Conception

You want to be pregnant!

To create a child in-house, one or both of the aspiring parents should have the ability to get pregnant. If only one of you is so equipped, it should probably be that one, and they will probably carry all your children. If both of you can potentially carry, you will need to make a decision about who it will be, and whose gametes (sperm) will be used to initiate the pregnancy. Options for such couples include:

This decision can be informed by whatever factors you feel appropriate. Fishmother hates being pregnant (who doesn't?), but was nonetheless the right choice to carry all the pregnancies because she 1) could and 2) wanted to. Fishfather chose not to carry because of 1) preexisting health problems, 2) gender incompatibility, and 3) bad vibes. The Fishparents did not attempt rIVF because neither of them were willing to consider any stage of the process. You may feel differently. What matters is to make the best choice for you.

The other component of in-house pregnancy initiation is sperm. Ideally, exactly one of you will be equipped to provide this. If neither of you is equipped to provide this, but you are equipped to carry, you are still 90% of the way there. Donor sperm can come from a known or unknown donor. The advantage of known donors is cost and the relative ease, low medicalization and low supervision of at-home insemination (i.e. turkey baster); you get to do it yourself, and no one can tell you not to. The disadvantage – and this might be a massive one, depending on your specific local laws – concerns the donor's status as a parent under the law. Research the laws, particularly paternity laws, of the place where you live before considering a known donor.

The disadvantage of unknown donors is cost; our transition from a known to unknown donor brought our costs from $25 per conception attempt (OPKs and syringes included) to over $2000 (for one vial of sperm, specialized extremely refrigerated shipping, lab processing and an IUI.) The advantages are legal insulation between the donor and parents, the extensive health and genetic screening the donor undergoes, guaranteed high sperm count, and (if you pursue IUI) the slightly better chances of conceiving via IUI versus at home.

You may also have philosophical feelings that affect your decision. Fishmother was initially more comfortable with the idea of a known donor that would have an established (not paternal) relationship with Fish. Switching to an unknown donor was not a dealbreaker, however, and allowed the Fishparents to select a donor based on things like RH+ blood type (not the top priority, but given the choice, we wanted to spare our Fish-daughters the difficulties of RH- blood type in pregnancy), CMV status and childhood resemblance to Fishfather.

Pursuing rIVF requires a clinic's involvement. One partner will have their eggs retrieved; the other will undergo IVF, as the clinic combines those eggs with donor sperm and place the embryos in the carrying partner. The price on this is potentially staggering, and the process quite invasive, but the opportunity for same-sex biological involvement is very special.

Gametes Located and Ready to Rumble

You can decide how serious you want to get right away. If you are a couple with one person able to get pregnant and one person carrying sperm, you have the option of "neither trying nor preventing", which is to say, stopping any methods of birth control you might have been using and kind of going at it without worrying. This is certainly the most relaxing and spares you the calendar-test-temperature rigamarole. However, if you have been doing this for a little while and are disappointed nothing has happened, it may be time to step things up. If you're involving a sperm donor, you'll need to be serious about timing from day one.

Sperm can contribute to a pregnancy at any time, and does not operate on a monthly cycle. The egg, however, appears once a month and sticks around for about a day, after which it gives up and you have a period. Your conception efforts will need to be timed towards this single egg day, or "ovulation". Ovulation is typically two weeks before the NEXT period, rather than a fixed count of days from the previous one. It is accompanied by signs such as abundant discharge and thick, egg-white textured cervical mucus. If you have regular menstrual cycles and regularly experience the symptoms of ovulation, you may find it relatively easy to predict and time. If your cycles are irregular or your symptoms inconsistent, this will be much more difficult, and you will probably want to involve OPKs (ovulation predictor kits) right away. Conception is theoretically possible for about six days, ovulation being the fifth of these; your chances are best, though, on the day of ovulation or directly before. The Fishparents were able to achieve one conception with their known donor based solely on counting Fishmother's regular cycle and observing symptoms of ovulation; however, as things got thornier, the involvement of OPKs took a major load off and added a modicum of certainty to the operation. If you make use of more expensive methods such as IUIs, you will definitely also use OPKs, and a lot of them.

Some people are also able to track ovulation by taking their temperature every morning. Fishmother is not good in the morning and does not enjoy finicky jobs that are easy to get wrong, so we did not attempt it. However, you can find a lot of information about this method (BBT, or basal body temperature tracking) online, and give it a go if it seems helpful to you.

Infertility

You may attempt to initiate a pregnancy based on certain assumptions about aspiring parents' equipment that turn out later to be false (aka infertility!) Either or both parents can experience difficulties that prevent conception. This is an extensive topic with many manifestations; don't be afraid to seek help after a relatively short time if you are struggling to conceive. Although a year is often cited as the benchmark for medical infertility, you may be able to pursue treatment after six months of well-timed attempts to conceive without success.

Waiting

After attempting to get pregnant on the day of ovulation, you now have two weeks to wait before you can take a pregnancy test to see if it worked. Yep... it's no fun. Time to get a hobby. You can play symptom spotting games if you want, to try and figure out if you've conceived, and Fishmother certainly did plenty of this. It didn't work for us – the earliest I ever correctly identified a pregnancy from symptoms was only three days before the missed period, aka could also have taken a Clearblue, but who's to say it won't work for you? No... the hobby is probably a better idea. There is not much you can do.

If you are on progesterone supplements, you will have symptoms resembling pregnancy symptoms from the day you begin taking them. These will put a kibosh on symptom spotting. Don't mistake them for signs of pregnancy, but do distract yourself by reading the entire Wikipedia article on "progesterone" to try and understand why you are feeling like crap before the pregnancy's even gotten started!

Testing

Pregnancy tests these days are extremely sensitive; a good test will give you a result near certainty on the day of a missed period, but Clearblue claims up to 75% accuracy as much as four days early. We avoided testing this early so as to avoid the psychic damage from a false negative test, but I liked to get at least one test in before the period date so I could have a better chance of catching chemical pregnancies (sometimes they say not to do this, but for our $2000 per try situation, I wanted to have as accurate as possible a sense of my conception success rate.) For our most recent pregnancy I took two tests, one the day before and one the day after the missed period date. It's all something of a mind game...as always, do what's best for you.

I'm Not Pregnant

When you're trying, this is disappointing no matter what; when a clinic is involved, it's a disappointment with something of a sickening price tag. Well, rinse and repeat. After two unsuccessful IUI's a clinic will probably want to step you up to a medicated cycle: this is a decision you and they can make together. If you are doing any type of at-home insemination, you get more free tries; after six cycles you might be able to get a referral for infertility services.

Time moves very slowly during this phase of your life, such that every month feels like six or more. Other people may succeed in getting pregnant while you are still trying, which may make you feel like it's NEVER going to happen, and it's also not fair, because the next door neighbor had her first pregnancy at the same time as you and she has two children and you still have none... and so on. I found great comfort in remembering my experience as a child with friends who were "close in age" to me, sometimes meaning two or three years younger or older, and my good relationships with three- and five-year separated siblings, with my eleven-years-younger cousin. Every day is an eternity when you are in it, but even though "getting lapped" may feel devastating in the moment, in the long run, it may just mean your child grows up with two older cousins that they love instead of just one.

I Am Pregnant

You've been bending all your efforts towards this faint second line for months, and you've finally gotten it. Welcome to a new stage. Check out our pregnancy resources, or go back to Fishparents Home.

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