How do you identify Endometriosis?

"Just take some Advil" How often have you heard those words when you complained of killer cramps? I remember vividly the first time I heard them. I was barely 17 years old. Here is my story:  “Just take some Advil.” He says, barely glancing up from the notepad where he has been diligently taking notes for the past ten minutes. (I’m starting to wonder whether he is completing a crossword puzzle instead of listening to me.) “No, really….” My 17 year-old-self answers. “They really hurt. Like I never get a period, but when I do, I am in the fetal position for, like, a day or two.” “Yeah – It’s normal. Your body is just sorting itself out. Just take a few painkillers, every four hours. Anything else?” I can’t think of anything else. I shrug and start getting my things, but my eyes are brimming with tears. I feel so frustrated. There has to be more to this story. There was. There is. Close to ten years after that day, I was diagnosed with Endometriosis through a laparoscopy. What is Endometriosis? Endometriosis is the abnormal growth of cells similar to those that form the inside or lining the tissue of the uterus, but in a location outside of the uterus. The cause of endometriosis is unknown. But it is said to affect as much as 7% of all women in their reproductive years. And it is one of the leading causes of infertility (as I found out much to my chagrin.) Symptoms of Endometriosis The symptoms of endometriosis are varied. But they include: • Cramps• Painful menstruation• Irregular vaginal or uterine bleeding• Irregular vaginal clotting• Large, painful ovarian cysts called “chocolate cysts”• Infertility, miscarriage, ectopic pregnancy• Pain during sex• Nausea/vomiting, gastrointestinal cramping, diarrhea/constipation, particularly during your period One of the many outstanding features of Glow is that it actually responds to the different symptoms that you input daily to give you insights as to whether you may need to have a conversation with your doctor about endometriosis. Treatment of Endometriosis There are many different types of treatment for endometriosis. Please visit the site of Glows’ medical advisor, Dr. Seckin and his foundation, Endometriosis Foundation of America for more information. But here are the key takeaways: Killer cramps are NOT normal. And Advil is NOT the answer.

The deal with pineapple

I'm not big on old wife's tales. I like my research to be conducted in a double-blind fashion with large cohorts. Call me kookie that way.  So I spent my morning researching this pineapple core thing. Have you heard of it? Several websites claim that if you eat the core of the pineapple AFTER ovulation and BEFORE implantation, then your little fertilized egg has a better chance of implanting. Pineapple core contains an enzyme called bromelain that reduces inflammation in the body, including in the uterus. It is also a mild blood thinner which some believe can aid in implantation.  Sounds pretty good, right? Then there are several sites that suggest how to eat it. A slice a day (including the core) for 5 days after Ovulation. And a whole bunch of women who claim it worked for them. And of course, a ton of websites selling Bromelain supplements in case you do not like eating pineapple for a week.  Here is what was missing: Any scientific study. I mean it. I looked everywhere the great google machine and my extensive list of medical journals would search for.  Here is what Medline said about it: Nothing.  That's not the say, it does not exist. It's just that I cannot find it. If anyone can - please post link below.  Having said all that - has anyone done this? 

How often to have sex if you are TTC

In studies done on fertile couples, having sex EVERY day of your fertile window resulted in a 37% conception rate.  Having sex every other day during your fertile window resulted in a 33% conception rate.  Having sex just once during your fertile window, resulted in a 15% conception rate.  As long as the male partner had no issues with sperm function, there is no downside to sex everyday. (ie, the sperm does not need that much time to "build-up" as is commonly believed.)  Clearly there is an advantage to more frequent sex, but it is very much up to the couples preference whether they want that extra 4% by having sex every day.  Source: ASRM 

