Making God Laugh

This past weekend Pope Benedict addressed the Pontifical Academy for Life, a group of a couple hundred scientists and other members.  The theme for their meeting was “The Diagnosis and Treatment of Infertility.”  Dr. Hilgers was among the attendees and gave a presentation on NaProTechnology.

What Pope Benedict said was really touching.  I definitely needed to hear his words.  I copied portions of his address below.  The whole text is here.

...The pursuit of a diagnosis and of a therapy represents the most scientifically correct approach to the question of infertility, but also that which is most respectful of the integral humanity of the subjects involved. In fact, the union of the man and woman in that community of life that is matrimony constitutes the only dignified "place" in which a new human being, which is always a gift, may be called into existence...

...The human and Christian dignity of procreation, in fact, does not consist in a "product," but in its connection with the conjugal act, the expression of the love of the husband and wife, of their union that is not only biological but also spiritual. The instruction "Donum vitae" reminds us in this regard, that by its "intimate structure, the conjugal act, while most closely uniting husband and wife, capacitates them for the generation of new lives, according to laws inscribed in the very being of man and of woman" (n. 126). The legitimate parental aspirations of an infertile couple must, for this reason, with the help of science, find a response that fully respects their dignity as persons and spouses. The humility and precision with which you deal with these questions -- seen as obsolete by some of your colleagues fascinated by artificial fertility technologies -- merits encouragement and support. On the occasion of the 10th anniversary of the encyclical "Fides et Ratio," I recalled how "easy gain or, worse still, the arrogance of taking the Creator's place, sometimes play a decisive role. This is a form of the hubris of reason, which can take on dangerous characteristics for humanity itself..."

...The Church pays much attention to the suffering of infertile couples, it cares for them and, because of this, encourages medical research. The science, nevertheless, is not always able to respond to the desires of many couples. I would like again to remind the spouses who experience infertility that their vocation to marriage is not frustrated because of this. The husband and wife, because of their baptismal and matrimonial vocations themselves, are always called to work together with God in creating a new humanity. The vocation to love, in fact, is a vocation to the gift of self and this is a possibility that cannot be impeded by any organic condition. Therefore, where science cannot find an answer, the answer that brings light comes from Christ...

Isn't that last paragraph just beautiful? :)

While I’m sharing words of wisdom from the current pope, I thought I’d add some of what the previous pope had to say as well.  I tried to look up if Pope John Paul II talked about infertility in his weekly audiences that comprise the “Theology of the Body,” but I couldn’t find anything.  If anyone can find that he did, please tell me the date of the audience.  (Thanks!!)

This excerpt below is from Donum Vitae (Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation), issued by the Congregation for the Doctrine of the Faith in 1987.  The whole text is here.

The Suffering Caused by Infertility in Marriage

The suffering of spouses who cannot have children or who are afraid of bringing a handicapped child into the world is a suffering that everyone must understand and properly evaluate.

On the part of the spouses, the desire for a child is natural: it expresses the vocation to fatherhood and motherhood inscribed in conjugal love. This desire can be even stronger if the couple is affected by sterility which appears incurable. Nevertheless, marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts which are per se ordered to procreation. A true and proper right to a child would be contrary to the child's dignity and nature. The child is not an object to which one has a right, nor can he be considered as an object of ownership: rather, a child is a gift, "the supreme gift" and the most gratuitous gift of marriage, and is a living testimony of the mutual giving of his parents. For this reason, the child has the right, as already mentioned, to be the fruit of the specific act of the conjugal love of his parents; and he also has the right to be respected as a person from the moment of his conception.

