Here’s the latest from the Ovia Health Clinical Team, including answers to your questions and some practical guidance. 

If I’m pregnant and I get COVID-19, will the infection be worse?

It’s possible. Research indicates that pregnant people and recently pregnant people (within 42 days of giving birth) are at higher risk for significant complications from COVID-19 than their non-pregnant peers. This means that while the overall risk for severe illness is low, there is an increased risk of hospitalization, intubation and mechanical ventilation, blood clots, and requiring intensive care. There is also an increased risk of adverse pregnancy outcomes, including preterm birth and possibly an increased risk of pregnancy loss when compared to pregnant women who did not get COVID-19. 

These risks are compounded for Black pregnant people, who have long experienced nearly twice the risk of preterm birth when compared to white people. Many studies have demonstrated that race is likely an independent risk factor when it comes to healthcare outcomes like preterm birth, separate from other risk factors like income or education. That race-related risk may stem from chronic stresses of societal racism as well as the race-related inequalities that have been identified within the healthcare system. 

Pregnant parents who test positive for COVID-19 should be offered a discussion about the medication Paxlovid. You can read more about that here.

What can I do to prevent infection?

Prevention is no different for pregnant people than it is for anyone else. Follow the advice that you receive from your local health department, from the CDC, and from your healthcare provider. Avoid going to public places if you think or know you have COVID-19, to prevent spreading it to others. 

If you know local rates of Covid are high, wear masks when indoors and practice social distancing. Being vaccinated has been shown to provide protection against severe COVID-19 disease. However, you can still get sick and pass the illness on to vulnerable people who aren’t vaccinated or cannot be vaccinated (like newborns).

Is hand sanitizer safe in pregnancy?

Yes, Yes, YES. The CDC reports [3] that handwashing with soap and water is more effective than hand sanitizer. However, you can’t take the sink in your car or on a walk or to the grocery, so make sure you use hand sanitizer regularly in addition to handwashing. Furthermore, it’s often much easier to wipe hand sanitizer on your children’s hands than it is to get them properly washed, so consider this a regular habit as well.

If I get COVID-19, will I pass it to my fetus?

The most recent research on the topic says that transmitting COVID-19 while pregnant is very rare – for moms in North America, the rate was about 0.1%. This does not include the risk of passing it to your newborn during routine care postpartum. However, studies suggest that people who tested positive for COVID-19 during pregnancy are more likely to have complications, such as preterm birth [6]. There is no evidence that cesarean delivery reduces the risk of infection for Baby, so this is not recommended.

What about during and after birth?

It is extremely important that you call your healthcare provider before you go to the hospital if you think you have COVID-19. Once at the hospital, your provider knows what to do to reduce the risk that your baby (and the healthcare professionals who care for you) will become infected.

Keep in mind that testing positive for COVID-19 when in labor may cause changes to your birth plan and hospital stay. You may want to consider extra precautions in the last weeks of pregnancy to avoid this.

What is the risk to my baby? And what about the risk to my other children?

Children seem to be at less risk of becoming really sick with COVID-19 than adults are, but infants make up the bulk of serious cases and hospitalizations in children under 17. Current evidence suggests that babies are not likely to get COVID-19 from their mothers as long as preventative steps are taken, such as wearing a mask around your baby, washing your hands for 20 seconds prior to holding your baby, and having them sleep 6 feet away from you. You should still do everything you can to reduce the risk of exposure. Children with certain underlying conditions are at risk for complications from COVID-19, so it is important to keep them safe and communicate with their pediatrician.

Is breastfeeding safe if I think I have COVID-19?

There are many benefits to breastfeeding for parents and babies. It appears unlikely that COVID-19 can be transmitted through breast milk, though helpful antibodies can be passed along! 

If you test positive for COVID-19, this may impact the care of your newborn. In-hospital, the CDC recommends discussing with your provider the risks and benefits of caring for your newborn while sick. Mildly ill people generally room in and care for their newborns. If you are seriously ill, this may not feel like a physically possible or safe option. Once you are home, wash your hands frequently — and always before touching your baby. Wear a mask when you are within 6 feet of your baby or another person. If you have a caregiver who lives with you, they should also wear a mask whenever caring for your baby.

