The Next 3 Months

Let’s be real. I’m not going to promise to give up caffeine or alcohol. And I can’t guarantee I’ll remember to take my vitamins every day.

But just because I can’t manage to do it right all the time, doesn’t mean I can’t do better. When it comes to my health, I know I can do better.

One idea I really liked from the “Making Babies” book was to think of the three-month program as a premester – the very first trimester.

But honestly, I don’t like focusing on making my body “baby ready.” As exciting as pregnancy would be, having it as a goal is kind of a downer. I would rather think about making my body healthy and strong and “life ready.”

Regardless of whether I have a baby, I do have a life and I have this body for living it.

Lucky for me, this Saturday, October 1st, is the perfect time to start a new premester. We have exactly three months left in the year, three months to prepare for 2012.

It’s actually a little bit thrilling to think about the next 13 weeks as wide open space for making dreams come true.

What do you want to accomplish before the year comes to an end and the next one begins?

How I did it

I'm not sure how many people might be interested in how-to-get-pregnant advice from a person who did finally manage to get pregnant but then miscarried. Nonetheless, that is what this post is about today.

First, I'll just say that most of what I did was on the advice of the book we've been following -- Making Babies. I have no idea if the things I did actually led to conception or if they might work for you. But I believe it can't hurt to try. 

-  Over the course of a year, I went completely organic. Organic meat, dairy, and fruits/veggies. The book says: "Eating organic allows you to avoid the pesticides, chemicals, synthetic additives, and other agents contaminating so much of our food supply and wreaking havoc on our health. ... In terms of fertility, many agricultural chemicals, as well as the hormones given to animals raised for their meat, milk, or eggs, affect hormonal balance. ... Some studies even show that organic foods boost fertility." One study showed that men who ate a diet free of pesticides had sperm counts more than twice as high as those of a group with a nonorganic diet. 

-  I went on a 21-day raw vegan cleanse about a month and a half before I got pregnant. I’m not positive, but I imagine it’s possible this reset something in my body. The cleanse I followed is in the book Crazy Sexy Diet. It promised to get rid of the acids in my blood, detoxify my body and balance pH. Balancing pH is a big deal in Making Babies, too. As a reminder from one of my previous posts, pH is the measure of acidity or alkalinity in a substance, including our bodies. Making Babies says your cervical mucus needs to be alkaline in order for sperm to survive long enough to fertilize an egg. If it's too acidic, it kills sperm. Furthermore, Making Babies says alkaline foods that will create friendly cervical mucus include fruit, vegetables (especially leafy green vegetables) sprouts and wheatgrass. Acidifying foods include meat, dairy, grains, alcohol, coffee, and artificial sweeteners.

-  I took holistic, organic prenatals and B-complex vitamins, flax seed oil, baby aspirin and chlorophyll. The holistic vitamins I take are by New Chapter and available at Whole Foods. Disclaimer: They are extremely expensive. Here's what Making Babies says about some of the supplements I take: "B vitamins are important for the release of the egg and for implantation and embryonic development, making them particularly important in phases 3 and 4 of a woman's cycle. A deficiency of vitamin B has been linked to anovulation (lack of ovulation. ... Vitamin B6 helps the body produce progesterone and metabolize excess estrogen." Additionally, the book says, B12 can improve low sperm counts in men. Flax seed is considered an essential fatty acid, which is crucial for healthy regulation of hormones throughout the body. This supplement (any supplement that has a good combination of Omega 3s and 6s) is considered the most important supplement you can take after a prenatal. Chlorophyll helps build red blood cells and its "high magnesium content ... boosts enzymes that restore the sex hormones. In fact, American farmers have been known to give their cows wheatgrass to restore fertility." The book also says chlorophyll helps build up the uterine lining. I take this supplement in liquid form, mixing it with water. Lastly, there's baby aspirin, which I often take on the advice of my cardiologist because I have an enlarged heart valve and arrhythmia. However, Dr. David, one of the authors of Making Babies, says he advises most of his patients to take baby aspirin because it can improve blood flow to the uterus and placenta and prevent clotting that can interfere with implantation. "Many women have problems with implantation that are hard to detect or pin down, and aspirin can help. It is not likely to hurt the mother or fetus." David advises women stop using aspirin after the first trimester. You should consult your doctor before beginning a daily baby-aspirin regimen.

