I could do with some quick advice (I need to tell the nurse tomorrow).. I am unsure whether I should get a rubella booster injection. I've been told my immunity is low and it's on the checklist of things to which I should attend before trying again to get pregnant. But once you have the vaccine you have to wait two months before trying to get pregnant. It's dumb, I know, but when the nurse told me that, I got upset - that seems like SUCH a long time to wait and I should be ovulating in the next couple of days, so I was already gearing up for it this month.

I'm torn - it's clearly sensible to have it, but I'm 35 and convinced (of course, but for no real reason) that I will struggle to conceive, and I'm aware that I could have the injection and wait like a good little girl and then the baby will die of a cord knot or something completely out of my control anyway, so why bother.. and I don't frequent child care centres or airports or anywhere the virus does..

I wish the doc had reminded me to get this jab sooner! D'oh. What did the rest of you do?

How frustrating that you're having to make this decision right now!

I realise your risk of actually catching rubella is low, but given the choice i wouldn't risk catching rubella while pregnant. The list of complications is terrifying, and includes a risk of miscarriage (just because the fates have a nasty sense of humour). And as always, the problem is that just because you don't frequent those kind of places, doesn't mean someone you know won't go there, somehow catch rubella and pass it on to you.

having said that, and after reading this http://www.hpa.org.uk/HPA/Topics/InfectiousDiseases/InfectionsAZ/1221202947595/ and this http://miscarriage.about.com/od/infections/f/mmrpregnancy.htm I would get the vaccination, but I personally would only wait one month. All the evidence is that the vaccine does no harm in pregnancy, and the advice to wait is just to counterbalance the small theoretical risk. YMMV, of course.

But I understand the whole wanting-this-to-happen-yesterday-why-do-i-have-to-wait thing. I did a pregnancy test this morning, on no evidence of pregnancy other than the whole having-had-sex-at-the-right-time thing, and I'm still devastated that it said a big fat NO. Even though I knew it would, I was still really upset. But at least I've got one whole extra day that I won't be tormenting myself with 'maybe's.

Interested to see what everyone else says....

What a frustrating situation! Having infertility and being 34, I can COMPLETELY understand your wanting to get things moving and not having to wait. I think the only thing that I would consider is how much anxiety it would cause me to weigh the risks vs. the benefits should I get pregnant and then have an outbreak near me. I know I was a nervous wreck with the whole H1N1 thing at the beginning of my pregnancy, as I was high risk to begin with and have a 3 year old in preschool. With each fever/sickness he got, I had to take him to the ped to be swabbed for H1N1...it was extremely unnerving.

I do hope you come to the best decision for you and that your path to conceiving again is simple. If not my advice (having infertility for 8 years) is to be your own best advocate. Don't let the doctors give you the 'just relax and wait, it will happen' speech. Give yourself a timeline (most conceive within 4 months) and then really get your OB on board with helping you. Too many OBs waste women's precious 'fertile time' assuming that stress and 'thiking about it too much' is the cause of infertilty. OK, off my soap box now.

Take care.

That's tough. My logical side says get the vaccine, better safe than sorry, one less thing to worry about, and while it seems long now, two months will fly by.

My emotional side says, ugh, no no no. Why wait? What will waiting accomplish? I guess you get the vaccine, but you are low risk anyhow . . .

But. . . I guess now I come down on the side of greater caution. Not just because I lost Gabe, but that definitely contributes. I have learned after the fact that my luteal phase is off kilter after a pregnancy, so the advice to go ahead and ttc immediately if we wanted was bad in our case and probably contributed to the cervical pregnancy (which was ultimately partially responsible for losing Gabe). And not pushing for better follow-up post-ectopic and during the bleeding w/ Gabe's pregnancy meant more questions later about what might have been avoided. And we didn't ignore the doctor's advice to have the shg done, but I mentally blew it off because I didn't expect it to turn anything up so we didn't try to conceive but we certainly didn't prevent conception either and I was disappointed by the negative result. However, it was ultimately a good thing, because that shg is what showed us the cervical damage and really changed my treatment plan for a future pregnancy (and probably saved a future pregnancy, or gave it a better shot by finding out I will require a preventative cerclage).

It's morbid, and a little creepy, even to me, but I tend to approach most post-dead-baby things related to a potential future pregnancy with the idea 'What can I live with if the worst happens?' How much guilt could I carry? Or, reversed, which choice is the one more likely to prevent a bad outcome, even an unexpected bad outcome?

That would probably sway me to get it and wait and I'd feel terribly resentful the entire time.

Moops,
I am annoyed for you. I really wish your health care provider picked up on this earlier too. At any rate, this is a decision I can help you with, so that's good because you have been very kind to me. I give immunizations at work, plus my very good friend ( the only friend who met my daughter before she died) owns a private immunization and travel clinic and I consulted her to make sure I was accurate. I also did a little research for you, not that you don't seem well versed in doing your own.

