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.

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.

Pregnancy implantation signs and symptoms

Timeline

The first difference is in the timing of the symptoms. Implantation happens any time between about 5-10 days after you ovulate, while PMS usually sets in closer to two weeks after. So if symptoms start and it feels a little early to you for it to be menstruation, it might be a successful implantation.

Cramping

Mild cramping can be a sign of successful implantation, as the fertilized egg attaches to your uterine lining. These cramps don’t happen in every case, and they’re not, on their own, enough to say for sure that implantation has happened. When they do occur though, they’re different from menstrual cramps in that they only last for short periods of time, rather than continuously like menstrual cramps. The pain they cause also tends to be much more mild than that from menstrual cramps.

Spotting

Implantation bleeding produces a lot less blood than a menstrual period. Instead, it’s more like spotting, and is more likely to range from pinkish to brownish, instead of red like menstrual blood. If you have heavier-than-period bleeding, especially with extreme cramping, you should contact your healthcare provider.

Soreness

Both implantation and PMS can cause soreness in your breasts. The two types of soreness won’t necessarily feel that different from one another, but soreness from a period will usually go away after a few days, whereas soreness from implantation might stick around through your pregnancy. In fact, the elevated presence of progesterone and other hormones during pregnancy can cause several different changes in your breasts. Another change that you might notice around the time of implantation is a darkening of your areolas.

Other signs

There are other signs of implantation that don’t correspond to menstrual symptoms, like nausea and morning sickness, increased urination, and, of course, missing your period. Since everyone’s body is different though, you may not notice some or all of these signs. At-home pregnancy tests can provide a bit more confirmation, though they won’t reach their full accuracy until around your expected period date.

Sources

• “Is It Implantation Bleeding — Or Just My Period?” WhattoExpect. What to Expect, Apr 12 2016. Web.
• Margaret Scott. “Signs Of Successful Implantation: Why It Is Important To Stay Optimistic.” ImplantationSpotting. All About Implantation Bleeding, 2014. Web.

Here are the TTC acronyms you should know about

AF:

Aunt Flow. Your period.

Thanks for the invite, but my Aunt Flow’s in town. I’m gonna go home and treat her to some wine and reruns.

BBT:

Basal Body Temperature. BBT may spike right before ovulation, so many women track it to help them pinpoint their ovulation.

The very first thing I did this morning was grab my thermometer and take my BBT.

BCP:

Birth Control Pills.

In almost no time after I stopped taking BCP, I was pregnant.

BD:

Baby Dance. Sexual intercourse, usually done on the most fertile days of your cycle. (Can also mean baby dust, which is a phrase you use to wish someone good luck.)

My ovulation test is positive, which makes me want to dance – the BD, that is!

BFN/BFP:

Big Fat Negative/Big Fat Positive (on your pregnancy test).

Every time I buy a pregnancy test, I think about how it could be the one to show the BFP.

BOB:

Baby on the Brain!

I’m having a hard time shopping with BOB. All I can think about is tiny socks and pacifiers, which makes it impossible to keep track of my grocery list.

CD:

Cycle Day. A specific day in your menstrual cycle (or fertility treatment cycle). To track it, start by counting from the first day of your last menstrual cycle.

It varies each cycle, but normally I ovulate on CD 13, or 13 days after the first day of my period.

CM or CF:

Cervical Mucus or Cervical Fluid. Changes in cervical fluid indicate that a woman is at different stages of her cycle.

At the most fertile point of each cycle, my CM is clear and super stretchy.

CP:

Chemical pregnancy. A very early miscarriage.

My doctor recommended that I put off trying again until one cycle after my last CP.

DD:

Darling daughter. A daughter you already have.

DH, DD, and I go on vacation next week.

DH:

Dear husband.

I’m 42 and DH is 43.

DPO:

Days Past Ovulation, or Cycle Date Post Ovulation.

By 7DPO of the TWW, I’m already wondering if every little cramp is a sign of pregnancy.

DS:

Darling son.

It’s a challenge to care for DD and DS while also TTC.

ENDO:

Endometriosis. A chronic disease in which tissue that is supposed to grow in the uterus grows outside of it. Millions of women experience this condition and it can affect fertility.

After getting diagnosed with ENDO, I was able to find a huge and supportive online community of other women who had the same condition.

EWCM:

Egg White Cervical Mucus. When your cervical mucus looks like egg whites, it may mean that you’re at your most fertile point.

