Here we go. The last time we went to Colombia was 3.5 years ago. There is a lot of excitement aside from the medical adventure we’re about to embark on. The doctor has been prescribing tests and medicine that I needed to get before I arrive and everything is in order. I’m taking contraceptives again so we can schedule my cycle precisely when I arrive. My husband and I are in the process of packing and re-packing bags because we bought too many gifts to bring to family members. It’s Saturday June 15th 2019 and we are finally flying home.

The doctor sees me the next day and explains the process again with drawings and photographs. After a sonogram, everything looks good. I go back to the clinic on Monday to get additional bloodwork done and to get the ovarian stimulating medicine, Gonal-F, and Letrozole pills. I stop the contraceptive pills and we have to wait for 5 days for my cycle to regulate again. On Saturday morning I’m half nervous about self-injecting the drug in my belly, and half excited with the official beginning of the process. Like clock-work, I got my period overnight. The injection turns out to be nothing, aside from a little sore belly afterwards, but my happiness returns when I go grocery shopping and buy granadillas. I’ve missed this little fruit so dearly for the past 3.5 years! This slimy and crunchy, and visually unappealing fruit makes my day.

We have now started the first of 4 IVF cycles (we chose the 4-cycle plan which includes everything for $10,000). We are mentally prepared to go through more than one, but really hoping this first one is the one. Being at home, away from work and with our parents, is also helpful for the emotional roller coaster that this is.

Today, with a little science and a lot of hope, we are submitting one more request to the stork!

Three years had gone by since we made our decision to have a kid. Now at 37, my obgyn refers me to a fertility clinic. During the first appointment the doctor explains the options very clearly. He even makes me repeat them to him to make sure I understand. We can try IUI (intrauterine insemination) for one or more cycles, or skip that and go to IVF (in-vitro fertilization). The recommendation will be dependent on the tests.

The tests come back and the news are not very encouraging. I’m almost out of follicles inside my ovaries, which means IUI might be a waste of time and he recommends IVF. But, after the good first impression, I find myself having to call the clinic to get the test results mailed to me, because it is not their standard practice to give the results to the patients. The doctor does not see me again after the results, only gives me a call. So, I’m faced with the decision to spend $25,000 dollars on one IVF cycle at a clinic that has not spent any time going over the test results with us (where I already spent $2,000 on tests). At this point we backpedaled fast and I start thinking about other options.

I spend hours researching about adoption. The more I read about it, the more excited I am with the idea of giving a chance to a child that might not get it otherwise. My first idea is to adopt in my home country, Colombia, but I find out that the US does not allow me to bring an adopted child, because I’m not an American Citizen. We still continue with the search, go to adoption fairs, go through adoption training and end up with mixed feelings. Most of the children that are given up for adoption in my country come from poverty, but they are healthy otherwise. Most children that go for adoption in the US come from drug and alcohol addicted mothers and have serious conditions derived from that. It is scary and my husband is not as ready to continue down this path now that we know the challenges.

Demoralized, I find another OBGYN who has a fertility background and at my next routine check-up, she recommends repeating all bloodwork (it’s been a year). The results are very similar, however, the AMH has increased. AMH is related to ovarian reserve, and it’s not supposed to increase, ever. In my case, it went from 0.04 to 0.43. It’s still low but it is a significant and unexplained increase. In the year between the two tests, after giving up on fertility treatment with the first clinic, I read about natural and alternative methods and foods to improve fertility. I bought royal jelly, pollen caplets, and other products that I read about, and I can only attribute the increase to them. However, the recommendation is still to go for IVF.

At this point we are stuck with the impossibility to adopt a healthy child in Colombia, the high cost of IVF in the US and the distrust in the clinics that we have to choose from. I start talking to my doctor from Colombia and he recommends that I go home for the treatment, at a better clinic and for a fraction of the cost. The logistics are complicated since it means to go home for a couple of months but even the salary loss is less that the total cost in the US. I get connected to a doctor and start learning about how the process is done in Colombia. Without having paid even a doctor’s visit, I have already spent a few hours talking about the process with the doctor, all the details and options are quoted by the clinic (in actual written documents). I finally start seeing a little glow at the end of this long tunnel.

Lesson number 4: there are many options, from conception to adoption, different methods and treatments, and plenty of doctors, clinics and agencies. It’s easy to get demoralized by a wrong choice or unexpected result, but at least one of the many options will be right for you. With so many undesired kids being brought into this world, those of us that truly want them should not give up, ever.

