Sperm Chromatin Damage from SSRIs

There's a study underway right now, I just read about it but it totally underscores what I suspected based on our experience with my partner's sperm count and subsequent improvement when we got him off of Paxil and onto vitamins to deal with some nutritional deficiences -- from 2% morphology to 5% morphology in just four months. We've not ever had his sperm chromatin checked but take heed -- those SSRIs aren't necessarily helpful for all of what ails you.

Federal Grant Awarded to Study Effects of Antidepressants on Male Reproductive Health

Study on Antidepressants and Male Fertility Generates International Interest

WSU Spokane Scientists Launch Clinical Research

Soy Might Impair Your Fertility and Hormone Balance

A lot of hype has gotten Americans consuming soy products in large quantities, in addition to the hidden additives of soy to many processed foods. But soy has hormonal affects and can be disruptive to your endocrine system, primarily interfering with thyroid function but it also may impair your ferility. Check out these links to learn more.

"Processed soy (actually, ANYTHING processed) is indeed bad. But, why soy? Three reasons: (a) contains chemicals that 'pull down' the thyroid (leads to hypothyroidism); (b) contains phyto-estrogens that block important minerals like Zinc and Magnesium from being absorbed into the body (2 VERY important minerals especially for women since having a deficiency in either one can cause numerous problems due to an estrogen/progesterone imbalance); and (c) does not contain essential amino acids. Soy products are commonly linked to weight gain and other hormone imbalances for these very reasons. It's also among the top allergens in this country, (the other top allergens include wheat, corn, dairy, chocolate, eggs, shellfish, and citrus). Many people have food allergies to soy and don't even know it. "
From: http://www.allergydir.com/Article692.php

"Soy foods couldn't possibly have a downside because Asians eat large quantities of soy every day and consequently remain free of most western diseases. In fact, the people of China, Japan, and other countries in Asia eat very little soy. The soy industry's own figures show that soy consumption in China, Indonesia, Korea, Japan, and Taiwan ranges from 9.3 to 36 grams per day.1 That's grams of soy food, not grams of soy protein alone. Compare this with a cup of tofu (252 grams) or soy milk (240 grams).2 Many Americans today think nothing of consuming a cup of tofu, a couple glasses of soy milk, handfuls of soy nuts, soy "energy bars," and veggie burgers. Infants on soy formula receive the most of all, both in quantity and in proportion to body weight."
Whole Soy Story: The Dark Side of America's Favorite Health Food

Chemical Found in Soy Products, Legumes Could Damage Sperm, Impair Fertility, Study Says

"The estrogen receptor beta is also known to respond to environmental and dietary chemicals that can mimic the effects of estrogen and stimulate the body's natural hormones. One example is genistein, a common component of soy products. These new studies by Korach and colleagues suggest that such environmental exposures could interact with estrogen receptor beta and possibly alter ovarian function in women."
from: New Discovery May Help Doctors Treat Infertility

Uterine adenocarcinoma in mice treated neonatally with genistein

It's not just that but most soy beans are genetically modified nowadays:

"Genetically modified soy has been on the market just five years. Yet it already accounts for two-thirds of the U.S. soybean harvest. Soy products are used in hundreds of processed foods, often to add texture and protein. So the biotech beans end up in pancake mix and baby formula, chicken soup and margarine, crackers and salad dressing, ice cream and granola bars."
From: Long Article on Roundup Ready Soybean Controversy

Some people say what choice do we have, but really there is a choice but we've not been given the chance to give our opinion. I remember listening to some FDA guy on the radio a few years ago as they debated GMO/GE crops and he said that the American public didn't care about the controversy and that they were fine with it. But, they didn't tell us that they were putting these products into the market, they just snuck them in. But other countries around the world weren't asleep and their press and public took action and blocked the use of these crops/products pending further scientific evaluation.

Corn is another crop that's largly GE these days in the States. It's hard to find any manufactured food items that don't contain corn or some corn-derivative. You have to look for products made overseas.

