Reviews

Queer Conception: The Complete Fertility Guide for Queer and Trans Parents-to-Be by Kristin Kali

bokslukaren's review

informative

4.5

Kali uses gender-neutral, educational and unbiased language that feels affirming to read, as well as relieving when taking into account that they answer so many questions about queer conception, fertility, health, and biology that I've had trouble finding online. I've learnt a lot and will definitely return to read this again once more of the information becomes relevant for my parenthood journey.

ella_francess's review

challenging emotional hopeful informative medium-paced

5.0

Superb! Made me feel less alone.

zoe_lenora's review

informative

5.0

jessiesb's review

hopeful informative inspiring medium-paced

5.0

mathilde_a's review

5.0

please don't ask me why.
but it was definitely a really interesting read! deeply filled with informations and it was actually helpful.

rrosenberger6's review

5.0

ruled

rutt's review

3.0

so grateful for this resource. affirming, informative, accessible, and to the point.

felt left in the lurch a bit at the end. i know it's a book about conception, but since various infant feeding options are discussed, i wish kali also covered:
- the labor and birth proces
- considerations about when to resume hormones afterbirth
- some of the complexities of being queer/trans after giving birth/as a new parent

kkraatz's review

emotional hopeful informative inspiring medium-paced

5.0

This book was phenomenal. I would recommend it for anyone who is trying to conceive - I was blown away by how empowering the information was. In particular, if you are trying to conceive through IUI or IVF (or you love someone taking this route) this book is a loving mentor through the process. 

sakusha's review

informative medium-paced

3.0

Has some good information that other conception books don’t have, like about using sperm from donors, both frozen and from known donors. But irritatingly written because the author caters to the queer and POC community. S/he uses ‘they/them’ pronouns and makes themself look androgynous (the trendy word for it now is nonbinary), but then uses the female name Kristin. Why not go with Kris?

S/he is white and apologizes for being so (ix). Can you imagine a black person writing this book and saying “I’m sorry for being black. As a black person, I can never understand what it’s like to be white like some of you out there.” People would say, “You poor, poor person! Don’t feel bad for the color you were born as! You are not lesser than the white person!” Well, just the same, white people shouldn’t have to apologize for being white! Being born white doesn’t mean one is destined to be racist. To believe all people of one race are the same is to be racist! These hypocritical leftist are unbelievable!

The author also makes sure not to step on any fat people’s toes. She tells them that some doctors can be insensitive and fat phobic by daring to suggest that they lose weight to improve their conception chances (186). You can be as obese as you want, honey! You just get yourself a new doctor, you hear? One that tells you that you are perfect just the way you are!

The author tries to perpetuate the myth of systemic racism by saying Xytex has the largest number of black sperm donors but won’t ship vials to homes (105). I know from personal experience that Xytex ships to homes if you get your doctor to send them authorization/permission. This isn’t a secret. It’s a known policy of theirs.

The author lists risk factors for miscarriage on p. 239. Among them is “chronic stress from systemic inequities such as racism,” as if racism is the only thing a POC can get stressed about! What about just life, work, traffic, finances, relationships, family, friends, health issues, etc.? Couldn’t the author have just said “chronic stress” without making it about racism?

Tips:

If you do strenuous exercise, do it “in the first half of your cycle, when the body is primed for physical exertion” (39).

“If you have an Rh-negative blood type, it is ideal to select an Rh-negative donor. If you have type O blood, it is best to select a type O donor” (60). But all other blood types (A+, B+, AB+) can pick whichever donor they want. “If you do not have evidence of immunity to CMV, you may be required to only use a donor who is CMV negative” (65), but sperm donations from donors who have an active CMV infection are destroyed, and sperm banks only let you know whether the donor has CMV antibodies or not (either caught it and recovered or never caught it).

“Fats that are solid at room temperature, such as butter, coconut oil, and dairy products, are called saturated fats, and they contain mostly omega-6 fatty acids, which are pro-inflammatory” (37). Dairy should be consumed in moderation while pregnant or TTC. When you eat yogurt or kefir, try to get one with lactobacillus rhamnosus (50).

Eat a plant-based, whole-food diet (31). “Plant-based proteins (lentils, legumes, whole grains, nuts) and fish provide protein without increasing inflammation. Get most of your protein from these sources, adding in moderate amounts of dairy and poultry, and keeping intake of red meat to a minimum” (33). A person needs .8 grams protein per kg of body weight (divide body weight in pounds by 2.2 to get kg) (34). But the author says that a pregnant body needs up to 100 grams of protein (34).

The book provides a chart with sources of protein and amounts (34), but the foods are not all listed under the same measurement. So fish is put at the top of the chart for animal proteins (making you assume it’s the best), but the fish is measured in 4 ounces while the meat is measured in half cups. I looked up online the highest sources of protein and made sure to find a chart that would show each food in the same measurement (100 grams). (Source: healthbeet.org) The real protein winner is bacon at 37 grams protein per 100 grams weight. But each slice is only 3 grams protein each. The chart I found also includes the typical serving size of each food. When that is taken into account, the highest protein food in a typical serving is chicken breast at 36 g protein per 4 ounce serving. This exceeds the protein amount in a typical serving of tuna, which the book author placed higher above chicken. Chicken also beats tuna by 3g protein when they are both 100 gram portions. As for bacon, you’d have to eat 12 slices of it in order to get the same amount of protein in a typical serving of chicken. This is important stuff to know! Instead of the author being ashamed of being white, s/he should be ashamed of misleading her readers with a biased protein chart!