Egg meets Sperm - A love story

The day after I ovulated, I would almost inevitably start feeling pregnancy symptoms. And they would DRIVE ME CRAZY. So in the interest of keeping a few of you sane - I compiled what happens the first 14 days past ovulation - and what you can expect if you are pregnant.  Day 1 - Ovulation: Your newly released egg will only survive 24 hours, but hopefully in that time, it will meet a sperm and be fertilized. Only about 300 sperm (out of millions) reach the right tube at about the right time, but only one is needed. Day 2 – Your fertilized egg is busy dividing. Day 3 – Vital cell divisions are now taking place as the fertilized egg is traveling towards implantation. Day 4 – The embryo is now at the 16 cell stage. Day 5 – Five days after fertilization, the embryo is now at the blastocyst stage. It has still not implanted. Day 6 – The blastocyst is not preparing to implant into your uterus lining. This is crucial. If this does not happen correctly, the fertilized egg will simply be flushed out with your next period. It is thought that as much as 50% of pregnancies miscarry before implantation even occurs. Day 7 – It happened! Your fertilized egg has implanted. Congratulations, you are officially pregnant. A placenta will now begin to develop. This is the earliest that you may experience a small amount of implantation bleeding. Day 8 – Your fertilized egg will signal its existence to your pituitary gland and switch of your menstrual cycle. Click. Just like that – no periods for the next nine months. Day 9 – Pregnancy hormones are now being produced. (Though they may be difficult to detect at this point.) Your embryo is less that .5mm long. Day 10 – More growth. More hormones. Now your breasts may start to hurt. You could have cramps or bloating. Although it is still VERY early to be feeling pregnancy symptoms – but some women are just very in tune with their bodies. Day 11 – Progesterone surge in your body is helping your lining thicken. It’s also playing all sorts of mind-tricks on you and driving you crazy as you analyze every twinge. Day 12 – This is usually about the latest that you will experience any implantation bleeding. About 25 percent of women will experience some bleeding on early pregnancy. Day 13 – The ball of cells is now firmly embedded in your uterus. Most pregnancy tests will pick up on the fact that you are pregnant by this point. Day 14 – You might feel you have your usual PMS symptoms – but this time around they will be pregnancy symptoms in FULL force. Feel free to complain about them to your partner with full impunity. You’ve earned it!

PCOS & Cinnamon

A small study by researchers from Columbia University Medical Center in New York City found that women with polycystic ovary syndrome who took inexpensive daily cinnamon supplements experienced nearly twice the menstrual cycles over a six-month period as women with the syndrome given an inactive placebo. Two of the women in the treated group reported spontaneous pregnancies during the trial. Of the 16 patients who completed Kort's trial, 11 were given daily 1,500-milligram cinnamon supplements and five were given placebo pills. Diet and activity levels were monitored, and patients completed monthly menstrual calendars. After six months, women receiving cinnamon had significant improvement in menstrual cycle regularity, having an average of nearly four menstrual periods over that time compared to an average of 2.2 periods among the placebo group. Two women reported spontaneous pregnancies after three months of cinnamon treatment, meaning they became pregnant without additional help. The 1,500-milligram cinnamon dose was chosen for this trial because it was between the 1,000 to 2,000 mg daily that seemed to have metabolic effects on diabetic patients in earlier research, Kort said. But all doses in that range are cheaply obtained, costing pennies per capsule. "Compared to most medical therapies these days, the cost is very small," he said. Although the study suggests a link between cinnamon and improvement of polycystic ovary syndrome, it doesn't establish a direct cause-and-effect relationship. And please talk to your doctor before you take anything. 

Pregnancy & Vitamin D

According to a recent article  - Research has shown that women's low vitamin D levels during pregnancy are linked to a higher risk of cavities in the teeth of their toddlers. Dr. Robert J. Schroth from University of Manitoba's dental school in Winnipeg and his team wondered whether low vitamin D levels in mothers during pregnancy would also translate into higher cavity rates for their toddlers. They measured vitamin D levels in the second or early third trimester in 207 pregnant women and then examined the teeth of 135 of their children when they were an average of 16 months old. Mothers-to-be were recruited from a predominantly poor, urban area. Women's vitamin D levels were mostly in the normal range, but about a third had levels that were too low. Depending on what definition of cavities the researchers used, 23 to 36 percent of the toddlers had cavities. Prenatal vitamin D levels were significantly lower in women whose toddlers later had cavities than in women whose toddlers did not have cavities, according to findings published Monday in Pediatrics. In fact, there was a direct relationship between low vitamin D levels in mothers and higher numbers of cavities in their toddlers. Besides low vitamin D levels in mothers, defects in the tooth enamel were also associated with cavities in kids. The researchers believe that improving nutrition during tooth formation and in early childhood could reduce the risk of cavities.  In place of supplementation, doctors recommend maintaining proper vitamin D levels during pregnancy the natural way - enjoy the sun, choose foods such as wild salmon, mushrooms and eggs.  Are you getting enough Vitamin D?

Are you getting enough sunshine?