If you are interested in more info sign up for the Organic Consumers Association email newsletter -- http://www.organicconsumers.org

Too much information

I saw this site linked from another blog so I decided to try it out. You can get t-shirts printed up with a "word cloud", a dynamically generated image based on content from your blog.



I have to say that seeing it all laid out like that, and even thinking about the possibility of seeing it on a t-shirt, it makes me feel a bit glum. Not really fun stuff at all, and is it really worthwhile?

And It All Comes Rushing Back

Sick and twisted girl that I am, dropped by the records department for the hospital/clinic to see what I was missing so I wouldn't have to pay $20 for getting a whole lot of chicken scratch. I've got most of the information already and just wanted the bits that I was missing. Instead what happened was that I got to sit around with my file and relive the first miscarriage and my surgery. How I was able to stand w/o dizziness after the first d&c (they check this stuff for patient release post procedure); how I was "pleasant", walking around, or having "tea colored" urine after my surgery. All these details came into sharp focus in my mind again: the color of the tile floor, calling for help with the PCA pump, sitting on the toilet trying to pee and having nothing come out after they first took out the catheter and the anxious voices behind the door. All the little notes they made, the nurses and doctors and patholgist too, and I felt like I was swimming in memories that my mind had put away for safe keeping, or rather to protect me from them. While I walked quickly and confidently to the office building after work, after picking through the file I left in a daze. And even more frustrating is that there isn't really any good information to be had from my second m/c. There was no pathology done, just blood work and some scans. I felt partly like there might be answers in that thick file and partly that it was sad that there weren't.

On the way home I dropped by to visit my friend, the one who was close to divorce a few months ago (and had a miscarriage a year ago). She's been diagnosed as bi-polar and is on lithium now. She's having a bit of a hard time adjusting to the meds and finally some of the mania she was experiencing is starting to dissolve and so she can remember things a little clearer. We talked a bit about how crazy it was that it was four years later and I was still talking about TTC. For now babymaking plans are totally on hold until they figure out which end is up.

Baby Steps

I bit the bullet today and scheduled an initial consult with my RE (the RE who did my surgery and helped me through 1-1/2 miscarriages). We're going to see if we can stick with her, recognizing her limitations but also the leverage we have with her and her staff.

I set up an initial consult with her since we never had one with her. I just ended up in her care after my previous RE left the clinic and trusted her with my surgery and that's where it was left off. I sort of feel like let's start over with all this and see where that gets us. Yes, I have lots of information and opinions but we also want to know her take.

I think I mentioned before, but the plan that was laid out for us by more then one RE was:

1. Have surgery to remove fibroid
2. After healing (3 months), try on our own for three cycles or so
3. If not pg then move onto Clomid/IUI for three cycles
4. If not pg then consider moving onto IVF (possibly with ICSI -- though with the SPA test his sperm performed really well so this shouldn't be an issue)

We were going to do a trial of Clomid/IUI in July '04 but then got pg and had the firsst m/c. Then we started TTC again after my surgery and retained tissue experience in Feb '05 only to get pg the third cycle and then lose that one as well. It's like we never get to go to the next step. Sharing it with you guys just reminds me of the feeling I had with each loss that maybe God was trying to tell me something -- it's so hard to know that though.

My appointment is scheduled for February 14th - Valentine's Day. I know that's a bit of a downer but at the same time it fits in really perfectly with my cycle -- so if we don't get pg this cycle (and chances are we won't based on our past lack of success) then AF is due right about then and there will be time to either get right into a Clomid cycle or do the HCG or both. There's a chance we might change the appt so to not ruin v-day but for now that's where it stands.

I also just set up a time to review my medical records so I can pick out the sections that I need for my files, which can supplements the ones I already have so I can transfer the files to my RE's new clinic.

One step at a time, right?

Sometimes a pregnancy goes by like a vapor

Today was my EDD for my second pregnancy. I know two other online gals who had that due date -- one is in labor today (how perfectly on time!) and I've not caught up on the details of the other gal.