After a year of deciding we wanted to have kids, we were finally able to start trying. Vaccines were in order, no more birth control and you think that’s all, right? When we’re young we’re led to believe that if you have sex any time one week before or after the 14th day of your cycle, then you’ll likely get pregnant. With the birth control off, nothing could stop us from getting pregnant in a month or two.

Maybe it was just me, but I didn’t think I needed to take any special measures to get pregnant. My obgyn had told me with an accusing stare at some point in the past that my eggs were created when I was in the womb. So, my eggs are kind of old, I thought. He didn’t bother really explaining that their number also rapidly decreases in the mid 30’s and many other things start changing in the reproductive system. Some people actually study biology and know these things already, for most of us, even if the information was received in high school at this level of detail, we’d have forgotten 20 years later.

After just a few months of trying to get pregnant (by simply stopping birth control), we had to go through some major changes, big move, job and such, and when things finally settled we got pregnant. Oh, it was just the stress that was affecting me off course, I assumed.

However, because we were not really “actively trying”, and I hadn’t read anything about pregnancy symptoms, I didn’t realize I was pregnant initially. I spent an entire night throwing up and blamed it on the food, then spotted at the time I was expecting my period and assumed it was just a light period, then my breasts were sore… and I started putting it all together.

I was 7 weeks pregnant when I went to the doctor and had a sonogram. There was no embryo. It is called a blighted ovum. You have all the symptoms, the tests are positive, you have a placenta sac, but no embryo. I was devastated. By then I had devoured 3 pregnancy books, installed 2 apps, bought grandparent coffee mugs for my parents, prepared how to give them the news…

I had to get an induced miscarriage, which was painful and emotionally draining. But then my body started cycling again pretty fast and on a positive note I kept thinking “I actually got pregnant once so I should be able to again”.

Lesson number 2: It takes precision to get pregnant. An egg is released and travels the tubes and uterus in a couple of hours and gets expelled. It needs to encounter sperm during that short time. This means having sperm already in your body 1-2 days before (yes, it typically lives that long). How long sperm can live inside your body changes from woman to woman. So, if you don’t have sex for 2 consecutive days you could have entirely missed the chance!

I always knew I wanted to be a mother. No question in my mind. I have a super-mom, really one of the great ones, and I was always convinced motherhood was one of the greatest things and not just a thing society expects of women. On the other hand, I come from a family of mostly high-achievers in education and career matters. I knew after high school I’d go to college and then a graduate degree. I didn’t always plan to get a doctoral degree but I did end up all the way there.

So, you start putting your plans in schedule. Go to school, work and travel before 30. Then get married at some point and then the kids. That pushes you easily into the after-35 downward slope of fertility. But I never knew there was such a steep decline. You always hear about women getting pregnant after 40 so you think it’s common, even if it’s still commented by people.

My husband and I moved in together when I was 28 and got married 2 years later. I was in the middle of my PhD at the time so I was on the pill. At 33 I finished my studies but we waited another year for things to settle.

Finally it was time. I was 34 and felt that it was a great time to get pregnant. I went to my obgyn and told him we wanted to have kids now. He gave me some blood work to make sure I was not in risk of infectious diseases and found out that my chickenpox vaccine (from some years before) didn’t work, for some reason, and I wasn’t immune. I went to get vaccinated, they recommended 2 doses which means waiting for 3 months between them. Then the vaccine was not available anywhere for a few months and finally about 9 months went by. I could have had a kid in the time it took to go through this immunization.

Lesson number one: Don’t wait until you’re ready to conceive to find out you’re missing an important vaccine, or have a vitamin deficiency, or anything that can be easily fixed but could take time. You could tell your doctor you want to have kids in a few years and s/he can start evaluating those things.

So, here is the deal. I’m almost 40, about to embark in the biggest process to conception with the help of science, called 4-cycle IVF, and I’m actually feeling pretty optimistic, even though this is the 6th year of my trying-to-conceive life.

I realize I’ve learned so much and also, I had no idea of how conception really works until I set up to try it myself. This is not an education we get normally. Not in my culture, in my generation, but I’m sure it applies to many other women and certainly men around the globe. Yes, I said men, because this is typically not a one-person plan even though it can be (but then you’d be skipping most of the steps I took first and go directly to the help of science).

I wish I had been writing this blog all along. Now I’ll attempt to reconstruct everything I went through in a series of articles. If you are a person of any age that hopes to be a biological parent at some point in the future, you can learn something from my experience or share yours.

Welcome to this stork’s journey!