We know that with other illnesses, you pass antibodies to your baby through your breast milk. Antibodies are what your body makes to help fight off illness. The research into COVID antibodies in breastmilk is really encouraging and suggests that antibodies are passed through breast milk after infection or vaccination. 

What if I’m trying to conceive and not yet pregnant?

There’s no evidence that COVID-19 or any similar viruses impact conception or cause birth defects if you are sick when you conceive.

Should pregnant people get the COVID-19 vaccine?

Multiple well-respected clinical organizations, including the ACOG (the American College of Obstetricians and Gynecologists) and the ACNM (American College of Nurse-Midwives), recommend the vaccine to people who are trying to conceive, pregnant, and breastfeeding [11].

The first clinical trials for the COVID-19 vaccines manufactured by Pfizer-BioNTech, Moderna, and Novavax did not include participants who were known to be pregnant or breastfeeding. This is typical for pharmaceutical research. Recent studies have included pregnant people and show that there is no increased risk and that vaccines given in any trimester do not negatively impact pregnancy outcomes. In addition, vaccinating in the second or third trimester may offer additional protection to your newborn.

Additionally, none of these COVID-19 vaccines contain a “live” virus. This means you cannot get COVID-19 from the vaccines. In general, vaccines that do not contain “live” viruses are safe during pregnancy and do not have increased risks for infertility, miscarriage, fetal anomalies, or stillbirth. Side effects of the COVID-19 vaccines include pain at the site of injection, fever, fatigue, and chills. These typically go away after a couple of days. These side effects are normal and expected and are indicators of your immune system doing its job to learn to protect you from the virus. There have been very rare reports of unexpected, adverse reactions from the vaccines. A severe allergic reaction called anaphylaxis can happen in very rare cases. The incidences of these adverse events are so low that getting vaccinated remains safer than potentially getting infected with COVID-19. [12].

You can also reach out to the experts at Mother to Baby for more information. Your midwife, doctor, or other healthcare professional is also a great resource for more information about the COVID-19 vaccine. Ultimately, you are the one who knows what is best for your body and your family.

Reviewed by the Ovia Health Clinical Team

Sources:

Dara D. Mendez, Vijaya K. Hogan & Jennifer F. Culhane “Institutional racism, neighborhood factors, stress, and preterm birth”. Ethnicity & Health. 19:5, 479-499. October 18, 2013.

Jasmine D. Johnson et al., “Racial Disparities in Prematurity Persist Among Women of High Socioeconomic Status,” American Journal of Obstetrics & Gynecology 2. 2(3), 100104. Nov 10, 2020

James W. Collins Jr et al., “Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination,” American Journal of Public Health. 94(12), 2132–2138. December 2004.

Braveman Paula, et al. “Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes” Frontiers in Reproductive Health. Vol. 3. 684207 September 2, 2021.

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.

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.

The differences between an IVF and an ICSI

Articles and websites are known to use the two names (IVF and ICSI) interchangeably, without explanation, or definition. How are people supposed to know what these treatments are and how they’re different? Wait, are they different? Let’s start from the beginning.

In Vitro Fertilization (IVF)

You may already know a little about IVF because it’s probably the most popular form of assisted reproductive technology (ART) out there. It’s also the most expensive. One IVF cycle can cost anywhere from $8,000 to $30,000 depending on factors like age, health, or if you plan on using donor sperm or eggs. However, if IVF turns out to be the right choice for you, it may very well be worth the hefty price tag.

Many people who seek out IVF treatment do so because they have issues with fertility. These could include endometriosis, polycystic ovary syndrome (PCOS), problems with sperm function, and unexplained infertility. For people over 35, IVF may also offer a better chance of conceiving than traditional intercourse, ICI, or IUI. It’s always a good idea to speak to your healthcare provider when you are thinking about moving forward with any ART or other fertility treatments.

