Thursday, December 15, 2011

Some birthday gift

So I got the date for the vial used in IUI # 2, where my second pregnancy ended because of a chromosomal number defect, *maybe* because of crappy swimmers, and not any issue with me.

That vial, which may have been so very ill fated, was collected on my birthday. Of all the 365 days in the year, my birthday. I do have vials from other dates, but ironically, the one collected on that day has the highest counts.

So the date weirdness continues---the first bit was where the astrologer predicted that it was safe for me to get pregnant only after a particular date. That date was the day my baby's heart stopped beating, one year before.

My brother argues that its just random probability, you can ALWAYS find make some connection between 2 random things. One part of me knows exactly what he is talking about and tends to agree with him, that I should make absolutely nothing of it, but the more fanciful part of me just can't let it go. Which feeling would you predominantly go with, were you in my shoes?

Monday, December 12, 2011

Need advice (post on male aneuploidy)

I'm about 2 months (maybe) from my next IUI and soon, I'll have to make arrangements to ship my donors swimmers over to my new clinic. That brings me to an question that has been brewing in my head for almost a year now.

My second pregnancy loss was because my child had Turners Syndrome, she had only one X chromosome but lacked the other (either X or Y) which determined gender. Whether it was the egg that came without an X chromosome, or a sperm without an X (or Y) chromosome haunts me.

The genetics counselor I met with told me that in Turner's syndrome, 70 % of the time,  its the sperm that turns out to be the culprit. Still you can't say. There are times I kick myself that I did not pursue this question further, I had the means, I could have probably sequenced my DNA and the baby's DNA, that might have provided the answer.

Give that in a healthy, fertile male, only 2 % of sperm have numerical chromosomal errors, if it had been a defective sperm, you can say it was either random, colossally bad luck, or the universe really, really did not want me to have a baby at that point.

What worries me is: what if it was from a bad day, where the frequency of chromosomal errors was higher that average? This fear is kind of baseless-- studies have compared aneuploidy rates in men with male infertility (which my donor has absolutely no risk of suffering from, he seems to be really good in this department)--- aneuploidy rates are about 18-24 % in men with different kinds of male infertility and 2 % in normal controls.

So though there is not much basis for it, I'm wondering whether I should check that all my donors vials are from the same day, and if possible, use a different day's lot, though a) this might require a lot of digging and b) might even mean added expense. Rationally, I know there is no real need for this, but the niggling fear remains. What would you do?

We know nothing and can control nothing-- the question is- to what degree do you make peace with far do you go to try to control the uncontrollable?

Tuesday, December 6, 2011

Vitamin D and melanoma

In response to my last post, both Jem and Oak asked the very relevant question about how one treads the fine line between getting Vitamin D from the natural source (the sun) when you are at risk for melanoma.

I think the first question one should ask is, do I have an elevated melanoma risk?  I should add, from those discussed in the link, the strongest is a family history of melanoma.. If you do have elevated risk, then yes, you should be very careful and avoid the sun. I would look into what is IN the sunscreen you use though-quite a few products are filled with carcinogenic crap. I highly recommend using the cosmetic database to see which brands are safest.

Also, another interesting thing - a lot of studies show that a Vitamin D deficiency seems to provide higher risk for multiple cancers, including melanoma.So its kind of a vicious cycle if you think about it. IMO, it provides a great explanation for why the melanoma risk is surprisingly high in the black population.

People with melanoma risk factors should be definitely advised to minimize their UV exposure and get their vitamin D through supplements.

However, I don't think advocating it for the entire population, on a constant basis, is that great an idea. If you are going to spend 5 hours on the beach, yeah, sunscreen is a good idea, but all the time you step out? Let me put it this way, everybody needs vitamin D, but only a subset of the population is at increased risk for melanoma.

But I digress--my post was not an advocation of going sunscreen-free as it was an essay on how such a large proportion of the population has come to be Vitamin D-deficient and the many, many dangers of it.  A Vitamin D-deficient mother is herself at risk for pregnancy complications, postpartum depression etc, and her child is at an increased risk for autism,schizophrenia, depression, cognitive disadvantages, diabetes, autoimmune disease, fibromyalgia, various cancers---its freaking scary!!!!

