IVF at 45. My secondary infertility story and IVF UPDATE!

Trigger warning: infertility, miscarriage and loss

A couple of weeks ago, I finally began openly sharing the IVF part of our story and fertility journey. Today, I want to share our IVF story and experience. I am presently 45 years old. This is my IVF story.

No matter where you are in your fertility journey, I hope you can find peace in the waiting and hoping and planning. And, I hope, by sharing my story, you are encouraged and know you are not alone.

Rebekah Maddux El-Hakam, ElMomma.com

My history:

In 2017, we were praying and hoping for one more El-Hakam baby. We had taken a substantial break of over 6 years after having our four older children in a 5 year time span. We had three boys and one girl at the time and were praying for one more little girl. In May of 2017, I fell pregnant with our fifth baby. In July we found out that our baby was a little girl. We were all over the moon for her and so excited for this little one to complete our family. In mid August, at nearly 18 weeks gestation we found out that our daughter had died in utero. She had no heartbeat at a routine visit with the midwives. We later found out that she had died because of a fetal maternal hemorrhage- anemia due to an unknown cause.

This time in our lives, changed us. It definitely transformed me, in particular. I felt this new fire ignite in me. I knew I wanted to have another baby. That was never in question. But, I also knew I wanted to have a couple more babies. It may sound crazy. But, losing my daughter at 18 weeks gestation and then waiting an entire year and 9 months to have our baby boy solidified for me that I wanted two little ones to be close in age.

Baby Jimmie, 2019

We were blessed with a healthy baby boy, Jimmie, in May of 2019. He was exclusively breastfed. I believe because of this (and possibly my age) that my cycle did not return until he was a year and a half old. It was another year and a half of trying before we fell pregnant naturally in July of 2022. To say we were blown away to fall pregnant is an understatement. We were shocked and I was only a few days short of turning 45. It felt like a real life miracle.

Sadly, the miracle pregnancy didn’t last and we miscarried at home at 9 weeks gestation on August 29, 2022. Because we believed that God had answered our prayers and provided us with our miracle final El baby, this was a particularly devastating time for us. As the momma of all of my children, I felt like it was one more loss that we all endured and it was just too much.

Moving back in time a bit to July of 2022, to just before finding out we were pregnant when I started a new job. This job is an incredible opportunity for me. I learned of this position in June when I was contacted by a recruiter and sent the job description. It was full time, at an amazing Episcopal Church, and with a job description that fits so many of my job skills. It was perfect! One funny part of the interview was when I was asked if I was okay not singing and leading worship with the band, as that was not part of the job description. I answered simply that The Lord always provides a place for me to use my gifts. In the very next part of the interview I was asked if I would be okay singing, as that was definitely going to be something they would want me to do when possible. I smiled and said, “of course!”

I learned during my first week at my new job that fertility coverage was part of the benefits package. When Mary-Linda died and we were trying to conceive, I often thought about IVF and fertility treatments. However, without insurance coverage, the cost was too prohibitive and honestly, impossible. It seemed to be even more of a miracle that I now had fertility coverage and didn’t need it, because I was pregnant naturally at 44 years old!

Obviously, things did not work out with that pregnancy, nor the next one. We did a couple of cycles trying via IUI and monitored cycles with no success. Finally, in March of this year, we began the IVF process. I feel incredibly blessed to be in a position to try to conceive this way at my age. We were not successful during our first attempt, however this is how it went:

For the March cycle, I started on suppression meds as soon as my cycle began. This is to keep my body from having only one or two dominant follicles. Apparently, this also helps the patient be on a schedule with the fertility clinic, so they can start many patients on fertility meds at the same time. *I requested to not be put on birth control again, after this first cycle. When it was time for the suppression check I had a small cyst on my left ovary. My hormone levels were checked and I was given clearance to move forward with IVF stimulation meds.

We did not end up having an embryo at the end of our first IVF cycle. However, here is what happened:

Once we started the Stim meds, I took:

  • Gonal 225 units in the am for 10 days (injection)
  • Dexamethasone in the am for 10 days (pill)
  • Menopur (3 vials) in the pm for 9 days (injection)
  • Cetrotide to prevent ovulation prior to trigger starting on day 5 through day 10 (injection)
  • Triggered with Pregnyl the evening of Day 10 (injection)

I responded fairly well. I had a cyst on my left ovary measuring 18.9 at the beginning of the cycle. However, my estrogen was in normal range, so we continued. 5 follicles (including the cyst were seen at the suppression check) On day 5 of stim meds, I had three follicles measuring 9, 10 & 13mm. We started Cetrotide in the evenings on day 5 to prevent early ovulation. On day 7 of stim meds, I had four follicles on my right ovary measuring 10.6-14.4. At this point we moved to daily labs and ultrasounds and by day 10 of stim meds, 7 follicles measured between 10.3-19.8mm (I think the 19.8 was the cyst, but not sure)

