• The Book

    The Book

    TTC Book cover Trying to Conceive by Fiona McPhillips, featuring a foreword by Dr John Waterstone and published by Liberties Press, is available countrywide now. It is an easy-to-read guide for all those trying to conceive, providing both medical information and a personal perspective on the entire range of fertility issues. It is also available from Liberties Press and Amazon.

  • The Author

    The Author

    photo of Fiona Fiona McPhillips is a freelance journalist and academic researcher. Having given birth to her son in 2003, she then faced three rounds of Clomid, three IUIs, two IVFs and suffered six miscarriages before giving birth to her daughter last year. She is currently expecting another baby.

    fiona at makingbabies dot ie

    Digital Media Awards logo
  • I’m an infertile, get me out of here…..

    May 19th, 2009

    God, this is not easy. Or maybe I’m just no good at it. Never was.

    A heartbeat at 6 weeks does not mean that panic won’t set in sometime later. Morning sickness has been adequately awful, but what happens when it is not quite so bad one day? The fear. Still feeling ok the next day? Meltdown.

    It was only a 2 day respite but enough for me to question everything I’ve learned in my 9 pregnancies. So I was almost shaking at today’s 9 week scan. All fine. Baby is measuring a couple of days behind but all completely normal according to obs. Heart is beating, growth is good since last scan. And yet I’m still thinking about the 2 days and what if it loses another 2 days by the next scan.

    Maybe it’s just the tiredness and the sickness and the feeling that I couldn’t possibly be this lucky again. And the thought that I could be this lucky, it is so exciting and wonderful and I suppose it might really happen!

    High FSH

    May 6th, 2009

    I get a lot of traffic to this site from people searching for information on high FSH. Here is my take on it.

    Follicle Stimulating Hormone is secreted by the pituitary gland and stimulates the ovaries to mature follicles in preparation for ovulation. An elevated level (>10mIU/ml) on day 3 of the menstrual cycle indicates that the brain is having to work harder to stimulate the ovaries; this is thought to be related to a diminished ovarian reserve. It also means that the patient is unlikely to respond well to ovarian stimulation medication used in IUI and IVF. Doctors tend to agree that you are only as good as your worst FSH result and that a lower result one month does not cancel out a poor result another month. However, there is no consensus on whether or not a low quantity of eggs also indicates a low quality of eggs. Many reports suggest that a younger woman with high FSH has a much better chance of success than an older one with the same FSH level because her eggs are younger and therefore likely to be of better quality.

    Conventional thinking suggests that patients with high FSH have a very reduced chance of pregnancy, either with or without assistance. However, we do not know the FSH levels of those with no fertility problems so it is not possible to say that those who conceive easily always have low FSH levels. It is possible that an elevated FSH level in itself does not predict pregnancy outcome but that coupled with poor egg quality and/or other fertility problems, it may seriously reduce the chance of pregnancy.

    Traditional Chinese Medicine believes that FSH and related egg quality can vary extensively from month to month and that this can be improved with the help of acupuncture and Chinese herbs. Practitioners believe that stress can play a big part in raising FSH levels and that this does not necessarily indicate lower egg quantity or quality.

    A real life friend recently started trying for a baby. She conceived after a few months but sadly miscarried. She had had day 3 and 7dpo bloodwork done early on, mainly to make sure she was ovulating. Her GP had told her that all the results were normal and she hadn’t questioned it any further. After her miscarriage she asked me advice on a few things and I asked about her FSH level, just to rule that out as a problem. She looked up the number and called me back straight away. It was 13.4, she was 33 years old. I recommended, as casually as I could, that she make an appointment with a fertility clinic, just in case. She did but never got to keep it as she conceived shortly afterwards and everything has gone well since. So, with an FSH level of 13.4, she conceived fairly easily twice. If I hadn’t mentioned it, she would never have known about the high level.

    My first FSH test, at age 35, showed my level to be 4.6. I was happy with that and didn’t think to research it any further. We carried on with tests and treatment (we were dealing with male factor infertility) for a year and a half before falling at the first hurdle of IVF. When I went for my first follicle scan after a week of ovarian stimulation, there were only three follices. Not the 15 or so I’d been expecting. I couldn’t believe it. My FSH levels were normal so how could this have happened? The nurse checked my blood test results. Yes, my FSH level was low but my E2 (oestradiol, a form of oestrogen) was over 400 pmol/l. Normal levels are below 275. A very high E2 level can suppress a high FSH level and give a low reading. My FSH should have been retested, the nurse guessed it would have been at least 10. A further week on ovarian stimulation medication yielded no further follicles but we went ahead with egg collection. We got two eggs, miraculously both fertilised and were transferred, pregnancy resulted, miscarriage followed.

