Struggling to conceive again

I am struggling with second child infertility and looking for suggestions. I easily conceived at 37 and gave birth shortly after I turned 38. I have been trying to conceive again since my period returned at 39. Now I am almost 42. I have seen several types of doctors and alternative practitioners but I have not been able to find the right match. A big part of my struggle is the distress at being unable to have a second baby naturally. I was so awed by my body's ability to make a baby -- everything was simple and wonderful from conception to birth -- and I was so intent on experiencing it all again. The difficulty I'm having conceiving again has been quite devastating. I went the midwifery route for pregnancy/childbirth, and have been looking for a similar type of care for fertility but coming up empty. I like the midwifery approach of respecting the body and using scientifically-grounded, low-intervention solutions to any problems. I also like the warmth and nurturing of that type of care. Straight-up fertility doctors are too aggressive and clinical and, frankly, depressing for me. The alternative practitioners just aren't my thing. I am not a taker of supplements, tinctures, etc. A prenatal vitamin is the extent of my tablet-taking history. I am rather frightened of medication and injections that alter my hormonal environment in unknown ways and fertility doctors don't do much hand holding. For a variety of logistical and emotional reasons, I've been kind of paralyzed about this whole topic (not to mention stressed and depressed). Plus the pandemic has been hard for me and I've felt unable to add the additional stress of fertility treatment to my life. Meanwhile each cycle keeps coming and going. I need to take action or accept that I have one wonderful, healthy, delightful child and that's enough. So I'm seeking either 1. a recommendation for a great doctor who you think would be a good match for me or 2. some help letting go of my sorrow and accepting having a single child. Thanks in advance.

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RE: Struggling to conceive again ()

I'm so sorry you're dealing with this. I conceived both of my babies through IVF (currently 36 weeks pregnant with my second) and I definitely attest to what you're saying - it's impersonal and quite medical. But for me, the outcome was worth it. I haven't personally worked with them, but I hear Kindbody might be more of what you're looking for - a fertility and women's health clinic that's by women for women. Still very medical, but with more of a personal and compassionate approach. Best of luck to you. 

RE: Struggling to conceive again ()

Fertility starts to dip around age 35, but accelerates rapidly at 40. At nearly 42, there's a good chance you are no longer able to conceive naturally.  IVF is not very effective in women over 42, as any reputable reproductive endocrinologist would tell you. Would you consider using an egg donor? It's expensive, but less so if you pay for a split cycle. I think DE moms are just as bonded to their non-genetic children as their genetic children, although I realize it's not for everyone. 

Adoption is another option of course, but there are few infants available these days and adoption agencies will tell you that older children and sibling groups are you best bet. 

RE: Struggling to conceive again ()

i'm sorry, infertility is really hard. you could try acupuncture, though it doesn't have a great track record of actually helping conceive - reproductive endocrinologists (REs) will be the only ones you can turn to for that. Peggy Orlin is a great therapist in Berkeley specializing in infertility, she knows all the options and could possibly help you work through both 1 and 2 options. She also works with Pacific Fertility Clinic, Dr. Givens there is quite compassionate as an RE if you want to try a different one.

RE: Struggling to conceive again ()

After 5 miscarriages and at age 45 I went to see Carol Lourie. After a deep fertility cleanse and taking lots of supplements TD - maybe 20 pills a day for 4 months, and her suggestion to see Spring Fertility, I got pregnant the first time we tried again with the addition of a follicle stimulant given by spring. Yes it was a week of injections or so and that was not fun but my beautiful baby at 46, now almost 4 was with every pill!

RE: Struggling to conceive again ()

There's a Slack group I'm a part of for people who are or have struggled with infertility (largely a group of people who have used or are using IVF, surrogates, etc). It's a group that shares recommendations, best practices as well as does a lot of venting/listening and sharing each others' stories. I'm happy to refer you if you'd like; please DM me if you're interested. 

