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Thursday, 17 July 2014

There's an app for that...

"Were you planning a pregnancy at this time?" I asked my standard question to a new OB patient. "Well, we stopped using condoms, but we weren't doing anything." she replied. "You mean you weren't doing anything proactive." I clarified "I think you did something..." That brought out a laugh. "Oh, um...yeah" she giggled "Well, we were doing it; but we weren't on a schedule or anything like that." you know, like a crazy infertile person... She elaborated. "One of my friends has been trying for a while and she was telling me that I needed to download all these apps. It was three different apps! So I told her 'that's crazy!' I just want one app! I mean, my banking is just one app!"

Well, it seems she used the the 'just have sex' app. There was something so genuine about her, I could look past any jealous feelings that she succeeded in conception without really trying. My follow up question was to ask when she confirmed her pregnancy. "Well, I had a regular period in March, and then I had some light bleeding in April. I didn't get a period in May, but it's not usual for my period to skip a month now and then. When I didn't get one in June, I thought I should take a test, as we had been trying, but I wasn't expecting that it would be positive." I proceeded with her exam. Heavy make up covered her acne scars. She had a male hair pattern on her abdomen. I started to wonder if she may have Polycystic Ovarian Syndrome. She probably wouldn't have had any luck with any fertility apps. She used the blind pig finds an acorn method.  

I started counting all my 'apps'. I have a menstrual cycle calendar app on both my iPhone and iPad. I downloaded the app from Freedom Fertility to use during my stim cycle, but found it really cumbersome and very disappointing. I went old-school and printed a calendar from timeanddate.com to record my meds and results. Currently, I'm using both the Clearblue Fertility Monitor, which measures both estradiol and LH off a first morning urine sample, and I'm checking for an LH surge with the smiley face test kits at noon. I've seen enough egg whites to make an omelet, but my low progesterone level confirmed that is a defective app. One of those free apps that totally sucks.

My 'P.log' app on my iPhone issued a reminder that my period is due in 3 days, but as it was CD25 and I still hadn't received any indication of impending ovulation, I know that was not going to happen. It was time to message my RE to determine when we would declare this an anovulatory cycle and induce a withdrawal bleed with Provera or Prometrium. Not surprising, he wanted to see me for an ultrasound. It was time to upgrade to a better app. My lining was 13 mm, indicating there has been some estrogen production and there was a 17 mm dominant follicle on my right ovary. Maybe my stim cycle hadn't put Si and Am out of commission after all.

It was another moment of feeling like the most ridiculous infertile. I was going to such extremes to determine when I would be ovulating and not directly for procreative purposes. In fact, it would be another occasion when spontaneous conception would not be advised as I'm planning to violate my endometrium. Before we needed to reach for the stash of condoms in the bedside drawer, Husband flew out on a red-eye flight to the east coast for another hockey tournament. Sure enough, the next morning, on CD28, I was finally reading 'high' on my CBFM, which was confirmed at noon with the presence of the little happy face. Ah yes, the google calendar with our travel schedules. So many times when we were trying to conceive, that app was the ultimate ovulation predictor. Nice to see that Si and Am are still keeping with tradition, even when it's irrelevant.

As it turned out, my patient was actually 20 weeks pregnant, which was fitting with her last menstrual period dating. To a certain extent, she was living my dream; just wake up one morning and discover you're five months into a seemingly normal and healthy pregnancy. Yet, she reacted as if she overslept and was late for an important event. I could appreciate her response. She must have had a sense of disappointment that she missed half of her pregnancy experience. It's quite a contrast to potentially being negative seven weeks pregnant.

11 comments:

  1. Wow! To wake up being 5 months pregnant?! Still amazes me that some people are just... lucky. Thinking of you! XO

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  2. I actually have my period tracker app to thank for gradually noticing that my cycles were getting shorter. Other than that, it was a very happy looking app that made me sad any time I had to open it.

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  3. Dang! I should have tried this just-have-sex app... oh wait.
    I can totally relate to your dream of waking up and being 20w. Even better, 24w. Although then I'd probably freak out about not having taken folic acid or something... but still, for anyone with a history of pregnancy loss this is an amazing scenario.

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  4. OH yes I was like Aramis too that my Period Tracker has been telling me that my cycles went from 28 days to 27 to 26.... Hmm something must have been wrong. I still don't know how you can do your job seeing these clueless fertile people.... Kudos to you. :)

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  5. I think we are living the same life right now (well other than the fact that I am not a doctor). I finally got that fucking smiley face on Wednesday (I swear that thing is smirking at me) on CD37, and that morning I was going to call the satellite clinic to get an ultrasound to see if this was an annovulatory cycle as well. Cheers to both of us finally ovulating and getting on with the FET process!

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  6. In my next life, I want to come back as your patient....

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  7. Five months? How is that possible? Well, man... good for her for being that lucky and props to you for being so incredibly patient. I would have lost it (probably on a daily basis in your line of work).

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  8. I have a friend who'd already had 2 babies find out she was pregnant with her third when she was 5 months along. So hard to believe!! She thought the movements were gas until they became unmistakable. How many patients have you had like her over the years?

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  9. I just can't even imagine. Wow. That's pretty amazing.

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  10. Crazy! I can't imagine being that far along and not knowing you were pregnant. Then having to think back and wonder if you did anything unsafe for the baby. Sigh.

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  11. I can't even imagine. Seriously. Not only to get pregnant without really trying, but that the pregnancy was so easy that she didn't even notice. I think my cousin was about 16 weeks with her first before she found out. In her defense, she had taken a pregnancy test that was negative. Sigh. When will I stop feeling bitter about fertiles?

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