    The following month, my FSH level was 17. A subsequent IVF cycle was abandoned after only one measly follicle was produced after two weeks of stimulation on the highest dose of meds possible. We triggered, tried on our own anyway. Two weeks later, two lines. Another miscarriage. Another natural cycle, another pregnancy, another miscarriage. What was going on? I wasn’t supposed to be conceiving at all with my FSH level of 17. (As for the MFI, my husband had had a varicocele ligation in the meantime and his semen analyses results were back to normal). It was retested, still 17. At this stage we reckoned IVF was a waste of time and money and invested our efforts in trying to stop the miscarriages rather than trying to conceive in the first place. I was already on Cyclogest, aspirin, Heparin, HCG shots and Prednisolone each cycle and had started Low Dose Naltrexone. I was also doing acupuncture 2 or 3 times a week, depending on the stage of my cycle.

    I took a month off and took a huge dose of antibiotics, designed to combat any low grade infection in my uterus that may be hampering my pregnancies. Next cycle I took 50mg of Clomid days 3-7 and all the above meds from ovulation. It worked. At the age of 37 and with an FSH level of 17, I supposedly had a statistical probability of about 2% of conceiving and even less of carrying to term.

    There was something preventing me carrying to term but I don’t think it was high FSH. I had six miscarriages in a row – what are the odds that I recruited six bad eggs in a row, that were eager and willing to be fertilised but unhappy to stay the distance?

    This time around I was too chicken to test. I was just too terrified that the result would be in the twenties and that would be the end of it. We were going to try anyway so I didn’t see the point in knowing, at least not at the start. And here I am, seven weeks pregnant with a healthy heartbeat, conceived with the help of nothing but acupuncture and a HCG trigger shot on my third postpartum ovulation. I am 39.

    I completely understand if my few remaining readers are reaching for the Unsubscribe button. I have done that. I’m not even sure if this post is the start or the end of something.

    Wellsphere blogging scam

    April 28th, 2009

    From www.helenjaques.co.uk:

    Health bloggers bite back as Wellsphere sells on posts provided for free

    Thanks to Robin for the parody of Wellsphere's logo.

    Wellsphere, a health community website that brings together information from more than 1,500 medical experts and bloggers, has been sold to HealthCentral Network, a collection medical information websites and condition-specific portals.

    Dr Geoffrey Rutledge, Chief Medical Information Officer of Wellsphere, generated content for his site by sending flattering emails to thousands of medicine and health bloggers (sample text “I want to tell you I think your writing is great”, “we are building a network of the web’s leading health bloggers – and I think you would be a great addition”).  Bloggers gave Wellsphere permission to publish the entire RSS feed of their site, i.e. posts they had already written, in return for exposure for their blog and more traffic.

    However, the small print of Wellsphere’s terms and conditions states that by giving Wellsphere permission to reproduce their posts, bloggers automatically grant the company “a royalty-free, paid-up, non-exclusive, worldwide, irrevocable, perpetual license to use, make, sell, offer to sell, have made, and further sublicense any such User Materials[.]” (Thanks to Symtym for checking this out)

    Bloggers who allowed Wellsphere to replicate their posts have suddenly realised that content they happily provided free is no longer theirs and has been sold off to HealthCentral for a profit, and boy are they mad.

    Exactly how much HealthCentral paid for Wellsphere has not been disclosed, but neither company is short of cash. Techcrunch reports that Wellsphere has raised $3 million in funding from venture capitalists, whereas HealthCentral has $50 million in capital.  Bloggers are fuming that such well endowed companies haven’t given them a share of the pie, or even consulted them about the consolidation deal.

    On the other hand, HealthCentral’s CEO Christopher Schroeder told the Wall Street Journal Health Blog that most bloggers “are happy and we hope with all our resources and quality-content background we will really strengthen these engagements”.  Fat chance, says the blogosphere.  Interestingly, his colleague Jeremy Shane told Medical Marketing & Media that “Wellsphere’s bloggers may be monetized through the placement of banners and other advertising”. Hmm…

    For the benefit of other Europeans like me who were happily sleeping while the Wellsphere debacle kicked off in the US, here’s a roundup of the reaction across the blogosphere.

