Optimistic at Age 42 - Grace Fertility Centre " "

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Optimistic at Age 42

My story begins about a year and a half ago when I was monitoring my menstrual cycle, hoping to start trying to conceive. I monitored for a few months using an ovulation kit, but didn’t see any “peak” period. I spoke with my nurse practitioner about the issue, and given my age (41) she referred me to Dr Cheung at Grace Fertility.

I met with Dr Cheung and shared with him that 10 years ago I didn’t have a menstrual cycle for a year. I recall consulting with an endocrinologist at that time and he told me I probably had a sensitive hypothalamus. Dr Cheung thought that was a reasonable assessment. He further explained that my cycle could be likened to a plane that takes off, climbs into the sky, and then runs out of fuel. Another explanation he gave was: “the system is quiet”. In terms of my lab work, every day of my cycle looks like Day 3. FSH 5.8. LH 2 estradiol < 100. Progesterone 2. It is what it is, but I move frequently between feeling hopeful about change, disappointed and frustrated, and then pretty much resigned. There are moments of lightness, but generally an agitated tightness about the issue. It’s out of my control. 

I have done my part I keep saying. My nutritional intake is excellent. I exercise regularly. My weight is in the normal range. I have consulted a naturopath, and followed her recommended supplements. I have worked with several different acupuncturists and even tried a 2-month plan of acupuncture 3 times per week. The relaxation was lovely, but it had no impact on my cycle. Arg!!

Between February and August 2013 I took Clomid. The first time I took 100mg and had what I now understand to be a “super ovulation” cycle.  We reduced the dosage to 50mg but I had no pregnancies other than one chemical pregnancy. I was ready for IVF after about the third round of Clomid but my partner wasn’t quite there. I’d say this is a normative difference between men and women, as the woman is thinking about fertility more and receiving much more information about her cycle and chances of pregnancy than her partner is. However, by September my partner was on board and we gave it a go. I had a fantastic response for my age, now 42. I had twenty eggs. A good number correctly fertilized and we transferred 3 on day 3. We froze one. I think at the time my partner was quite worried about the possibility of twins, but I figured we would be lucky to conceive one. Those 12 days were difficult. I recall the first week being ok but then I started to bleed. Yikes. This is bad, I thought. I held it together for a few days and then I called Dr Cheung who graciously took my call on a weekend. He said this was normal. I later read this on my handout and felt a bit bad about bothering him. He suggested testing one day early, to find out what was happening. I had been practicing mindfulness meditation all along so I pulled on my inner resources and kept turning my heart up towards the sky, trusting that pregnancy was possible. I did my bloodwork one day early and then went to a yoga class to help with the wait. After the class I recall taking a deep breath as I clicked on “my eHealth” application.  Holy crap it’s positive. Wow this is amazing. I felt so intensely grateful and happy.

For the subsequent few weeks I enjoyed the thought about being pregnant and what may lie ahead. I say “may” as I had been adequately warned that pregnancies at my age, and with that initial bleeding, could only be thought of as tentative. However, truly, I was excited and indulged in thoughts about where our new baby would sleep, and which renovations we might need to undertake. At week 7 of my pregnancy we went for the first ultrasound. The week prior I had started to feel a bit anxious, because I didn’t feel different in any way. No signs of pregnancy. No nausea. No fatigue. No tenderness. My partner joined me for this ultrasound, his first and my… well I had lost count. As Dr Chueng examined my lining, he seemed somber. I felt a tight, heavy feeling in my heart. He kept looking and looking, but no smile. After a few minutes he said “I can’t detect a heartbeat”. He suggested coming back in 3 days but I knew it was over. This pregnancy wasn’t going to continue.

“I’m grateful to have the opportunity to work with Dr Cheung and Bronwyn, both of whom are dedicated to helping me achieve my goal of baby #2. They remain optimistic, which in turn renews my faith. I am planning to do a frozen transfer in the next few weeks. I asked Dr Cheung if we could transfer all three embryos. He chuckled and then inquired if I was OK with triplets. Wow, he’s really optimistic.”