RE: Struggling to conceive again ()

I totally understand what you are going through.  I conceived very easily at 38 and have my daughter at age 39.  We waited a year or so and attempted for at least 3-4 years to have another baby.  My doctor informed me that unless I wanted to start the whole fertility process, I had better give up the ghost as it were.  In addition, my doctor informed me that I had begun the whole perimenopause business.  So you should ask your OB if that is a possilbility for you at your current age.  Having an only child is not a big deal.  We have our only child and while we had ideas of adopting or foster parenting, our daughter did not like either idea and wanted to be an only.  She has great friends and has grown to be very independent.  She is close to her older cousin who has become a brother figure for her.  It's okay to be a one child household.  Relax and enjoy your child.  Stop putting pressure on yourself which is making you stressed.  Just remember that as you get older, you put your life and the life of the unborn child at risk and all the potential birth defects for older moms.  Take care.

RE: Struggling to conceive again ()

I'm sorry to hear about your struggles. We also struggled a bit to get pregnant again (we had our first son in April 2017, when I was 34; I'm 39 now), and it was very distressing for me for awhile. Two things:

1) Acupuncture can be helpful for some women. I went to Berkeley Community Acupuncture because it's more affordable, and had a great ongoing experience with Thuy; there are more expensive places that may "specialize" in fertility.

And 2) after going through months of distress/depression and feeling like it was haunting me and getting in the way of enjoying my child and my family, I sought out therapy, and my therapist helped me directly address my ongoing issues. It wasn't until I addressed my feelings that I was able to regain a much stronger sense of contentment with my life, and I'm guessing it was not a coincidence that I finally got pregnant once I reached that point.

I hope this helps. As a side note, after our frustration with infertility, I ended up getting pregnant with twins (born October 29th), and twins/multiples are more likely to happen for those of us in our late thirties/early forties . . so be careful what you wish for! ;) (I joke, of course; just mentioning it because we never, ever expected to end up with 3 children.)

RE: Struggling to conceive again ()

I’m sorry you’re going through this. Infertility is so devestating.

It sounds like a good therapist would be helpful, as well as a reproductive endocrinologist. A therapist can help you with your grief over not having a second child in the easy, natural, no intervention way you wanted. They can also help you decide whether to keep trying or make your peace with being a parent of only the child you have.

In terms of a fertility doctor, I liked Dr. Heather Huddleston at UCSF. I felt like she was kind, understanding, and has a good bedside manner. She also always gave me choices in how we proceeded.

To speak frankly, midwives are specialists in “normal childbirth”. When things become higher risk or more complicated, they have to transfer to doctors to provide medical intervention. In the fertility analogue, you are are in a more complicated situation requiring medical intervention. It’s 42, with 3 years of infertility struggles, I think you either need to get medical intervention help from a reproductive endocrinologist or make your peace with having just one child.

That said, getting medical interventions to help conceive in no way rules out midwifery care for pregnancy and birth!

Fertility treatments are not “unknown effects”. They are well studied, and a good doctor should be able to explain the effects to you. They might not be hand holding, but they should be able to clearly explain what the meds do, if you ask.

Give Heather a call. I think you might like her. I have a lot of medical trauma and have problems with doctors who don’t listen, or are haughty or think they know what is right and don’t want to let me decide. I loved Heather.

RE: Struggling to conceive again ()

First, I empathize with your situation. I struggled to conceive my first, and only, child. I spent a lot of time, energy, and heartache. We did see a fertility doctor, then ended up conceiving naturally the month I was to do an IUI. That pregnancy ended in a miscarriage, but I got pregnant again about six months later, which led to our kiddo.

Some things I wish I’d known earlier or that helped:

- I was Vitamin D deficient and this effects fertility. It’s well worth checking your levels and supplementing, if needed. Most of us (especially people with a darker complexion) don’t get enough D

- I got this old book that taught me sooo much about my body and my cycle. The book is meant to be for “natural” birth control, but I used it to try to get pregnant. I’d done the test strips, etc. But taking my morning temp cracked the code for finally understanding when I was actually fertile - I’d been a few days off before checking temp. 

