Cervical fluid refers to the mucus made by your cervix throughout the course of your cycle, while cervical position is the position your cervix is in (high, medium, or low) during your cycle. You can track both in your Ovia app by heading to your calendar. 

How to check your cervical fluid

Your cervical fluid will change color and texture depending on where you are in your cycle. There are a few ways to check your cervical fluid to detect these changes.

• Wipe before you urinate, and notice the color and feel of the mucus on toilet paper — it may feel slippery, creamy, or dry.
• Insert a clean finger into your vagina and look at the color and texture of the cervical fluid
• Check the color and texture of the discharge on your underwear. This works best on white, cotton underwear.

There are certain factors that can affect your cervical fluid such as douching, having sex, infections, using lubricant, and taking certain medications.

What your cervical fluid means

Once you’ve checked your cervical fluid, you can tell whether you are approaching ovulation based on the color and texture of the mucus. Your cervical fluid will usually follow a predictable pattern throughout the course of a 28 day cycle.

• Days 1-4 days after your period: Dry with no noticeable cervical secretions.
• Days 4-8: Creamy and sticky, almost the same look as school glue
• Days 9-14: Clear, stretchy, wet, and slippery, the same look and feel as egg whites; this is the time just before and during ovulation, the best time to have sex or introduce sperm.
• Remainder of your cycle: Dry, with no visible cervical fluid until your period arrives.

Some things that may affect the pattern of your cervical fluid are if you are breastfeeding, approaching menopause, recently came off birth control or gave birth, or have hormonal conditions such as polycystic ovarian syndrome (PCOS). Check with your healthcare provider if your cervical fluid does not follow this timeline or if you’d like help identifying each stage.

How to check your cervical position

Now that you’ve checked your cervical fluid and have a good understanding of what it means, you can also check your cervix position, another sign of ovulation. Depending on where you are in your cycle, your cervix will be low, medium, or high. Low means it is closer to your vaginal opening and you only need to insert a finger up to the first knuckle to feel it. Medium is right in the middle. And high is up and back far enough that you can insert a finger up to the second knuckle to reach it (or you may not be able to reach it).

You can also feel for the firmness or softness of your cervix. If your cervix is high and soft like an earlobe, you’re likely approaching ovulation. If it feels low and firm like the tip of your nose, it’s not your fertile time just yet. Follow these step-by-step instructions every time you check your cervix.

• Wash your hands
• Get in a comfortable position either by sitting on the toilet, squatting, or by putting one leg on the edge of the bathtub
• Use your index or middle finger to reach inside of your vagina in an upward motion
• Locate your cervix, which will feel like a firm, round dimple
• Record your cervical position as high, medium, or low in Ovia

Try to check your cervical position at the same time each day and be sure not to check immediately after sex. Over time you will get more comfortable checking your cervical fluid and position and you’ll be able to quickly identify signs of ovulation. 

Reviewed by the Ovia Health Clinical Team

Sources

Mayo Clinic Staff. “Cervical mucus method for natural family planning.” Mayo Clinic. Mayo Clinic. March 24, 2021. https://www.mayoclinic.org/tests-procedures/cervical-mucus-method/about/pac-20393452.

“What’s the cervical mucus method of FAMs?” Planned Parenthood. Planned Parenthood. n.d. https://www.plannedparenthood.org/learn/birth-control/fertility-awareness/whats-cervical-mucus-method-fams.

“Cervical mucus method.” Cleveland Clinic. Cleveland Clinic. January 29, 2020. https://my.clevelandclinic.org/health/treatments/21066-cervical-mucus-method.

Rachel Gurevich. “How to check your cervix and cervical position.” Verywell Family. Verywell Health. September 17, 2020. https://www.verywellfamily.com/how-to-check-your-cervix-and-cervical-position-1960299.

The better you understand your unique menstrual cycle, the better you can understand your overall health.

Although the average menstrual cycle is 28 days, a cycle can actually be a few days longer or shorter and still be considered normal. Cycle length can also vary a little from cycle to cycle and still be considered normal.

Hormonal changes in the body trigger each cycle phase: menstrual, proliferative, ovulatory, and luteal. And while your period is the most recognizable phase, the other three are equally important and impact your energy levels, immune system, moods, and sleep patterns differently. Let’s dive in.

What are the menstrual cycle phases?

The body performs different functions throughout the four phases of the menstrual cycle, each of which plays a unique role in the reproductive process:

Proliferative: During the proliferative phase, ovarian follicles (structures in the ovary that each contain a single egg) mature and prime themselves for ovulation. Your hormones perform different functions that are geared toward the goal of producing an egg for fertilization during ovulation, the next phase. Although many follicles start maturing during the proliferative phase, usually only one eventually proves dominant, and becomes the sole egg available during ovulation.

Ovulatory: The ovulatory phase begins as a hormone surge forces the dominant egg to break free from its follicle and nest in a fallopian tube, where it will disintegrate if not fertilized within about 24-36 hours. Ovulation is the only phase in which you can get pregnant. But because sperm can live for up to five days in the reproductive system, if sperm is present in the short time leading up to ovulation, this can also result in conception.

Luteal: Following ovulation, the follicle that released the egg transforms into a corpus luteum, a structure that produces the pregnancy hormone progesterone. Progesterone thickens the lining of the uterus in preparation for a fertilized egg to make its home there for the next nine months. If conception occurs, the corpus luteum continues to produce progesterone to maintain a healthy pregnancy. If the egg is not fertilized, the corpus luteum ceases its progesterone production after about two weeks. This drop in progesterone signals menstruation to begin.