MMR is a live vaccine which means it is a weakened strain of the real thing. This means that your immune system gets introduced to the disease or antigen to activate it to bring about an immune response for life. Most other vaccines (with the exception of the chicken pox one, called varicella) are synthetic, ie have been invented in a lab by people with a very similar chemical structure to trigger your immune system to mount a response.

You have likely been immunized in the past for MMR, and for whatever reason, your titre, or levels of immunity that are measureable, are falling off to indicate you are not immune at present. This happens sometimes.

Rubella syndrome is a long list of nasty problems, while all outcomes are possible, the most prominant one (I personally know two cases), the children were born (early 1970's) deaf. No other handicaps.
Ideally, one does not want to contract this while pregnant.

Because the vaccine is live there is a theoretical risk that one could develop symptoms of reubella from the vaccine. However, this is just a theory and there have been studies of women who are pregnant and were unaware of this, who received the vaccine and there were no reported cases of an anomaly.

This is from the CDC.

"Because a number of women have inadvertently received this vaccine while pregnant or soon before conception, the Centers for Disease Control and Prevention has collected data about the outcomes of their births. From 1971-1989, no evidence of CRS occurred in the 324 infants born to 321 women who received rubella vaccine while pregnant and continued pregnancy to term. As any risk to the fetus from rubella vaccine appears to be extremely low or zero, individual counseling of women in this situation is recommended, rather than routine termination of pregnancy."

I confirmed with my friend Lana, your risk after being immunized is only theoretical. Plus, her advice is to only wait 4 weeks instead of the 8 that your health care provider advised.

You have to feel comfortable with your decision, so do what you think is right.
What I would do? Get vaccinated and ttc this cycle too.
If you are not comfortable, I would only sit one cycle out prior to ttc again. Waiting 8 weeks is not an accurate time frame. Plus it really feels like jail.

I hope you got this info in time. It's 10 30 pm, I hope you live in my time zone. Good luck Moops.

I do understand this problem, though with me it was more of a "done deal" - when I got pregnant with Oliver they discovered that my rubella vaccine had vanished in the year and a half or so between delivering my daughter and getting pregnant again. I had no immunity at all; I was already pregnant; and I had a one year old in full time montessori school/daycare. I can tell you that I was fine; that they basically told me to pay attention to any outbreaks but that kids are immunized for it anyway; it's very rare that it breaks out; and that they'd just top me up in the hospital after Oliver was born. (Which they did. Look! Something went right with that whole mess. Neato).

I know that one data point doesn't really help anything but for what it's worth, there it is. I'm in Canada and that might be different as far as required vaccines for kids go too....I'm not sure.

I'm really sorry this is so stressful for you - hope you are able to make a decision you can be comfortable with. How does your husband feel about it?

Eh, rubella (or MMR) is 'required' down here in the States, but there is a lot of objection and religious exemption based on the whole vaccine/autism debate and rise of AP (which as a philosophy may not be opposed to vaccines, but seems to be more prevalent in practice, at least among the AP'ers I know personally). Herd immunity is weakening and more previously rare diseases are making comebacks because fewer people are vaccinating now in the States.

But that is irrelevant, I think, because are you in Australia, moops?

One other consideration - does your husband or any friend/family members you have regular contact with frequent anywhere that would be higher risk for catching the disease? I have a friend who lost measles immunity without knowing it; she wasn't tested regularly because she did not work in or frequent high-risk contamination areas. However, her husband did come into contact with an infected child, brought it home and she caught it. In her case it was extremely dangerous because of a cardiac condition she has. After hospitilization she was fine, but they never thought to test (despite the condition) because she herself wasn't high risk - but it turned out her husband was.

Thanks everyone, that's really useful advice. Certainly some points I hadn't considered. I do live in Australia but the five of you were researching (gosh, Diana) and commenting while I slept - and your wise words were waiting for me in the morning. How nice that felt!

You've eased my worries, and what I decided to do was TTC this cycle, then if it doesn't work, have the booster next cycle. I'll aim to wait one month, but I won't worry too much if I can't wait. The nurse made it sound like the two months was non-negotiable. I'm too trusting; I really should question people more.

I had the H1N1 and a hepatitis vaccine four days ago, and my arm is still swollen and I broke out in a cold sore, so I decided my immune system was working hard enough this month, and I'd rather be baby making while my husband is semi-amenable. He thinks vaccines are 'poppycock'.. :)

I don't think Australian kids get the MMR vaccine as a matter of course (but then I don't know, because mine died!) Certainly when I was at highschool, all the girls got a rubella jab in grade nine, and all the boys tried to get them worried about it so they'd faint in the queue.

Loved your brackets, Christy!