- I saw an acupuncturist, who provided the type of time intensive, caring, listening help that - unfortunately- most medical providers don’t have the (insurance-dictated) time to provide. She did acupuncture/moxibustion to help support fertility. I also soaked my lower legs in warm water my cycle. I don’t remember the specifics now, because it was a while ago. But I have very cold extremities/poorer circulation, so I think it was meant to help that. Plus, the weekly appts were a great way to calm and stress-relieve. 
 

- I did not enjoy seeing a fertility doctor, and it made me question whether/how I wanted to have a child. But it did help my husband and me to have these conversations and clarify what we wanted. We also learned important things about each of our bodies, which we then took minimally intrusive steps to correct.
 

All of this is so clinical and time and emotionally intensive. It’s nothing like just getting pregnant because you stopped using birth control. So, if you decide that you’re just happy with your one child, that’s wonderful too. I’m still coming to terms with an only child (because I was 40 when he was born and had a lot of complications post-partum). I have to talk it out regularly, since it’s not what I originally wanted.

Wishing you peace with whichever route you choose!

RE: Struggling to conceive again ()

If you choose to go the route of letting go I know a great therapist who specializes in this. https://www.motherhoodisitforme.com/

RE: Struggling to conceive again ()

There's a lot to unpack here. I'm sorry you're going through this. Infertility is really hard. It took me 14 months with 1 miscarriage for my first, at 33/34, and 14 months using IVF for our second, at 37/38. It seems like you're holding on to an idea of how your pregnancy should go. I guess I'd challenge you to decide if you're rather get pregnant the way you think you should get pregnant (which already hasn't happened) or do you just want to get pregnant. Would I describe IVF as fun? Nope. Was it the worst thing to ever happen to me. Absolutely not. And I got my 6 month old daughter who completes our family perfectly. Would I do it again! Sure, just to get her. But if you had asked me 5 years ago if I'd go through IVF I would have said no. And that's ok because with the information I had at the time, that wasn't something on my mind. But life presented me new information: getting pregnant is hard for you. And in light of that we decided fertility treatments (IUIs and ultimately IVF) was going to get us the family we wanted. That was more important than HOW it happened. I don't know you but I wonder what you want more? The idea of how you get pregnant to come true or a second child? If it is a second child then there are some very real things you can do to get there, if you have the means. If it is the idea of how you should get pregnant then keep doing what you're doing and it might happen naturally. But it might not. We went through UCSF Reproductive Health and I saw Dr. Noelle. She was lovely. Is a clinic more or less depressing than your depression from not getting pregnant? You could also explore acupuncture, if you haven't yet. That could help. Final thought, I'd find a therapist who specializes in woman's health and family issues to help you work through your feelings. Good luck! 

RE: Struggling to conceive again ()

Hi,

I'm so sorry that you're going through this. It took me many years to conceive. I refused fertility medications.My husband had low sperm motility and had a surgery to help with that. Still nothing. A friend in academe recommended a book, Taking Charge of Your Fertility, and after 4 months of using her simple method of figuring out when you're fertile, I got pregnant. I think this book is a bible for women of child bearing age in academe :-)

Good luck to you. (I have one son, he's now 20 and I always wanted two children. But I was 42 when he was born and because I had preexisting non-pregnancy related health concerns I was treated as high risk and it was really stressful. I wanted to adopt but my now ex didn't want to. That's life, and I'm glad you have the one.)

RE: Struggling to conceive again ()

As a queer parent our journey was always going to be artificial insemination which eventually, after 2 years of IUIs with midwives and doctors, we went with IVF. I recommend having a consultation with Spring Fertility. They are incredily smart physicians and I found them more able to hand hold than other doctors. I had to weigh my resistance to medication/injections and an aggressive intervention that was time limited with the lifelong decision (or lack there of) of no child. My mantra was "eye on the prize." IVF was costly for us but it really wasn't a very long journey. Spring made sure we understood all of our options, the data, the cost, and expectations. 