Nevertheless, whatever its cause or prognosis, sterility is certainly a difficult trial. The community of believers is called to shed light upon and support the suffering of those who are unable to fulfill their legitimate aspiration to motherhood and fatherhood. Spouses who find themselves in this sad situation are called to find in it an opportunity for sharing in a particular way in the Lord's Cross, the source of spiritual fruitfulness. Sterile couples must not forget that "even when procreation is not possible, conjugal life does not for this reason lose its value. Physical sterility in fact can be for spouses the occasion for other important services to the life of the human person, for example, adoption, various forms of educational work, and assistance to other families and to poor or handicapped children." Many researchers are engaged in the fight against sterility. While fully safeguarding the dignity of human procreation, some have achieved results which previously seemed unattainable. Scientists therefore are to be encouraged to continue their research with the aim of preventing the causes of sterility and of being able to remedy them so that sterile couples will be able to procreate in full respect for their own personal dignity and that of the child to be born.

Dr. K gave me her recommendations in my last cycle review: two new drugs to take. I am going to start Clomid (25 mg on CD 3-5), but not until next cycle because my pharmacy didn't have any in stock when I called. I guess I'm a bit surprised they didn't have any since I assumed that was a fairly common drug. Oh, well. I guess that just means we'll have one cycle where I'm only adding one new drug instead of two. Dr. K also wanted me to start Cortef to try to combat my TEBB. Cortef is hydrocortisone, a steroid. It's used to treat adrenal fatigue. I haven't ever been tested for adrenal fatigue, but that is the only remaining cause of TEBB—of the six causes that I know of—that hasn't been explored for me yet. Infection could still be playing a role since we've only tried two antibiotics. (I am reminded of one of my clients whose TEBB was eliminated with the third antibiotic her doctor tried...) I am actually kind of excited to try the Cortef. Obviously if it helps us get pregnant I will be overjoyed, but I am very curious to see if it improves my TEBB, and I'm glad to have a break from the antibiotics. My face, neck, back, and chest are finally starting to clear up after a horrible acne breakout (maybe the worst since high school…yuck) that started suspiciously close to the time when I finished the second of the two back-to-back antibiotics. My theory, supported by Dr. Google, is that after the antibiotic effects wore off (yay, clear skin for a couple weeks!), a crop of really bad bacteria took up residence. Even my sweet DH, who claims never to see my acne, commented to me yesterday that my skin looked so much better than recent weeks.

Back to the Cortef…since I wasn’t supposed to start taking it until AF stopped this cycle, we won't know its effect on the TEBB for another month at least. I am also interested to see if it affects me in other ways—good side effects, if you will—like increased energy, improved concentration, etc. I looked at the list of symptoms for adrenal fatigue, and if I have any of them, they are very mild. For example, if you asked me if I have fatigue, I would say no. To me, fatigue would mean dragging through the day or having trouble staying awake. But I would qualify that by saying I am pretty much always open to taking a nap if the opportunity presents itself (give me a pillow and a flat surface), and I would have no trouble falling asleep even if I didn't "feel" tired and even if I was getting plenty of sleep at night. If I fit it into my schedule, I could easily sleep 10 hours a night or more. I bet that sounds odd. I wonder if it could be like what happened with taking naltrexone. If you had asked me before taking it if my mood was low/poor/etc. (even excluding PMS days), I would have said no, but after taking high-dose naltrexone I could definitely notice my mood was improved and not just post-peak. I guess I never knew any different so I assumed my mood pre-naltrexone was normal. That's how it is with my energy level; I don't know any different so I assume this is normal. I can function well enough during the day. I just happen to like to sleep. ;) But I would be pretty excited if taking Cortef made my energy and alertness even better. We shall see what happens. The jury is still out because I haven’t been taking Cortef very long.

And speaking of the naltrexone, I am up to 50 mg per day. I was at 25 mg but that just wasn't helping my PMS enough. When AF arrived this cycle (while taking 50 mg), I was much more stable emotionally than usual even though I still had some CD1 blues, and I'm attributing it to the higher dose. I hope this lasts.

Of course new meds means more pills to pop each day. I was feeling kind of maxed out in the pill department until recently when I found a couple of my supplements are sold in gummy form. Now I get to eat candy every day.  ;)  I wish all medications were available as gummies. That would certainly make the life of an IFer undergoing treatment a little brighter.

