What I Wish I Knew 6 Years Ago
There are many things I wish I had known 6 years ago when we were first starting on the journey of trying to conceive so I thought I’d make a list for those who are just starting out. These are not in any particular order of importance.
1) Be your own advocate. I wish it wasn’t like this but in today’s medical world it is. YOU are the person who cares about your health and knows your body the most. Being your own advocate means being prepared for each appointment with your doctor. Have a list of questions ready (written down) HOWEVER pick your top one or two questions to make sure you get answered. If you have a LOT of questions be prepared to make more then one appointment to get your questions answered. Bring a notebook and pen, ask the doctor if it’s ok to voice record your appointment. Do some research ahead of time to be informed about the procedure. Ask to speak the office manager (prior to your appointment) about protocols of the office. How often will you see your doctor versus a nurse or another doctor? How is billing done, is it ala cart or is there a package deal for a procedure? How will they communicate your results to you? My husband and I didn’t ask these questions and we were sitting around waiting to get results from tests while the Dr’s office was busy not caring about our anxiety levels. Don’t wait around! Call the office. Don’t worry about being needy or a squeaky wheel. You can’t put your health and future family into someone elses hands. You have to take control to make things happen. I grew up with a grandpa who was a doctor, my grandma is a nurse and my dad is a doctor. I had a deeply held conviction that doctors knew best and had your best interest at heart. It was a bit of a shock when I realized that most do not. They are on a strict schedule. Most doctors wish they could connect better with their patients however in order to get paid by the insurance companies they are required to document and chart and find codes for everything. Why? Because we live in a sue happy country. Doctors are forced to work for insurance companies which creates an environment that denies them the ability to make deep connections with patients. There are many doctors who are spending countless (unpaid) hours outside of work research and collaborating with other professionals about treatments for patients, just because you (the patient) don’t see it, doesn’t mean it isn’t happening but that doesn’t let you off the hook from being your own advocate either. While doctors read the test results, nurses/medical assistants and office personnel do most of the communicating. MAKE THEM YOUR FRIENDS! If the doctor orders a test or procedure that you either don’t understand or are uncomfortable with ask the NURSE or Medical Assistant, NOT the doctor. The nurse or MA will have more time to do some education with you, it’s what they went to school for.
2) Don’t wait to get testing done. I got into the mental cycle of telling myself ‘next month it will happen, I don’t need to get testing yet’. Before I knew it, 5 years had gone by. The definition of infertility is trying to conceive for 12 months (if under 35, 6 months if over 35) unsuccessfully. HOWEVER, if there are any problems like super painful periods, not being able to get positive results on ovulation prediction kits, painful intercourse, history of surgeries on the ovaries, cancer, etc. you should at least go see a doctor. You never get that year back. It was very depressing when I realized that all the tests they do can take months because they have to be done at certain times of my cycle. I thought I’d go in and have them all done in a day and get some answers. Nope.
3) Get a pre ‘TTC’ evaluation. Now…when we started trying we ‘weren’t really trying’, just kind of not being careful and seeing what would happen. There wasn’t a conversation and a handshake agreeing to try to start a family. If there had been, maybe I would have gone in for a pre conception evaluation. But I didn’t. This type of appointment can help someone save some of their precious time and emotional stability. Going in to the Dr will help you know what to start doing, stop doing, maybe some books to read and signs and symptoms to watch out for (either good signs showing pregnancy, or bad signs showing you need more evaluation and testing).
4) Find the right Doctor. This is HUGE. I (like many people I’m guessing), googled OB/GYN near me and made an appointment with someone who was a) close to me, b) was taking new patients and c) accepted my insurance. Those were my criteria. It never occurred to me to look into different licensure or area or study or what the different degrees meant. If I could do one thing differently in our journey it would be taking the time to find the right doctor. Not all doctors and licenses are equal in knowledge of infertility. In medical school very little time is spent on infertility specifically. You need to make sure that the person you are seeing is actually knowledgeable in infertility. Quick overview of licensure of medical professionals.
MD = medical doctor, doesn’t mean they know anything about infertility
DO = doctor of, also doesn’t mean they know anything about infertility
Infertility Specialist = not a real designation. Anyone can take this onto their name and claim it to be true.
Hormone specialist = once again, not a real designation.
CNM = Certified Nurse Midwife. This is someone who is a Registered Nurse and went on to get more training in midwifery. They typically have more time built into their schedule for appointments
ND = Naturopathic Doctor. Typically they will take a closer look at the whole body including lifestyle factors.
OB/GYN = Obstetrics and Gynecology. They follow a pregnancy and deliver a baby.
REI = Reproductive Endocrinologist and Infertility. Board certified in OB/GYN and Reproductive Endocrinology. These guys are the true specialists of infertility. Even here though they aren’t all the same. The good ones will look at all factors affecting infertility including lifestyle, diet, exercise etc.
5) Set your expectations. 6 years ago it didn’t really occur to me that just because you see a positive pregnancy test doesn’t mean you deliver a healthy baby. 25% of medically recognized pregnancies end with in miscarriage. Not 25% of women, 25% of MEDICALLY recognized pregnancies. Meaning, there was a blood test or an ultrasound and a Dr. confirmed a pregnancy. That’s a HUGE number. Also 1 in 7 couples struggle with infertility. That’s a huge number too. The older you are the higher both of those stats. The more I’ve learned the more naïve I realize I was. I just thought if you had sex around ovulation time you were going to get pregnant and the rest of your life you’d be a mom. Set your expectations correctly to avoid utter despair if you’re one of the unlucky ones.
6) How to use Ovulation Predictor Kits. I feel really stupid when I say I didn’t know how to use them but what I really mean is I didn’t know how to interpret them, what the results meant, or how to make sure they are accurate. Here’s what I NOW know.
Every brand is different. Make sure to read the insert (you know, the one we always throw away without reading? ya…read it) to understand that particular brand.
OPK’s (ovulation predictor Kits") test for your LH ‘surge’
LH surges in the morning and SHOULD BE TESTED WITH YOUR SECOND MORNING PEE (if you do it otherwise you’ll get inaccurate readings)
The LH surge happens about 24-36 hours BEFORE ovulation.
7) Read Making Babies. Someone turned me onto this book 5 years into our journey and I WISH I would have read it when we started out. It gave me a starting point of knowledge. I had just enough info from reading that book to be able to advocate for myself with my Doctor. If you’re interested in it, head over to the resources tab on this site and get more info.
That’s all for now. There are more things I wish I had known 6 years ago when we started, but this is the basic list that applies to pretty much everyone who is TTC. The other things I wish I’d known probably only apply to the people who are having trouble conceiving. The Resources tab on this site has other great things (books, podcasts and products) that were all helpful to me.