How IVF works

The IVF process can take up to two weeks, and there are several different ways to prepare the body for treatment based on individual health. These preparations include taking hormone-encouraging drugs to boost ovulation and improve chances of producing a high number of mature eggs. There are also medications to help prepare the uterine lining for fertilized embryos. Specialists work closely with patients to help develop a game plan.

When a healthcare provider gives the green light, mature eggs will be carefully retrieved from the ovaries. These eggs (or donor eggs) are taken to a lab where they will then be put in a petri dish with fresh sperm (collected shortly before the procedure), or sperm that has been thawed and prepared beforehand. These close living quarters will allow sperm to mingle with eggs in a way that is isn’t really possible during traditional intercourse. Aside from the setting of the petri dish, the fertilization process is much the same as during intercourse. In the end, one sperm should match up with one egg. Then it’s a bit of a waiting game. If the procedure is successful, after a period of two to six days, the fertilized embryo or embryos will finally be transferred to the uterus, where, hopefully, implantation will be successful and result in pregnancy! With IVF and ICSI, it’s sometimes possible to find out if it worked by taking a pregnancy test as soon as two weeks after implantation.

Intracytoplasmic sperm injection (ICSI)

This treatment is also used when people are having trouble getting pregnant, or by people using donor eggs or sperm. The name “intracytoplasmic sperm injection” makes ICSI sound like a very complicated treatment, but when you break it down, the concept is pretty straightforward. In truth, the term is just a really formal way of saying that during the ICSI process, sperm will be directly injected into an egg to fertilize it. But, what exactly does that mean, and how is it possible?

How ICSI works

ICSI is a form of IVF treatment, often referred to as “IVF with ICSI,” so both processes take place in a IVF lab. As for preparation, traditional IVF and ICSI are very similar, if not identical in some cases. The real difference between the two happens after the sperm and eggs have already been taken to the lab. Unlike traditional IVF, ICSI samples are not mixed together in a petri dish and left to match up on their own. Through the ICSI process, you are able to make the connection for them. A single egg is delicately held in a specialized pipette, while a very small and hollow needle carefully selects a single sperm and immobilizes it by picking it up. Once both parties are secured, the needle is slowly brought through the shell of the egg (zona) before reaching its goal at the center of the egg (cytoplasm). The needle then places the sperm within the cytoplasm. After injecting the sperm, the process is complete, and the needle is removed. Eggs are checked after a day or so to see if the process of “normal fertilization” has begun. Just like traditional IVF, the successfully fertilized eggs are then implanted in the uterine lining once they are mature enough.

Other things to consider

In the end, there really isn’t a “qualifying factor” that can say for sure whether you should use traditional IVF or ICSI treatment (though ICSI may be more effective in cases of severely low sperm count and unexplained male infertility). The process of egg retrieval and insertion of embryos into the uterus are the same between both options. Both are mostly painless, and have mild side effects. In fact, because ICSI has become more popular over the last decade with a 70% to 85% fertilization rate, many clinics have begun to use the two procedures interchangeably, and some have even begun using ICSI for every treatment!

We all know that it’s sometimes difficult to get a straight answer from the internet. We’ve covered the basics, but nothing can replace your healthcare provider’s knowledge and advice. Asking them detailed questions may be the first step in beginning your IVF journey!

Read more

• Sperm donation 101
• Egg donation: thinking it through

Sources

• Mayo Clinic Staff. “In Vitro Fertilization (IVF)”. Mayo Clinic. Mayo Clinic. March 22, 2018. https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716
• “Intracytoplasmic Sperm Injection- ICSI and IVF. Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/icsi.htm
• “Egg Donation Cost at the Advanced Fertility Center of Chicago”. Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/eggdonationcost.htm

There are many factors that might have you considering alternative insemination, and using a sperm donor to help you in start (or expand) your family.

