I discovered I was pregnant during Week Four, which is quite early by normal standards.  I tested via Easy@Home pregnancy test strips after my period was approximately two days late.  I absolutely expected a positive result because I had already been having vague-but-undeniable symptoms.  The most pronounced symptom was a massive increase in highly visual and intense dreams.  I'm likely understating the "highly visual and intense" part.  In one dream, a zombie was on top of me and within inches of devouring my head until I placed my hands in its mouth and broke apart its jaw.  Remembering detailed dreams is not a particularly unique experience for me, but having four straight nights of dreams that would take a massive special effects crew to recreate is:  by the end of this week, I was positive I was pregnant, even before my missed period.  I had also noticed a consistent, extremely mild sensation of nausea throughout the day.  I only experience nausea in relation to terrible flus (rare) or migraines (rare), so this was another somewhat unmistakable symptom for me.  I also seemed to have what could best be described as a "congested" feeling in my lower abdomen (likely a sensation of increased blood flow and slowed digestion.)  None of my pants seemed to be fitting in a particularly flattering way and I couldn't quite figure out why. 

By this point, I had taken three Easy@Home pregnancy test strips, all of which were positive.  The latter two tests were extremely dark pink lines, the first a bit paler.  This signified a promising increase in levels of human chorionic gonadotropin (hCG).  Since the first line had been a bit pale, the additional tests assured me that the first positive had not indicated a chemical pregnancy (i.e. pregnancy that ends very soon after conception, but still leaves a detectable amount of hCG in the bloodstream for a little while).  By Week Five, I was floored by a couple of symptoms: (1) weight gain - holy smokes!  I was already up several pounds, attributable largely to water retention and digestive troubles; (2) almost daily appearance of mild nauseous spells, especially after consuming a large or rich meal (this was the week of Christmas, so well...yeah); (3) unregulated digestion, which is a polite way of saying that food was either moving much too slowly or quickly through my body, neither of which seemed very pleasant; (4) breast sensitivity; and (5) dizziness after going a couple of hours without food or water.  I also became aware of a subtle "marled" appearance to the skin on my torso.  My skin is really pale, so I suspect that this was the effect of slightly increased blood flow in the capillaries in and beneath my dermis.  

Just shy of Week Six, I finally scheduled appointments with my OB/GYN, who is one of my favorite humans on the planet.  He is proficient and has a sense of humor drier than the Sonoran desert.  The first appointment will take place in about two weeks and will involve only the intake nurse and a likely confirmation of my pregnancy tests via urine or blood sample.  The second appointment will take place approximately four weeks from now and involve a visit with my OB/GYM himself.  Honestly, I'm in no rush to involve medical professionals, because it generally opens the gate to a plethora of uncomfortable poking and prodding.  However, because of my "advanced maternal age," there may be recommendations that I want to obtain earlier rather than later, such as progesterone supplementation or extra vitamins.  In addition, I'm holding off on telling everyone except my partner until I have my first doctor's visit and confirmed heartbeat, so I'm eager for that confirmation.  

Aside from scheduling doctor's appointments, I also picked up a couple of very simple and cheap pieces of clothing to help "hide" everything until we feel comfortable making an announcement.  Although I have a flat tummy when I wake up, the water retention has made many of my trousers and jeans uncomfortable, especially by the end of the day.  See this LINK for a few items that are useful if you are hiding the bump during the First Trimester of pregnancy.  

This is actually a challenging period of time in the first trimester, for the following reasons: (1) We don't feel comfortable informing anyone else about the pregnancy until we have a confirmed heartbeat, so there is the constant presence of a Very Big Secret; and (2) My weight gain fluctuates up to 10lb right now, based solely on water retention and digestive sluggishness - just yesterday, when I woke up my weight was 131 lb (let's say a solid 5-10lb heavier than usual) and 136lb at the end of the day.  Then, today, I woke up to a flat stomach and a weight of 129 lb.  I've already been sleeping in sports bras and they feel much more "filled out" than usual.  If my brain wants to keep everything a secret, my body is not cooperating.  I've already put away my skinny work pants and jeans (possibly forever! haha!) and replaced them with a pair of petite tummy-control leggings and oversized sweaters.  I haven't bought any classic maternity clothing yet, but it took exactly one day for me to replace my normal work wear with the office equivalent of pajamas.  I'm also experiencing chills, mild nausea, and mild fatigue.  I had a dream that I was eating paper.  Pica is a symptom of iron deficiency anemia, so I took it as a reminder to watch my iron intake. 

