I was honestly very naïve about the odds of getting and staying pregnant over 40 when I began my fertility journey. I thought since I was an active and healthy person my entire life I would be the one that could beat whatever odds there were. I also thought that since I was an acupuncturist and friends with some incredibly successful natural healers, I would have insider information on how to beat any odds there were. I now realize that getting and staying pregnant over 40 goes beyond cutting out gluten, reading “It Starts with the Egg,” taking supplements, meditating, practicing yoga, and seeking help through advanced reproductive technologies.
I’m a typical urban dweller and put off trying to start a family until I was 40. I did not think I would have any problems getting pregnant. Over a year went by and nothing happened. I spent that time just trying more and more natural remedies. I was getting treated by the top acupuncturists. Many people in the natural healthcare community make their living teaching how to treat infertility to other healthcare providers. I thought I was obtaining insider information by taking these classes and that I would succeed in no time. The day came when I finally sought out help from a reproductive endocrinologist. I knew from experience in my acupuncture clinic how low the success rates were for IUI, so I asked if I could jump straight to IVF. I was going to be 42 soon.
It’s a blur now how I ended up with my physician and my clinic. All of my acupuncture patients going through fertility treatments are pretty much doing very similar protocols, so I just went with a large clinic that could accommodate my hectic work schedule and my insurance. As with everything in life, there are things I like about the clinic and some things I absolutely loathe. One thing I cannot stand is that my clinic takes efficiency a bit too far. Any human aspect of treatment is lost during IVF. They make women waiting in queue for egg retrieval wait together in a small area so we can get rushed in without the physician having to wait too long between women. Talk about awkward.
During my first IVF cycle, there were three of us sitting together and the two other women knew each other. One was banking more embryos and the other was back after a failed round. I remember thinking to myself, “there is no way I am going to be back here like them—I’ve got this.” Three days later, I did a fresh transfer. I finally saw my embryos. I had one embryo that looked so perfect, it could have been in a reproductive endocrinology textbook. Since I am a high roller, I transferred all four of my good embryos. I was even hoping for triplets to get everything over with at once. Two weeks later, I went through the dreaded slow-rising beta hell that turned into my first miscarriage.
I decided to do another round of egg retrievals. I had a perfect heartbeat at my 6-week visit. If you have a good heartbeat at 6 weeks, the odds of success are very high, even if you are in your 40s, according to anything published in Pubmed. There was no heartbeat at my 8-week visit, and I had another miscarriage. Most people assume you must have either a thyroid, blood clotting, or immune disorder if you are having recurrent miscarriages. I ran the labs. Everything looked great. I even had my uterus probed and biopsied.
I’ve had many patients do the reproductive immunology thing and still not have success. I’ve had patients in my clinic take every drug imaginable for their thyroid, blood-clotting disorder, insulin resistance, etc., and still not have success. I’ve had patients do surgery after surgery for endometriosis, polyps, fibroids, etc., and still not have success. I was very conflicted about what to do at this point. There are people that criticize the lack of evidence for acupuncture, but they don’t have a problem with the lack of evidence for many of these reproductive immunology treatments or the lack of evidence for many infertility treatments in general.
Very shortly after my second miscarriage, I got naturally pregnant. Things did not go well from the beginning. It was right before Christmas when I had my third miscarriage. I could not understand why I was having problems. I was doing everything right. I was taking the right supplements and herbs. I ate the right diet. I did the right exercises. I have avoided toxins for my entire life. I had the right mindset. I was meditating and doing fertility yoga. I was in touch with my spirit baby. I even did IVF twice.
The majority of women at my acupuncture clinic eventually have success. I have had patients with fibroids the size of a baseball get pregnant. I’ve had patients with very low AMH or high FSH get pregnant. I’ve had patients that were perimenopausal get pregnant. Why was I having problems when these patients weren’t doing half of the things I was doing? Why were my patients with much worse odds than me having success? Was there a higher reason why? Was I not meant to have children?
A few months later I got naturally pregnant again during the COVID-19 pandemic. Mixed emotions don’t begin to describe what I was feeling. I had one bizarre beta that did not rise appropriately but everything else was normal enough. I had a good heartbeat at 6 and 8 weeks. I finally graduated from my reproductive endocrinologist’s office. I thought I beat the infertility code. Something I did finally worked. The miscarriage rate is about 50% for my age, which is the same as flipping a coin. The odds of flipping heads four times in a row are incredibly low. I had about a 6% chance of having a miscarriage at this point.
I went to my new OBGYN’s office, and again there was no heartbeat. Since a D&C was considered an elective procedure during the COVID-19 pandemic in NYC, the OBGYN could not help me and I was sent to Mt. Sinai’s abortion clinic, even though the procedure is identical. I have not gotten back to normal after this miscarriage. I have probably developed Asherman's syndrome or some other uterine anomaly that has stopped my period. The journey to birthing my own children, even with donor eggs, is most likely now over for me.
I received a call from my aunt a few months after this miscarriage asking me if I wanted to adopt her husband’s niece’s baby. His niece could not afford another child and wanted the baby to go to a good home. Maybe things will work out in the end. I don’t know yet. Maybe I was meant to go through all of this. If things worked out easily for me, I would not have learned everything you could possibly know about infertility. There is a difference between the knowledge you obtain by experience and the knowledge you obtain from a book. I began my journey thinking if I did what all of the natural healthcare experts say to do along with IVF, I would have success. I have learned that life is more complicated.
My friends tell me I should keep my story a secret. It’s bad for my acupuncture business. People don’t want to hear about failures. There is some truth to that. Women early in their journey don’t want to know the truth about infertility. Lena Dunham recently wrote an article about her single round of IVF failure, as if that is an anomaly. The majority of women undergoing IVF will fail their first round. Lena is the norm, not the exception. It’s tragic she thinks it’s over already. She was probably lied to and given false hope that things would work out quickly. Beating infertility takes time for the majority of women. There are no shortcuts or magic pills to speed things along.
My advice is to aim to live your life in optimum health without making it so restrictive that it takes the joy out of living. You don’t need to take every supplement to succeed, just a handful of critical ones. You don’t need to go on crazy diets. Many people in the natural healthcare community scare people away from doing IVF. There is nothing wrong with doing something that isn’t ‘natural.’ Don’t feel bad about your choices. Don’t feel bad about failing over and over again. You are not alone. Have hope. Getting and staying pregnant over 40 is possible. I see it with my patients all the time. But it is not easy for most people. You can do everything right, like what I did, and still fail. You can do hardly anything and just do acupuncture a few times and succeed. All you can do is try each month and see where this journey takes you.
Dr. Christine Palma, L.Ac, DACM, is one of NYC’s top fertility acupuncturists. She has successfully helped women struggling with infertility caused by endometriosis, polycystic ovarian syndrome, premature ovarian failure, advanced maternal age, thin endometrial lining, irregular menstrual cycles, and recurrent miscarriage. Her clinic, Fire Over Water Acupuncture, is located in the Manhattan neighborhood of the Upper West Side.