Nothing is as exciting as seeing EWCM when TTC!

FMU:

First Morning Urine. Most pregnancy tests require that women take them the very first time they pee in the morning. In the morning, urine typically has the highest concentration of Human Chorionic Gonadotropin, or hCG, an early pregnancy hormone.

I tested with FMU and got a faint BFP.

FP:

Follicular Phase. The phase of the menstrual cycle when follicles mature in the ovary. This phase begins on day 1 of your period, and ends with ovulation.

I’m so excited to try and get pregnant, I just want my FP to be over!

hCG:

Human Chorionic Gonadotropin. A hormone produced during early pregnancy that helps the baby grow.

I had a positive test, which means there was enough hCG in my urine to detect a pregnancy.

HPT:

Home Pregnancy Test. A pregnancy test that you can take at home. This morning my HPT showed a BFP – but I’m going to my doctor’s to take a blood test to confirm.

IUI:

Intrauterine Insemination. A specific kind of fertility treatment where sperm is placed directly into a woman’s uterus during ovulation.

After 2 years of TTC, we’ve decided to try IUI.

IVF:

In Vitro Fertilization. A procedure in which an egg is fertilized in a lab and then implanted.

We went through several rounds of IVF before getting a BFP.

LMP:

Last Menstrual Period. The first day of your last period.

I started my LMP on June 6th.

LPD:

Luteal Phase Defect. If the corpus luteum didn’t form properly, a luteal phase defect may occur, causing a short luteal phase. This can make it hard for a woman to get pregnant.

I’ve been really accurate with my charting, because I suspect I might have LPD and I want to have a lot of information to show my provider.

LSC:

Low Sperm Count. Commonly the cause of male infertility.

A semen analysis showed that my partner has an LSC.

M/C:

Miscarriage.

I got my first BFP a year ago, which ended in a really upsetting MC.

MF:

Male Factor Infertility.

To help with the MF issues, we found an infertility counselor who was covered by our insurance.

NTNP:

Not trying for pregnancy, not preventing pregnancy.

I just stopped taking BCP, so I guess that we’re NTNP.

O or OV:

Ovulation.

I O’ed on CD15 and BD on days 13 and 15.

OPK or OPT:

Ovulation Predictor Kit or Ovulation Predictor Test. These tests tell you when your body has a surge of luteinizing hormone (LH), which indicates the onset of ovulation.

I just got a positive OPK, which means BD as soon as possible!

PCO, PCOS, or PCOD:

Polycystic Ovaries, Polycystic Ovary Syndrome, or Polycystic Ovary Syndrome Disease. A condition in which a woman’s levels of estrogen and progesterone are unbalanced. Women with PCOS develop cysts on their ovaries, and the condition can cause infertility.

My doctor thinks I have PCOS, so I’m waiting to hear back about my blood work.

POAS:

Pee On Stick. Taking a pregnancy test (peeing on a stick), usually at home.

I’m 7DPO and it’s so hard to wait to POAS!

RE:

Reproductive Endocrinologist. A type of fertility specialist.

I’m meeting with an RE tomorrow to go over my fertility test results.

SA:

Semen Analysis. This is a test that providers can use to determine the quality and quantity of a man’s sperm.

The results of his SA show he has low sperm count, low motility, and poor morphology.

SO:

 Significant other.

My SO and I have decided that next month we’ll start TTC.

TWW or 2WW: Two Week Wait. The time period between when you ovulate and can take a pregnancy test.

 just started my TWW and I need to find some ways to distract myself!

TTC:

Trying to Conceive.

I haven’t decided who I want to tell that we’re TTC.

U/S:

Ultrasound.

Our first U/S is scheduled for the end of the month.

When to consider a false negative in a pregnancy test

The rollercoaster of emotions that come with taking a pregnancy test is often stressful. And if you’re actively TTC, we understand that a negative test result can be plenty disappointing. But don’t give up hope just yet. A false negative – when a pregnancy test says “not pregnant” but the test user is actually pregnant – do happen, and here are a couple of reasons why you may have received one.

Why a test could be wrong

There are several reasons the pregnancy test could be showing a false negative.

1. Test was taken too early

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.

2. Fluids are 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, so for the most accurate results try to take the test as early in the day as possible, preferably right after you wake up.

3. Test directions weren’t 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 you might have had on hand for a while.

Other things to consider

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.

