Sunday, February 21, 2010

Where I've been

Adele over at Delinquent Eggs graced me with this Beautiful Blogger award, which was oh-so-kind of her. The rules are the standard Thank, Copy, Link, Tell 7 things, Nominate 7 people. And so I will.

WiseGuy asked me "What's up?" and I'm going to use my first couple for that.

1. I have been writing and data analysing frantically. My dataset is finally finalised and the stats have been run and now comes the process of discussing what I did not find anything significant. That's a bitch with psych reports, one has to discuss both findings and non-findings.  I have to come up with a rationale for my non-findings without completely dissing the methodology of my project, despite the fact that it's most likely the fault of the methodology that it went pear-shaped. I am also writing the second draft of the literature review and to date I have 203 references for this 5000 word paper. That seems a little overboard to me and I am swimming in all the information (oh I wish I had a watery metaphor that made actual sense).

2. I have been planning the Big Guy's 40th birthday. He deliberated for a while as to what kind of occasion he would like and he settled on a BBQ with all his friends and family. That sounded easy enough, but now I am wading through the details of feeding and entertaining the 30+ people who have said they are able to come. Somehow, by next Saturday I have to have amassed a large quantity of food and beverages and have it all ready to roll by 1pm. Salads, marinades, cheesecakes ... here I come.

3. I have been eating and trying not to. In the middle of 2007 I found my wedding dress, it was off the rack, gorgeous and alterable. Which was great because I was a scrawny, bony thing back then. The dressmaker assured me that she would be able to take the dress in, but my mother screeched "arrgghhh, the bones, the bones, you can't get married with a chest like that" and I proceeded to put on weight. Not very healthily. Instead of buffing up and eating protein and getting some meat on me like that, I ate full-fat butter, and cheese and bread and pasta and all the things I did not naturally like to eat. I made my serving sizes larger and larger and made myself eat three times a day and I snacked ... a lot. And by the time it came to my wedding 7 months later, I had gained 5kg (11lbs) and the chesty ribby hippy bones were gone. But alas, did I stop gaining weight? No. Did I return to my sensible eating habits? No. I just kept packing it on. Over the course of the past two and a half years I have gained a total of 25% of my own 2007 body-weight. Horrific. I have love handles and I have a roll of belly fat. Did the IVF help - not one bit! So anyway, I have been eating and trying not to.

4. I have a penchant for crafting, cooking, sewing and baking and all good housewifely activities (except cleaning). I indulge these desires when I can and for the past 8 years I have felt guilty whenever I have been doing something other than studying (with the exception of mid-term holiday guilt-free times). I started this Honours project a year ago and I have had no breaks from it longer than a week (Fiji, how I remember you with love). As such all my indulgent creativity (except cooking which I have to do) has been either stifled or fulfilled with a large dose of guilt. I am really, really looking forward to finishing studying. I shall have my evenings to myself and I shall do whatever I like!!!

5. My husband is the absolute best. I'm not quite sure why he loves me so or why he is so wonderful to me. Suffice it to say that he does and I find myself quite overwhelmed by gratefulness for his affection and kindness. I dated a lot of losers, I even married one of them, and to find this man is a blessing beyond my hopes. That he loved me back enough to risk marrying me is truly amazing.

6. I like to talk to strangers. Mostly old ladies. They're happy to chat and I always imagine myself, old and alone with few people to talk to having a conversation with someone at the grocery store, finding a wee bit of sympatico in a passing stranger. And so I take those opportunities to gab a bit. Whether it be about the beauty of those kittens we're ogling in the pet store window (which leads to a conversation about her cats and how gorgeous the big Tom was) or about the indecisiveness of the Little Guy as he deliberates on which Treaty Tuesday lolly he will have (which leads to a conversation about how few and far between treats were in the old days and what a good idea it is to limit them).

7. My New Years resolution was to seek out social occasions and attend them. To catch up with friends and to be sociable. As part of this I found an old friend on facebook the other day and after she friended me I stalked through her photos. Surprise, she had twins 4 months ago.
In a flurry, a dreadful, terrible flurry I thought a few things.
1 - she probably had PCOS, she was always a big girl.
2 - she undoubtedly had some kind of assisted conception.
3 - it probably worked first time.
4 - she has tiny babies now and I don't.
That left me feeling bereft and jealous and sad and hurting. All those suppositions.
However - - - I went to visit my lovely old friend and her cute Little Boo and Big Boo and found out I was wrong. So wrong. In fact, those babies were an accident. She wasn't ready for kids, wasn't trying and didn't do anything at all to get them. She and her husband bought a house, and two nights later those babies were conceived. At 8 weeks she said she'd felt she was popping out a bit and thought maybe she had her LMP date wrong and so they went for a scan to see when the baby would be due. She said they both nearly died when the sonographer asked whose family twins ran in. I was so wrong. And somehow, strangely, I felt better. I definitely don't begrudge her her accidental twins, but the other way - my imagined way -  I did. How fucked up is that. I did have a nice day talking to my friend who has not changed, and cuddling and feeding her babies and I will return soon to do it again.

So there you are.

