What I wish I’d known sooner
Nicola, 33, shares what she’s learnt and what she wishes she’d known sooner on her fertility journey.
As I type, I am waiting for my bleed after another failed round of IVF. This time, we’d gone from high as kites, to a thud back to gloomy reality in a matter of days. Finally, we’d had a (faint but) positive pregnancy test, though sadly, our joy was short lived, as three days later, we were staring down at a stark white, negative result. I would have been four to five weeks pregnant, so I understand this is what’s called a chemical pregnancy. I despise this name. It’s so crass when referring to, our could have been, would have been, much longed for, first child. Our precious embryo, that showed so much promise in the lab just a fortnight ago, now gone.
Lesson one: IVF does not guarantee you a child
The science behind IVF is mind-blowingly incredible. I am still very much riding the wave of hope that it will work for us one day. But through forums, I’ve witnessed brave women face their 8th, 9th, 10th embryo transfer, to no avail. Some, miraculously find success on what would have been their final attempt, but others, begin to navigate alternative routes to parenthood, or heartbreakingly, face a future child free – not by choice. The brutal reality that there are no guarantees with IVF, even after throwing tens of thousands of pounds at the problem, lurks ominously at the back of my mind.
Lesson two: You can miscarry with no warning signs or symptoms
In the Summer of 2020, at ages 31 and 32, my husband and I began trying for a baby naturally. By October, I was pregnant. That was easy, we thought. We decided to book in for a private scan on 23rd December, when I would have been eight weeks along.
We didn’t think we’d be able to hide the pregnancy from our families over the Christmas period, and we thought this scan would give us the confidence to tell our parents and siblings our exciting news.
We naively strutted into the clinic without a care in the world, only to be told our future baby had stopped growing two weeks earlier. How on earth was this possible? I still had all the pregnancy symptoms, and I hadn’t had any bleeding. The sonographer informed me it’s what they call a silent or missed miscarriage.
I had heard of a missed miscarriage before, but I mistakenly thought it was when a woman loses her pregnancy so early, she didn’t even realise she was pregnant. I now reluctantly know that’s typically a chemical pregnancy and begrudgingly, I now have both traumatic events on my fertility résumé.
Lesson three: An estimated one in five pregnancies end in miscarriage
Had I seen this statistic before? Perhaps. But it only resonated once I was the statistic. Although, I didn’t understand how I could have so many friends with children, yet not be aware of anyone else who had suffered pregnancy loss.
However, after sharing my experience, two very close friends did comfort me by telling me about their losses, prior to their beautiful babies being born, and many others have done so since. I do understand why people choose to keep this private, but I wholeheartedly believe that if there were more conversations about miscarriage, we could reduce the stigma, and women or couples would feel able to grieve more openly, access the right support, and ultimately feel less alone.
Lesson four: A woman’s eggs are precious and finite
As a human biology degree student, this one is embarrassing for me to admit. But in the vein of being 100% transparent, I will confess, that I didn’t truly understand the menstrual cycle, until my husband and I started trying to conceive.
And, although it seems glaringly obvious now, I don’t believe I knew that women were born with all the eggs they would ever have, which reduce month by month from the onset of puberty, until one day they run out. Finito. I’ve spoken to several women about this (many with children themselves), and they too seem amazed that we’ve lived our lives in the dark about this fundamental, biological fact of womanhood!
Don’t get me wrong, we’d all heard of the ‘clock ticking’ but did we really understand what it meant biologically? I certainly didn’t. And anyway, that’s a problem to worry about nearing your 50s, right? Not something a ‘spring chicken’ like me had to consider. Wrong. Wrong. Wrong.
Lesson five: An AMH test can give info about the quantity of your ovarian reserve but not the quality
After a year of trying and failing to conceive following our miscarriage, we began to seek help. I learnt there was a simple blood test for AMH (anti mullerian hormone) that can provide an indication of a woman’s egg reserve (though not the quality of those eggs).
In December 2021, an email with results from my AMH blood test landed in my inbox. To my absolute shock, they revealed my egg reserve was much lower than it should be for my age. No one can say with any certainty, but suddenly, that stage in life (*whispers* menopause) which seemed far, far in the distance, was now staring me square in the eyes. We were encouraged to start IVF right away before my egg reserve depleted further.
When I was in my 20s, if someone had warned me, would I have listened and got my egg reserves checked? Would I have explored fertility preservation or started a family at a younger age? I frequently wonder this.
The need for fertility education
The truth is, I honestly don’t know how seriously I would have taken it. I’d probably have naively thought such things didn’t happen to me – I was super healthy! But if fertility education was weaved into our school systems, healthcare settings, and generally became less taboo than it currently is, future generations would at least enter their reproductive years armed with the right knowledge.
Knowledge that will help them achieve their desired family goals and lessen their chances of a life with the pain and heartbreak of infertility. The only ‘fertility’ conversations I can remember having at school were harsh warnings of unwanted teenage pregnancy!
If things had been different, perhaps, my husband and I would have spent the weekend kicking autumn leaves in the park with our three children, instead of curled up on the sofa, mourning another loss, painstakingly googling information to help explain it.
But for now, we have no choice but to continue riding the hope-grief-hope rollercoaster of infertility that we’ve been on non-stop for two years, and which I’m aware many other couples will have been on for much longer than us.