Saturday, October 13, 2018

Pre- and Post-Egg Retrieval - What Worked for Us

I've been thinking about writing about the lifestyle/diet changes we made pre- and post-egg retrieval as well as pre- and post-transfer. There are some things I wish I had known about before we got started (like cutting out alcohol and caffeine several months beforehand), so I thought it might be helpful to share these with anybody who is getting ready for an egg retrieval!

Now that I have 2 egg retrievals under my belt, I thought I'd share what worked for us. I will preface this by saying that I am not a doctor, and that not everything I am sharing was specifically recommended by my doctor. A lot of what I ended up doing came recommended by other people going through IVF, research studies/articles, other fertility clinics, etc. I will try to link to resources where I can. Please don't feel like you have to do any of these things, or that you messed things up by not doing these things. My thought process is this: Since we are investing so much into this--financially, emotionally, physically--I want to do whatever I can (reasonably) do to improve things, whether that is egg/sperm quality, number of eggs retrieved, quality of embryos, implantation rate, etc. I figure, even if there isn't scientific proof behind things, if it's not going to hurt, why not give it a shot so that I don't regret things later? I'd rather know I tried my best than live with the "what if?" later on. 

Scroll down to the bottom for Conclusions, or a recap of what I discuss in this post.

Exercise: 3 Months and Prior
This is absolutely something you should talk to your doctor about. They will let you know if you're at a healthy BMI, and what you can do to help achieve one. Doctors generally recommend achieving a normal BMI, as "obesity has been found to alter mitochondrial function and increase oxidative stress, leading to reduced fertility and egg quality. It can also alter hormonal balance, disrupting ovulation." If you have some time before starting Stims--maybe you're saving up money, or waiting for a good time--this is a great time to start exercising and improving your overall health.

Exercise: During/After Stims
You should definitely consult your doctor about exercise during/after Stims, and during/after the 2WW. My nurse said I could continue my normal cardio/strength training during the early stages of injections (days 1-5), but by day 6, I would want to decrease intensity and focus on non-impact exercises (yoga, light elliptical, swimming, etc.). The main concern with strenuous exercise during Stims is that the medications will cause your ovaries to enlarge as the follicles start growing. According to the Southern California Reproductive Center, "You need to protect your ovaries during this sensitive time and avoid strenuous training. Your IVF cycle is not a time to push any limitations...Your body is already working extremely hard during your IVF cycle, so take the time to acknowledge yourself for that." One thing to think about after egg retrieval is the risks of ovarian torsion or ovarian hyperstimulation syndrome (OHSS), so following your doctor's orders and avoiding strenuous exercise are very important here.

Diet: 3 Months and Prior
Alcohol/Caffeine
I read an article that said that "given that egg and sperm maturation takes up to 3 months, it is ideal to stop/reduce alcohol consumption for at least three months before attempting pregnancy." I didn't know this prior to my first egg retrieval, so I had a minor freak out and wrote all about it here. I came to the conclusion that it wouldn't hurt to reduce/eliminate alcohol/caffeine in the 3 months prior to IVF (for both you and your partner), but that ultimately, it is not going to drastically compromise your chances. Knowing this information, we eliminated caffeine/alcohol from our diets 3 months before our 2nd egg retrieval, and I think it did make some improvements for us!

Vitamins/Supplements
My nurse did encourage me to take a prenatal vitamin before we started Stims. Memphis fertility specialist, Dr. Amelia Bailey, recommends that "a woman planning pregnancy should start taking a prenatal vitamin with DHA 6 months before conceiving." She (and other other specialists) also recommend Coenzyme Q10 (CoQ10), DHEA, DHA, folic acid (as needed), and Vitamin D (as needed). CoQ10 is helpful for overall sperm and egg health. Vitamin D insufficiency and deficiency in women attempting to get pregnant has also become an increasing concern. (This article is really helpful if you're thinking of taking any of these mentioned vitamins/supplements.) I personally just took a prenatal vitamin, fish oil, and Vitamin D supplements before and during Stims.

