is produced by the placenta as the baby develops. The amount of HCG doubles approximately every 48-72 hours during the first 8 to 11 weeks of pregnancy. As the end of the first trimester nears, the HCG levels begin to decline and level off.

An HCG quantitative test will tell you how much HCG is present in your blood. When the placents is not developing normally, the HCG levels do not rise as they should. This may mean that the embryo is not viable and that a miscarriage is likely. However, HCG levels vary widely and many normal pregnancies have low HCG levels. One HCG test does not tell you much. It is not an accurate way to date a pregnancy – an ultrasound at 5-6 weeks is much more accurate. Two HCG quantitative tests 48 hours or more apart can give you an idea of how healty the pregnancy. HCG levels usually double every 48-72 hours. So, seeing that your HCG levels are rising can indicate a healthy pregnancy.

What if your HCG levels are lower than expected? While this could mean a problem with the pregnancy, quite often it is simply that the dates are wrong. I spent a difficult weekend worrying about a miscarriage only to have an ultrasound show that the dates were off by 12 days, making my HCG levels high for the actual gestational age not low! It is important to talk to your doctor since a low HCG level can indicate a problem such as an ectopic pregnancy.

What if your HCG levels are higher than expected? Again, this could mean that the dates were miscalculated. It may also mean a multiple pregnancy or a molar pregnancy.