Menstruation: The onset of menstruation is considered to be the start and end of a menstrual cycle, as it signifies the end of an opportunity for fertilization for one egg (and the beginning for millions more). Menstruation is triggered when the corpus luteum of the last cycle’s unfertilized egg ceases to produce progesterone, usually occurring about two weeks after ovulation, causing the uterine lining to shed, along with a bit of blood. The length and intensity of a period varies from person to person and cycle to cycle, but usually lasts between 4-6 days. Once the period stops, the proliferative phase begins again, starting the reproductive process anew.

Reviewed by the Ovia Health Clinical Team

Read more

• The menstrual cycle and your hormones
• Tracking fertility during the proliferative phase
• 5 signs you might be ovulating

Sources

• Mayo Clinic Staff. “Menstrual cycle: What’s normal, what’s not.” Mayo Clinic. Mayo Clinic, 4/16/2013. Web.
• “Patient Fact Sheet: Am I Ovulating?” ASRM. American Society for Reproductive Medicine, 2014. Web.

(If you’re already taking the pill or have an IUD, add it to your Ovia profile!)

Start with your priorities

Everyone has different preferences – and what’s important to one person might be less important to another. 

Some people gravitate toward options that they don’t have to think much about, or toward those that are easy to use. Some want help managing period symptoms. Some want a method that’s highly effective at preventing pregnancy. Some want a long-lasting option, while others are looking for shorter term use.

To work through all of these considerations, you might find that it’s helpful to narrow your focus by considering each question when thinking about the right birth control method for you.

Choosing a birth control method? Ask yourself these questions before making the decision

• How effective is it at preventing pregnancy?
• How convenient is it — do you have to take it every day or can you think about it less frequently?
• How easy is it to use the right way?
• How long-lasting is it?
• How affordable is it?
• How will it affect your period and cycle health?
• What kind of benefits or side effects might you expect — with your health history and other health concerns taken into account?
• Does it protect against STDs?
• Is it discrete?
• Will using it interrupt intercourse?
• How soon can you potentially get pregnant after you stop using it?
• Do you need a healthcare provider to get it?

Given the range of options available, even if you have a lot of specifics that are important to you, chances are you can still find a method that will meet all or most of your preferences.

Talk to your provider

Some birth control methods are available over the counter, but many need to be prescribed. To consider all of your options, have a medical professional walk you through which ones could be best for you. They’ll be able to consider your medical history, your general health, your period and cycle health, your past experience with birth control, your lifestyle, your plans to have children, and your preferences. It will also give you a chance to learn more about your options from a medical professional and ask questions.

Try, try again

Once you decide on a method of birth control, if it turns out that it’s not a good fit, you should reconsider your options. The same is true if you’ve tried birth control in the past that you didn’t like. And sometimes what works for you at one stage in your life just isn’t a good fit for you later on. If you’re frustrated with the method you’re using, or if you just want to try something new, there are an encouraging number of options. A healthcare provider can help you figure out what didn’t work out for you, reassess your wants and needs, and recommend what might be a better choice.

Reviewed by the Ovia Health Clinical Team

Read more about birth control methods

• Unveiling birth control myths
• Are LARCs more popular than ever?

Sources

• “Birth control methods.” Office on Women’s Health.” U.S. Department of Health and Human Services, April 24 2017. Retrieved March 31 2020. https://www.womenshealth.gov/a-z-topics/birth-control-methods.
• “Choose the Right Birth Control.” MyHealthfinder. U.S. Department of Health and Human Services, February 5 2020. Retrieved March 31 2020. https://health.gov/myhealthfinder/topics/everyday-healthy-living/sexual-health/choose-right-birth-control.
• “What do I need to know about birth control?” Planned Parenthood. Planned Parenthood. Retrieved March 31 2020. https://www.plannedparenthood.org/learn/teens/preventing-pregnancy-stds/what-do-i-need-know-about-birth-control.

Common misconceptions and facts about birth control

How many of these facts did you already know? Take a look at common misconceptions and vital facts about birth control.

“The pill” doesn’t just describe one single kind of pill.

The name might suggest that it’s just one single medication, but “the pill” actually includes a number of different kinds of oral contraceptives. There are two main varieties of the pill — combination pills, which contain estrogen and progestin, and the minipill, which contains only progestin. And each type comes in a variety of doses, brands and generics. Conventional packs lead to a period every month, whereas continuous dosing/extended cycle packs lead to a period once every three or more months. With so many options to choose from, many people can find a form of the pill that’s a good fit.

Most birth control doesn’t protect against sexually transmitted infections (STIs).

Many types of birth control do a fantastic job at preventing pregnancy — IUDs and the birth control implant are 99% effective! — but most birth control doesn’t protect against STIs. Male and female condoms are the only types of birth control that provide protection against STIs. They are not the most effective at preventing pregnancy — 85% and 79%, respectively — so it’s often a good idea to use more than one contraception in order to both prevent pregnancy and protect against STIs. Just don’t use male and female condoms together. They can rub against each other and break or slip, making them much less effective at protecting against both pregnancy and STIs.

You can use the pill to skip your period.

And it’s safe to do so. Essentially, you can skip taking the hormone-free “reminder” pills found at the end of a pack and instead take the first week of active pills in the next pack to skip your period. Some people do this so they don’t have to deal with getting their period on a special occasion or during travel. Others do it to skip out on pain or discomfort during their period. If you take the pill and are interested in skipping your period, just be sure to check in with your healthcare provider to understand how to do so with your specific brand.

The morning-after pill isn’t just for the morning after.

The name may suggest that you need to use the morning-after pill (or “emergency contraception”) right away to lessen your chance of getting pregnant after unprotected intercourse. But, technically, you have a little more time to do so — some brands of morning-after pill can be taken up to 72 hours (or 3 days) after intercourse, others for up to 120 hours (or 5 days) after. It is worth noting that the morning-after pill is most effective the sooner it’s taken because the hormones in it keep your body from ovulating — no ovulation, no pregnancy. Depending on where you live, the morning-after pill may be available over the counter or as a prescription. Just be aware: some studies suggest that these pills may be less effective at preventing pregnancy for people with higher body weights. In addition, many combination birth control pills can be used as emergency contraception if you have them at home. Talk to your provider about what option is best for you.

