Fertility Over 40: Hindsight from a 42-year-old Tryer

Thanks to the woman on the Choice-Mom-Over-40 discussion board who gave me permission to reprint her advice to a 39-year-old woman whose ob/gyn didn’t think testing was needed and that she should “simply try” to conceive. Fertility over 40 is not something to be treated lightly.

I would echo the other woman who urged you to get to an RE. You will read posts about women who successfully conceived post 39, but the sad reality is that the numbers are not in your favor. And, you need to know what your odds are before you start throwing money into the effort.

Please understand that my comments below are intended to be supportive. While they may sound a little direct / harsh, it is just so that you don’t waste the time / money / emotional energy that I did.

Like you, I started trying at 39. I thought that the posters who told me to go directly to an RE were crazy and were being reactionary. I was wrong. I wish I had heeded their advice and urge you, too. I don’t think my story is that unique for those trying at this age.

My numbers weren’t great, but weren’t awful. I thought I would beat the odds. I started by going to an OB/GYN, did 3 IUIs with her (with Clomid and Femara), and then she urged me to move to an RE, which I did. I tried 6 IUIs with the highest doses of Follistim and trigger shots.

Now, nearly 3 years later — 9 IUIs (6 with injectables) and one donor embryo cycle — I am still not pregnant. I wish I had been more aggressive earlier on and not wasted time with my OB. If I had started with an RE and — with full knowledge of my situation, which came from my RE, not the OB — I could have moved directly to donor embryo or adoption earlier and saved a lot of heartache and money. (FYI, I chose to proceed with medicated IUIs because I had coverage for much of it. And, after that didn’t work, knowing my numbers, I realized that my chances at IVF were so low that it would have been such an expensive gamble, so I chose to move forward with donor embyro / adoption efforts.)

My experience with an RE confirmed that their focus is to get you pregnant, or at least figure out what your odds are. You will get much better monitoring and attention to your efforts with an RE. This is not a slam on OB/GYNs but rather a function of what the respective areas of expertise are.

Your OB is wrong — “it is not just a matter of trying” — and the reaction to your request shows a lack of understanding (1) of the challenges of fertility and (2) the fact that single women have unique challenges that have to be address. When you are trying on your own, you can’t “just try,” because you have to time things perfectly. We do not have the luxury of having a partner to “try” with.

Also, this journey will be expensive. There are ways to save, but assessing your fertility options shouldn’t be the time to cut corners. Spending a little now may save you a lot in the future.

Good luck. I hope you beat the odds. I would not wait as long as you indicated you might, and I encourage you to start getting testing ASAP.

At 42, I wish I had not been so pig-headed when I started trying.

Editor’s note: This writer also told me one reason women on the Choice Mom boards might think they have a good chance of conceiving later in life is that the ones, like her, who find it such an emotional roller coaster to read of other, younger successes leave the discussion boards for awhile because it is too painful. So you hear from fewer women when they are at the bumpiest part of the ride.

As she said: “This is all meant to say that because of this drop out factor, sometimes I believe it may look to the newer member that there is more success than there probably is with older women. This is not a process for the faint hearted and I have been bothered by the intermittent anger, jealousy, and loss that I have felt over the past few years. I am not someone who often wallows in self pity or is generally unhappy with my life. So, this has been a real life lesson. Hopefully, sometime, not too far away, I will be able to teach my little one about perseverance.”

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