What helped me last year with the EDD of my first loss was to consider the week before to be a time to help come to closure about it. I was sort of forced to do it by the birth of my niece that same week -- based on advice from women online I bit the bullet and went to see her on the day she was born at the hospital. Yeah I cried a little too but I feel like I was able to change my perspective a little.

Since my surgery would have required me to deliver by c-section early, the second baby would have already arrived so in that sense there is no date for it really, it just would be here already. I don't have time to take off from work right now so I'm just trying to find some resolution about it.

Now, my niece's first birthday in a couple weeks might be more difficult (I still have some tension when I'm around her) but whatcha gonna do.

For all my stocism thought I'm still feeling a bit mucky about it. But it's been a long time since I was pregnant though so how could I really feel it, it's not like I was physically about to have a baby today. And from visiting with my niece yesterday, it's not like I know anything about the minutes/hours/days/weeks/months of attention that it has taken to get her to this point where she is taking her first steps. My past year (and then some) have been about a different journey.

Behold the Wonders of the Cervix

The Behaviour of the Cervix over the Phases of the Ovulatory Cycle

The Discovery of Different Types of Cervical Mucus and the Billings Ovulation Method

There are several methods of tracking your fertility that exist, the newer methods are actually more sophisticated than just counting days as in the Rhythm Method. Now we have charts, and even software to help us track our cycles and fertility patterns.

The ones I know of include:

Billings Method -- pioneered by Dr Evelyn Billings and promoted in the US by Billings Ovulation Method Association - USA

Fertility Awareness Method -- as described in Taking Charge of Your Fertility by Toni Weschler and incorporated into the Ovusoft/TCOYF ovulation calendar software

Creighton Model Fertility Care System -- promoted by Fertility Care Centers and the Pope Paul VI Institute and referenced in this article "Infertility Care and the Role of the Compounding Pharmacist" (PDF)

Easing Into It

I've been trying to ease my brain into the idea that it might be time to go that route, the possible IUI/Clomid route (and who knows what else). Even though we did it on our own twice there are reasons for us to see about other options as the clock keeps ticking.

I've been trying to slowly give my partner more info about it, he sometimes acts like he knows everything so I try not to jump on him with too much info. The other night he told me to hand him something to read so I reached in my nighstand and a copy of Conceive magazine was there and I gave them to him while I brushed my teeth. He read the ad for Preseed and saw how bad Astroglide is for sperm and he was like "I didn't know that!" To which I replied that I had told him over and over and even suggested that we try Preseed a year ago and he said no. He then said "Yeah but I didn't know you meant that bad"

Yesterday I sent him links to the three main fertility clinics in our area -- I've seen docs at all three. My partner and I talked about it briefly last night and he said that our greatest issue was with the profession and not the doctor per se, so he thought we should stick with Dr. Marshall who did my surgery and just coax her into trying things our way for the progesterone. I'm friends with one of the nurses in the office so that's a help too. Still, I loathe having to go back in. I had that consult last April where they told me to hang tight for a while and then got pg right after that and then lost it. My last appointment with the RE was in July, and then the ob/gyn appt but that was just for a pap.

I'll just have to ease myself back in slowly.

TTC After 35

Here are links to some articles I found when looking for info about my advanced maternal age.

Female Fertility After 35

36 and Over

How Aging Affects Fertility

Pregnancy After 35 - March of Dimes

Age Related Miscarriage


You might also appreciate:

How to increase your chances of conceiving and preventing miscarriages

Vitamin C: Too Much of a Good Thing

Commonly in fertility diets vitamin C is mentioned, it's really good for you and aids in iron absorption and tissue repair. There is a point when too much vitamin C might actually interfere in female fertility. Men can take twice as much and it will help with semen factors but here are a few points about what too much does to impact female fertility.