Some birth control is approved for use for up to 10 years.

The copper IUD is approved for use for 10 years to prevent pregnancy! The small T-shaped device is inserted into the uterus, and once in place, it can safely stay there for a decade. It can always be removed sooner, after which, it is possible to get pregnant right away. Because many people use this as a long-acting, reversible form of birth control, depending on your insurance, it may also come with the added perk of being cost-effective.

Hormonal birth control can be used for much more than just to prevent pregnancy.

42% of people who take the pill do so exclusively to prevent pregnancy. The other 58% take the pill for other reasons as well. Hormonal birth control can be used to help with irregular or particularly uncomfortable periods — heavy periods, lengthy periods, heavy cramping and discomfort, or pain and other health problems related to endometriosis — or even mood disorders and acne. Hormonal birth control can improve quality of life for those suffering from some of these conditions.

That’s the overview of important birth control facts and common misconceptions. If you want to learn more, or have questions about what sort of birth control might be right for you, be sure to speak with your healthcare provider.

And if you’re taking the pill or have an IUD, add it to your Ovia profile!

Read more about your birth control options

• Which birth control option is right for you?
• Finding the birth control method that works for you

Sources

• “Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, May 2018. Retrieved March 31 2020. https://www.acog.org/patient-resources/faqs/contraception/barrier-methods-of-birth-control-spermicide-condom-sponge-diaphragm-and-cervical-cap.
• “Birth Control.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, May 2019. Retrieved March 31 2020. https://www.acog.org/patient-resources/faqs/especially-for-teens/birth-control.
• “Combined Hormonal Birth Control: Pill, Patch, and Ring.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, March 2018. Retrieved March 31 2020. https://www.acog.org/patient-resources/faqs/contraception/combined-hormonal-birth-control-pill-patch-and-ring.
• “Contraceptive Use.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, March 21 2019. Retrieved March 31 2020. https://www.cdc.gov/nchs/fastats/contraceptive.htm.
• “Emergency Contraception.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, May 2019. Retrieved March 31 2020. https://www.acog.org/patient-resources/faqs/contraception/emergency-contraception.
• “IUD.” Planned Parenthood. Planned Parenthood, Retrieved March 31 2020. https://www.plannedparenthood.org/learn/birth-control/iud.
• “Long-Acting Reversible Contraception: Intrauterine Device and Implant.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, January 2018. Retrieved March 31 2020. https://www.acog.org/patient-resources/faqs/contraception/long-acting-reversible-contraception-intrauterine-device-and-implant.
• “Plan B morning-after pill.” Planned Parenthood League of Massachusetts. Planned Parenthood League of Massachusetts, Retrieved March 31 2020. https://www.plannedparenthood.org/planned-parenthood-massachusetts/online-health-center/planned-parenthood-services-birth-control-abortion-std-hiv-pregnancy-health-care/emergency-contraception-plan-b.

Birth control myths, debunked

We’re here to set the record straight by debunking some widespread myths and help you get closer to finding the best birth control method for you!

MYTH: Hormonal birth control makes you gain weight

Birth control might make you retain water, but it doesn’t make you gain weight. It’s not uncommon to gain a little weight as a result of retaining water when starting hormonal birth control, but this side effect typically goes away quickly. Some hormonal birth control may come with other side effects, like an increased appetite or feeling bloated, but there’s no proven association between hormonal birth control and longer term weight gain. (One exception is the birth control shot [Depo Provera], which for some patients has been shown to have longer-term weight gain as a side effect.) As with all birth control, if you’re concerned about or if you experience any side-effects, you should speak with your healthcare provider to see if there’s another option that might be a better fit for you. It could just be a matter of switching to a similar birth control with a different combination of hormones.

MYTH: All pills are created equal

There are many different types of birth control pills. Combination pills contain estrogen and progestin, whereas the minipill contains only progestin — both options come in a variety of doses. Some pills are organized in conventional packs and you can expect a period every month, others are continuous dosing/extended cycle packs with a period once every three months. There’s a wealth of different pills to choose from, brand name options and generic options.

Birth control pills have different benefits and side effects. For people with certain medical conditions, sometimes the pill is not a good fit. Your healthcare provider can help you learn more.

MYTH: Taking birth control can negatively affect your fertility

Birth control use — whether used for a short time or long-term — doesn’t affect your fertility. After using certain hormonal birth control methods, you may need to wait a few months before your menstrual cycle will return to normal so you can get pregnant. But there’s no evidence that birth control presents any long-term fertility issues, and some people get pregnant right away after stopping the pill.

MYTH: Using the pill to skip your period isn’t good for you

While you should check with your healthcare provider about the specifics for your birth control pill, it’s entirely safe to skip your period. It’s also very easy. Just take a pill that includes hormones every day and skip the hormone-free “reminder” pills at the end of a pack. Some people like to skip their period if it’s going to fall on a special occasion — like on a vacation or while traveling — others opt for this option to avoid period discomfort. Regardless of the reason you’d like to skip yours, you may experience a little bit of spotting, which is normal.

MYTH: Long term use of hormonal birth control isn’t healthy

Hormonal birth controls aren’t necessarily a good fit for everyone — certain health conditions might increase the risks associated with using specific birth control pills, or the pill in general. But hormonal birth control is a very good fit for a lot of people. It can even help certain people feel better. For those with particularly irregular or uncomfortable periods — a heavy period, lengthy periods, heavy cramping and discomfort, or pain and other health problems related to endometriosis — hormonal birth control can improve quality of life, with lighter, shorter, more regular, more comfortable periods.