The moral of the story really was, it is very hard to get enough vitamin D from sun exposure in our modern day lifestyle---so check your D levels and supplement if you have to. Although I advocate trying to spend more time in the sun if you do not have melanoma risk (mostly because its what mother nature wanted us to do and our constant deviation from her set plan sometimes ends up being really bad), its amazing how many people who actually get a decent amount of time in the sun ARE deficient and end up supplementing. For many of us, there is no way out, and so far, nobody has been able to come up with any data showing taking  around  2000-4000 IU Vit D daily may be bad for you.

Monday, December 5, 2011

Vitamin D- Its not just about fertility : Part I

Nothing fascinates me more than the workings of the human body. How it evolved to be what it is today is mindboggling. Nature is pretty darned amazing in utilization of resources- while designing an intricate system, you need multitasking. Vitamin D (which is a hormone, not a vitamin) is the ultimate multitasker. Its receptor is almost universally expressed on every tissue in the body. It is strongly involved in regulation of the immune system, the brain, the kidneys, your thyroid gland, bone development, your metabolic pathways, the list is endless.

When you look at evolution, you realize nothing ever happens without a purpose. Nature plugged vitamin D as an important regulator/processor into so many pathways, she also realized you need a good system to make it, wherein you would not be dependent on external sources for it.  So it came about that every time you go into the sun, you made vitamin D.

Vitamin D is also one of the two things (the other is folate) that has probably governed the evolution of skin color. Life probably originated in Africa, and the intense levels of sunlight there destroyed folate (so tanning beds are a bad idea during pregnancy:)). So dark skin evolved, to protect folate. Although this acted as a barrier in the production of Vitamin D, the ample sunlight there created a harmonious balance. When people migrated to colder climates, with weak sunlight and long months of winter, they were making far too little of an important metabolite. This was probably the driving force behind evolution of light skin.

But we started to change. Not only we migrate far away from the places that we were designed for, but we started wearing clothes. That did not cause that much damage IMO, still because 200 year ago, people were still spending plenty of time outside, they walked places or they rode on horseback in good weather, they got out a lot because they did not have so much to do indoors.

In the past 30-40 years, our bad habits have really piled up. We've also let go of some of the old ways of life. In India, a common practice would be to give babies an oil massage and then let them sleep in the sun, fully naked,  for a little while. I asked my mom about this the other day, probably nobody in the cities, with our new lifestyles, does it anymore. We built big buildings with far too few windows where we spend the day, we invented cars so you spend very little time outdoors getting from point A to point B, we invented video games that kids stay indoors playing all day, and probably the worst offence, we started using sunblock by the bucketload, which almost totally blocks vitamin D production. We are literally, in the worst cases, almost completely shutting down our Vitamin D3 supply route. We did start supplying it in our diet, but the amounts were not high enough.

We messed with what nature intended. And what the research shows is, some of us have been paying for it in ways we are just starting to understand. Vitamin D deficiency is linked to Type I diabetes, Type II diabetes, rheumatoid arthritis, other autoimmune disorders, thyroid disorders, bone deformities, fibromyalgia, depression, chronic pain syndromes, autism (!!!), PCOS, obesity--the list goes on and on and on.

Importantly, other than a lack of time spent in the sun, the two other big risk factors for vitamin D3 deficiency is dark skin and obesity- this website talks about the latter.

I'm going to post a comprehensive list of what diseases its involved in a while- but in the meantime, it is bloody important to be vitamin D3 replete during pregnancy. This website does a good job talking about it.

I totally believe the theory proposed herein of a maternal vitamin D3 deficiency 'imprinting' the baby so he/she has a much higher risk for other diseases later in life. Please spread the word- post it to Stirrup Queens, talk about it on facebook, tweet it, whatever. We don't know what the end result will be of any woman being Vitamin D3 deficient during pregnancy (a lot of times, the effect is probably minor), but if you can prevent even one child from developing asthma, schizophrenia, diabetes or autism later in life, its worth it.