Gaby was 31 when she started to try for a baby with her husband Tim. She already had a five-year-old daughter from her previous relationship, so she didn’t think it would be a problem. It took 8 years before she become a mum again ahead of her 40th birthday.
Age impacts fertility
The couple met at work as Gaby explains: “We were set up really, as we were both judges for this talent competition at the holiday park where I work.”
The couple were together for three years before they married and started trying for a baby. Gaby remembers:
“After we married, I thought it would be easy to get pregnant. It was our New Year’s resolution to go for a baby, but it wasn’t until eight years later that he finally showed up.
“My periods were like clockwork – I always knew when it was going to come on; it was always ‘bang on’, a full proper period with cramping. I thought: ‘everything is working okay, so I don’t understand why there is a problem with me’. It was stressful.
“We went and had all the tests with the NHS. At first, they said there was nothing wrong, but as time went on they started to say I had a low ovarian reserve.”
A woman is born with all the eggs she will have and these are gradually lost until about 35, when the process accelerates. The AMH test gives an indication of the ‘ovarian reserve’ the supply of eggs at the time of testing, but this does not give an indication of future fertility. When all the eggs are gone the woman enters menopause.
Using Clomid to stimulate ovaries
“I was nearly 32 when we started trying but the clock carried on ticking and nothing was happening. I began to panic because there weren’t many eggs left and time is of the essence.
“I went on Clomid to stimulate my egg production. I thought: ‘right, this is it; this is going to be our little magic spell – this should really speed things up’.
“But things still weren’t working and I was having so much intercourse that I just didn’t want it anymore!
“Eventually we were told that we could keep trying or go for IVF, but as I already had a child we wouldn’t be eligible for funding.
“That was quite scary, because from our research it seemed like a woman of my age only really had a 20 per cent chance. We thought: ‘oh God this is a massive gamble, we are not wealthy people at all’. We scraped everything together – we didn’t get into debt, but we did live off beans and toast to make it happen. If we hadn’t, we wouldn’t have Casper.
Chose Bourn Hall for IVF treatment
“We chose Bourn Hall because it was close, the nurse at the hospital recommended it and we had a friend who had gone there and had successful IVF.
“I felt sad for my husband more than anything, because he didn’t have any children and he really wanted a child of his own with me. Suddenly you find someone you are serious about and get married and you want to do everything right this time. I had the opportunity to have that and I couldn’t.
“I also felt bad because it was like the NHS was saying to Tim: if you had picked a wife who didn’t have a child then you could have had funding. And I did feel that being a woman over 30 the panic was on my behalf, to try and get this baby we both wanted it so badly.
“Covid had struck and we were putting all our holiday funds into having treatment.
“Obviously, it is a big financial strain; there are all these different packages where you pay for so many cycles and if it doesn’t work you get some money back. It is really hard to know which package to go for. The one we chose was for two goes. We thought: ‘if you pay for two and it works the first time then happy days, and if not we’ve got a second go – but if it doesn’t work on the second one then we need to re-evaluate’.
Getting older all the time
“We had our first telephone consultation with the Bourn Hall Wymondham clinic in 2020 just after the first lockdown.
“The doctor went through everything, but I couldn’t get my head around it. I was thinking: ‘I have only got this one telephone call – I need to get everything right in my head’. I felt like I was asking a zillion questions.
“I went for a scan at the clinic in Wymondham. At the scan they checked the lining of the womb and my follicles.
“But after all the tests and things I couldn’t actually get booked in until November, as the clinic had just reopened and they were giving priority to those who had already started treatment.
“Then I got Covid…so that got cancelled, and then rebooked for January 2021. I was so gutted. With me getting older I was panicking about the time.
Infertility is a type of grief
“The first egg collection in January only produced four eggs and only two fertilized. I had both embryos transferred at day three.
“I was feeling hopeful because I had two embryos in me so I thought ‘if one of them doesn’t work the other one will’. We waited two weeks to do the pregnancy test and I was so anxious every day. And then I started bleeding. We did the test; it was negative. We just looked at each other thinking ‘it can’t be; really?’ You feel so disheartened.