MYTH: Birth control’s primary use is to prevent pregnancy

Certainly, a lot of people use birth control to prevent pregnancy — and as the name suggests that’s the primary reason many people might use it. But many take birth control for other reasons already mentioned — like to have a more comfortable or more regular period and relieve major pain and discomfort — and for even to help improve mood or acne. Everyone has their own reasons for wanting to use birth control, and no matter your reason, a healthcare provider can help you find the type of birth control that’s a good fit for you.

And if you’re taking the pill or have an IUD, add it to your Ovia profile!

Reviewed by the Ovia Health Clinical Team

Read more about birth control

• Are LARCs more popular than ever?
• Who should I talk to about birth control?

Sources

• “Birth Control.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, May 2019. Retrieved March 31 2020. https://www.acog.org/patient-resources/faqs/especially-for-teens/birth-control.
• “Combined Hormonal Birth Control: Pill, Patch, and Ring.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, March 2018. Retrieved March 31 2020. https://www.acog.org/patient-resources/faqs/contraception/combined-hormonal-birth-control-pill-patch-and-ring.
• “Contraceptive Use.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, March 21 2019. Retrieved March 31 2020. https://www.cdc.gov/nchs/fastats/contraceptive.htm.
• “IUD.” Planned Parenthood. Planned Parenthood, Retrieved March 31 2020. https://www.plannedparenthood.org/learn/birth-control/iud.
• “Long-Acting Reversible Contraception: Intrauterine Device and Implant.” American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists, January 2018. Retrieved March 31 2020. https://www.acog.org/patient-resources/faqs/contraception/long-acting-reversible-contraception-intrauterine-device-and-implant.

How long does it take (on average) to get pregnant?

Many factors can influence how long it takes to get pregnant, including your cycle, general health, fertility conditions, age, and lifestyle.

Getting pregnant faster

Although it takes the average female up to six months to conceive, there are ways to improve fertility health and reduce time to pregnancy. Staying healthy through diet and exercise and taking folic acid supplements can greatly increase your chances of conceiving, relative to those who don’t do these things. Individuals who track their fertility data to pinpoint their ovulation are also able to speed up their time to conception. Even your mood might help with your fertility: some studies have found that happier emotional states correlate with faster conception.

How long is too long?

Although any female without a condition of infertility or sterility can get pregnant naturally before menopause, some may take a bit longer than others. Doctors recommend that couples who have not conceived after one year of trying seek a fertility consultation to determine if an alternative route to conception might be explored, whether it’s in vitro fertilization (IVF), surgery, or fertility medication. It’s recommended that women over 35 should seek a fertility consultation after six months of trying.

If you have any questions about trying to conceive or your fertility health in general, don’t hesitate to reach out to your healthcare provider for more information.

Read more

• Does pregnancy loss impact future conception?
• Trying to get pregnant for more than a year

Sources

• Dr. Walter Willett. “Nurses’ Health Study II.” National Institutes of Health. United States, 1989-. Web.
• “Nutrition During Pregnancy: FAQ001.” ACOG. American College of Obstetricians and Gynecologists, 4/15/2015. Web.

Gina Nebesar, Co-Founder of Ovia Health

I was so excited to speak with my two dear friends Becca and Jean Ann recently. Just this year they started on the crazy journey that is parenthood with their beautiful baby girl, Roz. They’re total badasses at home and at work, they’re incredible people, and now they have this gorgeous family. Their TTC journey took them a little while, and IVF helped them get pregnant, and I’m really grateful they could share their story – including incredible advice about choosing and buying sperm, real talk about IVF shots, and really candid conversation about adjusting to life as new moms.

IVF success stories: Two moms talk about growing their family… and how

I want to start by saying congrats! I know you just celebrated your 5 year anniversary, a big milestone. And an even bigger milestone is the birth of your baby girl! I’d love if you could start by telling us a little about your beautiful family.

Becca: We did just celebrate our five-year wedding anniversary, and in April we had our baby girl Roz. She’s almost 5 months old. And it’s been great so far!

I just left town for the first time, and left her alone this weekend with Jean Ann, her other mom. And in that 48 hours she learned how to roll over, without me there! And now she sleeps on her stomach, so I came home to a totally different baby. But I feel like she’s changing every single day, so it’s really awesome.

I love hearing about how people make the decision to start a family. Could you tell us a little bit about your journey to becoming parents?

Jean Ann: Because we’re two women, one question that I asked a lot is how we decided who will carry. And when your partner basically says, “One thing I’ve always wanted to do in my life is be pregnant and give birth, like, totally unprompted,” you’re like, “Cool, that seemed too easy.” Becca had always wanted to do that, and I’m still sort of on the fence – it doesn’t seem like something I have to do. So Becca had decided that she was excited about that a few years ago, and eventually I got more excited about it.

The first thing we had to do was choose a sperm donor. That was probably one of the biggest decisions we’ve ever made. Because you have to decide if you want an anonymous donor or someone you know. And we actually had a good friend who offered. And we took it pretty seriously, but ultimately decided it was important for us to have our own separate family unit. So then we looked at a lot of the websites for sperm. It’s basically like a KAYAK for sperm, and you can sort for different things.

Becca: It’s almost like online dating!

Jean Ann: We wanted someone that hopefully shared a lot of my characteristics. So were able to find someone who was half-Asian, he was getting a graduate degree in chemistry. We could even listen to a 45-minute interview with him where he talked about his favorite books, and he just seemed very thoughtful, quiet, serious, and nice.

Becca: We spent a lot of time looking for sperm – really thinking about these profiles and listening and narrowing it down. I remember we had all these pieces of paper on the kitchen table – we had written down the different donor numbers and which ones we liked – and then we narrowed it down.

And we actually had kind of had a long journey. It was about two and a half years from buying sperm until having Roz. Buying the sperm was step one. I remember, they were having an end-of-year sale, so we had to get it in before the end of 2015!

