Giant bold disclaimer: Of course, I need to start out by saying that there is no one-size-fits-all approach to getting pregnant at an “advanced maternal age,” and that I what I did of course won’t work for everyone. This is simply my story of how we overcame “secondary infertility” at age 39 and went on to carry a successful pregnancy with no genetic or chromosomal abnormalities. I hope it helps you, and if it doesn’t — please know I have been there during those sad and desolate times, so very many times. My heart is with you!
On Christmas Day 2021, five + a half years after the birth of our only child, I saw a faint second line on a cheapie Amazon pregnancy test. (Trying to conceive? Just buy these puppies — they are cheap and accurate, with no false positives.)
This wasn’t new — we’d been trying to conceive for almost two years. We’d had one miscarriage at 7 weeks, and five chemical pregnancies after that. (A chemical pregnancy is where you get a positive pregnancy test, but lose the pregnancy 1-2 weeks later — usually indicating something was wrong with the embryo and the pregnancy wasn’t viable.) I’d become a bit of an expert at losing babies, and didn’t really expect my Christmas-second line to stick around.
I’d done every test possible. I was one month away from turning 40.
My AMH level (ovarian reserve) was very optimal considering my age — 3.7. (This is a normal level for a 29 year-old. I chalk it up to coming from a long line of fertile females, as well as how I eat and treat my body.) So I had lots + lots of eggs left.
My progesterone was normal. My periods were extremely regular. My uterine lining was fine; I had no genetic markers that cause miscarriage; no blood-clotting disorders. My HSG ultrasound showed nothing out of the ordinary; my fallopian tubes were clear. I got the dreaded “secondary infertility” diagnosis, which just means they had no idea why I kept miscarrying. (Cool cool cool.) My fertility doctor (whom an OB referred me to without even examining me, simply based on my proximity to turning 40) chalked it up to age & egg quality, but he was also very optimistic with my AMH level that we could conceive without intervention. I was, and am, very grateful to him for this, because he could have simply told me in vitro was my only option. We weren’t necessarily against in vitro, but it wasn’t financially doable for us, and something deep in my gut simply said “no” every time we thought about it.
C and I left the fertility doctor’s office and said to each other, “Let’s just try for a few more months. If nothing comes of it, we’ll be happy with the family we have and pursue it no further.”
Right around that time, a friend my age who had recently had a successful embryo transfer recommended a book to me called It Starts with the Egg by Rebecca Fett. I have learned through grief + heartbreak that books, though well-meaning, are not usually packed with miracles. Still though, I gave it a try.
It was a short read, well-researched, and very logical. She recommended a few supplements, all reasonably priced, for both men and women. C and I bought the supplements and took them for two months (we did not try during these two months, to give my developing eggs time to mature). She also recommended some diet and lifestyle changes, all of which were mostly easy for me to incorporate. To be honest, I didn’t expect much.
I already wasn’t eating sugar or gluten, or consuming any alcohol. This is a big hurdle that I recognize is hard for many people. I am an addict with sugar, so I don’t let myself have it, and gluten makes me inflamed. Fett also recommended steeply dropping, if not totally eliminating, caffeine. Now THIS was hard for me — I am normally the type of person who can’t even roll out of bed without coffee. Lowering my dose (even gradually) made me forgetful, sad and foggy for WEEKS. I thought my brain fog would never clear! It did, of course, but it took way longer than I’d imagined.
She also recommended eating a Mediterranean diet. This was pretty easy, since I already ate relatively healthy, and there is thankfully a sweetgreen right by my work. I started to load up on salads with kale, chicken, feta, sweet potatoes, and balsamic vinegar. It was delicious, actually, and I looked forward to my big salad every day. Breakfast was a Perfect Bar, and dinner was usually pasture-rasied meat and rice cooked by C. I made sure I ate eggs during the weekend. (He’s a personal trainer, so it’s pretty easy to eat healthy in our house.)
Another point the book makes is eliminating micro-plastics and harsh chemicals, which we had already mostly done years ago. We use all glass tupperware. My shampoo comes as a solid that you mix with hot water, and is free of harsh chemicals. I store it in glass bottles I got on Amazon. I stopped using Retinol and switched to bakuchiol. (It’s not as effective as Retinol. Nothing is.)
