Author Topic: Trying to Conceive, the Mustachian way?  (Read 40045 times)

GreenQueen

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Re: Trying to Conceive, the Mustachian way?
« Reply #100 on: March 04, 2016, 11:44:46 AM »
Our first ultrasound was $415, I was in shock. Just a natural birth in the hospital near us (no anethesia or anything) costs around $12k. My OOP max is only $6500, so I guess I have that going for me. I was considering a home birth (which run around $4-5k), but in the event we would have to transfer to a hospital, we would be out that money on top of the OOP max, since a home midwife is "out of network" and that's not included in your deductible.

Now I'm freaking out about what else isn't covered in the OOP max. If they give you things at the hospital like lactation training or lanolin oil, could that be an extra charge? Even calling my health insurance doesn't help because they need codes before they'll tell you what they will pay for. The lack of transparency in medical billing is just freaking insane.

For that cost, have you considered a homebirth with a midwife? I have many friends who went this route, out of personal preference and due to cost. I've been reading a lot about how non-hospital births for normal pregnancies (no complications or high risk) are considered safe and even recommended. I'm grateful to be in a country where I don't have to think the cost.

Homebirth in the US is not safe unlike in many Western European nations. Most midwives who do homebirth here are not certified nurse midwives (CNM) with medical training. They are certified professional midwives (CPM) or licensed midwives (LM) and are not required to have any medical or nursing training at all. Basically they have to just pass a certification exam and watch a certain number of births to be certified. They can have no college degree, or a degree in english lit.  They usually only carry really basic instruments like scissors and hand held fetal doppler. Basically, they rely almost completely on the fact that the birth will go perfectly smoothly. If something goes wrong, they have to call 911 and even in the best circumstances it will take at least 20 minutes to get mom and baby to a hospital.

In the US we see many infant deaths in homebirths that could have otherwise been prevented in a hospital setting. I think the most recent estimate was that 2 out of 3 infant deaths in homebirth could have been prevented in a hospital. If a woman chooses to give birth at home in the US, she is unwittingly choosing to have a 3 fold increase in her chances of her or her infant dying or having serious injuries should something go wrong. Here, homebirth is really predicated on the false assumption that birth is not inherently dangerous and that if you are low risk everything will be fine. The trouble is, problems and complications happen pretty frequently even to the healthiest mothers, and there is no telling if a problem will occur until it happens.

Sorry to get on my soapbox - I have just known way too many crunchy and green oriented women (myself included) who would have been ideal candidates for homebirth but needed emergency c sections, had protracted labors, or hemorrhaging. One woman I knew was going the homebirth route, developed preeclampsia (and was not followed appropriately due to her and her CPM's belief in very little prenatal care), and almost bled out when she gave birth at the hospital. Only an immediate blood transfusion saved her. If she had attempted to give birth at home, she most certainly would have died. Then of course there are all the moms across the US who lost their babies, or whose babies are permanently injured.

The desire to give birth at home, or the money saved, really isn't worth it when you consider that the repercussions of not having immediate medical care are death or brain damage. If anyone is interested in homebirth in the US, I really suggest looking at both sides of the issue and not just the very supportive stuff. Visit a homebirth trauma and loss support group and read the stories of the births gone wrong (you need to hear about the bad stuff as well as the good to make a truly informed choice). Yes, when birth goes smoothly homebirth can be fine, just as it would be in a hospital. But when it doesn't, the results can be absolutely catastrophic. Any you never know whether you will be one of the lucky ones.

Good to know. I personally know lots of success stories, but there are many shades to the issue, as you point out.

little_brown_dog

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Re: Trying to Conceive, the Mustachian way?
« Reply #101 on: March 04, 2016, 12:59:26 PM »
Homebirth in the US is not safe unlike in many Western European nations. Most midwives who do homebirth here are not certified nurse midwives (CNM) with medical training.

When you say "most", do you have a citation? Do you have statistics on the safety of homebirth in the US when using a CNM? 
Most of the people I now who have had homebirths have used a CNM/ARNP. The same person who provides their primary well-woman care over a period of years. 
Obviously, that's only an anecdote, "my friends" are highly unlikely to be representative of any group- but I'm wondering what data your statement is based on.

Because your post seems to make the assumption everyone uses a CPM, and that is not the only kind of midwife available. Is it still unsafe in the US to deliver at home with a CNM/ARNP?

There was a MANA article (obviously an org very supportive of midwifery and homebirth) by Cheyney et al in 2014 on homebirth outcomes (http://onlinelibrary.wiley.com/doi/10.1111/jmwh.12172/pdf) that showed approx 80% of their reporting sample were CPMs (I think this includes a small few who had CPM and CNM cert, but the majority were CPM only without the nursing training). This study doesn't appear to break down the mortality/morbidity outcomes by provider status - this could be for legitimate reasons (like not having sufficient samples) or it could be because MANA doesn't want to rock the boat and find something that shows one group is seriously more safe or dangerous than another (they represent all types of midwives and that would surely cause some serious political problems).

I don't know how accurate it is, but midwifery today also wrote an article stating "Only about 150 CNMs do homebirths, however, because they are required to have a written collaboration agreement with a physician." This would back up why the MANA study had so few CNMs. Everything I can find looks at CNMs in hospital assisted deliveries, not homebirths. I wonder if the CNM homebirth sample is too small to effectively study?
http://www.midwiferytoday.com/articles/homebirthchoice.asp


 This same study while coming to the conclusion that homebirth seemed safe, also wrote that over 6% of the sample required assisted extraction or c section (requiring transfer to a hospital obviously).  10.9% of women required transfer to hospital for one reason or another. The study reported 1 maternal death, and a 2.18 combined rate of intrapartum infant death and early neonatal death per 1000 births. When they removed the higher risk women from the sample, the intrapartum death rate was .85 per 1000. Interestingly, this study did not look at what happened to those babies who required hospitalization, and only indicates that 75% of those who did ended up in the NICU. Its too bad they didn't look at the outcomes of the hospitalized babies, as that would be really what determines the safety of birth (ex: when complications DO happen, are the babies just as safe at home as in the hospital, or did the delay in medical care result in more severe or lasting injury?).

The American College of Obstetrics and Gynecologists wrote a position on the safety of home birth and found that homebirths were much riskier in terms of neonatal deaths. They recommend "Specifically, they [women] should be informed that although the absolute risk may be low, planned home birth is associated with a twofold to threefold increased risk of neonatal death when compared with planned hospital birth.  These results are from a metanalysis done in 2010.
http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth

When you look at the 2 opposing sides, and add in the often hidden and not discussed anecdotal experiences of those women who have experienced dangerous homebirths, it seems that the general consensus is that homebirth is fine IF everything goes according to plan. But that is a huge if, and MANA's own study confirms a significant number of women need to go to a hospital, a small number do lose their babies, and the babies that do go to the hospital require ICU care for whatever reason.

The problem is that alot of women who choose homebirth are not fully aware that they could be one of these unfortunate cases, they are misled to believe that this won't happen because they hear these statistics (90% of women were fine! Only a small number of babies need to go to the hospital!) and think that means they are safe. But absolute risk is not what we should look at, its what happens when something does go wrong that matters. And of course, once bad stuff is happening, everyone is desperate for help that is too far away. If anyone is interested, there is a former homebirth CPM who blogs at thehonestmidwife.com. She wrote a great piece utilizing alot of research from pro-homebirth organizations to describe why she came to the conclusion that homebirth was unsafe: http://www.honestmidwife.com/download-pdf-2/

I should mention that I am a huge proponent of low/no intervention vaginal births and had a team of nurse midwives as my primary providers for my birth. But even my own CNMs really felt that homebirth was just too risky (we were chatting about it), and that deliveries were safest with a crash cart, OR, and an entire team of medical staff nearby. As my midwife said to me: "if we want to go all natural, we have to be prepared for the consequences if things don't work out. Mother nature can be a b*tch."


« Last Edit: March 04, 2016, 02:23:58 PM by little_brown_dog »

woopwoop

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Re: Trying to Conceive, the Mustachian way?
« Reply #102 on: March 04, 2016, 06:01:26 PM »
For that cost, have you considered a homebirth with a midwife? I have many friends who went this route, out of personal preference and due to cost. I've been reading a lot about how non-hospital births for normal pregnancies (no complications or high risk) are considered safe and even recommended. I'm grateful to be in a country where I don't have to think the cost.
In my post you quoted: "I was considering a home birth (which run around $4-5k), but in the event we would have to transfer to a hospital, we would be out that money on top of the OOP max, since a home midwife is "out of network" and that's not included in your deductible."

As we've already spent about $1k on the prenatal stuff, we wouldn't be saving much money by going the home birth route. And if I had to transfer to a hospital (which is more common for first time moms), I'd be paying $6500 + the $5k homebirth fee instead of just the OOP $6500 I'd pay by going to a hospital.