Were they really? Like, they were really having a sale?

Jean Ann: Yeah, it’s expensive. It’s something that there’s a lot of in the world, but it’s not cheap!

Becca: Well, it wasn’t quite a sale, but they were like, “We’ll throw in an Amazon gift card if you buy today!”

Jean Ann: “And three years of free storage!” But, yeah, we’ve actually spent several thousands of dollars on sperm, if you can believe it.

So, obviously, you found a great deal, but how did you get started with that process?

Becca: Really, we just Googled.

Jean Ann: There’s three or four big sperm cryo websites.

Becca: The one we went with is called California Cryo, one of the largest ones. For us, they felt right— it was a good website experience, and their customer service has been great. We did look at the big ones, some other small ones, and some local ones.

Jean Ann: But I think, for us, wanting a donor who was half-Asian like me was important, and that actually narrowed it down a lot. It went from like 550 to like, eight.

Becca: So then we could spend our time kind of really thinking through those people.

Jean Ann: You can definitely get a situation where there’s a run on the sperm. So we had this total disaster about a year later, where we had used up half the vials that we’d bought, and we were getting really low, and we went online, and they had sold out! And the donor had stopped donating! So we recommend you check what’s in stock a lot.

Becca: Yes, check frequently! And if you can afford it, buy more than you think you need.

Jean Ann: Buy a lot!

Becca: Because you can store it, and you can sell it back if you don’t need it.

Jean Ann: Nothing is worse than the feeling of having decided on someone to be your sperm donor and being very excited about them, and being halfway through the journey, and then realizing that if you want to have more than just one kid that you’re going to run out of sperm.

Becca: You’re going to run out and you may have to use different sperm.

Any other advice about that process for others that are just starting out with sperm donation?

Jean Ann: Just check your sperm stock frequently. And if you’re really excited and settled on someone, I would buy more than you need or just be willing to have a weekly reminder to check that it’s not running out.

Becca: I think the other thing is I would pony up for the extra access to information. Because I think, for us, the interviews with the sperm donors, that was the most impactful. You can only tell so much from a baby picture and some  generic likes and dislikes – which is the basic info you get – but I actually think you can get a pretty good feel for a person from something like an audio interview. It’s like a typical website where it’s like, “Pay to unlock this feature!” but it’s worth it to pay for that premium membership.

So, in December 2015, once you made that decision about your donor, how did things progress from there?

Becca: So that winter when we were back home from the holidays, we started trying to get pregnant, and we were doing IUI.

Jean Ann: You basically have two options, you can do IUI or IVF with donated sperm. IUI is basically artificial insemination.

Becca: Turkey baster!

Jean Ann: The turkey baster method, but at a facility. So we started with IUI.

Becca: I actually got very lucky with the first IUI try in February 2016. I was tracking my ovulation – I was using the Ovia app – and I was peeing on sticks and all of that, and when my ovulation test said I was ovulating we went in for the IUI, we did IUI, and I got pregnant that very first time. And it was amazing! We were so excited! First try!

And then in the spring at about 12 weeks I had a miscarriage. So I got almost through my first trimester, and I had a miscarriage. That sucked, that was a setback and sad, and that was really hard.

So the summer of 2016 was kind of recovering from that, and then it takes a while to get back on track, especially when you have a miscarriage when you’re that far along there’s a lot that your body has a lot to process and then re-regulate. And then we didn’t have a chance to try again until September of that year. So we got back on the horse and started trying again. And we were gonna continue to do IUI at that same facility because it had worked that first time.

And I started tracking my ovulation and going back in monthly, but something was wonky with my cycles. I would think I was ovulating, but I would go in and I wasn’t ovulating. I think one or two times we did get an ovulation, and we tried, but I didn’t get pregnant.

Jean Ann: And that’s when we started running out of sperm. And we realized that there wasn’t more. So that’s when we panicked, realized we couldn’t get anymore, and so we decided to move to IVF. But neither of our insurances, we thought, really covered IVF.  We were both on my insurance, and it wasn’t explicit. It was basically like, “Your IVF is covered, if it’s for a medical reason.”

Becca: “Medically necessary.”

Jean Ann: Yeah, “medically necessary,” that’s the phrase that’s used – and so I went down this whole rabbit hole to figure out if that means coverage if you’re gay. It took forever. But basically, no, being gay was not a “medically neccessary” reason, so it wouldn’t be covered. So I fumed about this for a while.

And then I ended up talking to our company’s head of HR kind of randomly about something else, and I just kind of mentioned this to her and didn’t expect it to go anywhere—I just figured this would sort of take some kind of lawsuit situation to change it— but she was like, “Oh, really? I didn’t know that!” Then two days later somebody that worked for her called and they were like, “Oh, we added it for same-sex couples to our insurance, so it’s covered now!” So I guess some advice would be to know that in terms of your health insurance, you may be able to change the coverage for something like this, depending on your company.

I constantly tell women to ask for those benefits, because they might end up with that exact same story. I was in a meeting recently with a health plan and an employer where we we pointed out in the language of the plan how it was alienating to same-sex couples. And the woman didn’t even realize it and was like, “I’ve gotta change it!” She had just never read the fine print before, but then took action to change it as well. I’m so glad that you asked about it, and I wish more people would!

Becca: Yeah, it was pretty awesome. So, we started IVF in the summer of 2017, and there’s a whole series of tests and all sorts of painful things they need to do to make sure you’re ready for it. And that takes months— you have to wait a few cycles, you have to get on the right timing. So I remember this being such a frustrating time in our lives. It felt like everything was going slowly and like everyday I had to be at the doctor doing some other painful thing. It was a rough period. It is funny now looking back on it, because it all feels like such a blur in retrospect, but at the time it felt really pronounced and painful.