This one is interesting.  Did you know that in northern countries, which have dark, cold winters, couples are less likely to conceive during the winter, whereas conception rates peak in the summer? There are a number of reasons why this association exists, but new research highlights vitamin D as one of the most important variable. Vitamin D, a steroid hormone that influences virtually every cell in your body and has been positively linked to health conditions ranging from cancer to heart disease, may significantly boost fertility in both men and women. So the first step to ensuring you are receiving all the benefits of vitamin D is to find out what your levels are using a 25(OH)D test, also called 25-hydroxyvitamin D. There are two vitamin D tests -- 1,25(OH)D and 25(OH)D -- but 25(OH)D is the better marker of overall D status. It is this marker that is most strongly associated with overall health, and it is the one you should ask your physician for. The point of vitamin D testing is, of course, to be sure you are maintaining a therapeutic level of vitamin D in your blood. A few years back, the recommended level was between 40 to 60 nanograms per milliliter (ng/ml), but more recently the optimal vitamin D level has been raised to 50-70 ng/ml. To get your levels into the healthy range, sun exposure is the BEST way to optimize your vitamin D levels; exposing a large amount of your skin until it turns the lightest shade of pink, as near to solar noon as possible, is typically necessary to achieve adequate vitamin D production. You can also take vitamins.  Do you know your Vitamin D levels? Do you feel like you get enough sunshine?     

Weight and Fertility

Do you know that your weight affects your fertility? You do. That's great. I HAD NO IDEA.  When I first started trying to get pregnant I had an additional 40 lbs on me. (Thanks PCOS, you are a peach!). When things did not work out after a while, I went to see an RE. I still cringe when I think of my innocent self in that ill-mannared man's office:  "So first off, before we even begin testing, I just want you to know that I won't accept any patients who have over a certain BMI. You are right at that limit, and I think you should lose some weight before we do anything else." Who the what now? What does my BMI have to do with getting pregnant? Isn't being pregnant the one time in our lives when we do not have to worry about this stuff and we can eat gloriously for two?  Apparently not.  What I learned after that effective slap in the face is that my soon-to-be-ex doctor was right. Weight affects your fertility. If you are underweight (below 19 BMI) - you can stop ovulating all together. If you are overweight or obese, you may still ovulate, but your cycles tend to get longer and longer. Especially if you weight is a symptom of your PCOS. Part of this is because fat cells produce estrogen. If you have too much estrogen in your system than your body reacts as if it is on birth control.  Ugh!  Okay. So what's next? How do you know if you weight is effecting your fertility. The biggest clue lies in our menstrual cycle. If your cycles are shorter than 25 days or longer than 34, then yes, weight may be a factor for you.  The key then is to find a doctor who will work with you. One who - unlike mine - is understanding and realizes the weight is a SYMPTOM of a much larger issue that needs to be addressed first.  Anyone have any research that they have on this topic or any part of it they would like to discuss? Did you know this?  

"I think I am late - what is going on?

From our blog.  ----- How many times have we looked at Glow, rechecked the days, and wondered that phrase out loud – some of us with hope, some of us in fear. Too many to count? Well, welcome to the club. It’s called the “Our-bodies-are-not-Swiss-watches-and-sometimes-they-do-as they-damn-well-please” club. Membership: 2 Billion or so. But the fact is – we are not always late when we think we are. In fact, even if your cycles are regularly 28 days, and this month, they were 32, does not mean that your period is “late”. Because that depends entirely on WHEN ovulation occurred. Let’s break it down: Our cycles are made up of three phases. Phase 1 – The Follicular Phase. During this phase, the hormone estrogen causes the lining of the uterus to grow. This lining, called the endometrium starts to develop to receive a fertilized egg should you become pregnant. The increase of another hormone, called the follicle-stimulating hormone (FSH), in turn stimulates the growth of ovarian follicles. Each follicle contains an egg. By late in the follicular phase one, or more, eggs have reached maturity and are ready to be released. Estimated Duration: 14.5 days on average, with a standard deviation of 3.5 days. (However, the phase has been known to last much longer – especially in women with PCOS.) Phase 2 – Ovulation Ovulation is what happens when a mature egg is released from your ovarian follicle to the nearest fallopian tube. An increase in LH triggers ovulation. (This is what we keep testing for with all those OPKs) The egg then travels into the uterus. It takes about three to four days for the egg to travel toward the uterus. If fertilization is to occur, it must happen within 24 hours of ovulation or the egg degenerates. Estimated Duration – 1 Day Phase 3 – The Luteal Phase After ovulation, your body starts producing large amounts of progesterone, a hormone that stimulates the uterine lining development in preparation for implantation of a fertilized egg. About five to six days after fertilization, the fertilized egg enters your uterus and becomes embedded in the lining. With implantation, cells that will eventually become the placenta begin to produce the “pregnancy hormone” or human chorionic gonadotropin (HCG). It interrupts your menstrual cycle by telling your body to produce progesterone. This prevents the loss of your lining. If however, you are not pregnant, the lining of the uterus simply sheds through the vaginal opening. Then, a new menstrual cycle begins. Estimated Duration – 13 days, with a standard deviation of 2 days. The Luteal phase is remarkably consistent from women to women. Okay. Three phases. And you are 4 days late. Which phase is to blame? Scenario 1: You are 4 days late. You have not taken any tests yet.  What gives? Well, of course, you could be pregnant. In that case, it is your Luteal Phase that has lengthened to accommodate the increased progesterone in your body. The only way to know is to take a home pregnancy test (HPT) – which is incredibly accurate starting with the day of your missed period. So please take a test. Scenario 2: You are 4 days late. But the HPT is consistently a BFN.  What gives? First answer this: Do you know when you ovulated? If you do not, then it is very possible that this month your follicular phase lasted a little longer than usual. But why would it do that? Many reasons. Diet, exercise, stress, sickness, your weight, your caffine intake, whether you smoke, whether you have recently been on any oral contraceptives. You name it – and it probably affects your Follicular Phase. When you are late – a vast majority of the time – you period is not really late. It will still arrive 12 to 14 days past ovulation. However since you most likely ovulated later in your cycle, your period also occurs, later. Scenario 3: You are 4 days late. You know EXACTLY when you ovulated. And your HPTs are still BFN.  What gives? First let me say that it is difficult for anyone to say conclusively that they know exactly when they ovulated. But a couple of factors help narrow down the window.  1. You’ve been charting your BBT and you saw the dip followed by the spike in temperature that lasted for several days.  2. AND this tied in nicely with the OPKs you have been taking that showed a clear LH surge.  3. You felt one-sided ovulation cramping, and possible experienced some ovulation spotting.  4. Your doctor performed a vaginal ultrasound and told you that you would be ovulating soon. 5. Your blood work confirmed it. If all – or most – of this happened and you feel very confident that you know when you ovulated AND you are more than 18 days past that ovulation date without a period or a positive pregnancy test – then you have every right to be stumped. Your period is most definitely late. Please speak to your health care professional. So that’s it. Hope this helps with some concerns we consistenly hear in our community. And reinforces yet again the importance of knowing our bodies well, charting our symptoms, and figuring out exactly when we ovulate. KEY TAKEAWAY: The Luteal Phase is very consistent. If you are late – then the length of your Follicular phase is most likely the real culprit. 

