To Fertell or Not to Fertell

If you're new to this infertility thing, you have probably just gone to a dozen internet sites (a lot of them are really bad, aren't they?) and it's hard to know what's fact, and what's the opinion of a random yahoo chatroom person who's sort of a bad speller. So, thought I'd share with you the process as I have experienced it.

To give you a preview:
1) Not really "trying" but not on the Pill anymore
2)Used Fertell fertility test (available at drugstores)
3) Saw a doctor (reproductive gynecologist)
4) had blood, semen and HSG tests
5) took "time off" from worrying about it (i.e. didn't start IUI right away)
6) found a new doctor and are about to get started with him

My husband and I are both 37, and started trying when we were 36 - next month it will be one year (sorry to people who have been trying for a lot longer). At first, I thought, "I'll just go off the Pill and won't really think about it and we'll see what happens." Getting pregnant in January would have been sort of inconvenient for me workwise (can't believe I ever thought like that!) and would have cut into my ski season, so I didn't mind if it took a few months. In my mind, we'd just have fun for three months, and then we'd get serious and I'd get pregnant. I thought about being eight months pregnant at Christmas and wouldn't I look awful in pictures, haha but it'd be fun to have a January baby and Capricorns are very organized and kind and are all good students (at least, my sister is) so that would make for an easy first child.

Ah, the good old days. I have to say, one of the only good things about having a hard time getting pregnant is all that "I hope I have a girl/I hope she's cute and has blue eyes and doesn't get his eyebrows or she'll have to buy stock in Nads" is totally out the window. I just want a baby - any baby.

In April, I decided we needed to really try. I had been using ovulation predictors (aka pee sticks) so I'm not sure what "really try" meant (I guess have sex more than one time around the ovulation surge because I was away or we were both tired or my nails were wet) and not skimp on sticks because they are so ridiculously expensive. I also visited websites like babycenter.com, and at that time, I remember feeling like they were so cute, and wasn't it fun to use the ovulation calendar, and see when the baby would be born, or visit the chinese predictor site (to see if it would be a boy or girl) - the whole thing was fun and sort of exciting and I didn't mind the popups for baby toys or maternity clothes (how much fun was it going to be to buy a whole new wardrobe??). By the way, on a bad day, those same popups now make me cry...but we're not there yet.

When we weren't pregant by June (looking back I can't believe how long those few months seemed - it's crazy) I broke down in CVS and bought Fertell. It's a fertility test for you and for him - and it's $100. I measured my days wrong (I counted in 24 hour blocks instead of just Day 1, Day 2, Day 3) and when I called their 800 number, they immediately FedExed another test, so I have to give them snaps for customer service.

For ONCE, the Fertell test is easier for you than it is for your guy. You just have to - can you guess? - pee on a stick on the right day. He has to ejaculate into a little plastic cup thing and then there is some waiting and twisting of caps and after about an hour, you'll know if his sperm count is normal. For you, Fertell measures FSH (sorry, I know we promised no alphabet soup) defined as:

Follicle Stimulating Hormone – A hormone secreted by the pituitary gland in the brain. In women, follicle stimulating hormone stimulates the growth of ovarian follicles, which allows for the egg to mature prior to ovulation. High levels of FSH can cause the egg to be released before it has fully matured, making the egg incapable of fertilization.

Basically, my understanding is that if your FSH level is too high, your ovarian reserve isn't good - i.e. your eggs are gettin old.

The male test measures motile sperm - i.e. good swimmers who can get to the egg. If there are more than 10 million sperm per milliliter of semen (I am not kidding) then things are looking good (apparently that is a World Health Organization standard).

We got good news on both tests, and I have to say, I was thinking, WAIT a minute, he has at least 10 million sperm per MILLILITER and I'm not pregnant??? But then I read that if he has less than 20 million per milliliter, he's considered infertile. Here are some other facts I've learned (from New England Journal of Medecine type websites, but still, not sure if all of these are 100% correct):

In last 50 years, men's sperm count - worldwide - has dropped by half. (And everyone is blaming women having careers for the increase in infertility - HA)

After sex, it takes between 5 minutes and 70 minutes for sperm to reach the fallopian tubes (can you believe we're talking about this? I know, me neither).

Sperm can live for 12-48 hours if conditions are right inside you - but the estimates on this seem to vary wildly.

Your egg can only be fertilized for about a 12-24 hour period - some websites say 6 hours, some say 24, but basically, the window is a LOT SMALLER than they made it sound in 8th grade!! I mean, on the bus in 9th grade Robyn Hunter told me that you could get pregnant on the last day of your period - and she knew everything! Damn her. Liar.

Sperm quality is best if he has ejaculated 2 days prior but not more than 7 days prior (apparently they get a little funny in there if they haven't gotten out for some action).

Aha, I thought as I read this. Now I know why men are such horny freakshows! They are biologically wired to have an orgasm at least every three or four days. We get a hormonal surge once a month, and they get the most powerful drug known to humankind - testosterone - pumping 24/7. Again, not fair.

But as usual, I digress.

So, do I recommend Fertell? As a starting point, yes. If you don't think you want to go to the doctor right away, you can take the test and if it's normal, you can keep trying, which is what we did. The test isn't comprehensive - there could be plenty of other reasons you can't conceive, but it's sort of a good start, and it's over the counter, which is nice, and it doesn't require any blood tests, humiliating procedures or parking tickets when you can't get a space and your doctor's appointment is in four minutes (don't kid yourself, she's going to take you 49 minutes late anyway). It costs about $100, but if you're like me, and you can never get enough information about anything, it'll give you some peace of mind about two things, at least.

Next post I'll talk about the tests at the doctor's office and what to expect with those (in case you're wondering, yeah, not fun. Sorry).

-L