The One With Charts, Charts, Baby
Hey again! We're glad you're here. Wondering what this is? FAQ here. Otherwise, onward we go!
OKAY SO. Right now, for a client, I’m doing a research piece on fixed-vs-growth mindsets. TL;DR: If you live with the idea that you can change your natural abilities/outlook/life through smart+hard work, your success rates and happiness levels will be, like, 238439% higher than if you believe the opposite. As that applies to fertility, we’ve approached the last several months of Project Waterbear fully believing that if we have any underlying issues, we can likely reverse them.
(Note that we’re two young healthy kiddos with no warning signs (aside from ‘no spawn yet’) for, say, blocked tubes or zero male fertility or any super-serious impediments...and we’re working with People Who Know Stuff to eliminate actual barriers to conception. But God only helps those who learn to help themselves [GREAT song], and also we’re in the time of COVID and this type of non-essential medical help is generally restricted to being only a much-delayed phone call away. So.)
THE PROBLEM: It's easy to think that with fertility, um, there’s really only one way to see success? E.g., ‘do the lifestyle changes, and if you get knocked up, you’re good; if not, you failed’.
Well, that’s an incredibly narrow and binary notion of success, and one fraught with a zillion emotions. (It’s impossible to be entirely removed and clinical re: your own fertility experiment. Believe me. We tried.)
THE SOLUTION: Change your perspective on ‘success’. Yeah, our goal is to end up as parents, of course. But by zeroing in on sub-goals and sub-victories, we can have sub-wins that get us in the right direction. And, right now, it’s 2020 and we’re potentially infertile and we need a win.
ENTER: This series. Welcome to BBT CHART OPTIMIZATION.
(cue: thunderclap! cue: sports entry music! cue: AC/DC jamz! cue: Hallelujah Chorus!)
Anyway. Let’s start with the 101:
What Is a BBT Chart?
BBT stands for basal body temperature, and it can be a relatively easy way to get a status update on your physiology cheaply/non-invasively. BBT refers to the temp of your body when you’re at rest--the coolest you naturally are sans movement. Generally, first morning temperature, taken orally (or with a wearable temp monitor).
Charting your BBT over the course of your cycle can provide massive hints as to what’s going on with your plumbing. This basically comes down to progesterone, a really really really really important hormone for pregnancy (as well as normal women’s health). Progesterone is what’s known by people *in the know* as a thermogenic hormone. Which is just a fancy way of saying that it warms you up.
If everything in your body is working to spec, your mid-cycle ovulation will trigger a gush of progesterone...which means that, if you’re tracking temps, you can confirm ovulation by looking for a sustained temperature rise approximately midway through your cycle.
BUT OMG that’s not all you can learn from your chart. Your chart can literally tell you if you’re stressed on a physiological level, it can hint at thyroid issues and hormonal imbalances, it can give you an idea as to whether you have major menstrual issues like endo or PCOS, it can tell you if your body’s got enough progesterone to sustain a pregnancy (a super common infertility problem), and it can tell you if you’re likely pregnant. (Which has come in handy: I haven’t taken a pregnancy test in months because I’ve let the chart break the bad news instead of staring at *yet another* null test, which has been v helpful for mental health.)
Your chart can also give you an idea if anything’s abnormal with your menstrual cycle, and, CRUCIALLY, your chart can give you an objective, quantifiable way to see if any of your weird lifestyle changes are actually doing anything UM YES PLEASE.
Once we understood that, taking my temp at 5 every morning went from being something I avoided doing unless strictly necessary, resulting in a lot of frustratingly incomplete charts, to something I literally look forward to doing...because it’s an indicator of the efficacy of the last several months of yoga and research and eating beets and leafy greens. It’s a tiny win. And if something’s weird with my chart, that gives me a problem to solve...which is a tiny goal. Baby steps, right?
Okay! Moving from Charts 101 to Charts 102 introduces a few terms to the grown-ups' table:
Menstrual VIPs
(The ‘p’ is for 'phases'! HEART EYES)
The menstrual cycle can be broken down into four distinct phases. These are known as, in order:
- The Menstrual Phase: We’re all likely familiar with this one. Blood, gore, etc. Your uterus’s monthly spring cleaning.
- The Follicular Phase: Rebuilding. The follicles in question are the places your eggs get ready to be jettisoned and inseminated, so, this phase is all about keeping them happy after you’re done bleeding.
- The Ovulatory Phase: Shortest phase, usually only a handful of days wherein one egg erupts from its follicle and treks to the uterus. Along the way, it might bump into a stranger boi and create a human. It also might not.
