A new (life)line of business

It was just a matter of time - I'm just sorry I didn't think of it first. Fertility consultants. According to a story in the Washington Times today, it's the hot (fairly) new profession that "helps couples navigate the maze" of fertility. Not everyone's thrilled with the idea, least of all fertility doctors, but I think it's brilliant. Someone saw the need and filled it.

The story explains that a fertility consultant is "part researcher, part consumer advocate and part sympathetic ear, among other things." It also acknowledges that couples who are just visiting the local fertility doctor probably don't need the services of a consultant, but those who are grappling with the intricacies of fertility law and surrogacy, for example, could benefit greatly from a third party.

Again, brilliant. And just one more thing to file away as a good option - career option, that is...

Things are looking up, so to speak...

Chris paid a visit to our naturopath yesterday and came home with an armful of supplements and dietary advice to help his sperm. Here's what he was told:

Dietary:

• Avoid tofu and other soy-based products
• Avoid dairy (except, oddly, aged cheese)
• Minimize gluten / wheat intake (go for kamut or spelt instead)
• Eat lots of protein

Supplements:

• Sodium Bicarbonate for sperm motility (the ability of the sperm to move)
• Antioxidants for sperm motility, volume and concentration
• Coenzyme Q10 for sperm motility, density, count and morphology

But it was the supplement tribulus terrestris that I found the most interesting. When I Googled "tribulus herb" I found websites with the hopeful names bodybuildingforyou.com, illpumpyouup.com, and my favourite, trulyhuge.com. It appears the herb is commonly used as an aphrodisiac and does wonders when it comes to increasing sex drive and impotence. In fact, it's been called "Nature's Viagra".

However, a more, ahem, refined search found that tribulus also claims to help in male reproductive functioning and sperm motility, increases the production of the hormone leading to increased testosterone levels, and increases production of seminal fluid.

Another hopeful sign: Chris is no longer training for a marathon, which he was up until two months ago. While regular exercise is beneficial to male (and female) fertility, marathon running and the associated training can alter sperm production. So now that Chris is back to a more relaxed running schedule, things are looking up in that department, too...

The cone of silence

I have fantastic friends. They're supportive, loyal and we tell each other everything. Until now. All of a sudden, there are hushed voices and whispers, innuendos and sidelong glances, all in the name of failed conception.

It's a strange phenomenon, but when people - especially close friends - know you're trying to conceive, they don't want to let you in on the news about others who have successfully achieved pregnancy. I am now the last to hear about friends of friends who are pregnant. Some of my friends have even gone as far as withholding stories, information and anecdotes about their own children.

This, of course, is nothing if not thoughtful. It's kind of like when your friend's relationship is on the rocks, the last thing you want to do is gush about how in love you are. So, I'm writing to say: it's okay. Really. I like hearing about others who have managed to get pregnant. I mean sure, the wildly competitive side of me wishes I had gotten pregnant first, but really, pregnancy is something that should be celebrated, not reduced to petty competition, right...? Right.

It's a miracle I even want a child

An old friend of mine, who is a columnist for a daily newspaper, read my blog for the first time today. He asked if I wanted his editing thoughts and I jumped at the chance. Well, "jumped" may be overstating it a bit. It was more like crept, with much trepidation. This is what he said:

It's very good the way it is, but the next dimension is making it more personal.

• More emotion - what does this struggle mean to you, your relationship?
• How does the advice of others help and/or infuriate you?
• What does it matter if you have a baby?

Balance the clinical with the personal.

As someone who has watched three close friends go through this, I know there is a lot of anguish and frustration - some very funny - as well-meaning folk try to help. I think it would put a "human face" on the whole thing.

His points are well taken, insightful even. That isn't surprising. He's a brilliant writer, a fantastic editor and knows me well. So I thought I'd explore some of his well-placed questions and see where they take me.

What does this struggle mean to you/your relationship?
I suppose it's a miracle I even want a child. For a very, very long time I didn't. My biological clock wasn't ringing and I never felt (as the Aussies call it) clucky. I wasn't the one reaching out to hold the baby and the concept of relating to a little person who couldn't engage in a logical conversation never really warmed my heart.

At the risk of sounding cliche, that all changed when I met Chris. Suddenly I wanted a tiny, illogical, screaming child all of my own. So, I was nothing if not surprised when it didn't happen the first - or eighth - month. As for our relationship, I think this process has actually strengthened it. The pursuit of a common goal (not to mention regular sex) often does that. Nine months in and we're still able to approach this with grace and humour.

How does the advice of others help and/or infuriate you?
This one's easy. If there's someone out there, anywhere, who has advice about how to make this happen, bring it. I would love to hear any and all suggestions. Of course, I've been on the receiving end of many opinions out there. One friend - who tried for 13 months before she conceived her first child - is convinced that the day I forget all about it, throw out my charts and ditch the thermometer, is the day I'll get pregnant. That's something that worked for her and it makes sense: just live life as you normally would. Not sure where that leaves my blog, but the advice is appreciated nonetheless. However, the fact of the matter is most of my friends had no trouble conceiving, so they've been wise enough to keep their advice to themselves - and in turn avoid any potential of infuriating me.

What does it matter if you have a baby?
This one's a little trickier. Why indeed? It's an excellent question. I suppose if there's something out there of meaning and that interests me, I want the opportunity to experience it. That includes being a mom. Even though my love of kids hasn't exactly overwhelmed me in the past, I always knew that one day I would want them. But really, why does anyone want kids? Is it so we can pass on our wisdom, share our learnings, experience and enjoy childhood all over again, be comforted in our old age, observe how they grow and see how they show up in the world? I guess it's a little bit of each, and much, much more.