According to Dalene Barton-Schuster, Certified Herbalist and Birth Doula, "The life cycle of sperm, from production to maturation for ejaculation, ranges from 42 to 76 days...to make a plan for increasing fertility and boosting sperm health, you should start at least 2-3 months prior to giving sperm for IVF." CoQ10 is said to improve men's sperm motility and count. There are also many articles claiming that selenium, Vitamin C, zinc, and other vitamins/supplements can help improve male reproductive health. Three months prior to our 2nd egg retrieval, David cut out caffeine/alcohol. He also took a multivitamin, 200mg of Ubiquinol (CoQ10), and the Daily Wellness Company's Fertility Blend for Men daily. The Fertility Blend for Men is something I stumbled upon a few weeks prior to our first egg retrieval. It has great reviews online, and contains many of the recommended supplements to boost male fertility, such as L-carnitine, Vitamins B/C/E, zinc, and selenium.

Here's a helpful article on pre-conception vitamins written by Sarah Yang for the Bump. Here is an article on nutritional guidelines for your fertility treatment published on the Southern California Reproductive Center's blog.

Diet: During/After Stims
My nurse told me that during Stims, "the recommendation for caffeine intake is less than 600 mg" per day and that restricting "all caffeine intake is preferred." She also said that "no alcohol intake is preferred/recommended." I checked and she said that it would be okay to drink caffeine-free Diet Coke and decaf coffee. I had eliminated diet sodas and artificial sugar from my diet once I became pregnant, so it was easy for me to continue avoiding it during my 2nd egg retrieval, though I've added in the occasional Diet Coke or Splenda now that I'm done breastfeeding. (We don't plan to do our next embryo transfer for awhile.)

I think that eating healthy is something that is great to do now for yourself and for your future baby! There are a lot of diet changes you need to make when you become pregnant, so it doesn't hurt to start getting used to those changes now.

Acupuncture
I had never given much thought to holistic medicine (except for chiropractic) prior to IVF, but my fertility clinic actually has an acupuncture facility right in their building, so it was something I looked into. Some studies have shown that "when used in conduction with Western fertility treatments, acupuncture increases conception rates by 26%." Others say that "acupuncture is not harmful and most of those so treated swear by it. For the nay-sayers, what can be said with certainty is that at the very least acupuncture has a 'feel good' aspect to it and in most, evokes a psychological benefit that should not be discounted." My thoughts are that it's not going to hurt anything, so why not give it a shot? I didn't do acupuncture prior to my first egg retrieval, but I did do it for about a month prior to my 2nd one, and I think it did make some improvements for us the second time around.

Conclusions
My main suggestions for Before Stims (preferably 3 months or prior):
  • Exercise and get to a healthy BMI
  • Eat healthy--limit/eliminate caffeine/alcohol, fake sugars, trans fats, processed foods, etc.
  • Take prenatal/multivitamins, CoQ10, and other recommended vitamins/supplements
  • Acupuncture (talk to your acupuncturist, but you can start 3 months prior, or even 3-4 weeks prior to Stims)
My main suggestions for During/After Stims:
  • Limited non-strenuous exercise (as discussed with your doctor!)
  • Continue to eat healthy--eliminate caffeine/alcohol, fake sugars, trans fats, processed foods, etc.
  • Continue taking prenatal/multivitamins, and other recommended vitamins/supplements as needed (and recommended by your doctor)
  • Acupuncture (talk to your acupuncturist about what they recommend for during Stims and leading up to the embryo transfer...)

Sunday, April 23, 2017

Sharing "The Story Behind of Baby Nelson"

I struggled so much with whether or not I wanted to publicly share our IVF journey (with friends, family and coworkers). David was always for it. He wanted people to know that this baby was nothing short of a miracle. I finally came around and realized he was right, and we decided to share our "IVF story" today on social media, as it's the start of National Infertility Awareness Week. I posted a Note to my FB account and so far have been overwhelmed with the support and positive responses. Here's what it says:

Dear Friends and Family, 

By now you have probably heard the wonderful news that David and I are expecting our little Nelson Nugget at the end of July. What you may not know, however, is the incredible journey we embarked on to get to this place. When David and I decided we were ready to add to our family in September of 2015, we soon discovered that it would not be so easy. To make a long story short, we learned that the only way we could conceive would be through in vitro fertilization (IVF). After meeting with our doctor in December, we prayed long and hard over this decision and did much research before deciding we wanted to continue on this journey. So for the past year, whenever anyone has asked me when we're having kids, I've just smiled...even though deep down inside I would be crying. 

