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41, IVF, and Pregnancy

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41 and Pregnant

I am 41 years old and pregnant. Most of you will probably shrug and be like so what!? You're a young and healthy 41 and you're only 41! But let me fill you in on a not so big secret. Being 41 and pregnant is rare and dangerous. It is actually called a “geriatric pregnancy”. An estimated 100,000 women over the age of 40 give birth a year (in the U.S.). That sounds like plenty of women but out of the 167 million women in the U.S., that's only 0.05%. Tiny tiny percentage! 

The rarity might come along with the well known fact that a woman's eggs gradually decline both in number and in quality as she gets older. Fertility tends to drop off significantly around age 32. If she's over 35, she's considered to be of “advanced maternal age”. Over 37? Nose dive chances. By 44, the chances of a spontaneous pregnancy are around zero. Not so lucky for those of us who had other priorities. 

And so let's talk about that. I was never one to prioritize motherhood. I never felt like I have to have a kid or dreamt of being a mom. I told my mom when I was very young that I would never have kids and instead adopt. Perhaps I was setting up my own destiny. Which is ironic given I run a marketing company for adoption agencies. But the truth is, I've never had any interest in adopting either. I just wasn't interested in motherhood.

Of course, meeting Luca, I started to be more open-minded about it. We've talked about having a family pretty much from the beginning. He told me he wanted a full rugby team (9 players) early in our relationship. I was like, uhhh, I'm 36 (at the time) and that feels like a pretty unrealistic future with me! I've also sort of always known I would have some troubles becoming pregnant anyway (that's a longer story for another time...). But my age and fertile ability never seemed to phase him. 

And so I also never imagined I'd be that woman battling infertility, jealous over baby announcements, cringing at the site of a baby, staring in the mirror feeling less than, screaming 'what is wrong with you!? You have one job!!', longing to make Luca a daddy...

Let's Make a Baby!

It was April 2018 just after my brother died and I returned to Italy. Maybe it was him missing me, maybe I felt the mortality of life. But we decided, let's try to have a baby! Pre-marriage!? I know, shocking! ;) ...After about a year of diligent trying - not concentrated effort per say, but we definitely used an app and tracked timing monthly - it was in June 2019, we tested positive. Unfortunately it was an ectopic pregnancy, completely unviable and required some emergency action. I wrote about it here. We were just excited that we were actually able to get pregnant. By now I'm 39 and feeling the pressure. And you know what, timing is everything. I ended up making legacy and competing in Ironman World Championship in Kona that year which would have been impossible 5 months pregnant. So...

We continued to try, unsuccessfully, and decided to see a fertility specialist. We were quickly advised to consider IVF given our ectopic (if you have one, you're likely to have another) and my age. So in May 2020, we met Doctor Jane in Genova. I have an IVF Treatment Day by Day "journal" unpublished. This one I might keep private forever. I'm just going to say this: IVF is fucking hard. Physically, mentally, and emotionally taxing, trying, difficult! And it doesn't even have good success rates!!
A woman under the age of 35 has a 36% chance of a pregnancy with IVF.
Age 38-40, a 22% chance.
41 or 42 years old? 13%.
Over 42, 6% chance.
In case you suck at math and percentages, these are NOT good stats! We only had a 13% chance of this even working! (which honestly is better than 0% chance which is why we went for it). 

If I can just share any advice with kidless women (especially between the age of 32-37) - who aren't really sure about what they want in the family department, freeze your eggs now. Don't get to my age and put yourself through this. A family, having kids - it was never what I wanted either. Freeze those young, good quality eggs and when you meet the future father of your kids, you've got them ready! Had I known, had I been advised, I totally would have! 

IVF and Pregnancy

Do you remember trips to Genova and trips to Turin? I never explained our little adventures but this is what was happening. IVF treatments, injections, monitoring, egg stimulation, egg retrievals, testing, transfers... failures. 4 cycles in total. We did 2 full cycles in Italy both through summer and fall of 2020. Pretty good timing considering not much else was going on in the world given the pandemic. After 3 embryo transfer failures, we took a long break. My body was exhausted, my mind heavy. Luca went on the ship to America, me to the states. 5 months to recover. In the meantime, I researched the top IVF clinics in the world and found ours - IVF Spain in Alicante. 

