If you’ve been following my story, you know that my road towards motherhood has been a winding one. So far I’ve shared my concerns about having a kid, the reasons I thought I shouldn’t have a kid, the reasons I thought I should have a kid, why I ultimately decided not to have a kid, and the accidental pregnancy, abortion, and miscarriage that followed that decision.
At the beginning of this year, I embarked on a journey to make embryos with my husband. I went into the process confident about my fertility and our projected outcome, and I came out of it disillusioned and disappointed. The fertility clinics I consulted completely overpromised, and I was totally in denial of how limiting a factor my age was despite my stellar egg count. I want to share my story to help inform other women about the decision whether or not to do IVF and the mistakes they may be making concerning their fertility.
But first, let’s pickup where I left off. I’ve learned from previous pregnancies that I suffer from hyperemesis gravidarum, which means any pregnancy I decide to carry would be high-risk. This is in addition to already having an underweight BMI, chronic illness, and advanced maternal age. After extensive research, my husband and I determined that the pregnancy approach we were most comfortable with was to create embryos and then use a gestational carrier. A recent study revealing that children exposed to hyperemesis gravidarum in-utero had higher rates of autism was what clinched it for us.
So we decided how we would hypothetically have a kid, but I still wasn’t sure I wanted one. All the while my husband’s desire to have children was intensifying. Naturally this created a great deal of conflict to the point that we almost split up. Ultimately, he decided that his desire to be with me was greater than his desire to have children, and I decided my desire to help him realize his dream of being a father was greater than my desire not to have a kid. So we made a compromise. I agreed to do IVF to secure the option to have a kid, but I told him it wasn’t a guarantee that we would use the embryos. I also declared that I would only be open to having one kid, that I would likely seek the help of a nanny, and that he would have to be an involved father. It was also really important to me that he accepted my potential limitations as a mother since my dream was to be an artist and not a stay-at-home mom. Also, he would need to step up and take good care of me during this IVF process since he has a history of not being particularly nurturing when I’m sick.
Once the ground rules were established, we began the IVF process. After our initial ultrasound and hormone tests with our fertility doctor, we determined that I had a well-shaped uterus (not helpful since we were going to use a gestational carrier), abnormally high level of anti-mullerian hormone (which is positively associated with fertility), and a very high number of follicles (sacs where the eggs develop). Although I was 39 years old at the time, I had the fertility of an 18 year old. I spent the rest of the day bragging to my husband about my youthful and superior reproductive system.
My husband’s sperm test revealed no abnormalities, and we did genetic testing to assess the risk of passing down genetic conditions to our child, and that also looked great. The doctor was optimistic and felt confident we would be happy with our results with just one IVF cycle. We set a date to start the two week egg retrieval process and signed legal documents that determined what would happen to the embryos in different scenarios such as death and divorce.
We paid in full before we started the process, and the total was about $15k, not including storage fees, labs, the anesthesiology fee, genetic testing of the embryos, and medications. So if you’re looking to do one egg retrieval cycle with embryo fertilization in California, I would budget around $25k. Wait until you hear how much a gestational carrier costs (which I’ll be sharing in the future)!
As you may have heard, the egg retrieval process involves a lot of injections. The typical retrieval cycle lasts 8 to 14 days and includes two to three injections per day. If you have a needle phobia, you would have a tough time with this process. I’m not scared of needles, but I couldn’t bring myself to self-administer the shots, so I had my husband do it, and they hurt and left bruises.
The purpose of pumping your body with hormones is to trick your body into growing all your eggs at once instead of the one your ovary releases each menstrual cycle. The goal is to stimulate the eggs to maturity while simultaneously preventing them from being released from the ovaries. At just the right time, the eggs are retrieved directly from the ovaries by being pulled into a needle. It’s all very sci-fi and the process felt that way: unnatural and dangerously experimental.
At the baseline of my menstrual cycle, my IVF cycle began. I had 36 follicles to work with, which is exceptionally high. As I expected, my body was sensitive to the hormones and my estrogen jumped quickly. Estrogen can certainly affect your mood and for many women it does so in a positive way. But for other women, it’s the opposite. Researchers don’t completely understand how estrogen affects a woman’s brain because it’s complex and variable. Unfortunately, I was not one of those women who felt uplifted by my rising estrogen levels.
For 5 nights, I had to do two injections: one was a follicular stimulant and the other was low-dose HCG, the hormone that is naturally produced during pregnancy (and responsible for morning sickness). My estrogen levels were monitored with a blood draw about every other day and my developing eggs were tracked by ultrasounds that revealed increasingly bloated follicles that looked and felt like balloons about to pop.