I've seen varied studies on the safety of US home births. That one big meta study said there were fewer maternal problems and 3 times the neonatal mortality, but I thought they retracted it to review it since the underlying studies weren't combined properly? And has been said, in most other countries CNMs do home births but here it's all CPMs and LMs, who are more likely to have to transfer to a hospital in case of complications.


Bakari

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Re: Trying to Conceive, the Mustachian way?
« Reply #103 on: March 04, 2016, 09:57:51 PM »
When you say "most", do you have a citation? Do you have statistics on the safety of homebirth in the US when using a CNM? 
Most of the people I now who have had homebirths have used a CNM/ARNP. The same person who provides their primary well-woman care over a period of years. 
Obviously, that's only an anecdote, "my friends" are highly unlikely to be representative of any group- but I'm wondering what data your statement is based on.

Because your post seems to make the assumption everyone uses a CPM, and that is not the only kind of midwife available. Is it still unsafe in the US to deliver at home with a CNM/ARNP?


I can't speak to the rates of using a midwife with a medical degree, but here's some information that supports that there is real risk in going the home birth route:


"Conclusion:Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate."
http://www.ajog.org/article/S0002-9378%2810%2900671-X/fulltext?refissn=0002-9378&refuid=S0002-9378%2812%2901074-5


"although the absolute risk may be low, planned home birth is associated with a twofold to threefold increased risk of neonatal death when compared with planned hospital birth."
http://www.acog.org/Resources%20And%20Publications/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/Planned%20Home%20Birth.aspx


"around 40% of first-time mothers who plan to deliver their child at home end up being transferred to hospital."
http://www.theguardian.com/lifeandstyle/2011/apr/16/home-birth-trial-or-rewarding


And perhaps the worst irony of all:
"[home births have] higher rates of operative and cesarean deliveries compared with women who labor in the hospital."
http://www.ajog.org/article/S0002-9378%2812%2901074-5/fulltext

Granted a couple of those links may be somewhat biased, but they do offer statistics and not just opinion.


My partner is interesting in hiring a mid-wife to come over during labor and help make the decision of when to go to the hospital so we aren't there for 24 hours of labor (both because of the cost, the possibility of being pressured into inducing, and because its just not a nice environment to be in), and then having the mid-wife come along as an advocate, since doctors can be, you know, a little doctory...
Its called a monatrice.  Most of the emotional benefits of a home experince, but with the safety net of hospital equipment.

Of course we'd have to pay her, but hopefully that will be somewhat offset by less time in the hospital and perhaps avoiding any unnecessary procedures.

« Last Edit: March 04, 2016, 10:06:30 PM by Bakari »

little_brown_dog

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Re: Trying to Conceive, the Mustachian way?
« Reply #104 on: March 05, 2016, 05:36:22 AM »
When you say "most", do you have a citation? Do you have statistics on the safety of homebirth in the US when using a CNM? 
Most of the people I now who have had homebirths have used a CNM/ARNP. The same person who provides their primary well-woman care over a period of years. 
Obviously, that's only an anecdote, "my friends" are highly unlikely to be representative of any group- but I'm wondering what data your statement is based on.

Because your post seems to make the assumption everyone uses a CPM, and that is not the only kind of midwife available. Is it still unsafe in the US to deliver at home with a CNM/ARNP?


I can't speak to the rates of using a midwife with a medical degree, but here's some information that supports that there is real risk in going the home birth route:


"Conclusion:Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate."
http://www.ajog.org/article/S0002-9378%2810%2900671-X/fulltext?refissn=0002-9378&refuid=S0002-9378%2812%2901074-5


"although the absolute risk may be low, planned home birth is associated with a twofold to threefold increased risk of neonatal death when compared with planned hospital birth."
http://www.acog.org/Resources%20And%20Publications/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/Planned%20Home%20Birth.aspx


"around 40% of first-time mothers who plan to deliver their child at home end up being transferred to hospital."
http://www.theguardian.com/lifeandstyle/2011/apr/16/home-birth-trial-or-rewarding


And perhaps the worst irony of all:
"[home births have] higher rates of operative and cesarean deliveries compared with women who labor in the hospital."
http://www.ajog.org/article/S0002-9378%2812%2901074-5/fulltext

Granted a couple of those links may be somewhat biased, but they do offer statistics and not just opinion.


My partner is interesting in hiring a mid-wife to come over during labor and help make the decision of when to go to the hospital so we aren't there for 24 hours of labor (both because of the cost, the possibility of being pressured into inducing, and because its just not a nice environment to be in), and then having the mid-wife come along as an advocate, since doctors can be, you know, a little doctory...
Its called a monatrice.  Most of the emotional benefits of a home experince, but with the safety net of hospital equipment.

Of course we'd have to pay her, but hopefully that will be somewhat offset by less time in the hospital and perhaps avoiding any unnecessary procedures.

Is she working with a CNM as her primary provider? I labored at home for all but 3 hours before it was time to push. Our practice's policy is that once contractions start or your water breaks, you call the practice and they'll patch you through to the midwife on the unit that day/night. She hears whats going on, and provides instructions, and alerts the unit of your impending arrival. I called when my water broke, and when the contractions were about 7-6 minutes apart because they were bouncing around from 6-8 and as a first time mom I was anxious about knowing when to go. At a solid 5 minutes, I called again and she said to come in. I only labored in the hospital through 5-10cm, a total of 2.5-3hrs max which was perfect.

I think most practices now actually discourage women from laboring in the hospital unless you are getting pretty close. I've heard many won't admit you until you are 4-5cm dilated at least, and it typically moves pretty swiftly from there. Then again, I shouldn't really talk about usual cases - most births take a max of 2 hours of pushing and my daughter required almost six!
« Last Edit: March 05, 2016, 05:40:25 AM by little_brown_dog »

mrsstache

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Re: Trying to Conceive, the Mustachian way?
« Reply #105 on: March 05, 2016, 06:12:07 AM »
Congrats to the OP and the couple of others who posted about their success getting pregnant! Just wanted to chime in and say that although doing things the "old fashioned" way is great (and certainly what we tried to do) it doesn't always work for everyone. I know everyone knows that, but just thought to share my journey so far.

I'm 38 and we have been trying for about 20 months. Tried timing sex, using OPKs and preseed. No dice. Eventually went to the fertility doctor. We found that I had very large uterine fibroids that were preventing implantation. We could have just kept trying and maybe, one day, we would be successful (but likely not). We took into consideration all the other issues those fibroids were causing me (prolonged, heavy bleeding - just sitting around on the couch was becoming a precarious situation- , anemia, constant exhaustion, severe cramping - although this became less *I think* due to a switch to reusable menstrual products...). Given all of those factors and our desire to have children, I ended up having not one, but two hysteroscopic myomectomies to remove the fibroids. I'm not pregnant yet (and had to take a month off from trying due to varicella booster) but my quality of life has dramatically improved. Also had an HSG in which one tube was occluded. Doctor says this occurs often and if at least one is clear, we have a good shot at getting pregnant. At this point, we could go back to just doing things the old fashioned way, but we are opting to try a few cycles of clomid + IUI. It's not the most "mustachian" thing, but for us it makes sense and we think is worth the expense given my age and the other complications we've faced. For anyone who is curious, hubby's sperm is apparently quite impressive (LOL) so there is no issue there.

I just wanted to share this for anyone else who may have similar complications or who may not be able to relate to the other posters here and/or is wondering, "why is it so hard for me?". The human body is a curious wonder. Sometimes it doesn't do exactly what you expect. For us, even though this will be more costly than just waiting and continuing to try naturally, it is a worthwhile expense. And I guess that's part of what financial freedom is all about - freedom to spend your money on the things that matter to you (which may include fertility treatments, if you want or need them). I know nobody has implied otherwise in this thread, so I hope it doesn't sound like I'm saying anyone has. I value every post in this thread and it's been enlightening so far.

One last note - while we really hope to have a biological child, we are very open to adoption, and also just as open to it being just the two of us. Time will tell. We are just grateful to be able to pursue our different options.

Thanks again to everyone who shared and best wishes to the mommies to be!!!


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« Last Edit: March 05, 2016, 06:15:06 AM by mrsstache »

Bakari

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Re: Trying to Conceive, the Mustachian way?
« Reply #106 on: March 05, 2016, 07:57:01 AM »
Is she working with a CNM as her primary provider?
We haven't even started trying yet, but we plan to this year, so we're starting to think (and plan) about this stuff in advance (while there is no clock). 


Quote
I think most practices now actually discourage women from laboring in the hospital unless you are getting pretty close. I've heard many won't admit you until you are 4-5cm dilated at least
I think that's one of the things a monatrice can tell you at home...


Thanks for the additional information

justajane

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Re: Trying to Conceive, the Mustachian way?
« Reply #107 on: March 05, 2016, 08:38:28 AM »
Quote
I think most practices now actually discourage women from laboring in the hospital unless you are getting pretty close. I've heard many won't admit you until you are 4-5cm dilated at least
I think that's one of the things a monatrice can tell you at home...