We started the 3rd IVF cycle with them on my 41st birthday.
But I swore this would be the final try. We ended up with 1 embryo that didn't make it and broken hearts. We can't do this again! The 3rd time is supposed to be the charm, not the 4th! It didn't work, it will never work! Even though I was feeling super broken...
We started round 4 in August. This is it. Even our doctor said she would not allow us to do a 5th cycle. So for real, this is it. Back to Spain batman! 

Come transfer day, September 25, 2021, we had one survivor. One lone survivor.
Our designated survivor
The 2 week wait; which was only a 10 day wait... Positive pregnancy test! And the next day, blood tests: HCG levels 87, indicating a pregnancy! We did it. We're pregnant. We're going to have a baby. Oh hell, we're going to have a baby!!! We are so thrilled but so cautious! There is a high risk of miscarriage and we haven't had the best luck so far. We stayed super positive and calm. Each week we had an ultrasound and each week, there it was growing! We got a heartbeat in week 6 which, if you didn't know, because I didn't know either, once you have a heartbeat, the chance of a miscarriage drops to 3%. And even closer to 1.6% for women experiencing no symptoms. Guess what, no symptoms!! Sometimes I even fear or doubt I'm actually pregnant because of no symptoms! 

So let's talk about what an IVF pregnancy is and why I haven't talked about it. Why is infertility such a secret? OMG it drives me crazy but I found myself too, keeping it a secret. What the hell!? It's almost like there's this layer of embarrassment; it's laced with shame. I'm broken, something is wrong with me; something that's supposed to be so natural isn't working; and God forbid anyone know. I think it also makes people feel uncomfortable because we're talking about body parts and uterus's and sperm and eggs... But also, I sort of feel like I don't have anyone TO talk with about it. Nobody cares. It freaks people out. Or maybe because we have this stigma of a "test tube baby". As if an IVF pregnancy isn't equal or real. Well let me educate you... An IVF pregnancy is exactly like a natural pregnancy

With IVF, the egg (mine) and sperm (his) are united in the lab instead of in the body.
In simplicity: A woman is born with a certain amount of eggs to be cycled through during her life. Each month, 1 egg drops and goes out searching for sperm. As I mentioned, as a woman ages, the # of these eggs as well as the quality of them decreases. IVF treatment includes a series of meds and injections to stimulate eggs. Instead of 1 egg searching for the magical sperm in the exact perfect timing during a woman's cycle, stimulation helps a woman's body generate multiple eggs to mature and grow inside of her which can then be retrieved. Special meds can also help improve the quality of these eggs. 

On retrieval day, simultaneously, the man is providing a sperm sample. Scientists inspect the sperm, withdrawing the healthiest most active ones and unites them with the best of the freshly retrieved eggs. When (if any) fertilize, after 3-5 days of development (if any), the embryo is transferred to the woman's uterus in hopes it will implant and thus, pregnancy! For a natural pregnancy, all of this is happening inside a woman's body - no difference. We transferred a 5 day embryo which was also (naturally) hatching - a good sign (a fertilized embryo is covered by a shell, called the zona pellucida. To result in a successful pregnancy, the egg must hatch and attach to the lining of the uterus).

Some people require donor eggs or donor sperm to accomplish the same. We did not. 

When transferred, the first few weeks that would happen in the body - egg goes on the prowl, meets sperm, unites...etc. -  is happening outside of the body so when the embryo is transferred it's actually somewhere between 2 and 4 weeks - there's no way to know an exact date since we don't know when the embryo actually implants. So, when/if she tests positive, she's assumed to be around 4 weeks pregnant. Congrats, 1 month in! Pregnancy and gestation is confusing - like, how they time it and consider gestation. The first 2 weeks (of any pregnancy) she isn't even actually pregnant. But anyway... Most women don't even know they're pregnant until 6 weeks, 8 weeks, even 10 weeks! Knowing I was pregnant from the VERY beginning has made for VERY long weeks!! Too long for secrets, ha ha!!
As most everyone knows though, getting to week 13 (out of the 1st trimester) is crucial and let me just tell you, DRAGS ON FOREVER...

