Monday, March 23, 2009

Mel’s Show and Tell — A Cautionary Tale

Coming late to Show and Tell this week. This week I have a “Tell.”

“Advanced Reproductive Age”

“Advanced Maternal Age”

That’s the diagnosis for us older women. I’ve even heard the term Geriatric Maternal Age! YIKES! I knew as I was getting older that it could be harder to conceive, but I really didn’t know the cold, hard facts until my first RE visit. No gynecologist ever warned me. I knew once I hit 35 that the chances of genetic abnormalities increased, but I still thought I had a good chance of getting pregnant. Maybe I’d need some clomid or something.

I have a cousin who was anovulatory who got pregnant her second month on clomid. A friend in her late 30s got pregnant on her second IVF, but she’s a DES daughter, so I didn’t think her situation applied to me. Another friend tried some DIUIs as a single woman in her late 30s that didn’t work. But she had irregular cycles and told me that her hormone levels were very bad. (I didn’t know about FSH and all that stuff at the time.) My cycles were like clockwork. I’d never gotten pregnant, but I’d been so careful when I was younger. As I got older, I was less careful. I figured I was just missing the “window.” I spent most of my 30s and early 40s working freelance and had no insurance. I would just pay out of pocket for my annual pap and the occasional dr’s visit.

Then at 44 I was hired by the company I’d been freelancing for. I made my first RE appointment. I was stunned to hear the dr tell me, without any testing yet, that at my age, we needed to go straight to IVF. He said that when a woman is in her 20s, 90% of her eggs are genetically normal. At 44, at least 90% of my eggs are genetically abnormal. I was told that even with IVF, at the maximum dose of medication, I had a less than 5% chance getting pregnant and bringing home a baby. That if I did manage to get pregnant, the miscarriage rate at my age is 50%. Cold. Hard. Facts.

Then I started the testing process and found I had a polyp in my uterine lining that was certain to prevent implantation. It was right past my cervix. Two drs looking at my HSG films said I basically had a homegrown IUD. So whatever fertility I’d had the previous years was screwed by this damn growth. The last few years of OPKs and baby dancing were a waste of money and pee.

The polyp was removed, and after SIX cancelled IVF cycles, I managed to get to retrieval and transfer. I had one lone embryo. My RE said my chances of success on that cycle were about 1%. As you know, I was not in that 1%. But getting that far has made it easier to move on.

Why am I sharing this? I know most of you are aware of these facts, but if I can save one woman the heartache I’ve endured, it’s worth sharing. I was inspired to share this by a woman I met in the waiting room last Friday while waiting for my lining check. Usually people make an effort not to interact in the waiting room, but I’m chatty, and it’s so damn boring. Everyone sitting there is going through something difficult. Why shouldn’t we connect? So, I’m talking to this woman, she’s 37 and going through her first IVF. As we talked more, it turns out she’s not really feeling ready for motherhood yet, but she has great insurance coverage, so she is planning to freeze all her embryos for future use. I WAS SO DAMN IMPRESSED! Proactive fertility treatment! Awesome!

It’s so easy to live in denial and just hope that everything will work as it should when the time is right. Biology doesn’t wait for us. Brava to this woman for taking action. She wasn’t doing this fearlessly. She has a fear of needles and sometimes faints at blood draws. And she was really scared about the retrieval. BUT SHE WAS DOING IT ANYWAY! Again, BRAVA!!!

So that’s my cautionary tale. Don’t forget to see what the rest of the class is showing.


Mrs. Gamgee said...

Isn't it amazing how derogatory the terms seem that they use for 'old eggs'? Thank you for posting this... and I echo your brava for the lady you met in the waiting room.


Lollipop Goldstein said...

I have been thinking about it all year, how I'm crossing over the line. The worst is when the medical community itself supports this media-driven idea that technology can circumvent all time factors. Thank you for posting this. It's important for people to read.

Kristin said...

Wow..I am so impressed by that woman!

Jo said...

Thank you for posting this. So many people believe that they will be able to have kids when they are ready; only we IF'ers know that it isn't always quite as easy as it looks!

Happy ICLW,

Beautiful Mess said...

Good for her AND you! Great Show and Tell tale! said...

Brava indeed!

I wonder how long will I be in the saddle before being called stale eggs myself.

That woman you met in the waiting room is a rocker! So spot-on about reproductive troubles sure to come by at a later age!


Edenland said...

Dora I love how you want to connect in the waiting room, LOVE. That speaks volumes about you :)

Deathstar said...

ICLW. Having heard the term "a woman your age" more than I care to, I decided to name my blog that but I left out the big fat middle finger pointing up. We were referred to donor eggs, but of course, we would have to go the States because you can't get donor eggs here unless someone volunteers to and I wasn't about to ask my niece. It was also agreed that if we couldn't have our own genetic child, we'd prefer to adopt. Of course, the theory was simpler than the reality..... I certainly wish I had the foresight frozen my eggs when I was younger - course, that was when I thought I'd be married and just have to have plain ole sex.

Good luck with your transfer.

Anonymous said...

Thank you for paosting the information I think so many poeple need to be aware and not just assume they can have kids whenever they chose

Also VERY impressed by that woman ..

battynurse said...

Great post. I like you had known that the possibility of genetic problems increased at 35 and even more at 40 but thought I had at least until I was 40 with a pretty good chance of acheiving a successful pregnancy. I had very regular periods, all the signs of ovulation. I too was shocked to hear that there was so few chances of having normal eggs at my age of 38. That has made it easier for me to move on to donor eggs or embryos also. It's true though that so many women hear about increased chances of downs or other problems but not the decline of fertility.

Stacie said...

I was in a world of shock about how challenging it would be to get pregnant, too. I thought I would be okay because I was "only" 34 when I finally made it to the RE. Of course, there I found that I had higher than you'd want fsh, so my possibilities shrank even more. Sigh.

Thanks for the information. It is definitely important to get this word out to everyone.

ICLW (although I have been reading you for several weeks now)

Cara said...

Dora - you are a weathly of information and insight. I feel better prepared with that knowledge.

And -YEAH! for tomorrow. Tomorrow!!!!!

sticky thoughts your way.

Anonymous said...

That woman you spoke with is a smart cookie!


Shinejil said...

Good luck tomorrow, Dora! said...


All the very best for tomorrow!

nancy said...

It's scary. I have my last baby at age 36 and those numbers scared the shit out of me too. And it's why we opted for the CVS when we did manage to get pregnant after IVF/FET.

If you and I ever would have been in the same waiting room at the same time, we definitely would have chatted. I'm totally the ONLY one starting conversations too! :)


Liz said...

That is some forethought!


Lut C. said...

Popping in from the crème de la crème list.

Hm, I've gotten funny looks last time I said to a group of women around 30 that they'd better make up their mind soon.

I hope that woman you met was well informed. It's a big gamble, banking on FETs. So far ours have never survived thaw, but to be fair we've only ever had very few to freeze.