Showing posts with label my story. Show all posts
Showing posts with label my story. Show all posts

Monday, December 28, 2015

2015 wrap-up

I cannot believe 2015 is about to come to a close. It's been a really incredible year with many amazing opportunities. It's also been exhausting!

Here are a few reflections and updates for you.

We are in fact still TTC (Trying To Conceive). I'm not taking any drastic measures, we're just doing what we know to do and trusting God. There are days when I'm not sure I can handle starting over, and other days when I ache to bring another child into the world...so we just take it a day at a time and remain "open to life."

Two years ago, I kicked my sugar addiction. And I've been gluten, wheat and cow's milk-free for about 18 months and I feel better than I have in, well, my entire life.

This was me right around my birthday in November 2015, wearing my second-hand top and size 6 Levi's!



The boys are now 10 (yikes!) and 6. They're so precious and we are incredibly blessed that they are kind, smart, strong, thoughtful boys, and so good to each other. They both earned new belts recently in karate and are getting all As in school. They love playing video games, making up stories to act out with their Angry Birds plushies, and riding their scooters to the park.

Andrew age 10 and Ethan age 6


I'm making some adjustment for my business in 2016, primarily because I want to publish a book about the miscarriage story. My main focus is helping work-at-home moms elevate their image and expand their influence so they can have their work, family and faith in harmony and pursue God's best for their lives. You can find out more on my work with me page.

For this space, I hope to encourage more women in 2016 who are experiencing unexpected setbacks on the journey of motherhood, from infertility to unplanned pregnancies. My work at the Pregnancy Care Center of Chandler will continue and I hope to host some support groups as well.

In 2016, I hope to get back to walking, yoga, herbs and essential oils--some of my loves that were placed on the back burner for too long!!

If you're reading, I'd love to connect with you so feel free to email me at tabitha@tabithadumas.com or say hello on my Facebook page.

Let me know how I can support you or what you'd like for me to blog about!

Wishing you all the best in 2016 and beyond.

 

Friday, April 10, 2015

He said his peace!

Weeellll....we've been hem-hawing about having another baby for months--nay, years--now. We've even "tried" off and on quite a few times! Then we just weren't sure what we wanted to do, so we took a break.

Well, my sweet hubby kept asking me if I wanted another baby. He'd ask our boys if they wanted a brother or sister. He'd mention "now or never" and ask if I'd made up my mind.

I've knows for quite a while that I'm definitely open to the idea or having another baby but I wasn't SURE one way or the other.

Then recently, I've been feeling the draw again...that puuullll to become a mother again.

It's that time of the year, too...when we got pregnant with the miscarriage baby, Mother's Day, Ethan's birthday...when I'm thinking about pregnancy and babies again.

And I noticed on Countdown to Pregnancy that if we conceived this cycle, I'd be due December 28. That rings a bell--that was our due date with the miscarriage baby. 

Songs on the radio...looking at baby pictures of the boys and feeling that tug on my heart...I finally thought, "Yeah, we need to think about taking another leap of faith."

Drew prayed about it. He said he had peace. So we're going for it.

The night before we first "tried," Ethan added, "getting a new baby" to his nighttime prayers....like he KNEW or something. Funny.

This time FEELS different. Our hearts are in it. Life is good, our family is doing great, I'm feeling amazing...it's time.

So we're taking that leap of faith and this time, we're sticking with it! 

Assuming my fertile phase just passed, we'd be looking at news before the end of April. If it doesn't take this month, I'll start charting again. I had to brush up on my Fertility Awareness knowledge--thankfully, a lot of it is still ingrained in me!

The last two times we really made up our minds we got pregnant on the first try so of course that's my request. But really, any time in the next 10 months would be lovely.

Here we go!!


Friday, February 22, 2013

On Using Contraception

A friend posted a link to this post today on Biblical Homemaking about whether Christian should use birth control and I thought, "Gosh, I haven't written about that on God Knits! I should tell MY story!" so here I am.

I don't really write about or discuss controversial issues. EVER. In real life or on my various blogs. I do, however, tell my stories and let my readers come to their own conclusions.

Here's my story where it concerns the use of contraception. We will save the "family planning" aspect for another post.

When my husband and I got engaged, I went to my naturopathic doctor and asked her about birth control. We knew we didn't want to start a family right away. She wrote me a prescription for the Pill and I started it right away.

