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Integrative Fertility  (Expert Forum)
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Is It Too Late At My Age?
Answered by
John H. Kim, M.D. - Women's Health, Gynecology, Acupuncture, Integrative Medicine, REI, Mind/Body Medicine, ReproductiveMedicine, IntegrativeFertility, Herbal Medicine, infertility, menopause
John H. Kim, M.D. Los Altos - CA
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This forum is for questions and support regarding an integrative approach to healing that combines the best practices in complementary and conventional medicine. Topics include: Acupuncture, Herbal Therapy, Mind/Body Medicine, Traditional Chinese Medicine, Fertility, Stress and Fertility, Body Weight and Fertility, Environmental Contaminants and Fertility, Polycystic Ovarian Syndrome, Recurrent Pregnancy Loss, Fibroids, Endometriosis, Hormone Imbalances, Menopause.

Is It Too Late At My Age?

by pussycat617, Apr 20, 2008 09:37PM
I am 44yrs. old and have never been pregnant, although my cycles are regular and I am still ovulating.  My mother had me at 38yrs. before a BTL and did not hit menopause until around age 52yrs.  My doctor put me on 25mg. Clomid Days 5-9 to give me a boost.  I had bloodwork done during my annual after my second round on Clomid in March 2008, and my progesterone came back in the 90's.  Doctor's office thought I was pregnant or had OHSS from the Clomid.  It was neither.  All pregnancy tests, including blood tests, were negative.  Got my period at Day 31 after having a lifetime 28-day cycle on no meds.  Ultrasound showed one follicle having ruptured, fluid behind my uterus confirming ovulation, and no cysts on either ovary.  My progesterone was nearly 16 at Day 22 in May of 2007 when I was 43 yrs. old.  This is my third cycle on Clomid.  From what I'm reading in these forums I feel like I have no time to waste.  However, my husband feels we should leave everything to faith, not medicine.  I'm not trying to make this a religious discussion, it's not.  I believe my husband is hesitant and fearful of getting himself checked out.  Should I look at an RE or getting an HSG done even if my husband wants to do no more than throw caution to the wind?  He has desperately wanted children all this time, but I feel like if we don't at least find out now whether or not we can or can't conceive it is going to be a lurking question and source of distress years down the road.  I don't mind paying out of pocket for the HSG for peace of mind.  Additionally, I wouldn't know where to go to find a reputable RE.  Thank you for your time.

by John H. Kim, M.D., Apr 21, 2008 07:20PM
I agree with you. At your age, I would go to a reputable Reproductive Endocrinologist and Infertility specialist as soon as possible and complete your work up including an HSG, and semen analysis and discuss fertility treatment. If you live in Texas, you can look at www.ihr.com to see the different fertility programs there.
Member Comments (3)

by pussycat617, Apr 21, 2008 10:03PM
To: Dr. Kim
Thank you immensely.  I've given new meaning to "I'm not getting any younger."  Thanks for your courteous and prompt response.

by lucky3, Apr 29, 2008 07:15AM
To: pussycat617
please get yourself to a *reputable* RE quickly! i can't stress that enough.

i spent 10 years with an MD (general practice) who always commented about my "large thyroid," but never ran any blood work other than a TSH, nor any ultrasound. she was negligent or uninformed or both.

her nurse practitioner (i couldn't get in to see my doc for annual appt.) was the one who said my thyroid needed further exploration. she was right!

apparently hashimoto's (thyroid antibodies present) can throw all sorts of curves and TSH can show in the normal ranges.

ANY thyroid disorder/disease can throw off pregnancy. at the very least - your doc of choice needs to check TSH, T4, T3U, T7, TPO, TGAB.

i'm not writing to say it is or isn't thyroid.

the message i want to give to you is - if you want children the old-fashioned way - do want you need to get an appointment quickly!

make appointments with several docs (at the same time), asking to be put on the cancellation list. i hated tying up appointments for others, but i was 43 at the time and knew the clock was ticking. the waiting time around here (cape cod) was 4-6 months. i got in to see a wonderful doc in boston in one week.

also, know that an endocrinologist is different than a reproductive endocrinologist. my docs didn't explain that to me and i wasted several more months on that aspect.

if you are not currently doing it now, chart basal temperatures, read cervical mucous, do all you can do to provide information for the docs! you can use the natural family planning method. it is acceptable by the church.

get plenty of rest, drink lots of water, eat right, sleep right. avoid stress. lol!

it is not my intention to make you sad, but after i was put on levoxyl for hypothyroid/hashimoto's, i had olny four chances at pregnancy.

i got pregnant 3 times, and have very early miscarriages.

my numbers now show low ovarian reaserve, blah, blah, blah.

IMPORTANT: have the docs test FSH, and also INHIBIN-A and INHIBIN-B. and don't let them tell you "no." these numbers will give information on egg quantity and quality.

although these numbers are not the end all and be all, they are pretty significant. there may or may not be anything that can be done with numbers out of normal range.

check to see what is covered by insurance first so there are no surprises.

you may want to consider freezing eggs, if that is an option for you.

here's my final message to you: if you hope to be a parent, ADOPT! our family includes two beautiful children. we adopted them many years ago (internationally), before we even considered pregnancy. it was the best decision ever!  :)

sadly, i was just told yesterday that i am entering menopause, and the typical meds (clomid, etc) and procedures (iui, ivf, etc) are not an option for me, religious stuff aside.

at the time of the phone call, i was 44 years and one day old.

there is some evidence linking early menopause with late menarche, no pregnancies, breat feeding, etc.
http://www.geocities.com/menobeyond/age.html.

i am now exploring the option of chinese acupuncture. i have a consult this friday.

please let me know of your progress. i wish you all the best.
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