 -  Around the time that implantation likely took place, I was doing a lot of walking (at BlogHer). The book says "...the newest research shows that moderate exercise actually benefits fertility. One finding to emerge from the Nurses' Health Study was a reduction in the risk of ovulatory infertility with exercise. Hitting the gym three to five times a week could bring the risk down by as much as 25 percent or more." There are really too many benefits of exercise to mention here. The book does say you shouldn't exercise too intensely, as that can cause you to become anovulatory.

-  I’d quit eating/drinking all artificial sweeteners. I’d switched to using agave nectar in my coffee and if I wanted a soda, I had one every few weeks – a real, full-sugar soda. "The artificial sweetener aspartame has been linked to infertility and birth defects, as well as cancer. Everyone would benefit from avoiding it. While you're at it, skip all artificial sweeteners -- they make the body too acidic." 

-  I cut out tons of gluten. My husband found out he is sensitive to it a little over a year ago, so we really don’t have any in the house. There's nothing in Making Babies specifically regarding gluten, although the book does advise that people with my fertility type cut back on carbs.

- I cut way back on caffeine and was drinking one cup of coffee in the mornings. "Caffeine can decrease the flow of blood to the uterus, which can interfere with implantation. Too much caffeine may increase the risk of clotting and miscarriage. ... Coffee is acidic and can make the body and the cervical mucus acidic, too. Several studies have concluded that coffee (with or without caffeine) diminishes fertility. A recent large Dutch study determined that four cups of coffee a day lowered a woman's chances of having a baby by more than 25 percent." Yikes! 

-  I sat in the sun for 20 minutes a few times a week, starting in the spring, to get more Vitamin D. This vitamin protects sperm and eggs against genetic damage and supports the production of estrogen. "In some cases, bumping up vitamin D intake to adequate levels can restore ovulation in women with polycystic ovarian syndrome." If you're curious about your vitamin D levels, ask your doctor to test you! My last test showed a severe deficiency. 

-  One evening on the cycle we conceived, we did our “business” and then I went to sleep right afterward, without getting out of bed.  We also conducted some additional business after ovulation, which is a bit unusual for us but may have been the success factor in this case. This follows my friend Michelle’s dad’s method to an extent, although this was before she’d told me about his method. Click here to visit the post about his tips. 

What I didn’t do, but thought for sure I would need to do in order to get pregnant, was lose weight. I can't help but wonder if I was in better shape if things would have turned out differently. 

I had also completely abandoned tea when the weather warmed up. I’d been drinking raspberry leaf tea for a while but gave that up in the spring. I think I'll re-incorporate that. I'd actually started drinking lots of it before the miscarriage happened in an effort to stimulate the uterus to do its job. While I don't know if it helped, everything did go really well.

In any case, I hope that this helps someone out there who's not sure what might be preventing herself from conceiving. Here's to having fun trying, and trying again.

Trust Your Gut

I officially have low progesterone, and one fewer doctor.

I also have a renewed commitment to trusting my gut.

I had promised myself to only do what felt right following our foray into assisted reproduction. Too many times I had let myself be talked into or out of things by someone in a white coat to whom I was paying a large amount of money. I promised myself that this was my body, and my money and if I was going to try to get pregnant again it would be on my own terms, and only with things I wanted to do, that I really believed would work.

Then I met my naturopath and that all flew out the window.

Looking back now, I can admit that I was uneasy the first time I met her. Without so much as a history taken she had me try progesterone cream, and said things like "you can feel it working already, can't you." I didn't know what I was supposed to feel working, but I agreed. After all, I had been told this woman was really good at treating women outside of the bio-medical model, and the book she had me read before the visit really spoke to me. Also, I wanted to believe this would be the magic bullet. I didn't even mind that the first consult was 4-hundred dollars and that she didn't take insurance. I told myself any unease was because I just didn't understand her methods yet.

For the more than a year under her care I was on Metformin, progesterone, spironolactone, and a thyroid drug. For all that time I went to see her every two months and she would tell me how much better I was looking, how much more energy I had, and how my body was aligning itself. When I had a problem she would tell me it was a cyst and give me a progesterone shot. For more than a year I saw no real changes in my body, or my reproductive health. Still I agreed with all her assessements when I sat in her office. I wanted to believe.

Then I asked her for the progesterone level test. She said no, not until another consultation. And my eyes flew open.

