I heart compost

I started writing a post about sustainability in general, but there was too much to say! For now i’ll stick to a short post about how much i love compost. Although sadly, part of my drive to be more sustainable means that i now have a lot less vegetable waste. We used to throw out whole, untouched vegetables as i would over-buy and under-cook. I’ve balanced that out now but as a consequence our compost bin is filling rather slowly.

our current compost bin, less than half full!
our current compost bin, less than half full!

Compost is one of those things that needs a continual amount of small work. Does that make sense? Anyway, what i mean to say is that i can see why it is not for everyone. So for my next experiment i’m going to try and compost our own waste but also another household’s worth.

Step 1: I needed to provide my friend’s house with a bucket. I could pay for a new plastic bucket but that would not be very sustainable. I know that supermarket deli’s throw out buckets regularly. If i could scrounge a bucket for free i would not only save a few dollars but save something from going to landfill. I asked at two Woolies (Australia’s leading supermarket) and got denied. Frankly i wasn’t surprised, although it was a bit odd that i got the same nonsensical answer both times:

me: “hi, do you have any fetta buckets you are throwing out?”

deli crank: “No, we use them” *points to one bucket with spoons in it*

I used to work at Woolies delis, i used to open those fetta/olive buckets and toss them in the dumpster when done. If the supplier took them back, or they were somehow recycled, great!, but there is no way they are all ‘used’, forever, in the deli.

Anyway, odd.

The next store i asked at was the other supermarket chain (Coles), and the guy there was lovely, he went and searched out the back straight away and was super nice about the whole thing, without even treating me like some weirdo hippy.*

the bucket!
the bucket!

Step 2: retrieve bucket on a regular basis. The most sustainable way to do this would be on my bike. I took the bike to my volunteering gig today as per usual. I could have detoured on the way home to pick up the bucket (with it’s first vegetable bits!), but it looked like it could rain and my legs were not up for the hill in the middle of the detour….

Step 3: Build a bigger compost heap! This step is getting ahead of things a little.. but I’m happy to assume that my adventures in collecting my friend’s waste (and potentially more?) will go swimmingly. The most sustainable way to do this would be to go to the tip shop (recycling store at the garbage dump) and pick up some old wood. Done! Although we will need a bit more, and some other bits and pieces, so we’ll still have to go to the hardware store. And we’ll pick up the bucket on the way 😉

our wood haul
our wood haul

That’s it for now, I hope my leg strength increases so that i can pick up the bucket on the bike regularly, and so my friends don’t complain that i have left a bucket of rotting vegetable matter on their hands.
*I actually need another bucket, so that i can leave a spare when i retrieve the full one. Hopefully the nice deli assistant can help me out again.

My DHEA decision

When i found out my ovaries weren’t working i was compelled to find out all i can. It quickly became apparent that POI is just a big mystery and there’s not much anyone can do about it. I also noticed people mentioning DHEA though, in that it’s possibly helpful, although it is controversial.

DHEA (dehydroepiandrosterone) is an androgen, a male hormone. It’s the starting material that testosterone (that famous androgen) is made from, but it’s also a starting molecule for oestrogen. Both male and female humans make it in their bodies. Some people are not aware that females produce ‘male hormones’, but we do, mostly from the adrenal gland, but actually also in the ovaries. And these androgens are just now being recognised as important in ovulation. Walters 2015 is a great resource to learn more (although heavy with biochemistry concepts and jargon): http://www.reproduction-online.org/content/149/4/R193.full.pdf+html

Instead of delving into the mechanistic details of why DHEA might improve ovulation (we don’t know yet), we can assume that it does, and look for data to support this. My review of the data is by no means the most comprehensive, but a few days of work was enough for me to make a decision in regards to my personal situation. I started with a simple search on Google Scholar  with the search terms ‘DHEA’ and ‘diminished ovarian reserve’. Then i limited to only those published this year. This gave me 31 documents to check. A lot of them were review articles, which was handy in that these would report on earlier studies. Others were not actually relevant, in that they only mentioned DHEA or ovarian reserve in passing. My aim was to find recent data that showed the effect of DHEA on ovaries like mine. This turned out to be only 3 studies.