Dealing with Baby Showers while TTC

Posted today on our Blog. Be sure to follow Glow on Tumblr!  --------------------------------------- I am in hell. Okay, technically it is a very ritzy baby shower for a good friend, attended by about thirty of our other friends…but it feels remarkably like hell. The gloriously pregnant mother-to-be is seven months along and walks everywhere in an adorable wobble, holding her back in that classic pregnancy pose. She holds court with a few other pregnant ladies (why is everyone pregnant?) by the pink cupcakes: “I haven’t slept well in weeks, and oh my goodness – why didn’t anyone tell me about the heartburn?” I hate her. I love her. I am so happy for her. I despise her. I despise all her stupid pregnancy symptoms. I’m insanely jealous. I want heartburn. I want insomnia. Hell, I’d take hemorrhoids with a side of constant nausea if I could only get pregnant too. I’ve been trying to get pregnant for a little over a year at this point. And was greeted by a most unwelcome sight just this morning. (Oh, the cruel irony!) She has many nicknames: Crimson Tide, Aunt Flo, the Curse. But I personally call her “Game Over” – because to me that’s what she signifies: The end of the cycle. The end of hope. It is a testament to my love of my good friend that I picked myself off of the puddle of tears on the bathroom floor, took a shower, got dressed and made it over to this tea. While my outward appearance borders on respectable, my heart feels laden with lead. And my eyes - I am holding back a Hoover Dam worth of tears. Don’t say “Hi” to me. Don’t talk to me. Because the dam will burst and I will cry and cry and my tears will drown the world. I am never going to make it through this day. No, you can do it. Head up. Chin out. Smile. Just smile. Everything is lovely. The adorable pink cake that looks like a baby’s bum peeking out from under a blanket. Lovely. The pink balloons everywhere. Lovely. The mountain of gifts piling up at the corner. Lovely. I am not going to make it. There should be a law against this. There should be a checkbox on the invitation: - Yes, I can make it. -  No, I’m regretfully unavailable. -  No, as much as I love you and am so terribly happy for you, the sight of your pregnant belly pours molten lava into my heart and I feel like I cannot breathe and so please excuse my absence from your joyous event. I will be sending along an egregiously expensive present to compensate for being a crappy friend. Alas, no such option existed when I was asked to send back the RSVP six long weeks ago. Besides, I was still bordering on hopeful then. I am not anymore. I know the road ahead now: The exams, the invasive tests, the shots, the heartache, and the procedures. There is no way out. Only a way forward. After an hour of non-stop “ooh”ing and “aah”ing (Why must baby clothes be so damn adorable?) I can take no more. I go to beg good-bye and kiss my dear friend on the cheek. She grabs my hand and brings it to her belly. “Feel, Günce, she is so active today!” My friend, she is radiant in her joy. I feel the kick. And then another one. And it is impossible not to smile. This. This is what I strive for. This feeling of life. This feeling of endless possibility. This miracle. I leave a few moments later – no less sad, but infinitely more resolved. For today, my journey begins anew…