I went to the web and actually looked up all of the drugs she had me on. While they can help, the levels she prescribed were too low to do anything. I also learned that no one really prescribes progesterone cream for an imbalance because the dose is too low and delivery inconsistent.

After I was done banging my head against a wall screaming "damn it, what happened to trusting yourself" I called my regular OB to see if she would order a progesterone test. She did. No big deal. When it came back low she called in a prescription for progesterone pills I will start on next cycle. No big deal. And she did it all without trying to convince me she was right.

Even better? I didn't have to convince myself.

A miscarriage primer

There is a lot of information about miscarriages on the Internet. And a lot of misinformation, unfortunately. As I expect many women who are preparing to miscarry naturally do, I scoured the Web for any and all information that might be available.

If the Internet was to be believed, I could expect the worst pain of my life -- worse than real labor! -- in addition to vomiting and probably passing out unconscious on the bathroom floor.

What I think is probably true is that miscarriages are different for every woman. I'm certain a lot of it has to do with how far along the pregnancy was.

So what I'd like to do is explain, without reserve, the details of my own miscarriage in case there is a woman out there who is going through this same thing and is, perhaps, a little terrified by what she's read on the Internet.

Now for starters, I'm not going to leave out the dirty details that I feel lots of Internet miscarriers leave out. That is to say: I had diarrhea every day for 10 days before the miscarriage. This may not be normal, but this was my experience. 

I'd been spotting off and on for almost two weeks before I started bleeding, like a period. The bleeding began four days before the miscarriage.

The evening before the miscarriage, I was feeling pretty good but there was definitely a tightening in my abdomen; some cramping that I could feel growing stronger. I went to bed around midnight. 

I woke up at 3 a.m. with strong cramps. It felt like very strong period cramps. I knew this must be the beginning of the miscarriage, and I got up to go sit on the toilet. First there was more diarrhea - joy! About twenty minutes later, the first chunks of uterine lining slipped out.

Now, what I guess I hadn't anticipated was how that was going to feel. It felt larger than I expected. I didn't look at it; I just flushed it. And then I cried for a good ten minutes.

I'll interject here to say that while the cramps were painful, and the contractions did ramp up over the next three hours, at no point did I feel the absolute need to take the Vicodin my doctor had prescribed. This was not the worst pain of my life, and I am sure real labor will be worse. That being said, the embryo had died at 6 weeks, 4 days, so it was small.

So over the three hours of the main part of the miscarriage, I had contractions in waves. I would sit on the toilet, push out a chunk or two, get up, walk around, drink some water, lie down for a few minutes, and then repeat. The worst part of the whole thing was probably the back labor -- a deep ache in my lower back that was very uncomfortable.

*Note -- I think staying well hydrated during this process helps keep things moving.

I did finally take a look at what was coming out and I'm sorry if this grosses you out, but it looked like pieces of offal. Chicken liver and such.

At 6 a.m., I was too exhausted to continue. I was still cramping, but the cramps had leveled off to a level I thought I could probably sleep through. And sleep I did, until noon, getting up once to change my pad at 9 a.m.

Throughout that day I had some cramping, especially in the early evening, when it got so bad I did consider taking the Vicodin. Luckily, after about two hours it had stopped.

On Monday I was feeling physically pretty good. I still had some niggling aches in my lower back, but it wasn't constant. I decided I felt well enough to run some errands. About 30 seconds after I walked out of the house, I felt the amniotic sac slide out.

I am quite certain it was the amniotic sac because it was large -- about the size of my hand -- and grayish in some areas. Parts looked veined, if you can believe it. In all honesty the thing creeped me out so bad I could barely look at it. Another reason I'm quite sure this was the amniotic sac is that the cramps stopped right away. Everything I've read on the Internet has said the sac is the last to come out, and as soon as it does, the cramping stops.

I have an appointment this afternoon for an ultrasound. I fervently hope everything came out. I can't have gone through all that, only to then need a D&C.

Physically, I'm feeling decent. No more nausea, thank goodness. I do still feel a little fatigued, which is probably to be expected, and I've unfortunately developed pupps rash -- a rash pregnant women sometimes get after labor. It's quite itchy and annoying.

Emotionally I am relieved. I feel that now that this is hopefully behind me, I can move forward. Not just with trying to conceive again, but with other areas of my life. This experience has helped me reevaluate the way I've been living, and it's lighted a fire under me to be more ambitious.

