It's National Infertility Awareness Week! And to celebrate, RESOLVE: The National Infertility Association has created a Bust a Myth Blog Challenge to raise awareness about some of the most common infertility myths. Accordingly, I'm dedicating this post to busting one of my favorite all time myths: Only "Older" Women Have Egg Quality Issues
In the land of TTC, once you hit 35 you might as well start planning your day around the Price is Right and making dinner reservations for 5:30-- because it’s how the reproductive medical community is going to view you: OLD. Of course it is fair to say that we’ve been warned of the tragedy that befalls those who are endearingly referred to as “women of advanced maternal age.” More and more clinics are now urging women to make use of egg banking services and at least one company has now come out with an over the counter FSH test-- (really awesome for us infertiles who already pee obsessively on sticks “just to be absolutely sure” that we are not pregnant--now we can follow up the initial $15.95 test with a second $15.95 test that will confirm that we’ll likely never get pregnant).
But I digress. What nobody ever tells you is that not only do egg quality issues affect those +35, but they also affect the -35 crowd as well. And even…ready for this…the -30 crowd too! Though it is not nearly as common, it does happen, and I can tell you from personal experience that nobody (including the medical community) is prepared for it when it does. So what should your doctor’s response be when an FSH test reveals that you've tested at an above normal level at a below normal age?
A. Nothing. Medical providers should assume it is just a flawed test, not say anything, and not suggest a retest until the patient has spent several thousand dollars on failed treatments that were completely inappropriate for someone with high FSH.
B. Repeatedly ask if you are absolutely sure you never had chemo or were exposed to radiation when you were younger. (Because clearly these are the kind of things that one forgets.)
C. Repeatedly refer to you as “a 45 year old just for the sake of discussion.” (WHY? Why can’t I be the twenty-something year old who happens to have very high FSH levels? Regardless of egg age there are a lot of other differences between a woman in her twenties who is trying to conceive and a woman in her forties who is trying to conceive.)
D. Prohibit you from cycling in the regular IVF program because you don’t meet their FSH cut-off (i.e. you will royally screw up their clinics statistics) but eagerly suggest that you enroll in their donor egg program (i.e. you will totally boost their statistics). Oops…bad call on their part. Even with a 95% chance of success I still royally screwed up their statistics.
E. Acknowledge the uniqueness of your position. Recognize that support options that may be helpful to a woman in her forties may make a woman in her twenties feel like even more of an outsider (i.e. donor egg support groups). And suggest alternative family building options that have a high chance of success but are not completely cost-prohibitive (i.e. using a surrogate and egg donor in India!!!)
While Options A-D are all a part of what makes my journey mine, I hope that by bringing awareness to this myth, others will have the courage to seek out an Option E approach... even at an age, when 5:30 still means happy hour.