The other thing that makes this period somewhat challenging is the emotional landscape.  I am a little nervous about this pregnancy, although I have no reason to be anything but optimistic.  I would say that this is due 10% to legitimate concern over age-related risks and 90% to the fact that we really, really wanted this baby and knowingly tried to get pregnant.  Our first pregnancy was a complete and total surprise - we were not actively trying to get pregnant (at thirty-five, we simply assumed things would probably take a while, so pregnancy was far from our minds even though I hadn't taken birth control medication since I was in my twenties.)

This pregnancy is different:  We actually got exactly what we prayed and hoped for, without any difficulty - could it be taken away as easily? I'm dealing with those feelings by choosing not to dwell on them or empower them, instead celebrating every single day as it comes and not getting too far ahead of myself. I think I will feel these fears dissipate after we confirm heartbeat and receive our first medical intervention at about eight weeks. 

Moreover, the twenty-five year old girl who works the front desk at the office gym just had the most adorable baby girl about three months ago.  The simple fact is that this twenty-five year old girl could be my daughter by now, had I been a little careless with a prom date.  There is no word in my vocabulary for how this fact makes me feel sometimes.  I definitely appreciated every silly article about "celebrity pregnancy over 40" this last week.  

I also find myself reminiscing about my last experience with maternity leave:  I was off twelve weeks.  My boss, who happened to be in the UK, became pregnant the following year and was able to have protected leave for one year.  Five years after the fact, the maternity and parental leave policies in this country are still firmly entrenched in an era where the Earth was still cooling.  My vocabulary has PLENTY of words for how I feel about this fact.  I really adore my job and my boss and have already started to give consideration to how best to manage preparing for and taking maternity leave. 

For now, I'm continuing to workout 30 minutes per day, with two days off per week. 

A typical week looks like this:

Monday:  Tone It Up Prenatal Total Body Workout (weight bearing)
Tuesday:  30 minutes on the stationary bike
Wednesday:  Prenatal Barre Workout (weight baring) and Prenatal Arms Workout
Thursday:  30 minutes on the elliptical or Denise Austin Prenatal Cardio Routine (the "OG")
Friday:  Rest day/30 minutes of walking
Saturday:  Tone it Up Prenatal Total Body Workout (weight baring)
Sunday:  Rest day/housecleaning and meal prep

After completing a kettlebell workout (12lb) I found that I had a lot of pelvic and abdominal discomfort, so I'm retiring the Kettlebell of Doom for the rest of the pregnancy.  I did a lot of deep squats during that particular workout.  While squats are generally safe for pregnancy, you have to listen to your body.  I am taking a break from squats for a few days, and then plan to revisit without weights.  I've definitely had an increase in morning sickness this week and it had disrupted my sleep.  No one feels like working out when they've been up since 4:00 AM.  On those days, I just try to eat healthy and walk a little bit more throughout my day. 

The Pregnancy Dreams are still in full effect.  It probably sounds overly dramatic to say that this is one of the most challenging "symptoms" so far, but it is!  In the last two weeks, I've dreamed about zombie attacks, witchcraft, abandoned orphanages, ancient Feudal conflicts over land, ambush attacks on foggy inlets, sea monsters and at least half of my most disappointing and embarrassing moments from high school.  It's actually really difficult to wake up and go about your day after such distressing or intense dreams.  It feels like someone is excavating the deepest recesses of my subconscious.   

This week, I've commenced my prenatal fitness and nutrition program in earnest.  For my size, that means consuming approximately 1800 calories per day of healthy, Tone it Up-approved foods that pass the "morning sickness" test and at least five days of exercise per week.  I'm a little nervous about not gaining too much weight in the first trimester. 

This is a complete 180 from my first pregnancy.  When I was pregnant with my son, I was so scared of missing vital nutrients in my diet that I actually overate a lot of healthy foods.  In addition, my workout routine the first go-around was based solely on walking and yoga.  While those activities will keep you feeling relaxed and healthy, they won't necessarily shave off any pounds. Last time, I weighed approximately 156 lb when I delivered my son, and frankly, it was a difficult amount of weight to hold on a frame that can be healthy at 105 lb.  It was even harder to shed!  I feel like I spent an entire year in plank pose just to fit back into my pre-pregnancy size(s).

It is a challenge to fit in the workouts now because I'm experiencing some of that First Trimester fatigue, nausea and frequent urination, the last of which likes to appear at two in the morning.  Still, if I can keep the total weight gain a bit lower this time, I think that I'll feel better and recovery more quickly.  Please don't feel bad for the baby!  He/she celebrated the kickoff of this fitness program by downing an entire bag of veggie sticks over a single "girls' night in."  Gleefully.  And with abandon. 