Other things which can cause infertility include taking more than 1,000 mg of vitamin C a day. If a woman is doing this and trying to get pregnant, she should decrease it to 500 mg a day. Infertility caused by a higher dose should resolve within a few weeks.
From: Effective Holistic Treatment for Infertility

Vitamin C and bioflavinoids help strengthen the blood vessels lining the uterine wall. When C is too high, however, it can decrease the absorption of copper, a mineral necessary for ovulation, and increase the risk of both infertility and miscarriage.
From: Alternative Health Care Methods of Improving Fertility

Women should avoid megadoses of vitamin C because it can dry up cervical fluid, preventing sperm from reaching the egg. Limit the amount you take to the dose included in your prenatal vitamin.
From: Natural Ways to Boost Your Fertility

What do you think we should do?

It just struck me that I've never asked your opinion of what you think we should do for 2006 in our pursuit of having a child. I don't have a plan right now at all and I'm really wondering what other people think when they read about our situation.

Do you think we will get pregnant again on our own? (it's been 5 cycles since we started trying again -- though the past two cycles I haven't been trying trying just not preventing. It's also been over a year since my myo)

Should we try an IUI? With Clomid or not? (what about the excess estrogen and The Infertility Cure mentioning that it tends not to mix well with liver qi stagnation -- I wonder if I still have that...)

Should we go straight to IVF? (even though this offends our sensibilities and makes it all seem so desperate and only heightens the stress of the situation)

Should I consult a new RE or stick with the one I've ended up with who isn't up on progesterone supplementation? Should we consult with someone outside of our area in another state -- preferably a larger metropolitan area?

What do you think? Please share. Thanks.

Cute Diapering Accessories

I did say that I was going to share some of my pregnancy and beyond links so here are some really cute bags and things.

Diapees & Wipees -- cute little holders for a few diapers and some wipes.

Darling Diaper Bag from Lexie Barnes


I'll add more to this post as I come across more things worth noting.

More Thoughts About Fibrocystic Breasts

So the common things they say to do if you are having PMS and fibrocystic breasts are:

Increase calcium consumption

Decrease caffeine consumption

Make sure there isn't a thyroid problem

Cut back on refined sugars

Increase dietary fiber

Increase B-vitamin consumption

Increase magnesium consumption

Drink more water

Use natural progesterone cream

Increase vitamin E consumption



-----

So I used to eat a fair amount of dairy and I had bad PMS but cutting back to almost none hasn't made any difference so dairy doesn't seem to do anything for me favorable. Less dairy does seem to help with my allergies and digestion so I'm going to stick with that plan.

I've always been a very moderate consumer of caffeine, I didn't drink coffee or cola. I do eat chocolate and have some black or green tea but in moderation. So, that didn't seem to make any difference at all -- in fact I recently started drinking a little more coffee than usual (a few time a week instead of once a month) and it's made no difference.

I've had my thyroid checked several times including a full thyroid panel last summer as it comes up as related to many of my conditions (fibroids, elevated estrogen, PMS) -- each time the test results were so normal it was boring. My mother has thyroid trouble so I thought for sure this might be related for me but evidently not.

Due to my naturopathic and TCM treatment I was told to cut back on refined sugars. It's helped me to feel better but I was never a total nut about eating candy or anything. I've made a concious effort to be careful about my intake of simple carbs. Still I've got sore breast in my luteal phase.

Increase of dietary fiber does seem to help me feel better generally but it hasn't seemed to help with the breast issue at all. Since this helps your body to eliminate excess estrogen I'm sticking with this for general health.

I eat a largely vegetarian diet (though I am an omnivore) and the foods I eat contain a lot of vitamin B and magnesium. Stress depletes b-levels and my work can be stressful and sometimes I don't get enough foods rich in vitamins B or magnesium but I really do try. I was never on birth control pills which can rob the body of B vitamins and magnesium so that's not an issue with me. I have been trying to be better about taking my vitamins but the best I usually do is 4 times a week -- better than nothing in my book.