5 Birth Control Myths—Debunked!

Our top 5 Birth Control myths – debunked. 1. Birth control will make me gain weight. No, it won’t. Well, you might gain weight. But it won’t be because of your birth control. They did this massive examination of 49 different studies of different types of birth control – you can read it here – and they could not find any causality between birth control and weight gain. (With the exception of the Depo-Provera shot, which one study has shown to lead to some weight gain.) Also, given the wide variety of birth control options available, you can always switch it up until you find one that makes you comfortable. 2. Birth control will make me barren. No, it won’t. Most types of birth control stop working as soon as you stop using them. (The Depo-Provera is an exception again – and can stay in your system for up to a year.) In fact, this one study – you can read it here – showed that your chances of getting pregnant quicker INCREASED after you got off the pill compared to someone who had never taken it. 3. If he pulls out before he ejaculates, I can’t get pregnant. Of course, you can. But withdrawal can actually be an effective form of birth control. Of every 100 women whose partners use withdrawal, only 4 will become pregnant each year if they always do it correctly. But – and this is a big but – if they do not do it perfectly – if they wait a few seconds too long to pull out, then 27 of those women will become pregnant. That’s right: More than 1 in 4. So before you agree to use the withdrawal method, please make sure that your partner knows when to pull out and has the wherewithal to do so. 4. I’m having anal sex – but I am still worried I can get pregnant. Don’t be worried. The only way this could happen is if your partner’s ejaculate leaks down from your rectum into your vagina and then travels towards the cervix. It’s kinda like if the sperm boarded a plane to NY and ended up in California. What are the chances, right? Use a condom and make it even less likely. 5. Birth control is expensive. No, it’s not. Young people can even qualify for free birth control depending on where they live. Go check out bedsider.org and look into all your options. They also do a good job explaining your bevy of choices. Okay. That’s it for now. That’s definitely not all the different myths out there, but we will tackle the rest next time. You are already way ahead of the game – because you have downloaded Glow and are becoming familiar with your body and its patterns. You know about your fertile period, and you know things like BBT and CM and the roles they play.  And it is empowering, right? Please remember – we are here for you. The entire Glow community. Let us know if you have any questions.

Gunce's path to Glow

(From our blog, again. Posting it here just in case any of you were wondering who this strange-named chick is. 8-)  Somewhere in the middle of the four year period that I spent trying to conceive my first child, I had one of my best friends ask me to babysit her six month old daughter - who was an absolute darling. As cute as cute can be. It was a special occasion and their sitter had unexpectedly cancelled. As I knew my friend would never have asked me unless she had no other choice, I said, of course, yes, my husband and I will be right over. When we arrived at their place, she gave me basic instructions, diapers here, food there, bedtime in half an hour. And then, they left. We did as told but about an hour after we put the baby down to sleep, she woke up crying, as babies sometimes do. Excited to spend more time with her, I immediately grabbed the baby from her crib and brought her out to the living room, where we proceeded to coo and ahh at each other. She was so sweet, so precious… My husband interrupted my communion. “Why are you crying?” Funny thing… I had not realized that I was. But as soon as he pointed it out, I virtually buckled over with the intensity of my primal need for a child. The deep and hopeless longing all but shattered my heart….and I broke apart - sobbing.  My husband deftly extracted the bewildered child from my arms and disappeared with her to her bedroom to put her back to sleep. Then he came back and held me until I was myself again. My scarred and scared self. For as long as I could remember, I had wanted to be a mom. I had my theoretical daughter’s name picked out well before I was thirteen years old. And yet, between schools and jobs and cross-country moves, the timing had never been right. And once we got the timing right, everything else started to go wrong. Then, the waiting was no longer voluntary. Then, we waited with increasing impatience. We waited for test results. We waited in doctor’s offices. We waited in IVF suites. We waited for blood work. We waited to see tiny hearts that we hoped would this time beat. We waited. It took drastic measures for my fifth IVF cycle to work. For my daughter to be born. It took the cessation of my successful ten year career. It took vast amounts of money. It took an undeniable toil on my heart, body and soul. And that’s why I am here at Glow. I am here to help an incredible company develop an ambitious new approach to both fertility and infertility. I am here because I know exactly how scary this journey can be. How heart-wrenching. How debilitating. I am here because I have walked that path. I’ve shed those tears. I’ve worn that brave mask. I am here because if there is any way I can help Glow make the journey easier for other couples out there – then that’s what I want to do.