I made the graph below for fun and out of curiosity. These are all the TTC-related medications and supplements I’ve taken since we started TTC in summer 2009. The spike in February 2011 is for my laparoscopy. The graph does include the gummy supplements I’ve been taking lately, but I don’t count those as a “burden” anymore. They almost should count as negative pills because they’re so fun to take.  :)   I should mention that I could decrease my pill count by four if I ordered my vitamin B6 online (500 mg capsules). It’s easier for me to buy it locally, but the store only sells 100 mg capsules, so I take five of them.


DH wanted to see his pill count too, so I added it to the graph.  He's the red.  But I'm guessing you could have figured that out.  ;)


P.S. I have a list of my current meds on the right side bar if you were wondering.

Most of these topics are seemingly taboo on an IF blog and for good reason, I suppose. An IF girl can still dream though...

1. I own a glider (chair) and matching ottoman that are obviously designed for a nursery. They are white with pastel cushions. I obtained them for free; I don't remember if we knew we were IF at that point. I have plans to recover the cushions with a non-nursery-inspired material which would be suitable for the living room. Luckily they fit in the closet which is where they sit at present hidden under a stack of boxes.

2. I own maternity clothes, some of which were purchased after our IF diagnosis... I think my current collection includes: two pair of pants, a pair of sweatpants, a skirt, at least four shirts, and a spring coat. (Technically I am keeping an old winter coat that is too big for me now—for the singular purpose of using it during a winter pregnancy.) The pants I bought on super clearance before we even started TTC after a pregnant friend complained to me how expensive maternity pants are. At that time we were planning to start TTC soon (after my regular ob/gyn finished running some tests related to my unusual bleeding...wow, that was a long time ago). Then the unexpected happened which delayed our TTC plans quite a while. I knew circumstances could change quickly so whenever I went shopping I kept an eye out for non-maternity clothes that could be also worn during part of pregnancy (extra long or roomy in the front). I still do that. My only rule is that it has to look good on me now (and not just if I had a large belly). I may actually wear one or two maternity shirts as part of my normal wardrobe. Might as well make use of them, right? :) The maternity spring coat I wear all the time. I bought it because it's cute. And because I could wear it should I miraculously become pregnant...let's not kid ourselves here. You'd never guess it was maternity. I get compliments on it occasionally so I don't think anyone can tell. I really should cover up the label inside the collar though... One of these days I'm going to visit a friend who takes my coat to hang it up, sees the label, and asks me about it. :P

3. I am still not comfortable giving myself the HCG shots, even though I've been self-administering them for the past 9 cycles. I sit there—for a long time—with the filled syringe in hand and chicken out while attempting to stick it in my thigh. I am lucky the medicine doesn't completely go bad (while at room temperature) in the time it takes me to actually inject it. Thankfully my P+7 blood work has shown that the HCG is helping, so at least the P+5 shot is going well.

4. I have planned out exactly how I would tell DH if we became pregnant. I had the idea before we were IF but I didn't buy the required item for the announcement until after we were IF. It's hidden in a secret spot with the maternity pants and some rubber duckies we received as a wedding present.

5. As long as I'm not within about 5 days of CD1, I (usually) like looking at pictures other people's kids and babies. I recently stalked two friends' Facebook pages to see if they had given birth yet. Being bombarded with Christmas letters and pictures of babies in December was an exception—that was too much. I had DH prescreen them for me and remove all the pictures. I looked at the pictures when I could handle it (and one at a time). I really appreciated those that had a separate card. If we ever have kids, I hope I remember never to do the photocards. Sending a photo inside of a regular Christmas card is a better alternative, in my opinion.

6. DH and I sometimes talk about baby names. I started "the list" with my favorite names before I met DH. (Don't all single girls discuss this with their other single girlfriends and update each other when preferences change?) Of course once DH entered the scene I let him add his preferences. (awfully nice of me, huh?) I'm currently trying to convince let DH get used to my top boy name, which didn't get added to the list until recently. He's a choleric so these things take time. Maybe by the time we'd have the chance to use it DH would like it... Boys names are hard for me. I have a long list of girl names ready to go (all of which I love) but only one or two boy names, and I only like the boy names so-so.