My only concern about that would be fetal monitoring and to be sure that whoever you have is pretty experienced with that. I personally loved the comfort of constant fetal monitoring at the hospital, especially with my third. It turns out the cord was wrapped tightly multiple times around his arm. If I laid in any other position but my right side, his heart rate would plummet to the point that four nurses would come running. They didn't know the reason until he was born. Laying on that side took the pressure off the cord. It's possible that walking and sitting would have done the same thing, but I had an epidural at that point.

For my first, I bought into the narrative that constant monitoring was somehow problematic or even oppressive to me. But now I ask myself - why did I consider such an advanced technology to be oppressive? To know minute by minute what is going on with your soon-to-be-born infant's heart rate is a wonderful thing in my experience.   

La Bibliotecaria Feroz

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Re: Trying to Conceive, the Mustachian way?
« Reply #108 on: March 05, 2016, 09:14:02 AM »
Quote
I think most practices now actually discourage women from laboring in the hospital unless you are getting pretty close. I've heard many won't admit you until you are 4-5cm dilated at least
I think that's one of the things a monatrice can tell you at home...

My only concern about that would be fetal monitoring and to be sure that whoever you have is pretty experienced with that. I personally loved the comfort of constant fetal monitoring at the hospital, especially with my third. It turns out the cord was wrapped tightly multiple times around his arm. If I laid in any other position but my right side, his heart rate would plummet to the point that four nurses would come running. They didn't know the reason until he was born. Laying on that side took the pressure off the cord. It's possible that walking and sitting would have done the same thing, but I had an epidural at that point.

For my first, I bought into the narrative that constant monitoring was somehow problematic or even oppressive to me. But now I ask myself - why did I consider such an advanced technology to be oppressive? To know minute by minute what is going on with your soon-to-be-born infant's heart rate is a wonderful thing in my experience.   

For me, it's not a question of whether it's somehow oppressive, but whether it is advisable and supported by the evidence. Everyone's experience is different. Continuous fetal monitoring has been found, however, to INCREASE the risk of cesarean WITHOUT improving outcomes (but do your own research--it was a while ago that I read that). While there may be indications for it, its routine use was not officially recommended last time I checked.* (As opposed to intermittent fetal monitoring.)

I wound up having more or less continuous fetal monitoring both times because the first time there was mec and the second time I was a TOLAC patient (although even then, they let me walk around and go in the tub). Which was actually fine. It's just one of those topics that it's good to know something about so you can discuss it with your doctor.

*This sounds counterintuitive--isn't more info always better?--but is part of a growing trend in medicine suggesting that more information sometimes just leads to more medicine without more health. Recommendations for cancer screenings, for instance, have been getting dialed back in recent years.

Kaydedid

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Re: Trying to Conceive, the Mustachian way?
« Reply #109 on: March 05, 2016, 06:08:31 PM »
We also used some kind of special lubricant that's supposed to help. I can't remember the name. In fact, it worked so well I only had to buy one package of it to conceive both of our kids.

Pre-Seed?

For the OP, traditional lubrication has substances that can actually kill sperm (without being labeled a spermicide).  Pre-Seed had me pregnant in 30 days after having tried for 6 months.  Oh, and track that tempurature!

Canola oil and mineral oil also are safe and should be less expensive than Pre-Seed.

Source: "Optimizing Natural Fertility", in "Fertility and Sterility" Vol. 90, Suppl 3, November 2008

Olive oil works too!

little_brown_dog

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Re: Trying to Conceive, the Mustachian way?
« Reply #110 on: March 06, 2016, 01:43:12 PM »
Is she working with a CNM as her primary provider?
We haven't even started trying yet, but we plan to this year, so we're starting to think (and plan) about this stuff in advance (while there is no clock). 


Quote
I think most practices now actually discourage women from laboring in the hospital unless you are getting pretty close. I've heard many won't admit you until you are 4-5cm dilated at least
I think that's one of the things a monatrice can tell you at home...


Thanks for the additional information

Ive found that midwives actually prefer not to do numerous cervical checks because they dont want to keep messing around in there. So id be suprised if the monatrice would do more than simply be there as a psychological support given that it is sortof against the midwife philosophy to repeatedly check a woman if nothing is wrong. But ultimately it comes down to what makes your wife most comfortable. If she is scared of laboring on her own then having an additiinal support person there might be very valuable. But if she us having a normal labor, from a medical standpoint, she can defjnitely manage it just timing the contractions and calling her provider when she has questions.

I know it sounds so weird that something as big as labor is treated like not a big deal...but its crazy how those contractions really do tell you what to do. As you look into the monatrice definitely ask alot of questions so you dont end up paying a ton for something most couples successfully manage to dothemselves. Make sure she would be offering something above and beyond that (which could simply be peace of mind too).
« Last Edit: March 06, 2016, 01:52:18 PM by little_brown_dog »

KittyZero

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Re: Trying to Conceive, the Mustachian way?
« Reply #111 on: March 10, 2016, 01:25:26 AM »
I think you should hold out and keep trying for a little longer. I understand - Im only a little longer than you and I am soon hopefully to start trying. But what I do know is that in Australia, we are encouraged to try for around a year. Then get advice. I know my friends your exact age were literally on the verge of starting to go the IVF route, and got pregnant. 6 months doesn't mean you need to start down the alternative route. If you were nearing 1 year, then I would think about it.

I think its important not to stress yourselves out. Trying for 6 months is normal, but imagine for you it might seem like a lifetime!

justajane

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Re: Trying to Conceive, the Mustachian way?
« Reply #112 on: March 10, 2016, 05:30:30 AM »
I think you should hold out and keep trying for a little longer. I understand - Im only a little longer than you and I am soon hopefully to start trying. But what I do know is that in Australia, we are encouraged to try for around a year. Then get advice. I know my friends your exact age were literally on the verge of starting to go the IVF route, and got pregnant. 6 months doesn't mean you need to start down the alternative route. If you were nearing 1 year, then I would think about it.

I think its important not to stress yourselves out. Trying for 6 months is normal, but imagine for you it might seem like a lifetime!

If you read through the thread, you'll find out that she's pregnant now! Woohoo for annajane! Sometimes discussions take on a life of their own, even when the OP's question has essentially been answered.

fitfrugalfab

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Re: Trying to Conceive, the Mustachian way?
« Reply #113 on: March 13, 2016, 05:45:21 PM »
I'm so happy for all of the pregnant mums and I'm getting emotional reading this thread. We're probably 1-1.5 years away from TTC, but would love to start trying now. Instead, I've been doing reading and this thread and others in this sub forum have been very helpful.

And I'm also now convinced that I'm staying at my employer because the insurance is dirt cheap and covers mostly everything. I work for a municipal government.


Same with getting emotional. I'm TTC now I'm on my third cycle of trying.

Roman

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Re: Trying to Conceive, the Mustachian way?
« Reply #114 on: March 19, 2016, 11:01:36 AM »
We have been TTC for four years. My wife has blogged the journey at http://in-due-time.com

For any considering IVF that is not covered by their insurance - my friend works part time at Starbucks, and they covered it completely.

chemgeek

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Re: Trying to Conceive, the Mustachian way?
« Reply #115 on: April 01, 2016, 01:42:58 PM »
Roman Fancy pregnancy tests really aren't required, though they make it seem a little more official maybe. Same thing for OPK strips if that's something you're considering. Internet cheapies are the way to go.

 http://www.amazon.com/Wondfo-Pregnancy-Strips-25-count-medical/dp/B0002YIQEQ?ie=UTF8&keywords=wondfo%20pregnancy%20test&qid=1459539705&ref_=sr_1_1_a_it&sr=8-1

naners

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Re: Trying to Conceive, the Mustachian way?
« Reply #116 on: April 01, 2016, 03:35:02 PM »
Our first ultrasound was $415, I was in shock. Just a natural birth in the hospital near us (no anethesia or anything) costs around $12k. My OOP max is only $6500, so I guess I have that going for me. I was considering a home birth (which run around $4-5k), but in the event we would have to transfer to a hospital, we would be out that money on top of the OOP max, since a home midwife is "out of network" and that's not included in your deductible.

Now I'm freaking out about what else isn't covered in the OOP max. If they give you things at the hospital like lactation training or lanolin oil, could that be an extra charge? Even calling my health insurance doesn't help because they need codes before they'll tell you what they will pay for. The lack of transparency in medical billing is just freaking insane.

Don't forget to negotiate after you get your bill: "it would be easier for me to pay right away if you could reduce the price" etc. I got a lab to knock 30% off in 2min over the phone. I think they really prefer you to pay in full right away so emphasizing that may be worthwhile.

Cognitive Miser

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Re: Trying to Conceive, the Mustachian way?
« Reply #117 on: April 01, 2016, 03:51:29 PM »
Also had an HSG in which one tube was occluded. Doctor says this occurs often and if at least one is clear, we have a good shot at getting pregnant.

