Decisions

It’s pretty obvious that my life has been in limbo for the last 2 years 9 months.

I’m currently going through the second baby-boom with 4 people I know that are concurrently pregnant, and a horrible, sneaking, cold-chill inducing fear that my sister-in-law is going to be next (not to mention my next door neighbour). They got married a couple of years back, her husband is now home after 6 months away on a boat and more permanently stationed on land (Navy man). They’ve just got back from a huge, no-expenses spared holiday in the Caribbean (way more than anything we can afford), and before they left she said to me We’ve got to do it while we still can.

I know a pregnancy is coming and I’m terrified. Terrified of how it’ll make me feel, and terrified that all my baby things, which I’ve so determinedly held onto, will be under call for donation (our families do not know we are still trying because it just became too difficult to keep telling them about the losses). I really don’t know how to prepare for this, or what the hell I’m going to do when it happens. I wanted to be done, so I could help out, and be a fantastic auntie, and be on hand for my SIL. But instead I’ll be tearful and jealous and I won’t be able to visit them and my mother-in-law will talk about the new baby all the time and expect me to do that thing that mothers do when they’ve had their families – get all soppy about babies. Oh gawd, we’re gonna have to move to another country. Seriously.

And on top of that, I’ve become horribly aware over the last few months of just how much my life is on hold. I do pretty much nothing career-wise, despite being highly educated and previously a proud and conscientious employee. My sense of self, my sense of worth has fallen so far. I haven’t been shopping for new clothes (other than the absolute basics here and there) for over two years. Almost everything I own has a hole in it somewhere. I asked for knickers and socks for Christmas. I don’t like to ask my husband for money to buy new things because a) I’m not earning and b) I’m just kind of waiting to get pregnant so I can wear these things out for good and chuck them. I can’t even really explain why I’m slobbing around in old clothes to be honest. Well – I can, it’s because nothing else is as important to me as this baby. I have energy, and I’m reasonably intelligent, and I could write or program for money, and I think I’ve got the guts and the resources to freelance my way to a reasonable income, but I just have false start after false start because I keep coming back to the obsessing, the reading, the research, the everything.

(Did I mention I found out I had a mild B12 deficiency? It was in my medical records that I requested for the clinic, but no doctor thought to tell me. DER!!!! I’m taking methylcobalamin now – best bioavailability – and don’t even get me started on the research linking low B12 and miscarriage rates.)

The thing is, I AM better than I was. I am no longer a tearful mess. I eat pretty damn well most of the time, I have fairly consistent energy levels physically and I’m more content, more happy at home than I have been for a long time. I don’t cry every day like I used to. In fact, I’m in quite good spirits about 50% of the time! Ha.

But progress is slow. I still have bad days. Bad weeks even. And I feel like I’m never really going to do anything until I shake this RPL ball and chain. My life is tick-tocking by, along with my body clock.

How far are we willing to go? Do we want to approach IVF? Do we really want to do that when we cannot afford to? Really? And what if it fails? Then what? Do we call it quits, or carry on trying?

What if it never happens? How long am I prepared to wait?

In some ways, RPL has been a blessing. Without it I may not have discovered I was celiac. I could still be suffering bloating, gas, running bowel movements, eczema, exhaustion, weird rashes, heart arrhythmia and building up to a whole host of much worse issues as I get older. I could still be drinking tons of caffeine instead of being able to power through the day without that horrible afternoon slump. I could be eating crap food and wondering why my body is falling apart. RPL has given me the awareness and power to radically improve my health – even if there has been no baby. I’m undoubtedly in better shape now that I’ve been in for years. None of that would have happened if I hadn’t been trying to create a safe, healthy environment to grow a child.

But the benefits are going to run out soon. I can’t get younger. And neither can my eggs.

Cycle update

I did eventually get a temp rise this month, but it took several days post my opk to go up. I don’t know if that’s just a slow rise, or a late egg release, but my temps are nice and high now, which I am relieved about (stay away menopause!). We’re heading towards the month I had planned to get pregnant – I’ll ovulate in about three weeks I guess and this is going to be the one. If it’s not, we thought maybe IVF. And I know we need to make the decision so we’re not left waiting around for ages getting tests and all sorts before they can get started.