I hereby nominate these 7 people for the Beautiful Blogger award: I love their writing, their honesty, their inspiration, their humour.
Marianne at Zen and the Art of Peacekeeping
Jen at Of Cabbages and Kings
Kelle at Enjoying the Small Things
S at Woman Anyone?
Mad Hatter at Late for a Very Important Pregnancy
Frank at Memorie Di Angelina
Eden at Edenland

Oh and Adele, you are so right. I got asked about the predictive value of AMH level for pregnancy and the research I found suggests that while the AMH test is great at telling you how low your ovarian reserve is, it's not so great at specifying which people will become pregnant and which will not (especially if AMH is over 7.8)

A number of authors have tried to identify cut-off levels for AMH that are able to distinguish between pregnancy and non-pregnancy (Hazout et al., 2004; Eldar-Geva et al., 2005a; Kwee et al., 2007; Elgindy et al., 2008). However, the majority of them indicated that AMH measurement is not useful for predicting this end-point (Van Rooij et al., 2002; Fanchin et al., 2003b; Penarrubia et al., 2005; Ebner et al., 2006; Ficicioglu et al., 2006; Kwee et al., 2007; Smeenk et al., 2007). Up to the present, only one study has been published relating serum AMH levels to the live birth rate following IVF (Nelson et al., 2009). In this  prospective study of 340 patients it was demonstrated that the live birth rate dramatically increases with  increasing basal AMH value. However, as concluded by the same author, this finding may at least in part be explained by the very good correlation existing between basal AMH and the number of retrieved oocytes (Nelson et al., 2009), indicating that circulating AMH may definitely be considered a better marker for quantitative than for qualitative aspects of ART.
Anti-Mullerian hormone (AMH): what do we still need to know?
A. La Marca, F.J. Broekmans, A. Volpe, B.C. Fauser, N.S. Macklon, on behalf of the ESHRE Special Interest Group for Reproductive Endocrinology – AMH Round Table Human Reproduction 2009 24(9):2264-2275; doi:10.1093/humrep/dep210

Analysis of live birth rate relative to AMH and FSH quintiles (Fig. 1) demonstrated that although there was a significant relationship between increasing AMH and escalating live birth rate, above an AMH concentration of 7.8 pmol/l there was no discrimination in live birth rates.

If AMH was less than 4.9 then the live birth rate was 15%.
AMH of 4.9 to 7.8 then the LBR was 22%.
AMH of 7.8 then the LBR was 35%+ (normal live birth rate for >35yr old IVFers)
Serum anti-Mullerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles—implications for individualization of therapy. Scott M. Nelson, Robin W. Yates and Richard Fleming, Human Reproduction, doi:10.1093/humrep/dem204

Maybe there's hope for me yet. Maybe.

I saw that Mel had put me into the Lost and Found for my last sad post, hundreds of people read it, and yet I feel like it's a lie.  Not the sad post but the words "is heartbroken over test results which are putting an end to her dreams of having another baby". I got those test results, I am heartbroken about them but my dreams aren't ending. Maybe I'm delusional.


  1. You're not delusional. Or, if you are, then I am too. And I refuse to entertain that possibility. Perhaps its stubbornness. Perhaps the rowers in us have materialized into fierce, combatant TTC amazon women. But I think your attitude is the right one, and I am well pleased with that research you did on AMH. It is music to these ears.

    Good luck with your data and with your husband's barbecue! 30+ people is no small feat. And I hear you about having the evenings free and doing nice things, and not feeling guilty about them. My summer cannot be here soon enough.

    And the IF train serves only high-fat, zero-nutrient munchies. And the meds don't help with that one bit.

  2. Thank you for the nomination, Pundelina! I totally thought I was following your blog, but somehow it didn't end up sticking so I missed your last few posts...All these numbers are such a mindbender (not to mention, heartbender!). I am glad you found the research to prove that AMH just shows quantity, not quality...And I've yet to find any estimates of the approximate correlative number of eggs for each AMH level - for all we know, an AMH of 1 could mean a woman has 300 eggs remaining - who knows, and maybe the doctors don't even know!

    Every diagnosis is so individual, so I don't think it is delusional at all to keep searching for answers and ways to conceive - if we all let every number and everything doctors say to us defeat us, my pregnancy blogroll would be a lot shorter. Don't give up, my dear friend - all it takes is one good egg and one good sperm, and excellent timing! At 37, you have time - you can get there!!!


  3. Nopes, not delusional at all. I have post in complete despair at times, and when I review my posts later, I am able to make out how dark I was. I can obviously make that out when I am over it, or better placed and so on. So I am scream, the sky is falling at some point, but that may not be what I feel later.

    I am wishing that the statistics would translate into a baby or two for you.

    Loved to go through your sheet. I understand your frustration with the literature review, and finalizing the dataset. I am still tweaking my review and simultaneously going through with the data entry, and the latter gets tad boring for me.

    Thanks for the award. I will certainly do it. Actually, you gave me Honest Scrap in January, and I am planning to combine that one, this current one, and the same one that The Pitter-Patter hass given me.


    Happy 40th birthday to your DH!!!

    We want pictures...of everrrything!

  4. Wow, this was a truly fabulous post. I loved learned a little more about you, your loves, your work and your perspective. Thanks for posting about AMH and putting some of the scientific papers in context for those of us who don't have full access/need a little help interpreting the results.

  5. Hey, Pundelina - I was actually the one who submitted the blurb about you for the LFCA - sorry if I misread where you're at; I try to reflect the feeling that I read in the post but it's often hard to distill a whole breadth of emotion into a single sentence. I'll try to do better next time.


"Scout yonder's been readin' ever since she was born." I wasn't quite so precocious but I do love reading comments!