Eliminating caffeine 100% helped my sleep, which honestly has never been great — but I didn’t realize how much avoiding my main stimulant would help. I also started drinking more water, easier to do when you’re not guzzling coffee like a freak, at least 1.5 liters a day.
After two months of this, we decided to try. I use an app called Glow (it’s free) to calculate my ovulation window. I knew after a year of regular periods around when I would ovulate. (If your ovulation is irregular, I would recommend tracking with basal body temperature — there are lots of resources on this, and BBT thermometers are like, $10.)
The one fertility “helper” I took was a 20mg progesterone suppository (which any OB or fertility doctor will give out to you if you’ve had 2 or more miscarriages). I took it each night once I got into bed, timed at 5 days post-ovulation. The data on progesterone is still vague — a lot of studies show it can help women with recurrent miscarriages, but some studies show it doesn’t really do anything, especially if your progesterone is not low (which mine wasn’t). I already had it on-hand after the previous miscarriages, so I took it as a fail-safe, just in case.
We got pregnant that month.
Out of seven pregnancies in 18 months, it was my only pregnancy to stick. My fertility doctor had me come in and do blood work right away once I told him I’d had a positive test. The nurse called and said my HCG was over 3,000 at 5 weeks (during my prior chemical pregnancy, it had only been 24). I tested every day like a psycho. The lines got darker and stronger. Still, it felt too good to be true.
At 7 weeks, he had me come in for an ultrasound and we saw the beginning of a tiny fluttering heart. At 9 1/2 weeks, we heard the heartbeat, fast and strong. He reassured me then that my chance of loss was less than 5-10%. Still, based on the past, I worried.
For my 40th birthday, we went to Disney World. It was a trip we’d been planning excitedly for over 9 months. But oh my goodness, I was so stressed! Stressed about the strain on my body and walking 5-10 miles a day, stressed because the 70-degree weather we were supposed to get vanished and it was in the 40’s every single day, stressed because extreme nausea had kicked in and I could barely keep my prenatals down, stressed that I’d lose the baby on the trip. We also all got sick during the trip — it wasn’t COVID (we tested, were vaccinated + boosted, and V had already had it), but it was bad. We missed a couple of days in the park and just stayed in the room, resting. I felt much sicker, morning sickness-wise, than I ever had with V.
In the end, we came back from our trip. I was so convinced I’d lost the baby. But I had one more ultrasound, and there it was. The fertility doctor told me, “Congratulations, get out of here and go to a normal OB. You don’t need me anymore, this baby is sticking around!”
I saw the “normal OB” at 13 weeks. We did all the first trimester genetic testing (called NIPT testing) — everything came back normal. A high-risk OB did a 30-minute ultrasound with me where she painstakingly took every single measurement possible. That was also completely normal.
I saw my OB last week, and at the end of the appointment, I quietly asked her, “Is the baby still in there?” (After six losses, your mind can start to fuck with you.) “Oh my goodness, yes!” she said. “I promise she is still in there.” She pulled out her doppler to confirm, and there I heard that sweet, musical sound of a strong heartbeat. Sigh of relief! I get tears in my eyes every time.
So what is my take-away from all of this? Well, I obviously wish Rebecca Fett’s book would have come into my life sooner. But like all sadness & grief, I don’t know if deleting the six losses from my history is something I’d actually do if given the chance. Those lonely, sad months taught me a lot about myself — about acceptance, about hope in the face of what’s bleak, and about appreciating what I already have. I have a depth of compassion and kindness for people struggling with infertility that I never would have had without the last 18 months.
I am also so deeply grateful for my existing healthy child, even more now than I already was. Having even one healthy baby is a miracle!!!
I am also still cautious. Everything was perfect during my pregnancy with V until the end, which was really scary. I am painfully aware of how much can still go wrong, despite the doctors telling me to relax and that everything is progressing nicely. I’m only 17 weeks…there is a long way to go before I’ll get to have a baby in my arms.
That said, I am enjoying each day that this little person — currently the size of a “large onion” according to my pregnancy app — grows + lives within me. Despite the nausea, heartburn + food aversions, I count my lucky stars every day. I am hopeful that we get to meet this spunky kid on August 29th with no complications. And if that is not is what is to be, I am still grateful for this time, this miracle, this life. ❤
As always, I’m here to answer any questions you have, or even just to offer support if you’ve had sadness on your fertility journey.
Here for you, with love.