How much do you know about your fertility?

So - this great magazine (Fertility & Sterility) which Glow loves as a source of research came out with this incredible article a couple of days ago.  Researchers at Yale quizzed 1,000 women between the ages of 18 to 40 on their knowledge of pregnancy, reproduction and sex – and these were the results: - 30% of the women reported that they only visited a reproductive health provider less than once a year or not at all. - 50% of the women did not know that taking multivitamins and folic acid are recommended to avoid birth defects. - 25% of women did not know that things like STDs, smoking and obesity impact fertility. - 20% did not know that aging can impact fertility and increase rates of miscarriage - 50% of the women thought that having sex multiple times in a day increased their likelihood of getting pregnant - 33% of women thought that different sex positions can increase their odds of getting pregnant - 10% did not know that they should have sex before ovulation to increase the chances of getting pregnant instead of after ovulation.  What do you think of these results? Were you as surprised by them as we were?     

Why does my Fertile Window move?

You might have noticed that your fertile window in Glow is not set in stone. It can move away, before you ever get to it, so you feel like you are playing catch up. And it can shift even after it has passed, which can be frustrating because now you might have had intercourse at the wrong time. So why does it move? Well, frankly, as frustrating at it can seem at first, the fact that your fertile window moves is what makes Glow such an excellent and successful fertility app. Glow learns from you. Glow analyzes your data. Glow self-corrects and comes up with better predictions for the future.  But let's look at it a bit more closely.  Let's say you have the typical 28 day cycle and are expecting your ovulation around CD14. Well, in the absence of all other information, so will Glow.  But then let's say you start entering some data - maybe your CM, or BBT, or ovulation tests. Or even other symptoms. Glow will examine this data and actually move around your expected ovulation based on it. It might move it closer to today. Or further away. For example, if you are CD12 and you keep telling Glow that you have very little CM, or negative ovulation tests, believe me....Glow will use that information and push out your fertile window.  Now let's say that you and Glow decide finally that you ovulated on CD15. Great. For the interim, your fertile window locks into place. That is until if and when you miss your period. At that point, several things come back in to question. Such as, why is your period late? 1. You could be pregnant. (But if that is the case, please tell Glow.) 2. Glow might have miscalculated your correct day of ovulation. Glow assumes this because the one consistent part of every woman's cycle is the Luteal Phase. (The period of time that lapses between ovulation and your next period). For almost all women this is 14 days, with a standard deviation of  one or two days. So if your miss your period, especially by 5 or more days, the correct assumption is that you did not ovulate when you think you did.  So if you miss your period, Glow will start dragging out your past fertile period in lockstep. It will simply assume that the data that led to that original conclusion was not ideal. This can be very frustrating for you - but please believe that it is actually in your benefit. Because now Glow uses this new information to more accurately forecast your next cycle and you have a better chance of getting pregnant than if it had maintained that your fertile period happened when you initially thought it did.  We hope that makes sense. Please let us know if you have more questions on this subject.  Thank you!                   

Checking Your Cervix

Hi Ladies – As you can see in your updated app – Glow now lets you log in the position of your cervix. (Yeay!)   So, let’s start at the basics:  "Where is my cervix?" Your cervix is towards the back of your vagina. You can check it by sticking a clean finger into your vagina while in a squatting position or lying on your back. I have found that one foot on the toilet also works well. Some women like to check it in the shower, where everything is nice and clean and lubricated by the water. No matter where you are, it should be a position in which you are SUPER comfortable – as you have to use the same position each time to get consistent measurements. "Should I use a lubricant?" As we all know, lubricants can wreak havoc on sperm. So if you have to use a lubricant, please use Pre-Seed or any other natural lubricant such as Canola Oil. "What am I looking for? What does my cervix feel like?" Now that’s the hard question. Because see, the position and texture of your cervix will change during your cycle. And ultimately, it is this change that gives us clues about our fertility. During menstrual bleeding, the cervix is normally low and hard and slightly open to allow the blood to flow out. It feels like the tip of your nose. After your period stops, the cervix remains low and firm but closes up. As you approach ovulation, the cervix rises up to the top of the vagina and becomes softer and moister. At the height of ovulation, the cervix feels more like your lips than your nose and it is ever so slightly open to allow sperm to enter in. There is a name for this position. It is called SHOW. (Soft, High, Open and Wet.) This is what you are looking for. This is your most optimal time to get pregnant. Once ovulation occurs, the cervix drops lower and becomes more firm - once again feeling like the tip of your nose. This can happen immediately after ovulation or may take several hours to several days. And then the cycle repeats. (That is unless you become pregnant. In that case, as early as 12 days after ovulation, the cervix can rise up and become soft again. But it will not feel open like it did in the SHOW position.) "How often should I check?" Obviously, every day works best. But who has time for that? So start checking the day after your period stops. Then every other day until you hit your fertile window. At this point, do a check every day until you feel that you have achieved SHOW. Once your fertile window closes, you can do a check every few days. That’s it. Please let us know if you have any other questions. And let us know if you have been doing this for a while and have additional tips for our users.