Everything else in life seems to move too fast, and all this baby stuff seems to move too slow. It’s frustrating as hell. I’ve never been any good at waiting, or multi-tasking, and this whole thing has just totally floored me and my progress in life. I’m almost embarrassed to meet up with friends socially because I have just done NOTHING for so long. How can I explain I’ve been dealing with pregnancy, loss, medical tests, research, appointments, tears, joy, hope and despair? And that’s another thing – my social life is pretty much nonexistent anyway where I’ve cut myself off from so many people.

Eugh!!! I want to be happy and pregnant! Is that too much to ask? I want to get back out there and feel good again!

What am I gonna do people? This is a theoretical question – I know I’m the only one who can answer it. I’ve got to look deep inside and find the answer and then somehow decide that I’ll integrate that answer into a successful life, regardless of what actually happens.

What I do know is, as long as I am TTC, I’m not putting 100% into anything else in my life. As long as I am TTC, everything else gets the leftovers. And that’s no way to live.

Second Hand News

Once upon a time, I fell in with a group of four other mums. We met up every week for about 18 months. We even all went on a weekend break together once.

They were nice, but that was about it. I never fitted in, I was always clearly the fifth person, and I was never particularly close with any of them. In fact, after a while I realised that after I saw them each week, I would come home feeling worse about myself and my life than I did beforehand.

But we carried on meeting up.

Why?

Because they invited me into their group when my youngest was just a few months old. I had a baby and a 2 year old and I was struggling to get through the days, struggling to give each of them the attention they needed. I was grateful to be included. I was also (probably) a bit depressed, not having recovered psychologically from the trauma of my first birth, and having had a narrow miss of a repeat on the second. My ‘real’ friends – the ones I would rely on in a crisis – live across the country from me. If I’d known how much I would have needed them when my children were babies, I’d have moved back to where I came from a long time ago. So I was lonely too, and like I said, grateful.

About six months after I fell in with this group, DH and I started trying for our third. I didn’t know it at the time, but so did one of the other mums. She also had two young boys.

When I miscarried, which was at just over 13 weeks, and after I got out of hospital, I explained everything to them. The mum who was trying, let’s call her Sally, said to me that she had started trying at the same time I had gotten pregnant. She got all upset because she wanted the same age difference between her children and she said with such sorrow in her voice “it would have been the perfect time for me to get pregnant…” She had tears in her eyes. Although I had just come out of hospital with no baby, she was upset because I had gotten pregnant and she hadn’t. I knew that TTC was an emotional journey – and I well understood the close-in-age issue as it was such an important thing to me, which I still grieve the loss of. So I put her tears down to that.

Time passed, and for a while we shared the basics of our TTC journey. Then, four months later, she tested on the morning of her oldest son’s 4th birthday. It was positive. At his birthday party she came over, shoved a bag of ovulation tests into my hand with a big smile and walked off (the confidence of those who haven’t experienced loss).

Meeting up each week became torture. Conversations revolved around Sally’s pregnancy progression, all the while we were trying and failing. We were at a picnic once and pregnancy was the topic of conversation (as usual), and Sally said to a new mum that had joined us “You don’t want to have a third, third babies are tricky aren’t they Rose?

The other mum looked confused and said, “Are you pregnant as well Rose?”. I had to explain the miscarriage to her, and she looked really awkward and apologised a lot.

Sally had the baby just as I approached the one year anniversary of my miscarriage. I went to her baby shower and put on a brave face.

After the baby was born, she did a weird thing. Although I overheard her a couple of times talking to the other mums about how hard it was, and how difficult she was finding three kids under 5, whenever she talked to me directly about it, she told me it was the ‘best thing in the world,’ and ‘the boys are besotted by her.’ and ‘it’s just easier having more kids.’

I don’t know whether it was my state of mind, but it seemed like she was trying to make me jealous. Which of course she didn’t have to do, because I already was.

The five of us went out just before Christmas for a birthday meal (three of us had December birthdays). The conversation turned to housework and Sally shouted out “It’s just really hard to clean a house with three children, isn’t it Rose?!

I don’t know Sally,” I said slowly, “I don’t have three children.

Oh, well the baby doesn’t really do anything.” she said, and then carried on talking.

A little later, she waved her arms around to get everyone’s attention.

Guess who I SAW!!?

A chorus of who? who?

Erica! She’s pregnant!! After her miscarriages she thought she’d never have another, she said she was going to stop trying, but she’s pregnant!!!

Two of the mums looked a little uncomfortable. I suppose this was news, but it was still my birthday, and I still remember how uncomfortable I felt with her that evening.

When her youngest was 4 months old, I fell pregnant again (I’ve skipped over the chemical pregnancies I experienced in the interim). I told the four mums together after a scan I had at 10 weeks (my third, or fourth scan by that time).