Cui et al. used a mouse model, where the ovaries were damaged to make them resemble poorly functioning ovaries: http://europepmc.org/abstract/med/25790679

I don’t know enough to evaluate if this is an adequate model of POI/DOR, or how closely mouse ovulation mimics human ovulation. These issues should be addressed in the full-text of the article, but i only have access to the abstract. I’m not going to go to the trouble of trying to get a copy of the full text because the results in the abstract are not intriguing enough. The authors state that measures of ovarian function (including anti-mullerian hormone, AMH) increased in the mice given DHEA, as compared to mice who had not. This sounds promising, but perhaps isn’t at all. The authors state the results are statistically significant, with a p-value less than 0.05. This is the bare minimum that needs to be met in terms of statistically comparing two results ( of the mice treatment groups, in this case). But the authors don’t actually state the p-value, or the size of the result. This makes me think that the difference between the groups was very small. Additional evidence for this is that they state that AMH etc. increased in the DHEA group compared to the model group (with damaged ovaries). But they also had a ‘normal’ group, without damaged ovaries. Supposedly then the AMH etc. was a little higher than the model group, but not as high as the normal group.

If you are thinking, ‘well that’s ok, every small improvement is worthwhile, you perhaps can’t expect the treatment to completely reverse the damage and restore normal hormone levels’. But that is only one way of interpreting the data. We know all of these hormones fluctuate (even AMH!), so this small difference could very well just be ‘noise’, i.e. chance is involved because there is natural variance, there is no actual increase, it just appears that way.

Long story short, although i haven’t even seen the data, there is no strong evidence here (that’s what i’m after).

The next study was Tsui et al. http://www.tjog-online.com/article/S1028-4559(15)00025-X/pdf This one was very helpful. The entire article is available for free, and it includes a review of other studies done as well as new data. This data also purported to be promising due to small changes in ovarian function in patients who had low ovarian function. One obvious limitation of this study, is that there is no control group, another is that it is small (just ten patients). In fact this study closely resembles other studies on DHEA that have been criticised for the same reasons. At least this study was prospective. In terms of comparing to my own personal situation, these patients were not that ‘dire’. An FSH (follicle stimulating hormone) of ~15 IU/L is still within the normal range. And while an AMH of ~0.4 is a concern, it’s not the worst case. It was interesting to see that the inclusive criteria in the other studies (presented in Table 2) were similar. My conclusion therefore is that better studies might be warranted to improve the chances for ‘poor responders’ (not exactly the same as DOR/POI) but for those of us with menopausal hormone levels there is still no evidence that DHEA could help.

Thirdly, Vlahos et al. http://www.rbmojournal.com/article/S1472-6483(14)00551-3/abstract They state some hormonal improvements, although similar to the first study the size of the effect is conveniently left out of the abstract. I don’t have access to the full text but i will take on board their comment about ‘uncertain effectiveness’. This conclusion keeps on being mentioned, as in the review of Vardos et al. (http://www.rbmojournal.com/article/S1472-6483(14)00551-3/abstract) , who state: “Unfortunately despite the lapse of 5 years since the last publication, there is still a lack of robust evidence for most of the adjuvants searched and large well-designed randomised controlled trials are still needed” in reference to DHEA as well as other treatments/adjuvants for fertility.

Overall, there is just not enough evidence for me to bother trying to get my hands on DHEA. I’m glad i double-checked this as an option, and learnt a lot about ovaries in the process!

Since drafting this post i’ve read even more about DHEA. My decision is still the same, but there should be another DHEA-relevant post coming soon.

On being healthy

Historically, i haven’t been too fussed with being healthy. I’m naturally thin, so after i’d moved out of home in my 20s i ate plenty of junk (rebelling against my healthy upbringing). I’ve never been sporty, i get out of breath very easily, and muscle sore from low levels of exercise.

Entering my 30s did make me start thinking about fitness and health though. Although still slim the weight was creeping on, and the energy levels were dropping. After getting married i also wanted to get fit before getting pregnant, as i figured it would be harder afterwards. Then i found out i was infertile, and then i stopped working, so things just coincided that i could spend a lot more time and energy into improving my general health.