On night 6, a third injection was introduced in order to prevent my ovaries from releasing the eggs. This one stung pretty bad. I was also feeling pretty lousy at this point. This continued until day 9, when I was ready for my trigger shot. In women with a normal number of follicles (between 8 and 15) an HCG trigger shot is most commonly used. This is basically a last-minute push of hormones to encourage the eggs to fully mature before retrieval. For women with over 15 follicles, it may be too risky to use an HCG trigger shot because this can lead to Ovarian Hyperstimulation Syndrome (OHSS). This is a scary and potentially fatal consequence of over-stimulation during an IVF cycle. To prevent OHSS, my doctor prescribed me a safe alternative which is a Lupron trigger shot. He claimed that this would be just as effective as the HCG trigger, but we later wondered if that were the case, why wouldn’t they use this safer alternative for all patients?
My husband injected the first trigger shot on night 9 and the second trigger shot the next morning. The last two days were especially uncomfortable. I felt nauseous, couldn’t sleep, my uterus was distended to an unnatural degree, and I was anxious. In the morning of day 11, I had my egg retrieval surgery. The surgery was quick and uneventful. Shortly after the procedure, the doctor came to the recovery room to report that out of the 36 eggs extracted, only 12 of them were mature (and therefore viable). Still feeling loopy from the anesthesia, I was not able to disguise my shock and disappointment. I asked the doctor to explain how it could be that we had a significantly lower number of viable eggs than the 18 or more that we expected. He replied that it must have been my advanced age (39). This was the first time my husband and I heard that my age would be such a prohibiting factor.
It would take another week after fertilizing the eggs with my husband’s sperm to wait for the embryos to develop and send the best ones off for genetic testing. The final results were a blow. These were the actual outcomes of our embryos at each stage against the projected outcomes:
Projected: 18 mature eggs at retrieval (50%) Actual: 12 mature eggs at retrieval
Projected: 14 eggs successfully fertilized (77%) Actual: 11 eggs successfully fertilized
Projected: 7 embryos to reach blastocyst phase (50%) Actual: 6 embryos reached blastocyst phase (but only 3 looked promising)
Projected: 3 to 4 normal embryos after genetic testing (50%) Actual: 1 normal embryo after genetic testing
So after $25k, 2 weeks of hormones, 2 weeks of recovery, and all the risks of surgery, we only ended up with 1 normal embryo. Our doctor said we had about a 75% chance of a successful pregnancy via gestational carrier with the 1 embryo, but I’m guessing 50% is a more realistic estimate.
So what do we do with this outcome? A new egg retrieval cycle would be another $25k with no guarantee that we would have any normal embryos at the end. My husband said he was open to another cycle but that it was my decision. I wasn’t keen to go through the physical and financial hardships to try again with such a low chance of success. Plus my desire to have a child is not intense enough to carry me through the marathon of heartache that often accompanies the chase for a baby.
I have heard the stories of infertile couples enduring years of failed IVF cycles and the subsequent grief, health issues, debt, and marital strain the journey can bring. One of my closest friends tried for years (in her 40s) and it still ended in heartbreak. If my husband and I were younger, this might be a different story. But at 39 going on 40, it feels reckless.
Of course, none of the doctors I consulted with discouraged me in any way. There are very few fertility doctors who would advise you to stop grasping for the near impossible. But for me, there needed to be a line, and I wanted to draw it before we got too invested. I decided that we would give the one embryo a chance in the near future, but if that failed, we would accept our fate.
I fear that my IVF story won’t have a happy ending, and I don’t think my experience is unique. Women have been misinformed about their fertility by the doctors who stand to gain from the growing trend of women having kids later in life. Women have been misled by feminists who shame them for prioritizing motherhood over education and career. Women have allowed themselves to be deceived by their own wishful thinking. They want to “have it all,” kids and a career, without making sacrifices. So they put off having children and end up devastated when they realize that freezing their eggs and IVF is not nearly as effective as everyone makes it seem.
I am a total outlier as a woman. My maternal instinct never kicked in, and I will be fine without kids. But most women realize at some point that their highest calling is to be a mother. Today, many women realize this too late. Get out of your head. Get feminism out of your head. Get the bloated success rates of IVF out of your head. Tune into your heart, and ask yourself: will I regret never becoming a mother? Take that answer, and let it inform your decisions about career, marriage, and family. And hurry.