Friday 24 November 2017

Why I faced biology and got my fertility checked at 32

Just how fast is your biological clock ticking? That's the burning question for women in their thirties who hope to start a family one day. Writer Deirdre Reynolds plucked up the courage to find out

Waiting game: Deirdre Reynolds holds her vial of blood after her fertility test
Waiting game: Deirdre Reynolds holds her vial of blood after her fertility test
Mick Jagger
Deirdre Reynolds

Deirdre Reynolds

Here's the tiny vial of blood that could determine whether or not I become a mother. Just a few cubic millimetres of blood is all it now takes to reveal the state of your reproductive health.

But be warned: once learned, the results can never be unlearned.

It's National Fertility Awareness Week. And one Irish IVF clinic is urging young women here to face up to the "baby question" - whether they're planning to have one or not.

Although babies are not part of my immediate plans, as a single woman in her early 30s, I've also heard the scare stories, and know that the window of opportunity isn't going to remain ajar forever.

For the growing contingent of friends who've already become mothers, just as many have confessed to struggling to gain membership to the world's most popular club.

And, like me, they're less than half the age of 70-year-old Daljinder Kaur, the Indian woman who made headlines earlier this year when she gave birth to a baby boy following IVF treatment.

With three siblings, six nieces and nephews and 60 first cousins, fertility has seemingly never been a problem in my family, and I've always just assumed it wouldn't be for me either, should I decide to start one of my own.

Read more: Irish mum (43) who conceived using donor egg after five rounds of IVF: ‘Every day with Clodagh is like Christmas because we feel so lucky’

Having spent most of my adult life actively trying not to get pregnant however, and now two years older than the average Irish woman giving birth for the first time, frankly I have no idea if I actually can.

As I sat in the waiting room of the Sims IVF clinic in Dublin, surrounded by couples not much older than myself, I realised it's not something I should be taking for granted any more.

Searching for a vein in my arm a few minutes later, Dr Lyuda Shkrobot explained how - at 32 - she'd expect my ovarian reserve to be around 10 nanograms per millilitre (ng/ml), but says she regularly sees younger women with levels less than a tenth of that.

"Recently we've changed a little bit of the measurement and it goes as low as 0.3 [ng/ml]," she explains. "You would expect normally a 0.3 in somebody who's 45 up to 50, but recently we've been having lots of younger patients with low ovarian reserve, I'd say partially [due to] the duration of the contraceptive pill.

Dr Lyuda Shkrobot takes a blood sample from Deirdre to test her ovarian reserve at Sims Clinic in Clonskeagh, Dublin Photos: Fergal Phillips
Dr Lyuda Shkrobot takes a blood sample from Deirdre to test her ovarian reserve at Sims Clinic in Clonskeagh, Dublin Photos: Fergal Phillips

"Some patients start on the pill when they're 14 or 15 and then non-stop take the pill up until they're 30. Sometimes being on the pill for such a long period of time, your ovaries forget how to work and therefore when you want them to work, they don't know what you want from them."

As I watched the shiny red fluid flow from my vein and into a plastic tube, it struck me that this was one test I wasn't entirely sure whether I was hoping to pass or flunk.

By my age, my own mother was married over a decade, and juggling four children under 10. As the youngest though, I've always been the one being mammied - rather than doing the mammying - and am probably better known for being a dog person than a kiddie person.

But as the saying goes, knowledge is power. So this test - which works by gauging the levels of anti-mullerian hormone (AMH), a substance produced by cells around the ovaries, in the blood and normally costs €120 - is this week being offered free to the first 500 patients in a bid to raise awareness of fertility issues.

"We have loads of patients [of] different ages from as early as 25 to as late as 45 who are coming to us for the blood test just to see what their ovarian reserve is," continues Dr Lyuda, as she bags and tags my blood sample before it's sent to the lab for closer inspection.

"A good few of them eventually become a patient because they've realised, 'Oh my gosh, my time is ticking'.

"Some of them went for egg freezing if they don't have a partner and [their] ovarian reserve is on the low side. We don't have a cut-off age [for the test], but really once you hit 45 there's no point going with your own egg because it's not the number, it's the quality."

Compared to our mothers and grandmothers, it's no secret that women of my generation, whether by chance or choice, have grown accustomed to putting the those big life decisions on the back burner. In Ireland, the average age for first-time mothers and brides has never been higher, at 30 and 33, respectively. We delay marriage and motherhood, then secretly breathe a sigh of relief when celebrities like Jennifer Aniston are decreed pregnant at 47 on the front pages - even if the "miracle baby" later turns out to be a "food baby". Or, at least, I do.

Don't get me wrong, as an aunt of six and godmother of two, I know a little something of the joys of snuggling up on the sofa to watch 'Frozen' on loop and scoffing sticky jam sandwiches for dinner.

And whenever I cradle the latest newborn welcomed by a family member or friend for the first time, I can feel my hardline approach to procreating softening ever so slightly - until it's time to change their nappy, anyway.

Three days later, the phone call of fate finally came. It was good news, according to Dr Lyuda, who declared my results to be "perfect".

"Your results came back 17.88 [ng/ml]," she revealed, "so you're right in the middle of the 50 percentile of the normal, healthy female. It's just absolutely perfect for your age group.

"Right now, you're in a perfect position to freeze your eggs," she added. "You have a very good ovarian reserve. I can get as many as probably 20 eggs per cycle and the quality should be good as well because of your age.

"[But] I wouldn't suggest leaving it because once you hit 35, it's the egg quality that's going to start to decline."

Hanging up, now officially "childfree by choice", I didn't know whether to feel happy or panicked. Apart from still being on the fence about having children in the first place, at €3,000 per cycle, egg freezing isn't really an option for me at the moment.

Even though it's the opposite of what the awareness drive set out to achieve, ironically I can't help feeling that I've just bought another couple of years before making the biggest decision of my life.

Still, I can't say I wasn't warned. Now that I know what's in my blood, ultimately it's time to decide what's in my heart - or accept forever remaining 'Aunty Deirdre'.

Sadly, that's a question no test can answer.

It's not just women who can safeguard their fertility

Mick Jagger

• Just like women, men are most fertile in their early 20s, with their fertility going into gradual decline from about the age of 40. Just like Mick Jagger, above, however, who's set to become a dad for the eighth time at 72, most can still father children in later life.

• Although largely painted as a female problem, around half of all couples who are struggling to conceive are actually thought to be affected by 'male factor infertility' - an issue such as semen abnormalities or erectile dysfunction.

• Smoking, drinking excessively (more than two standard drinks per day), taking steroids, wearing tight undies and, most recently, keeping your smartphone in your trouser pocket, have all been found to damage sperm.

• Men - particularly those experiencing loss of testicular volume - who are still having fertility issues should chat to their doctor, who may carry out sperm and semen analysis, hormone evaluation or genetic testing.

Irish Independent

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