    Writing on on Getting Better, Dr Val Jones asks “Is this the biggest scam ever pulled on health bloggers?”, whereas over on Science-based Medicine she goes a step further and calls for “the medical/science/health blogosphere to rise up ‘Motrin moms-style’.” (Last year Motrin, a company that sells analgesic medicines, tried to sell product to Mums who carry their child in a sling or a wrap by pointing out that this practice could cause back pain, and also for good measure said that ‘baby carrying’ was a fad that made Mums look “tired and crazy”. Unsurprisingly, Mums didn’t take kindly to this and headed to the internet in droves to voice their outrage, eventually forcing Motrin to take down the offensive advert and apologize to each Mother who had complained). Dr Val discusses the issue at more length in yesterday’s Doctor Anonymous show.

    Jenni Prokopy, Editor of ChronicBabe.comis sympathetic to bloggers who feel short changed by Wellsphere’s actions. She does point out, however, that blogging constitutes proper publishing and as such writers should be thinking about getting paid and about their rights regarding copyright and intellectual property.

    On Musings of a Distractible Mind, Dr Rob details his lucky escape from Wellsphere after 4 months of syndication provided him with zero extra traffic.

    Theresa Chan, author of Rural Doctoringis nervous about possible sinister outcomes of Wellsphere’s approach to content. “What if they decided to compile and publish a book for sale on their site, entitled 1001 Health Tips From Real Doctors, and proceeded to include one of my posts verbatim, along with posts by a proponent of chelation therapy for operable coronary artery disease and an anti-vaccination followers of Jenny McCarthy?”, she asks.  “Their Terms of Service would give them the right to use my post in their book, and I would have no control over the implications of association with other content I strongly oppose.”  Kevin, M.D. likewise is suspicious of Wellsphere’s motives, and asks “Is WellSphere a scam, and is its leadership laughing all the way to the bank after the HealthCentral acquisition?”.

    Ana, a Brazilian who writes about mental health, tried to get out of Wellsphere mere days before the storm kicked off – I wonder how she’s getting on, as diabetes patient Kerri Morrone Sparling of SixUntilMe had toresort to shock tactics to get her Wellsphere account deleted.

    My Strong MedicineBeyond Meds and The Butter Compartment have all also given their two penneth on the Wellsphere scandal.

    Over on Twitter there is reams of discussion on the subject of Wellsphere.  Dr. Vijay Sadasivam, who blogs atScan Man’s Notes, points out a 2007 expose of office life at Wellsphere, and TrishaTorrey notes that Wellsphere are on Twitter themselves (@wellsphere) and should be copied in on any complaints.

    And me?  I was also approached by Wellsphere last year but turned down their offer mainly on the basis of their shonky web design.  I thought their homepage was completely unhelpful, giving away nothing about what the site was for, and their WellPages portals, although packed with pretty good content, weren’t exactly easy to find or navigate.  I also read a post from August 2008 on the Neurocritic blog and took heed of their gossip on Wellsphere’s employees and business approach, and read on The Assertive Cancer Patient about how ill advised it is to sign away your blog – your own intellectual property – to a company like Wellsphere.

    Like the Assertive Cancer Patient, I am also a freelance writer.  Although I happily blog for free – for pleasure and as an online CV – I know that if I chose to I could sell the same quality writing, or even the exact same post, to a newspaper or magazine; thus, giving it away is just silly.

    So where does this leave bloggers?  If you’re happy with the exposure Wellsphere is giving your blog then you don’t necessarily need to do anything, but most bloggers are severely irked by how they have been treated by the company and are doing their best to delete their account.

    If anything, this whole kerfuffle has been a lesson to the whole blogosphere on the importance of protecting your intellectual property online (check CreativeCommons.org for more info on this subject) and on how crucial it is to read the small print.

    Best technology blogger

    February 26th, 2009

    I finally got to pick up a Blog Award. Pity it wasn’t mine! Big congrats to Justin.

    Irish Blog Awards

    February 20th, 2009

    Off to Cork for the weekend for the Irish Blog Awards. Neither of us is shortlisted this year but both of us can drink (previous years have featured IVF and pregnancy) so looking forward to it properly this time.

