Almost 41 and Infertile…

Full disclosure: My name is Mary Katherine, but almost everyone calls me M.K. I’ll be 41 in two weeks. And, I have an arcuate uterus.

The combination of being six years into “advanced maternal age” and having a uterine abnormality is making it difficult for me to get pregnant. Well, to be honest, it’s been impossible for me to get pregnant this time around. But, I’m a positive person who has had two miraculous life experiences, so I have hope.

Miracle #1: With an underdeveloped, T-shaped uterus, one-third normal size, I finally had a successful pregnancy from May 2004 to February 2005—as a result of my seventh intrauterine insemination. It was a high-risk pregnancy in which I was dilated starting the 27th week (of the normal 40-week pregnancy), began having contractions at 31 weeks, was hospitalized and on bed rest. However, my too-small uterus stretched to accommodate all 9-pounds, 7-ounces of my super-sized son, who, after all that worry about pre-term delivery, stayed put until his due date.

Normal Uterus vs My T-shaped Uterus

Miracle #2: I had my son as a 36-year-old single woman, using anonymous-donor sperm. But, after 21 years of dead-end dating, I met the man who is now my husband—nine days before I got pregnant. He was attracted to the strength I displayed in deciding to be—and then struggling through infertility to be—a single parent. He stayed, we got married 2 ½ years ago, and he adopted my son, who is now four.

So, as you can see, based on my recent experience, I know that sometimes the unbelievable can come true.

But I’m also a rational person: Maybe two miracles is my quota.

My reproductive endocrinologist has outlined my odds, so I know the likelihood of having another child is slim. To be exact, during the in vitro fertilization (IVF) cycle I underwent in May and June, my doctor said the probability of having a successful pregnancy was 10 to 15%, because my husband and I decided to transfer only one healthy embryo, as determined by pre-implantation genetic diagnosis (PGD), into my uterus. If we would have elected to transfer two healthy embryos, our odds of having one child would have doubled to 20 to 30%.

To recap, with one healthy embryo transferred, that’s an 85 to 90% chance of not having a child; with two healthy embryos transferred, the probability of failure is 70 to 80%.

This is where I feel the need to have an intervention with anyone, male or female, holding off on having kids. Age-related infertility affects both genders, although awareness of female infertility is much more prevalent. Yet, when I decided to try to be a single-mother-by-choice six years ago, at age 35, almost all of my friends and family members thought I was crazy for feeling the pressure of looming infertility. They cited example upon example of female celebrities in their forties who had recently had children.

Newsflash: Even female celebrities can be too old to have biological children, but, unlike most of us, they have the disposable income with which to pursue IVF with donor eggs. Yep, the odds are they’re not using their own eggs…

When I was attempting to conceive in 2003-2004, I worked for the WGBH Educational Foundation, based in Boston; therefore I had Massachusetts medical insurance. RESOLVE: The National Infertility Association was founded in Massachusetts and lobbied the state first, so it has the best infertility coverage in the country. So, six years ago, as nonprofit girl, it was much less expensive for me to pursue having a biological child via infertility treatments, necessary because of my T-shaped uterus, than to adopt.

Now my husband and I have Illinois insurance that covers three IVF cycles at 80%; however, it doesn’t cover PGD unless both parties are carriers of Cystic Fibrosis or Tay-Sachs, for example. “Advanced maternal age” and “advanced paternal age” don’t justify coverage.

The cost of PGD is $4,000 per cycle.

I cashed out part of my retirement fund. What else is an almost 41-year-old to do? Time isn’t on my side here.

So, my husband and I not only have infertility coverage, which many people don’t, but we also had the ability to access cash without having debt hanging over our heads as a result.

Then the IVF nurse called to tell me that my Follicle Stimulating Hormone (FSH) level is 8.3. FSH demonstrates the quantity and quality of ovarian reserve—in lay terms, how many eggs a woman has left and whether they’re any good. Anything under 10 is considered positive, so I was thrilled that, at my age, I have the FSH of a younger woman. (At my age, I’m happy to have anything of a younger woman…)

I responded really well to the ovarian stimulation medications. My doctor retrieved 19 eggs, which made me feel like a rock star.

But only 11 were mature enough to fertilize. Of these, only 10 did. Of our 10 embryos, six had major chromosomal abnormalities—missing chromosomes, extra chromosomes, and combinations thereof. Of these six, the abnormalities of three were egg-related; the other three, sperm-related. (My husband is only 43.)

Of our four healthy embryos, two simply stopped developing, which the genetic counselor said just happens sometimes. On the day of embryo transfer, we had only two healthy embryos—after starting the process with 19 eggs.

I was still very hopeful. After all, we only need one healthy embryo to have another child. Plus, my formerly T-shaped uterus was stretched out a bit by my son during his nine-month stay, and its expanded surface area provides more opportunity for implantation. And, now that I have a larger arcuate uterus, my previously too-thin uterine lining is the thickest it has ever been, also making implantation more likely.

Although transferring two embryos would have doubled our chances of having one baby, my husband and I are already financially responsible for three children—my 15-year-old and 13-year-old stepsons and our four-year-old—so we decided to be cautious: We only had one embryo transferred. She was a girl. And, she didn’t implant.

When I got my period four days before I was scheduled for a pregnancy test, I didn’t expect to mourn as I had when I’d miscarried 5 ½ years ago. After all, I have my son, so I am already blessed. But, I lost our baby a month ago, a daughter for my husband and me, and a sister for our three sons.

I’ve mourned. My husband has mourned. We worry about each other, while trying to take care of ourselves.

We have infertility insurance. We’re receiving treatment in a world-class IVF clinic that just happens to be located in Chicago, where we live. We have the financial resources to do PGD. My FSH is 8.3. I produced 19 eggs. My uterus is bigger and better than before. But, I am not pregnant with another baby.

I wouldn’t wish infertility on anyone. I would have faced it regardless because of my uterine abnormality. But, for so many, infertility is simply age-related.

The publicity surrounding the fertility facts featured in Sylvia Ann Hewlett’s 2002 book, Creating a Life: Professional Women and the Quest for Children, stimulated me to act when I turned 35. But, that book was published seven years ago, and on April 9 RESOLVE and Church & Dwight, Co., makers of First Response® products, announced the results of their recent research, which show that most women of childbearing age still are uneducated about their fertility. This leads to uneducated decisions among those for whom having children is a goal. (To read the press release outlining the research results, click on www.resolve.org, then For the Media, then Press Releases, then the April 10 press release titled, Resolve: The National Infertility Association and First Response Release New Findings That Assess Women’s Understanding of Fertility.)

Because I started trying when I was 35, the very beginning of “advanced maternal age,” I was able to overcome age-related infertility. But, even if I hadn’t been able to have a biological child, I would have known that I had done everything I could to try, before my eggs were elderly and useless.

I want every aspiring mother to have that same serenity.

So, when I cashed out part of my retirement fund to pay for our out-of-pocket IVF and PGD costs, I took out even more to pay for the development of this website, so I can try to do my tiny part to generate awareness of infertility.

Our doctor has been out of town for the month since our IVF failure. The nerve. But today is his first day back in the office, and this afternoon I have our post-failure consult, so we can plan IVF Attempt #2. I will blog as we undergo IVF again—and maybe again.

More tomorrow…

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