I was very lucky to get pregnant so quickly with my son via IUI at 39. But it also made me underestimate how hard getting pregnant with baby #2 might be. Here are a few things I wish I had known going in that would have completely changed the game for me.
1) Bank your embryos if you have the option
When you’re over 40, every month counts. Ovarian cysts, polyps, irregular cycles, trips abroad, miscarriages – these are all unfortunate obstacles to your success that are more likely as you get older (link to post).
That’s why if you’re trying to become a single mom in your 40s (or even if you’re not), and you have the option of banking embryos, go for it. Unfortunately, I did not have that opportunity. After IVF from my first cycle, I no longer had frozen eggs, most likely due to a decrease in egg quality.
2) You’ll need lots of patience and faith
I consider myself to be a person of faith. (Many of my articles here will address that aspect of being a single mom). I read many, many articles about women over 40 who conceived. I had several close friends who gave birth right before the age of 42.
At the same time, I am also a highly practical person. As I passed the same age they gave birth, I wondered if I could also get pregnant. After all, I was still trying to create an egg at an age that they had already given birth.
The fertility world likes to say “it’s a marathon, not a sprint.” Another expression it likes is “it only takes one.” Try to keep these in mind as your mantra. Meditate on them if you have to. It helps.
I chose to believe the statistics that were the most optimistic (and then have a backup plan on top of that.
3) Try to calculate your personal odds
It was extremely difficult for me to calculate the chance of my own personal success for getting pregnant through IVF after age 40. Not the odds of “any woman,” but me. I had not fertility issues, and my married friends over 40 were getting pregnant right and left, having their last baby at 41 and 42.
I looked to experts but everyone seemed to say something different. One fertility doctor told me my eggs were fine (Really? So that’s why 98% of my 3-day embryos didn’t make it?). One of my acupuncturists told me I didn’t need IVF, but she also said “it depends on how urgent it is for you.” My suspicion is that both of these experts were looking at my FSH and AMH levels, which were good but also didn’t give insight into my egg quality.
Ongoing IVF statistics versus one or two IVF cycles
The statistics available for IVF success after 3 cycles is very different than for success for individual cycles. Even for older women (in some calculators), cumulative results of IVF after 6 cycles can be quite different than calculating each individual cycle’s change of success. I found my personal odds of individual cycles at 4% while accumulated cycles of up to six rounds were almost 70%.
I have been unable to verify for the Aberdeen IVF calculator, which was the basis of why I chose to limit my journey to 6 IVF treatments, in addition to sperm sample limitations. It has both a pre-IVF and post-IVF calculator, since the way you react to medication can have a drastic effect on the odds of your success.
These accumulated calculations come from countries where IVF cycles are paid for by the state. That means that many, many other calculators around the world (especially the US) are limited by couples who would love to try for a third, fourth, fifth or sixth time but cannot afford it or their insurance simply doesn’t cover it.
If you have the funds and are able to try multiple rounds of IVF after 40, I’d say go for it.
4) IVF is time consuming and all-consuming
My biggest complaint about IVF is that it was time-consuming. But even that is a good thing because you are highly monitored to ensure you don’t have a bad reaction. During a typical 2-3 week period every month, I’d have 3-4 ultrasounds and blood tests (each of which took around 2 hours). If you add on any holistic treatment like acupuncture, which was recommended for me twice a week at one point (each appointment would take 2 hours), you are talking about a full day of work once a week. That’s not including the egg retrieval which generally took me half a day and the transfer which was another 2-3 hours.
Since I had originally gotten pregnant via IUI, this was a whole level of monitoring I wasn’t used to. Had I been able to go back through time, I might have chosen IVF over IUI earlier on, banked embryos, and avoided so many IVF cycles later on in my 40s.
After doing a few cycles of IVF however, I was able to streamline things. I did drop out of acupuncture after around 9 months, once I started working full-time. My job let me work at home twice a week, and I had flexible hours. Those factors helped immensely in my ability to continue treatment.