Three days later, no heartbeat. I took a medication to induce a miscarriage. First dose, nothing. I knew I needed to take the second dose but I was afraid of what might come. My sister’s friend had unfortunately gone through several miscarriages and she let her know that I was welcome to call. So I did. I told her my story, and she started to cry. She apologized many times and said although she ended up with a healthy pregnancy in the end, and that her child was now 3 years old, she felt intensely sad. She kept crying. Clearly she was re-traumatized. I moved into counseling mode. I’m a psychologist so this happened quite naturally. Then after a little while, she said “just take the drugs… just take them”. She was right. I had to take the second dose and see the miscarriage through.

It happened fairly quickly after that, and really to be honest quite painlessly. I had one phase of intense cramping, and then it was over. I “birthed” a gestational sac, which I placed in a sterile container. It was a weekend, and I had been instructed to bring the materials to BC Women’s. But where? That was unclear to me, and unclear to the admitting desk attendant too. However, after a few phone calls I spoke with a nurse who was willing to take the container and store it until Monday morning, when it would be picked up. I was grateful, as I certainly didn’t want to keep it in my fridge.

And so it was over. I continued with my work and home life. I had a follow up ultrasound about a month later and to my surprise the miscarriage was incomplete. So I went through another round of emotion, but Dr Cheung was able to quickly connect me with a colleague who was able to conduct a D & C a few days later. He was lovely. Warm, attuned, understanding – just what I needed. Now it was really over. My partner and I went out for lunch.

We tried another IVF cycle in February 2014, but that one wasn’t as fruitful. We had 12 eggs, I can’t recall how many correctly fertilized, but we transferred 3 embryos on day 3 and froze one. Again the first week of waiting was non-eventful, but the second week was replete with anxiety. I felt a lot of cramping and was sure I was getting my period. And I did.

Since that IVF cycle felt terribly unsatisfying I decided to increase my attention to nutrition and supplements. I started DHEA, added in Vitamin D, multivitamins, and fish oil, and increased my CoQ10 to 200-300mg.

In May 2014, we transferred the two frozen embryos. I decided to add the intralipids, to boost my chance of implantation. I had a similar experience with the wait. The first week I took it easy and felt fine. The second week I noticed some cramping and worried about the implications. The cramping persisted. I was sure I was getting my period, so I did my blood work a day early. I didn’t even check the results this time as I was so sure it would be negative. I came home from work, sat on the front steps, and cried. My neighbours, who both have 3 year olds and newborns – a situation I envied – listened and consoled. About 30 minutes later I received a call from Bronwyn at Grace Fertility. She told me my result was positive. I was in disbelief. My neighbours smiled. Frank walked around the corner, having just arrived home from work. He was thrilled too.

However, my joy was short-lived. Two days later my blood work showed a drop in HCG and I was instructed to stop all meds. I got my period a few days later.

At this point I need to pause and mention that I feel very fortunate to have a partner who has been extremely supportive. He told me he would be thrilled to have a child, but he accepted that it might not happen. Nevertheless, he has followed my lead and despite a few hesitations and a dose of skepticism with regards to all of the non-medical treatments I have dabbled in along the way (I have left out an entire section about my experience with a spiritual guide), he has been a willing participant. And so, it was with great relief that he agreed to undergo a third IVF cycle.

A few weeks before I was due to start my next IVF cycle, my partner received a phone call from his family doctor. He asked him to come into the office the following day to discuss the results of a follow up CT scan. The year before he had been diagnosed with prostatitis, but with no recurring symptoms he didn’t expect anything to be detected on the CT scan. Now he wasn’t so sure. He didn’t sleep that night.

The following day, I spent the morning with a friend. I told her about my partner’s appointment, but I wasn’t concerned. I expected to get a call from him letting me know that his doctor had little to say. I was wrong. My partner’s doctor told him that he had a small tumor on his kidney, likely renal cell carcinoma. It was picked up incidentally. My partner was overwhelmed and I was shocked. When we met up an hour later, he told me that having a second child was all of a sudden out of the question.