I have my first prenatal doctor's visit this Friday.  My biggest concerns right now are about cervical insufficiency and prenatal screening panels for chromosomal or other abnormalities.  Of course, I'm also really looking forward to confirming the heartbeat!  Once we have that confirmation and the first set of ultrasound pictures, we'll share our news more broadly. 

I'm actually really looking forward to being able to openly participate in this year's Tone it Up Love Your Body Challenge as a pregnant women.  It can be hard to maintain relationships with female friends when you are a busy working mom, and morning sickness does not help that cause.  It's nice to have the extra support and companionship of women who are going through similar experiences. 

I am currently four weeks along with my second pregnancy at the age of forty-one.  I've seen countless articles devoted to women who are trying to conceive at ages often regarded by the medical community as being a bit advanced, and it inspired me to put my two cents in.  I'm certainly not a doctor, but I do have a degree in biology, so hopefully some of this will be helpful.  It can be challenging for many women to conceive naturally at any age, and perhaps even more so for those over the age of thirty-five.  I've outlined some of the things that I think may have contributed to our success in conceiving naturally at the age of thirty-five and forty-one.

TLongevity. 

There are quite a few studies examining the relationship between human longevity and age at conception, including the impact of older parents on the health and longevity of the children born to them (this is basically negligible, so please don't add it to your list of worries!)  A study in the Journal of Science Research and Reports (2014) examined evidence from eight studies demonstrating that smaller body size is related to greater longevity.  My family seems to bear this out!  The women are generally petite and tend to live for a very long time.  My paternal grandmother was my height (five feet) and lived to the age of 96.  My maternal great-aunt was about five four and lived to be 97.  My maternal grandmother was about five foot five and lived to be 83.  Through my life, I've often joked that I take such good care of my body because I expect to be in it for such a long time!  This is relevant for two simple reasons: (1) there appears to be favorable correlation between advanced maternal age and longevity, although it can be hard to figure out which causes the other; and (2) I have always felt that my genetics (not only my lifestyle) allow me to skew a "real age" younger than my actual calendar years. 

I think it is important to note that what is most valuable here is the concept of an "inherited" longevity - how long will you be on this beautiful Earth if everything goes well and you make responsible choices?  If your relatives barely made it out of their fifties due to lifestyle choices, such as ill-managed diabetes, smoking or illicit drug use, this is not relevant to you at all.  What is more valuable is being aware of the genetic legacy your family has bequeathed you and properly managing any negative tendencies (e.g. a propensity toward diabetes or cardiovascular issues) so that you can optimize your health and longevity. 

If the women in your family routinely make it to their nineties and people often confuse you for being much younger than you are, these are things that imply that you have been favored with a robust ability to repair age related damage to your cells - not a terrible thing if you are trying to conceive naturally. 

Regularity.

When I was in my twenties (e.g. college years) my menstrual cycles were a bit all over the place.  I was quite a bit thinner at those ages, and this may have contributed.  My frame was likely 15-17% body fat, and my hormones had clearly not found their happy balance yet.  Still, by the time I entered my thirties, my body fat percentage increased to 20-24% and you could set Greenwich time according to my cycles, trends which continued to my present age. Having a predictable cycle implies that the underlying biology is working as designed - again, this can't be a bad thing if  you want to conceive naturally.  For women in their forties, cycles also offer a huge clue as to whether you have entered peri-menopause or menopause; natural events which can certainly impact fertility. 

Prior History

When I delivered my son at the age of thirty-six (I literally went into labor on my birthday after eating five pieces of cheesecake), I had originally expected to have a natural childbirth.  I was so committed to this idea, having done meditations every single day for more than six months, that I declined any intervention for six hours of active labor.  Well, flash forward twenty four hours later, and I had a baby and a discharge sheet that looked like Keith Richard's 1970s.  Still, my body had demonstrated that it could naturally conceive a baby and carry to term.  This was especially important for me, as I had a history of multiple cervical surgeries (three to be exact) in my early thirties.   I really had no way of knowing whether scar tissue would impede my efforts to get and remain pregnant, and was greatly relieved to find that it did not.

This favorable history was another "plus" when we attempted to conceive at the age of forty-one.  While there are plenty of things you can do to foster a healthy pregnancy, the bottom line is that anyone who has been pregnant understands that much of the process is out of your control.  Again, favorable prior history speaks to the underlying biology working as designed at least once.  With the exception of progesterone supplementation, I had a history of needing little medical intervention to conceive or carry to term. 