Jean Ann: As someone that has now done IVF three times myself – and Becca has done it once – it’s not as bad as people think it is. It sucks giving yourself the shots, but it’s fast. It’s like a two week period of shots.

Becca: At this point we’ve both done it, because as the journey continues, we ended up having a baby and decided that we wanted to at least give ourselves the option to having another baby in the future with Jean Ann’s eggs.

Can you share more about that experience and what it’s like? Again, I’m sorry to hear about this part of the journey. I just can’t imagine having the 12 week miscarriage, that’s just awful, and the fear of the sperm running out, and then going through the pain of IVF. And I know you say it’s not that bad, but I think maybe you’re just tougher than many – that sounds really hard to me!

Becca: Honestly after being pregnant for nine months, you can barely remember the IVF, it’s like a blip. But I think that the shots – for us at least – I think the shots look scarier than they end up being.

Jean Ann: I feel like the first and second time you’re really just like, am I really going to stab myself in the leg with this needle?

Becca: The thought of it is tough. The first time is the hardest, because you’re just staring at this needle and you’re like looking at your leg, and you’re just like, so I’m really just going to push this in, huh? But it’s a needle, and it’s made to go in. I actually think over the two week period of shots, it gets progressively more painful toward the end. So the last few days are the worst. I think at that point you’re feeling a little bit bloated, you’re not allowed to go to the gym, you’re giving yourself shots every single night. For some reason those last few nights hurt the worst. At that point you’ve shot yourself everywhere on your legs, everywhere on your stomach, and you’re looking for a new spot. So those last few nights, you just want it to be over.

Jean Ann: And then you have the trigger shot, and everybody makes a big deal of the trigger shot. Somebody else gives you that one, and it has to be at an exact time – like, 1:45 in the morning, 10:30 p.m. – so when you go in to have your eggs be retrieved, it’s exactly 36 hours after the trigger shot.

Becca: And then for the egg retrieval process you do go under.

Jean Ann: Under some very temporary anesthesia. You’re all the way under, but it’s very short. And then you’re done!

Becca: And then there’s some anxiety as you wait to hear your egg count. For us we were doing embryos, so right when they retrieved the eggs they fertilized them with our frozen donor sperm. So after that you’re kind of waiting on eggshells – no pun intended – to hear how many of your embryos made it to day 3 or day 5, or just what the status of them is. And we’ve been on both sides of the spectrum. For me, I was really fortunate, I had a pretty high egg count, and with just one retrieval I got enough embryos that we felt comfortable and were able to freeze them. For Jean Ann, on her first and second try she didn’t get that many, and so she’s had to go through the egg retrieval process three times now.

Jean Ann: I will just add that for anybody that’s getting close to age 35, 35, you can get a blood test that will give you your AMH number. It basically tells you how many eggs, roughly, you have left. It’s a very good indicator or whether IVF is going to be a breeze and you’ll just have to do that once, or if your egg yield is going to be low and you’re going to have to do it multiple times like me. It is also a good predictor of if you will have to do IVF at all because the same number is also a good indicator of whether or not you will naturally be able to get pregnant. It’s a very easy first step.

Did you know about this AMH (or Anti-Mullerian Hormone) test before starting the IVF process, or did you learn about that after?

Jean Ann: Actually, someone at work told me about it. Because I was like, “I don’t think I want kids for a few years,” and this very matter of fact 40 year old man was like, “How old are you?” And I said, “35.” And he was like, “Just go get your AMH number. My wife had a low AMH number and it took us 5 years of trying and then we ended up adopting.” I was like, oh, my gosh!

And then I got the test, my AMH number was bad, and, indeed, it took me multiple times to do IVF. So I feel like this AMH blood test is pretty much free information.

A lot of healthcare providers might say no to that sort of testing, but I always suggest that people go to their provider and just insist on it. So, through this process, who was supporting you along the way? Obviously, you had each other. Was there anyone else in your life who was particularly helpful during this time?

Becca: Each other, for sure. I’m not a big oversharer, but it’s been really helpful for me to share, because what I’ve found is that as soon as I start talking about it, everyone has either a similar story themselves, or their friend does, or their sister does. So when I had my miscarriage, it was really helpful for me to tell people about it – even at work – and then people would share these success stories, and that made me feel better. And it was similar when going through IVF. I would talk about it with my friends, and they all had someone they knew who had been through it. At the time, I was really the first of my very good friends who was having a lot of trouble getting pregnant, and I felt a little bit alone, so their IVF success stories were helpful for me.

Jean Ann: But since then, now we know several people who’ve been through this.

Becca: We know people who’ve had miscarriages, been through IVF, and now I’ve been able to help them because we have this success story. So, for me, I would tell anyone who’d listen! And that helped me a lot.

Jean Ann: Then you had a pretty good pregnancy.

Becca: Yeah, and the IVF really worked well for us. We did an egg transfer, and I got pregnant on that first one, and then I had a pretty good pregnancy.

Jean Ann: And you have to give yourself these progesterone shots for the first 12 weeks.

Becca: No one talks about this!

Jean Ann: No one talks about this, but these are actually really terrible shots. And every night for the first 12 weeks that you’re pregnant—

Becca: You give yourself a progesterone shot in the butt.

Jean Ann: That was probably the worst part.

Becca: I think some doctors will allow you to do a suppository instead. So I went, like, running in after three nights of shots and was like, “Give me the suppository!” And they were like, “No, we highly recommend the shots.” They wouldn’t do it. So you’re giving yourself shots for 12 weeks. So much worse that the two weeks of IVF shots! It’s so much longer! So you’re basically so sore in the butt for the entire first trimester. But once we got through that, things were okay.

Jean Ann: Smooth sailing.

Becca: Yeah. I had a lot of heartburn, and that was my main symptom really.

Jean Ann: Then because you were a geriatric pregnancy, they told us that they wouldn’t let you go past one week over your due date. So we got an induction date for almost a week past your due date.