I am bad about drinking enough water every day -- mostly when I'm at work. I'm much better than I used to be I think.

Natural progesterone cream didn't really seem to do much to help, maybe a little, but it mostly makes my breasts seem to swell more, not necessarily become more lumpy or sore.

And then there's the Vitamin E thing. It's in my prenatal and that on it's own doesn't seem to do anything.

But then there's that DIM/Vitamin E thing. It really did seem to help over the past three days. Today I'm spotting so AF is just around the corner but previously I used to not have my breast stop hurting until I had full-blown AF. It seems so curious to me. And some of the links I've found mention that vitamin E can increase estrogen levels, and also that DIM might do the same -- it just doesn't seem to be doing that to me -- it seems to be helping something hormonally.

(Vasectomy and) Vasectomy Reversal Information

I'm surprised that I haven't really posted about it before but I guess since my partner's reversal was so long ago (1998) that I haven't really gone into it in much detail over the past three years. I'll try to remedy that so that others can learn from what I've learned.

My partner thought that he was going to help out the overpopulation problem and in a fit of idealism and with encouragement from his wife at the time, underwent a vasectomy. That was several years before we met, and as it would happen, on the cusp of the end of his marriage. I can't really speak too much as to how his post-op recovery was though I know that he went in for the procedure alone and was hurt that she didn't even come to see him home afterwards. (Lesson #1 -- it is an emotional thing and the female partner should be there to provide support).

I've had a few sexual partners in my past and so I was a little familiar with what ejaculate looks like. What was weird about my partner's prior to his reversal was that it was thicker than the intact guys I engaged with. I guess this is due to the ejaculate just containing the portions from the prostate and seminal vesicals. After his reversal it returned to a normal looking consistency.

The final product of semen that you see when you come contains only 5% sperm; the other 95% is made-up of secretions from the seminal vesicles (considered an extension of the prostate) and prostate fluid (about 80% of the final mix), which gives ejaculate its whitish color.
From Premature Ejaculation


From when we first started dating he told me he intended to have a reversal, he had already worked through his regrets about having the procedure and so we knew it was on the horizon. From what we learned online at the time, having a reversal within 4-5 years of the initial vasectomy supposedly would help to ensure a greater likelihood of success.

The first step was to locate a doctor who specialized in vas reversals as we wanted this done right the first time. I searched online and at the time, Columbia University had and still has some great vasectomy reversal info and doctors who looked pretty good but through a friend's father who is a urologist in Washington, we learned about Dr. Dale McClure , a urologist specializing in fertility at Virginia Mason Hospital. My partner, since we were still just dating at the time, went for his appointments without me. I remember feeling embarrassed when he came back and told me that Dr. McClure asked about the fertility of his partner (me) and he provided some answer about my having regular cycles -- ack! things were going really fast for me and we'd only been together for a couple years.

The surgery was scheduled to be done through a facility at Group Health Hospital on Capitol Hill; there was some reason it was done there which if I recall correctly might have had to do with both insurance and the technology available. I insisted on being at the hospital the day of the operation, knowing how hurt he had been by the lack of support when he had his vas.

On the Internet prior, we had learned that the medical term for a vasectomy reversal is vasovasostomy and that there was a microsurgical technique used to sew the tiny vas deferens back together again using a fancy sewing technique under intense magnification -- this techique was supposed to have a higher success rates than older techniques.

Prior to the procedure my partner was sedated in a pre-op are and I was able to spend time with him and massaged his feet and kept him relaxed and calm (it was from this experience that he learned how to take care of me surrounding my first d&c and then my fibroid surgery which was really nice for me). The nurses told him that he better be really nice to me and that I was a "keeper". When he was good and loopy on the meds I stepped out into the waiting room and he went into the operatory. I told him that I would be there the entire time he was being operated on so he should know that he wasn't alone ever.