    Irish Blog Awards Book Event

    February 18th, 2009

    I will be on a panel to talk about blogging and books at the Irish Blog Award Book Event tonight. Also on the panel will be Sarah Rees Brennan, Twenty Major, Ivan O’Brien and Mags Walsh. It’s at 7pm at the Teacher’s Club at 36 Parnell St, Dublin 1. Not sure what a panel is or does but we will be drinking wine and talking about blogs and books.

    Life after infertility

    February 14th, 2009

    I will not go back there.

    I will not go back there.

    I will not go back there.

    Period arrives on Valentine’s Day.

    Moving on up

    January 12th, 2009

    Every night for the past five and a bit years, I have checked on James before going to bed, to make sure he is still breathing.  Every night I feel the usual relief, give him a kiss and off I go.  Then I check on Anna (still in our room).  Once again I feel relief when I see her chest rising and falling but then something else happens.  I feel a little thrill of excitement and then I get giddy.  Sometimes I giggle, sometimes I jump up and down.  Every night I get this rush of…..I’m not sure what – happiness?  joy?  innocence?  She is still here, yes, there is definitely a beautiful, breathing, live baby in my room.  We did it!!!  Seven months on and I still get a buzz every time I think of that.

    She is chatting (mama (this was her first word, at five months), dada, baba, anna, nana (technically the same word as anna)), sitting, not rolling or crawling, obsessed with remote controls, smiling and laughing almost all the time (the only time she complains is when there is a remote control out of reach) and generally behaving very well indeed.  She doesn’t sleep through the night (wakes 2 or 3 times for a breastfeed) but she does eat everything she can get her hands on (brussel sprouts, yum yum!).  I am used to the painful process of mealtime with a fussy eater so am overjoyed to have a food-compliant baby.

    I’m not going to lie (I was going to but decided not to!), I do think constantly about trying again.  I think about how far I could go, how much I could put my family through and to what extent it would be worth it.  I also think about the fact that I probably won’t have another child and I think I could come to accept that.  Not when I hear pregnancy announcements obviously – I still get in a strop about those and probably always will!  But they belong to other people’s hopes and dreams.  I have mine already.

    As for me, I am a normal person now.  Really.  I look forward to social events, meeting friends, making plans, hanging out, going shopping, eating out, staying in.  I’m cleaning up and I’m moving on, going straight and choosing life.  I’m going to be just like you: the job, the family, the fucking big television, the washing machine, the car, the compact disc and electrical tin opener, good health, low cholesterol, dental insurance, mortgage, starter home, leisurewear, luggage, three-piece suite, DIY, game shows, junk food, children, walks in the park, nine to five, good at golf, washing the car, choice of sweaters, family Christmas, indexed pension, tax exemption, clearing the gutters, getting by, looking ahead, to the day you die.

    Anna

    December 23rd, 2008

    I have wanted to write about Anna for a long time now but for various reasons, it has not happened.  I may post about her, and about the reasons I no longer post much, in the new year.  For now, here are some of the highlights of her first six months.

    9 weeks9 weeksJohn and Anna (3 months)Anna (4 months) and Mum5 months
    4 months6 monthsJames and Anna (6 months)

    Tomorrow we officially welcome her into the world.  For the first time in ages (about six months probably), I am weepy as I think about what we went through to make her and how darn wonderful our lives have been since she arrived.  Not a moment goes by that I don’t consider how much she (and my boys) means to me and how lucky I am to know her.

    I wish a peaceful Christmas and a fertile new year to all.

    Deno – how are you?

    Seoige

    November 26th, 2008

    I was on the Seoige show on RTE1 last Wednesday (Wed 19 Nov – about 28 mins in).

    Last Monday the Irish Independent reported that a Galway fertility clinic was refusing to treat unmarried couples. David Quinn of the Iona Institute was on to argue the case that married couples make better parents than unmarried ones and therefore should be the only recipients of fertility treatment and I was there to speak for normal people.

    Infertility is a medical condition. It is not up to doctors to choose which patients they treat on the basis of their own religious beliefs or morals. If you think children’s lives are at risk from their parents’ marital status then outlaw it completely. Don’t pick on those with physical disabilities and make examples of them. Just cos you can.

    Incidentally, these are the same doctors that won’t prescribe the morning after pill for women who don’t want a child, yet refuse treatment to those that are desperate for one. Guys, a little consistency is needed here if you want to be taken seriously.