“ Like a 39 year old “

We triggered that night with Ovadrel (hcg), had labs the next morning and the egg retrieval the following morning. We had 7 eggs retrieved in total. 5 of them were mature and 5 fertilized with my husband’s sperm. One made it to day 6 and began to disintegrate at that point. We met with our fertility doctor and he was very pleased with how well I did. He said I responded like a young 39 year old! 💫

After a failed IVF cycle, it’s good to regroup with your doc and discuss the plan moving forward. We decided that we would try twice more before my birthday. I will turn 46 and at that point, my fertility clinic will not retrieve any more eggs. I feel good about trying and knowing we did all we could.

Our second IVF cycle followed the same meds and protocols. On day five of stim meds, the ultrasound revealed 7 follicles growing and measuring 9.7 10 15 12.6 14.1 12.3 10.8mm. We all thought this was fantastic and awesome that we weren’t dealing with a cyst on one side this time. By day 7, I had 3 follicles measuring over 16mm, so we added the Cetrotide to prevent early ovulation. This time we triggered on Day 9, when I had 5 follicles measuring over 17mm.

Post second retrieval

The egg retrieval was a success. We retrieved 11 eggs- 5 mature and 4 fertilized. And one made it to blast! That little embryo is was frozen and a sample of cells was sent to be tested. Unfortunately, the embryo was not compatible with life. we await test results. We found out the test results during our third and final round of IVF.

Our third and final IVF stimulation cycle had the best results of the three. On the day of trigger (day 9 of stim meds) I had 9 follicles measuring 13-18mm. We triggered that evening (Thursday) and went in for blood work the next morning to confirm that the trigger was absorbed in the body. Results were good. We had our egg retrieval early Saturday morning and retrieved 9 eggs. Of those 9, 7 were mature and injected with my husband’s sperm and all seven fertilized. The embryologists watched them for the next 5 days and any that develop to day 6 would be frozen and a sample will be sent off for testing. We are praying for a healthy embryo. We had one embryo make it to testing. May God help our little embryo.

Holding the Space Between

Tw: blog post discusses loss
Christmas Day with the El-Hakam family

This is our fifth Christmas without our daughter, Mary-Linda. This reality shocks my system. I can’t believe it. Five Christmases. How? We actually never had a Christmas with her alive on earth. We were pregnant with her in April of 2017, she passed in Mid August and was due to be born at the end of December, beginning of January 2018.

As a grieving person, I’ve learned that we can be both- we can be thankful for what and who we have in our lives and grieve those who are no longer with us. That’s okay. And, as far as I know, it’s normal. The happy and joy-filled times come a little easier for me now. But, I’m still sad. I’m happy and I’m sad. I’m thankful for all I have and devastated that I don’t have two daughters on earth.

I am also very aware that there are people who long to be mothers and don’t have any living children with them. I promise you, I do not take my living children for granted. But, just as each person has unique characteristics and DNA, so do our children. Our living children are not replacement children for our baby in heaven.

Our living children are not replacement children for our baby in heaven.

El Momma
Rebekah Maddux El-Hakam

Years ago, in the space between losing Mary-Linda and expecting Jimmie, I would attend a support group with a non profit org called MEND. There I met mothers who had also experienced the loss of their babies in pregnancy, through stillbirth or in the first year of life. These women became dear friends who I love very much. One thing that was always said before the start of each meeting was that we don’t compare our losses. We look at every loss as devastating for that precious momma and daddy. And each baby matters, whether or not they were an early loss or late term loss. They matter. That has impacted me so much as we have faced more grief in the following years.

Our grief is unique to our story and our experiences. We can share our grief and our burdens with others without comparing our grief.

El Momma
Rebekah Maddux El-Hakam

The space between is different for me now. I am constantly in the space between celebrating the wins and accomplishments of my living children and wishing Mary-Linda was here sharing a room with Trinity and loving on Baby Jimmie. I am also in the space between the struggles with raising three teenagers and a tween and trying not to compare them to a daughter in heaven, who can do no wrong.

And then there come the holidays in the middle of the crazy of the last several years. As author, Ashley LeMieux stated last week, I find myself using the word AND a lot. For example, I am incredible grateful to spend the holidays with my husband and five living children AND I’m deeply saddened and heartbroken to have our fifth Christmas without Mary-Linda on earth!

I honestly don’t know any other way to be. I believe it’s acceptable and should be encouraged that we feel all of our feelings. It’s valid to be happy AND sad. Angry AND grateful. Depressed AND hopeful.

As a grieving mother AND a celebrating mother, I wanted to share with you that it’s okay. I am comforted knowing that the Lord meets me exactly where I am and gives me comfort and strength that is not my own. I pray you find comfort and peace this year, friends. Time just seems to move faster and faster. Merry Christmas and Happy New Year!