I just wanted to share this for anyone else who may have similar complications or who may not be able to relate to the other posters here and/or is wondering, "why is it so hard for me?". The human body is a curious wonder. Sometimes it doesn't do exactly what you expect. For us, even though this will be more costly than just waiting and continuing to try naturally, it is a worthwhile expense. And I guess that's part of what financial freedom is all about - freedom to spend your money on the things that matter to you (which may include fertility treatments, if you want or need them). I know nobody has implied otherwise in this thread, so I hope it doesn't sound like I'm saying anyone has. I value every post in this thread and it's been enlightening so far.

Here's a good anecdote: my best friend from childhood had a tubal pregnancy and nearly died - but her remaining tube is working great and 6 months later she got pregnant.  She said her doc told her that sometimes the one ovary kicks in and starts releasing eggs more often than every other month.

I appreciate your positive attitude.  It sounds like you've been through a lot.  Hugs and good luck to you!

Cognitive Miser

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Re: Trying to Conceive, the Mustachian way?
« Reply #118 on: April 01, 2016, 03:53:56 PM »
My partner is interesting in hiring a mid-wife to come over during labor and help make the decision of when to go to the hospital so we aren't there for 24 hours of labor (both because of the cost, the possibility of being pressured into inducing, and because its just not a nice environment to be in), and then having the mid-wife come along as an advocate, since doctors can be, you know, a little doctory...
Its called a monatrice.  Most of the emotional benefits of a home experince, but with the safety net of hospital equipment.

Of course we'd have to pay her, but hopefully that will be somewhat offset by less time in the hospital and perhaps avoiding any unnecessary procedures.

I've never heard the term "monatrice" before, and I'm pretty crunchy!  How is a monatrice different than a doula?  My doula offers these same services, but perhaps has different training?

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Re: Trying to Conceive, the Mustachian way?
« Reply #119 on: April 01, 2016, 04:04:34 PM »
I started using these ovulation predictors.
50 predictors and 10 pregnancy tests for the same price I used to pay for 3 store-brand pregnancy tests.

http://www.amazon.com/ChoiceMMed-Ovulation-Pregnancy-Test-Strips/dp/B00UYC8XV2?ie=UTF8&psc=1&redirect=true&ref_=oh_aui_detailpage_o03_s00

I got really sick right when I ovulated this cycle though and was on heavy pain meds and antibiotics, so I don't have much hope I'll get pregnant this round.

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Re: Trying to Conceive, the Mustachian way?
« Reply #120 on: April 01, 2016, 04:10:59 PM »
My partner is interesting in hiring a mid-wife to come over during labor and help make the decision of when to go to the hospital so we aren't there for 24 hours of labor (both because of the cost, the possibility of being pressured into inducing, and because its just not a nice environment to be in), and then having the mid-wife come along as an advocate, since doctors can be, you know, a little doctory...
Its called a monatrice.  Most of the emotional benefits of a home experince, but with the safety net of hospital equipment.

Of course we'd have to pay her, but hopefully that will be somewhat offset by less time in the hospital and perhaps avoiding any unnecessary procedures.

I've never heard the term "monatrice" before, and I'm pretty crunchy!  How is a monatrice different than a doula?  My doula offers these same services, but perhaps has different training?

My understanding is it is like a doula but with some nursing credentials. Doula's on the other hand provide no medical care. But a monatrice doesn't provide the "official" care that a doctor or midwife does. It's more like having an advocate with a really good idea of what is going on, who could do cervical checks if you wanted them to, or would be knowledgeable in an emergency.

brycedoula

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Re: Trying to Conceive, the Mustachian way?
« Reply #121 on: April 01, 2016, 07:18:28 PM »
My partner is interesting in hiring a mid-wife to come over during labor and help make the decision of when to go to the hospital so we aren't there for 24 hours of labor (both because of the cost, the possibility of being pressured into inducing, and because its just not a nice environment to be in), and then having the mid-wife come along as an advocate, since doctors can be, you know, a little doctory...
Its called a monatrice.  Most of the emotional benefits of a home experince, but with the safety net of hospital equipment.

Of course we'd have to pay her, but hopefully that will be somewhat offset by less time in the hospital and perhaps avoiding any unnecessary procedures.

I've never heard the term "monatrice" before, and I'm pretty crunchy!  How is a monatrice different than a doula?  My doula offers these same services, but perhaps has different training?

My understanding is it is like a doula but with some nursing credentials. Doula's on the other hand provide no medical care. But a monatrice doesn't provide the "official" care that a doctor or midwife does. It's more like having an advocate with a really good idea of what is going on, who could do cervical checks if you wanted them to, or would be knowledgeable in an emergency.

A birth doula provides physical, emotional & informational support, as well as helping the mother/family advocate for her/themselves in a healthcare setting. A birth doula does not know how to listen to the baby's heart, do an internal exam, take the mother's blood pressure, etc.

A montrice has some clinical training but isn't as trained as a midwife, or isn't certified as one.

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Re: Trying to Conceive, the Mustachian way?
« Reply #122 on: July 15, 2016, 11:00:45 AM »
Hi everyone!

So my due date is today! Just wanted to post an update as I'm going a bit crazy wondering when this will happen. No signs yet other than some Braxton Hicks-feeling things.

I'm about to go for a super long walk. I've been doing squats the past few weeks. I will also indulge in the possibly unscientific method of eating spicy food tonight with a date night at our local Nepalese place (not frugal, but my excuse is that curry is the one dish I just can't replicate to a high quality at home, despite years of attempts). Any other tips for getting this thing started??

I hope everyone else on this thread who was/is trying to conceive is doing well and in good spirits.

Exciting!!
Baby #1 (2 weeks early): spicy food and sex
Baby #2 (on his due date): 1.5 hour walk the day before in deep sand and acupuncture.  I was going to acupuncture to help me sleep, and the day before my due date she said "I've got a couple of extra locations I can hit that may bring on labor..."  I said DO IT!!

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Re: Trying to Conceive, the Mustachian way?
« Reply #123 on: July 15, 2016, 11:31:23 AM »
A long car ride up and down bouncy not-well paved roads may have helped with baby #2.

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Re: Trying to Conceive, the Mustachian way?
« Reply #124 on: July 15, 2016, 11:42:53 AM »
Congrats and please post a pic when baby gets here!
Waiting for baby is just the first of many lessons to teach parents that you are no longer in control of your life!
When I was a week and a half overdue with my first and having tons of pre labor contractions my OB swore that an Ambien and a glass of wine would start labor. She prescribed the ambien and I did as instructed. It didn't work, but I got the best nights sleep I had had in weeks.

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Re: Trying to Conceive, the Mustachian way?
« Reply #125 on: July 15, 2016, 11:52:42 AM »
Congrats!

I only have one child. But when I was preparing for that child's arrival, I had a mental birth date of two weeks past my due date. I felt quite unprepared when the baby came the day before her due date!

So basically, since I wasn't trying to get her out, I have no personal experience. But I think long walk, spicy food, and some typical post date night activities sound like a good plan. And maybe adjust your expectation to two weeks from now, if you can? Good luck with everything!

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Re: Trying to Conceive, the Mustachian way?
« Reply #126 on: July 15, 2016, 12:07:24 PM »
Homebirth in the US is not safe unlike in many Western European nations. Most midwives who do homebirth here are not certified nurse midwives (CNM) with medical training.

When you say "most", do you have a citation? Do you have statistics on the safety of homebirth in the US when using a CNM? 
Most of the people I now who have had homebirths have used a CNM/ARNP. The same person who provides their primary well-woman care over a period of years. 
Obviously, that's only an anecdote, "my friends" are highly unlikely to be representative of any group- but I'm wondering what data your statement is based on.

Because your post seems to make the assumption everyone uses a CPM, and that is not the only kind of midwife available. Is it still unsafe in the US to deliver at home with a CNM/ARNP?

A three-year study of EVERY low-risk baby born in the United States, totaling over 10 million babies, found that babies born at home with a midwife are dramatically more likely to die than babies born in the hospital. They defined low-risk babies objectively, as being full term, singleton, head down and weighing at least 2.5kg (5.1lbs). As you can see below, being born at home with a midwife puts low-risk babies at a dramatically increased risk of death--between 2.5 times and 4.5 times higher, depending which hospital births you look at (the ones attended by midwives, which only includes low-risk moms, or the ones attended by doctors, which includes moms of every risk level from low to stratospheric).