Anguish and frustration
Anguish, nope. Frustration, yup. Living in that "in-between" place of not being pregnant and waiting to become pregnant is indeed frustrating. But I don't feel I'm at the anguish stage yet. It may come but I pray that it doesn't. I'm more at the information-gathering-exploration-hope-to-hell-it-happens-soon stage. In the meantime, this blog has provided me with an excellent opportunity to put my elusive fertility in a positive light - every month I'm not pregnant is another month I get to blog about it. Just think, when I do get pregnant, I'll have to go through the tedious task of coming up with a new name for my blog.

The other half of the story

There is, of course, another player involved in this conception game - Chris. This fact did not elude us, it has just taken a little longer than we anticipated to get his sperm results back. Much longer, actually. As it happens, the lab somehow lost Chris's first results and therefore required a second "donation". So, after another visit to a cold, impersonal (and to his chagrin, not unfamiliar) doctor's office, his final results were nothing if not illuminating, adding yet another complexity to our fertility endeavour. Although Chris's doctor told him everything was normal, our naturopath had a different interpretation of the results. She was most interested in his morphology, or the shape of the sperm.

If a sperm is abnormally shaped, it can't fertilize the egg. Many labs use what's known as the Krugar technique, or "strict criteria", which dictates that if any sperm isn't perfect, it isn't counted. A normal sample using the Krugar criteria should have 14% normal forms, which means 86% of the sperm from that sample are considered abnormal. By this measure, it's a miracle anyone gets pregnant.

So it comes as no surprise that there is an ongoing debate about how sperm should be evaluated and measured, not least of all because of the (human) subjectiveness of those investigating sperm samples. The World Health Organization's criteria is 30% normal sperm per sample, more than double Krugar's "strict criteria". But even those aren't set numbers, with analysis varying from lab to lab. Indeed, the lab that tested Chris considers 15% to be the normal morphology. Based on this reference, Chris's sperm morphology is above-average at 17% - which still means that 83% of his sperm are considered abnormal and therefore unable to fertilize my eggs.

Add to this hodgepodge questions as to what causes sperm morphology, and it gets even more complicated. Some say it's environmental toxins that have progressively lowered men's normal sperm count, while others believe the steady reduction of sperm morphology over the years is due to the criteria itself - labs are getting stricter and stricter as they look harder and harder for "flaws", ultimately eliminating every sperm that doesn't look perfect. Now, many men's results show 2% to 6% morphology.

So, after all these numbers and percentages, what's to be done? Well, a couple of things. First, I'm going to continue doing what I'm doing. Second, Chris is going to follow our naturopath's recommendation of putting him on a detoxifying diet to help eliminate any environmental toxins that may (or may not) be affecting his morphology. We'll know exactly what that entails in two week's time after Chris's scheduled appointment, but I'm envisioning a few months without dairy for my lovely husband. Then, after the detox, Chris will re-visit the all-too-familiar sperm doctor's office and see if he can beat the lab at its own game...

Climbing the hill of conception

A Doctor of Chinese Medicine friend of mine said that I should, among other things, hold as many babies as possible while I'm trying to conceive. I'm sure there are studies showing the correlation here, I just haven't found them. However, he said his wife is convinced she got pregnant because she held a friend's baby daily. I believe the theory is that, when holding a baby, your fertility hormones are stimulated. I like this idea. It's nice and nurturing and makes good sense to me, even if I can't find any evidence to support it.

So today, on my regular walk with a dear friend, I embraced my desire to have a baby by, well, embracing a baby - her 10-month-old son, to be precise. I've never actually worn a sling before but we strapped me up and slung him in. And then we walked. Up a really big hill. As he giggled and cooed, I huffed and puffed. And nearly collapsed at the top. Truth be told, it was a small price to pay. As another dear friend of mine so eloquently put it, "I'd spin on my head and spit nickles if I thought it was going to help me get pregnant." That will be on the next walk...

Desperate market or well-informed women?

When is enough, enough? I ask myself this as I drive home from my appointment with my massage therapist. She's just performed CranioSacral Therapy on my uterus. It's non-invasive, pleasant even. And who knows? It might even help. It's what's tucked into my wallet that I'm pondering - a business card she gave me for a chiropractor that specializes in a procedure called NUCCA (named for the National Upper Cervical Chiropractic Association).

My massage therapist is the first to acknowledge that it sounds crazy, but that chiropractic treatments may help address fertility issues. So I think: Why not? Which brings me back to my initial question: When is enough, enough? When I'm pregnant? When I've run out of money for treatments? When I've exhausted every potential fertility-enhancement option under the sun?

What this underscores for me is the perfectly captive and desperate market many fertility-challenged women are. I'm one of them. A logical, well-educated, well-read woman. Have I lost all reason or am I simply being open-minded, willing to consider any non-invasive, safe treatment that may lead me down the pregnancy path?

These questions come fast on the heels of yet another potential route to explore: Hypno-Fertility (God, is there any way I can write this without sounding like a total flake?). I mean, come on! But it actually sounds really good: "Guided visualization whilst in a relaxed state." Nothing wrong with that. At the very least, it's yet another option to contemplate. But before I do, I've taken the NUCCA business card out of my wallet and placed it on my desk. A logical first step...