Longevity, regularity and favorable prior history are blessings that I did little (or nothing) to earn, foster or cultivate.  They are simply statistically significant items that help move the needle in a slightly favorable direction.   Moreover, they barely scratch the surface of blessings most of us have received that foster fertility, such as access to clean drinking water, affordable medical care, freedom from pollutants, publicly available education and access to healthy foods.  Even those who struggle with challenging fertility issues have more things in their favor than they will likely ever really realize. 

The purpose of starting with items "out of our control" is to establish a bit of a baseline:  If your periods are not regular, you will likely need to work with a medical professional to fix that up before you can make any meaningful attempt to line up your - ahem - extracurriculars with your ovulation date.  If you do not see youth and vibrancy when you look in the mirror, then you may need to work with a medical professional to understand what is dragging you down (e.g. a subtle hormonal imbalance or stressful lifestyle).  After all, four decades is plenty of time to accumulate the effects of bad habits or otherwise trigger an underlying disease propensity: those who will be diagnosed with Type II diabetes in their 70s likely show signs of metabolic syndromes or imbalance as early as their 40s.  If you have a history of challenging conception(s) or inability to carry to term, you need to seek understanding of your personal biology and environment to best confront those challenges. 

Biological processes are intricate - any improvement you make will likely have a ripple effect.  That is how the body works:  change one variable either internally or externally and watch for its impact.  Pregnancy - at any age, for any woman, with any history - is partially an exercise of fate, which we humans can influence one way or another only by trying to take statistically meaningful actions based on the research in existence that particular day. 

I actually take great issue with the common phrase "getting pregnant."  The word "getting" seems to imply an action of grabbing, grasping, obtaining, and these concepts completely trouble me when used with pregnancy, especially because the word "get" is so fraught with connotations about deserving-ness - we "get" what we deserve, some people just "get" lucky.  Creation of human life is no different than creation of any other life.  Flowers don't "get" blooms, trees don't "get" seeds - the continuation of life for any organism is simply cultivated or not cultivated by its environment.  All we mothers can hope for is that we have been partially blessed with and partially created the proper environment for such cultivation, just like a garden. 

I don't believe that the things we do "on and off" do much to impact our chances of conception (unless that "on and off" activity is rolling around in pesticides or the like).  So here, I am only going to focus on things that I do religiously, every single day, as these are most likely to be pertinent to an actual attempt to conceive. 

Consuming a LOT of nuts and seeds.

I will go out on a limb and say that my consumption of cashews, almonds, flaxseeds, sunflower seeds, pepitas, and peanut butter is probably higher than fifty percent (or, um, ninety percent) of the population.  I don't do this because of any attempt to improve my fertility.  I do it because sugar/insulin sensitivity runs in my family and nuts and seeds are a quick, easy snack with enough protein to keep me away from things like fudge or Fruit Loops.  Nuts and seeds are quite nutrient dense, containing zinc, omega-3 essential fatty acids, protein, and vitamin E (all of which are utilized in biological pathways relevant to fertility.) 

Increasing my heart rate - a little bit

I've mentioned before that I believe having a low body fat percentage may have unfavorably impacted my hormonal balance when I was younger.  What can I say? I wanted abs.  So, I think it is important here to note that overdoing anything - including exercise - will likely have a negative impact on your fertility.  For me, I make an effort to simply boost circulation and build strength without taxing myself to the point of exhaustion: no Bikram/hot yoga or strenuous HIIT programs, even outside of pregnancy.

I aim to keep my heart rate at an appropriate range (generally below 179 bpm - actually who am I kidding? generally below 160 bpm).  If I went harder, I'm sure that I would be pleased with the aesthetics, but I suspect it would have other deleterious effects over time (as it did when I was younger).  Exercise is very personal, and advanced athletes may have a lot more latitude to challenge themselves than the typical desk-bound lawyer. 

I would only say that regular exercise is essential to flood ALL of your organs with nutrients and oxygen, and cleanse away toxins.  Exercise sends key biological messages to your brain:  "I am healthy.  I am capable.  I am safe.  Look, I am not under physical stress or strain, nor at risk of exhaustion or overheating."  This is the kind of biological atmosphere that fosters fertility, and frankly, better health in general. 

Drinking green tea

I drink one or two weak cups of green tea every morning.  This is not a meaningful intake of caffeine, which can be detrimental to pregnancy.  In low amounts, green tea offers a nice boost of antioxidants and (surprise!) folic acid.  It also contains trace amounts of potassium and polyphenols that have been linked to reduction of inflammation.  People often talk about green tea as a panacea - a cure for everything!  I think that likely overstates its health benefits.  Still, as a substitute to sugary, caffeinated drinks like the ones I covet from Starbucks, it's a solid choice.  As a daily beverage, it likely provided me with a consistent level of compounds that helped to keep the inflammation load within my body fairly low.  The rest of the day, I attempt to consume at least 60 oz of plain old water.  When I bore of regular water, I mix in a little bit of apple juice or a few drops of Mio. 