[Graphic detail]
From what he's told me, in the operatory he was awake but sedated during the operation. There was a camera pointed at his testes throughout the procedure, with a screen within his view which was fairly intense for him to watch. The doctor made two incisions into the front of he scrotum and lifted out his testicles to have access to the surgical site (in contrast, vasectomies are done through very small incisions through the back of the scrotum). When it would get too intense for my partner he would tell the nurse to dose him more. It took about two hours to do the operation and then he was moved out into post-op where I was able to come in and see him and rub his feet some more.
[end graphic detail]

We left the hospital that afternoon and went home to rest. He was instructed to not ejaculate/have sexual intercourse for four weeks after the operation to help with healing. Since then I've heard of other doctors wanting to have men begin ejaculating sooner (10 days post-op) to help keep the vas open. I don't know if there is a standard, I assume it is still going to be based on your doctor's own experience and preference. While he was healing the most noticible thing was that his scrotum was HUGE. His balls were swollen to the size of large oranges at least and it took weeks for the swelling to go down.

I believe he was meant to have a semen analysis within a few months of the procedure but we weren't ready to start a family yet and the doctor said that he had found sperm during the procedure from the testical side of the vas. I think it was fear of it not working more than anything that made my partner delay his semen analysis. Finally over a year later he went in and had it done and the results were pretty poor by WHO standards. He was instructed to come back for another test in a few months if I recall correctly. He asked the doctor at the time about some ongoing pain that he had in his scrotum/testes and the doctor thought it might just be part of the healing process. We felt a bit discouraged but only time would tell.

Specific things we learned along the way from our experience:

There might be pain for a while

Sperm counts might be low for a while and continue to improve over time without intervention (we saw significant improvement after 2 years)

Ejaculate consistency will change after the reversal, to a more normal consistency

You should be sure to have a semen analysis based on Kruger morphology standards and not just WHO standards, and also make sure you are tested for anti-sperm antibodies as well

MFI supplement cocktails can actually improve morphology

The our doctor felt that our chances of conception would be better with a repeat reversal (though it wasn't required ultimately because things improved on their own) than with trying TESE/IVF

General post vas reversal fertility info:

There is a greater chance of having ROS damage to the sperm

That the success rates post procedure have more to do with the health and age of the female partner than just on the time between vasectomy and reversal

That there is about a 50% chance of conceiving on your own post reversal

Vasectomy and Vasectomy Reversal Links:

FIND A SURGEON

Society for Male Reproduction and Urology (SMRU) - Member Search

INFORMATION ABOUT THE PROCEDURE

The Patient's Guide to Vasectomy Reversal

Microscopic Vasovasostomy

Vasectomy Reversal - Introduction

Microsurgical Vasectomy Reversal

What's New in Male Infertility Treatment at Cornell
Vasectomy Reversal: The Microdot Method for Precision Suture Placement

Google Groups: alt.support.vasectomy

International Center for Vasectomy Reversal

Vasectomy Reversal - Johns Hopkins

Building Bridges to Conception - Vasectomy Reversal

Vasectomy Reversal Questions &s; Answers

Microscopic Vasectomy Reversal

Vasovasostomy

The Infertility Center - FAQs - vas reveral Qs and As link

Cary Urology Vasectomy Reversal

Vasectomy.com

ARTICLES ON VARIOUS RELATED TOPICS

Warning over vasectomy reversals

Vasectomy - Can it be reversed?

Morphological changes of spermatozoa in proximal vas deferens after vasectomy

Microsurgical Vasovasostomy versus Microsurgical Epididymal Sperm Aspiration/Testicular Extraction of Sperm Combined with Intracytoplasmic Sperm Injection

Some vasovasostomized men are characterized by low levels of P34H, an epididymal sperm protein.