As far as when we will try again, I don't think that emotionally I can do it right away. My current plan, barring any unforeseen change of events, is to wait until January to try again. I hope that by then I can get to a healthy place where I feel completely ready to embark on this journey once more.

Ragey

Ragey is a word I learned from Erin. I’m not sure if it has been officially added to Webster’s, but my personal definition is angry + crazy. To me, ragey is more than being mad. It’s being mad + slightly to severely unhinged. Thank God this is not how I feel all the time. It’s not even how I feel most of the time. But it is how I have been feeling for a couple of weeks.

I’m pretty pissed off, and I can’t fully explain why. Everything feels like an injustice. Everything feels like a struggle. Libby’s experience with her doctor makes me want to scream. Erin’s miscarriage makes me want to cry. Circumstances in my own life (related and unrelated to fertility) make me want to scream and cry.

The other week I had a full-blown, can’t-stop-crying, teenage-like breakdown in front of my dad. It was ugly and embarrassing, and he asked me twice if I was on my “monthlies.”

I have a friend whose primary symptom of pregnancy is emotional outburst, so after spending a day in tears, I took a pregnancy test. Negative. Since I still felt ragey a week later, I took another test. I’m only slightly exaggerating when I say I could hear the test scream NEGATIVE. It was so rude I felt like slapping it across its face.  To my credit, I managed to refrain from brawling with a pee stick and just threw the stupid thing in the trash. Two days later, I started my period.

One of the most annoying aspects of trying to conceive is how similar the symptoms are for PMS and early pregnancy.

• Moodiness
• Tender, swollen breasts
• Fatigue
• Backaches
• Headaches
• Acne
• Weight gain

Check. Check. Check. Check. Check. Check. Check. I love being a girl, but I look at this list and shake my head in disbelief. How do we manage to put up with all this B.S. every month? It’s unbelievable.

I’ve decided I want a surprise pregnancy. I want to be so detached from my monthly cycle and my body that I don’t even notice I’m pregnant. You know, like those women who go to the bathroom at a rest stop and practically deliver a baby in the toilet. It doesn’t matter that they’ve never taken a prenatal in their life and that they’ve drank alcohol and caffeine and maybe even smoked every day of the last 10 months. Their baby is perfectly healthy and they didn’t even know it was growing inside of them.

Of course, I’m not serious. If that ever happened, I’d get ragey over the fact I missed the joys of pregnancy.  

Disappointment

To get this out of the way and prevent the paragraph-skipping your eye is going to want to do unless I just come out and say it, I’m going to just come out with it.

I was pregnant, and now I am not.

I found out I was pregnant about four and a half weeks ago. When I got an ultrasound at seven weeks, things didn’t look great. At eight weeks – last Thursday -- the fetal heartbeat was gone.

With that out of the way, I’ll now start at the beginning.

First of all, I’m sorry I couldn’t tell you right away. The reason I didn’t is because of exactly what happened. I couldn’t live out the joy and tragedy for a live audience. I’d planned to tell everyone after my seven-week ultrasound, if everything looked good. Since it didn’t look good, I kept quiet.

You might remember that Christina and I each took pregnancy tests before leaving for BlogHer in early August.  I was on cycle day 23, and had ovulated around day 15 or so, if The Machine was to be trusted. The result of my test was negative. Not even the faintest line. I proceeded to the airport and had two glasses of wine to calm my flying jitters, then another on the airplane. Then another that evening at the expo, and then a giant margarita at dinner.

For the entirety of BlogHer, I was ravenous. I ate so much I gained two pounds in the few short days we were there.  The first night I slept terribly, but the next two nights I dropped into a deep sleep and had strange, vivid dreams. By the end of BlogHer I felt deeply fatigued and when I got home, I crawled into bed and took a long nap.

I continued to feel extremely tired and have strange dreams. The night before I got my “big fat positive,” I dreamed I had a baby but kept forgetting to take care of it. In my dream, I awoke and remembered I’d left the baby in the living room, and I scrambled out of bed to get it. When I got there, a raccoon had somehow gotten into the house and scratched the baby’s face. I awoke – for real – in a panic.

