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  • Kassandra Vaughn

7 Things You Can Do to Select an IVF Clinic that Supports Women Over 40 Well

It's been a little over a week since my initial RE labs came back... and one thing is clear...

It's critical to have a fertility support team that BELIEVES in your ability to get pregnant with your own eggs after 40 AND is willing to go the extra mile with you to figure out how to make that happen sooner rather than later... and I don't have that in the current IVF doctor I'm seeing.

This journey is such a hard one. I have days where I really believe that my body can STILL do this... and days, like today, when I wonder "Can this actually happen?" Add to that the changes a woman's body goes through in her 40s and I'm sitting in a place where, at this moment, I don't trust my body's ability to do this... and I have a lack of body trust that is way stronger than it was in my 20s or 30s.

Even then, I didn't trust my body's ability to conceive and carry life... and how can you have that trust when you spend years TTCing... only to have a miscarriage happen... or nothing happen at all? It's hard to trust a body that hasn't done what so many of us believe it should easily and naturally do...

You add to that a doctor who basically, before she even got my test results, told me I had less than a 1% chance of having a baby and I find myself asking, "Am I going for something I can never have? Is all of this going to be worth it in the end?"

And then I look at the test results (at age 45) that have come back:

  • WBC: 8.5 x10E3/uL

  • RBC: 4.66 x10E6/uL

  • Hemoglobin: 12.7g/dL

  • Hematocrit: 40.2%

  • MCV: 86 fL

  • MCH: 27.3 pg

  • MCHC: 31.6 g/dL

  • RDW: 12.7%

  • Platelets: 295 x10E3/uL

  • ABO Grouping: O

  • Rh FActor: Positive

  • Hemoglobin A1c: 5.3%

  • T4, Free (Direct): 1.19 ng/dL

  • DHEA-Sulfate: 53.2 ug/dL

  • Testosterone, Serum: 16 ng/dL

  • Progesterone: 19 ng/dL

  • Thyroglobulin Antibody: 8.1 IU/mL

  • Thyroid Peroxidase (TPO) Ab: 183 IU/mL

  • AMH: .64

  • Vitamin D: 19.22 ng/mL

And then my husband's first semen analysis also came back with some issues...

Other than putting in the results "Will discuss results of blood work at your follow up appointment", nothing else has been said by my doctor... Oh, and the things highlighted in bold (thyroid, AMH and Vitamin D) are considered to be at 'abnormal' levels.

So... for the next two weeks, I'm left to use Dr. Google to understand the above numbers and think through what I'm going to do next... without feeling like I have tremendous support from my reproductive endocrinologist.

I say all of this to say this- I am going to find a new IVF doctor...

And if you find yourself in a similar dynamic with your RE, I highly recommend you do the same.

There is NO reason that you should waste a month let alone a year working with ANYONE who is NOT on your team.

From the bloodwork my current RE has done, a few things become clear to me:

  • I have some sort of autoimmune disorder (thyroid issues) which will require medication, a stricter eating approach, and definitely more time in the sun to get more Vitamin D

  • While my AMH at .64 is above average for women my age (at 45, the average is .50), it's below the 1.00 threshold that doctors like to see for IVF- so I have some work to do there

  • I need to lose the weight. I am approximately 100 pounds (yes, 100) over where I'd like to be; that has to be impacting my fertility, even if it's only by a little

  • There's some work to do to improve my husband's sperm morphology. With a morphology of 0%, there's definitely opportunity for improvement. The good news is that men with morphology of 0% still help to conceive healthy babies naturally so this is a matter of improvement and doesn't mean that things MUST go the IVF route

So... back to the issue of the IVF doctor.

Here are the 7 things I'm going to do to find an IVF clinic that supports women over 40 WELL:

  1. Get all initial testing done: I'm going to wrap up all the testing with the current reproductive endocrinologist. I still have a hysteroscopy and some other initial scans/ultrasound/bloodwork things to do and I want to finish up all of the initial testing with her.

  2. Decide what treatments that will/won't be done by the current RE: Because I now know I may have to go out of state for treatment, I may consider doing 1-2 IUIs with the current RE to have those attempts (and the results of them) available for consideration in developing future treatment plans.

  3. Conduct AT LEAST 3 initial IVF consults: I'm going to consult with AT LEAST three other IVF clinics (preferably in person) to get a sense of the RE's feeling about women conceiving with their own eggs in their 40s.

  4. Commit to NOT settling: I'm making the commitment to NOT SETTLE- If I do the three consults and don't like what I find, I'm committing to myself that I'll do more research, do more consults UNTIL I find a clinic that feels right to me. Yes, I will still feel the clock ticking as I do this but I'm going to make myself give myself the time I need.

  5. Choose a clinic that does mini-IVF: I'm going to choose a clinic that does mini-IVF and believes in gentler approaches for women over the age of 40. Standard IVF can be harsh on a 40+ woman's body and impact egg quality. I want an RE who understands this and is willing to do IVF.

  6. Decide what other specialists to see and set deadlines for when to see them: I'm going to consider going to see Dr. Andrea Vitale to deal with my endometriosis. Make no mistake- I don't want to have to travel to New York City and I don't want to have surgery to remove endometriosis so I'm giving myself a year (from 45.5 years of age to 46.5 years of age) to try other things. IF nothing works, then I will do the consult with Dr. Vitale at 46 and a half and go from there. I really don't want to have to do the endo surgery but we'll see how that goes...

  7. Find ways to enjoy and live life: When you make your joy, your goals, and your dreams a priority, you start to set similar NON-NEGOTIABLE standards for those who will be involved in your life. That includes your selection of an IVF doctor. For the last three years, I haven't really focused on losing weight because of all of the controversial recommendations about working out versus not working out for fertility. While I no longer am at a point where I can work out 2-3 hours a day, 6 days a week, I am going to ramp things up and make losing weight an important focus because my body matters to me... and the way it looks and feels matters to me... and I am no longer willing to put that dream on the backburner for this one. I am putting my dreams back to the place they belong-front and center and now that I'm no longer settling for my own second best, I can consult with IVF doctors KNOWING that I am unwilling to settle for less from them either. Again, I set the standard and hold everyone (including myself) to it.

Feel free to apply these seven steps to your fertility journey... and please share this post with someone who could benefit from reading it...

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