7. DH has (not often but at least twice) looked at my stomach during the late post-peak phase and addressed the nonexistent-but-hoped-for baby by name. He uses two of my favorite girl names. He is eternally optimistic about a future pregnancy. I'm glad at least one of us is. If only his attitude might rub off on me a little... :)

I don't always live in dreamland but it's nice to visit every once in a while. :)

I'm not the only one who will admit to these things, right?

Much has happened since my last post.

1.  I had my first blogger meet-up!  It was lovely.  The group included Rebecca (The Road Home), Ania (The 411 on the 418s), E (God's Plan is my Joy), and TCIE.  It was as if I was chatting with old friends, even though I had never met any of them before (except TCIE).  It was so nice to talk to ladies who completely understand what it's like to be infertile and Catholic.  And since Rebecca had just had her surgery, we of course had to swap surgery and doctor stories.  I wish they all lived closer so I could hang out with them more often.  :)

2.  I earned this:

I had my ultrasound (US) series.  TCIE was so kind to let me stay at her house the entire week and a half. Hers is the only clinic besides the PPVI Institute itself where Dr. K would allow the series to be done.  TCIE explained to me in detail what a NaPro US entails and why it has to be done by a NaPro-trained ultrasonographer.  She told me they have tried to work with other ultrasound centers that are more conveniently located for out-of-town patients, but no one to date has been able to do a satisfactory job.  Her clinic has a detailed worksheet that they've sent along with patients who go to outside centers, so you would think the ultrasonographer would be able to handle checking boxes and filling in blanks if it's all spelled out for them.  Apparently that is not the case.  Some things on the checklist are not taught in ultrasound school, and others are simply not part of the template report that many centers use, so it's too much work to make extra observations or measurements.  TCIE said even when the patient holds a copy of the worksheet and asks for certain things while she is being wanded, the ultrasonographer still doesn't always cooperate.  I understand now why Dr. K insisted I go to a NaPro ultrasonographer, and I am thankful I had the opportunity to do so.

Here's how my US series went.  TCIE described it as an "ultrasonographer's nightmare."  It doesn't seem THAT bad looking back...

CD6:  I had my baseline US.  It was the only one that included both a pelvic US (on the belly) and a vaginal US (internal).  (The rest were vaginal only.)  I completely forgot that I was supposed to have a full bladder for the pelvic US, but luckily I had drunk enough water that day that my bladder was full enough to proceed.  A follicle on my left ovary was identified as the one that would likely progress toward ovulation.  There was a shadowy area of my left ovary that looked suspiciously like an endometrioma (endometriosis on the ovary).  I was told it doesn't necessarily interfere with pregnancy since they see endometriomas in pregnant patients sometimes...  [Note: it turned out not be an endometrioma.]

CD9:  I started to observe fertile mucus just before the US.  The US showed that my cervix was dilated a tiny bit, and my endometrium was thicker than it was on CD6.  These were good signs.  (The endometrium is supposed to grow in thickness as you get closer to ovulation.)  The follicle on the left ovary didn't grow at all since CD6.

CD11:  This was the third day of good mucus.  The US showed my cervix was dilated more and my endometrium was thicker than CD9.  Progress!  However, my follicle on the left ovary still hadn't grown at all.  (Nothing was happening on the right either.)  This was not consistent with my mucus, endometrium, and cervix status.  At this point it was possible that 1) the follicle could have a quick growth spurt right before ovulation or 2) the follicle would be too small when it ruptured at ovulation.  Still it was puzzling that I was having good mucus with zero follicle growth.

