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Hurry, Ladies, Hurry.

Red Clock

a blog by Amy Klein, February 19, 2014

As I mentioned earlier this week, our fertility journeys are often the same. And the sad truth about it is, like with so many things, it takes a long time to learn the ropes – but by the time you do, it’s often too late.

A woman I don’t know who reads my twitter account reached out to me recently to ask advice about fertility treatment. She had just turned 40 and was thinking about doing one round of IVF with her partner – that’s all they could afford. There were all these other complications to her story – they’d recently moved countries, didn’t know which doctor to visit, had some other fertility issues, etc. etc. But I didn’t need to know all the details of her FSH, AMH, or prior attempts, to give advice: “Hurry Up.”

I should know. After my second miscarriage, we finally met with a fertility specialist (it took six weeks to get an appointment!!) and he wanted me to move to IVF right away since I was 41.

“Your fertility declines every 3-6 months,” the doctor warned me. But I didn’t listen – I’d just gotten pregnant twice on my own without even trying. (I needed him to solve my miscarriage issues, not my getting pregnant issues.) So we did four months of IUI’s (or what I like to call “the turkey baster procedure,” where they insert your partner’s concentrated sperm at the exact right time). But I did the IUIs without medication, because I wanted to be all natural. I think it took six months for me to start IVF, and by that time I was 42.

Now, I’m hardly saying every older woman should immediately start IVF. If you’re between 35-39, you should try however you’re going to try – whether it’s timed sex, IUIs, a fertility cleanse diet – but you should try it sooner rather than later. Actually, what I mean is try it now.

I know, I know, there’s so much information out there: how do you find a doctor? Which treatment should you try? What’s wrong with you? You could spend months researching all of this. But you shouldn’t. Especially if you’re near the 40-year-mark. I know that there are plenty of women who conceive naturally over 40. But what if you’re not one of them?

Some studies show that between ages 40-45, the likelihood of getting pregnant declines from 36% to 5%, and the chances of infertility rises from 32% to 69%. That’s like your fertility on fast forward.

Of course I didn’t study those statistics when I started all this. If I had, I might have skipped the six months of IUIs and fast tracked myself to IVF. Hindsight, as they say, is 20/20. And youth is wasted on the young.

So I counseled this woman, this stranger, who asked me for my advice. I told her which doctors to call, where she could get cheaper meds, and questions to ask.

“When does your next cycle begin?” I asked her. She said in three weeks. I told her to start whatever she was starting by then. Time, after all, is of the essence.


Comments (11)

I'm so sorry your fertility treatments weren't successful. I've been following your journey in the NY Times and hoping for your success. It takes a brave person to share so many personal details with the world but I'm so glad you did, despite the judgmental commentary you received. You have been so honest in your posts, even though some of what you shared opened you up to a lot of criticism. Thank you. I hope you find peace.

Good luck! I am 20 weeks pregnant from IVF and so glad I did not wait. There seems to be a cultural bias towards keeping things as natural as possible with assisted reproduction. Good thing I love science. ;) As for all the judgmental comments out there, my goodness, some people need to get over themselves.

perhaps because you are all readers of fertility blogs -- ahead of the game already!! -- you are surprised about how little I knew about fertility. Firstly, I speak to women every day who know much less than I do. Every day. They all think IVF is a miracle antidote to age. That it can save you, no matter what.. (Truthfully, llike me, they have husband finding on their minds, more than baby making). Secondly, my ignorance was understandable, since most of the literature out there says you have problems starting at 35 -- and yet I saw many women 35-40 have babies, no problem! With the new information emerging, how the problem is really 40, I think by not fear-mongering -- and showing realistic numbers, it will allow women like me to really hear what's going on. By the way, I thought I would have trouble, but got pregnant on my own twice, right away, without help. So that's why, at 42, I didn't worry.

Amy, I enjoy reading your blog and NYT articles. Like many readers, I was surprised to learn that your 42 and that as an educated person you honestly believe you have a real chance of carrying a healthy baby to term. I don't say this meanly, but for some reason, I had imagined you more in the 37 year old range. It seems that at 42-43, it's just a waste of money and effort. I know having your own biological child is important to you. Therefore, why don't you consider surrogacy? I read that India has many clinics that match families with surrogates, and it seems like a better track for you since you still have viable eggs. I know you're just starting the IVF adventure, but you seem to be delusional about the realities of life. Firstly, you waited too long to try to have a baby and then you waited too long to pursue IVF. My point is, since you want your own biological child, you should start the surrogacy search now. It would take at least a year and would probably be money better spent. Soon, your eggs won't be viable and you will have missed out on this, too. Think it over. Good luck.

I have PCOS, so I've been infertile all my life - but I still didn't realize how slow the fertility treatment process is. I started with a fertility doctor at 34, but after months of attempts with clomid (that didn't work), I switched to another doctor, who had me start over with clomid, and by the time I got to the shots and IUIs, I was 36; I didn't get pregnant on my first round and waited a month in between, and I finally conceived, giving birth at age 37. You'd think I would have learned from this, but the second time I was 42 - I thought my chances were 0 but the doctor felt that it was worth a try, and so I did another IUI round (even though the doctor recommended IVF due to my age). I miscarried. I did another IUI and nothing. So then we did IVF, but it took awhile for us to make up our minds, and in the mean time I was 43. However, probably due to the PCOS, I was able to conceive with just one round of IVF (due to the cost, we were only going to do one round), and I have three leftover embryos on ice. Were I to do it again, I would say go straight to IVF, and I wish I'd listened to the doctor. One year was lost, and I would have loved to have my kids a year closer together.

How can you not have researched this already?!? You waited util 41 to pregnant and are surprised when it doesn't happen? The fertility info you mention is years old; seems like you could have done some research before.

I'm not trying to be rude or unkind...but I can't understand why you waited until age 41 to try having a baby when those stats you mention above have been known for many years now. Maybe it's simply time to move on and recognise that you're body is no longer in it's best condition to carry a healthy baby full term, safely.

This is more than true...I have wasted nearly two years so far trying to figure this stuff out...

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