Tuesday, October 21, 2008

Failure

I am one of the youngest looking 35-year olds you'll ever see, five feet tall with a cute round face and big baby eyes. I see the signs of my own aging clearly in my face, the ever deepening under-eye shadows that are the curse of the sallow-skinned, the frown-lined brow calling out for Botox. But apparently what everyone else sees when they look at me me is a totally exhausted and very grumpy sixteen-year old inexplicably decked out in Eileen Fisher.

I was carded last week. When I laughed and told the waiter I was old enough to be highly flattered, he shrugged only half apologetically and said, "listen we have to card anyone under 30." When I told him I'll be 36 next month, he looked genuinely flabbergasted.

As a working woman, I have mostly found my exaggerated youthfulness to be a serious annoyance. Whatever one may say about the cult of youth in this country, the fact remains that age equates with experience and competence for most people. Look young and they may proposition you at the corner bar, but they won't promote you to the corner office.

With an outer appearance that makes everyone assume I'm much younger than I am, I was totally unprepared to be given news so terrible it has taken my breath away. Flattened me bodily. I appear to have entered perimenopause at the age of 35.

From the beginning of my fertility struggles, back in 2003 at the tender age of 30, I have always had one thing on my side. "Don't worry, you're still so young," everyone told me. And so my secret fear has been losing the one straight arrow in my quiver, the ability to conceive with relative ease and to produce genetically sound embryos. As an archer, I've been working with a broken bow, a body almost unable to shoot straight and send a baby out into the world. Four dead embryos. Four missed miscarriages. One live birth. Hitting the target that one lucky time meant everything, of course. It meant a child. And it meant that if I could only manage the strength of arm, if I could only muster the will to try again, I could seize another arrow from the quiver and I might, just might, score the pot shot that would bring another child. Now I have only broken sticks and shreds of feathers, dreams in dust.

When I didn't conceive last month, I went to Dr. Cookie Pie and said: "Let's do day three blood work." She said, "Are you kidding me? You're absolutely fine." I said, "I'm an information junkie. I'm about to turn 36. Let's just do it and see where we stand." I'd had a couple, that is two, episodes of night sweats over the last 4 months, and it had given me a little nagging worry. I wanted to reassure myself. And I thought that if my FSH had edged over 9, it might be time to think about IVF, to freeze some embryos from 35-year-old eggs, to give myself a fighting chance to carry to term with a viable embryo.

To my utter shock and grief, my FSH cam back at 15.5. Cookie Pie, always the optimist observed that my LH was 4.5 (when it would typically also be elevated with elevated FSH) and insisted that it must be a lab error. They ran it again and the numbers came back 16.5 and 5. They ran them yet again, and they came back 17.8 and 6. Cookie Pie will not believe it and says we'll try again next month with a different lab. Maybe it is a false alarm. But I feel devastated. These are the numbers of premature ovarian failure, numbers so bad no IVF clinic would even touch me.

The first thing I did, after hanging up the phone with Dr. Cookie Pie, was consult Dr. Google about premature menopause, whence I quickly discovered that it's associated with, you guessed it, hypothyroidism. And that information makes me feel enraged. Because no one, no one, not one person ever mentioned this fact to me. No one ever said, you had better try to conceive again the very instant you give birth cause your days are numbered. On the contrary, everyone spouted platitudes about primed pumps. Somehow, in all my googling on Hashimoto's, I never came across that little factoid. Or maybe I believed the hype about how I'm actually 16.

I am soo sad I am moving through my days in an utter fog. Tears come unbidden whenever I let my mind wander, and so I mostly try to pretend this is happening to someone else. I've told no one but my husband and my mother, but I have the oddest sensation walking down the street that everyone can sense I'm barren, that I'm a walking black hole.

Only here, in the safe virtual world of my fellow infertiles on the internet, can I stand to take this news out and run my fingers lightly over it. Thank you, thank you from the bottom of my heart for your comments last week. It means so much to know I am not utterly alone at a time when I feel so forsaken.

FSH.
Further Surprise of Hashimoto's.
Fantastically Shitty Hormones.
Failed Second-child Hopes.
Fucking Sorry History.

16 comments:

Shelli said...

Hi, I am a frequent lurker to your blog. Your post struck me, as I just had the same conversation a week ago with my RE. I am about to embark on a donor egg cycle, and when I had my required conversation as part of my pre-work, I mentioned that the biggest travesty was always being told I had more time. From three different OB/GYN's. I didn't, and I am as upset with them as I am with myself not opening myself up to testing until I was 37 (2 years after I gave birth to my son, and after my 2nd loss). It was tragic irony, as my body barreled from fertile to decidedly unfertile in just two years.

I am so sorry that you are dealing with this bad news. I know how you feel, unfortunately. And I wish things we so different for all of us.

Anne said...

Shelli

Thanks much for your comment. I am sorry for your difficulties but glad you've found a way forward. Hope you feel inspired by the recently A Little Pregnant Julie.

