Today didn't go well.
I'm sitting with puffy, red eyes as I write.
The news shouldn't have been shocking. I shouldn't be this upset. But, I am.
I kept hoping that Babydoc was wrong. I kept thinking redoing the test would yield different results and it would all be okay.
I apparently had too much hope.
Today Newbabydoc confirmed that I have premature ovarian aging (POA)** which has already reached levels of diminished ovarian reserve. My ovaries are officially over the hill.
So what is premature ovarian aging?
As a woman gets older, her ovarian reserve naturally declines. This means that the number of eggs/follicles in her ovaries will decline in a fairly predictable way. When this decline reaches a certain level, a woman is said to have diminished ovarian reserve and her chances of conception drop drastically. For most women this happens in their 40s, with an expected age of menopause of 51. For approximately 10% of women, this decline happens earlier in life. This is called premature ovarian aging. For less than 1% of women it happens before age 30. I can think of so many things I would rather be the lucky 1% for!
The Center for Human Reproduction in New York offers this interesting little chart that shows where hormone levels *should* be at different ages. The top box shows the AMH (Anti Mullerian Hormone) which should be just above 3 for woman who is 27. At my first test my AMH was 0.36. This time it was slightly higher, but still below the critical number of 1. My AMH level is in line with a woman in her 40s. My ovaries are over the hill. They are old. Apparently my ovaries didn't get the memo that I AM ONLY 27!! In some regards I have always felt mature beyond my years, but I really wasn't looking for this kind of confirmation!! My FSH remains in the perfectly normal range (The bottom chart shows that anything less than 7 is appropriate for a woman my age. Mine was 6).
Trying to get pregnant with these results is only part of the battle. Unfortunately, the quality of a woman's egg declines in direct proportion to the quantity. Therefore, women with diminished ovarian reserve have the highest rates of miscarriage of any infertility diagnosis. This is because "approximately 95 percent of embryo quality comes from the egg, and poor quality embryos are more likely to result in miscarriages."
I reread this mornings post and laughed a bit at naïve me who felt at peace moving forward with IVF. I'm no longer at peace. I am now plagued by fear. By doubt. Can I truly deal with attempting a round of IVF and daily (or even twice daily) shots just to have my ovarian function not be sufficient for transfer? Can I emotionally deal with a successful IVF that results in a miscarriage? If IVF were God's plan for me wouldn't I feel better about doing it?
More than the fear, I still have doubts. So many people look at IVF as another option. A final card to keep in the back pocket. For many people it is the hope in the next step of the journey. I don't feel hopeful when I think about IVF. Instead I feel scared. I feel doubt. I wonder if it is my Hagar.
** In a previous post I mentioned that I was told I have premature ovarian failure (POF) and the POA and POF are synonyms. That is incorrect. Premature ovarian failure is the complete cessation of ovarian function before age 40. I haven't reached premature ovarian failure along the spectrum yet. But it is just a matter of time before I get there.