As soon as I was finished teaching my spring 2016 semester, I flew to Maryland to start the IVF process. And let me tell you...it was not easy. I do not like needles, and IVF requires a lot of needles! I had my blood drawn every other day to the point that both my arms were black and blue. I had invasive ultrasounds done every other day. I learned to give myself subcutaneous injections--2 to 3 per day--and later my mom and David learned to give me nightly intramuscular injections. (In total, I have had ~108 injections.) All the while, we dealt with the emotional roller coaster that comes with IVF. There are so many hurdles you must get over before moving on to the next step, and if one fails, you have to start over. Our first transfer in July was unsuccessful; the embryo did not implant. I was devastated. I couldn't get out of bed. I didn't think I could go back to work in the fall. Yet somehow, by the grace of God, I picked myself up again. In November, I flew back to Maryland and transferred our last frozen embryo. This little miracle embryo implanted, and we are 26 weeks,1 day pregnant today. 

The reason I am sharing this is because I do not want people to think that this was an easy, planned, journey for us...because it wasn't. At the same time, we were blessed to find out about our need for IVF from the very beginning, and I am very thankful for that. I know several people who have experienced (and are experiencing) the hardships of infertility...and have experienced this for too long. My heart truly goes out to them as I can only share in some of the pain they feel. 

While I know most of you are happy for us, I know that some of you may also have some questions...and I am happy to try to answer them if you want to private message me. Please note that this is a very sensitive topic for us, so if for some reason, you are against our choice of doing IVF, please refrain from contacting me, as I do not wish to get into an argument or debate about one of the happiest moments in our lives. However, I will share that we did not have to worry about multiples, as our doctor practices elective single embryo transfer (eSET), so we only transferred 1 embryo at a time. And in our case, we are not worrying about extra, frozen embryos. We had 2 embryos and we transferred both of them. The first one did not implant, and the second one did. 

David and I just wanted to be honest and transparent about our journey. We got the good news the day before Thanksgiving and we were elated...but even then, we were not "out of the woods." I still had multiple blood tests and ultrasounds before my doctor would release me into the care of my OB/GYN. At 5 weeks, 6 days gestation, we had a scare and I ended up in the ER. I was diagnosed with a subchorionic hematoma (SCH) and was put on bed rest. The SCH was a scary diagnosis because it is linked to an elevated risk of miscarriage or pre-term labor. (As of the 3/10/17 anatomy scan, the SCH is no longer showing up on he U/S.) Beyond the medical side of things, there are also the the financial burdens associated with this. Unfortunately, our insurance does not cover fertility treatments, so we are paying for everything out of pocket. Some have asked if they could donate to our IVF fund, and the answer is yes, we would be so very grateful. We have an IVF GoFundMe account set up here if you are interested. 

Thank you for taking the time to listen to our story. We hope this doesn't change how any of you feel about us, but we wanted our story to be heard. This week (April 23-29) is actually National Infertility Awareness Week, which felt like the perfect time to share our story with you. Did you know that 1 in 8 couples struggle to build a family? "The CDC tells us that this is 15% of couples in America. Infertility does not discriminate based on race, religion, sexuality or economic status. You never know how badly you want something until you are told that it may not be possible." For more information, please visit https://infertilityawareness.org/about-niaw. 

Love, 
Dorothy & David 

Post Note: We are overwhelmed with the positive responses we have received. To be honest, I never knew if I wanted to share this story with anyone. It’s something I’ve gone back and forth with for months. Part of me worried that we would be judged for the particular route we chose to expand our family, whether for moral, religious, or other reasons. Part of me just didn’t want the whole world to know after we’d kept this secret for so long. David is the one that encouraged me to share our story, and I’m glad he gave me that push. We’ve gotten to see Baby Nelson since she was just a small cluster of cells and it’s hard to believe that that tiny little miracle embryo is now kicking me as I write this. (She kicks even more when I eat pizza.) Thank you so much for your kind words and support. It truly means a lot. :)

Thursday, April 20, 2017

Maternity Style

I have been wearing my normal clothes for the majority of my pregnancy, but with my waistband starting to feel a little snug, I've started embracing showing off "the bump," and have found a few great maternity wardrobe pieces that I wanted to share on the blog today. A few weekends ago, David and I had to make the long drive to Ikea to return some stuff, so we stopped at a Motherhood Maternity Outlet Store where I found so many amazing pieces.

We live in a small little town and the closest maternity clothing store is 2.5 hours away...so I've also found many of my favorite pieces online or at Target. My friend and coworker introduced me to Pink Blush, which I've quickly fallen in love with. What I love about them is that many of their pieces can be worn before, during, and after pregnancy-and their models show what it looks like either way. Below are 10 of my favorite maternity wardrobe pieces:


Here are 10 of my absolute favorite pieces!

