My life changed in three years

 

-        When Melanie found the guy, she wanted to spend the rest of her life with, he was 38 years old. Would it be too late for them to start a family? She had been inundated with information about fertility waning around 35 and was eager to attempt IVF at 40.

Before meeting Mark, I had always wanted children but had never found the appropriate partner. He claimed he didn't care if we didn't have kids, but I knew he did.

I wasn't one of those girls who was frantic to have kids, but I just always felt that if I didn't have kids, my life wouldn't be complete. Even as I grew older, I believed that IVF would always be available. I never considered even for a minute that IVF won't work at 40.

I'm from South Africa and have spent the last 19 years living in the UK. I met my spouse when we were both 38 years old and working at Canary Wharf in London before the epidemic. Mark was 39 at the time. We met on Tinder, where there are a lot of sketchy men, but he was honest and had a good family.

After meeting in March 2017, he proposed to me on Christmas Eve. In 2018, we wed in Cape Town.

Ø IVF at 40

We had to act quickly if we wanted to start a family. I've always had a regular cycle, so I can nearly always predict when I will ovulate. Due to my advanced age, when it took longer than expected, we went to our gynaecologist. She suggested that we get the AMH test done privately so that we could get the results more quickly. The Lister Hospital then referred us there for testing. Ovarian reserve can be determined by an AMH test.

I could utilize my eggs for fertility therapy because my AMH level was good for my age, but I was cautioned that egg quality and quantity decline beyond the age of 35. When Mark's test results were revealed, his sperm's morphology and motility weren't very good.

After completing all of these steps, our GP and the Lister Hospital determined that we qualified for an NHS-supported IVF treatment cycle. However, because I am over 40, I was only permitted one funded round. In December 2019, it was confirmed and we started the treatment in January 2020.

Ø One cycle of IVF funded by the NHS

We decided to attend Bourn Hall Cambridge because my friend had found success there and because other people had recommended it.

I applied every strategy I knew: I changed my food, and my products, gave up alcohol, took all the vitamins, drank tonnes of healthy smoothies, and talked to a specialist who specializes in fertility.

In 2020, egg collection began at the beginning of March. Since the pandemic was still in its early stages, nobody knew what was going on. Only two of the four embryos produced in this new cycle survived to day three and were both transplanted at three days.

Mark was permitted entry for the egg collection and embryo transfer, but Covid prevented him from entering for the eight-week scan (note this has now changed). The scan confirmed my pregnancy.

Ø Losing the pregnancy

I had a strong feeling that I needed further scans, especially considering my advanced age.

A few weeks later, I paid for a blood test and a Harmony scan at the Lister Hospital to have some confidence. I was just hoping for the best while Mark had to wait in the car outside the hospital. However, doctors were unable to locate a heartbeat since I had miscarried. They offered me the choice of what to do next and allowed Mark to come in to see me. They didn't want me to go home and take a tablet, so I chose to have a procedure called a manual vacuum aspiration instead of going to the hospital, which they had warned against because of Covid.

We had only completed one sponsored IVF round at the time, and it was the first time I had ever been pregnant.

The next one had to be paid for out of savings.

Ø More possibilities for therapy that is self-funded

As they don't know how you will respond to the drug, they give you a protocol for the first round based on your findings and medical history. However, during the second round, they can use information from your past reaction to treatment to personalize it to you.

We used ICSI for the initial round, in which the sperm is inserted into the egg. The HFEA lists IMSI as an "unproven treatment," but I wanted to take every step possible to increase the chances. IMSI enlarges the sperm to a greater level so it is simpler to select the best one.

This time, Mark was unable to accompany me due to the ongoing pandemic. Nine embryos were produced by the procedure, and four of them survived to the five-day blastocyst stage.

Ø Sadly, I miscarried once again

The first time was a "missed miscarriage" because I didn't realize I was no longer carrying the baby until the second scan, but this second time, I was told it was a "blighted ovum," in which the embryo fails to develop and leaves an empty sac. This time, I was told to miscarry naturally, but after 10 weeks passed without anything happening, the Lister suggested that I take the pill.

Still, because of the epidemic, I had to go back to the car and tell my husband that he couldn't come in for the scan. We were heartbroken. I tried to remain optimistic despite my repeated thoughts that my age was the reason IVF at 40 would never be successful.

Ø I didn't want to waste any time

I didn't want to spend any time because, despite being heartbroken, I felt fine. Many women experience severe depression, which I completely understand; perhaps I am a little tougher than others. I was distraught after the second miscarriage and the first was dreadful, but I tried not to think about it too much. I didn't want to spend any time; all I wanted was another round.

I continued to have regular periods that came exactly on time every month like clockwork. I was still generating eggs. I never gave up because getting my hubby to take vitamins was difficult.

The choice of when to begin the subsequent round was made after we learned that we had three additional frozen embryos, which gave us some hope. Ultimately, we began using two of the frozen embryos in January.

I don't believe I would have used donated gametes if it hadn't been successful. I doubt I would have had kids if I couldn't use my eggs or my husband's sperm.

Without them, we would have decided to enjoy our lives, earn our money, and travel the world.

Ø Natural transfer of frozen

I performed a good deal of research. Do your homework, I would advise other people. I believe it made all the difference since it made me feel more in charge.

The alternatives for frozen embryo transfer and their ramifications were addressed when I walked in for the appointment. I asked about a "natural frozen transfer" because a friend had mentioned it, and the consultant said that a natural cycle would be an excellent option for me.

For a natural transfer, you must have regular periods. You then take only progesterone, skipping the other hormones that control the cycle, to help the uterine lining become receptive to the embryo. The transfer is timed to coincide with the natural cycle, which is less predictable than a cycle regulated by medication but may be a choice for certain people.

I had a scan, during which they measured the thickness of my uterine lining and the development of my natural follicles. They scheduled the transfer and instructed people to come in on a specific day to complete it. I believe that this was the key; without the oestrogen hormones, I was less stressed and I believe it was much better for me.

On the day I was instructed to take the pregnancy test, I did so at 4 am following the freezing round. Although it was positive, it appeared strange, as if the dye had crossed over from the control line to the test line. I didn't completely grasp what was happening, so before going to bed, I Googled it. The results indicated that twins and/or high hormone levels may be to blame.

I only wanted to see a heartbeat when I went in for the ultrasound.

Ø Mark looked and sobbed

I left Mark in the car for the eight-week scan and entered Bourn Hall [Note: this has now changed and partners can now attend early pregnancy assessment scans]. I was unable to stare at the screen, and the nurse understood. After ten seconds, she advised me to call my husband since there were two heartbeats. I was in awe of it!

Mark looked at me and started crying when I was able to call him on a video call. After two miscarriages, you don't think it's going to succeed, so he was really upset and as white as a ghost. We were also extremely excited but also obviously in a state of shock.

Matilda and Oliver were born at the Lister in October 2021, four months after I turned 43. I reached my due date at 37 weeks.

Even if it hadn't worked, at least I would have known that I gave it my best effort. Fortunately, everything worked out: after two miscarriages, we had twins, and it was well worth the effort.

"Being a parent in my 40s has been a wonderful blessing," Mark continues. I initially experienced such a sense of relief when the twins were delivered since the horrible feeling that develops after the miscarriages we experienced never goes away. After Melanie gave birth, that emotion vanished and was replaced by an intense sense of pride and relief. Being blessed with healthy twins makes us feel incredibly lucky.