When to get help...

If you look at resolve.org (Resolve is the National Infertility Association here in the US), their official recommendation is to seek help if you have not conceived after a year of unprotected sex and you are under the age of 35. Those 35 and over should seek help after 6 months. In the general population, according to my gyno and RE, you would expect that 60% conceive after 6 months, 80% by 9 months, and 92% after 12 months. After a year, you get to the point of diminishing returns. Only 2% of the remaining 8% actually conceive on their own over the next 6 months. It goes down hill or actually, over the cliff at this point. I believe it is something like 0.2% of the remaining 6% conceive on their own by 24 months.

When you get to the 12 month mark with no success, you have every reason to be concerned. Or, if you know you have something wrong with you, like polycystic ovarian syndrome (PCOS) or endometriosis, you have every reason to seek help sooner than later. I am constantly shocked at the number of women I meet in the waiting room (on the extremely rare occasion that anyone is talking to anyone else in the waiting room at the fertility clinic I go to) or on message boards that have tried for YEARS on their own. It's not unheard of for someone to go 4, 5 and even 7 years before seeking help. WHY???!!!

Let's face it sister (or partner to the sister), if you haven't made a baby in 1, singular year, chances are high that it ain't gonna happen. Hand yourself a tissue, cry, and then call your doctor, please! It doesn't necessarily even have to be a fertility specialist (RE) at this point. Your regular ob/gyn probably has several tricks up his or her sleeve. If nothing else, he can probably get some initial tests run for you and refer you to an RE in your area.

What if you don't want to wait a year? Well I sure as heck didn't. Most fertility clinics don't require you to wait a year. Some may have wait lists that are up to a year long. If you live in a densely populated area, I definitely encourage you to call sooner rather than later. You can always cancel. Your ob/gyn shouldn't mind if you request an appointment before a year. If he or she does, do yourself a favor and see someone else. You're paying them, so why not?

For me, I started to get really concerned after 3 months. June 2010, the first month we tried I was really disappointed. In July I tried keeping track of my basal body temperature. It was no help, and I was sad. August (third time a charm month) I used an ovulation predictor kit (OPK). It didn't help us out any, and I was angry and worried. I ordered a Clear Blue Fertility Monitor at the hefty price of $159.00. The sticks you peed on cost $50.00 a month. Each month I madly calculated out my ovulation date and potential due date, which was hard since my periods were becoming more irregular. However, in September, my due date, if I were to conceive would have been June 11, my birthday. Of course my kid would ruin my birthdays for the rest of my life! It makes perfect sense! I was sure that between my monitor and Murphy's Law, it was our month.

It wasn't. I was devastated. I knew something wasn't right. My first clue, I've had since I was 15. TERRIBLE menstrual cramps that kept me up all night, occasionally out of school, and hurt so bad sometimes that I would vomit. The only thing that I found to help was pacing back and forth with a heating pad on my abdomen. I would tether myself to the wall with an extension cord and the heating pad and spend about two hours in the middle of the night walking back and forth in my room. One morning during a particularly bad month, my mom found me still pacing when she came to make sure I was getting ready for school. An appointment was made with my pediatrician, much to my disgruntlement. As if being a teenage girl wasn't bad enough, now I have to share my female issues with a fifty something old man...Thanks Mom!

My pediatrician who I had always hated, anyway, was rather unimpressed. His advice was to take ibuprofen and to make sure I started it before the cramps began. Well good luck to me! I usually had a period every calendar month, but it could have been the first of one month and the 30th of the next. My only clue that I was about to start was cramping. So it didn't work until I tore my ACL doing gymnastics the next year. As luck would have it, after my ACL reconstruction surgery I consistently took ibuprofen all the time. It counteracts the prostaglandins which cause the cramping. For the rest of my gymnastics career that went through college, I ate ibuprofen almost all the time for injuries, soreness etc. My cramps did, for the most part, go away. However, when my gymnastics career ended, my ibuprofen habit squelched, and my cramps came roaring back with vengeance.

Fast forward a few years and two different gynecologists that told me cramping was just part of being a woman, I started using depo provera (at the recommendation of a friend, actually) which eliminated my period and thus the pain. Free at last!

Skip ahead to October 2010, married and trying to procreate. I also noticed that my cramps were starting earlier. My period was coming a lot sooner than my fertility monitor would predict. More red flags!

Mostly because I was afraid of being laughed at, because even my mother thought I was being rediculous for panicking this early. I waited until December to call my gyno, trying all the while. I set an appointment for worsening premenstrual syndrome. My doc already knew we were trying to conceive, and I took my husband with me. Thank God I did.

My doctor told me it was ok that I hadn't conceived yet and gave me the stats I opened this post with. He asked about my cramping and after being told it was nothing by three doctors at this point, I started with my usual gloss over. I just take 1000 mg of ibuprofen every four hours and use heating pads and patches, and I move on with my life. My doctor was like, "How much ibuprofen? How often?" My husband chimed in at this point with an, "it's bad." My doctor and my husband got into a detailed conversation with each other while I sat there with a sheepish look on my face hoping they would eventually remember I was still in the room. Sheesh! At that point it was decided that I would need an exploratory laparoscopy, and I sat there stunned. All I really wanted was a miracle drug that would get me pregnant! Not surgery! Ahh!

Well, the point to this post/non-fiction novella was to encourage you to get help sooner rather than later. Follow your gut. If you think something isn't right, there's a distinct possibility it isn't! Especially you lovely ladies that are starting the conception game with a little more life experience...get help sooner. I don't care if you look 22, but you're really 37. Your ovaries look 37, and you are wasting precious eggs. Why be embarrassed? You wouldn't be embarrassed if you had cancer! All these doctors do all day is help lovely ladies like you. You aren't gonna tell them anything they haven't heard, or show them anything they haven't seen. You have nothing to be embarrassed about and every reason to get yourself help so you can have a beautiful baby and move on with your life!

Well, I'm off my soap box and being handed a margarita! Perfect timing! (I'll explain later...)

MK