If you’re thinking about sperm donation, here’s what you should know

Your primary care provider (PCP) will be able to give you a fertility evaluation, and this will help you decide whether using donor sperm, or other reproductive assistance, is right for you. During this appointment, you’ll be asked to provide information about your lifestyle, but don’t worry, this isn’t a test. You won’t “fail” the exam if you admit to being a couch potato every once in a while, and it’s important to be honest if you want a care plan that’s specific to your family’s health and needs.

Choosing sperm

After meeting with your PCP, your mind may shift to figuring out the type of sperm you’d like to use. “Known” sperm (the sperm of someone you know) and anonymous sperm are the two options you’ll find. Both can be the right choice, but each has different emotional and legal considerations that go with them, so take your time with this decision.

Remember, all donations (anonymous or not) are screened for sexually transmitted diseases, as well as any evidence of genetic disorders. In the case of anonymous donation, the sperm is usually frozen and kept for 6 months after it is deposited, before it is then re-tested and given to patients.

In addition to deciding whose sperm to use, there is also the matter of what form of sperm you’re going to use. As with insemination procedures, there are few different options that are available:

• ICI-ready sperm: Semen in this category is used for intracervical insemination. This process is probably the closest to the movie and TV representations of sperm donation. These specimens are not “prepared” or altered before they are frozen (but of course they go through the same thorough screening process). Often, this sperm is injected into a patient at a clinic or doctor’s office, but this type of sperm can also be used for private home insemination. ICI is the least invasive form of alternative insemination, and has success rates of anywhere from 10% to 18% (tracking your cycle can help give you the best odds).
• IUI-prepared sperm: These samples are prepared for intrauterine insemination. The seminal fluid is removed or, “washed” from the donor’s semen to isolate sperm, and all dead swimmers are removed before the sample is frozen. This option is more expensive  than ICI sperm because of the process the semen goes through, and because by eliminating seminal fluid and dead sperm, there is a better chance of fertilization.The IUI procedure is also a little more invasive than ICI because the sperm is directly inserted into the uterus rather than the cervix. This process is always performed in office, and has a success rate of 18% to 30%.
• IVF-prepared sperm: This is the cheapest form of prepared sperm, but it isn’t offered by every sperm bank. These samples have a lower sperm count than ICI or IUI prepared sperm. This is because it is believed that less sperm is needed to conceive through IVF, and that saves you some money. But despite saving a couple of bucks on sperm, IVF is one of the most expensive options for alternative insemination. This process involves taking already fertilized embryos and inserting them into a uterus. And again, this increases the success rates to 13% to 41%.

The varying success rates within methods are due to a lot of situational factors including medication, health, age, and lifestyle.

Because the cost of donor insemination can range from $300 to $4,000 depending on what sperm is used, and an average cost of $12,000 per IVF cycle, be sure to ask your provider how many vials of sperm you’ll need!

Preparation

Sometimes people are prescribed medication to help prepare the body by encouraging fertilization. Every case is different, but many medications prescribed in these situations are follicle stimulating hormone (FSH) treatments. FSH is a naturally occurring hormone in your body that helps mature an egg living in the ovaries, while also causing a follicle to grow around that egg as it continues to mature before ovulation. The medications prescribed by healthcare providers encourage this process in the same way.

The day of

Traditionally ICI, IUI, and IVF are all outpatient procedures. IVF can be a little different because the process may involve two outpatient procedures. In those cases, there is a standard egg retrieval and a seperate embryo transfer performed after the eggs have been fertilized. Though all of these procedures may be a little different, a benefit of all three options is that once the insemination process is over, you’ll be able to resume your day as normal.

After insemination

After these outpatient procedures, you’ve made it! And despite popular belief, there’s no need to lay on your back with your legs in the air. You may be asked to lay down or relax for a while, but your legs won’t be airborne, and this downtime could help you process your excitement or calm your nerves. After insemination, you may experience some mild cramping or bloating. This is normal, and shouldn’t be too intense. Then, you may be able to take a pregnancy test as soon as two weeks after insemination! On the other hand, some healthcare providers may suggest waiting a longer period of time. Waiting a little longer will be hard, but if you can do it, you’ll get a more accurate reading on whether or not the insemination was successful.