The study looked at the death rates for babies and broke them down as follows:
  • Babies born in the hospital with midwives (by definition this means low-risk babies AND low-risk moms): death rate of 3.1/10,000 births.
  • Babies born in the hospital with doctors (this includes all high-risk moms, since hospital midwives are not allowed to attend high-risk moms): death rate of 5.4/10,000 births.
  • Babies born in a birthing center with a midwife (this should only include low-risk moms, but some birthing centers flout that rule): death rate of 6.3/10,000
  • Babies born at home with a midwife (this should only include low-risk moms, but some home-birth midwives flout that rule): death rate of 13.2/10,000
  • Babies born in at home with someone other than a midwife (this includes accidental home births, intentional unassisted births and intentional home births with someone other than a midwife): death rate of 18.2/10,000

Here's a link to the study. The chart at the bottom shows the death rates per group.
http://www.ajog.org/article/S0002-9378%2813%2901155-1/fulltext

And of course, death is not the only risk. Another recent study found that the risk of brain damage at birth was almost 18 times higher in home births than hospital births:
http://www.ajog.org/article/S0002-9378%2813%2901604-9/abstract
That's just the abstract--not sure you can access the full study there, but it's summarized here:
http://www.skepticalob.com/2014/01/risk-of-anoxic-brain-injury-is-more-than-18-times-higher-at-homebirth.html

As for who attends such births, here are a few sites with some stats you may be interested in:

"In 2012, 53,635 births in the United States occurred out of a hospital, including 35,184 home births and 15,577 birthing center births."
http://www.cdc.gov/nchs/products/databriefs/db144.htm

"In 2014, the majority of CNM/CM-attended births occurred in hospitals (94.2%), while 3% occurred in freestanding birth centers, and 2.7% occurred in homes."
http://www.midwife.org/CNM/CM-attended-Birth-Statistics

And at that same site you can see that CNMs and the newer but still real qualification CM, both of whom are real midwives with medical training, attended just under 32% of out-of-hospital births in 2014--but about 1/3 of out-of-hospital births are in birthing centers, not at home, and it's in the birthing centers that you're likely to find CNMs. Basically midwife-attended births are like this:

- Hospital birth: always a CNM or, more recently, a CM. You will never find a CPM working as a midwife in a hospital birth, because they're not medically trained or licensed. Some CPMs work as doulas in hospital births, but they are employed by the mother, not by the hospital.

- Birthing-center birth: in some states (for instance, PA) this is always going to be a CNM. In others, it could be a CNM or a CPM. It depends on the licensing laws in each state (who is permitted to work in a birthing center). All states allow CNMs to work in birthing centers; many also allow CPMs.

- Home birth: usually CPMs.

Another important note: home-birth midwives, whatever their "credentials," virtually never carry malpractice insurance. There are even birthing centers that don't carry it. So if you or your baby are injured, you are ON YOUR OWN when it comes to paying for that. Here's how that worked out for one Oregon family whose son has cerebral palsy due to oxygen deprivation at birth:
http://www.bendbulletin.com/home/1897490-151/the-risk-of-being-born-at-home
« Last Edit: July 15, 2016, 12:20:31 PM by Daleth »

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Re: Trying to Conceive, the Mustachian way?
« Reply #127 on: July 15, 2016, 02:38:57 PM »
Hang in there! Hope baby arrives soon! I have been in the awkward waiting place, too. :-)

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Re: Trying to Conceive, the Mustachian way?
« Reply #128 on: July 15, 2016, 02:52:00 PM »
I only have one child. But when I was preparing for that child's arrival, I had a mental birth date of two weeks past my due date. I felt quite unprepared when the baby came the day before her due date!

Literally same thing for us, word for word!

We did go on a long walk that day, but unrelated to trying to get the baby out--that's just what we were doing that day, walking over to, and all around, the Grand Bazaar in Istabul.  Probably walked 3-4 miles?  Later that evening Ali realized the lower back pain was, in fact, labor. 

We were quite surprised, as we had been thinking she'd be for sure a week late, if not two.
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Re: Trying to Conceive, the Mustachian way?
« Reply #129 on: July 15, 2016, 03:39:42 PM »
Hi everyone!

So my due date is today! Just wanted to post an update as I'm going a bit crazy wondering when this will happen. No signs yet other than some Braxton Hicks-feeling things.

I'm about to go for a super long walk. I've been doing squats the past few weeks. I will also indulge in the possibly unscientific method of eating spicy food tonight with a date night at our local Nepalese place (not frugal, but my excuse is that curry is the one dish I just can't replicate to a high quality at home, despite years of attempts). Any other tips for getting this thing started??

I hope everyone else on this thread who was/is trying to conceive is doing well and in good spirits.

oh my goodness!! all my well wishes to you for your upcoming labor & birth!

I'm almost 35 weeks pregnant now myself.  and like others said above, even though my due date is 8/22 I'm trying to mentally prepare myself to be pregnant until labor day (although at the same time, trying to "mentally prepare" my partner to have all the apartment reorganizing & remodeling (only light projects, no worries) done by 8/15.

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Re: Trying to Conceive, the Mustachian way?
« Reply #130 on: July 15, 2016, 05:37:45 PM »
OMG, our first grandbaby was born today, one day after her due date! Fingers crossed you have an easy delivery and a healthy baby!

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Re: Trying to Conceive, the Mustachian way?
« Reply #131 on: July 15, 2016, 05:58:22 PM »
OMG, our first grandbaby was born today, one day after her due date! Fingers crossed you have an easy delivery and a healthy baby!

Congrats to you and your daughter(in law?)!  Hope everyone is healthy and happy.  :)
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Re: Trying to Conceive, the Mustachian way?
« Reply #132 on: July 17, 2016, 07:07:34 AM »
OMG, our first grandbaby was born today, one day after her due date! Fingers crossed you have an easy delivery and a healthy baby!

Yay! Congrats =)

Best of wishes to everyone for your deliveries.

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Re: Trying to Conceive, the Mustachian way?
« Reply #133 on: July 21, 2016, 04:36:45 PM »
The spicy food didn't work, still waiting here :) I was getting crabby and then realized that having to wait a few days to meet the baby is textbook first world problem and that I need to stop grumbling.

Both my babes were 10+ post-date.  I was expecting it with my second, but I can very easily recall my feelings of impatience and frustration as time dragged on with my first.  I worked until I went into labor, and was unproductive and crabby the first few days after my due date because I felt like I couldn't start anything big because I was going to have a baby any second, and then had to say on every. single. phone call, "no, I haven't had the baby yet!!!".  By day three I figured I'd be pregnant forever and went back to business as usual until my water broke while on a conference call.  Fun memories.  Good luck!!

smella

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Re: Trying to Conceive, the Mustachian way?
« Reply #134 on: August 03, 2016, 09:56:13 AM »
@annajane83, any baby yet?!

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Re: Trying to Conceive, the Mustachian way?
« Reply #135 on: August 03, 2016, 04:19:31 PM »
Congrats!  :)
We are two former teachers who accumulated a bunch of real estate, retired at 29, spent some time traveling the world full time and are now settled with two kids.
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1967mama

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Re: Trying to Conceive, the Mustachian way?
« Reply #136 on: August 03, 2016, 04:25:03 PM »
Wonderful news! Enjoy your Babymoon!

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Re: Trying to Conceive, the Mustachian way?
« Reply #137 on: August 03, 2016, 08:45:59 PM »
Ahhh yay! So glad she is here and it went well. Savor some moments of those baby snuggles for the forums, while some of us still live vicariously through you =P

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Re: Trying to Conceive, the Mustachian way?
« Reply #138 on: August 03, 2016, 11:02:32 PM »
Yes! She's here :) I got induced at 41 weeks, 22 hours of labor (mostly with an epidural after I decided I couldn't hack back labor, little thing was pressing on my spine) and 8 lbs 6 ounces of delicious baby! She is snoozing on me right now. Still feels surreal. I'm very grateful for the advice and encouragement here (sorry no pics, she's an offline baby :) )

Congratulations!  Hope you are both doing well!  Enjoy your little sweetheart, they grow up so fast!

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Re: Trying to Conceive, the Mustachian way?
« Reply #139 on: November 17, 2016, 11:26:21 AM »
This is a long post on an old thread, I apologize for that, but it seemed a pretty relevant place to share this story...


I should start with a disclaimer:
The opinions and experiences expressed in this post are purely that of the author.
This is not meant in any way to be directed at any particular person or be in response to any particular comment.
I fully acknowledge that my own personal experience is nothing more than an anecdote, and a data set of one (1) generally proves nothing.


My wife was (is!) really excited about starting a family. I've been looking forward to it too. 
I convinced her to agree to wait just a couple more months after we got married to save up some money so we can both take 6 months to a year off to be full time parents.

And I also asked for one critical thing:

Can we please not "try" to have a baby? 


Can we instead just make conditions such that it is possible, and then "allow" it to happen?
She agreed to this.
No testing kits, no books, no thermometers, no fancy expensive lubes, and no pills of any kind.

Of course she took vitamins with folic acid and DHA, and she has a free app where if you put in the dates of each period it will predict the next one as well as likely fertile days based on the historical pattern.  But she was doing both of those things for the past year anyway.
The app has the option to add temperatures to improve accuracy of fertility prediction, but we just took the calendar based prediction as a good enough rough guide.  Fertile days start several days - up to 5 days - before ovulation anyway, and only last about a day after, so knowing the exact day is of limited usefulness anyway - once you know for sure its basically too late.

Here's what we did:
We had sex often.
At least once every day (with possible exceptions during her period), usually twice (or more) on suspected fertile days.

If you read the studies online, people who mate every day tend to be more successful than those who only do it every other day. 
People who mate every other day are more successful than those who try to "time" it.
But of course both are always reported with the caveat that if you feel like its a chore, it can backfire.