Becca: Yeah, 5 days past my due date they scheduled us for an induction. We went in, I got induced, and like these things do, it took forever to get a room, it took forever for the induction to start.

But then, like, once it started, it really started.I had pretty strong contractions for a long time, for like 15 hours. But I really wasn’t dilating. So, it was kind of sad, I kept having these big contractions and the doctor would go away and then come back a couple hours later to check my cervix and every time I was like, “Oh, I think I’m making progress!” and then she would check and be like, “Nope, still 3 cm. You’ve barely made it to 4 cm.” So I just wasn’t dilating. And then at some point, in about hour 16 or 17 of labor, I got a fever, and they said we’ve got to do a C-section. So we went in on a Thursday night, that Friday night at 11:30 p.m. she was born via C-section. And she was great!

Jean Ann: There’s so much pressure to not have a C-section and to be able to breastfeed right away and all this stuff, and, like, if you walk out with a healthy baby, that’s the goal, that is 100% success. I feel like people shouldn’t put that much pressure on how they want everything to turn out.

I know. There’s so much pressure for birth to be this perfect experience, just as planned. And I remember, too, even with me, I had a C-section, just feeling guilt, feeling like a failure, and realizing that, like, my baby’s awesome, and I really don’t care about how I got her! Do you remember what the first couple of days after Roz was born were like?

Becca: It’s funny, it’s such a blur. And I remember at the time saying to myself, I’m totally lucid and I’m recovering fine and I’m gonna remember all of this. And now I realize I don’t remember much of what those days were like!

I remember stumbling out of bed in the middle of the night and either feeding or pumping, and I remember napping a lot. Because I was recovering from a C-section, I needed a lot of help both during the days and the nights. So luckily I had Jean Ann to help, we had family, we got some help for me during the day when she went back to work. We were fortunate to be able to do that because I couldn’t lift the baby, but it’s all such a blur.

I do remember her being so cute. Like everything she did was so cute. I would feed her, and she’d fall asleep on me right after, and it was the cutest thing I’d ever seen! This weekend, actually, I saw a picture of Roz from her first few weeks. And I remember at the time looking at her and thinking, My newborn is so cute! She doesn’t look like a weird scrunched up newborn like every other one! She’s a perfect baby! And, like, five months later I realize that she definitely looked weird! But you just don’t see it at the time.

You do have an exceptionally cute baby! So what is it like now versus what it was like then?

Becca: I just feel like we’re getting more into what our life will look like for the next few years. Those first few weeks in my maternity leave I just kept thinking about how it was a temporary time – and it was wonderful, and I really enjoyed it – but now we’re trying to figure out what our real life looks like. Like how we manage the jobs and the baby, how we manage finding time for ourselves, how we manage time for the extended family who wants to visit. So, it’s different – I’m much more lucid, I’ve recovered from the C-section, all of that kind of blurriness is gone – but I’m in this, like, this half-place where I feel like, we don’t quite have enough time for everything. And I don’t know if this is just what the new normal is, or if we’re still figuring it out. So that’s kind of the phase we’re in now.

I feel like our journey has taken a lot of different turns. And where we are now – we’re so so happy and so lucky that we have this wonderful healthy baby – but it took a while. And it took a lot of different types of interventions, and along the way there were times when it felt like it wasn’t going to happen, but now she’s here, and she’s perfect, and it makes the last two and a half years feel like a blur, like just a blip. So it was all worth it.

Jean Ann: But at the time, it was tough. It can be very tough.

Becca: Yeah, and I guess some advice we would give is to try to release some of the expectations that you have and some of the perfection that you’re striving for, because you really just don’t know how things will turn out. Like, you might not always be able to hit that exact timing for getting pregnant that you want. Or we thought we wanted a boy, but we obviously love our baby girl! It turns out it doesn’t matter. So just to try to release some of that, to the extent that you can, because the journey is hard enough.

Pregnancy test facts…and fiction

Here are some of the more commonly-held beliefs about taking a home pregnancy test, some of which are fact; others, fiction.

Fact or fiction? Your body starts making hCG after implantation.

Fact! After the fertilized egg implants, the placenta starts producing hCG, the pregnancy hormone. A woman’s hCG levels rise very quickly in early pregnancy, but the amount of hCG that a woman has can vary, depending on the individual. Some women have a lot of hCG right away, while others’ bodies take a little longer to start making noticeable amounts of hCG. This is why testing after a missed period can produce more accurate results.

Fact or fiction? Antibiotics can interfere with pregnancy test results.

Fiction. Certain fertility drugs that contain hCG could affect the results of a pregnancy test, but according to the Mayo Clinic, antibiotics or other hormonal medications like birth control pills don’t interfere with the results of a home pregnancy test.

Fact or fiction? You can use an ovulation test like a home pregnancy test to pick up your pregnancy early.

Fiction. In theory, you could, but it wouldn’t be worth the time or money. Basically, home pregnancy tests look for levels of hCG in a woman’s urine, and ovulation tests look for levels of luteinizing hormone (LH) in urine. Both hCG and LH show up nearly the exact same on an ovulation test, so if a woman has enough of either hormone in her body, an ovulation test could technically detect the hCG and show that she is pregnant.

The reason why you can’t use an ovulation test in place of a home pregnancy test is because home pregnancy tests are much more sensitive to hCG. Unlike ovulation tests, home pregnancy tests can pick up on the pregnancy hormone much earlier than ovulation tests. If you use an ovulation test to check for pregnancy, you have a much higher risk of a false negative (and honestly, who wants or even has time for that?).

Fact or fiction? A blood test is the only way to confirm 100% if you are pregnant.