The bottom line

Alternative insemination is a procedure without many physical risks, and is a great option for people looking to expand their families. Because there are varying success rates to each procedure, your PCP can offer a great deal of guidance and support when making this decision. Be sure to keep all of your personal needs in mind, and take everything at your own pace.

Sources

• Office Andrology. Illustrated Edition. Battaglia, David E. and Patton, Phillip E.. Human Press. 2010. Web. https://books.google.com/books?id=WMazHT_VXrcC&printsec=frontcover&dq=Office+Andrology&hl=en&sa=X&ved=0ahUKEwjh9tXSqJfcAhVDn-AKHZDTCcYQ6AEIJzAA#v=onepage&q=Office%20Andrology&f=false
• “Single Cycle IVF Cost Details – Advanced Fertility Center of Chicago.” Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/ivfprice.htm
• Mayo Clinic Staff. “Female Infertility”. Mayo Clinic. Mayo Clinic. March 8, 2018. https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
• Seattle Sperm Bank Staff. “Demystifying IUI, ICI, IVI, and IVF”. Seattle Sperm Bank. Seattle Sperm Bank. 2015. https://www.seattlespermbank.com/demystifying-iui-ici-ivi-and-ivf/
• Seattle Sperm Bank Staff. “How to Inseminate at Home Using Donor Sperm.” Seattle Sperm Bank. Seattle Sperm Bank. 2015. https://www.seattlespermbank.com/how-to-inseminate-at-home-using-donor-sperm/
• Pacific Fertility Center Staff. “Donor Sperm.” Pacific Fertility Center. Pacific Fertility Center. 2018. https://www.pacificfertilitycenter.com/treatment-care/donor-sperm
• “In Vitro Insemination: IVF”. American Pregnancy Association. American Pregnancy Association. 2018. http://americanpregnancy.org/infertility/in-vitro-fertilization/
• “Artificial Insemination (Intrauterine Insemination, IUI)”. University of Wisconsin Hospitals and Clinics. University of Wisconsin Hospital and Clinics. 2018. https://www.uwhealth.org/infertility/intrauterine-insemination-iui/26136

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.

How to time your pregnancy test properly

Here’s what you should know about this timing – and the science behind our recommendations.

First, understand how home pregnancy tests work

In the earliest stages of pregnancy, a fertilized egg will begin to implant in the uterine lining. This happens around four to six days after conception. Once implantation starts, the placenta starts producing human chorionic gonadotropin (hCG), the pregnancy hormone. Home pregnancy tests work by determining if there is hCG present in urine – and, as you might know, home pregnancy tests ask you to pee to a stick to measure this.

Because hCG doesn’t show up until after implantation begins, if you don’t wait a few days to make sure the embryo has had a chance to implant, there’s the chance of getting a false negative – meaning that the pregnancy test reads as a “negative” even though pregnancy has occured. Implantation usually happens six to twelve days after ovulation, so the absolute earliest that you can test for pregnancy is a week after ovulation. For even more accurate results, it’s preferable to wait a few extra days so that levels of hCG can rise to more detectable levels. Waiting a few days after the first day of a missed period usually guarantees the most accurate results from a home pregnancy test.

Utilize Ovia Health to help with pregnancy testing

When it comes to pregnancy test timing, you probably know it’s best to take it at least one or more days after your next period is due. But your menstrual and ovulation cycle can fluctuate every month, meaning certain days of your cycle might change on a monthly basis and make it harder for you to know exactly when it’s time for you to take a pregnancy test. The US Department of Health and Human Services reports that nearly 20% of individuals who are pregnant get a false negative, because they’ve miscalculated their period or it arrived later than expected that month.

This is where tracking is helpful. Different ovulation symptoms can suggest that you’re in a certain part of your cycle. For example, in the luteal phase, which is when the egg implants and your body starts making the pregnancy hormone, your body releases progesterone, which can affect your moods, breast tenderness, and cervical mucus. Spotting might happen as a sign of implantation bleeding, too. These kinds of symptoms tell Ovia what phase of your cycle you’re in.