And Sally cried. She cried over my happy news, because she wanted another baby.

When I lost that pregnancy as well, which was just days later, I sent them all a text. And that was when I realised my priorities were all wrong, and I broke out of my friendship ‘jail’.

The one that had made me feel so shit for so long. And I have never regretted it – I am so, so glad I don’t see them any more.

There were many other weird little things that Sally did and said that made me feel bad, odd comments, bitchy text messages, too many things to chronicle here. But the weirdest thing of all is that although I slipped out of their lives with ease, Sally, out of everyone, was the one who kept trying to maintain a friendship. She texted me several times over the next couple of months asking to meet up or suggesting activities for the kids. Once she asked if I’d tried to connect with her on LinkedIn (I hadn’t). I ignored the messages and eventually she stopped.

I don’t know why she was this way with me. Maybe she saw something in me that reminded her of something in her past, or maybe she felt that she could be ‘better’ than me because I kept losing my pregnancies. I don’t know.

Why am I telling you all this?

Because I am still friends with one of the nicer of the four mums on Facebook – she lives literally round the corner from me. And although I’ve seen her a few times, and she’s never mentioned it, Sally is pregnant again. With her fourth. I know because she was in a baby shower photo that was tagged on Facebook. Bloody Facebook.

As if Sally didn’t give me enough to complain about while we were friends, I’m now haunted on Facebook by pictures of her about to have her fourth child. I don’t want this to sound like it’s some kind of competition – it’s not about numbers. What upset me this morning is simple. Jealously. Jealously that she can just get pregnant, whenever she wants, and have a child. Jealousy that she will have grown and given birth to TWO babies in the time we’ve been trying. That my uterus has remained stubbornly empty of a beautiful new baby and she will have borne two children from hers.

I hope we never, ever meet again, because I can imagine her fake condolences, “Oh, so you never managed to have another baby then? Such a shame…

I know I have nothing to complain about, really. And I know that given my mental state I could have misinterpreted things she said and did. And I know I should have broken off the friendship with her and the others long before I did. But it still felt like an arrow through my heart when I saw the photo of her and her huge belly this morning.

The Plan

Here’s what we’re going to do:

1. Skip trying this cycle.

For a couple of reasons. I have a big cyst, and my lining was “very thin” at ultrasound. Although, saying that, a few weeks before that I was told it was “very thick”, so hopefully it’s just good at growing and shedding. Even so, I don’t want to take a chance. Most importantly, having researched how crucial the two weeks before ovulation is to egg health, I want to give it a really fantastic shot and this month isn’t the one as I’m already on CD7.

It pains me greatly to sit out for a month. The clock ticks away and it’s another month closer to trying for three years, but I think it’s a sensible decision.

2. We do a 5 day juice fast (I’d like to do longer, but I don’t think I’ll be able to).

We start on Sunday and we have prepared as well as we can. The house is already full of kilos (literally kilos) of apples, beetroots, and kale, with another delivery to come on Sunday morning to make up what else we need. We’ve had lots of practice with the juicer. I’ve not touched refined sugar in 9 days, and I’ve been completely and utterly caffeine free for 2 days. I had my last glass of wine 2 days ago as well. Withdrawal has been mild for all of them, as although my eating went downhill over Christmas I didn’t go completely mad. As a bonus I’m finally sleeping properly again – the last two nights I haven’t had to get up, which is fantastic.

3. We go back onto a 100% plant based diet

I’m staying off meat and dairy as long as I can manage (ideally throughout my February and March cycles). I also intend to keep juicing each day and eating lots of raw fruits and veggies.

4. We TTC on my 14th February cycle

I think my cycle is all reset, after the lightest AF I’ve ever had (worrying). I should be due a period on 14th February, as I’m currently on cycle day 7. I’m still getting the odd temperature spike in the mornings though, which is a little worrying, but my periods have always been regular, so I’m hoping I fall back into my usual pattern this month.

On ovulation day (around 28th Feb), I will have been on a strict plant-based diet for 35 days and sugar free for 46 days.

Most importantly, I will be juicing twice a day in the two weeks before ovulation, as well as trying to ensure I get lots of gentle exercise and lots of good quality sleep. This IS going to be the best egg I have ever ovulated.

5. We get pregnant for 14th March.

If only it was that easy, huh? That’s the plan, but if we don’t, we’ll try one more cycle – which will be our last shot at having a baby in 2015.

