When my husband, Ilan, and I began talking about starting our family in the fall of 2020, we knew we might run into challenges. With my history of breast cancer and choosing not to freeze my eggs before treatment, we knew that my fertility may have been negatively affected by the chemotherapy. We decided to see where I’m at first with an initial fertility test before making any decisions.
It was a simple blood test from my regular OB-GYN to check my anti-mullerian hormone (AMH) level. It’s one of a few indicators of fertility status. Mine was 0.68, which is low, especially for a 30 year old. I felt uncertain, mostly because I didn’t have a good understanding of what that meant for us. We were immediately referred to a local fertility clinic for additional testing to get a better picture of the situation.
Testing by the fertility clinic included another blood test and a hysterosalpingography (HSG), which is a really long word to describe an X-ray with contrast dye to check your uterus and fallopian tubes. The blood test checked a whole bunch of levels, including estrogen, testosterone, antibodies for certain vaccines and more. Ilan also went through some testing so we could see our whole situation. All the numbers didn’t really mean much to us, so we were looking forward to the doctor explaining it all.
Our first consultation with our doctor was virtual, as it was still during Covid in January 2021. He spent about an hour with us, explaining the big picture of our situation and what his recommendations were after the tests.
He explained it with a marble analogy, which was actually really helpful. It went something like this – you’re born with all the marbles (eggs) you’ll ever have. White marbles are healthy, high-quality eggs and blue marbles are low-quality and potentially abnormal eggs. As you get older, the proportion of white to blue marbles changes as the quality changes. Because of chemo (we assume), I have significantly more blue marbles than the average woman my age. I basically have around 20% white marbles, which are the ones we want, and only one marble is released every month naturally. It is what he would expect to see in someone who is around 40 years old.
When looking at all our numbers, our doctor explained that it is theoretically possible for us to get pregnant on our own, but it would likely take a long time (a year or more), and the risk of complications is higher. Ilan is a 5th generation Israeli and has family that survived the Holocaust, so it is very important to him to have a biological child and I want to honor that. We also want the chance to have more than one biological child in the future, if at all possible. Since my situation will continue to decline over time, we didn’t want to take any chances away from ourselves by waiting so we decided to follow our doctor’s recommendation and jump straight into In Vitro Fertilization (IVF).