And that last bit is what brings us back to that very important thing we agreed to:
not "trying" to get pregnant.

It's sort of how work is better when you don't need the money.
Or if you reward a child for playing their favorite game, they stop playing it spontaneously.
Why volunteering feels so much more rewarding than employment.
Or why monetizing a hobby makes it less fun.

Anytime you do something for some other external reward, it takes away from any intrinsic value that activity might have.  Its just human nature.
So we didn't have sex "to get pregnant".
We stopped using birth control, and we had sex because sex is fun, and it feels good, and we are attracted to each other, and it makes us feel closer to each other and strengthens our relationship.
All the same reasons we did before.

And, if we end up with a baby, well that's a great bonus for an activity we would have wanted to do anyway, because we would both love to be parents!

Instead of looking at it as we "have to" have sex, we looked at the whole baby situation from a different perspective - the fact that we want this outcome is a great excuse that ALLOWS us license to have sex all the time.
Well, not that we couldn't have anyway, but maybe "reminds" or "inspires" us, would be the better term.

But if you aren't timing sex, I don't really see what the point of knowing when ovulation occurs is... I don't think there is any good reason to do much special besides have lots of sex (and take enough folic acid)

Finally, some women can conceive perfectly fine but have something funny about their cycle that makes the 'just have sex a lot' advice not effective. Like super short fertility windows, or maybe way early ovulation that happens closer to their period than they realized (in which case maybe they weren't in the mood then).



True, there are times one or both of us feel like it more than others.

Though, notice, I didn't say "have lots of sex - if and when you feel like it".  I just said "have lots of sex".  That would include even when one or even both don't feel like it.

Now, granted, at first that seems to contradict everything I said earlier about doing it for fun instead of the reward of a baby, but it actually fits with my (and my wife's) general philosophy on the subject...
See, even when we don't already spontaneously happen to feel particularly horny, if either of us allows ourselves to be seduced by the other, we always, 100% of the time, end up getting into it and enjoying it.  Knowing that from past experience, we are both in the habit of saying "yes".  We believe this is good relationship policy, regardless of whether you are trying to get pregnant or not. 

Obviously there are exceptions; cases like injury, illness, running late or needing sleep. But mostly its a shift in mindset.
Its kind of like a yummy treat.  You can feel hunger, and then you make a point to find food.  But if someone offers you a bite of something delicious, you are likely to accept even if you aren't at all hungry, because you know it will taste good.  Similarly, when you "feel like it" you may seek out sex, but even when you don't, it will still end up feeling good, so why not accept - or even make! - the offer anyway?

So, anyway, this is what we did.
and, if that free app is actually accurate, then, based on when we stopped using birth control, it took exactly one day(!) to conceive...
...well, that would have been a little too easy. 
Turned out to be a "chemical pregnancy" (an odd choice of term to mean "very early miscarriage"), only 2 1/2 weeks later, basically immediately after implantation.


And here our methods served us in an unexpected way:  We had a couple of days of suspecting it might be possible from how she felt, but we didn't actually have any confirmation there had ever been conception until after we knew there wasn't any anymore - the advice nurse had her come in the the doctor's office because her symptoms could possibly have indicated an ectopic pregnancy and her HCG levels indicated she had been pregnant, briefly, but wasn't currently. 
That meant a situation that for many is mildly traumatic was more of just a mild disappointment. 
It turns out likely somewhere in the range of 50-70% of all conceptions end in either "chemical pregnancy" or official miscarriage.
(You see the range 20-25% a lot online, but that is only counting "medically confirmed" cases.  The likelihood of being confirmed by a doctor goes up with each passing week, but the likelihood of losing it goes down, which means the majority of cases are unlikely to ever be medically confirmed in the first place.  The earliest ones - those that occur in the first 1-3 weeks - often won't produce any symptoms at all and a period may not even be late, so no one ever even suspects it happened.)


So this wasn't necessarily a sign of any real problems, and it let us know we are both fertile.
In fact, supposedly fertility increases after a miscarriage, so, statistically speaking, this put us "ahead of schedule" so to speak, since its expected to take 6-12 cycles, and we were only at number 2.
 
Then a few months later, similar circumstances: 5 days after the soonest she might have ovulated again she started feeling nausea and sore breasts, which increased a couple days, but upon testing learned it was a chemical pregnancy.


So then we had to make a choice - statistically this is still not particularly abnormal, and could easily just be coincidence.  So we could do nothing.


Then again, there was some reason to suspect (from some completely unrelated things a long time ago) that there may be a mild hormone balance issue.  We could wait a month or two and run a bunch of tests and possibly have a better idea what, if any, issues there may be (but still not a conclusive answer, because medical science rarely gives conclusive answers to anything.
Or we could just keep doing what we are doing, and see what happens next time around. 
For now at least, we are going with this last option.


And here's the most significant part: despite the complications we ran into so far, there is still no reason we should have done anything differently before hand. It wouldn't have changed anything.  We would still be at exactly the same place we are right now.  The only difference is the process would have been a lot more stressful (and we probably would have had much less sex - and the sex we had would have been less fun!)


Guess now I'll have to check back in in a few months with updates...

I started with a disclaimer acknowledging that this story is an anecdote, a sample size of one.
But that isn't entirely true.

In the US 50% of all pregnancies are unplanned.
50%!
That's about 3 million people every year who get pregnant without having done anything special to "try".
In fact, most of them were probably trying NOT to!
They definitely weren't charting, or timing sex to ovulation, or using special pro-sperm lubes
(which, by the way, have not been found any more effective than regular commercial ones in practice, in real life studies of actual people trying to conceive.  The lab tests that supposedly confirm it's superiority were done in grossly unrealistic conditions that don't simulate real sex.  Also, the lab tests that have purported to compare special lube to "regular" lube have used weird stuff like "warming" and "tingling" and thick gels.  The ingredient lists of ordinary, inexpensive, no frills lubes is nearly identical to the specialty stuff)

So, my point in all this is this: try not to worry so much!
People have been having babies for hundreds of thousands of years.  Millions, if you count all the living things that aren't quite "people" per say.
It seems entirely possible (and there is even some evidence to support this), that the mere fact of stressing about it makes it a little bit harder to actually succeed.

I'm not suggesting anyone actually change any behaviors or do or not do any particular thing.
But what I am suggesting is reframing the process, mentally, emotionally.
You probably won't get pregnant any sooner (or later) by reframing.  But you are very likely to have a more pleasant experience in the meantime if you do.
« Last Edit: May 18, 2017, 08:13:42 AM by Bakari »

Daleth

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Re: Trying to Conceive, the Mustachian way?
« Reply #140 on: November 28, 2016, 07:55:15 AM »
You probably won't get pregnant any sooner (or later) by reframing.  But you are very likely to have a more pleasant experience in the meantime if you do.

That's definitely true. It's good advice for people who are just starting out. Although, for those whose efforts don't result in a pregnancy that sticks after one year of relaxing/reframing/shaggin (or 2 years if the woman is under 30), not only is more effort needed, but reframing and just trying to relax and enjoy themselves isn't likely to work anymore--by which I mean, it won't help them relax anymore. And there's nothing wrong with that; if a couple reaches that point, it's time to see at least a gynecologist, and (if you want to cut to the chase) ideally a reproductive endocrinologist, for some testing.

One quick note: you mentioned the possible option of trying an over-the-counter progesterone supplement. Please do not try to self-medicate with hormones. That is a genuinely terrible idea because (1) if progesterone is not the problem, you will be throwing her system out of whack and (2) even if it is the problem, the dosage and type of progesterone in the OTC supplement is highly unlikely to be what she needs.

Oh! And another note: we were told when trying to conceive NOT to have sex daily or multiple times daily because it exhausts the man's sperm count. They suggested every other day at most, except that when her ovulation testing shows it's the right time, then do it every day (just for that roughly 2-3 day period).

Also, hoping things work out for you, but if you reach the one-year mark without a continuing pregnancy, here's the basic testing to be done: (1) sperm count/morphology for you; (2) blood tests on day 3 of her menstrual cycle for her, specifically: (a) E2 (estradiol); (b) FSH (follicle stimulating hormone); (c) AMH (anti-mullerian hormone--this can be done on any cycle day but since she's already getting blood drawn on day 3 for the others, might as well test this now); and finally, (3) a transvaginal ultrasound to count the number of antral follicles on her ovaries.

If any of those tests come back abnormal, your doctor will advise you on what to do. If they're all normal and she's under, say, 35, you can just keep on shagging... :)


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Re: Trying to Conceive, the Mustachian way?
« Reply #141 on: November 28, 2016, 09:24:49 AM »
If anyone uses snagshout(.com)- Easy@home brand midstream pregnancy tests are up with a super cheap code to get them on Amazon (free shipping with Prime)

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Re: Trying to Conceive, the Mustachian way?
« Reply #142 on: November 28, 2016, 10:18:37 AM »
This is a long post on an old thread, I apologize for that, but it seemed a pretty relevant place to share this story...