- The Luteal Phase: The most wonderful time of the month! Two of every woman’s very favorite events, the Two Week Wait and PMS, occur during this time. (This is a time to be nice to yourself.) It’s also a time when either there’s an alien burrowing into your uterine lining, or there isn’t. At the end of the luteal phase, if you’re not pregnant, your body triggers spring cleaning.
Depending on how much we end up needing to vamp for content, there may eventually be a PWB piece just on the fun hormonal conga that underlies those phases. But, for now, that’s a good place to start.
A Picture-Perfect Cycle:
V basically, this is what the biology books say a cycle should look like:
- 5 days Menstrual
- Ovulation ~cycle day 14-16
- Next cycle (or pregnancy) confirmed ~14 days after that, for a 28-30ish day cycle
- Temps = 97.0ish for the follicular, 98.0ish for the luteal, with a 1 degree difference
- Sustained high temps during luteal, with a drop back to baseline a day before cycle restart
- Little variation on temps on a day-to-day basis.
Okay, so, like most picture-perfect textbook situations, I’m sure it’s the rare woman who has a cycle with stats precisely like these. (A really fun study with tons of data found that only 13% of included cycles were 28 days long.) I’m also VERY sure that you don’t have to have a cycle that looks like this to get pregnant and have a healthy kid. But! There are bio reasons each phase needs to have these approximate lengths and temps and etc, so, as I’m optimizing my stats, these are good, if potentially lofty, goals to keep in mind.
What I Have Been Doing
For the past 1-4 months, I’ve been incorporating the following lifestyle changes:
- A crapton of supplements all aimed at restoring hormonal balance (prenatal, magnesium, omega thing, probiotic, turmeric, just healthy OTC stuff)
- Cold showers to raise body temps and increase body circulation
- Sun walks, ditto
- Relatively balanced diet (low grain, v low alcohol, low sugar, no dairy; could be tweaked more, but it’s in a decent place)
My Current Charts:
Voila, my two most recent BBT charts, courtesy of the lifestyle changes cited above. First one’s a Clomid cycle, second one is au naturale:
My personal statistician analyzed these charts and did some math-y stuff, which he'll speak to next:
Charts! I crunched Rebecca's BBT numbers for May and June to see what stories they might tell. We have some personal goals set for the next few months, and BBT analysis will be a good way to evaluate progress.
So what are we seeing? First, the phases were simplified to only follicular and luteal; menstrual was ignored and ovulatory was lumped in with follicular. That made it easy to compare A to B. The first chart shows average BBT, and the second shows BBT standard deviation.
From May to June, average BBT numbers were about the same. No significant change. That covers pre-ovulation and post-ovulation. It also shows no noticeable effect of pausing Clomid and messing around with TCM ideas. (*Note that pausing Clomid and doing more sunny walks resulted in a VERY SUBSTANTIAL improvement in mental health.)
However, BBT numbers became more *consistent* during that time. In both phases, temperature standard deviations fell, which means there were more repeats and and a shorter range.
So what? It's hard to say for sure yet, because only a few months of data is not much to work with. We do like that this analysis gives a way to track our progress toward goals. So we'll keep plotting (and scheming).
This has been a TedTalk.
Goals:
Just looking at these two charts - and I’ll say that these charts are pretty indicative of others I have - I have four goals:
- Shorten follicular phase. Ideally/textbook, that’d be about 14 days. I’m at 17-18 while not on Clomid, so I have the teensiest case of delayed ovulation.
- Lengthen luteal phase. Again, target would be about 14 days - it should be between 12-15 to make sure that any fertilized egg has enough time to move in to the endometrial layer and get comfy before his/her new home...literally avalanches. I had a nice long luteal on Clomid with all those artificial hormones, but on a natural cycle I was only at 11. So, lengthen that. (I feel like this is a conversation I’d have with a tailor, if I had a tailor.)
- Increase overall temps. We talked about this last week, but my temps are overall pretty low. An increase would be welcome. (And this is a conversation I’d have with a boss about a raise, if I had a boss or could get a raise.)
- Increase temp difference between follicular and luteal. Ideally, there should be about a degree of difference between your average follicular and luteal temps. I’m hovering more around a 0.6-0.7 change, so, that difference could stand to be a bit more dramatic. (Who am I talking to here???)