Vasectomy Myth Debunked: NewYork-Presbyterian/Weill Cornell Study Finds Vasectomy Reversal Highly Effective, Even After 15 Years

Vasectomy Reversal & Sperm Antibodies

VASECTOMY

Vasectomy Blog

Vasectomy Information

Requesting Patient Medical Records

It's a good thing to keep a copy of all your records, particularly when you are dealing with an ongoing condition (but generally as well). Request the records be sent to you if you are switching practices as well and then you can bring copies of the records to each new doctor you see --- you will be better informed and it will cost less too.

Some doctors are very strange about not giving you access to your records, they are actually required to do it under the Federal HIPAA law. You have to make a formal written request, and you need to specify both the time period and sometimes even the specific test results/appointments/etc. you are looking for. They have the right to charge you a reasonable fee. (See HIPAA and Medical Record Copy Charges

Here's a great site from the Health Information Management Association about Creating a Personal Health Record with some excerpt below.

Your Rights Under HIPAA:

Right to access, inspect, and copy health information
Right to request correction or amend health information
Right to request accounting of disclosures of health information—who has received it

Accessing Your Health Records
You have the right to access your health records. You may view or receive copies of your records, or instead request a summary of the information. If you receive copies of your records, the office holding the records has the right to charge you the cost of making the copies. You may have to submit a written request to view or receive copies, so the office has a record of your request.

You also have the right to request that changes be made to your health record. If you believe that information in your record is incomplete or incorrect, you can request an amendment.

Amendments can be requested by either contacting the person who made the entry (such as your doctor) or by contacting your healthcare organization's health information management professional. If your request for an amendment is denied you may still request that your request for a change be kept with the record and given to anyone who requests a copy of your health information.


Here's another link that you also might read to help bolster your confidence as a health care consumer if you are having surgery:

Quick Tips -- When Getting Medical Tests

Bad Estrogen

Sounds dramatic doesn't it but there really is estrogen known to be the bad kind, the kind that can lead to cancer. Since I'm not doing acu treatment or chinese herbs right now and its just up to me to try to fix me I decided to do some more research into PMS and estrogen. It's that time of the month (mid-luteal phase) and my breasts are so uncomfortable. The only time I've had real relief for a while was after both pregnancies, I guess due to the pregnancy types of estrogen being dominant then.

So here are some of the links I came across that interested me:

Predictors of the plasma ratio of 2-hydroxyestrone to 16-hydroxyestrone among pre-menopausal, nulliparous women from four ethnic groups

The relationship between physical activity and 2-hydroxyestrone, 16alpha-hydroxyestrone, and the 2/16 ratio in premenopausal women

DIM (Di-Indoly Methane)For Natural Protection from Estrogen's Effects

What I picked out that might relate to me are:

...that since dietary therapy alone hasn't helped, and my mother had PMS as well that there might be a heriditary factor.

...that exercise really might help my body to metabolize the bad estrogen more

...that taking DIM for a while might not be such a bad idea, at least to see if I can detect any changes.

Back from Paradise

So I can now say that if you feel like infertility is getting you down that you haven't been pampering yourself enough and you should make plans to go to Fiji. The people are lovely, the sun and sea and coral are beyond compare, and it's far enough away that you don't find lots of families on vacation -- provided you pick the right island resorts.

I've been happier than I've been in years -- no sign of depression for me (though I've got a touch of PMS right now). All that wonderful sunshine and the warm sea -- we went swimming every day and there was no need for a towel it was so hot every day. My biggest decisions each day would be which bikini to wear and whether or not I wanted a cocktail at happy hour. Sooooo incredibly relaxing.

Oh and here was a thing, my myomectomy incision, the bikini-cut, it fell just below the top edge of my string bikini. How about that? I've never worn a string bikini before but I thought why not start now.

I got lots of exercise as well while on holiday -- running, playing volleyball, swimming, snorkeling, and hiking -- which helped work off some of my fluff. (Some I said, not all)

Seattle is so cold, dark and damp in comparison -- I think I'll just have to move to Fiji and learn how to weave mats.