  1. Ivory Floral Striped Colorblock Maternity Top from Pink Blush - I actually got the Fuschia top (#2) first, but loved it so much that I had to get the floral one as well. I love the raglan sleeve, and this top can definitely be worn pregnant or not. I love wearing it with black leggings or skinny jeans.
  2. Fuscia Striped Colorblock Maternity Top from Pink Blush - You can see what it looks like on a non-pregnant model vs. a pregnant model (#1). I don't usually wear bright colors (like hot pink) but something about the raglan sleeve makes it so fun. 
  3. Keyhole Side Ruched Maternity Tee Striped from Motherhood Maternity - This top is so comfortable and flattering that I got it in black/white and black/blue. The back has a fun little keyhole, and the elbow-sleeve makes it perfect for spring or summer.
  4. Jessica Simpson Back Interest Maternity T-shirt from Motherhood Maternity - I haven't found a maternity T-shirt I've liked until I tried on this one. Jessica Simpson makes some really cute maternity clothes for Motherhood Maternity . This T-shirt has a really fun back detail and is super soft. I can't wait to wear it this summer. I got it in black and light blue.
  5. Heavy-Knit Shift Dress from Old Navy - This isn't actually a maternity dress, but it's one of my favorites and I have it in 3 different colors! The material is thick and forgiving, and I wore this dress so much during the first trimester. People never even realized I was pregnant! In the fall and winter, I wore it with tights and boots and in the spring I've worn it bare-legged with flats.
  6. Liz Lange Maternity Over the Belly Distressed Jeggings from Target - I had given up on maternity jeans until I discovered these. Everything I tried on was too big in the waist until I realized that even though my bump was still small, an "over-the-belly" style worked better for me than "under-the-belly" or "side-panel" options. The latter two are always too big/loose for me in the waist/belly area, but the "over-the-belly" option works because you can wear it folded over (when your bump is still small) or pulled up (when your bump is bigger and needs the support). I love the distressing detail on these jeans!
  7. Liz Lange Maternity Under the Belly Ponte Pant from Target - "Under-the-belly" can also work too. I found these ponte pants on clearance and couldn't pass them up. They feel like leggings, but are ponte pants, so they're much thicker and are suitable to wear for work.
  8. BeMaternity by Ingrid & Isabel Seamless Belly Black Legging from Target - I've been mainly wearing my normal favorite leggings, but the high waistband has gotten a little tight, so I searched for a pair of comparable maternity leggings and found these. These are great because you can also fold the waistband over or pull it up. 
  9. Side Ruched Maternity Dress from Motherhood Maternity - When I was at Motherhood Maternity, the sales lady insisted I try on this dress even though I wasn't looking for dresses. I tried it on in two patterns and instantly fell in love. The ruching is great because it grows with your bump, but I anticipate being able to wear this when I'm not pregnant too. I wore this striped pattern with a denim jacket yesterday and our admin. asst. kept telling me how cute I was.
  10. Royal Damask Bottom Maternity Maxi Dress from Pink Blush - I love this dress! I got it just before we left for our Babymoon and luckily my seamstress was able to hem it for me before we left that weekend. This can be worn pregnant or not, and it's just so eye-catching! I get compliments every time I wear it.

Monday, March 27, 2017

It's a...

I've been meaning to share this story for weeks now, but I was waiting until after our anatomy scan, and then totally forgot to do it. 

We actually could have found out the baby's sex on January 19, 2017, when we went in for a 2D U/S, but we had the technician put the information in a sealed enveloped, and then I had David hide it from me. Our plan was to open it up on a special occasion, like Valentine's Day, so we could celebrate the news. Well, Valentine's Day didn't end up going as planned this year. We were both extremely busy and the night just did not turn out the way we had hoped it would, so we didn't end up opening the envelope that night. 

That weekend (Saturday, February 18, 2017), David planned a special date for us. We went out to dinner (originally planned to be at a local restaurant/wine bar, but then at the last minute, I got a weird craving for potato skins, so we ended up going to a wings place instead--haha!) The plan after dinner was to go to one of our favorite European cafes for dessert, where, unbeknownst to me, David had set up for the waiter to bring out a special cupcake for us that would reveal the sex once I cut into it. However, I ruined the plan again because I was feeling so anxious about the baby's sex, and wanted to find out at home in private...so we ended up picking up some delicious desserts (macarons and tiramisu), and bringing them home.


