When my husband and I decided to deal with our infertility we wanted to educate ourselves and find a solution to our problem. We were considered by our doctors to fall under the category of "unexplained Infertility," I was 36 years old and had not gotten pregnant after 8 years without birth control and had 6 failed Intrauterine Inseminations (IUI's). It was time for a more aggressive approach and we needed to find a doctor who would really know our case and make us feel involved in our course of action.

We were referred to a doctor who had gotten two couples we knew successfully pregnant so we trusted her success rate. On our first visit, the doctor sat us down and discussed all of our options. We didn't even know we had options before this visit. The doctor said we could do more IUI's because she felt the timing was off with the 6 we had done, we could do straight IVF (In Vitro Fertilization) or we could do IVF with PGD. PGD is a chromosome or genetic wash/screening that identifies any embryos with genetic defects or any major diseases that would cause a pregnancy to terminate after implantation. PGD can identify almost 200 genetic defects that can inhibit a healthy pregnancy. We opted for IVF with PGD because we saw it as the fastest and least complicated way to have a healthy pregnancy after so many failed IUI's and so many infertile years. I also was concerned about my age but only because the medical community made me feel so self conscious about the complications that I could have as I got older.

I had 24 eggs harvested for IVF (yes I did!). Five were "no good," or had complications like a missing cell nucleus. There was one embryo that had double XXYY chromosomes and one had Turner's Syndrome (or one X chromosome affecting females). Of the 19 left, 10 were allowed natural fertilization after PGD (meaning my husband's sperm naturally fertilized my eggs without assistance). We implanted 3 "good" eggs during our first round of IVF. We used two male and one female embryos knowing that the female would be strong enough to pull through :).

The remaining 9 eggs were to be used in research. We were told this meant that the sperm would be manually injected into the eggs for fertilization. We did not realize before this was done that it could possibly compromise the genetic make-up and viability of the embryos. It was suggested to us that these 9 eggs be destroyed (after the research) as their future development and health would be unknown. Had we known this prior to the procedure, we definitely would have had more to say about it. I do not regret that a contribution was made in the name of scientific research but I would have liked more time to consider what that meant. Ethically, we should have been given all of those facts beforehand but I think the doctor and staff figured we just wanted to get pregnant. "No matter what" was not part of the equation for my husband and I. We liked to talk about our options and think things through before making such major decisions.

Even though we went through the genetic screening, it was still possible for the embryos to develop either an inherited or environmentally caused disease, defect or illness. PGD is not the end all be all but it helps prevent complications that can develop in older pregnant women. If you read my previous blog, you know that my daughter developed an Immune Disorder at age 1 regardless of all of this prevention before her birth. There is also not a lot of information available about the future health of a PGD child. We knew we wanted to be parents so we chose to trust this method to have our children. I often think about what this means for my children's future but I look into their beautiful eyes and healthy faces and I have to trust that it will all be OK.

Morally and ethically we had to deal with a lot of hard decisions. First whether to do IUI, IVF or PGD at all. Then we had to choose the sex of the embryos we wanted to use (we didn't have to- the doctor could have, but since we could..). We also had to discuss selective reduction which meant that in the event that the 3 embryos we implanted created several babies (I think there are limits medically as to how many babies you can carry at once) did we want to reduce in the womb. We also had to decide what to do with our remaining 7 healthy eggs. As for selective reduction, we figured at this point, what ever we were graced with was meant to be. We opted to refuse the reduction for both ethical and religious reasons.

The hardest decision I had to make had to do with embryo storage. The remaining 7 eggs were frozen at the ART center and each year we would have to pay for that storage. There are studies that support the viability of these eggs after years of being frozen but not enough is known about it since IVF/PGD and frozen embryo storage for pregnancy are relatively new. There comes a point where this decision has to be made unless you want to pay this bill every year, and for my husband and I it was a tough one.

I will tell you that these were some very hard decision to make, but I will say this. Even though there are a lot of people who may feel that we are trying to play God by using such procedures to get pregnant, I feel that the embryos STILL have to implant into the uterine lining and they STILL have to make it through pregnancy to become our children. I also know the we wanted our children so badly..... they are loved, taken care of and will make a positive contribution to society. How can this be wrong? A pregnancy in any form is still a miracle.

Please visit www.en.wikipedia.org/wiki/Preimplantation_genetic_diagnosis for more information on PGD.

Gina

Have you ever had to accept something you didn’t want to? As some of you now know, I suffered through infertility for 5 years. It took me and my husband one year of trying before we even considered the idea of us being infertile. We were both young (sort of) and in great shape. The thought of infertility never even entered our minds. All of those years of stressing out when my period was late and it turns out I had nothing to stress about. Truth is; I was never going to get pregnant without medical assistance.

Once I finally accepted the fact we were having fertility issues, I joined a support group. I wanted to learn from other women how to handle the surprise of it all. I was in shock over my infertility for many years. It was probably the hardest thing I ever had to admit to myself. It turns out many other women feel the same way. Almost every woman, at one support group session, started off their story by saying they had a hard time accepting their inability to conceive. This made me question, “Why is infertility such a surprise when millions are facing it daily?”