When you log your data consistently, Ovia takes all of the information you provide, like your period dates, cervical fluid consistency, basal body temperature, symptoms, and moods, and uses it to predict when you’re ovulating and when is the best time to take a pregnancy test. If Ovia tells you to test on a day that’s different from what you expected, this could be because of natural fluctuations in your cycle, as well as symptoms that suggest to Ovia that you’re at a different day in your cycle than you previously thought.

Other things to consider

Cycles fluctuate month by month, and it can be difficult to know for sure when one phase of your cycle ends and another begins. And if you’re patiently waiting for some positive news, we know you can’t get it soon enough – so we’re here to help. By consistently logging your symptoms and moods, you’re providing Ovia with important information that will help us predict the best – and most accurate – day for you to take a pregnancy test.

Sources

• “Home use tests: Pregnancy.” FDA. US Food and Drug Administration, Jun 5 2016. Web.
• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2 2015. Web.
• Connie Matthiessen. “Week 01 to Week 04 of Pregnancy.” HealthDay. HealthDay, Jan 20 2017. Web.

Things to consider about sex after a miscarriage

Individuals and couples who have experienced a miscarriage often report feelings of hesitancy towards resuming sexual activity, for both physical and emotional reasons. What is most important is that you take care of yourself, and keep the lines of communication open.

What factors influence when someone can start having sex again?

Sex after miscarriage is a very personal and individualized situation. That being said, there are some physical and mental factors that most people will want to take into consideration after experiencing any kind of pregnancy loss.

• Physical factors:

After a pregnancy loss, women are generally advised to maintain ‘pelvic rest’, including no tampon use or sexual activity, for two weeks after miscarriage. This is partially due to the fact that the cervix and uterus are more dilated in the weeks following a miscarriage, which makes infection more likely. A pelvic exam from a provider is the best way to know for sure if you’re medically ready to have sex again. Sexual activity can typically be resumed after this time. However, a healthcare provider may give different recommendations about when it’s safe to resume sexual activity based on their assessment and your experience.

• Emotional factors:

Many people don’t feel quite ready to start having sex again for some time after a miscarriage. This is very normal. Open, honest conversation between partners should be encouraged in order to remain connected and work through these feelings.

Your healthcare provider is a valuable resource to help you determine when it is safe to resume sexual activity and, if you’re ready, to try and conceive again if that is something you want. Your provider will base their recommendation on multiple factors including the type of loss, the gestational age at the time of loss, and the your personal experience.

When does the menstrual cycle return?

You may ovulate as soon as two weeks after a miscarriage, but it is also normal for ovulation to take longer to resume.  Healthcare providers usually recommend waiting at least one menstrual cycle before trying to conceive again, and that people not try to conceive until they feel emotionally healed. These recommendations may be different for those who have had more than one miscarriage. As always, it’s a good idea to ask your healthcare provider for their opinion about when it’s safe to start trying again. In the meantime add a safe method of protection, if that’s necessary for you, until you’re cleared.

Long-term grief

It’s normal to experience a shift in mood, or strain in a relationship after a miscarriage. While short- and medium-term grief and sadness are expected, if you’re experiencing grief or depression lasting for months and it’s impacting your  ability to perform daily activities, seek the help of a specialist. There are many options to get the help you need. This could be a therapist, a psychiatrist, a support group, or a combination of them; the most important thing is that you feel comfortable talking to your healthcare provider about how you’re feeling and any concerns you may have. Sexual activity after loss might be emotionally or physically difficult at first, but as long as both partners are respectful of one another and understand where each other are at in the healing process, things will get easier over time.

Sources

• “When can I resume sex after a miscarriage or pregnancy loss?” UTMBHealth. The University of Texas Medical Branch at Galveston, 2016. Web.
• “How soon can couples have sex again after a miscarriage?” ISSM. International Society for Sexual Medicine, 2016. Web.
• “Getting pregnant: when is the best time to get pregnant after a miscarriage?” MayoClinic. Mayo Foundation for Medical Education and Research, May 17 2016. Web.