What's it like being 41 and pregnant?

My belly has looked pregnant since about week 4/5 - protruding out. This is partly due to swollen ovaries and follicles, but also, IDK, maybe I'm a shower not a grower!! I'm scared how big I will potentially become! And it bounces when I laugh which cracks Luca up but is just humiliating. I've never felt so big. I feel huge. I am huge. As mentioned, IVF really takes a toll on the body and that includes extra weight. Hormones, steroids, and an inability to overexert yourself all play a role. And take a toll!!

Not running is making me crazy. I have been walking and I'm easing my way back to running (why I'm not running has little to do with being pregnant and more to do with some internal tissue damage, normal after IVF, and the necessity for it to heal so the baby stays healthy in my womb. Running would have caused too much impact, irritation, possible bleeding, etc). Better to put it aside for a few weeks. 

Anyway, I have had minimal symptoms. I mean, I guess, consider "symptoms"... Tender breasts, swollen belly, I pee a lot, and I get tired easy, super out of breath. My emotions are pretty up and down too but considering all the hormones over the last 3 years, to be expected. As far as nausea and morning sickness. Zero. I hate certain smells: fish and cigarettes. 
Cravings: sour candy and/or lemon... I really wanted a hotdog at one point (I do not like hotdogs!!!). And Luca's ragĂș (I love Luca's ragĂș). I'm also very thirsty for something that isn't water and isn't sugary. I don't know what this beverage is...but I want some!

I honestly don't feel much of anything! At least anything bad. I feel good. I feel the same, only bigger. I do have endless gas. And intense hunger. Maybe I'll be one of those lucky gals who lovesssss being pregnant and never feels terrible. Let's hold on to this and see how I feel at 7, 8, 9 months. LoL!! I'm sure you momma's are all thinking, just you wait

Right now I'm just so excited to share this news with you and finally TALK ABOUT IT!! I've been struggling with "when" to share given all the fears of miscarriage. We are so influenced by society (the norm, family, friends...) to wait wait wait. I didn't feel this need to wait. I kept thinking, gosh if I lose it, I want the SUPPORT and in order to get support, they need to KNOW! I've wanted to tell you since transfer day, Sept 25th!! Because WHY NOT!? Given some pressures and outside influences, we waited. But let it be known, I'M ANTI-WAITING TO ANNOUNCE PREGNANCY!!! 

So talk to me, how old were you for your first pregnancy!? What were your symptoms? What were you craving!? Let's laugh about this together!!! 

That Brings Us to Today

Having started this blog post a few weeks ago - and we are now in the 2nd trimester, have announced, and, it's a girl!!!!! I can add that she is HEALTHY, has a STRONG heartbeat, and growing just as she's supposed to. She's almost 3 inches long and in our last ultrasound, Dec 13th, she was moving and rolling all around. Pretty incredible. Despite a bit of gender disappointment, which I didn't even know was a thing, I am already getting over it and watching this life develop inside of me is just...wow. WOW! We saw her spine, how cool is that! 

Life is crazy, isn't it? One minute I'm running marathons and the next, a baby making factory. I don't feel like this will change who I am other than adding "mom" to my resume. We intend to continue to live our adventurous lifestyle, traveling, racing, spoiling the Jake, endless back and forths from the U.S. and Italy... We want her to embrace both cultures, learn both languages, and know and love both families. She's really going to have the coolest life! I mean, I hope we can give her the coolest life! 

If you have any questions about the IVF journey or you just want to talk, even about infertility - we never know what someone is going through until we know. It's a lonely path. I'm here.