Sleeping eight hours

Sleep is your body's repair cycle.  Lack of sleep can disrupt your monthly cycles, impact hormone levels of hormones linked to both dietary and fertility cycles and thwart your body's ability to repair cells properly.  I am in bed no later than 9:00 PM every night, and aim to be asleep no later than 9:30 PM.  The sleep-wake pattern of human beings is intimately tied to fertility.  There is a reason that our cycles line up so beautifully to that of the lunar transitions. 

The CLUE App

I've been using the CLUE App on my Note 8 for about a year and it's fantastic.  I currently use it to track the following: Period start date, PMS symptoms (e.g. cramping or headaches), emotions and temperament, the amount of sleep I had that night, extracurriculars (sorry, I was raised by a literal 1950s housewife!), digestive issues (e.g. nausea or bloating), and even cravings.  The app provides predictions based on past entries, including the start date of your cycle and your most fertile days.  Perhaps most importantly, it's so nice to have this information at my fingertips when I go to the doctor.  Doctors can still sometimes be dismissive of women, so it is nice to come "armed," especially if you feel that something with your health is not quite right.  CLUE is a fantastic free app, even if having a baby is the farthest thing from your mind.

Easy@Home Ovulation Test Strips & Pregnancy Test Strips

We had tried for a couple of months using only the CLUE App to guide us to our optimal days, without success.  Around this time, I had a candid conversation with a close friend who had recently had her second child.  She is a couple of years younger than me, so I was a little taken aback when she revealed that they had not been cavalier at all about conceiving their second child.  My partner and I had always had a really chill, "whatever happens, happens" approach.  Still, I was starting to feel like maybe being that laid back was irresponsible at our age, when it seems like every article I read admonished me with a huge ticking biological clock.  She mentioned that she had used these strips and found that the ovulation date she identified by using tracking methods was actually off by a couple of days.  Sure enough, I used them for one month and found that the strips actually informed an ovulation date about 24 hours prior to the "peak fertility day" represented by CLUE.  Although this seems like a subtle difference, apparently it was a notable one, as we conceived that month.  I definitely recommend combining both the tracking and test strips into one approach. 

Consuming heme iron sources

Having been vegetarian for twenty years, I found that as I entered my late thirties I was finally struggling with nutritional deficiencies.  For a couple of years, I scoffed at my symptoms, such as extreme fatigue ("What working mom doesn't feel tired all of the time?"), disrupted sleep cycles ("I must have had too much to drink before bed?"), heart palpitations ("It must be caffeine") and tingling and numbness in my extremities ("I must have slept wrong.") 

While all of those rationalizations may have held a kernel of truth, the simple fact was that I was significantly deficient in iron, zinc and most B vitamins, despite my efforts to incorporate sources of these into my diet.  So now, I eat heme protein (a delicate way of saying "Meat") every single day.  I try to obtain this from sources that are most respectful to the environment and cause the least offense to my personal ethics. 

I make no mistake about the fact that reincorporating heme protein sources into my diet has been absolutely critical to the restoration of my general health and fertility.  Other women may be able to overcome such nutritional deficiencies via supplementation, an approach that proved unsuccessful for me.  I think that the most important point I can make here is that I "thought" I had been eating extremely healthy, and still had significant deficiencies in vitamins and minerals that can directly impact fertility and general health, so I have to assume that many women out there may also have a similar dietary profile.  Particularly if you subscribe to any kind of specific diet, such as keto, vegan, vegetarian, paleo - I recommend paying for an extensive blood testing panel by a qualified functional medicine clinic to identify deficiencies - plus a healthy dose of humility and openness to change when reviewing the results. 

Avoiding Alcohol

At the age of forty-one, I can still count the times that I have consumed any sort of alcoholic beverage on my fingers.  I've always been a teetotaler, even in high school and college.  A lot of this simply stems from a general intolerance of alcoholic beverages - I would usually get sick to my stomach long before any sign of that fun "buzz" everyone assured me was waiting around the next corner.  In addition: I'm tiny.  I've felt the effects of a shot glass of beer or wine.  I have no moral or religious prejudice against imbibing, I just simply don't like it, it doesn't make me feel particularly good, and I have yet to identify a single meaningful benefit to its consumption.  The presence of alcohol is so ubiquitous, I can't help but feel that I may be painting an inaccurate picture by not mentioning my abstention.  I'm not sure if it impacts my fertility or not, but it is a noteworthy feature of how I live my life, so I suspect the answer is likely "yes."