CD13:  This was the fifth day of good mucus.  I don't usually have more than five days in my mucus cycle, so I expected that the follicle would have grown by now.  The US showed my endometrium was thicker than CD11, and my cervix was still dilated.  Unfortunately, that silly follicle still did not grow one bit.  This really didn't make any sense.  Why was I having a normal mucus cycle, normal endometrium growth, normal cervix dilation, and zero follicle growth?  Neither TCIE nor the doctor could explain it.  When I spoke to DH on the phone, he joked that Dr. Hilgers should use me as a case report in his next book or presentation.  I hoped someone would be able to figure out what was going on.  I didn't particularly want to be a case report...I just wanted my ovaries to work!  A few hours after the US, I had 10KL that stretched three inches.  (Yes, I just wrote how much my mucus stretched.  I have no shame.)  :)  I also had very obvious left-sided abdominal pain (mittelschmerz), which I have observed occasionally in past cycles.  I mentioned this to TCIE in the evening.

CD14:  TCIE told the doctor about my mittelschmerz and fabulous mucus from CD13.  She called me and said that the doctor wanted to run some labs (estradiol, progesterone, FSH, LH) to see if that would give us a clue of what was going on.  I drove to the clinic to have my blood drawn.  The woman who drew my blood took one look at my arms and complimented me on my veins.  (She had her pick of four easy-to-access veins.)  Just about every phlebotomist who draws my blood comments that I have good veins.  I wish I could take credit for them.  hahaha  At least it made one person's job easier.

CD15:  It was Peak+1.  I had a six-day mucus cycle, which is great.  At least my cervix was on its best behavior this cycle. :)  I wish I could say that about some other organs...namely my colon.  Yes, my colon.  You'll see why in a minute.  The US showed my cervix was closing up, and the follicle was as dormant as ever.  The blood work from CD14 was perfectly normal for someone who had just ovulated.  The doctor was completely stumped.  TCIE continued the US and guess what she found on the left ovary?  A corpus luteum!  (that's what the follicle becomes after ovulation) That meant I ovulated!!  But the follicle we'd been watching since CD6 on the left ovary was still there.  The corpus luteum was not near that follicle; it was in a separate location but still on the left side.  What did this mean?  I have a dumbbell-shaped left ovary.  The corpus luteum was on the other half of the ovary.  We had never seen this half of the ovary before this US.  Apparently the half of the left ovary with the dormant follicle had very nice, clear borders so there was no reason to suspect that my ovary was dumbbell-shaped. So you might be wondering why the other half of my ovary didn't show up on any other US...that would be thanks to my very active, redundant colon.  My colon has extra loops to it (a normal variant which I knew about before the series), and the loops covered up the half of my dumbbell ovary containing the follicle that eventually ruptured.  For whatever reason, my colon decided to get out of the way on CD15 so we could see the corpus luteum.  Silly colon.  Unfortunately, we don't know how big the follicle got before it ruptured.  Follicle size is important to know.  (If the follicle is too small, it's not a good ovulation.)  The corpus luteum looked "fresh" which meant I likely ovulated on CD14, which was consistent with the blood work.  How's that for a textbook cycle?!?  Ovulating on CD14 and Peak Day!!  ;)

On the bright side, measuring follicles is something any ultrasonongrapher can do, so if Dr. K decides that she wants to know how big my follicle gets before ovulation, I could have that done locally.

3.  DH was able to visit for a short time while I was having the US series done.  We spent a whole day in New York City, which was a lot of fun even though there was snow and slush on the ground.  It was his first time there.  The timing of his visit was okay but not great in relation to ovulation.  I don't think I can completely blame our not getting pregnant this cycle on the timing though (as much as I want to!).  There's obviously something still wrong, and I wish we could figure out what it is.  I still have lots of TEBB, so that's one thing to focus on yet.  I am really curious about where Dr. K will want to go from here.  I'll find out in a few days when I receive her feedback on my cycle review.

4. While I was staying with TCIE I visited these beautiful shrines, each with first class relics of the saint.  I offered prayers for bloggers still waiting at each one.

St. Rita is a patron saint for infertility and hopeless cases.  Her parents prayed for many years to have a child before St. Rita was born.


St. Anne went through a period of infertility before becoming the mother of the Blessed Virgin Mary.  She is a patron saint for those facing infertility.