I did not think I would be single and 41. I was pretty sure at 25, 27, 33, even 35 that kids were unconditionally on the horizon. I was not concerned that I would have kids later – after all I didn’t even graduate from medical school until I was 27. Then, I broke up with my long term love at 35. A quick trip to the fertility clinic at that time told me I was still good to go, and gave me info on my options.
I have been a lesbian for most of my adult life, so assisted reproduction was a necessary part of the planning. I had considerable time to collect information on the legalities of sperm donors vs sperm bank options, and to become familiar with the insemination options that both gay and straight couples use in the quest for pregnancy. As a fertility specialist, I have supported many people through natural conception, IUI, and IVF. Now, well, lets say it could happen accidentally as I have switched teams. But, at my “advanced maternal age” natural conception is quite unlikely. So, after a second trip to the fertility clinic to confirm my continued fertile-ability, I am 3 days away from cryopreserving my eggs.
What this means, is I am doing the first half of an IVF cycle, and then instead of fertilizing and transferring them, the eggs are put on ice for a later date. I am choosing to suspend the eggs instead of pre-made embryos, because as referenced above, I am not in a relationship ready for babies. Its a logical choice for a single woman who is reaching the end of the #fertile years. It is also exciting to foil time, and have the possibility of a young family in the next few years. The miracles of modern medicine
Fortunately, I decided around 33 to become an expert in #enhancingfertility and Assisted Reproductive Technology (ART) as an Integrative Medicine doctor. I studied TCM/ acupuncture and fertility support from 2005-2011, and switched my focus to botanicals, endocrine function and anti-aging medicines in 2012. Read my published article about Integrative Medical support for the follicular phase of #IVF here.
I have quietly been preparing for this date in case I did not end up with a kid on my hip during my rather tumultuous 30’s. I will gracefully accept a child-free lifestyle if that is what is meant to be, as it has a freedom I value and I have wonderful children in my life. I may also choose to foster and adopt locally in Maine. The point of this cryopreservation is not only to end up with a child, it is to preserve my choice to work towards conceiving within the next few years.
For those in the know, I am on day 8 of a stimulation cycle. I took 450 IU of Gonal-F for the first 6 days, and have ramped down to 300 for the next 2 days. I started 0.25 mg Cetrotide yesterday and will be continuing that for the next few days. Then, the trigger shot and retrieval Tues or Wed. My response is good and side effects minimal, which I am very grateful for. It really does pay to prepare for an event like this even years ahead. (PS. I had 21 eggs collected! 12 mature and 8 immature)
Here are my Top 5 steps for Fertility Preservation in Women over 35
1. CoQ10 preserves the quality of the eggs mitochondria – essential for replication and good “egg energy” aka ATP for cell division. 100-400 mg daily prevention, 400 mg twice daily during a stimulation cycle. ( The use of mitochondrial nutrients to improve the outcome of infertility treatment in older patients. Fertility and Sterility 2010; 93:272-5. )
2. DHEA is a lipid antioxidant and youth-reviving hormone precursor. I suggest 10 mg daily for prevention, 25 mg daily 6 weeks before stimulation cycle. Up to 75mg daily is evidenced to improve egg and embryo quality and enhance spontaneous conception. (Addition of Dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Hum Reprod. 2010; 25(10): 2496-500 Accessed September 13 2013)
3. This is your individualized medicine step – what do you need to tonify your specific reproductive patterns and enhance the chances of conception?
4. Fertility Massage is key for addressing muscular and ligament stress lodged deep in the pelvis that could mechanically impair the ability to maintain pregnancy. Concomitant castor oil packs clear debris from the ovaries and fallopian tubes, flushing lymphatic channels for a more balanced local immune response. The self massage/ hands on aspect maintains a connection between the cerebral, medicalized experience of ART and the physical sensations of the lower belly while reducing emotional stress. http://natural-fertility-info.com/fertility-massage.
5. Optimize your nutritional status with: extra leafy greens on a regular basis; superfoods especially in smoothies;daily fresh vegetables; and choosing clean meat and dairy whenever possible. Reduce or eliminate sugar during high intensity hormone treatments including birth control pills.
It is the grit of everyday living that builds the pearl of one’s career. In the process of enhancing my own fertility, I have learned as much from the patients I have treated and supported as they learned from me. This primal biological drive has helped me to become a much better doctor in this field as I experience the nuances of treatment myself. I look forward to continuing to support all patients seeking conception, especially those of us above 35 that have lived full complicated lives and have had to balance the biological desire to have children with the real-life tensions of sex, gender, career, finance, and relationship.