I don’t actually think my fitness or diet has much to do with my infertility. Maybe i’m just genetically programmed to have kids at an earlier age or not at all? Maybe something in my body has been altered so that no more eggs mature? Some scientists used to think women with POF had higher rates of follicular atresia* than normal women, which might account for a faster decline in ovarian reserve. But i am motivated to get the most out of life (whether childless or not), so being healthy sounds like a good idea, especially as high-energy hedonism doesn’t really do it for me anymore.

In terms of short-cuts to health, I’m pretty sceptical of supplements, i’ve always seen vitamin tablets as a waste of money. There seems to be plenty of evidence around that moderate exercise and a healthy diet will do you more good (and for your wallet too!). The same goes for ‘alternative therapies’. I just don’t want to spend money on them, especially now that money is tighter, with my husband and i living off his wage only. Mostly though, i’m just not happy to let the placebo effect to do the work, too sceptical for my own good perhaps?

In between my March and June appointments (with the gyno/infertility specialist) I tried to ‘amp it up’ in the healthiness stakes. I figured it could be an experiment. If i put maximum energy into getting fit, would my measures of fertility increase? (In terms of hormonal measures, i just got the March results, and will see some June results in July). In my head i imagined superwoman levels of dedication and effort. In reality, i put in a little more effort than i ever have, but still nothing like approaching the training of an actual athlete or fitness junkie.

These are the things i have done:

  • cut out alcohol for nearly 3 full months!
  • one term of yoga
  • heart-rate increasing exercise about 5 times a week, usually walking up the steep mountain(hill) near my house, or bike riding, sometimes soccer
  • maintained same healthy-ish diet, lots of veggies, cut back on chips (a little?), still plenty of olive oil and cheese
  • some supplements: iron tablets for a while (not currently), fish oil, folate
  • improved my mental health

So basically, cut back on the alcohol and increased exercise. The alcohol was an odd one. We knew we were drinking too much (I found my last job really stressful, and drank to compensate), so i expected to feel wonderfully better just by cutting out alcohol. It certainly helped, in terms of exercising more often (less hangovers), but it didn’t bring the renewed sense youth and vigour that i thought it might. I think it did help me lose weight, and we saved plenty of money! And best of all, we now find that we’re not going back to the old habits of reaching for a beer every evening.

The iron tablets were because my husband is a vegetarian so i thought i could do with a top-up. I had had my iron tested last year at a bulk-billing/free clinic, and my levels came back as at the lower end of the normal range. It’s probably better to rely on getting it from my diet though, so i’ll just try and remember to eat some meat every now and then (a small amount once a week?). My favourite at the moment is the smoked kangaroo from a local place, it’s really good on pizza or in wraps. The fish oil tablets are purely because a friend gave them to me for free. She had used them during her pregnancy, but had a nearly full, large bottle left over. They make my poop softer and smellier (i’ve noticed when i miss a day, sorry for the TMI), so i’ll finish the bottle but not buy any more. Folate is obvious, i’ll keep taking this one (even though i try to eat lots of leafy greens), just in case i ever get pregnant. I made sure to get the non-pregnancy one though! I’m joking, i just mean i didn’t buy the (pink) bottle that said “Folate for pregnancy and conception” because that is 4 times more expensive than the bottle that has exactly the same amount of folate but isn’t marketed solely to worried mothers to be.

The last point is the one i’m really concerned about, and motivated to do something about. I have lost about 5 kg since the start of the year, which is lovely in a vain way. But I’ve done it gradually and in a relaxed manner, because if there is one thing i want to avoid it’s needlessly stressing myself out. Last year i had high anxiety, and even though i didn’t like the idea, i went on an SSRI (selective serotonin reuptake inhibitor) drug for 6 months because i had to do something. Things had gotten to a point where so many little things bothered me, i was just tense all the time and wasn’t enjoying much of anything. This contributed to me losing my job (it’s ok, i didn’t want that job anyway), so then for the last three months of last year i just ‘relaxed’. It’s actually sort of tricky to relax when you’re stuck in a cycle of anxiety and overthinking things. AND when you’ve found out you’re infertile, and you wonder if all the stress you are putting on yourself (which you can now feel physically in your run down body) is affecting your reproductive organs. So i took a while to do little, and to try and enjoy it. Don’t get me wrong, at times i could be really grateful that i was in a position where my husband could support us financially. Sometimes i could lie in the sun like a cat and just bliss out.