Short cycle = Fertile window starts right after period

If your cycles are shorter than 27 days, it is not a glitch that your fertile window starts almost as soon as your period ends.  Most women have very defined Luteal Phases - that is the amount of time that lapses between your ovulation and your next period. (It usually is 14 days +/- a day or two.) For example, if your period lasts 6 days and you have a 26 day cycle. Then you will most likely ovulate around CD12. Since your fertile window itself is 6 days - that will mean that your fertile window will start as soon as your period ends. (Sometimes earlier - that is how women get pregnant while they have their periods.) So: CD1 - CD 6: Period CD7 - CD13: Fertile window + Ovulation CD14 - CD26: Luteal Phase If you have a short cycle, it is all the more important to start tracking your BBT, CM and/or take ovulation tests. Some wome have shorter than average LT phases - and the only way to know for sure is to track your cycles more closely.  Thank you.   

How do I know that WHEN I want to get pregnant, I can?

“I have no interest in getting pregnant anytime soon – but how do I know when I want to, I can?” My friend, a successful Wall Street gal, who knew of my fertility challenges, asked me that loaded question the other day while we were devouring our limited-time pumpkin lattes. How, indeed? The truth of the matter is – there really is no way to know for sure. Having a baby is one of those rare things that you only know that you can do, once you’ve already done it. Like climbing Mount Everest. Or walking out of Target having only purchased that one thing you walked into purchase. But there are certain clues along the way that can put your mind at ease. That’s not to say that you should panic if you cannot check ‘Yes’ to every box below. However, I would suggest that you have a little less to worry about if all the following hold true for you: You have regular cycle. And by regular, I mean you have your period once every 24 to 35 days. Having a regular period is one the clearest signs that everything is working as it should. What’s more, your periods should not be too heavy or too light. And you want them to last somewhere between 3 to 7 days. Deviation from these norms could indicate a problem like Polycystic Ovarian Syndrome or Endometriosis, and those conditions can make becoming pregnant more difficult. “Well, that’s no good,” my friend interrupted. “I’ve been on birth control since college. I have no idea what my real cycle is. No idea if my real flow is heavy or light. That does not help me. What’s next?” I insist that this is the most important piece of the puzzle and I suggest that she go off birth control for a few months to check if she is ovulating. You can do so with the help of Clearblue’s fertility monitors (and obviously, Glow). She shrugs. “I’ll think about it. What’s next?” You have lots of eggs. There is a simple blood test that now measures your Anti-Mullerian Hormone (AMH) levels. This hormone is produced by specific cells, called Granulosa cells, which surround each and every egg in a woman’s ovary. So obviously, the more eggs, the more granulosa cells. And the more granulosa cells, the more AMH produced. By takings this test, you can determine your ovarian reserve. And the more, the better. But you have to remember this test shows you the quantity of the eggs you have left, but not necessarily the quality. Nonetheless it can be an important indicator. And you can do the test even if you are on birth control. However, check on costs. Your insurance may or may not cover it. She jots the name down on her phone. “Okay. What’s next?” I rattle of the next few in one breath: You have not had any unchecked STDs. Diseases such as chlamydia and gonorrhea can cause pelvic inflammatory disease (PID) where the disease spreads to the reproductive organs. The infection causes scar tissues to build up in the fallopian tubes, ovaries and other organs and prevents both ovulation and the ability to conceive. You do not smoke. It should surprise exactly no one that smoking can seriously delay your chances of conceiving and increase your chances of miscarriage. While we are it, heavy drinking and recreational drug use might also result in fertility problems. You are neither significantly overweight nor underweight. The American Society of Reproductive Medicine (ASRM) has said that having a BMI of over 35 or less than 19 can affect how long it takes for you to become pregnant. I pause before I drop the last tidbit: You have a fertile partner. Be it a donor’s or your partner’s, you need viable sperm to fertilize your eggs. And the fact of the matter is almost 40% of all fertility related issues arise from the male partner. So you could be going through fertility treatments even if you yourself are completely fertile. “Ugh!” She rolls her eyes at me. I empathize. This is an area of our lives that we mostly don’t want to think about, much less talk about. I mean, how often have you heard the phrase “When it’s meant to be, it will be” in reference to making babies? Well, I hate that phrase. Here is one that I like better: “The more you know about your reproductive health, the better equipped you will be to make the right choices for you!” Sure, it’s not as catchy. But it is smart. And ultimately, that’s what counts.