The following week we had a consult with a urologist, who confirmed that the small mass on his kidney was likely cancer. The good news, he told us, was that it was small, slow growing, treatable and curable. He said that fertility and IVF in particular, was absolutely possible. My partner was relieved about his prognosis and I could remain hopeful about having a second child.

The subsequent weeks were stressful and at times we felt very close, but other times miles apart. My partner experienced waves of anxiety, and along with this he had mixed feelings about IVF. I was keen to keep moving with our plans, as in my mind time was running out. I was approaching 43 and that meant a diminishing likelihood of conceiving. However, this was NOT what my partner needed. He needed undivided support, and the fact that I was still thinking about fertility made no sense to him, and at times he added that it made no sense to most of his friends. Ouch!

But, as I’ve learned from my training in mindfulness meditation, everything is impermanent. My partner’s resistance to IVF and frustration with me passed, and he realized that nothing would happen with regards to his treatment plan for a few months so why not move forward with IVF. I’m quite sure that the main reason, perhaps only reason, he agreed to it was because he wanted to make me happy. So I’ve decided to accept this as his “gift”.

I started my third IVF cycle in July 2014, and had my best cycle. I had at least 30 follicles removed, which included 21 eggs, 12 of which correctly fertilized. On day 3, 9 embryos had divided into 8 to 9 cells so the embryologist said she would continue to monitor the development until day 5. Dr. Cheung had warned me that with so many eggs, I was at risk of Ovarian Hyperstimulation Syndrome and that he may need to stop the cycle to let my body rest. However on day 5 we decided to transfer at least one, and possibly two embryos. Sitting in the surgery, my partner said he had a good feeling about the first embryo that the embryologist showed us. Good feeling? Hmm, that’s compelling. He hadn’t said anything like that before. I was leaning towards transferring two embryos, but sensed that I needed to trust my partner. I agreed. He was thrilled. He exclaimed “this is the first decision I’ve been able to make” and I felt his excitement. I wondered if other men felt this way? Probably. So including him was something new and something to trust.

This wait period felt different. My partner sent me text messages every day saying “I’m still feeling positive, xxoo” and the like. I felt positive too. I saw a counselor who specializes in women’s reproductive health because I read on her website that she is trained in hypnosis. I’ve always been someone who is open to new experiences, especially if they might help me let go and trust in something bigger than me. The session involved deep relaxation paired with affirmations to support my goal of pregnancy. Nothing earth shattering, but certainly a worthwhile experience.

During the second half of the wait, I had no bleeding or cramping, except on one day which sent my anxiety level through the roof. I went for acupuncture that night and the cramping settled. I did my blood work on the appropriate day, and then checked all afternoon for the results.

  • 11am – results pending.
  • Noon – results pending.
  • 1pm – results pending.
  • I better stop checking.
  • Finally at 4pm my results were posted—Negative.

I called my partner and told him the news. He thought I was joking. I wasn’t. He came home from work. I cried.

It’s been a month since my last period, and despite feeling a bit “different” and vaguely hopeful about ovulating my blood work indicates “the system is quiet”. I feel frustrated but have coached myself back into accepting and letting go. It’s a mystery. Out of my control. No point thinking about it.

I’m grateful to have the opportunity to work with Dr Cheung and Bronwyn, both of whom are dedicated to helping me achieve my goal of baby #2. They remain optimistic, which in turn renews my faith. I am planning to do a frozen transfer in the next few weeks. I asked Dr Cheung if we could transfer all three embryos. He chuckled and then inquired if I was OK with triplets. Wow, he’s really optimistic. I’d be thrilled with one, and if that happens I will thank him, his team, and most certainly the universe for the rest of my life.

A close friend of mine, commenting on her new approach to dating, told me “I’m not going to over-function any more. I’m going to do my 33.3%. That leaves 33.3% for the guy and 33.3% for the universe. I am learning that this fertility journey is much the same. I have to be careful to accept that I can only do 33.3%. Others, including my partner and health care providers can do their 33.3%. And the last third is up to the universe.