The Boo-hoos Caught Up With Me

Yeah so I'm not invincible. Finally Friday night, when my partner came home from visiting with friends I erupted. Two of his friends are currently TTC with their girlfriends and finally he has guys to talk about it with. But for all his enthusiasm it's been an anguishing time for me personally, what with the miscarriages and anemia and all. I hate feeling like he's just lumping us in with these other women who have just started trying, even though I know enough about them to know that they both have infertility issues (a 21-day cycle for one and fibroids and a miscarriage for the other). He comes back from hanging and talks about how he told them about how I chart and all that and how so-and-so's girlfriend wouldn't do that because it would make her obsess too much. It just makes me want to scream. I'm not like them, it's been too many years, we both had surgery, I've been through two losses and seen all those doctors and charted and temped and used a fertility monitor and got bloodwork and still no baby after more than three years.

So I started crying and I cried and told him that he better leave me and I just kept crying in the dark on the pillow and so I got up and I cried more, for another hour at least. Crying and blowing my nose and all that for a good long while.

When I woke up on Saturday I pulled out a journal and made a list of all the things about our fertility that are bothering me -- and cried some more. I read it to him and the rest of the day Saturday I just felt emotionally drained. Sunday I felt a bit better though.

I'm still congested from the flu and a little queasy as well. Everyone in our office has been sick. Half of them have had the stomach flu but no one has had both. I hope that I'm just feeling the remains of the same flu and its just lingering and not because I'm going to get the stomach flu as well. Oh please no.

Looking forward to sunshine

We're going away to the tropics for a couple weeks in the sun. I'm so looking forward to it and the break from work and everything, though I will miss my pets while I'm away.

My period showed up today, right when Ovusoft said it would; a little crampy in the morning but not too bad so far. A nice, average 29-day cycle.

It's hard for me to lurk on my TTC buddies, so many of them have gotten pregnant this year, even ones that had infertility problems. A fair number are still waiting in the wings as well so I don't feel a total freak but it's still pretty ouchy knowing that for some of us this is not something that happens anything close to easy.

Still, this year had things arranged in a way so that it was for the best. We had some staff turnover and our business really needed our attention. It wouldn't be an easy thing to be expecting a baby right now. And you know I wouldn't be going to the tropics right now if I was pregnant. Even AF is cooperating with the plans and should be cleared out before we leave town.

Hysterosalpingogram (HSG)

An HSG is a hysterosalpingogram, an x-ray of the interior space of the uterus and fallopian tubes using a contrast dye. It can be used to look for uterine abnormalities and adhesions, determine how much infringement fibroids are making into the interior of the uterus (to some degree), and identify if your tubes are open (referred to by docs as "patent"). Some docs do it standard a few months after a myomectomy, mine did not. The dye does have what my RE referred to as a "voodoo effect", where there is some slight increase in pregnancies after the procedure, speculated to be caused by the dye perhaps causing the little hairs (cilia) in the tubes to function better.

It can be done by your doctor in a radiology facility or by a radiologist -- mine was done by my RE and she was a lot more comfortable with the procedure than the radiologist I could tell.

They insert a catheter to insert the contrast dye through your cervix; a good cough evidently will open up the cervix so it is less painful. The dye feels like pressure going in, and it can cause a drop in blood pressure. It's generally uncomfortable and causes some cramping. My RE tried to manipulate my uterus for the xray shots using the special speculum and I found that to be very uncomfortable with my 6-7cm (at the time) fibroid.

Here is an link detailing Guidelines for the Performance of HSG - it advises taking 1000 mg of NSAIDs prior to the procedure.

Rarely it can cause infection, and some people are allergic to the contrast medium. Some docs give antibiotics preventatively ahead of time, they also might have you take a heavy dose of Tylenol an hour beforehand.

Here are some links to sites showing images from HSGs:

HSG Link 1

HSG Link 2
HSG Link 3

I should go pick up my x-ray film from the University of Washington Radiology Department, where I brought it when I consulted about UAE a couple years ago. I'd like to scan it and and post it here so you can see what my distorted uterus looked like.