Sometimes i would feel guilty that i should be contributing more to society, but at the end of the day i don’t really buy that. In the end what spurred me into action was that i had to feel like i was someone. I could spend my days cleaning house, reading good books, generally not getting in anyone’s way and that wouldn’t bother anyone. But it started to bother me. Earlier, I had to strive for some calm in my life, and once i got that i realised that optimal mental health isn’t just calm and bliss. Life doesn’t have to be a desperate struggle but there will always be some struggle. I think the goal is to strive at something, but have the resilience to deal with set-backs, failures, disappointments etc. I had gotten caught up in worrying over the things in my life that were going terribly (and oftentimes things in other people’s lives too! and the world at large!) instead of just focusing on what could work for me. Hopefully this blog will help sort some of that out.

Anyway, the main point i wanted to make was that for me a healthy lifestyle is all about feeling good about your lifestyle. Exercise is undeniably helpful. I’m definitely the type of person prone to sloth, who complains to myself when it’s time to change into my gear and get moving. But each time i feel better for it, not always physically, but always mentally and emotionally. It helps that i have access to my chosen best form of exercise, walking up mountains; it’s free, you get fresh air, on the steep bits my heart rate really gets going, it’s weight bearing too, i get to say hello to my friends who live on the mountain (parrots, kangaroos, lizards and sometimes the shy echidna 🙂
201505xxtreesonMajura20150515lizard*https://en.wikipedia.org/wiki/Follicular_atresia

Hormones update

So i had my AMH re-tested in March, but had to wait 3 months to be told the results. When really i would have liked to know straight away if my AMH had changed at all, from undetectable(!) in August last year. Finally! the time for the appointment rolled around. It was a little frustrating, a little bit of a pleasant relief and a lot confusing.

Frustrating, because my doctor was reluctant to share my actual results with me. Yes, i would like your job, but don’t worry i think it’s safe (is what i should have said to her). In the end i asked for a print out, and had to pore over the actual numbers in my car after i left the clinic. In the consulting room i got her interpretation of the results, put here into my own words for brevity: your fertility still sucks, you’d better watch your calcium intake (take supplements, make sure to get the ones with vitamin D), i’d advise – do nothing, we’ll run the tests again and see how you’re going, don’t forget time is running out if you want to consider donor eggs, and even more so, if you’d like to adopt. Oh and she forgot that i was married to a man, because when i was asking questions about hypothetical donor eggs she interrupted with ‘well, you need a man!’. I guess sometimes i dress like a lesbian? Anyway, i don’t blame her for forgetting which patient i was, she’s only seen me three times in 9 months, and doesn’t think there is anything much she can do for me. At least when i asked about DHEA , she admitted that she doesn’t know much about it, but gave me a referral to another doctor who may know more.

The pleasant relief was that i wasn’t urged to go on HRT (hormone replacement therapy). 3 months earlier in March this was suggested as something that I might have to take to maintain my general health, even though it might mean dropping my chance of pregnancy from 5% to 0%. I still got the talk about calcium supplements and osteoporosis, and got asked if i was feeling menopausal (ugh. not a pleasant question to have to answer, even when the answer is no). So i was surprised when i looked over the results myself later that my oestrogen (oestradiol to be precise) looked much better than it did in August, at 138 pmol/L (normal range 90-3000, depending on stage of menstrual cycle; mine was

