Friday, March 15, 2013

Answered Questions

At 32 years old, my AMH was 1.8, typical per this graph and standard estimates. At 33, it was 1.4- lower but not incredibly out of range or out of the realm of IVF possibility.

Today, at 34-years-old, my AMH is a whopping .22. (Just in case you didn't notice, there was a decimal point in front of those 2s.) Do you know who would be expected to have an AMH of .22? A 45-year-old woman. And no, this is not the typical trajectory of most people.

So, why did my hormone levels drop so dramatically in such a short amount of time? With perfect timing, we just so happened to have an appointment scheduled with RE#3 the day after we got the results and apparently, this drop could have been hapenning for years. Hormone markers can have a lag time, so when we were working with embryos from my 30-year-old eggs in the face of 'normal' hormone values at the time, I kept wondering why A.) I needed more stims than other 30-year-olds and B.) why my implantation rate VS. chemical/miscarriage rate was a little wonky. Now we might have the answer.  The doctor made clear what I already knew. These were possible signs all along that something was awry. It just took my body awhile to reveal it.

It sounds crazy, but it's nice to have an explanation to match the inuition that has been screaming at me all this time. Male factor--yeah, we had some of that. But reading all the way back to my blog entries over the past almost-5 years, I asked the question over-and over: is it also female factor? Doctor after doctor told me no. In fact, they always wondered why I would even ask this. I mean, who could blame them? They had nothing, no black-and-white numbers at least, to suggest it. The only thing that clued me in was my intuition and last time I checked, that wasn't exactly a scientifically valid marker (personally, I think I've had it confirmed often enough to say that it is. In fact, my DH calls the level at which my intuition is correct 'creepy'.)

And yet, we got one healthy child from one IVF, which is far above average. "Consider yourselves tremendously lucky" is the message we've received. You don't need to say that again to me. I know this very, very well. And then I can't help but think that perhaps I should also consider myself lucky that I never did another IVF with my eggs. It's quite likely that the chances would have been so much lower than any of us actually knew. That was my hesitation to begin with. 20K on what? A 10% chance? That's what it probably would have been, while my age suggests that it would have been closer to 30%. Do you know that RE#4 was satisfied with going on my AMH/FSH numbers from last May? That had we not been messing around with RE#3 on the side who requires them every 6 months, we might have actually gone through with a full fresh IVF with my almost-permimenopausal eggs that would have probably ended up cancelled/unsuccessful? (that's not totally true-I would have requested them, but still...)

So, yes, I am grateful that our discovery saved us money, heartache and also answered years-long questions I had been harboring. It's not everyday that someone from the unexplained camp (which is what I have always considered myself) actually gets an explanation. It certainly helps with closure. I won't deny that it also calls up more 'what-ifs' than I can count, but generally speaking I have a strong sense of 'everything happens exactly as it's supposed to' which buffers me from that.

It is likely that I will reach perimenopause before I hit 40. I will be in the pre stages of menopause at the same time many women my age will still be having kids. Wow. That is really a piece of information that is hard to swallow. I mean, I know intellectually that there will be no more biological children for me, but beyond reproduction, there's an entirely new level of blending this idea into the overall schema of myself that I need to grapple with. It's redefining. That's what this whole thing really is about: redefinition: redefining self, redefining family, redfining life. It's not what I pictured, but it's mine and I need to find a way to embrace it or in the very least, accept it.

In that very meeting, we were presented with other options and for now I will say that we're exploring them. I think we have made our decision, but perhaps we have not made our peace with it yet. I'm sure I'll be back on here soon over-analyzing every emotion and idea connected to it, but until then, thank you so much for your support. What a crazy ride this continues to be and I'm not sure what I would have done without this space...once again.


S said...

I'm so sorry you got this news. As you say, the discovery did save you money, heartache, etc., but it must really suck to learn at only 34 that you essentially have the eggs of a 45-year-old.

I started TTC at age 37, only ever achieved one chemical pregnancy with my own eggs, and moved on to donor eggs at 40. My numbers were always good--my RE said I had the hormone levels and ovaries of a 30-year-old, even when I started my DE cycle--but I guess my quality was poor nonetheless because we had success (times two!) on our first DE IVF cycle.

Thinking of you as you process this information and make the decisions you need to make.

AnotherDreamer said...

I'm really glad that you found this all out before going through with IVF again, and that you have answers- but I'm also sorry that it came back like this. It must add another layer, and I'm sure it's a lot to process.

Keeping you in my thoughts. You've been through so much this past year, and I hope that there are good things to come (*hugs*)

Catwoman73 said...

I'm so sorry you got this news, though glad that you got answers. I do think getting answers helps in the long run, but it sure doesn't change the mourning process- it's still a tough slog. I'm in exactly the same boat- I totally feel your pain. HUGS!

JJ said...

I'm so sorry to hear this news. But I would say "don't give up hope". My AMH was less than yours - 0.1something (at the age of 37) and I was able to produce 9 eggs with a less than maximum stimulation and am now 26 weeks pregnant with our miracle baby (after being told we had a 15% chance during IVF). Numbers are numbers, and I think many times they just lead to more worry, oftentimes unnecessary. Thinking of you as you decide what to do next!

Lorraine said...

Wow! But like you say, you knew. Something. I was the same way, and it does help to confirm that you were not just a hysterical worrier all that time, that you do have an intuitive grasp of your own situation.

I hope you do find what the answer is for you. Use that keen intuition to guide you, I know you'll know what's best.

On a side note, interesting that the median falls below the mean in that graph. I guess I knew that as hearsay, but was never so clear on how that really panned out.

Shelby said...

Lorraine-my guess on the median falling below the average is that there are a number of outlier super-fertile chicks out there who have AMHs through the roof throwing the whole curve off. I can pretty much guarantee that was never me!