Our Mary-Linda Angel topper

The Journey

When we started out on this grief journey, it was unexpected, as grief and pain often are. We were, in many ways, unprepared. You know how people say “I can’t imagine” what you are going through? What they mean is they don’t have any life experiences that relate directly to what you are going through. Because, of course we can imagine. We don’t want to imagine.

But, today I want to focus on how we unknowingly prepared for this and what I believe we did that has helped us as we process and heal.

Number 1- we prayed and planned for our baby girl. We heard God very clearly and we knew it was the right decision for our family to try for one more baby. We continued to pray and seek the Lord throughout our pregnancy and loss.

In Matthew 6:33-34 the Bible says “But seek first his kingdom and his righteousness, and all these things will be given to you as well. Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.”

We also cling to the scriptures and knowledge that God is near to us. Psalm 34 says the Lord is near to the brokenhearted and saves those who are crushed in spirit.

We believe.

Gender reveal for our daughter, Mary-Linda

Number 2- we celebrated every milestone. We had never done a gender reveal for our older babies, but wanted to do a gender reveal this time for our four older kids. It was absolutely the right decision for our family. The moment we learned, as a family that our baby was a girl will be a memory we all can take with us always. We don’t have a lot of memories with Mary-Linda, so this one stands out as one of the most joyful moments of our time together as a family.

Number 3- we created memories. Did we know that our time with her was going to be short? No. We had no idea. But, we enjoyed the time when we were expecting her. We went on vacation, celebrated birthdays, spent time with family and friends and soaked up those precious moments.

Staycation at The Houstonian Hotel

Grief is not easy, nor is there a formula to move through it. My advice for you whether you are grieving or not, is to live your life to the fullest. Love on your family and friends a little extra. We can all use a little more love.

“You will rarely regret celebrating life too much, but will likely regret celebrating life too little.”

Be still and Hold on, friends

Be still

🌟 When the world feels too heavy and impossible, there is One who knows our burdens and wants to bear them.

🌟 When our daughter died at 18 weeks gestation, so much changed about our family. We were now a family with a daughter and sibling in heaven. We were faced with many awkward questions about how many kids we have and how it feels to only have one girl. (We are blessed with one living daughter and 4 living sons) Jokes about being outnumbered and feeling sorry for our living daughter for being the only girl. It goes on and on.

🌟But, the one constant was and is Jesus. Were we angry with the Lord? Yes. Did we question Him? Yes. Where was He when He was supposed to be “knitting Mary-Linda together” in her mother’s womb? We serve a Big God and He can not only handle our anger, questions and pain, but He wants to bear it for us.

🌟Remember that today and always. When things seem dark, know that the light is near. Hold tight. You are loved.

Happy birthday to Me (trigger warning)

Our lives and my birthday changed forever in 2017. In 2017, I was the happiest I had ever been in my 40 years on earth. I wasn’t the least bit upset to be turning forty. I was pregnant with our second daughter and fifth child. Life for us was in the highest of highs.

My 40th birthday, our first home Dec 2004-July 2019

The following month, at my 18 week appointment I learned that our daughter had unexpectedly suffered a fetal maternal hemorrhage and her heart had stopped beating. We would go on to deliver her and hold her and deeply grieve and be changed F O R E V E R.

I’ve heard people make comments and say “she should be over it.” “At least she has living children.” “She didn’t even know that baby.” And there are people who are so uncomfortable with me sharing about our walk through grief that they question my mental health. Do you really think that I share everything on social media? No. No, I don’t. But, by me sharing my heart and my experience, I have helped a lot of women who have lost their babies in pregnancy through miscarriage and stillbirth and others who have experienced early infant loss. And, by God’s Grace we have a safe space for all, no matter where you may be in your grief journey, your fertility or infertility journey or your mental health condition. This is and always will be a safe space for you. I am here to listen, to share and to be there for other mommas and hopeful mommas.

That brings me to this year. This year, I am turning 44. There is a different level of joy from my 40th birthday, as we have waded the depths of grief and celebrated on the highest mountain tops since that day. One of our greatest joys came in May of 2019, when God blessed us earth side with our son, Jimmie.

This year, at my birthday dinner, Jimmie was so much fun. He’s learning to keep his cup down when he is drinking from a straw. And in between sips and telling me how he’s supposed to hold his cup, he would remind me of why we were at dinner, sweetly saying “happy birthday, momma.”

44TH birthday dinner at The Gristmill

I cried. Our lives look so different than what we would have anticipated them looking like just four years ago. We’ve experienced the loss of our daughter, who would be 3 years old right now. We’ve experienced the joy of having our precious Jimmie (age 2). Expecting him, being together for his birth and being home together for much of his first year and second year of life. We are incredibly blessed and thankful. Our big Els wanted to know why I was crying and Moustapha said this “God didn’t have to give us Jimmie.”