And the confusing part, of course, is the one i was really curious about, my AMH test. The doctor distinctly said “you have had two readings of 1, which is not good”. But the print out she gave me stated 0.2. At this point the rollercoaster kicked in. There is no point denying it, and no point being ashamed but i initially got quite excited about that result. My initial thoughts were “Oh, they must have switched to the other unit of measurement. Odd. But, hooray! 0.2 is still very low, so i shouldn’t get excited really, but it is an increase!”. Australian labs use the pmol/L unit, whereas US labs use the ng/mL (or microgram/L), the conversion factor (based on the molecular weight of the AMH protein) is about 7.14. In fact, i got so excited that i drove to my husband’s work to meet him on an early lunch break and explain the news. That’s where the rollercoaster took a dive, as i noticed the ‘pM’ next to my result. See what excitement can do? It makes you miss important details that might mean that the result is not as exciting as you thought. I was explaining to hubby that they must have switched units, then i pulled out my old results and saw that the previous unit was pmol/L (in my excitement i had forgotten which one was used here!). ‘pM’ can stand for ‘picomolar’, which is another way of saying pmol/L (picomole per litre). So then i was deflated but only actually for a brief moment.

Firstly, the limit of detection in the AMH assay is higher than 0.2 pmol/L, that’s why I was told i had an undetectable result, which was stated as 30 pmol/L). The March result was followed by “3.1-34”. Huh? This isn’t the correct range using either unit of measurement!! I guess the most likely explanation is that a few typos have crept in somehow. Maybe my result was actually 2 pmol/L?!? (this would still be very low, but even higher than 0.2 ng/mL, which is still only about 1.4 pmol/L).

The only place left for the rollercoaster to go, was to roll back to where i had started, on even ground. I’d been waiting for months to look at this little number and then wonder what it meant. Now, what it means is even less clear than i thought possible, but actually, i ended up looking uphill. Because the whole confusion confirmed for me that the doctors have no idea either, and perhaps the AMH test isn’t going to help me that much, and i should just carry on carrying on 🙂
Oh, and my FSH (follicle stimulating hormone) looked better 🙂 51 in August, 42 in March (i also had a result from last July; 44,  and the July result was the only one tested on the correct day 3 of a menstrual cycle). So perhaps some of the healthy living is paying off? I’ll save that full discussion (what i’m doing to try and be healthy etc) for the next blog post!

* http://humrep.oxfordjournals.org/content/27/10/3085 doi: 10.1093/humrep/des260

I don’t have a cartoon for this post (ooh, i should have drawn a rollercoaster!), but here is a random beetle instead:
durras jan 08 005

Ovarian insufficiency

My infertility timeline:

Ages 17-34, using contraceptive pill most of the time

July 2013 – stopped contraceptive pill, trying to conceive (TTC)

Mid 2014 – wondering what is taking so long, see a fertility specialist to see what’s wrong

August 2014 – undetectable AMH result,

August 2014-May 2015 – two long occurences of amenorrhea (15 weeks and 12 weeks) but otherwise menstruating

Infertility blogs are really useful to someone who has just been diagnosed with infertility, with plenty of details regarding what to expect if you are going to try ‘stimming’ or IVF or other assisted reproduction. However, they are mostly useful some time after you have gained some sort of understanding of the options and processes. I went into this knowing very little at all. I wasn’t even familiar with the term ‘assisted reproductive technology’ (ART)! (the broader term that encompasses IVF as well as other procedures/treatments). I wasn’t even really thinking of seeing a specialist till i mentioned to a GP (primary care physician) that we had been trying to get pregnant but that it was taking more than 6 months.

I like trying to figure things out, so i thought it would be cool to see a fertility specialist so that I could figure out what wasn’t working. I wasn’t totally naive, i had heard of ‘unexplained infertility’ and that in general women have lower fertility after the age of 35. I wasn’t worried though, i was still 34! Plus, i had friends who had had their first babies after the age of 35 (not very scientific thinking, but complacency happens). I’d also had too much stress in my daily life, so i was hoping that perhaps this was why my hormones might be ‘a little out of whack’.

Initial tests were done and nothing was too unusual except the doc seemed to think that my FSH (follicle stimulating hormone) result was too high, and was perhaps a lab error. At this point, if i had done some prior reading, i would have known that she was trying to assess my ovarian reserve. The next appointment was much shorter, my FSH had been retested and my AMH (anti-mullerian hormone) also. The doctor was quite blunt, telling me that i wouldn’t be able to have my own children, although i still had the option of donor eggs, although that is quite expensive. There wasn’t much else in the way of explanation, just to think things over and then see her again in a few months.