Since my journey started later than I had liked and was frustratingly taking longer than I wanted, I ended up focusing on aspects of my fertility that took less time and were more convenient for me. I started buying seasonal fruits and vegetables that were delivered to my door; I also purchased organic soaps and shampoo. I took ubiquinol, vitamin D, a probiotic, omegas, and of course prenatal and folic acid.
Beyond the ubiquinol, which my doctor agreed might help (I had read about it in my extensive, frantic fertility googling), I really don’t know if any of this made a difference.
There’s another aspect of my time that I hadn’t anticipated fertility treatments interfering with. For roughly 2.5 weeks out of the month, I had to be home at a specific time. My injections demanded that my medicine be refrigerated, and since I was in a warm climate, I didn’t want to risk this. I also had problems remembering to do things when my schedule changed, so I stayed close to home with my son and didn’t do much for those periods.
During my miscarriage, 2-weeks waits, and other times my treatments were postponed, I traveled as much as possible!
5) The logistics will drive you mad
I wish IVF were a simpler process in terms of what we could expect from month to month. But with raging hormones, bureaucracy, early-morning toddler meltdowns, and precise medication amounts, it can be challenging to know what to expect.
Just getting to blood and ultrasound tests is tough(er) now
I didn’t anticipate the stressful mornings I spent trying to get my little son to daycare as early as possible so that I could get to my blood test before they closed the lab. It was (and unfortunately is) hard.
Tip: Get a babysitter for the morning (yes mornings). I asked my son’s daycare staff to come to work 15 minutes early so that I had peace of mind that I wouldn’t get stuck in traffic and arrive at the clinic after they close. (It never happened, by the way, but with the traffic here where I live, you never know).
Keeping up with your IVF medications
A couple of times I learned at the last second that I didn’t have the right amount of medication, and I suddenly ran out and had to hurry to various clinics. That was a nightmare, since the clinics here all close at different hours, and only certain ones provide fertility drugs.
Tip: Find a few local clinics with crazy late-night hours and call around to see who has fertility drugs available most of the time. My city hospital (which has a fertility clinic in it) had what I needed at the last second.
Try to get a handle on the bureacracy as early as possible
Forms. Oh my god, the forms! I had many months of delays due to not understanding how long blood tests results take, what kind of genetic tests I should take, and pure bad luck (as in, the Department of Health and the genetic counselor were not in sync and did not tell me the correct types of genetic tests to take, knocking me out of the game for 4 months). This was during the pandemic, so it’s likely that I can blame it and not completely lay the blame on myself. But if I had known in advance that those genetic tests take 2 months (and pap tests take 5 weeks), I’d have been in a different place when I started.
Tip: Join a Facebook group like Single Mothers By Choice or find local women TTCing (trying to conceive) in your community. I did that at a much later point and I really regret it.
6) Delays, delays
(I would put a video of Marvin the Martian to lighten things up here but I don’t think it’s allowed due to copyright issues).
Thank god, my overall health is good. But I found from the beginning that I had a lot more issues to deal with than my first time around. After my first round of IVF, I had a polyp that had to be removed. After 3 rounds of IVF, I developed an estrogen-producing cyst that knocked me out of the game another 5 months. Then I got pregnant and miscarried.
It was maddeningly frustrating.
I don’t have a tip for this one.
7) Success may look different than you thought
I am still on my fertility journey for baby #2 as we speak. It’s been just about two years. I’m honestly not sure how much more fight I have in me, but for the moment, I’m continuing.
What comforts me (somewhat) is that there are many different solutions to infertility. If I choose to stop pursuing IVF treatments, there are other paths to having a child. Beyond IVF and your own eggs, there is embryo donation, donor eggs, and surrogacy. You can get donor eggs from someone in your family if you want the DNA connection. You can go abroad if you want donor egg anonymity (or you want an “open” donor).
It is disappointing to me to think of not having that genetic bond with my child, and him or her not having a full genetic bond with my son. But I am trying to change my mindset to one of gratitude for the opportunities available today in the world of science. Donor eggs can help you avoid the increased risks to the baby and yourself as an older mother, while at the same time drastically increasing the odds that you will get pregnant faster.
And that may be exactly what I need. Let’s see.