I felt terrible, gained weight, had headaches for the first time in my life and even threw up on the side of Thunderbird Road one night. The Pill was not kind to me.

In the meantime, I was working as an administrative assistant at a engineering firm and a kind Catholic gentleman handed me a brochure one day in the hall and said, "We never need to speak of this." It was about Natural Family Planning.

As a lifelong learner and a Bible believing Christian, I read it and did some research. I was surprised to learn about what the Pill does to a woman's body and felt betrayed by my naturopathic doctor.

That experience taught me that I am in charge of my health and must look out for what enters my body. To this day, I rarely take any type of medicine and am very careful about what goes on and in my body. As a disclaimer, I do still love Oreos and Cheezits and am by no means "all natural."

The thing about the Pill that rocked my heart and left me feeling very convicted was discovering that one of the "benefits" of the Pill is that it thickens the uterine lining to make it inhospitable to a fertilized egg. Believing that life begins at conception meant that it was NOT OK that my body would reject a fertilized egg!! Imagining mine and my husband's cell combining and multiplying and our future baby coming down my fallopian tubes just to be met by an inhospitable environment I created was heart breaking.

I debated for a while about what to do but I couldn't escape the unsettled feeling I had about being on the Pill. As I gave it some thought, it just so happened that Phoenix was experiencing a gas shortage and I was planning to stay the night with friends to avoid the 50 mile drive home. While I was parked behind the tutoring center where I worked, my car was broken into and my backpack stolen, along with my pills. I felt like God was sending a clear message: "Stop taking the Pill." Message received. I never refilled my prescription.

I knew I wanted a long-term birth control solution that didn't involve artificial hormones, had no side effects and was easily reversible so I ordered two books: "Natural Family Planning" and "Taking Charge of Your Fertility" by Toni Weschler.  As a Christian who is not Catholic, the NFP method didn't quite gel with my beliefs. TCOYF, however, changed my life.

I started the Fertility Awareness Method immediately and have used it with great success for ten years now. We have conceived without problems three times and have not had a surprise pregnancy in all that time. What I've learned about my body because of charting is better saved for future posts but suffice it to say, I am now a self-proclaimed fertility nut and a big believer in the FAM.

Human life is precious and a decision about your birth control method (or lack of) is an important and personal one.

I will encourage you to search your own heart, ask trusted mentors, search the Bible, have a conversation with your spouse and make an informed decision. There is a lot to consider.

I'd also encourage you to extend grace to those whose method or perspective differs from yours, especially as you become more educated on the topic. Everyone is in their own phase of their journey--myself included. This is not a black and white issue for most people.

By the way, endometrial abalation destroys your uterine lining, too. Mayo Clinic's explanation of endomertial abalation is: Here. It's just something else to think about.

Saturday, November 3, 2012

Tab's Tips For Taking Pregnancy Tests

I say tipS (plural) because, seriously, who can take just ONE test!?!?

These are mine from September 2, 2008, approximately 14 days past ovulation. I dipped one in the cup and it popped up before I even set it down. Not trusting my eyes, I dipped the other one immediately afterward. I was amazed!!




When I was learning the Fertility Awareness Method, I remember reading that it is almost impossible for a woman to go beyond 18 days past ovulation without being pregnant. For charters, being past day 18 post-ov without a period is an almost sure sign of pregnancy. "Well, I'll just wait the 18 days and test after that, then," I remember thinking.

Riiiiiiight. That never happened.

With all three of my pregnancies, I started taking $1 tests as early as 10 days past when I thought I ovulated. I would have negatives or even light positives on days 11 and 12, but I didn't get a STRONG, dark, CONCLUSIVE positive result until fully 13-14 days post-ov.

I was never an obsessed test-taker, but I did try the dollar tests just for fun in the days leading up to day 13-14, knowing I'd have to splurge on a 'real test' for the official result.

So! Here are my Tab's Tips for Taking Pregnancy Tests:


1. Wait to take a test until your period is truly LATE.

Implantation needs to occur before hCG is produced, and that generally happens between 6-12 days post ovulation, usually by 10 days after. I recommend not testing before at LEAST 10 days post-ov, and closer to 13-14+ days if you can bear to wait that long.