RE: Struggling to conceive again ()

Hello - I’m so sorry for your situation. I struggled with fertility for many years and understand how truly soul shattering the journey can be. I am so thankful now for my daughter - she is such a blessing. Here are some recommendations for you:
 

As part of my journey I worked with Michelle at “At Home Fertility” in Berkeley. She is a midwife and will come to your house to do IUIs in the comfort of your own home. She is a truly warm and caring person. Also her office suite mate is Meadow Evans and she is a doula (was my doula) and masseuse. You could ask her to teach you about Mayan belly massage to improve fertility.

There is also a great book I read called “inconceivable” by Julia Indichova, which I found very inspiring. Also check out her Fertile Heart imagery programs, which I followed. 
 

and finally, there’s an inspiring website called “tomakeamommy”, the author has a list of 79 things you can do to improve your fertility. I found it very inspiring and followed it very closely. 
 

good luck!!! You’re not alone… take good care of you. 

RE: Struggling to conceive again ()

I think this comes down to what are you willing to do to bring a second child into this world? If you are committed to avoiding Clomid, IUI, and IVF, or on the alternative medicine route, working with an acupuncturist who will test your hormone levels and other pregnancy-supporting vitamin and blood levels (AMH, LH, Estradiol, Vitamin D, etc) and do a diet, supplement, and herbal workup to try to correct any major imbalances, then you are probably left with coming to terms with accepting a single child. While it is still possible that you could conceive naturally, given your age and the length of time you have been trying, the odds are not in your favor without some intervention. Egg quality begins to decline rapidly with age once we hit our late 30s. There are lots of peer reviewed studies that you can find about how modern medicine and alternative medicine can improve your pregnancy odds in your late 30s and early 40s, but most (all?) of these methods will require some combination of things that you seem to want to eschew (fertility treatments and/or supplements/herbs). If you want to give some of these methods a try, but are scared, I recommend working with a therapist around your fear to see what you might become comfortable with.

Alternatively, there is nothing wrong with having one child! I am an only child, as is my husband, and we both had positive experiences growing up as onlies. We are still deciding whether to only have 1, but are leaning that way because of the various advantages of one child (both for the child and the parents). Here is a great summary of research regarding the many positives (and a few negatives) of being an only child: https://researchaddict.com/only-child-benefits-research/

RE: Struggling to conceive again ()

I realize this is another thought and emotional process entirely, but do you have adoption as a consideration simmering on a back burner anywhere in you? your child does not have to be an only due to secondary infertility. so many ways to build a family love ❤️. i hope you get the answers and solace you seek. being in the midst of infertility treatments has a way of blurring many things. i truly feel for you.

RE: Struggling to conceive again ()

This sounds so painful. If you are averse to alternative treatments such as acupuncture as well as fertility doctors, I don't think there's much else to do except to accept your secondary infertility and enjoy your one healthy child.   I've had friends and colleagues get pregnant up to age 50, but always with the help of a fertility doctor which means taking hormones and the like.  Would you consider adopting?  If not, it may be time to mourn the second child you won't be able to have and to be grateful for the one you do have.   I made sure our child, also an 'only,' was brought up with close connections to other children close to his age who were family or chosen family so that he has sibling-like relationships.    

RE: Struggling to conceive again ()

I can very much relate to your anguish about not being able to conceive a second child. I’ve gone through that, and the intensity of my desire and the anguish coming from not being able to achieve it shocked me, and I still remember it well. I was able to conceive eventually, it just happened out of the blue after years of trying. 
now, to give you a perspective. My first child grew up to be a hugely problematic teenager and young adult, and it’s been very hard on both me and my husband, and took away the joy from and the resources needed for my second one. My friends are talking about how proud they are of their kids and sporting new hobbies and interests, while I am struggling with depression and feeling lost, still picking up from the continuous fall out of the disastrous decisions made by my first child.

at this point in my life, I wish I never had kids at all, as it is so heartbreaking to watch my first one destroy anything good he has going for him. I feel guilty about not having much left in me for my second one who really needs her parents, especially her mom, me. And there’s not much of me left.

