TTC and UTI: A PSA

I really should be cleaning some spreadsheets for a database import right now, but I'd much rather share with you some painfully-earned knowledge. It probably won't apply to most of you...or any of you, I hope...but if there's anyone out there TTC'ing under similar circumstances, I think it's important to pass this info along.

The Background

IF aside, I've always been a remarkably healthy person except for an anatomical proclivity for urinary tract infections. I started getting them as a virginal teenager, but they really started rearing their ugly head once I started having sex.  I'd average about 3-4 major UTI's a year - by major, I mean having to go get antibiotics - and a handful of minor ones that could be flushed out with water and cranberry juice.

I eventually figured out after a few years that simply peeing immediately after DTD and washing up "down there" prevented them for the most part. I managed to get the frequency down to about 1 or 2 minor ones a year, which I figured out I could self-treat with concentrated cranberry pills and/or D-Mannose, which is a type of sugar that binds to bacteria in the urinary tract.

And then I started TTC

I'd like to think we had an active sex life before, but TTC apparently ratcheted things up a bit because I got a big bad UTI within the first two months. I was stubborn at first, trying to self-treat without antibiotics, because I didn't want to take antibiotics (ah the naivete of those early days!) if I was already pregnant.

And once I sucked it up and actually went to a doctor, I fell into a bit of a Catch-22, as they'd put me on a milder antibiotic (Macrobid instead of say, Bactrim or Cipro) when I told them that I was TTC. I'd dutifully take the antibiotics for two weeks, the symptoms would go away, and then BAM! I'd be back in the next month with another raging UTI. 2008 basically became a throwback to those college years when I'd be bouncing in and out of the clinic for UTI antibiotics.

The shit...or I should say pee... really hit the fan in late 2008/early 2009 when I got "the UTI that wouldn't go away," even with antibiotics. It was a miserably painful time - my gyn was running bacterial cultures that were coming up negative, and scary terms like "interstitial cystitis" (IC) were being thrown around.

(I know this sounds terrible, but I think if I had to choose between IF and IC, I'd choose IF. IC just seems too agonizingly painful to deal with on a daily basis - I'm amazed at the women who bear with it and more so, the mothers who bear with it. I mean, I could barely deal with a few weeks of severe bladder pain as it was.)

Eventually, I wound up in a urologist's office, and she determined that my urinary tract wasn't infected - it was badly inflamed from all the recurrent infections of the previous year. Ironically, she put me back on Macrobid, because it has an anti-inflammatory effect - and I had to take it for six weeks. She also put me on a daily regimen of taking cranberry or D-Mannose supplements and gave me a long-standing prescription to take Macrobid each time after sex to ward off another infection.

Thankfully, it worked. Within a week, the pain that I thought would take up permanent residence in my nether regions was gone, and it didn't come back after six weeks of antibiotic therapy. I happily took my supplements, and refocused my energies on getting pregnant.

But then I did some research a few months later.

It turns out that just about everything that I was doing was unfriendly to TTC:

• D-Mannose doesn't just bind to bacteria, it also binds to sperm. Sperm have mannose receptors, and D-Mannose is apparently effective enough at this that there is a patent out to use it as a contraceptive.
• Cranberry supplements create an acidic vaginal environment that is partially hostile to sperm. This too, is apparently effective enough to be used as a gender swaying technique for those maddeningly fertile women who use it to kill off the "weaker" y-chromosome sperm.
• Macrobid shows a slight risk for miscarriage. Now don't get me wrong - this is one of the safest antibiotics one can take, and there are probably millions of pregnant women who have taken it without adverse effects. That said, though, there have been a few women who claimed that taking it resulted in miscarriage. There isn't a lot of strong scientific evidence that demonstrates this, but when you're as paranoid as I am, it's best avoided.

And of course, my tried and true technique of peeing and washing up right after sex is a little harder to do when there's a ton of advice about lying down with your legs in the air for a half hour after DTD. Sigh.

This makes me wonder if I've just wasted a bunch of cycles while I was on antibiotics or sperm-killing supplements. I don't blame my urologist - she's not an RE, after all, and I'm eternally grateful to her for putting an end to those weeks of pain. I think this information is pretty obscure, as well, since one of my acupuncturists at the Poke Clinic even recommended D-Mannose to me when I mentioned my penchant for UTIs. Which is why I thought it prudent to publish my experience on the Internets.

So what now?

Well, I gave up on the daily D-Mannose and cranberry supplements a few months ago. And I'm only taking Macrobid after "fun sex" in the early part of my cycle as opposed to baby-making sex  mid-cycle. Poor Mr. Stick knows better than to try to jump me late in my cycle when I'm worried about taking Macrobid during the 2ww, as well as not wanting to "shake things up too much down there" (irrational, I know, but welcome to my IF mind).

I'd also like to think that the acupuncture is overall having a balancing effect on my body. It did eradicate my allergies, so I don't think it's unreasonable to think that it might be resetting my body's chemistry to something that is both sperm-friendly and UTI-bacteria-unfriendly.

I've been lucky so far, in that I haven't had any UTIs - major or minor - since that horrible one more than a year ago. So I'm just hoping that it continues to hold out until I get the biggest lucky streak of all with a BFP.