During the 'waiting to test' phase is when knowing the typical length of your luteal phase (the time between ovulation and your period) is extremely valuable. Knowing what's normal for you means that you can test confidently within a day or two of when you would usually expect your period.

With my first pregnancy, I knew my luteal phase rarely went past 12-14 days AND I usually had spotting on days 11-14 or so. When I got to day 13 post-ov with NO spotting, I figured something was up. Sure enough, the test on day 13 was very faint but on day 14 it was VERY positive.

CAUTION!! Many factors can lead to a longer-than-usual cycle including delayed ovulation due to stress of sickness. So unless you KNOW when you ovulated, just thinking you're 'a little late' doesn't necessarily mean you're pregnant.

COOL TOOL!!! Wondering when to test based on your specific cycle?? Try this on CountDownToPregnancy.com. Gives you a run-down of when various pregnancy tests will pick up the hormone levels. Very cool! According to my dates, I'd be a fool to test before at least Nov. 4 and I'm advised to wait until Nov. 7th and beyond. My plan is to hold out until Thursday the 8th because I have a big teaching gig the next day AND my grandmother arrives into town so I will HAVE to know!

2. Test with your first morning AND midstream urine if possible. You should use midstream urine--meaning you should pee a little first and then either hold the test stick in your urine stream or use a collection cup. And I recommend.....

3. Pee in a cup, THEN dip the stick IN (rather than trying to pee ON the stick). You will be nervous and your hands might be shaky, so don't attempt to pee ON the stick!

Follow the package instructions, of course, but for MOST tests, you can pee in a paper cup then dip the absorbent tip into the cup for the specified amount of time and lay the test down to get your result.

4. Keep the test pointing downward and then lay it flat afterward. I remember with my third pregnancy, I dipped it in the cup then watched it move across the control and BAM! The second line emerged, before I could even set it down! That was awesome.

5. Know your tests. Some tests are more sensitive than others. If you're testing early, you want a test that detects the LOWEST amount of the pregnancy hormone. There are many tests on the market that can pick up 25mlU. Some even pick up levels as low as 10mlU or 15mlU.

Check out this list from FertilityPlus.com for a list of the most sensitive tests then take it to the store and see which ones are on sale. 

Wondering about the hCG levels? A rounded-off average would be about 25 mIU at 10 dpo, 50 at 12 dpo, 100 at 14 dpo. You can see why I got FAST, clear positives on day 14!

I'd wait to get the digital "I'm pregnant" test until you're pretty sure you are OR if you are just DYING to know for sure early on. It is a fun picture for the scrapbook (or to use as a prop to announce your pregnancy), but cheaper tests can still give you a conclusive positive (or two or three or six) before you have to splurge on the expensive digital version.

Happy testing!

Do you have tests you love or hate? Do share!


 

Friday, November 2, 2012

Early Pregnancy Symptoms

For women who think they may be pregnant, it's fun to compare notes on the early pregnancy symptoms other women experienced. Here are mine.

Andrew's pregnancy (2005):
1. My first tip-off was being 12 days post-ovulation without any spotting. If you are hoping to be pregnant, anything unusual about your cycle is a good sign!
2. Bright blue veins across my chest and later, on my belly. Increased blood flow, I believe.
3. I walked into Target and almost wretched when the smell of popcorn hit me like a wall.
4. My jeans were tight around the belly almost immediately. Or they FELT that way, anyhow. It's said to be a result of hormonal changes.

**Reading over old blog posts, I discovered that I had what was almost definitely implantation spotting a day or two before my positive test with Andrew. Good to know!

Once I found out we were pregnant (13 days post-ov officially), I had increased appetite and energy for about a week. At about the six week mark, the evening tiredness started in. I had some food aversions early on, too, like I didn't want coffee or sweets, and I was thirsty a lot.

Miscarriage pregnancy (2008):
I had to read old blog entries to remind myself...
1. "Drooly" and light-headed, some achiness and lower back aches. "A little tired." I don't remember many clear signs, which may have been a sign.

SIDENOTE: My theory now, four years later, is that I was exposed to a bug or virus of some kind at about 5 weeks pregnancy. I'm not sure how all of that works, but I wonder if my 'symptoms' were merely the bug starting to kick in. My midwives theorized that I had a 'blighted ovum,' which would have resulted in a positive prengnacy test, but isn't technically--maybe--a 'baby.' I'll write more about this at some later point.}

REST ASSURED, however, that MANY women without strong early pregnancy signs go on to have healthy babies! Every woman and every pregnancy is different.

