Tuesday, July 21, 2009

So many babies!

Everywhere I look, people are having babies. I was worried that I'd be a little depressed about this, but I'm not so depressed. Just kind of thinking we really ought to get down to business. This is a picture of colleagues from work. There's a joke going around the office that just being in the office makes you susceptible to pregnancy. I certainly hope that's the case!

Tuesday, July 14, 2009

Preconception Planning

So today D and I went for a "preconception planning" appointment with an OB/GYN. I visited this doctor in a pinch two years ago (he's right downstairs from my primary care physician), and as I was thinking about this whole project, I remembered how good natured and gentle he was. I was a little nervous about asking D to go with me--he sounded so scared when I called him to tell him about the appointment! He's a good egg, though: agreed to go to the appointment and was good natured and supportive the whole time. The big surprise was how nervous *I* was. It was like: oh my god, we're actually thinking about doing this!

Initially, I didn't remember the doctor's name, so I just googled "OB/GYN" and my PCP's address and voila! When I found his name, I also found that he had a website: http://www.drovitsh.com/biography.php After I got my hopes up about how great it would be to have this doctor provide my prenatal care, I was certain that he wouldn't be in my insurance network. I called my insurance company and the rep put me on hold while he searched to see if Dr. Ovitsch was in my network of providers, and my head began to spin. I thought about how hard it is to find a doctor you like, and had my first experience of feeling tied to a decision and tensing up realizing that I need to let stuff go or I'll drive myself crazy. My elation was palpable when they told me he was" in network" and there would be no problem. After a huge sigh of relief, I took a moment to remind myself how lucky I am to have health insurance. When I called and was easily able to get an appointment within two weeks, I reminded myself how incredibly lucky I am that the one doctor I went to and liked is so easily accessible and in my insurance network.

I made the appointment because we both had some questions that were making us nervous--I asked about how difficult he thought it might be for us to conceive at this age (I'm 41) and about whether he anticipated any problems because I am overweight. Neither thing seemed to concern him too much, he said he had plenty of patients who are my age or older and had no trouble conceiving or having an uncomplicated pregnancy. And as for my weight, he asked if I was active (I am) and told us that I should keep that up throughout the pregnancy. He started to suggest a nutritionist, but then D and I explained how healthy we eat (see my other blog: http://mysticgypsypickles.blogspot.com) and he seemed impressed. He said that I could gain between 15-30 pounds during pregnancy, but that I should realize that I shouldn't worry about nutrients getting to the baby if I eat healthy. In other words, I don't have to "eat for two" as they say! The most reassuring thing he said was that I wasn't carrying enough extra weight for him to be concerned; and that breastfeeding might help with losing the extra weight I will gain if I become pregnant.

Of course he asked if I was taking folic acid, and I told him about my multivitamin which has 100% folic acid. He said that was fine. He suggested that I might want to buy a home ovulation meter or something, but I think I can read my body pretty well. Plus, it's not like we're only going to have sex when I'm ovulating for god's sake! He told me to go get a panel of blood tests on the third day of my next menstrual cycle to test for estrogen levels and some other things that will tell him how easily I might be able to conceive. He also suggested trying for three cycles (fun!) and if there's no luck, I should come back and he can talk with me about hormones and some other tricks to boost the chances of conception. I'm not sure about all that--I've always thought that if it doesn't happen, it's not meant to be...don't fool around with nature. But I'll cross that bridge when I get to it.

All in all, it was a good appointment. I think we both left feeling a little bit more comfortable with this decision. I didn't raise one big question that I had: whether he would be supportive of us planning a home birth. That's another bridge we'll cross when we get to it--and another blog post altogether!

Uh oh, though--in keeping with the title of the blog, this visit cost me a $5 copay. The first expense of the project. I gotta start a spreadsheet.

Saturday, July 11, 2009

Airplane headphones

So we were at the airport walking to the gate and passed by one of those little stores that sell travel electronics. I stopped in saying I wanted to get a new set of headphones before we got on the plane because I'd forgotten to pack mine from home. D says to me: "Zero Dollar Baby, Dear." I replied: "Yes, honey, Zero Dollar Baby, not Zero Dollar Mommy."

Wednesday, July 1, 2009

Damaged Sperm

This was interesting, so I thought I'd re-post it. Of course, I had a discussion with D after reading this article....

Study: More sex may help damaged sperm
By MARIA CHENG, AP Medical Writer Maria Cheng, Ap Medical Writer
Tue Jun 30, 8:07 am ET

LONDON – For men with fertility problems, some doctors are prescribing a very conventional way to have a baby: more sex.

In a study of 118 Australian men with damaged sperm, doctors found that having sex every day for a week significantly reduced the amount of DNA damage in their patients' sperm. Previous studies have linked better sperm quality to higher pregnancy rates.

The research was announced Tuesday at a meeting of the European Society of Human Reproduction and Embryology in Amsterdam.

Dr. David Greening of Sydney IVF, a private fertility clinic in Australia, and colleagues looked at 118 men who had damaged sperm. Greening and colleagues told the men to have sex every day for a week. After seven days, the doctors found that in 81 percent of the men, there was a 12 percent decrease in the amount of damaged sperm.

Many fertility experts suggest men abstain from sex before their partners have in-vitro fertilization, to try to elevate their sperm counts.

Sperm quality can also be improved if men don't smoke, drink moderately, exercise, or get more antioxidants.

Since concluding the study, Greening says he now instructs all couples seeking fertility advice to start by having more sex. "Some of the older men look a little concerned," he said. "But the younger ones seem quite happy about it."

Experts think sex helps reduce the DNA damage in sperm by getting it out of the body quickly; if sperm is in the body for too long, it has a higher chance of getting damaged.

Some experts said that while Greening's research is promising, it doesn't prove that daily sex for men with fertility problems will actually produce more babies.

Greening said he and his colleagues are still analyzing the study data to determine how many women got pregnant.

"Looking at sperm DNA is just one part of the puzzle," said Bill Ledger, a professor of obstetrics and gynecology at the University of Sheffield, who was not connected to the research. "Maybe this will improve pregnancy rates, but we still need to do more studies."

Ledger said instructing couples with infertility problems to have more sex could stress their relationship. "This may add even more anxiety and do more harm than good," he said. He said couples shouldn't feel pressured to adjust their sex lives just for the sake of having a baby.

Greening said the study's findings were ultimately very intuitive. "If you want to have a baby, our advice is to do it often."