Fertility
When trying to get pregnant, fertility can mean different things to different people. The general definition is the natural ability to conceive or induce a child1. For some of us, it is that quiet thing in the background that is taken for granted. We tend to think of it as something in reserve for when we actually need it, or a spendy inconvenience. We just assume that, like any other super power, it will just be there unaffected by time or circumstance. Unfortunately, this is not always the case.
When I was younger, I was extremely fertile. Birth control measures failed pretty consistently with me. I got pregnant very early in the game (at 15). By the time I was 24, I had had 4 children and two marriages. While some of my family members had heart breaking struggles with fertility (I love you guys and understand your struggles more now than ever before), there was a strong history of fertility. My grandmother had had 12 children. Most the women in my family also had several children (up to 4 including my mom and my sister). So, later in life, after I had my second divorce and met a wonderful partner who desperately wanted a child, I though to myself “No problem! I got this!”
The Slow Trickle of Reality
Unfortunately, I didn’t have it. It just took some time to figure that out. I started suspecting about 7 months after I had quit birth control that maaaayyybeeee something wasn’t quite right. So, I did what every rational human does, I started researching the Internet to see what other people were doing or suggesting. In my 30s it had been suggested that I had Endometriosis. I had also been diagnosed with Uterine Fibroids. These caused hellish menstrual cycles that would, on occasion land me in the ER.
I started treating myself to address those issues. I changed my diet to the Endometriosis diet. Supplements that were accredited with helping with the symptoms and making eggs healthier (like CoQ10, false Unicorn horn, vitamin D, magnesium, and calcium) were added to my regimen. Castor Oil heat packs followed by Castor Oil massages on my abdomen to break up scar tissue became routine. While my cycles did calm down enough to keep me out of the ER, I still did not become pregnant. I was beginning to wonder if perhaps there was a little more going on than when I had originally thought.
Looking Deeper
In moments of doubt, my default action is to hit the Web. I finally searched “Chances of getting pregnant at 40.” That search and those results took the wind out of my sails. Not only did I NOT have this, I feared I never was going to. Not without help .
As you can see by this handy dandy little chart3, 4 I cooked up for you, the chances of getting pregnant drop as you age. The fine print here, is that so does egg quality and thus if you do get pregnant naturally, there is also an increased risk of miscarriage. That news sucked and was painful to hear. Up until that moment, mentally I was in my twenties somewhere, soaring high and living life. After that news, some of the realities of being a bit older than that (um ok, 45ish) kind of kicked in. I say kind of, because there was still this crazy hope that I would be in that very small percentage of women who beat the odds.
The Quiet Wind down
Breaking the news to my partner was not easy. I did it in stages. He knew I was trying some things to help increase our odds, but I didn’t tell him what those odds were at first. I just stepped up my efforts. I started pointing out that we had been trying for a bit and I was concerned. Then, I silently quit the supplements, the diet, the massages, the hoping. One day, I quietly mentioned that perhaps I needed some help.
We discussed different things that might be needed. Adoption? IVF? A Surrogate? All of these things sounded expensive and very much out of reach. They sounded like things other people who were much better off than we were did. However, as time went on, we came to realize that if we really wanted a child, we were going to have to do something bold.
After a heart felt discussion, we chose to put adoption to the side. Not forever, just for now. While I was open to adoption (and had planned on it before meeting my partner), he was not. Not for his first child. His reasons for wanting a child were varied, but among them was a strong biological drive to have children. He wanted the chance to see his mother’s smile or his grandmothers cheekbones on our precious progeny. I understood this drive. I can’t count the times that I searched for my father’s eyes or my grandmother’s smile on my children. We have compared feet, hands, ears. There is something to that genetic link that can help us feel connected.
Infertility
The first thing we needed to know was what the issue really was. We all assume infertility is just the inability to get pregnant after trying for a year, 6 months if you are over 36. In reality, it is also the inability to stay pregnant. Was I getting pregnant and having miscarriages? Was there some kind of disfunction I didn’t know about? So many questions, absolutely no answers, and this growing concern that time is still flying by. Not a great feeling. I know many of you out there have experienced all of these feelings. The urgency. The hopelessness. The wild hopefulness that we are that one special case that will beat all the odds and are blessed beyond our wildest dreams, just to have our hopes dashed when our period starts. All of it. I love roller coasters, but after that ride? I just want my money back. It sucked.
After speaking with a midwife that I was seeing for my routine Women’s Health exams, I was referred to a physician. That appointment did not go well. The only thing this doctor was interested in was performing a hysterectomy. I told them that I was not interested in having my uterus removed as I was not quite done with it. I was informed that there was only one course of action that could be taken and that was a hysterectomy. The chances of pregnancy were so astronomically low as to be non existent. IF I managed to get pregnant, no doctor in their practice would be willing to have me as their patient. Rude.
That Time IVF Looked Like a Horse
I laid low and licked my wounds for a little bit after that. But, as my father says “You got to get back on that horse.” I had a wish I was trying to make into reality. Two wishes really. Not to mention time was still tick tick ticking away. I got back on that horse and road it to a fertility clinic.
The conversation that I had with the doctor there was much different. It was not about my body but about my eggs. My body was fit, trim and in excellent health. My eggs, however, were past their prime. The actual possibility of having a live birth with my own eggs were somewhere around 13% at 40 but continues to drop afterwards. My doctor told me that some tests had to be ran, but they believed that my chances were great if I tried IVF. The catch? I had to use donor eggs. Mine were too old. My uterus, however, was not.
As you can see in the graph above curtesy of the CDC2, using donor eggs increases the chance of live birth through IVF at all ages, but significantly starting after about 38 years old.
After that visit and for some time to come, my partner and I had a lot to discuss. We still had a lot of questions, but we finally had some answers. Maybe even a direction.
What about you? I want to hear your opinion! What is/was your fertility journey? Did it lead you to IVF or did you beat the odds?
Office On Women’s Health- Infertility
Citation:
2 https://www.cdc.gov/art/reports/2020/summary.html
3 https://advancedfertility.com/patient-education/causes-of-infertility/age-and-fertility/
4 https://www.forbes.com/health/womens-health/female-fertility-by-age/#footnote_2
