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.

Pregnant over 40! It’s possible!

Trigger warning- miscarriage and infertility

I had no idea how difficult this journey would be when we decided we wanted to try for one more baby…at age 39. In my mind, none of the negative statistics had impacted our fertility journey before, so I just tuned out the noise. In some ways, I’m thankful for my innocence before secondary infertility, second trimester loss and more miscarriages. In other ways, I wish I could have prepared my heart for the unimaginable. But, now that we are here, let’s press on and talk about how it is possible to have a healthy baby and pregnancy at over forty. I’ve done it! Praise the Lord.

A little bit more about our fertility story and secondary infertility

We started TTC (trying to conceive) when our oldest four children were 6, 8, 10 and 12 years old. I was 39 and DH was 41. We were blessed to get pregnant right away. I can’t remember exactly how long we were trying. I just know that I was on a girls trip in April talking about TTC and how I had read about ways to sway for a girl or a boy. And we were trying for a girl. By early May, we were pregnant with a baby girl.

Bakri, 12. Maddux, 10. Leeland, 6. ElMomma 39 & expecting Mary-Linda

We gave very little thought to the idea that we were older or that we may struggle to conceive this time around. When we miscarried due to a fetal maternal hemorrhage at 18 weeks gestation, we were 40 and 42. The months flew by as we learned what had happened to our daughter. No, she didn’t have any chromosomal or genetic abnormalities due to our age. It wasn’t an “egg quality” issue and we knew that because we knew to ask for a KB test when I was in labor.

Any other scenario and surely my age, in particular, would have been blamed for the miscarriage in my second trimester. We were really fortunate to know what happened to her. Although, it’s heartbreaking that she had a condition that went undiagnosed by our midwives and that our midwives missed huge trouble markers on our blood work that should have sent me to a high risk doctor. It’s also comforting to know what happened to her. An unexplained miscarriage can be even more devastating, in my opinion.

Our success after 40

To recap: we have one healthy conception at 39. And, another healthy conception at 41. This one resulted in a live birth. (Baby Jimmie) As far as supplements, I started taking a prenatal with folate and not folic acid. I also took a baby aspirin throughout my cycle and continued until a couple of weeks before expected delivery. I increased my vitamin D, as well as magnesium.

Expecting Jimmie, age 41

In this article written by Tracy Slater, the focus is on Pregnancy over 45 and how it is very possible and has a higher success rate than many of us think. I, like many women trying to conceive over 45, have done a ton of research. In April, I ordered the book It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF by Rebecca Fett. The title pretty much sums it up, but this book helped me realize the things I was doing that were helpful to my fertility and the things that I was doing that could be done better. Rebecca recommends supplements specific to your situation, whether you are trying naturally or trying via IUI Intrauterine Insemination or IVF In Vitro Fertilization. There are also different recommendations for where you are in your cycle. She also recommends starting most of the supplements three months prior to trying to conceive. This is because the dominant follicle that will mature to the egg that you will ovulate, is chosen three months prior.

In my research, I also discovered FAM: Fertility Activation Method by Heidi Brockmyre. FAM also focuses on ways to improve egg quality and quantity using Chinese medicine and acupressure treatments. This has been amazing. I follow the calendar Heidi sets out and do the appropriate massages for where I am in my cycle. Click here to learn the basics about the FAM program. This program has changed my life. I do the self acupressure treatments twice a day, based on where I am in my cycle. I’ve seen a huge increase in my progesterone levels after ovulation. I’ve also seen my cycles regulate. These treatments are specifically targeted for egg quality and egg quantity and more. If you are interested in the FAM program, click here to watch testimonials, including mine.

I do believe that these lifestyle changes impacted my fertility in 2022 at age 45. After Jimmie, we began TTC again, but I did not have my cycle back for nearly a year and a half. We started FAM and after changing supplements recommended by It Starts with the Egg, we were pregnant within 3 months. On July 22, 2022, we found out we were pregnant at 44 (me) and 47 (him) years old! We were over the moon. Jimmie had just turned three two months earlier. We had blood work to confirm that HCG- the pregnancy hormone -was rising appropriately. Everything was good. Unfortunately, we miscarried at home at 8 weeks and 4 days on August 29, 2022. I had a routine ultrasound the week prior that confirmed there was no growth after six weeks and no heartbeat.