I had gone into the appointment simply wishing to try and figure out why i hadn’t gotten pregnant. It was a huge decision for me to try to conceive in the first place. I was finally at a point in life where i had some financial security. I was willing to investigate my fertility because i had heard that sometimes it’s a simple issue that can be easily medicated (maybe i just have to take some clomid?!). I wasn’t really looking forward to be told that it might be a lot more complicated, with IVF as an option. I really thought it would come down to these two choices. Some simple imbalance, with a simple treatment, or a major issue with an expensive treatment.

Instead, i was told that i didn’t really have options. I couldn’t even contemplate donor eggs, it was just such a foreign idea. This was a huge shock, one that i am still trying to get my head around 9 months later! And a reason for that is that denial was my first reaction. I knew that “this can’t be right, i need to see the actual data”. So when my emotional state allowed, on and off over the last 9 months i have checked all the data i could get my hands on (hooray for open science!). This is what i have learnt (in summary form):

AMH decreases with age. If you google “AMH test” you’ll easily find helpful fertility websites that tell you that AMH is the most up to date test to measure what is referred to as your ‘ovarian reserve’. Some sites will simplify this as ‘how many eggs you have left’ but it is a lot more complicated than that. It is said that ‘AMH decreases with age’ because fertile younger women generally have more AMH (circulating in blood) than older women. This can be seen in Figure 1 of van Rooij et al., where women with proven fecundity had their AMH levels tested with a resulting inverse correlation with age (full paper in link):

DOI: http://dx.doi.org/10.1016/j.fertnstert.2004.11.029

This wasn’t the hard data i wanted to see though. Figure 1 from van Rooij et al. (and similar data sets) shows a snapshot in time of a population of women. Figure 1B in Anderson et al. 2015 (doi:10.1016/j.fertnstert.2015.01.004) shows a similar data set, although the shape of the data is a little different, in a telling way. The relationship of AMH vs. age is ‘flatter’ with more data points at close to zero AMH, at younger ages. This is because the study population in Anderson included infertile women, whereas the van Rooij study did not. So AMH decreases with age, unless you are young and it’s already low, in which case your ovaries resemble that of a menopausal woman (and your reproductive chances likewise?). This is the manner in which my doctor was interpreting my AMH result, except for one small, insignificant point that had to be mentioned. Sometimes women with POI/POF/DOR ‘spontaneously’ get pregnant! eg. for documented cases see: http://humupd.oxfordjournals.org/content/5/5/483.short

This means that although women with POI hormonally resemble menopausal women, it is not the same thing. Women with my symptoms (amenorrhea, high FSH) used to be told they had gone through, or were going through an early menopause (before the age of 50). Although my diagnosis came as a shock, it was a tiny bit less of a shock because of the added disclaimer of ‘you may have a small chance of falling pregnant naturally’. The implication of this is that for some women they haven’t stopped ovulating forever, they’ve just stopped ovulating for a while. And that is why the population snapshot data was frustrating for me, when what i wanted was longitudinal data! Ok, so some women have low AMH for their age (which essentially means their ovaries are not growing follicles, which in turn are not growing eggs, see http://www.reproduction-online.org/content/131/1/1.short doi: 10.1530/rep.1.00529 ). But, in a single woman, can her AMH level fluctuate? Can my prematurely aged ovaries act their age again?

At this point hope can interfere a great deal. I kept on thinking about this question on and off for 9 months, but it was difficult. I knew that it was an arrogant question (I had been told that the chances were not good, but i doubted that). It doesn’t help that there really isn’t much data to go on. AMH is a convenient test as it is not supposed to vary much over a single menstrual cycle (therefore you can test on any day). Overbeek et al. 2012 shows that for some women this is not always true and some large variations can be seen (doi:10.1016/j.rbmo.2012.02.023). Hooray! Data that shows that AMH fluctuates. But the disappointing thing for me is that for women with very low AMH (close to zero), they had the lowest variation. But what about over multiple cycles?? This aspect was tested by Fanchin et al. 2005 (http://humrep.oxfordjournals.org/content/20/4/923.short doi: 10.1093/humrep/deh688) where AMH was tested for 3 months but the data is presented in an aggregate manner, so you can’t see the variance for any single patient*. I couldn’t find any more data on the manner. The assumption remains, once your AMH has dropped, and your ovaries are not functioning, that’s probably the end of the story.