I should start with a disclaimer:
The opinions and experiences expressed in this post are purely that of the author.
This is not meant in any way to be directed at any particular person or be in response to any particular comment.
I fully acknowledge that my own personal experience is nothing more than an anecdote, and a data set of one (1) generally proves nothing.


My wife was (is!) really excited about starting a family. I've been looking forward to it too. 
I convinced her to agree to wait just a couple more months after we got married to save up some money so we can both take 6 months to a year off to be full time parents.

And I also asked for one critical thing:

Can we please not "try" to have a baby? 


Can we instead just make conditions such that it is possible, and then "allow" it to happen?
She agreed to this.
No testing kits, no books, no thermometers, no fancy expensive lubes, and no pills of any kind.

Of course she took vitamins with folic acid and DHA, and she has a free app where if you put in the dates of each period it will predict the next one as well as likely fertile days based on the historical pattern.  But she was doing both of those things for the past year anyway.
The app has the option to add temperatures to improve accuracy of fertility prediction, but we just took the calendar based prediction as a good enough rough guide.  Fertile days start several days - up to 5 days - before ovulation anyway, and only last about a day after, so knowing the exact day is of limited usefulness anyway - once you know for sure its basically too late.

Here's what we did:
We had sex often.
At least once every day (with possible exceptions during her period), usually twice (or more) on suspected fertile days.

If you read the studies online, people who mate every day tend to be more successful than those who only do it every other day. 
People who mate every other day are more successful than those who try to "time" it.
But of course both are always reported with the caveat that if you feel like its a chore, it can backfire.

And that last bit is what brings us back to that very important thing we agreed to:
not "trying" to get pregnant.

It's sort of how work is better when you don't need the money.
Or if you reward a child for playing their favorite game, they stop playing it spontaneously.
Why volunteering feels so much more rewarding than employment.
Or why monetizing a hobby makes it less fun.

Anytime you do something for some other external reward, it takes away from any intrinsic value that activity might have.  Its just human nature.
So we didn't have sex "to get pregnant".
We stopped using birth control, and we had sex because sex is fun, and it feels good, and we are attracted to each other, and it makes us feel closer to each other and strengthens our relationship.
All the same reasons we did before.

And, if we end up with a baby, well that's a great bonus for an activity we would have wanted to do anyway, because we would both love to be parents!

Instead of looking at it as we "have to" have sex, we looked at the whole baby situation from a different perspective - the fact that we want this outcome is a great excuse that ALLOWS us license to have sex all the time.
Well, not that we couldn't have anyway, but maybe "reminds" or "inspires" us, would be the better term.

But if you aren't timing sex, I don't really see what the point of knowing when ovulation occurs is... I don't think there is any good reason to do much special besides have lots of sex (and take enough folic acid)

Finally, some women can conceive perfectly fine but have something funny about their cycle that makes the 'just have sex a lot' advice not effective. Like super short fertility windows, or maybe way early ovulation that happens closer to their period than they realized (in which case maybe they weren't in the mood then).



True, there are times one or both of us feel like it more than others.

Though, notice, I didn't say "have lots of sex - if and when you feel like it".  I just said "have lots of sex".  That would include even when one or even both don't feel like it.

Now, granted, at first that seems to contradict everything I said earlier about doing it for fun instead of the reward of a baby, but it actually fits with my (and my wife's) general philosophy on the subject...
See, even when we don't already spontaneously happen to feel particularly horny, if either of us allows ourselves to be seduced by the other, we always, 100% of the time, end up getting into it and enjoying it.  Knowing that from past experience, we are both in the habit of saying "yes".  We believe this is good relationship policy, regardless of whether you are trying to get pregnant or not. 

Obviously there are exceptions; cases like injury, illness, running late or needing sleep. But mostly its a shift in mindset.
Its kind of like a yummy treat.  You can feel hunger, and then you make a point to find food.  But if someone offers you a bite of something delicious, you are likely to accept even if you aren't at all hungry, because you know it will taste good.  Similarly, when you "feel like it" you may seek out sex, but even when you don't, it will still end up feeling good, so why not accept - or even make! - the offer anyway?

So, anyway, this is what we did.
and, if that free app is actually accurate, then, based on when we stopped using birth control, it took exactly one day(!) to conceive...
...well, that would have been a little too easy. 
Turned out to be a "chemical pregnancy" (an odd choice of term to mean "very early miscarriage"), only 2 1/2 weeks later, basically immediately after implantation.


And here our methods served us in an unexpected way:  We had a couple of days of suspecting it might be possible from how she felt, but we didn't actually have any confirmation there had ever been conception until after we knew there wasn't any anymore - the advice nurse had her come in the the doctor's office because her symptoms could possibly have indicated an ectopic pregnancy and her HCG levels indicated she had been pregnant, briefly, but wasn't currently. 
That meant a situation that for many is mildly traumatic was more of just a mild disappointment. 
It turns out likely somewhere in the range of 50-70% of all conceptions end in either "chemical pregnancy" or official miscarriage.
(You see the range 20-25% a lot online, but that is only counting "medically confirmed" cases.  The likelihood of being confirmed by a doctor goes up with each passing week, but the likelihood of losing it goes down, which means the majority of cases are unlikely to ever be medically confirmed in the first place.  The earliest ones - those that occur in the first 1-3 weeks - often won't produce any symptoms at all and a period may not even be late, so no one ever even suspects it happened.)


So this wasn't necessarily a sign of any real problems, and it let us know we are both fertile.
In fact, supposedly fertility increases after a miscarriage, so, statistically speaking, this put us "ahead of schedule" so to speak, since its expected to take 6-12 cycles, and we were only at number 2.
 
Then the next cycle, similar circumstances: 5 days after the soonest she might have ovulated again she started feeling nausea and sore breasts, which increased a couple days, but then there was either a miscarriage (if she had been pregnant at all), or a period (no conclusive tests this time).


So now we have to make a choice - statistically this is still not particularly abnormal, and could easily just be coincidence.  So we could do nothing.
Then again, there was some reason to suspect (from some completely unrelated things a long time ago) that there may be a mild hormone balance issue.  We could wait a month or two and run a bunch of tests and possibly have a better idea what, if any, issues there may be (but still not a conclusive answer, because medical science rarely gives conclusive answers to anything.
Or we could just use a little bit of over-the-counter progesterone supplement - which would deal with the most common and likely source of this specific issue, other wise keep doing what we are doing, and see what happens next time around. 
For now at least, we are going with this last option.


And here's the most significant part: despite the complications we ran into so far, there is still no reason we should have done anything differently before hand. It wouldn't have changed anything.  We would still be at exactly the same place we are right now.  The only difference is the process would have been a lot more stressful (and we probably would have had much less sex - and the sex we had would have been less fun!)


Guess now I'll have to check back in in a few months with updates...

I started with a disclaimer acknowledging that this story is an anecdote, a sample size of one.
But that isn't entirely true.

In the US 50% of all pregnancies are unplanned.
50%!
That's about 3 million people every year who get pregnant without having done anything special to "try".
In fact, most of them were probably trying NOT to!
They definitely weren't charting, or timing sex to ovulation, or using special pro-sperm lubes
(which, by the way, have not been found any more effective than regular commercial ones in practice, in real life studies of actual people trying to conceive.  The lab tests that supposedly confirm it's superiority were done in grossly unrealistic conditions that don't simulate real sex.  Also, the lab tests that have purported to compare special lube to "regular" lube have used weird stuff like "warming" and "tingling" and thick gels.  The ingredient lists of ordinary, inexpensive, no frills lubes is nearly identical to the specialty stuff)

So, my point in all this is this: try not to worry so much!
People have been having babies for hundreds of thousands of years.  Millions, if you count all the living things that aren't quite "people" per say.
It seems entirely possible (and there is even some evidence to support this), that the mere fact of stressing about it makes it a little bit harder to actually succeed.

I'm not suggesting anyone actually change any behaviors or do or not do any particular thing.
But what I am suggesting is reframingthe process, mentally, emotionally.
You probably won't get pregnant any sooner (or later) by reframing.  But you are very likely to have a more pleasant experience in the meantime if you do.[/size]


Sorry to hear about your chem pregnancy/early miscarriage. I had early losses before successfully conceiving my first. Even though they are disappointing and upsetting, they are ridiculously common. Chances are, you both are completely fine and your next one will stick. Even if it doesn't, that still doesn't mean you should panic. After having consecutive losses (pretty rare but not unheard of) I was referred to a fertility specialist and she ran a bunch of hormonal tests etc but turns out I was in perfect health (better than perfect even, apparently I have the egg reserve of a teen/early 20 something). Conceived my daughter immediately after my last loss and she is now a nutty 1 year old. The fertility specialists think I just ended up being one of the really unlucky women who experience back to back false starts due to chance alone and not a medical problem. We are currently trying to conceive #2, so hopefully we'll have some luck in the next couple months!

