Accident

Late Friday night, C. was in a bad accident. (He was riding on the back of his friend’s scooter and got hit by a deputy sheriff who was running a red light without her siren on…) C. has some pretty serious injuries – including 6 broken ribs, one fractured vertebra, a pneumothorax, and – most disturbingly – large lacerations on his liver and spleen (class 4 and class 3, out of 5, respectively). Fortunately, he does not appear to be bleeding internally, and after 48 hours holding stable, they’ve moved him from ICU to a med-surg ward.

Needless to say, we aren’t thinking too much about fertility at the moment. Although I have to admit that one of my grossly inappropriate thoughts upon hearing about the accident was, “I guess we won’t get to try this month…” When I confessed this to C., he was super disappointed and tried to convince me that he would be up for BDing by ovulation time. Since he is on strict bed rest now, hasn’t walked or eaten more than a bite of solid foods since Friday, and ovulation is 3-4 days away, I find this pretty unlikely.)

Anyway, please keep C. in your thoughts and prayers.

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HSG

The HSG took about 5 minutes (excluding time for me to strip from the waist down) and was virtually painless. (I had a few cramps on the drive afterward, but less even than a bad menstrual cramp – not that I ever get bad menstrual cramps…) To the utter bewilderment of my radiologist, I asked to take a photo of the screen. For your viewing pleasure, here’s my uterus and Fallopian tubes:

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I think the fact that you can see the white hair-like projections (my Fallopian tubes) coming out of the white triangle in the middle (my uterus) shows that everything is flowing freely. So plumbing doesn’t appear to be the problem (which we pretty much already knew). Now all I have left for my IUI homework is my injections class next week. Should be fun!

For today’s chemistry lesson, I tried to figure out the likely structure of the dye that they put in my uterus to appear all pretty and white on the x-ray above. I didn’t actually check what they used, but from what I can tell the vast majority of these dyes are small, iodinated organic molecules like the ones shown below. The iodine atoms are the most important part, and are what makes it show up white on the x-ray. There are two classes of iodinated contrast media: ionic (which contain a carboxylic acid group – shown in blue below – somewhere in their structure), and non-ionic (that don’t have a carboxylic acid). For imaging the digestive tract, they often use an inorganic compound – barium sulfate – but I’m going to assume that’s not what they used for my HSG.

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My IUI ‘homework’

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Today, I had my blood drawn for a blood pregnancy test, and picked up my prescription for doxycyline. This is in preparation for my hysterosalpingogram (HSG), which happens tomorrow morning, all part of the ‘homework’ my doctor gave me to do before we can move on with medicated IUI.

The HSG involves injecting a dye into my cervix and taking x-rays of my plumbing to see whether I have any blockages or uterine abnormalities not visible by ultrasound. This whole process would not do good things for a fetus, which is why I had to take the blood pregnancy test today. There is also a slight risk of infection, hence, the doxycycline.

Since this blog is titled ‘The Infertile Chemist’, I figured it should have some chemistry in it… Doxycycline is a broad-spectrum antibiotic (so I should be protected against a wide variety of pesky bacterial pathogens!), designed by chemists at Pfizer in the ’60s. More interesting (to me, anyway) is that it was inspired by the tetracycline family of natural products, including the first tetracycline to be discovered – chlortetracycline (aka aureomycin). Chlortetracycline is produced by a soil bacterium called Streptomyces aureofaciens. (Streptomycetes like S. aureofaciens make tons of cool antibiotics and other natural products.) Chlortetracycline is a polyketide, which means the bacterium makes it by connecting together two-carbon units in an assembly line fashion.

Anyway, I’ll start taking doxycycline tonight, and go in for my HSG tomorrow… I’ve read that it can hurt, particularly if one has blockages, so I’m hopeful that everything flows through without too much resistance. On the plus side, I’ve also heard that women who’ve just had their plumbing flushed by HSG have slightly higher pregnancy rates that month, so here’s hoping!

How we got here.

Hmm. How far back should I go?

I could start at the beginning… Once upon a time, there was a 21-year-old girl who loved school in general – and organic chemistry in particular – so much that she left her college boyfriend to move out to the east coast to go to graduate school. She didn’t worry about having kids yet. After all, she was only 21 years old, and would have plenty of time once her career was on track…

Hmm. Maybe that’s too early to start. How about when we started trying to get pregnant… After getting married last January, and recognizing that we wanted more than one kid and that we weren’t getting any younger, we started trying to get pregnant in early March. In month 1, this just meant ‘pulling the goalie’ and going for it. The next month we tried to time it starting around day 10 and continuing for about a week straight. The third month, a friend gave me her copy of ‘Taking Charge of Your Fertility’ by Toni Weschler. I read it in a couple days and figured out what we were actually supposed to be doing… We got pregnant that month, in my first attempt at charting.

Everything was great. We went on our perfect little honeymoon to Ireland (which we had put off due to my work schedule), where I restricted myself to the hard Irish cheeses, and only the tiniest sips of Guinness and Irish whisky. We came back and went to our 8 week appointment the next week, only to see that there was no heartbeat. The baby had stopped growing at 5 1/2 weeks…

But we were okay. We had gotten pregnant once. We knew that I was ovulating, that nothing was blocked, that his swimmers could swim,… Fast forward to December. By that point, we had had several cycles in which we timed things perfectly and no pregnancy. By this point, I’d read enough books about infertility to know not to put off seeing a specialist. So we made an appointment in January with the Kaiser Reproductive Endocrinologist.

And what now? After the standard tests, we know that C. is superman. (The nurse literally said his sperm test results were the ‘best she had ever seen’.) And at the ripe old age of 34, I apparently have the ovaries of a 45-year-old woman…

So we’re moving ahead with medicated intrauterine insemination (IUI, aka ‘the turkey baster’) next month, and probably in-vitro fertilization (IVF) after that. This month we have ‘homework’ to get ready for IUI, including a hysterosalpingogram (HSG, more about that later), and a 2-hour class on how to give myself hormone shots. Add another notch to the tally of stuff-I-never-wanted-to-know.

Tomorrow I take a blood pregnancy test (spoiler alert: I’m not pregnant) and pick up a prescription for antibiotics. Both are required before they’ll do the HSG on Thursday. Will let you know how it goes!

Here goes!

A few weeks ago, after getting the diagnosis of “female infertility” and confronting a variety of painful emotions, a friend of mine suggested that I read her friend’s infertility blog (http://tracysue.wordpress.com/). I did, and it was awesome.

And then, after deciding to move forward with treatment, I felt inspired to write my own little blog… I think a blog will have the benefits of:

  • keeping close family and friends up-to-date without having to tell the same sordid details over and over
  • providing an outlet for my ever growing trove of information-that-I-never-wanted-to-know about infertility
  • serve as a first step in helping me get connected up with the online community of IF-ers like me
  • provide inspiration/consolation/comiseration/some other-ation to someone else struggling with this

Okay, so the last two are probably optimistic, but maybe… Anyway, I’m hoping the benefits will outweigh the costs of this blog – namely, time. (Ahem, that is, time I should be spending prepping lectures, grading, cooking, cleaning up, shopping, reading, hanging out with my dogs and  husband, or countless other things…or so says the little voice in my head.)

Anyway, I’m choosing to ignore the little voice and give it a try. Here goes!