Ethan's pregnancy (2008):
1. All I recorded on my trying-to-get-pregnant blog was "achy and tired." Naturally that can also mean 'impending period' so that's not a big help.

Once I got the positive test (about five weeks in due to 35-day cycles), a couple of days later I reported..."I'm feeling fine. A little low on energy at times, even breathless, like everything is harder. Very HOT. Definitely hungry and thirsty all the time. A little woozy from time to time but otherwise, GREAT!" There ya go!

By six weeks, I reported on feeling "tired and woozy, just enough to be annoying." Sounds about right.

So...we'll see if I'm 'achy and tired' a week from now!

In the meantime, this is a really cool chart to see what pregnant and non-pregnant women were experiencing at the various days past ovulation. Find it on
Countdowntopregnancy.com.

Friday, September 7, 2012

A Great Way to Figure Out If You Want to Have Another Child

What is a great way to figure out if you want to have another child? Wonder if you could possibly have accidentally gotten pregnant!
 
My current cycle is dragging on for longer than usual with NO spotting. I am a little achy and crampy--symptoms of early pregnancy AND impending period, of course. Love that.

Other things that have made me curious??

1. I've been tired this week, but I've also had a sort throat/sneezing/stuffy nose thing since about Monday, so it's hard to say what causes what. BUT, I've had colds or weird stomach issues at the start of my other pregnancies, too. Strange. I wonder if it's an immune system thing: as soon as pregnancy sets in, your body puts all of its attention there and then you come down with any little thing you're exposed to. Just a theory!

2. On Tuesday, in fact, I was so tired that I laid down to see if I could sleep and woke up THREE hours later when the school called to ask if I was going to pick up my first grader! I almost never nap, and certainly not that long and that hard in the middle of the day! But again, that could have been simply the restless sleep I had the night before in combination with my little case of the sniffles.

3. I had strange belly pains (like gas or indigestion) that was quite painful a couple of days ago, too. Who knows??

4. I woke up two days ago remembering an angst-filled pregnancy-related dream now that I think about it. Hmm. I wish I remembered it better but there was a roomful of babies involved.

5. This cycle is a little 'off.'

6. I felt kinda breathless for a moment yesterday--an early sign from last time.

My 'charting,' by the way, currently involves a pocket calendar where I keep track of days that I seem to be fertile, any strange symptoms (spotting, belly issues, poor sleep, even vivid dreams) and, of course, my period. I actually sat down yesterday and recorded my cycle details for 2011 and so far in 2012! I highly recommend keeping track of those minimum details, by the way. Just for such a time as this!

Let me state for the record that until about two years ago, my cycles were notoriously long. Like, MONTHS long. Even in recent history, I would typically not ovulate until day 21 or later, making my cycles anywhere from 35-40+ days long! BUT, almost like someone flipped a switch, when we moved two years ago from the home we built in 2003 to Phoenix, my cycles regulated and shortened. My anxiety all but vanished, too. {Yes, there is a correlation. But that's a post for another day.}

ANYway, since making that major life change (plus finally fully recovering from Ethan's pregnancy along with slowing down and taking better care of myself), my cycles have gotten MUCH shorter!

In 2011, my cycle average was 33 days long with ovulation near day 20.
In 2012, my cycle average was 29 days long with ovulation near day 17.

The time between ovulation and the start of a new cycle tends to be the most 'set in stone' number for most women: mine is 11-12. With both of my pregnancies that 'took,' I had positive tests on about day 13-14 post ovulation.

I don't always record pre-period spotting but I do typically have some (the lack of it tipped me off to my first pregnancy) and I have had 1-3 days of it for the last FIVE months.

So. Based on that. Here I am on day 29 of my cycle with an approximate ovulation day now 14 days ago and with NO spotting. And all of the above strange symptoms.
Naturally all of the above could be NOTHING. And there's about a 99% chance that it IS nothing.
The real issue is....how am I feeling about the possibility that we had an 'oops?' It would be truly miraculous, by the way, because I assure you that we are NOT trying to get pregnant! We are actively preventing it, in fact, and we aren't risk-takers!!

But in trying to navigate the whole "Do we want another child or not?" debate....this exercise in the 'what if' is good.

