Until we ttc

[riehlism]

My plan before TTC:

Medical work up: Negative for all known tests, but my hematologist is suspicious of some type of blood disorder. You know, the undiscovered kind...just my luck
LDA: Both my MFM and OB suggested I start LDA prior
Diet & Exercise: As best as I can. I bought an elliptical and was more cognizant of food choices/portions
Folic Acid: Before I found out I was pregnant, my RE placed me on extra folic acid. Little did we know I already had a baby in the making at that appt
Metformin: For PCOS. I HATED my metformin. It totally messed with my cycle. I ended up with 60+ day cycles...it was not fun when TTC. I was on it until 12 weeks (as some evidence shows it provides a level of protection in the first trimester). I am off it now but will go back after the baby is born.

Birth Control: Because of the strong link between preeclampsia and blood clotting, I was advised to not be on traditional birth control. I took Jolviette (mini pill). My OB friend, and OB suggested I use Mirena (an IUD) if I planned on waiting a while to TTC. But since we were going to wait a few months, the cost and trouble of Mirena just didn't make sense.

I have tried the NuvaRing in the past, which is fantastic. But because it is a traditional birth control (that is an estrogen-bearing medication) it does increase your risk of blood clots. So while I loved the NuvaRing, it is not recommended for those with a history of preeclampsia.

And I may be wrong, but spermicide alone is only 80% effective when used correctly. Risky odds, if you ask me.

If you are just planning on waiting a few months (7-8) like we did, maybe the minipill is a good bet. It is a progestin-only type of birth control. Estrogen is the hormone you have to worry about with blood clotting. Bring it up again with your OB (and make sure he/she isn't after your money if they push the IUD, which is $900 for the IUD alone). The mini-pill just seems to be a good short term solution to hold you off until you are ready to TTC.

[flori]

Jasmin, did you have a classical c? I've read conflicting recommendations regarding the amount of time you should wait before ttc after a classical. My peri actually said to wait a year, but I've read that some recommend waiting up to two. However, because I know it will probably take several months before we conceive because of the PCOS, dh and I were thinking that maybe we'd start at the 8 or 9 month mark. I would love the option of starting sooner, but I'm terrified of uterine rupture. I'm interested to hear if your doc ok'd a shorter wait.

I haven't scheduled an OB appointment yet, but I think I am leaning towards the mini-pill. I did just read that they suppress ovulation, which concerns me. Could this lead to a problem later, especially if I have PCOS and trouble ovulating on my own? Also, does it stay in your system as long as traditional pills?

[riehlism]

Because it's birth control, it should inhibit ovulation. That's it's job and you should bounce back in a couple of cycles or so...just like regular birth control.

I did have a Classical C-Section. My MFM said 8 months. Some people say 1-2 years, but that is pretty conservative. With a classical the concern is tissue healing and scarring. Really, tissue healing will occur at 3 months. But they need to tack on time for scarring. 1-2 was the old recommendation. But I can see why providers might have a tough time cutting the time because they would rather be safe than sorry.

[angieb]

Ah, the oral sex thing has been discussed here (ie. ingesting sperm) several times, as has immunological response theories (in many of the same discussions if you do a search). Personally, I don't buy into either of them. DH and I were married and did not use condoms for around 7 years before I got pregnant (we got married young, I was only 18.) That certainly didn't prevent me from getting HELLP.

My MFM only made me wait 6 months with a classical c-section and my OB was okay with 3 months-- you'll find that the recommended time varies. I was a lot more concerned with getting pregnant again in the 2 year window than I was with the very very small risk of uterine rupture. (I know they say 10% but all of the most recent research and studies I read about it was less than 1%.) But anyway, you could start charting to avoid, so you would recognize the signs of imminent ovulation, and then use either withdrawal or condoms for the period when you are fertile. That can work the other way and help you when you are TTC. The book Taking Charge of Your Fertility by Toni Weschler goes very in depth on how to do this and most people can successfully avoid for years/indefinitely as long as they follow the rules. I would still use another back up like condoms for the first 3 months or so while you are figuring out what your cycle is doing, etc. but that might be the best preventative that won't potentially mess you up hormonally.

[angieb]

Regarding the pill, it can really go either way. If you look at some online fertility forums,(www.tcoyf.com is one I like) the pill can mess some people up for months to up to a year. Others it doesn't effect at all. I don't really think it especially hurt or helped me, my cycles were screwed up before I was on the pill and then again after I went off it (about 6 years later.) My friend was on it a few years and had normal cycles prior to being on it, it took her about 9 months for her cycles to be normal again, which is not really that abnormal. I guess it depends on how quickly you want to get pregnant again when you are ready, but personally I won't ever go back on the pill or anything hormonal like that again because the last thing I need is my cycles to get screwed up more.

[angieb]

Lornarose- Thank you so much for your very sweet comments!

[sam10]

I had a classical c-section and my ob said to wait 9 months and my MFM 1 year. At the 9 month mark, I was not ready (emotionally).

I was advised not to use any hormone based birth control, so condoms seem the most convenient, as it does not interfere with my cycle; When time for TTC has come, it was easy to just not use them anymore. As Angie mentioned, the information and methods from the book TCOYF I find quite helpful too.

[sarahkm]

Hi there,

I'm kinda coming into the conversation late but I thought I'd chime in on the birth control issue. Our son was stillborn in 2006 due to placental abruption, and Class I HELLP syndrome at 38 weeks. I ended up in acute renal failure and still have insufficient kidney function and hypertension. My hypertension is controlled right now on diltiazem and metoprolol. We used condoms for the first 2 to 3 years after Nathanael's delivery. My doctor had been recommending the IUD but I couldn't get myself to agree to it. Then I again asked about restarting some sort of pill instead and he started me on the progesterone pills. My blood pressure remains stable.

I'm sorry for your loss! We are in the middle of deciding whether to ttc despite my hypertension and kidney issues.

Sarah