My husband had forbidden me to take a pregnancy test until my period was abnormally late, and as it happened the date I took the test was on his 35th birthday. I used an EPT test and the plus sign showed up immediately. I started shaking. I looked at myself in the mirror and recognized sheer terror. I’d been trying to get pregnant for so long that I’d never actually envisioned a positive pregnancy test. My husband was elated.

More symptoms started cropping up. Nosebleeds, sore breasts, sensitivity to smells, cramping and nausea. Fatigue and crazy dreams continued to be a mainstay.

And then we went to the first ultrasound. I was seven weeks along. The ultrasound tech showed us the embryo and the fluttering heart. She congratulated us and sent us on to the doctor. We sat in the waiting room, grinning ear to ear.

And then the doctor congratulated us and told us the baby’s due date would be April 22 – our wedding anniversary. But, there was a caveat. She said the fetus looked to be only about six weeks, three days old, and the heartbeat was lower than she’d like, at only 80 beats per minute, so she had us schedule another ultrasound for the following week. She said it could be a fluke and she advised “cautious optimism.”

I already felt optimistic – after all, I’d just seen my baby’s heartbeat. So I smiled and asked the doctor if I could proceed with asking her the dozen or so questions I’d written down. And she said: “You know, let’s wait until your next appointment.”

At this point I realized two things. 1) My doctor is kind of a bitch. 2) She didn’t think the baby was going to make it.

I, of course, jumped on the internet immediately when I got home and found a study that concluded that six-week-old embryos with heartbeats of 80 beats per minute die within one week of the first ultrasound 61% of the time. Even if the heartbeat returns to normal, there is still a 25% chance of fetal demise in the first trimester after such a low heartbeat reading.

This was devastating news. I crawled into bed and cried.

We kept busy over Labor Day weekend. There was a lot going on and we met friends and family for various gatherings with smiles plastered on our faces. My symptoms had begun to fade. The nausea wasn’t nearly as bad. My breasts didn’t hurt at all. And then I started spotting very lightly. I warned my family not to be surprised if I delivered bad news after the next ultrasound. They’d all been so excited when we told them about the pregnancy. My sister is almost six months along and the cousins would have been close in age.

At the next ultrasound, a male technician stared quietly at the screen, perhaps deciding how best to word what needed to be said. I could see on the monitor there was no flutter; no heartbeat. I just stared at it, dry-eyed. My husband didn’t make a sound. The tech said he was sorry for the bad news and sent us on to my doctor, who sat us down to inform me of my options for the next, essential step.

There are three options. 1) Wait it out and miscarry naturally. 2) Insert a pill in my vagina to induce miscarriage. 3) A D&C (abortion) to remove the fetus.

All three are terrifying, but I chose the natural option. My doctor wrote me a prescription for vicodin and I imagine when the time comes I’ll pop a couple pills and spend some time on the toilet. She likened the process to a “mini-labor.” If it doesn’t happen on its own within a couple weeks, she wants to do the surgery.

I am ok, if by ok we mean that I am getting up in the morning and acting mostly human each day. I am a little shell-shocked, and pretty bummed out. I feel a bit of low-burning rage in the pit of my stomach, and I would kind of like to break something and maybe scream a little bit. For now I just sit silent, thinking about how this happened, what must happen next, and what should happen a couple months from now.

The doctor says we can try again once I have a normal period. This probably means we can try again sometime in November, providing I haven’t been committed to a mental hospital (I kid! You have to laugh, or you’ll cry). I admit the thought of trying again makes me want to vomit. But this is still so fresh, of course I feel that way. Also, I still have nausea from the pregnancy, to add salt to the wound.

The good news is that in all my google consults, I discovered another study that says women who get pregnant within six months of a miscarriage have a greater likelihood than normal of having a healthy pregnancy.

And the other good news is that throughout all this, we found out one important thing: I CAN GET PREGNANT. This is pretty astounding.

This is probably enough to have said about all this – more than enough, likely. I’ll be dealing with the fallout for the next couple of weeks and I’m sure I’ll write more about that. In the meantime I’m being as much of a hermit as I can and trying to feel sorry for myself only in the shower or when the lights are off and I’m trying to fall asleep. Miscarriage is something normal, something everyday, that has happened to almost every mother I know. I know this. They made it through and I will, too.

ARGH!

I am beyond annoyed.