I took a pregnancy test today.

A $1 test that I got a clear negative on the DAY before my two clear positives with my last pregnancy! It was clearly negative today, though. And I was disappointed. The 'almost brought tears to my eyes when I thought about it' kind of disappointed. I found myself saying, "God, could you just PUT a baby in there for me??"

I went to my son's school this afternoon for his teacher's birthday party and found myself wishing someone would talk to me and I could slip in, "Well, I just found out today that I'm pregnant!" I felt myself wishing I could stick my belly out and rub it and know there was a baby in there. Funny, huh?

We don't need another child right now. I don't have a burning desire to have a baby. I don't want to put my body through another pregnancy. Yes...there is that little part of me that felt hopeful today and kinda wished we were more reckless and there was just a small chance that I accidentally got pregnant.

I daydreamed about telling my parents Sunday on Grandparent's Day, I pinned 'announcing your pregnancy' ideas on Pinterest this week 'just in case' and I found myself going through my old pregnancy blog. My heart is open.


I realized today that I'd be open to having another baby, to adding to our family, to bringing another one of our offspring into the world, to rolling the dice again.

My back hurts tonight. I feel crampy. I'm betting it's impending period this time. I'll wake up tomorrow having started a new cycle and feel silly for all this vain hope. But I wanted to sit down and write this so I'd remember.

And at least now I know. Getting pregnant would be pretty spectacular someday. I think once we're more financially stable and my health is up closer to 100% and things have settled down...I might be ready to give it another go.

And no one is more surprised by that revelation than me.
 ADDED LATER: I was looking again at my trying-to-get-pregnant blog with Ethan and ran across this post, published almost exactly at this time of night:  Title:: "Hoping still" Based on my loose calculations, I'm about 14 days post-ov and no period yet. Feeling tired and crampy but that can be pregnancy or impending period, so that's no help. No spotting, though. I'm betting I ovulated later than I think I did. I took a $1 test this a.m. and it was clearly negative. I'll give it a day or two and test again but after that, I'll know it didn't "take." I hate waiting. But God's plan is best and I'm OK with whatever. Really. 

I realize that I am almost certainly not pregnant....but I'm very happy that I've figured out that I'd be ok with it if I were! :)

 

Friday, May 20, 2011

Becoming a Fertility Nut

I am a self-proclaimed Fertility Nut. Here's the story of how I got that way.

BACKGROUND:
In high school, my friends were actually jealous of me because I had periods so infrequently. Granted, it was kind of nice—but the unpredictability was a little inconvenient at times. I never really wondered what was going on or why my cycles often dragged on for two or three months or more.

When we got engaged in 2002, I was seeing a naturopathic doctor to try to balance my hormones and clear up my skin. I told her I was getting married and needed birth control and she prescribed the Pill for me. I didn’t question it at the time but looking back, I wonder, “What naturopathic doctor prescribes the Pill!?!” If SHE hadn’t suggested a form of natural birth control, I can’t imagine how other women ever find out about it! She also had me pay about $400 for a saliva hormone test, which revealed that my luteal phase is longer than average and suggested that my testosterone levels were slightly out of whack. In case you’re wondering, she gave me some supplements, “prescribed” herbal tinctures (disgusting!) and had me using a castor oil pack on my belly (to supposedly draw toxins out of my liver)—none of which I kept up after the first month. Somewhat ironically, charting is what ultimately helped me deal with my hormonal issues—not her costly and highly impractical prescriptions.

I was on the Pill for our first year of marriage and experienced headaches (and I’m not at all prone to headaches), nausea and weight gain. I didn’t feel well and started wondering about whether the Pill was right for me. Around the same time, I was working as a secretary at an engineering firm and one day, one of the engineers (a kind Catholic man) that knew I was newly married approached me with a brochure. He handed it to me, said, “We never need to speak of this,” and walked away. It was about Natural Family Planning and mentioned how the Pill makes your uterine lining inhospitable to a fertilized egg. So IF we DID fertilize an egg (which has been known to happen while on the Pill), the effects of the Pill would mean the egg couldn’t attach and grow. As a person who believes that life begins at the moment of conception, that bothered me and gave me even more reason to quit taking the Pill. I started praying about it, asking for wisdom about whether to stop the Pill or not. Several days later, my backpack was stolen out of my car and my Pills with it. I felt like my prayer had been answered. “OK, Lord! I’ll stop taking the Pill!” I look at that incident as a major turning point in my life.