If we’re not pregnant by 10th April:

6.  We might go ahead with a single round of IVF.

Might. We’re still not sure.

 

Overall, we want to give one more pregnancy a go, and we think we can do that ourselves. But if we can’t, we might try with IVF. The emotional cost of trying IVF and failing is great – I don’t know if we actually will go down that road, but it’s still on the table at the moment.

So that’s the plan.

If we do the fast and the 100% clean diet and that doesn’t work, and we do IVF and that doesn’t work… then I think we’ve probably tried everything we possibly can.

I’ll be blogging mostly about juicing and eating over the next 6 weeks 😉

The Life of An Egg – Folliculogenesis And Oogenesis

I’ve been doing a TON of research over the last two days. Given the fertility clinic had no new ideas, and even suggested it might be time to call it a day as our chances with IVF were so uncertain, I think we are really on our own here.

So, we’ve formed a plan, but before that I want to go into great detail about the actual process of egg development – because I had misunderstood what actually happens at a cellular level and I think it has impacted my approach.

Feel feel to skip this if you’re not into the nitty gritty details.

There are two processes that are important with regards to creating an egg that can be fertilised into a healthy baby (and I’m deliberately ignoring the sperm side of the equation here, although healthy sperm obviously do play a large part).

  1. Folliculogenesis – the development of the follicle within the ovary
  2. Oogenesis – the development of the egg within the follicle

Part 1: Oogenesis

Chromosome abnormalities occur in eggs during a very, very brief window (again, excluding meeting with the sperm where the second set of chromosomes are added). These abnormalities happen during a process called meiosis, which is the division of the egg cell to create an ovum that contains only 23 chromosomes – half the amount needed to make a new human.

Now, meiosis is really interesting because it actually starts when you are in the womb. Meiosis is divided into two phases – meiosis 1 and meiosis 2. When you are born, all your eggs are suspended in the prophase of meiosis 1. What this means is that the cell division has started, but has effectively been frozen.

Years later, when you enter puberty, these eggs are recruited during a menstrual cycle to complete meiosis.

Only the dominant follicle (the egg you actually ovulate with) completes meiosis 1 (i.e. splitting into two to halve its chromosome number) and this happens in reaction to the LH surge before ovulation. The splitting process in meiosis 1 is very complex, involving crossover of the chromosomes to make two genetically different cells. One of the two new cells is very small and remains with the egg as the polar body (all polar bodies eventually degenerate).

The window for chromosomal abnormalities is therefore in the final days before ovulation.

Once that division has occurred, and the egg bursts out of the follicle, the chromosomal contribution from the mother is complete. Meiosis 2 only occurs if the egg is fertilised by a sperm. This chromosome “dance” however is more straightforward – it is an alignment of maternal and paternal chromosomes followed by a simple division (akin to normal cellular division, or mitosis).

The egg (and the polar body, although not always), divide to make 2 cells each.

The result is one fertilised egg, and three polar bodies.

That egg will (hopefully) grow into a blastocyst, implant, and turn into a healthy baby.

So here’s the important part of this process:

The egg is “frozen” at birth and although it grows in size (it takes nutrients from the follicle – see below), the actual change from frozen-birth-egg to egg-we-ovulate occurs in response to the LH surge. i.e. in the days before ovulation.

The egg cell requires energy to complete meiosis – a huge amount of energy. This energy is supplied by tiny “organs” in our cells called mitochondria. Mitochondria basically turn our food into cellular energy (ATP). That’s it. What we eat fuels mitochondria either well, or badly.

And once your egg bursts out of the ovary and gets fertilised, if the mitochondria can’t make enough energy, that egg is not going to be able to divide and grow like it should.

So this brings me to my first ah-ha moment.

Because of our repeat losses, and my coeliac diagnosis and my focus on immune issues up until now, I have been extremely careful in the two week wait – the window of implantation. That is my time when I don’t drink, I try to eat really healthily and I try to get enough sleep each night. Before the two week wait, I was assuming everything was ticking along happily. I thought my problems started when the egg actually got out of the ovary.

But actually, it makes more sense that the week before ovulation is the crucial one. That goes some way to explaining why older women can carry a pregnancy with (younger) donor eggs, but can’t carry a pregnancy with their own eggs, even via IVF.

What if, in the week before ovulation, I stopped having the odd glass of wine, and rushing about, and eating on the run?

What if all the green smoothies and healthy food I’ve tended to focus on in the two week wait was just too late?