I have been tracking my basal temperature, and it appears that every month, after the spike showing ovulation, it falls off. Goes of a cliff. Enters an ice age. What does this mean? Well, it could mean many things, including a progesterone deficiency. The one thing that during all of the poking and prodding that was done to me -- I was never tested for. After all, they reasoned, my luteal phase was long enough, so the progesterone had to be there. Of course, as we all know from MB the length of the luteal phase is just one of the markers, a progesterone deficiency can still exist, even if there are a full 14 days after ovulation.

I was sure it was a break through! My acupuncturist thought so too, and said I should call my doctor and see if she would order a test. I decided to call my naturopath, who has ordered testing like this before, sure she would help me out. I had an appointment already scheduled, so we could discuss the results.

She refused to do it.

She said she doesn't order tests just because an "acupuncturist" has a theory. I told her about the basal charting. She said we could discuss it at my next appointment. I said by then it would be too late because according to all the books it needed to be tested seven days after ovulation. I said it would be another month down the drain. She still refused. Oh, then she asked if I was trying to get pregnant. I guess she has short term amnesia.

Now, I know that doctors can't just order tests whenever a patient wants them. But when a doctor is working on a certain problem with a patient, and a test could help get to the bottom of it, shouldn't they be interested in having it done, no matter where the idea came from? Especially when the year of other medications they have prescribed haven't made any difference?

It made me wonder if she was just waiting to get her fee for the next appointment before she would help. Yep, that's how distrustful her response has made me. It also makes me want to dump all the pills she has put me on, at some cost, down the toilet. And it definitely makes me wonder if I want her involved in this process any more.

So, what do you think? Am I being a baby? Or is she being unreasonably unhelpful?

Drinking like a pregnant person

For starters, I have to share one story. Over the weekend someone asked me if my husband and I are planning on having children. I accept that people are going to ask me this even if they barely know me, as was the case this time. It's simply something humans do, inquiring after each other's procreational intentions. My blanket response is: "We're working on it," which is what I said this time. The person asked me how long we'd been working on it. I said, "A while." She said, "Oh, then you should stop trying! Then I'm sure it would happen. You know, because of all the stress that builds up in your body."

I think I said, "I know, right?" But I was thinking of an infertility blog I sometimes check in at that's titled, "Just Stop Trying And It Will Happen." The title is obviously hyperbolic and represents one of the infertility community's most detested pieces of advice. That, along with "Are you sure you're doing it right?"

Our favorite response to this one is: "You mean the penis is supposed to go in the vagina?!"

So anyway. That's not what this post is about today; that was just a little anecdote to whet your appetite.

What today's post is about is how I've stopped drinking caffeine and alcohol. In the circles I hang out, this has not gone unnoticed. I love me some wine. And coffee, for that matter.

So let's start with coffee. Here are some bullet-pointed nuggets from Making Babies:

- Caffeine can decrease the flow of blood to the uterus, which can interfere with implantation.
- Too much caffeine may increase the risk of clotting and miscarriage.
- Coffee is acidic and can make the body and the cervical mucus acidic, too. Several studies have concluded that coffee (with or without caffeine) diminishes fertility. A recent large Dutch study determined that four cups of coffee a day lowered a woman's chances of having a baby by more than 25 percent -- comparable to the damage done by smoking, being overweight, or having three or more alcoholic drinks a week.
- Some studies have linked coffee and low sperm count.

And alcohol:

- Some studies show even low levels of alcohol can cut fertility by as much as one-half.
- One large study concluded that women who had fewer than five drinks a week were twice as likely to get pregnant in a given six-month period compared to women who drank more.
- Another study demonstrated that men who drank alcohol regularly took twice as long to get their partners pregnant as men who didn't drink at all.
- Alcohol is toxic to sperm, and overuse can reduce sperm quality, increase abnormal sperm, and lower motility. Men who drink have been shown to have lower sperm counts and lower testosterone.
- In women alcohol can be  a risk factor for ovulatory infertility.
- Alcohol also interferes with the body's ability to absorb nutrients from food. That includes zinc, which is key for male fertility in particular.
- Alcohol interferes with the action of folic acid as well, which plays an important role in the maturation of an egg for ovulation.
- Alcohol acidifies the body, including the cervical mucus. If the mucus gets to acidic, sperm can't survive in it, and so can't reach the egg.

These are good things to remember, that I'm constantly "forgetting." It's so much easier to just take some extra supplements than it is to turn down a glass of wine at a party; believe me, I know. But the payoff just might be worth it.