That is so true. Jimmie doesn’t replace our baby who died. But, we know we would be in a very different place right now, if we were still waiting on baby Jimmie. Thankfully, God made a way where we did not see the way. It was not easy and we are incredibly thankful.

My birthday will always be a reminder that we are missing Mary-Linda and that we are blessed with our Jimmie, Leeland, Trinity, Maddux and Bakri. A reminder that we are not promised tomorrow and to be grateful for our blessings today.

July is Bereaved Parents Awareness month.

Newborn Baby Jimmie

TW……Our detailed experience TTC after loss

Starting this with a trigger warning. This post will mention loss. So, click past it, if you do not want to read about miscarriage, stillbirth or infant loss.

After we experienced an unexpected 2nd trimester loss, I wanted (so much) to learn from the experiences of others. Particularly, had anyone experienced a loss like mine? Had anyone gotten pregnant immediately after? Did it take a while? What interventions did they use, if any, when they got their BFP?

I’ve just uploaded a video to my YouTube channel which covers all of these questions and answers and so much more. Like, a lot more. I’m really just talking to you like you are my friend and I’m sharing all the details.

A couple of things to note:

When we conceived Baby Jimmie I was taking one baby aspirin a day and a prenatal vitamin with folate (not folic acid). I took 50mg of Clomid on cycle days 5-9 at bedtime. I had a blazing positive on an Ovulation Internet Cheapie test on Cycle day 14 and 15. Ovulated on day 15 according to my Basal Body Temp Click here for my thermometer on Amazon. and had a BFP at 9 DPO(days past ovulation). I also ate a few bites of pineapple core (CORE ONLY!!) on 2,3,4 & 5 DPO.

Please subscribe to my elmomma blog and YouTube channel and leave a comment. Do you need prayer? I would be honored to pray for you.

Love,

Rebekah Aka El Momma

This is what my BBT chart looked like from the month we conceived Jimmie
Jimmie Josiah, just born.

PS I share never before seen photos from Jimmie’s labor and after birth in the Youtube video I just uploaded.

How I imagine You

El Momma, big Sis Trinity and baby Mary-Linda

It’s always been hard for me to imagine how my babies will look and who they will look like, when I am pregnant. It was the same when we were expecting our second daughter in the summer of 2017. I knew she would look like an El. But, would her eyes be hazel like mine and Bakri’s? Would her hair be curly like Maddux and Leeland? Would she have olive skin like Trinity and Leeland? Or would her eyes be blue and her hair be blonde like Maddux?

When she died at 18 weeks gestation, I held her tiny little body in my arms. I remember that day so vividly. I never ever wanted to let her go and yet, I knew that her little body would not keep. And, I could not hold her like this forever. As the days passed, I would imagine her. I would have day dreams of her in heaven. I could see her. I could touch her. She wasn’t a baby at all. In my mind she was a little girl. She was three.

She was the age she would be now, had she not had an undetected fetal maternal when I was 4.5 months pregnant with her. She would have a sweet nature, because, well the Els all have sweet natures as babies. 💗 She would have had a distinct way of speaking. They all do. Each one had their own special way. She is so loved. I wish I knew more of her. But, I know there is someday. And, we are one day closer to that day.

Mary-Linda’s expected due date in 2018

Grieving During the Holidays

I posted these reminders in 2017, after our daughter died of a fetal maternal hemorrhage at 18 weeks gestation. Now, in 2020, there are so many grieving across our nation. They are grieving the loss of their livelihoods, their jobs, a family member, a loved one, the loss of so many experiences over the last 9 months, and many who will not be able to be with their families this Holiday season.

So, for all of those in our lives who may be grieving this Holiday season, a few kind reminders:

1. Lower your expectations.Your grieving family member might not be able to do things they “normally” do at the holidays. (Baking, cooking, gathering around the kitchen just to visit, or showing up etc.) Whatever they are able to do, should be okay. Let that be okay.

2. Be willing to change or alter traditions.In our family we usually take turns around the dinner table saying what we are thankful for. For someone who is grieving a loss, this can be especially difficult. We altered this tradition to have each family member have a spokesperson to “highlight” things the family was thankful for. This should also be mentioned in advance, so people are not caught off guard and can prepare.

3. Try to listen without offering a solution.It’s hard to see our loved ones sad. But, sometimes it can’t be helped and it is part of the grieving process. It’s better to just be there and say “I love you” and “I hurt for you” than to say the wrong thing.

Psalm 118 says “Oh give thanks to the Lord, for he is good;for his steadfast love endures forever!” I wrote and recorded this little tune of Thanksgiving, based on Psalm 118, a few years ago. Still giving thanks!