What if I changed my approach to look after my body very, very carefully in the days before I actually ovulate? When my body is using up vast quantities of cellular energy to create a healthy egg? What if I flooded my body with good food and nutrients in the week before ovulation?

It’s something I haven’t tried before.

Okay, onto Part 2

Part 2 – Folliculogenesis

Now, it turns out that the “improve your egg health in 90 days” thing comes from what happens to the follicle not the egg.

Follicles start out as primordial follicles in the womb, and just like the eggs they contain, they don’t do much of anything until puberty.

At this point, they are recruited into a growth stage, many at a time. The initial growth phase lasts around 300 days (!). Interestingly, this period of very slow growth is hormone independent – so it doesn’t matter how out of whack your cycle is, the hormone craziness is not affecting the follicle.

Then, about 65-70 days before ovulation, the follicles become early antral follicles that are hormone dependent. Antral follicles have a small pocket in them which is filled with follicular fluid (this is absent before this point).

For the next 50 days, they grow at a new, faster rate, providing a support structure that actually feeds the egg inside, with nutrients and hormones, and removes waste products from the egg. Kind of like the placenta that will develop and support a growing baby.

At the end of a menstrual cycle, about 15-20 days before the next ovulation, and a few days before your period arrives, the follicle enters a new, even faster growth stage which takes it to maturity – the point at which the egg is released.

Now, not all follicles develop – the death of growing eggs is called atresia, and is very high.

It’s estimated that around 1,000 eggs are lost each month (and this number decreases with age, because less follicles are recruited to enter the growing phase as we get older).

Since only one egg makes it to ovulation, and follicles are constantly being recruited out of the primordial pool, that means about 35 follicles are recruited to grow each day (and a similar number die off each day).

The process of selecting which eggs make it and which don’t is poorly understood. I would like to think (and I would imagine nature would intend that) the healthiest eggs are the ones that stay the course.

Now here is the next thing that just blows my mind – because I didn’t understand it before.

In preparation for IVF, FSH injections are given in the early part of the cycle so that the FSH level never declines, as it would normally. This sustained elevation of FSH, which is all that the administration of ovulatory stimulation hormones amounts to, sustains almost all of the thirty or so antral follicles so that no single follicle can gain dominance over the others. Therefore, the number of eggs retrieved in a hormonal stimulation cycle for IVF is directly reflective of your antral follicle count, and your antral follicle count is directly reflective of your total remaining number of eggs. [Source]

So, essentially, every single egg that you collect for IVF comes from an already formed antral follicle on the day you start the injections. Every egg is the product of the previous 65-ish days worth of growth. Your body would have rejected all but one of those eggs, yet IVF takes them all (or, as many as it can get).

And the most amazing thing of all is they can still make healthy babies!

Anyway, I’m getting off topic a little bit.

The big ah-ha for me regards folliculogenesis is that if you count back from the day of ovulation, the eggs in your ovaries truly are a product of your lifestyle in the preceding 70 days. And most importantly in the preceding 15-20 days, when the follicle undergoes the most rapid growth spurt and the remaining eggs are the ones already deemed to be the best by your body at that stage.

Follicular Fluid

I mentioned follicular fluid above, which is present in the hormone dependent growth stage, in each follicle.

The rate of follicular fluid formation in the final days before ovulation rises about 50-fold above that of the previous phase, and substances in our body can flow freely into and out of the fluid cavity in the follicle. In fact, hormones flow into the fluid in order to influence the growth (or atresia) of the follicle – hence why the follicle is not hormone dependent before the antral follicle stage.

Studies have shown that BPA makes it into follicular fluid, as does caffeine, cadmium (smokers), the broken down products of alcohol, and glucose (which is toxic to the body unless it is used by cells for energy).

Basically, what we eat, and what we are exposed to, finds it way in microscopic form right up to the nutrient delivery system of our growing eggs.

Conclusions?

I think I’ve been focusing far too heavily on the two week wait, and early pregnancy. Given I get pregnant and keep losing them, I suppose this is understandable – why would I have thought there was an issue with what was happening before fertilisation took place?

But I hadn’t realised the complexities of what goes on to create an egg – especially in the two weeks before ovulation and the vitally important days leading up to ovulation.

I know that at least one of our losses was chromosomal, and I suspect my missed miscarriage was too, because the consultant at the time said the sac and baby did not look normal (stopped growing three weeks earlier).

Saying that, I have had one loss tested which was chromosomally normal, although I was still eating gluten at the time and I know my body had a high level of systemic inflammation back then.

