This was my birthday cake last year when I turned 36. My aunts had organised a small birthday dinner for me at their place, which I am grateful for, even though I really didn't feel like celebrating. For me, as I grow older and older, my birthday is not something I feel I should celebrate anymore. I'm just getting more anxious because it feels like I'm running out of time. Women have what you call a "biological clock", which pertains to the relationship of a woman's age and her fertility.
I had just had my heart broken knowing that I didn't conceive at all. I had my hopes high thinking that my period was regular and never this late (it was 45 days long), and so there was a big part of me that was getting really excited, I might be pregnant. I already anticipated some symptoms like morning sickness, nausea, but of course, how would I know what it actually feels like. I had never been pregnant in my life.
So when I had severe painful cramps and heavy bleeding a couple of days before my birthday, I thought, did I miscarry? Were those clumps of blood that I felt and seen the remnants of cells forming in my uterus? Was it a miscarriage?
To put my mind at ease, I went to the Emergency Room with my aunt (who is a retired Obstetrician-Gynaecologist) as per her recommendation to get a check-up. Even my aunt was worried that it could be that. But like I said in my previous post, My IVF Pregnancy Journey Part 1, the nurses at the E.R. could not do anything. I had no choice but to wait until the morning to see my regular G.P. and hoping I could get immediate answers.
The doctor then ordered me to take the blood test, as I told her I had already taken 3 pregnancy tests a few days back, and they all turned out negative. The doctor said the blood test is the most accurate to determine pregnancy. At that time, the bleeding was still going on, but it was a regular flow. Even though I had that, there was still a small part of me that I might be pregnant. I heard that some women didn't know they were pregnant because they still had their period.
So I did take the blood test and the result came out two days later, exactly on my birthday. I went to see my G.P. again just to get a copy of the result. I had to be sure. Unfortunately, the test result was:
Right then and there, I asked my doctor if she could give me a referral to see a fertility specialist. She printed two letters for me: one for the private clinic (Repromed) and the other one for the government-subsidised clinic (Flinders Fertility). She also arranged for me to get cervical screening (or pap smear), more blood tests to check the levels of Vitamin D, thyroid function and my hormones, and the anti-mullerian hormone test (which is the ovarian reserve test). She said that it's very important that I had all these results prior to my first consultation so that the fertility specialists would have all the data they need, and that I would come prepared.
*** Note: The anti-mullerian hormone test cost me $90 as it is not covered by Medicare.
Results:
- Cervical Screening Report - Normal; Lower Risk for significant cervical abnormality; HPV not detected.
- Vitamin D - within normal limits
- Thyroid Function Test - Normal
- Hormones (FSH, LH, Prolactin, Oestradiol, Progesterone) - Well, I can't really read the result, but my doctor said they're all normal.
- Anti-Mullerian Test - for my age, I still have a high ovarian reserve.
Anti-Mullerian Test
| Reference Range (pmol/L) - picomoles per litre | |
|---|---|
| 20-29 years old | |
| 30-34 years old | |
| 35-39 years old | |
| 40-44 years old | |
| 45-50 years old |
For women who have been struggling with infertility, AMH or anti-mullerian hormone test is highly recommended because this test can indicate if they are likely of menopausal age already. It can also indicate the reproductive frame and if the ovaries are likely to respond to drugs in an IVF cycle (like how many eggs are to be retrieved from a woman's ovary in a cycle). The AMH test can also be used to detect and confirm if a woman has a polycystic ovary syndrome which gives a guide to the quality of eggs produced in her ovaries. What the AMH test cannot tell is whether a woman is going to have a baby. 1
My AMH test result was 23.1 pmol/L.
I just turned 36 years old at the time I took the AMH test. Apparently, when it comes to counting the fertility range of a woman, that age is not my exact age. So, basically, I wasn't 36 years old anymore, because the number of months when I was a fetus or a baby in my mother's womb should also be counted. When my reproductive cells were formed then, my ovaries had already started producing millions of egg cells. And as years had gone by, the number of egg cells produced in the ovaries were gradually depleting.
But anyway, that result - 23.1 pmol/L - meant that I still have an average number of eggs left in my ovaries, which means I am likely to have my menopause at around 50-52 years of age, so I'm still likely to have babies until I am around 41. The IVF may help push this up a little bit, maybe get pregnant beyond 41 years old. Also, with that result of 23.1 pmol/L, I am likely to get an average number of eggs in an IVF cycle.
Hope
In my previous post, I explained that we chose Flinders Fertility because it would be less expensive, even though we would have to drive 4 hours from our town to Adelaide. The private clinic, Repromed, has a branch in Port Augusta which would only take us about an hour to get there, but because it's private, they're way too expensive. We would not be able to afford that. Also, there's that 50/50 chance of us getting pregnant with either one of them, so we'd rather drive hours to the city, at least if it failed, then we didn't spend that much money in trying to get pregnant.
Anyway, knowing all about those test results gave me hope. I was excited about my first visit - I and my husband's first visit - with the fertility specialist. We had to wait for 4 weeks before our scheduled appointment with Flinders Fertility Clinic in Adelaide. I started counting the days down until 14th March 2019, and those 4 weeks of waiting seemed like forever. Meanwhile, I focused on my studies and work which gave me reasons not to stress about getting pregnant.
All photos are my own unless otherwise stated.
Related Post:
My IVF Pregnancy Journey Part 1
Reference:
1AMH - Understanding the Results by Dr Mary Birdsall