What makes my situation especially awful is that donor eggs probably aren't an option: my 4 unexplained miscarriages all occurred with genetically normal embryos from my eggs. So it would probably be a serious waste of money to put an embryo made from donor eggs in my uterus and expect it to eventuate in a live baby. This leaves the gestational surrogate plus donor eggs scenario, but it's really not one I can imagine entertaining. It also, obviously, leaves the possibility of adoption. But I am frankly unready to turn to solutions. I am in grief, somewhere between denial and anger, but in no mood for acceptance.

Anonymous said...

I just wanted to say I am sorry. It all sucks.

Anonymous said...

I too am sorry to hear this news.

Baby Smiling In Back Seat said...

You forgot one of the abbreviations for FSH:
(in)Fertility Sucks Hard.

I am so sorry to hear this. Sending you a hug today.

Aurelia said...

Hi,

I also have POF and got the diagnoses in 2002, but really started having issues in 98 when I was only 30, so i get where you are.

I have some things on my blog about my POF, but I have to say that I have never bought the crap that fertility is over with POF. I recently used DHEA on the recommendation of my RE, and concieved my son who is now 5 months old.

My FSH was measured as high as 80 and soared over 100 I'm sure. (I stopped letting them measure it at some point!, and just insisted on treatment.)

Seriously, you can do this too. A little HRT, and a little miscarriage treatment to support those embryos, like heparin and baby aspirin and progesterone...and what the heck, you never know, it might work.

Email me if you have any questions.

Anonymous said...

I just came from the Lost & Found to say that I'm sorry for all you're going through. This is very hard news no matter how you slice it. Wishing you some peace amidst your grief.

Sam said...

I am so sorry for you. I was diagnosed with high FSH (15 and then 17) at 36. It's a nasty bitter pill, and I am just so sorry for you.

Thalia said...

Oh Anne, I'm so sorry. What absolutely awful news.

I know you are not in the mood for solutions, but I know that the latest studies show that FSH is a poor proxy for ovarian function, particularly in younger women. AMH is a much better predictor. Since you are an information junkie, perhaps it's worth asking dr cookie to check that?

Shinejil said...

Here from L&F. I sorry you're faced with this crap outcome and this big slap in the face. I never knew that about Hashi's, either.

I've also never quite gotten secondary IF--that is, until I read your previous post. I have to thank you for that, as it makes me a better person who will now be able to be supportive to my IF buddies in different but difficult circumstances.

Anonymous said...

I'm sorry that yiur facing this.

LEV

Anonymous said...

I found you through lost and found and had to stop by and give you some support. I was diagnosed with POF a few years ago during my IF treatments, my first high fsh reading came when I was 32. My fsh swung from 5 to 20 in the years we were testing. I never did conceive, but have completed my family through adoption.

I'm sorry you got this random diagnosis. I think I know how you feel and I hope you'll be one of the lucky ones who's fsh is not a good predictor of ovarian function.

Anonymous said...

Dear Anne, I was so shocked to read your news in Lost & Found. One factor in my shock was that I thought I was subscribed to your blog and that you hadn't posted, so I completely missed months' worth of your news -- please forgive me! But mainly, of course, I am so, so sad and sorry about your last losses and your diagnosis. That is such a blow. I hope that you are one of those lovely stories of success despite elevated FSH levels.

I had no idea about the Hashimoto's link to POF either. Don't know if we've talked about this before, and I'm sure you know much more about the condition than I do, so please ignore this if it's old (or even obsolete) information, but according to my endocrinologist (from a visit about 2 years ago) selenium supplementation (100mcg/day) seems to help suppress the immune response of Hashimoto's, and that you should avoid iodide at all costs -- no iodized salt either -- because it stimulates the antithyroid immune reaction. I am just mentioning this because iodide is in practically everything, especially prenatal supplements. Again, please forgive me if this doesn't help, but anything that could possibly help your thyroid might make your other hormones better...

Big, big hug, Anne. I'm thinking of you and sending you hope... and putting you on my Bloglines once and for all as soon as I send this.

Geohde said...

Here from L+F...

I'm so sorry.

J

Anonymous said...

Here from Lost and Found. This is awful news and I am so sorry you received it.

-Kim

Alexicographer said...

Also here from L&F. I too have Hashimoto's and high FSH and a son conceived through IVF after my thyroid problem got diagnosed and treated -- before that I had 3 unsuccessful IVFs and 2 unsuccessful FETs. Like you, I had "good" embryos; mine didn't stick.

I haven't gone back through your blog, so I'm sorry if this is old hat (as seems likely), but in case it's of some use, to the extent that the treatments involved in ART raise our estrogen levels (as they do), they "stress" our thyroids (T4 binds to estrogen, so as estrogen rises, the need for T4 does too). Since our thyroids can't respond (given the Hashi's), we need dosage increases while taking Clomid, or stims, or -- and this is true whether or not we use ART -- when we get pregnant (pregnancy also stresses the thyroid).

It took me 3 years to figure this out on my own and connect with a thyroid specialist willing to treat me accordingly (after I explained the ART process and its effects on my estrogen levels to her). It worked. My RE still doesn't know about/acknowledge this connection.

If you want more information about what I did, dosage-wise, and when, please email me...(ditto if anyone's lurking and wants more info.). I kind of winged it, but there are also some newer studies related to this issue; I can provide citations.

I'm sorry you're dealing with the high FSH news. It stinks. Good luck.