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Re: Trying to Conceive, the Mustachian way?
« Reply #143 on: November 29, 2016, 03:20:17 PM »
You probably won't get pregnant any sooner (or later) by reframing.  But you are very likely to have a more pleasant experience in the meantime if you do.

That's definitely true. It's good advice for people who are just starting out. Although, for those whose efforts don't result in a pregnancy that sticks after one year of relaxing/reframing/shaggin (or 2 years if the woman is under 30), not only is more effort needed, but reframing and just trying to relax and enjoy themselves isn't likely to work anymore--by which I mean, it won't help them relax anymore. And there's nothing wrong with that; if a couple reaches that point, it's time to see at least a gynecologist, and (if you want to cut to the chase) ideally a reproductive endocrinologist, for some testing.




Oh, yes, I 100% agree with you.  The reason I thought to write was because there are SO MANY people who buy thermometers and tests and books and everything else right from the very beginning, without even having tried a single month, never mind 6-12.
Reading all the many forums on TTC online, it seems that it is almost just the default, instead of a last resort.  And that made me think of this thread, and my comment in it last year.



Quote
One quick note: you mentioned the possible option of trying an over-the-counter progesterone supplement. Please do not try to self-medicate with hormones. That is a genuinely terrible idea because (1) if progesterone is not the problem, you will be throwing her system out of whack and (2) even if it is the problem, the dosage and type of progesterone in the OTC supplement is highly unlikely to be what she needs.
I've read of it working for a number of people, but you're right, we should get 2nd opinion / doctor feedback.
It appears that all the forms have the exact same effects, and the main drawback of the topical version is the small, and possibly inconsistent, dose:

http://www.webmd.com/vitamins-supplements/ingredientmono-760-progesterone.aspx?activeingredientid=760&


https://www.ncbi.nlm.nih.gov/pubmed/16109596


https://www.ncbi.nlm.nih.gov/pubmed/15772572

Quote
Oh! And another note: we were told when trying to conceive NOT to have sex daily or multiple times daily because it exhausts the man's sperm count. They suggested every other day at most, except that when her ovulation testing shows it's the right time, then do it every day (just for that roughly 2-3 day period).


True that this is the conventional wisdom, and what "everyone" recommends, however it isn't backed up by science:

https://www.theguardian.com/lifeandstyle/2015/oct/12/will-having-sex-every-day-increase-my-fertility


https://www.sciencedaily.com/releases/2009/06/090630075311.htm


http://www.kidspot.com.au/birth/conception/fertility/7-surprising-fertility-facts




As far as "exhausting" sperm count (or depleting, or whatever) outside of the fertile window, that simply doesn't matter one way or the other, because there is no reserve.  Each time everything available is used, so it wouldn't make any difference if he had sex twice a day, every other day, or just once the day before, the first time during the fertility window will only consist of what built up in the past 24 hours.


Ovulation testing will tell you when, or more likely the next day after, ovulation occurs.  But the fertility window is the 5 days leading UP TO ovulation.  If you wait until testing says it is the right time, its actually just about too late.  You want (healthy) sperm already waiting in the fallopian tube by the time the egg gets there.


The egg has no way to distinguish the number of sperm in it's general vicinity that come from any particular ejaculation.  Sperm live as much as 5-6 days (hence the 5 day window).  So even if the sperm count per sex instance were half as much, the total sperm available for conception is the exact same amount.  In other words, 2 consecutive days with 30 million sperm counts leads to the same total sperm in her reproductive tract as 60 million once.Except that his body will more likely ramp up production to the maximum it can with more frequent sex (though it would take 1-2 months to make a difference, since that's how long sperm production takes), so it is likely slightly more total, for example maybe instead of halving with doubled frequency, the sperm count drops to 31 million per time as it tries to keep up, resulting in a slightly higher total of 62 million. Ultimately, the "minimum" sperm count thing is just a probability/statistic thing, not an actual reproductive biology rule.  Ultimately, it only takes a few dozen.There is evidence that production rate in several species of animal matters more than absolute count, and it's documented that rates vary in humans based on a number of factors including environment, diet, drugs, possibly age (conflicting reports) and notably testosterone - which in turn is known to increase with more sexual frequency.  Unfortunately, the study that would give a direct answer to the question has never been done, but the bottom line is that couples who have actually had sex every day tend to get pregnant faster than ones who do every other day.   What ever the reason(s) turn out to be, whenever real world results conflict with "expert opinion", reality wins.
What seems likely is that people noted that men with abnormally low sperm counts have lower fertility rates, and inferred from that the count per ejaculation is what matters in general.

Quote
Also, hoping things work out for you, but if you reach the one-year mark without a continuing pregnancy,
Thanks!! 1 year, or a another chemical, which ever comes first...
Thanks for all the feedback and advice![/size][/font]
« Last Edit: November 30, 2016, 08:30:33 AM by Bakari »

I'm a red panda

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Re: Trying to Conceive, the Mustachian way?
« Reply #144 on: December 26, 2016, 11:20:15 AM »
Snagshout deal again:
https://www.snagshout.com/offers/easy-home-8-ovulation-lh-plus-2-pregnancy/31f0d7
8 ovulation tests and 2 pregnancy tests for $1.00
That's good for one cycle.  I used this brand and they work great.

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Re: Trying to Conceive, the Mustachian way?
« Reply #145 on: December 27, 2016, 04:38:50 PM »

Ovulation testing will tell you when, or more likely the next day after, ovulation occurs.  But the fertility window is the 5 days leading UP TO ovulation.  If you wait until testing says it is the right time, its actually just about too late.  You want (healthy) sperm already waiting in the fallopian tube by the time the egg gets there.


Each to their own of course about whether and when to test. However as we are discussing alot of anecdata, here's mine.

I had been on the pill for approx 13 years when we decided to start trying to conceive, so of course I had no idea how long my real cycle was or when/if I would ovulate.

I used an app, which works on the 14 days to ovulate, 14 days to period assumption, but this wasn't correct for me, and in the absence of ovulation tests or temperatures I would have continued to think my fertile days were a week before they actually are.

I decided to temp, and to use the Clear blue dual hormone ovulation tests, which pick up the hormone rise prior to ovulation, so you can see when the fertile days start, and then show the LH rise which confirms ovulation.

These showed that I didn't ovulate the first month after going off the pill.
The second month I ovulated on day 21, so it was nice to know my fertility was back as it can take 6months +.
The third month again was day 21, and I fell pregnant, and am now 8 months and due in Feb.

I probably could have ditched the temping, but that was what told me I was pregnant several days before the test confirmed it. But the ovulation tests were key for me to understanding my body's cycle quickly.
I'm at the age now though that if we want to have multiple kids and avoid fertility issues later I really don't have a year to wait and see.

All up the spend was about $100 for the ovulation tests, thermometer and pregnancy test. I feel it was money well spent. (I got prenatal supplements on prescription)

MrAlanBreck

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Re: Trying to Conceive, the Mustachian way?
« Reply #146 on: December 30, 2016, 09:45:05 AM »
My anecdotal data:

My family used the Creighton model for our two children.  Both times, my wife got pregnant within two months of trying.

http://www.creightonmodel.com/

Mind you, this is HARD, but very cheap and VERY effective once you have the basic training down.  Among my social circle, four out of the five people who used the method got pregnant within two years.  One was able to find an issue with her cycle that would have otherwise been invisible using the method.  The only one who didn't get pregnant was not using the system consistently and has a husband with VERY low sperm count.


This can also be used to AVOID pregnancy and you have the luxury of not needing to put chemicals in your body

Of course, YMMV. Maybe all of them, and my wife, would have gotten pregnant anyways.


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Re: Trying to Conceive, the Mustachian way?
« Reply #147 on: December 30, 2016, 10:02:35 AM »
Four out of five people getting pregnant in two years is just kind of a norm, regardless of method... Something like 85% of couples at any age trying for one year get pregnant.

MrAlanBreck

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Re: Trying to Conceive, the Mustachian way?
« Reply #148 on: December 30, 2016, 10:37:51 AM »
Four out of five people getting pregnant in two years is just kind of a norm, regardless of method... Something like 85% of couples at any age trying for one year get pregnant.

Yes it is. 

I should have been clearer in my post.  It's effectiveness is mostly in finding out issues in a woman's cycle that may point to difficulties in conception.  As a general rule, people with no biological issues at a reasonable age will get pregnant as long as they consistently have undisturbed intercourse.

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Re: Trying to Conceive, the Mustachian way?
« Reply #149 on: December 30, 2016, 10:55:00 PM »
Four out of five people getting pregnant in two years is just kind of a norm, regardless of method... Something like 85% of couples at any age trying for one year get pregnant.

Yes it is. 

I should have been clearer in my post.  It's effectiveness is mostly in finding out issues in a woman's cycle that may point to difficulties in conception.  As a general rule, people with no biological issues at a reasonable age will get pregnant as long as they consistently have undisturbed intercourse.
After a quick review of the website, this seems to be the "Fertility Awareness Method". I agree it can be very useful for a woman wanting to understand her cycle.