“It was the most devastating thing. I was so wound up and upset– it really is a type of grieving, but you don’t actually believe it, you think ‘it’s not even a baby so why do I feel like that?’
“With no embryos to freeze, I knew I would need another fresh cycle so we had to start from scratch all over again.
“We said: ‘okay we have got one go left; if it doesn’t work this time I think we are going to have to draw a line under it and say we are not meant to have kids together and just accept fate’.
Threw everything at the last shot
“I took two weeks off work in the build-up to having the eggs collected so I could get my body completely relaxed. We went for nice casual walks, watched feel-good movies, I didn’t touch any form of junk food – not even a bar of chocolate! – and tried to relax completely, stay positive and go into it with a positive mindset.
“I suffer with anxiety and take Sertraline every day to try and calm myself down; this was recommended by a nurse as it has a low risk if you are pregnant.
“After the two weeks of mindfulness we went in the second time for the egg collection – this time I had eight eggs, which was obviously a lot more than I had had before.
“Six of the eggs fertilized and four were strong. There were two that looked stronger than the others at day five – blastocyst stage.
“On day five they asked if I wanted one put back, or two. You only have a short amount of time to make this decision. When you want a baby so much a part of you feels maybe we should put two back. But they said one had a better chance of working and with two we might end up with twins.
“We decided to go for one, which would give us another option if it didn’t work.
“We did have embryo glue as well, as this is supposed to help implantation. No one had ever recommended it, but I mentioned it to the nurse and they said we could go for it if we wanted it – it costs extra but it wouldn’t hurt. They don’t always recommend it because it doesn’t always work.
“I was a bit naughty because they said not to test early but I was so disappointed the first-time round that I thought I would do a cheeky test to gear myself up – and there was a line. I called Bourn Hall and they said it didn’t necessarily mean I was definitely pregnant; I needed to wait and do it again on the right day. This was positive too, but they warned me it was still early days – ‘be happy but don’t get too excited’ – and they invited me in for a seven-week scan.
“I went in for the seven-week scan and there was a little heartbeat! A little thumper – the beat was banging away. Through all of the pregnancy we called the baby Thumper because it was such a miracle – and even now we call Casper Thumper!
An obstacle to overcome at every stage
“You feel like everything has been a hurdle: how many eggs am I going to get? Are they going to fertilise? Are they going to make it? Will we get to day five? Will it implant? Will the second pregnancy test be positive? Will there be a heartbeat at the seven-week scan?
“And then after that: I am 39 – will the baby have Down’s Syndrome?
“It wasn’t until we had had our second scan that we felt a little bit more confident – but then even when I was in labour, I wondered if I would be able to deliver safely. Everything has been a massive hurdle to get to this point.
“Casper was born on 9 January 2022 and we felt ecstatic. My husband says the cup of tea we had in the delivery suite was the best cup of tea we have ever had, because we were just gazing at our little miracle and he was absolutely perfect.
A mum again at 40
“I turned 40 in March this year so I have just done it by the skin of my teeth. My daughter is now a big sister at 17 – she always wanted a sister or brother to play with, so although she wanted a playmate, she has now become a babysitter!
“When we brought him into the house it was tears all round! It was such a long journey; thank God we have got him and he’s home. He is ours.”
Fertility after 35
Clomid is often prescribed as a first line treatment to stimulate the release of eggs in women with irregular periods and achieves good results for many women. It stimulates the ovaries to increase the chances that a mature egg is produced each month, then intercourse can be timed to coincide with egg release (or ovulation) and this can boost the chances of natural conception.
Unfortunately, regular periods are not always a sign of regular ovulation, so it is recommended that the hormone levels are checked.
Anti-Mullerian Hormone (AMH) decreases with age as the ovarian reserve is depleted. The AMH test therefore gives an indication of the immature eggs present in the ovary and can help to determine whether and how urgently treatment is needed, and also how a woman may respond to treatment. A very low reserve may suggest that IVF may be more successful with donated eggs, but this is a discussion to have with your doctor.