The 4 Rules of Implantation Bleeding

While every woman is unique and every situation is different, these four conditions do hold true for many of us: 1. Implantation bleeding resembles spotting. It does not get heavier as the days go by. 2. Implantation bleeding usually lasts shorter than a regular period. One to two days being most common. 3. Implantation bleeding usually occurs anywhere from 6 to 12 days past ovulation, assuming you had sex during your fertile window.  4. Implantation bleeding is often pink or rusty brown. It is rarely red.  Only one in every three woman notice any sort of implantation bleeding. That means two of three get pregnant without any bleeding.   What about you? Please let us know if you thought you had implantation bleeding. What DPO it was? And what the ultimate outcome turned out to be? (BFN or BFP). Thank you! 

Do you know when you ovulate?

Knowing when you ovulate can be very helpful in your quest to become pregnant because “the likelihood of conception is increased if intercourse is timed to coincide” with your fertile period. Ninth grade health class told us that women ovulate around 14 days before their next period.  That’s very useful information if your cycles run like a fine Swiss watch. Unfortunately, my cycles tend to resemble the old Soviet train schedules – I never know when the next one is coming.And it turns out I am not alone.In a wonderful and useful study done at the Tufts Medical School, scientists proved that MOST women have NO idea when they ovulate.Three hundred and thirty women were recruited to report when they believed they ovulated and also took tests to determine when they actually ovulated through the detection of the luteinizing hormone.Turns out, only 12.7% got it right.  The rest, not so much. Some women missed the mark by up to 27 days.27 days!Here is the really scary part: Only 55% of the estimated ovulation days fell within the volunteer’s fertile window.That means for the remaining 45% of the women in the study, when they thought they had ovulated, they were nowhere near their most fertile time. They missed the boat entirely, as it were.If you ask us, this study is just another wonderful reason to use Glow! Because as anyone who has been trying to get pregnant for more than a few months knows, the process is hard enough. There is no need to add to your stress levels by flying blind.More on that illuminating study here: Accuracy of perception of ovulation day in women trying to conceive.

What do all the acronyms mean?

Here is a brief introduction to some of the most commonly used acronyms on our website and app. Feel free to add to the list.  TTC - Trying to Conceive DPO - Days Past Ovulation - used to keep track of the days of the luteal phase. BBT - Basal Body Temperature - Your basal body temperature (BBT) is your lowest body temperature in a 24-hour period. The best time to take it is when you first wake up in the morning. Before you even get out of bed to brush your teeth or start your day, pop a basal thermometer into your mouth. (This kind of thermometer shows the very tiny degree changes that a regular one can't.) It's important to try to wake up and take this reading at about the same time each morning. OPK - Ovulation Predictor Kits - These are test strips you can buy at a pharmacy that you use to determine when you are about to ovulate. Recently there are more advanced digital versions. HPT - Home Pregnancy Test – These are hormone tests that you can take at home to determine if you are pregnant. If done correctly, they can be up to 99% accurate. CD - Cycle Day - indicates what cycle day you are currently on. CD 1 is the first day of your period. CM - Cervical Mucus - Every woman produces cervical mucus. It is a discharge that can vary throughout the cycle. It can be tacky, sticky, egg white, and lotion like. It can be clear, white, and sometimes yellow tinged. Many women find the cervical mucus check to be the best way to predict ovulation. In general, as the day of ovulation approaches in your cycle, your vaginal and cervical mucus should increase (i.e. become more moist) and the consistency should become slippery and clear (such as that of egg-whites). This type of clear, slippery CM helps sperm to move faster and to survive longer within the female’s body giving the best chance for fertilization of the egg. You can check your CM by looking at the toilet paper after you wipe or by inserting a clean finger into your vagina and reaching toward your cervix (which is deeper inside). You're likely to find more CM if you check after a bowel movement. Some women check after they shower every day. It is helpful if you check at roughly the same time each day so that Glow can get consistent measurements. EWCM - Egg White Cervical Mucus - The increase in estrogen around ovulation causes a female's body to produce an abundant amount of cervical mucus. This creates a sperm friendly environment that is ideal for conception. LH - Luteinizing Hormone - This is the hormone that surges causing ovulation. It is what OPKs check for. HCG - Human Chorionic Gonadotropin - This hormone is what a HPT tests for. It is the pregnancy hormone. Luteal Phase – Most women have a consistent period of time between ovulation and their period. This is identified as your luteal phase.