[Editor's note: In 2009, shortly after marrying her (first and only) husband, Paolo, Elizabeth Heath was diagnosed with premature menopause and resulting infertility. Paolo and Liz are now parents to a baby girl, Naomi. In this series, Liz recounts the couple’s struggle with infertility, and how they finally achieved a successful pregnancy and parenthood.]
FACING MY INFERTILITY
I was 41, nearly 42 when Paolo and I met. I’d never been married, but I hadn’t given up on the idea. I had, more or less, given up on the idea of having children of my own. I figured I’d meet some older, divorced professor or architect who had grown kids of his own, and settle comfortably into the role of cool stepmom.
But instead, I fell in love with a man six years my junior. He too had never married, but for whatever reasons, the planets aligned and we both felt ready to make the leap—very soon after meeting, at that. So it wasn’t until we were already committed to a life—and a family—together that I got the first hints that I was infertile.
Paolo was in Italy and I was still in Florida when we both began to set the wheels in motion to get pregnant. He had a sperm analysis, the results of which he proudly reviewed with me on Skype. Millions and millions of healthy swimmers. I, on the other hand, had less positive news to share.
THE NUMBERS DON’T LIE
I’d seen a reproductive endocrinologist, who ordered a standard battery of hormone tests to assess my fertility. Key among these are the FSH (follicle stimulating hormone) and the LH (luteinizing hormone) measures.
In simplest terms, the FSH is what sends the message to the pituitary gland to produce ovarian follicles, which eventually become mature eggs. The LH is the hormone in the pituitary gland that triggers the release of mature eggs so they can await their encounter with eager sperm. Both tests are usually run three days after the start of your period, as this is the time your body is gearing up for its monthly fertile period (ovulation), somewhere between 11 and 18 days after your period starts.
If the pituitary does not produce follicles, the FSH keeps sending the message anyway. So, a high FSH is a bad FSH—it means your body is working overtime to try to produce follicles, but nothing is happening. And a low LH is bad news as well; it essentially means that ovulation is not taking place. In fertile women, a Day 3 FSH of 9 or lower is the norm, and the LH is usually around the same. (The LH peaks later, closer to ovulation.)
So, you guessed it. I had a high FSH that should have been low, and a low LH that should have been high. Most troubling was my FSH result, which at 15, was indicative of a woman in pre-menopause.
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But wait. I was only 41. Lots of women have babies in their early 40s. I had always thought that when the time came, I’d be one of them. That unfounded sense of optimism in the face of daunting odds had gotten me through a lot of rough times, after all. Why not now?
The RE (reproductive endocrinologist) explained to me that my ovaries were functioning as if they were several years older than the rest of me. Plus, he added, every month that passed was like 3 or 4 months for my ovaries. The hands of my biological clock weren’t just ticking, they were spinning. I asked if there was anything I could do in terms of diet, supplements, or other non-invasive therapies to try to turn back the clock. He just shook his head.
He then took out a chart that illustrated the abysmal results that women with my “numbers” have when undergoing IVF, or in vitro fertilization. Next, he slipped a piece of paper across the desk that discussed IVF using donor eggs, as opposed to my own. The cost for the first cycle? $25,000, and that didn’t include fertility drugs, which would run another $5,000. Thirty thousand dollars! Win, lose or draw—no baby guaranteed at the end.
A DREAM CRUMBLING
I felt my face getting flush, and tears welling in my eyes. I’d finally found the man I wanted to marry—who wanted to marry me! We wanted children. We wanted to build a future together. And our happiness was already being shattered.
I mumbled to the doctor that I’d have to speak to my fiancé. When I got out to the car and checked my phone, there was already a text waiting from Paolo, asking how the visit went. In my then-horrible Italian, I texted him back: The doctor said no good. A text from him arrived: Call me on Skype when you get home.
By the time I arrived home after the short drive from the clinic, I was in pieces. I called Paolo on the computer, and promptly burst into tears when I saw him onscreen. I tried to explain as best I could what the results showed, but really, what did the details matter? Pregnancy for me was off the table—that’s basically what the doctor had said. Paolo tried his best to reassure me, saying we’d see a doctor in Italy after I moved there. I cried that I didn’t have that much time to lose—it would be more than six months before I moved, that we couldn’t afford IVF, that I wouldn’t use an egg donor.
Then, I said it. I told Paolo that he should find someone younger to marry. It might have been a silly and emotional thing to say, but I felt I needed to give him an out. After all, we hadn’t known each other very long. I knew how important it was to him to have children. Why should he tie himself forever to a woman six years his senior, one who would not be able to give him babies?
He very nicely told me to shut the hell up, and I loved him even more for it. Still, I wondered if he was starting to have second thoughts about his Americana.