When you’re trying to conceive, the similarities between symptoms of implantation and signs of PMS can sound maddeningly similar on paper, but in reality, there are differences you may be able to feel, and there’s a good chance you’ll have an idea whether implantation took place before a pregnancy test can even tell you.

Signs of implantation: A timeline

The first difference is in the timing of the symptoms. Implantation happens any time between about 5-10 days after you ovulate, while PMS usually sets in closer to two weeks after.

Implantation symptoms

If symptoms start and it feels a little early to you for it to be menstruation, it might be a successful implantation.

Cramping

Mild cramping can be a sign of successful implantation, as the fertilized egg attaches to your uterine lining. These cramps don’t happen in every case, and they’re not, on their own, enough to say for sure that implantation has happened. When they do occur though, they’re different from menstrual cramps in that they only last for short periods of time, rather than continuously like menstrual cramps. The pain they cause also tends to be much milder than that from menstrual cramps.

Spotting

Implantation bleeding produces a lot less blood than your period. Instead, it’s more like spotting, and is more likely to range from pinkish to brownish, instead of red like menstrual blood. If you have heavier-than-period bleeding, especially with extreme cramping, you should contact your healthcare provider.

Soreness

Both implantation and PMS can cause soreness in your breasts. The two types of soreness won’t necessarily feel that different from one another, but soreness from a period will usually go away after a few days, whereas soreness from implantation might stick around through your pregnancy. In fact, your hormones during pregnancy can cause several different changes in your breasts. The other one that you might notice around the time of implantation is a darkening of your areolas.

Other signs

There are other signs of implantation that don’t correspond to PMS, like nausea and morning sickness, increased urination, and missing your period. Since everyone’s body is different though, you may not notice some or all of these signs. At-home pregnancy tests can provide a bit more confirmation, though they won’t reach their full accuracy until around your expected period date.

Sources

• “Pregnancy Symptoms.” American Pregnancy Association. American Pregnancy Assocaition. June 29, 2018. http://americanpregnancy.org/getting-pregnant/early-pregnancy-symptoms/
• Mayo Clinic Staff. “Symptoms of Pregnancy: What happens first.” Mayo Clinic. Mayo Clinic. Jan. 5, 2017. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853

Why might I have tested negative?

One of the most common reasons women test negatively inaccurately is by taking a pregnancy test too early. You may be able to test as early as 10 days after ovulation, but it usually takes an average of 13-15 days after ovulation and fertilization for a pregnancy test to turn positive. Many women test too early, use a test with low sensitivity, or use the test incorrectly, which can lead to false negatives.

Other causes of false negative pregnancy tests include diluted urine, expired tests, improper testing, and ectopic pregnancy. If you test negative but have not gotten your period, make sure to take multiple tests throughout the week, and consult your healthcare provider with further questions.

Getting proper results

Women who do not use fertility and ovulation trackers often miscalculate the date of their next periods, meaning that it is possible they have not missed their period but simply haven’t started it yet. Knowing exactly if and when you’ve ovulated, using Ovia’s tools, can help you avoid false negatives and make sure you take a pregnancy test at the right time.

How Ovia can help you check and track your cervical position

Ovia’s algorithms help you check and learn when you’re most (and least) fertile by interpreting the data you track – including moods, cervical mucus, temperature, and the position of your cervix – to give you  a daily fertility score. The more you track, the more accurately Ovia can predict when you’re ovulating.

How does cervical position indicate ovulation?

If you’re ovulating, your cervix will feel high up, making it harder to reach, and it’ll feel soft and open. This openness allows any sperm in the area to enter your uterus and potentially fertilize an egg waiting there. In contrast, your cervix will feel low, hard, and closed when you aren’t in the fertile part of your cycle.

Here’s a quick reference guide to how your cervix may feel during different fertility levels and cycle times, including during pregnancy:

Ovulation

• Position: High (hard to reach)
• Firmness/Texture: Soft (like your lips)
• Openness: Open (tip of your finger can rest in the little divot, more circular)

Fertile window (approaching ovulation)

• Position: Medium
• Firmness: Medium (like your chin)
• Openness: Medium

Not fertile (both follicular phase and luteal phase)

• Position: Low
• Firmness: Hard (like the tip of your nose)
• Openness: Closed (like pinching your fingers)

Pregnant

• Position: High
• Firmness: Soft
• Openness: Closed