I came to one conclusion. This conclusion took me on a long memory ride. The first memory took me back to the sixth grade. In the sixth grade I learned about the birds and the bees. Everything was so matter of fact. The teachers explained conception in a way that simply stated, “This is how it works” and nothing stated, “This is how it fails.”

Let’s jump ahead a few more years to my eighth grade health class. Fertility was brought up again and this time they were trying to frighten kids into not having “nookie” because they will definitely conceive if they do. Do you remember everyone preaching, “It only takes one time?” I do. That was drilled into my head. Natalie and I were friends back then and I remember a conversation we had at school one afternoon. We were wondering if we should swim in a pool with boys. We were so frightened by our teachers and society expressing how easy it is to conceive; we wondered if we could get pregnant just by swimming with boys.

I know, you are probably laughing at us right now and it is embarrassing to admit to our “naiveness.” However, it is important to understand how we were trained to think. Keep in mind we were young and we eventually swam with boys again (I have to “save face” a little bit).

My next round of fertility education came through a college course. The professor was very detailed oriented. So much so, that I never had a question about “nookie” again and I often wondered if she should have been arrested for lewd behavior. But, I digress. The interesting fact about her course is that she went into such depth about fertility but never brought up infertility. How can you teach this sort of class and not talk about infertility? It was simply not mentioned. Personally, I feel there is a lot of shame behind it but that is another blog post altogether.

How can a child be taught from such a young age how easy it is to conceive but throughout the years never be taught how difficult it can be as well? Is this fair education? If you are struggling with infertility don’t you feel our educators failed us in this area? I do. I often wonder if infertility was never talked about because our educators were more concerned about scaring us so they would not have young pregnant girls running around school. Well, lesson learned. I was so afraid of conceiving that it was inconceivable to think I could NOT conceive.

It wasn’t until age 30 that I finally learned about infertility and how common it is. In so many words, I grew up “infertility clueless.” So, when the day finally came and I accepted my inability to create life on my own it was a very emotional day; a day of shock and tears; a day of bereavement; a day of mourning the children I may never have.

With all of that said, my conclusion lies in that my education failed me and infertility was simply something I had to learn about the hard way. I propose our fertility education be revamped and children learn about infertility at the same time they are taught fertility; and I do not mean just a mere mention of the illness but a full chapter on it. If I had one inkling infertility existed, I would have sought help earlier and I know, without a doubt, I would have been better equipped to deal with the surprise and shock of it all.

Who is with me?
- Alicia

Are women having children later in their lives? I think a lot of things factor into this decision: Getting married later in life, career choices that focus on moving up in the ranks at work, higher education and infertility may all play a role in why this has come to be. With almost 10% (6.1 million people) facing infertility, maybe it isn't always the best choice to wait but I am glad I didn't really have a choice.

As I said in my last article, I tried to get pregnant early in my marriage. I was 26 when I got married. When I finally started focusing on finding answers to my infertility, I was already 32 years old which is an age where a woman's fertility potential starts to decline (different references will give slightly different ages). This places women at a 21.4% chance for miscarriage as opposed to a 13.1% at age 25-34 (Environmental Working Group). At age 45, this rate increases to 50%! We are born with over 1 million eggs but by puberty we only have about 300,000 left of which only about 300 will be utilized during ovulation (Women'sHealth.gov). And that is if our bodies are in "normal" functioning order.

As eggs age, they start to develop chromosomal abnormalities causing women to be at a higher risk for miscarriage. This degeneration of egg development cannot be stopped or altered- there are no drugs available to address this issue. As we get older, we are also more susceptible to health risks that may not affect us in our 20's. Of course, there are always rare occurrences where a female in her 20's may have health issues that affect her fertility but I am speaking about the majority of the population and the aging process. I also want to note that there are a number of other factors that can affect infertility but my age always seemed to be a big deal to my doctor's (and everyone else) so I am discussing it!

Now given all of this, I did In-Vitro at age 36 giving birth to my twins at age 37 (I had just turned 37 and they were delivered a week later). In my doctor's office, I was told by one of the nurses that there were 13 women doing In-Vitro at the same time I was and I was the youngest. I was initially surprised by this but the more I thought about it, the more it made sense. Given that women want more out of life including financial stability, I understand the extended time-line. I am sure most of us assume that we have time to get pregnant and the truth is until we start digging into our fertility, we may not have a clue if we can get pregnant or not.

It's a catch 22 because you would not normally start infertility testing at a young age if there is no medical reason to do so (or you can if you want to go through invasive tests and if you want to spend a lot of money out of pocket). If you choose to wait to finish your career goals and buy a house before having kids you are in the same boat I was although I ignored my infertility for quite a while.

As I look back I am glad I did not make the choice to deal with my infertility right away and I will tell you why. I finished school, traveled, achieved my career goals and had financial stability. Now that I am a stay-at-home mom, I am grateful to be able to watch my kids grow and learn and I don't feel like I am missing out on anything. I have experienced a lot over the years but by being at home I am truly enjoying and noticing my life now more than ever. As always, I love to hear other stories. Please share about your experience as well...

Gina