Puzzle Pieces: Part 2

     In most things in life, admitting that you have a problem is the hard part.  As humans, we rarely like to accept our faults. We don't like feeling like we are to blame when things go south in our lives. This is not the case when it comes to infertility. After trying for a long span of time to conceive, you can't wait to figure out which part of your reproductive system is to blame for all of your troubles. You become more than willing to consider any issue that you discover that could possibly be the culprit for your current crappy, frustrating and usually downright heartbreaking situation.

     Maybe I'm not ovulating, maybe it's faulty sperm, maybe it's consistently poor timing, maybe it's a physical blockage of some kind; the possibilities are endless. Around the two year mark of TTC, I had quelled my thermometer obsession and had become more comfortable checking cervical fluid and cervix position than I would wish on my worst enemy. I was now completely immersed in my obsession of fixating on my charts and looking at the charts of other women to identify clues and patterns. I was the Nancy Drew of infertility.

     Through charting, I was able to narrow my problem down to a hormone imbalance. I believe that I was suffering from low progesterone, the hormone that directly effects the Luteal phase of one's cycle. I scoured the internet for other women who had this same pattern in their charts. I searched for any clue indicating what had helped them. As I researched this issue a little more in depth, some interesting solutions popped up. I read about suppositories for every hole of your body, different foods to eat in bulk and various supplements that claimed to combat this issue.

     Again, let me reiterate that I am not a doctor or a fertility specialist of any kind. Please do not take my experience as a substitute for treatment or consultation with your own health care provider. This story is simply my personal experience.

     The solution that I found to be the most promising and most feasible for myself was natural progesterone cream. These creams, which are made from a variety of fruits, herbs and spices are most commonly made out of wild yam and mimic the progesterone created by your own body naturally. Many are sold online and can be purchased for around fifteen dollars a tube.

     My doctor had no concerns with me using one, but you will need to be careful and research what brand you decide to use. Some are synthetic and some are natural. Some are formulated for issues related to menopause or PMS more than fertility and I chose to avoid those simply because nothing is pure anything so I felt more comfortable using a product that was intended for use during pregnancy than one that was not. There are natural progesterone creams formulated specifically for fertility and it is best to stick with one of those in my opinion.

     You will also find progesterone pills on the market as well as women who swear by them. I found however, that progesterone cream is better than a progesterone pill because it is believed that when progesterone is taken orally much of it gets broken down in your liver. As a result it is more difficult to get an effective dose orally. By applying cream directly to your skin, more of the hormone gets into your system.

     It is imperative that you chart religiously if you are going to use progesterone cream. The reason for this is that progesterone is also effective in keeping one from ovulating if taken or used during the Follicular phase of one's cycle. In fact, this is how most birth control pills work. They protect you in two distinct ways. They are high in progesterone early in your cycle to prevent you from ovulating while being high in estrogen late in your cycle to prevent an egg, if released and fertilized from implanting. That is why your birth control pills come in a cool little pack with a pill marked specifically for each day of your cycle rather than just in a bottle floating loosely around. It is necessary that you take specific pills at specific points of your cycle for the pills to be effective.

     For this reason, you MUST chart while using progesterone cream. If you start using the product before you have actually ovulated, you can prevent ovulation from taking place at all and will therefore have zero percent chance of getting pregnant that month. You must watch your chart, look for your temperature spike and then begin to apply your cream only after you have absolutely confirmed ovulation.

     There are specific locations on your body that you should apply this cream. They are places in which your capillaries are dense and close to the skin. These include your face, neck, upper chest, breasts, inner arms, and the palms of your hands. It is important to rotate the location that you use for each application as well to prevent saturation. You will also want to avoid applying it to the fattiest areas of your body because fat will store the hormone rather than allowing it to proceed into your bloodstream.

     I found that between working, running around all day and just the regular craziness of life it was very easy to lose track of where my next dose was supposed to go. I began keeping track on my phone to ensure that I was not repeating the same spot over and over again. You must apply this cream twice per day to ensure that you are getting a constant delivery of the hormone as would be the case if your body was producing it naturally.

     During treatment, your chart is also important to indicate for you when it is okay to stop using progesterone cream. You should discontinue use only when you have confirmed that you are NOT pregnant. This can happen in two different ways. Usually, your period will start and your temperature will drop as usual albeit, a few days later than normal at which point it is okay to immediately stop using progesterone cream for that cycle. Sometimes however, using the cream can cause your temperature to remain high which mimics the chart of a pregnant woman. After eighteen days of a consistently elevated temperature you can take a home pregnancy test and if it comes back negative it is okay to discontinue use of the cream. It is not unheard of by any means to have a late positive pregnancy test, meaning after eighteen days of an elevated temperature, but it is not common. In most cases you can get an accurate answer by day eighteen.

     It took me 3 months to get my dosage to the correct level where I was no longer seeing any spotting before my period. Three months after that, I conceived little Archer. I can't say if it was the progesterone cream or not, but I can tell you that using it, I had the most normalized charts of my life and was able to conceive, both of which had not occurred in the many, many months prior.

     When you do find out that you are pregnant do not stop usage of your progesterone cream. While opinions vary regarding how long into a pregnancy you should supplement, I chose to begin tapering my dose after the 16^th week of pregnancy, when the placenta takes over progesterone production. While pregnant do not skip even a day. Always keep an extra tube on hand so that you will not run out. Stopping progesterone cream without weaning will cause a sudden drop in progesterone levels and could cause a miscarriage. While pregnant, I did inform my doctor and nurses that I was using progesterone cream and none of them expressed any concern about me doing so.

     There are an endless number of factors that can cause a couple to experience unexplained infertility. Low progesterone is only one. I share my story not to imply that every problem is as easy to identify or that every fix is as easy to obtain. I share this story as an example of why you need to be your own advocate when it comes to your healthcare. Doctor's are the experts of medicine and treatments, but you are the expert of your body. Don't be afraid to educate yourself and take charge of your fertility. I want to empower you to do your own charting and your own investigating. Don't feel like you are only at the mercy of a doctor or an invasive medical test or treatment to achieve your goal. It is your body and you have more control over it than you think.