This is a long and arduous story about trying to start a family: a story with which many vets are all too familiar. But read on to the end as it does have a happy ending.
One day you wake up and realise you are 38, or 39, or 40. You spent years building your career and kept saying to yourself “It’s not the right time. The practice is short staffed/I may become a partner/my practice doesn’t tolerate part time/I’m building my caseload…” but then you look up and you’re tipping 40. I did just that and at 38 started that long road to try to start a family.
To already stack to odds against me, I had never had a normal cycle so the doctors tried Clomid which makes you ovulate. This does work for a lot of people and can help you make a schedule… but getting pregnant and reading the train timetable are slightly at romantic odds so this won’t work for everyone.
We then tried IVF using my own eggs. Injecting myself with drugs was fine, with no side effects, but some people have a horrendous aversion or terrible side effects and the process stops there. The basic process is injectable drugs to make you develop the most eggs for harvesting, which is then done under a short GA. The eggs and sperm head off the to lab and within a couple of days you get a phone call about how many embryos look healthy. Try not to take this phone call in your practice’s reception.
Then you head back in for implantation and PLEASE NOTE: DO NOT head straight back to work just because you have a case booked in that someone said was urgent. Relatively speaking, nothing is that urgent, and if it is, you have colleagues. In fact, try to go somewhere quiet for a few days and make up an excuse to do so if you have to do so.
And then you stock up on pregnancy tests in Sainsburys and wait until 14 days… and then you are at work and get your period. And know it didn’t work. And you think how much money you spent on this… and then reception calls you for a phone call to take, while you try not to cry in public. (NOTE: Don’t lose ALL hope if this happens as sometimes small bleeds happen after a week, so called “Implantation bleeds”, which scare the bejesus out of you for days…..)
And the nurse says “wait three cycles before you try again” and you think “time is ticking, and passing me by”. So you do cycle number two, have great hopes when they harvest 18 eggs and get six embryos…. But then the same things happen. More tears and you are not getting any younger. And this time a sac develops but no foetus so your body thinks you are pregnant but you aren’t. What a dilemma. And then you need surgery to scrape everything out and know that that surgery increases the risk of scarring and decreases the likelihood of conception. But what can you do?
I then went on a holiday with my husband and came back pregnant. Jubilation! So we trundled off the 12 weeks scan, happily oblivious to what was to come. At twelve weeks or so they do a basic scan and also a nuchal ligament translucency test which is a test for Downs Syndrome. What I didn’t realise at the time was that this test is combined with blood tests for a final odds ratio of Downs Syndrome. But on that day the ultrasonographer said he didn’t like what he saw, and we didn’t realise at the time that this meant very significant abnormalities and a non-viable baby. We were completely blindsided by this… and two weeks later lost the baby.
For the next month I felt very ill. I assumed it was the emotional and physical trauma of the situation until one morning I couldn’t get out of bed and was taken to the hospital. I was given antibiotics and sent home…weeks later I was back in the hospital and saw a very straight forward consultant who said I needed hysteroscopy. A large piece of retained placenta was removed and I was well again very quickly. But still not pregnant and getting older.
I was now in my 40s. We had spent thousands of pounds on IVF. This doesn’t even open the discussion about a wife who is keen on children, and husband who is not…or the reverse. We met with the consultant who said that at my age the likelihood of conceiving was 16%. What they don’t tell you is that is the chance of getting pregnant, and not carrying the baby to term. That was about 6%. But we had an open minded progressive consultant who said the best option was egg donation.
Egg donation means eggs from another female, usually much younger. The age of the eggs is the rate limiting step so younger eggs have a much better chance. In the UK, regulations dictate that an woman who donates eggs must have had all the family she intends to have, which usually puts them in their late 30s. The wait can be up to two years. Other countries have stringent egg donation programs along with genetic and psychological testing of the donors. In some countries there is a very altruistic society and these young women donate eggs in their 20s for no remuneration other than expenses.
The first cycle involves flights, back and forth, sperm donation, incubation, fretting in a hotel room, implantation, and home again. And BAM, same again, Pregnant with no baby. So surgery again and I was becoming more despondent by the day but trying to keep it together at work.
Egg donation cycle two. Same again but this time I flew to see relatives within days of implantation and I do think this made a difference. Not going to work, not trying to keep the show on the road…
But then at eight days, bleeding. I remember having a dear friend to dinner and I couldn’t keep my mind on the conversation. What if this didn’t work? Would my husband said we had spent enough money? I had now had three surgeries, each of which decreased my potential fertility. This was truly the law of diminishing reproductive returns. I saw women with several children and wondered why I couldn’t have that too?
If there is an upside to bleeding, it’s that you get an early scan and then the amazingly good news that there was a tiny sac, with a tiny heartbeat, which we watched over the next nine months grow and grow and finally emerge as a gorgeous, precious long awaited gift. Which just gets better every day.
So the moral of the story? Hang in there! You have options! I worried that I wouldn’t feel the child was mine with someone else’s eggs. It crossed my mind only once but I carted the child around for all those months and until I sat down to write this, haven’t thought of it since. This is MY child. (research since has shown that there is indeed transfer of genetic material from the mother who carries the baby, to the baby. Have to slot in EBM somewhere…)
So my advice? If you hit 35 and want a family but are not pregnant, get on with in. Your practice will NEVER take you aside and say “We are so grateful that you devoted yourself to us… and not to a family”… so give up hoping for that.
And having a child is simply THE BEST THING EVER!!