It's a girl!
Even though I ruined his plans, David still managed to salvage the moment. He set up a smorgasbord of our desserts (including 2 cupcakes that he had specially baked by a friend at work) and some roses. Since the plan with the waiter didn't work out, David ended up having to peek at the envelope first, but then he gave me the "right" cupcake to cut into...and it was pink!

We are overjoyed to share that we are having a baby girl! The sex was confirmed at our March 10, 2017 anatomy scan, and now we can plan accordingly!

On another note, I finally "officially" felt the baby move for the first time on March 21, 2017. The past two visits to the OB, my doctor and nurse have asked if I've felt anything and I've always been hesitant to answer because I haven't been sure...but at 3am on March 21, I was lying in bed with my hand on my tummy, and I distinctly felt it. I tried to wake David up for him to feel it, but he was so groggy. He ended up feeling it for himself in the morning at 8:13am. Since then, I can feel (and distinguish) baby girl's movements throughout the day, and most actively, at night. I can't tell if she's kicking or punching, but I love feeling the little nudges, pokes, and prods!

We have also made the decision to hire a DONA-certified birth doula to assist with the labor. We met a wonderful (and highly recommended) woman, and I am looking forward to sharing more about that later on!

Sunday, March 26, 2017

22 Weeks, 1 Day

I am 22 weeks and 1 day today. So many things have happened in the past few weeks:

  • David and I had an amazing time in SoCal. We stayed in the cutest little beach bungalow in San Clemente. We went to a live taping of The Big Bang Theory, and also made it on camera for The Late Late Show with James Corden. We had a chance to meet up with his sweet cousin, Katie, and her husband, Brad.
  • My friends (coworkers) are so sweet to be planning me a Baby Shower in early May. While I am excited for this, it also meant I was asked to come up with a Baby Registry, which I have been dreading completing. I spent the past week or so asking friends/family for suggestions and then weighing all the different options available. Let me tell you, there are so many options for every little thing, and there are so many things that people tell you you need (or don't need)! I ended up making an Excel spreadsheet with categories and listed different things that were suggested to me (supplemented by a few helpful lists: Baby Registry Checklist, Must-Have Registry Check List, Ultimate Registry Check List). I am now able to cross off the things I've registered for or have purchased myself. 
  • Speaking of purchases...David and I spent the entire day yesterday shopping for baby gear. I had the most anxiety over the stroller/carseat combo, but after doing a lot of research (and listening to a lot of opinions), my friend suggested the best thing I could do was go test them out and take a look at them in person. First, we went to IKEA, where we purchased a crib, dresser, bookcases, and high chair. (We seriously spent 4 hours there). Then we went to Babies"R"Us to take a look at some other things, including strollers. I am so glad we went with the IKEA crib, because I found the ones at Babies"R"Us to be too bulky/heavy for my taste. (I have had several friends recommend their IKEA cribs to me.) We took a look at infant bath tubs, and then took a look at some of the strollers and carseats. David and I both really liked the Baby Jogger City Mini GT for its smooth ride, maneuverability, and small size when folded up, but the price tag is a little hefty for us. There is one other stroller/carrier combo I really want to see, the Graco Aire4 XT Travel System, but unfortunately, I can't find a store with a display to check it out in person. The Graco Aire4 XT Travel System includes an infant car seat, stroller, and base for the same price as the Baby Jogger City Mini GT alone. (If we added on the infant car seat, base, adapter, and other accessories, we'd be spending an additional $200-$300!) On a side note, a few friends recommended I get a copy of Baby Bargains, which was really helpful in affirming my registry items. The funny thing is I totally read the Bridal Bargains book when we were planning our wedding!
  • Another source of anxiety has been planning the layout of the nursery. We are turning our guest bedroom/office into the nursery. This means David moved his office into his Man Cave, and I moved my office into the office nook off of our great room. This also means we had to sell our queen guest bed and try to come up with a different guest room solution. After debating many options (including a murphy bed and air mattress), we have decided to get a daybed with pull-out trundle. After speaking to several new moms, I found that they all appreciated having a bed to rest on in between feedings (or when baby is sick). The bed will also serve as a guest bed (such as when my mom comes) and then hopefully baby will move to the bed after outgrowing the crib!
Now that I know what I want/need, and now that we've purchased a few of the big ticket items, I am feeling a lot better about being "ready" for the baby. I still need to clean out and organize the room, but once that's done, I can't wait to start decorating!