However, if you search for ‘increase AMH’ online, you will find plenty of anecdotes about increases in AMH (eg. http://www.reddit.com/r/infertility/comments/2dcm6n/amh_increased_advice_appreciated/) as well as plenty of unscrupulous sites trying to sell you something to increase your AMH. DHEA supplements are controversial, I aim to write a whole separate post on that issue**, perhaps one on vitamin D too. Also, i’m aware of the book written on this very question: ‘It all starts with the egg’, which i will get a copy of soon, and will write a thorough review of. But for right now, there is not much real data to give me much hope, so i am bracing myself for another appointment.

the question at hand
the question at hand

*I aim to expand on this point later, in a post where i’ll ponder personalized medicine.

*this has already been done, and perhaps done well, here: https://infertilechemist.wordpress.com/2013/07/04/supplements-part-i-dhea/

Introductory

Hi. I’m Peggy and this is my blog.

Expect plenty of talk about living sustainably, enjoying the small things, pondering the big things, avoiding negativity but embracing evidence and science. Oh and i’ll throw in a few jokes here and there.

My first few entries will be about dealing with infertility because that is something which has been heavily on my mind since i found out my ovaries are not working. I’ve known for 9 months (ha!) and my first thought was “right, let’s look at the actual data and see what can be done”. So i delved into the scientific literature and proceeded to do lots of reading around ovarian function. From the start i aimed to condense what i learnt** into a blog post that was worthy of sharing, but i shouldn’t have been surprised that it has taken me longer than i had imagined.

I have primary ovarian insufficiency (POI), also known as primary ovarian failure (POF) or diminished ovarian reserve (DOR). And choosing a name for this condition is not the only confusing aspect. But even more notable than following the confusing and contradictory science, are the interfering emotional states that have at times paralysed me or at least distracted me. I am trained as a scientist, so i have experience in reviewing scientific literature and distilling notable points therefrom. But this is the first time i’ve attempted doing that in regards to my own ‘disease’. Infertility is a difficult issue in so many ways, but at least it doesn’t come with a death sentence for yourself, only for potential offspring. This journey of discovery has given me some insight into the rollercoaster of hopes and fears that someone with a more debilitating diagnosis must endure. The issue of ‘hope’ deserves a whole blog entry on its own.

Suffice to say, hope, and no small measure of desperation can easily drive a patient into looking for ‘cures’ and there are bucket loads of pseudoscientific ‘treatments’ or advice. In any area of science there are more unknowns than knowns, so it’s always going to be tempting to think “well, they just don’t know what is going on here, so there is a chance that X will help me”. But i really, really dislike pseudoscience. In the ‘research stage’ of writing this, i was glad to see some backlash in social media and the traditional press against ‘wellness bloggers’ who profit off buoying hopes of others (whether they hope to lose weight, ease chronic disease or more). It’s dangerous territory, that can easily invite vitriol and i aim to distance myself from any accusations that i am providing unfounded advice. It’s actually funny that i feel i have to say this upfront, considering that at the moment i don’t have much advice for myself! But, i’m going to try and figure it out, and the aim of making this public is not to let people know ‘what worked for me’. I’m sure most of it will actually be along the lines of “crap, this is hugely confusing, and i keep going from points of hope or moments of clarity to getting depressed about it all the very next day or angry with myself that i’m even thinking about it too much!”.

And that, after all, is a good reason to write all this down and share it. Lighten the load 🙂

I apologise for the lack of jokes in this introductory entry, here is an artists impression of my ovaries:

sultanas
not juicy and fruitful

*Not my real name

**This is correct English, the American English translation is: learned.