FINDING THE FERTILITY AWARENESS METHOD:
I immediately started researching natural birth control options on-line and quickly ordered two books: one on Natural Family Planning and one on the Fertility Awareness Method. We had just moved into our brand new home and my husband was out of town for the weekend so I spent the entire time pouring over those books, sitting on our mattress on the floor and reading by lamplight. I’m not Catholic so some of the concepts of NFP didn’t gel for me so I set it aside. “Taking Charge of Your Fertility” by Toni Weschler, on the other hand, really opened my eyes to what was happening in my body and was practical, easy to follow and down-to-earth. I read the entire thing in one day, purchased a digital basal thermometer and started filling out a chart immediately.



THE DISCOVERY PROCESS:
I was amazed at what I learned and the most amazing thing was that a typical chart for me was identical to the one the lab sent me with the $400 price tag. I could say that the information you gain from charting is invaluable but it’s more accurate to say that it saves you at least $400, the cost of two doctor’s visits AND 40 days of spitting into a vial every morning!

My first cycle coming off the Pill was annovulatory, meaning that I didn’t ovulate. I could tell because my temperatures remained mostly the same and the cycle dragged on for well over 40 days. The bleeding I eventually experienced was simply due to hormone withdrawal.

I learned some interesting things about my body in my first year or so of charting. #1, I ovulate much later than average, at around day 35 instead of day 14, making my cycles about 50 days long instead of 28. #2, sometimes I wouldn’t ovulate, then would try again within the same cycle (by the way, this has to do with reaching an “estrogen threshold” that I’ll address in future posts). Again, this resulted in much longer cycles than average. But, when we were “trying” to get pregnant, it meant I had a second shot at it! #3, I didn’t ovulate when I traveled OR when I was stressed—good OR bad stress. My body seemed to know when something was out of the ordinary, whether it was a vacation getaway or the week of my teacher evaluations. My body said, “NO! We can’t get pregnant NOW!” This is a good thing (no one wants to get pregnant during a natural disaster or when a loved one is sick), unless you are desperately “trying” to get pregnant, of course. It is just our body’s way of preventing pregnancy when the timing isn’t right.

With charting, I also came to realize that things like stomach upset, skin break-outs, fatigue and even an increased sense of smell were predictable from chart to chart and, thus, clearly hormonal. For the purposes of getting pregnant, I was also able to track patterns of spotting, abdominal cramps and pelvic pain to help me interpret my charts and maximize my fertile window. Just knowing I was—or wasn’t—ovulating made charting worth the effort.

BECOMING A WAY OF LIFE:
I will admit that charting quickly became a way of life and, as a person who likes checking off boxes and filling in blanks, I enjoyed the actual charting AND the information they gave me. I would dream that I woke up and forgot to take my temperature, just to wake up and think, “Did I already take it!?!” I actually looked forward to filling in the information at the end of the day to see what it could mean. I spent a lot of time studying my charts and reading about all the possible explanations for my patterns. I congratulated myself when I turned out to be right about when I ovulated or when I predicted to start my next cycle. I was truly amazed at what I was learning AND, it only cost me the expense of a $10 thermometer and the cost of printer ink!

FAM IN REAL LIFE:
My husband and I have used FAM successfully for almost eight years now. It took us about three cycles of “trying” with our first son (Drew had an uncanny way of being out of town when I was most fertile) then we got pregnant on the first time with both subsequent pregnancies. And we’ve never had a “surprise” pregnancy. With my unusual cycle patterns, I truly believe that learning FAM was a gift. Without charting, I truly believe that I would have been trying to time fertilization during the typical fertile window (days 12-16 or so), then would have gotten to day 30 and beyond and thought I was pregnant. How heart-breaking! I am so grateful to have learned what I did to help me maximize my own fertility, especially since I’m only fertile about eight times during a calendar year instead of the usual twelve. Without FAM, I am sure the financial and emotional cost would have been tremendous. Learning to interpret and trust my own body is truly priceless.

What have you learned from charting your cycles? OR...what would you gain to learn from charting?

Please contact me with questions, or just leave a comment.

{{COMING SOON! Fertility Awareness and PCOS}}