Fiction. It’s true that blood tests are more accurate than home pregnancy tests, but only slightly. Blood tests have an accuracy rate of 99%, compared to the 97% accuracy rate of home pregnancy tests that use urine. If you get a positive pregnancy test at home, your provider will likely perform another urine test in his or her office, along with an ultrasound to confirm your pregnancy.

Fact or fiction? Tests that use pink dye are better than tests with blue dye.

Both? There’s not a ton of scientific evidence about this, but many women report that blue dye fades and blurs in a way that makes it much harder to read on a pregnancy test. No matter what test you use, if you get a positive, make sure to test again a few days later, and then schedule an appointment with your provider.

Sources

• “Pregnancy Test.” MedlinePlus. US National Library of Medicine, Oct 2016. Web. Accessed 8/18/17. Available at https://medlineplus.gov/ency/article/003432.htm.
• Liza Torborg. “Mayo Clinic Q and A: Ovulation predictor kits can be useful for couples trying to conceive.” MayoClinic. Mayo Clinic Foundation, Sep 2015. Web. Accessed 8/18/17. Available at https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-ovulation-predictor-kits-can-be-useful-for-couples-trying-to-conceive/.
• “Getting pregnant.” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. Web. Accessed 8/18/17. Available at http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940?pg=2.

Are you pregnant or is your period just late? Here’s how to tell

Learn more about actual pregnancy symptoms before you start getting concerned.

The science behind symptoms

Pregnant or not, your body starts releasing progesterone after you ovulate. This hormone keeps getting released and is at its highest point around five to seven days after ovulation. If a woman is pregnant, her body continues to produce progesterone in high amounts to help sustain the pregnancy. If she’s not pregnant, her progesterone levels decrease, and she’ll start her menstrual period.

Thanks also to progesterone, the symptoms of early pregnancy and your period are nearly identical. Cramps, fatigue, dizziness, breast tenderness – all early signs of pregnancy, but also possible signs of your period coming.

What about light spotting a week after ovulation? It could indicate implantation bleeding, but most women don’t experience this symptom and spotting can happen for other reasons.

What about nausea? This symptom is typically attributed to hCG, the pregnancy hormone, but it can be caused by other things, too (including PMS).

In the weeks between ovulation and a pregnancy test, many women “symptom spot”; that is, they take note of certain physical symptoms and think that they are definitely signs of early pregnancy. Is symptom spotting so wrong? Absolutely not, and it can even be kind of fun, as long as you know that only a blood test can tell you for sure if you’re pregnant.

Is there anything I can look for?

Probably the most reliable physical symptom of early pregnancy is a missed period. Noticing that your breasts are getting increasingly sore, or experiencing symptoms that you don’t usually get around the time of your period, are also signs that you could be pregnant. But again, a blood test will be the best way to know for sure.

Final thoughts: things to keep in mind

The bottom line is that without a blood test, it’s nearly impossible to know for sure whether you’re pregnant or experiencing a late period. Even home pregnancy tests can sometimes give a false negative, if taken too early, so it’s really smart to wait to take a test until or after your expected period.

If you’re paying attention to your symptoms, just know that it can get a little stressful for some women. So if you find yourself symptom spotting, try to be aware of how often you do it, and how you feel – does it distract you or stress you out? If it starts to get emotionally taxing for you, look for ways to stop paying attention to your symptoms.

Finally, make sure you’ve scheduled a pregnancy blood test, and keep taking your prenatal vitamins! Whether it’s sooner or later, when you get that BFP, you’ll be glad you did!

Sources

• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. Web. Accessed 8/3/17. Available at http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940.
• Lori A Bastian, Haywood Brown. “Clinical manifestations and diagnosis of early pregnancy.” UptoDate. UptoDate Inc., Jul 2017. Web. Accessed 8/3/17. Available at https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-early-pregnancy?source=search_result&search=waiting%20for%20pregnancy%20test&selectedTitle=1~150.
• “Morning Sickness: Nausea and Vomiting of Pregnancy.” ACOG. FAQ126 from the American College of Obstetricans and Gynecologists, Dec 2015. Web. Accessed 8/3/17. Available at https://www.acog.org/Patients/FAQs/Morning-Sickness-Nausea-and-Vomiting-of-Pregnancy.

No period, not pregnant: What does it mean?

The rollercoaster of emotions that come with taking a pregnancy test is often stressful, but don’t give up just yet. Here’s what it means to have no period for a while and still not be pregnant.

Reasons why a test could be wrong

Here are a couple reasons why you may have received a false negative.

• Taken before the first missed period: Pregnancy tests work by detecting levels of human chorionic gonadotropin, hCG, a hormone that the body starts to make when an egg has been fertilized. Because the tests look for the presence of this hormone, it is possible that they miss the hormone in the very early stages of pregnancy, mainly in the days leading up to the first missed period. For the most accurate readings, it’s best to wait until at least the missed period, if not a few days after.
• Fluids diluting urine: Yes, you should still be drinking lots of water! But taking a pregnancy test later in the day can sometimes mean that urine is diluted and hCG is more difficult for the test to detect. The hormone levels are highest in the morning too, so for the most accurate results try to take the test as early in the day as possible, preferably right after you wake up.
• Test directions not followed correctly: We don’t mean to suggest that you would miss a step . . . but could you have missed a step? Some tests require waiting a specific amount of time before reading the results. Pregnancy tests also have an expiration date, so we recommend buying new ones as opposed to using old ones that could be in your house.

Final thoughts

Ultimately, it’s always a good idea to read and closely follow the directions on home pregnancy tests, even if you consider yourself a pro by now. There’s also always the possibility that the negative test is accurate, and your period is simply a few days late. Home pregnancy tests are great, but after a positive result, it’s still important to visit your healthcare provider for a blood test to confirm.

Sources

• “Pregnancy test.” MedlinePlus. US National Library of Medicine, Oct 4 2016. https://medlineplus.gov/ency/article/003432.htm.
• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940.