Don’t do intermittent fasting because then “your body is focussing on keeping your blood sugar stable instead of reproductive function” (31). The author recommends eating small meals every three hours to keep blood sugar stable (34). Seems counter-intuitive to me, because what about when we sleep? That’s an eight hour fast right there. So shouldn’t the body be able to handle eight hour gaps between meals while awake too? Didn’t cave women still conceive babies even though they went days without food? Don’t wild animals do it all the time?

When pregnant, maintain “your blood sugar with protein rather than high-carb foods. This is because your body will be shifting from an insulin-sensitive state to an insulin-resistant one, and if you eat too many carbs, your pancreas might not be able to keep up” (254). This results in gestational diabetes. 

*Helpful information:

First trimester bleeding “occurs in 20-30% of pregnancies, but only 12% of those who bleed in the first trimester actually miscarry” (239).

“Ferritin levels are considered normal above 12, but it is ideal to start pregnancy above 20 so that you have some leeway in case you have nausea, vomiting, and food aversions in early pregnancy that keep you from being able to eat iron-rich foods or keep supplements down” (60). When TTC, A1C should be lower than 5.8% (63), AMH should be above 1 or 2 ng/mL, AFC should be 10 or higher (70), TSH should be .3-2.5 mU/L (62), and vitamin D should be 50-60 ng/mL (64).

Pregnancy and miscarriage rates by age with frozen donor sperm (23):

Age - Preg w/ unmed. ICI - Preg w/ Unmed. IUI - Miscarriage

<35 - 6% - 17-22% - 10%

35-40 - 6% - 8-14% - 19%

40+ - 6% - 3-6% - 27%

Age - IVF Live birth rate by age per cycle of egg retrieval (23)

<35 - 54.7%

35-37 - 40.6%

38-40 - 25.6%

41-42 - 12.8%

43+ - 4.4%

Normal semen values (73):

5th Percentile (Low Cutoff) - 50th Percentile (average)

Volume - 1.5 ml - 3.7 ml

Count - 39 mil - 255 mil

Concentration - 15 mil/ml - 73 mil/ml

Motility - 40% - 61%

Progressive motility - 32% - 55%

Morphology - 4% - 15%

“Sperm quality starts to decline over age 40. Chromosomal abnormalities are more common over age 45” (1). 

Sperm life span - best time to inseminate (123):

Fresh - up to 3 days - 24-48 hrs before ovulation

Frozen - 12-24 hrs - within 12 hrs of ovulation

If you are doing IUI, get IUI vials with at least 20 million motile cells per ml (107).

Scientific evidence about IUI (154):

With frozen sperm, IUI doubles the success rate over ICI.

Chances of success: 17% average, but varies based on age.

Egg cells are able to be fertilized for 12-16 hours after ovulation.

Pregnancy rates are higher when IUI is performed as close to the release of the egg as possible (just before or within 10 hours after ovulation).

The time of ovulation in relation to the onset of the LH surge varies from person to person.

Detection of the LH surge in urine typically happens 12-48 hrs before ovulation; however, in some individuals it can occur after the egg is released.

The beginning of the LH surge is a more reliable predictor of ovulation than the peak.

Pregnancy rates are higher in unmedicated donor insemination cycles than with medications.

Timing inseminations with the LH surge rather than a trigger shot/hCG injection increases the pregnancy rate significantly.

At-home urine LH kits are just as effective as blood work in identifying impending ovulation.

Success is increased when you lie down for at least 10-15 minutes after IUI.

Scientific evidence for self-insemination with fresh sperm (155):

Pregnancy rates are higher with fresh than with frozen sperm

Pregnancy rates are highest with fresh sperm when insemination happens during the days of peak quality fertile fluid.

Chances of conception are highest when sperm is deposited near the cervix 1-2 days before ovulation. The day of ovulation is slightly less effective, and there is almost zero chance the day after.

Some of the sperm cells reach the fallopian tubes within 2-10 minutes of insemination near the cervix. Others are harbored within crypts alongside the cervical os.

With fresh sperm, success rates are higher when two inseminations are done instead of one.

“The best [fresh] samples occur between 24-48 hours after the previous ejaculation. After about three days without ejaculation, sperm cells start to break down” (171). 

If you do self-insemination with a known donor, you are risking that the donor can call himself the father and sue for custody, because couples that conceive via sex are legally called the parents (96). To avoid this risk, you can either have a midwife or doctor present that it was just an insemination, not sex; or you can draw up a contract that the donor signs. Using a lawyer is recommended.

You can also have your donor ship samples to you overnight using a shipping kid to keep the cells alive. Donor Home Delivery charges $200 per kit including shipping. Must be mailed the day before you anticipate needing it, and use it the day it arrives (99). Time insemination the same as you would with a frozen sperm sample (172). Don’t use a turkey baster, and you don’t need to use the Mosie syringe (178). 

ART resources:

Sart.org - for calculating your chance of success with ART

Fertilityiq.com for IVF grants/charities

Sincerely, 
A POC

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Content Warnings

Moderate: Racism

Racist against white people.

cedardleland's review

informative medium-paced

4.0