you must be wondering why is that relevant to you, but what I’m trying to say is that the feelings you have now are just that, feelings. They may and will change as you age and your first one grows and changes. They may turn out to be a completely problem free wonderful person, or not. it’s extremely hard to see that far ahead, but think about yourself as an older woman, with interests and abilities that are not related to child bearing and rearing. You have your own worse, you can do so many different things. Start thinking about that, and see your role as a mother as just one of many. I wish you all the best, peace of mind, and health and happiness to you and members of your family, whether growing or not

RE: Struggling to conceive again ()

I'm sorry that you're going through this - many, many of us have lived through infertility and have found our way either to accepting of whatever state we are in (child-free, one child, fewer children than hoped for), or have gone the route of aggressively going after the desired state (sometimes with results, sometimes not). For that reason I think there is a 3rd option you aren't outlining, which is living with the yuckiness that is fertility treatments, but understanding that it is a temporary state and a means-to-an-end. Given your age and previous 'gentler' interventions not having had the results you want my advice is to just go for whichever doctor is the most likely to be successful and not worry about their style not matching with yours. Conception, pregnancy and birth are all important but ultimately very short periods of time, and a family is forever. I myself had IVF at a younger age due to other reasons but have 'coached' several friends in their early 40s subsequently, and my experience has been just gritting teeth and going for the full-on medicated, needles, hormones and all that jazz route while uncomfortable, is the most likely to have results. 

RE: Struggling to conceive again ()

You mentioned that you had a midwife for your first? Have you tried contacting her? She may be able to offer resources or support. If she’s not local, there are midwives in the area who do IUIs and may be able to provide information or support for fertility and conceiving. Two who I know do IUIs are Michelle Borok and Michelle Edgar. Best wishes to you!

RE: Struggling to conceive again ()

Hi, I wanted to write to say that I so appreciate and understand where you're coming from. It took me a while to get pregnant on the first try, and then my second one came (surprisingly) quickly 9 months later. I can relate to the feeling of sadness and despair when each cycle comes with no signs of pregnancy.  I don't know if this is too much of an alternative practitioner, but what ultimately helped for me (and for others I know and love) was to see an acupuncturist. This is a relatively low intervention route- some do prescribe herbs and supplements, but not all, and has research and studies to back up its efficacy in supporting fertility. I wish I could recommend someone (the woman I was seeing retired) but a quick yelp search yields a few names that may be worth trying. Sending a big hug & best of luck to you!

RE: Struggling to conceive again ()

I experienced primary and secondary infertility. The first time acupuncture was a huge help as was "eating clean." The second time we adopted. Both times we did some regular medical intervention--clomid (ended up on a half dose since temp charts showed a full dose messed with luteal phase), progesterone, iui, and iui with injectables I stopped short of ivf. To your question, Resolve support groups and the facilitators, were very helpful.  Resolve helps find the path between the two choices you've  identified. I believe their are lists of individual therapy providers as well It sounds like letting go of some of your 'non intervention' past may be part of what you will mourn, as well as the loss of the ease of the first try. Margie Kennedy has a great acupuncture practice.

RE: Struggling to conceive again ()

Hi, first, let me say that I'm so sorry to hear about your struggle -- I can imagine that feels very hard. I had my own kids (2) many years far apart, in part because of how long it took me to conceive -- each without assistance, but only after a long time of trying and with a lot of anxiety and heartache. It sounds as if, in addition to a doctor, you might also be interested in a therapist, and I wanted to recommend Wendy Quickel -- she is very warm and supportive and she has a special emphasis in her practice on supporting people struggling with fertility/conception as well as grief. She practices from a somatic (or body-based) lens, which sounds like it might resonate for you. I think she'd be great person to talk to however you decide to move forward. Her website is: https://www.wendyquickel.com

RE: Struggling to conceive again ()

Hi! I highly recommend a book called “Taking charge of your fertility” by Toni Weschler. I conceived my first and only child at age 40 by following the natural practices recommended by the author. It took a few months, but we were successful. Best wishes!!!