I’d like to note that I’m super, super lucky. I (now) have boringly regular cycles; I can read them and see that I’m ovulating and when my period’s about to show up with high degrees of certainty. I know many women who have anovulatory cycles or really really long or short cycles or completely erratic cycles, and … that is really, really tough. I’ve been there. Here’s a weird cycle I had a while back:
SO FUN I MEAN OBVIOUSLY THAT WAS A FANTASTIC AND NOT AT ALL INCREDIBLY FRUSTRATING MONTH.
Anyway. I think following these lifestyle changes helped me get from there to here, and I’m just hoping to continue the journey :) But am I doing this based on my own research!?!?! Almost, but not quite because LOOK I FOUND A BBT OPTIMIZATION STUDY!!!
My New Favorite Study
A student out of Yo San University in LA wrote a paper for grad school in April 2015 about a study he did for a capstone grad project. Basically, he was studying BBT as an indicator for women’s reproductive health. He followed fifteen women who had subfertility or related issues (recurrent miscarriages, lack of periods) through four cycles, and he came up with a grading system to track the stats of cycle improvement over time. Over the four months, the women received TCM remedies as well as dietary/lifestyle suggestions (which I’m assuming were implemented).
Ultimately, he wasn’t able to draw any conclusions, because the sample size was so small (15 women) that the results weren’t statistically significant. BUT! If you set aside the math of whether the results were good and just look at the actual results, you see some pretty cool magic happening:
LOOK AT ALL THOSE VIABLE PREGNANCIES!!!!!!
Anyhoo. I decided to post-facto join the study, sort of, by grading the cycles above against the metrics he came up with (also available as an appendix to his paper, same link). Here are my scores:
The elongated cycle with the dates strategically cropped out: 23
The June cycle: 29
The July cycle: 37
Okay, so, that’s improvement, right? Anyway. We’ll see where those numbers go.
What I’ll Be Doing This Month
I did a bit of research based on my goals (read: I googled ‘how to lengthen luteal phase’, etc) and came to the following conclusions:
For BBT raising, I’m already doing some stuff, like we talked about last week. Leveling up a bit: There is some evidence to show that intermittent fasting (hereafter, IF) can help jumpstart higher temps, so I’m interested in incorporating that. BUT HOLD UP. IF can be really really really bad for women’s hormones. And hormones = important. So I’ll be experimenting with super low-key sorta-IF, that’s basically more like ‘just don’t snack plz’ and ‘slightly delayed breakfasts’.
For luteal/follicular phase length, a quick TCM search would indicate that my Kidney system might be imbalanced, so I’m going to prioritize foods in my diet that would balance that out. (We talk more about the super-basics of TCM here!) Seafood, beans, broth, sign me up.
Because I also like to have something that’s weird and fun in the mix as well as just dietary stuff, I’m also going to seed cycle. (Basically: eat flax seeds and pumpkin seeds during the follicular phase, eat sesame seeds and sunflower seeds during the luteal, to support ~dynamite~ progesterone production.) I’ll likely do a post about it once I have a month or two under my belt. Esp if it works…………………….so, we’ll see.
Now, I’m aware that these are ambitious habits. Will all of them stick? Idk. Tbh, tho, I’m SHOCKED that the cold showers and sun walks from several weeks ago actually stuck, so I’m giving myself the benefit of the doubt and a little bit of props and hoping that I’ll make this happen.
And there we have it: Our series on BBT CHART OPTIMIZATION! (cue: majestic eagle screech! cue: trumpet blare! cue: riff from Guns’n’Roses! cue: heraldic angel choirs singing! cue: sound of expectations shattering nationwide.)
We probably won’t check in monthly. Maybe bi-monthly? Idk. Whenever there’s something to celebrate or note, we’ll post a chart and spend a couple thousand words gloriously dissecting every single tenth-of-a-degree we can. (SO FUN, RIGHT???? cue: droopy slide whistle, cue: crashing piano sound, cue: sound of audience collectively face-palming.) Thanks, as always, for reading!
JOIN US NEXT WEEK for our first Corgan Family Update, where we’ll talk about safe travel in the time of COVID, what’s in-real-time up with us generally, post a few slow-mo vids of our dogs failing to catch things we throw at them, and share resources you guys have shared with us.
AFTER THAT, we’ll be discussing the effect of caffeine on preconception health. (Basically, watch as I blubber and flail and scramble to justify my morning coffee.) (spoilers: caffeine + fertility = it’s complicated.)
RESOURCES NOT LINKED ABOVE:
This series is directly inspired+influenced by this incredible infertility blog: http://www.thepreggerskitchen.com/results. Check her story out when you have a chance!