July 2022 Baby HCG progression

This experience was heartbreaking. We believed that our miracle was on his or her way. We believed that God would see us through this pregnancy. Of course, when it all fell apart, we wondered what went wrong? But, since we don’t have any clear answers with that, we decided to focus on what went right:

First, we got pregnant at our more advanced ages. That’s so amazing to me! We were just blown away that God created another El-Hakam baby after we had waited and prayed and tried for so long. Second, conception and implantation happened! We have no idea what happens after we do our part when TTC naturally. This time, we know that the egg made it down the Fallopian tube for conception and back up for implantation.

In October, we fell pregnant again. This time, I tested positive at 14 dpo (days past ovulation) and tested negative at 16 dpo. That’s also when AF (aunt flow aka menstrual cycle) began. This is often referred to as a chemical pregnancy. The embryo implants and HCG begins to rise and then something goes wrong. Likely the embryo had issues making them incompatible with life.

Again, I felt hopeful because we fell pregnant two cycles in a row. This was after two years of TTC with no success. Our lifestyle changes worked. I recently found this article written by a momma who just had her second child at 46! I was happily surprised to read about so many successful pregnancies and births by women in their forties. I do believe that our fertility outlook and chance of having a baby in our forties is not as bleak as the general medical community tells us.

Things I did to help improve my fertility over 40

1. Cutting out anything that is known for causing inflammation. There’s an exhausting list of things. And, we can’t cut every single one of them from our diets. However, even doing better, is helpful, in my experience. I am gluten free, so I already do not consume any gluten or wheat products. I’ve also cut out caffeine, drinking only the best decaf coffee from Cafe Du Monde in New Orleans. Reduced processed sugar, and increased fruit. These changes have also helped me feel a lot better.

2. Doing my best to remove items that are known to be unhealthy and can harm fertility. For me this means cutting out plastics, not drinking from plastic water bottles, not eating microwaved food, drinking filtered water and being mindful of the products we use in our home. I changed cleaning products, detergents, shampoos, soaps, and more to do my best to remove products that have known toxins.

3. Drinking drinks warm or at room temperature and avoiding ice cold beverages and cold treats. Apparently, these can be quite shocking to the uterus. We want to keep the womb warm and inviting, so avoiding ice cold drinks is critical.

4. Diet and supplements. I love the Mediterranean diet. I eat eggs in the morning and enjoy salad (not super cold) with lots of berries and leafy greens. I eat lots of nuts, hummus, lebne, fruit, fish, lamb and beef once a week. I also cut out soda. I’ve never been a huge soda drinker and already refuse to drink diet drinks (aspartame is terrible for our bodies and fertility). However, I would allow myself a maximum of one Coke a day- usually on ice. I love the bubbles in Coke. However, it’s probably not the best for fertility, so I gave up Coke. It was difficult for about three days, and then I was fine. There’s a lot of information out there about which supplements to take and when to take them. I take a prenatal with folate, vitamin D, magnesium and vitamin C. There are other recommendations depending on if you are doing IVF, IUI or a natural cycle. I have another post that will go into specifics and brands I use. Bird & Be goes into more detail here.

5. FAM: Fertility Activation Method. This has truly changed my fertility life. I did not get pregnant for two years and then conceived at 44 and 45 years old. I continue to focus on the acupressure massages at least two times a day. If you are interested, please follow the links above or click here.

To conclude, I’ve found great comfort and peace in being able to make life changes that can positively impact my fertility. I know it’s not as hopeless as some say, because my experience tells me otherwise. If you really want to carry a child, don’t give up. Pray. Ask God for guidance. I do believe that we can trust the Lord AND be proactive in our healthcare and fertility journeys. In fact, I think for many of us struggling with infertility, it’s essential that we take an active role in knowing our bodies and fertility challenges.

The Fab Five, August 2022

Wishing those of you who are in this journey all the baby dust. Please reach out, share our story and comment. We would love to support you in your fertility.

Xoxo,

Rebekah, ElMomma