I’m pretty sure there isn’t a single answer that will cover all my losses, but going forward, and given my rapidly advancing maternal age (ha ha), care of my eggs should be a priority at this point.

Which leads me onto my next post: what we’re going to do now.

PS If you’ve read this far, you deserve a medal.

Sources

Physiological factors underlying the formation of ovarian follicular fluid

How does the biological clock work?

Folliculogenesis (Wikipedia)

Ovulation (Human Embryology)

Oogenesis (Human Embryology)

Follicle growth and development

Consultation

Before I talk about my appointment, I just want to mention that in addition to cooing over a newborn in the morning yesterday, when I came home I discovered a pregnancy announcement on Facebook (12 week scan!), and then, as if that wasn’t enough to convince me the whole world is having babies apart from me, my next door neighbour catches me out the front to warn me they are having an extension built, just in case they have another baby.

Right.

Just in case.

This is the neighbour who has already gotten married, pregnant and had one child in the time it’s taken us to not be pregnant with number 3. She’s going to lap me again – I bloody well know it. She’s probably pregnant already. I’ll have to spend my time furtively ducking out of the house so I don’t have to coo over her bump for months on end just like I did two years ago.

Sigh.

Well, now I’ve got that out of my system, onto my appointment.

I don’t have any experience with fertility clinics, but what’s the first thing I have to face on the way in? A corridor of massive montage photos of thousands of babies. Lovely! There really is no escaping babies at the moment. I hope it’s catching.

Dr Bird was really nice. She was also very matter of fact.

They did a very, very thorough ultrasound. Nothing was missed – that probe squished around in places that nothing else has ever reached.

In short, this is the outcome:

  • I have another cyst, this time on my left ovary. 5cm x 4cm x 3cm. She said I should be scanned again in 6-8 weeks to ensure it has resolved.
  • My uterine lining is “very thin”. Both of these are probably a result of my recent miscarriage.
  • Left ovary is normal with several follicles (yay!)
  • Uterus 100% normal (yay!)
  • They need me to dig out some immune testing details from my recurrent mc tests, to ensure I was tested for everything they would recommend, back in Aug 2013.
  • They do not test for natural killer cells. It is controversial and because it is a blood test and not a sample from the actual womb, the clinic is of the opinion it is not overly helpful.
  • Husband’s SA from two years ago shows some abnormal morphology (our GP told us it was “normal”). He’s going to get a repeat test. However, she said that since I obviously get pregnant, this is not likely to be an issue.
  • Going forward, she suggested that it might be a good idea to try on our own for a while longer because I have only been gluten free since April and the loss I just had was a chromosomal issue. These are more common given my age, and there is still a good chance that my coeliac diagnosis will now allow me to carry a pregnancy to term.
  • If I do get pregnant, their recommended treatment if they suspect immune issues is steroids. I’m not sure how I feel about that. She said there is a very low risk of defects (cleft palate). Er, okay…
  • DH and I could consider a round of IVF. She said that the theory for us would be it would allow a collection of lots of eggs in one go and that they could “flush” the good eggs to the top (by selecting the best quality ones out of those that make it to day 5). She also said that it was a possibility that we would undergo IVF only to have another miscarriage anyway.
  • She didn’t recommend genetic testing of the embryos (PGD). She said for the expense (close to £10,000) it would gain us very little advantage because it only tests for the correct number of chromosomes, and at least one of our losses was tested and was normal.

And here are the worst parts:

  • I am 40. She mentioned this several times. Apparently, just 35 days ago, my chances became significantly worse. She said that not only are my eggs of lower quality, but there are less of them. She told me that my miscarriage risk has increased regardless of my history, and that abnormalities and miscarriages are now even more likely.
  • At the end of the appointment, she folded her hands on the desk and said to me that given I already have two lovely children, I might want to think about drawing a line in the sand at this point.

That was when I finally cried.

So.

I’m still mulling over all this and working out how I feel about it. I also have a terrible headache, which I think is a combination of the emotion and the lack of sugar and (already tiny amounts) of caffeine where I’m preparing for the juice fast on Sunday.

My overall impression from the appointment is that they will do what they can, but that I should be prepared for the fact that it may never happen. I am 40, which is apparently reproductively old, and I may not ever have another child.

As far as doctors go, and aside from a round of IVF that will only do what me and DH can already do, with no guarantee of an improved outcome, I have pretty much exhausted current medical knowledge.

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