Fertility - Part One

I wasn’t sure if I’d ever be in a position to talk about this subject publicly.

After two and a half years of living with the knowledge that I have fertility challenges I finally feel in a strong enough place to share some of the learnings I’ve gathered on this rocky road in the hope that this can help others and prevent some of the heartache I’ve experienced. I want to caveat that each person is different and this is only my personal experience. 

Before I’d ever even had penetrative sex I was overly concerned about falling pregnant. The only message I remember learning in sex education was use a condom or get pregnant, and the absolute worst thing was to be a teenage mother. To put it into some context I also grew up in Norfolk which at that time had one of the highest rates of teenage pregnancy in the UK and Europe.

So I carried the message that the worst thing was to fall pregnant accidentally and started taking the contraceptive pill around 16 or 17. I thought I was being sensible. In one part I was, I was so careful. Yet I knew absolutely zero about how my menstrual cycle worked. I didn’t even know that by taking the pill I wasn’t having a cycle, all I knew was I was bleeding every month and to my knowledge that meant all was ok. When I went to pick up prescriptions for the pill I was constantly told it was good to be on it. Sometimes I would take a break for a few months and I distinctly remember a nurse telling me there was no evidence to support that this was of benefit.

In my twenties I lived a wonderfully promiscuous and playful London life and bar a couple of accidents or very drunken rendezvous, always used condoms. I took myself for regular sexual health check ups believing that this was protecting my fertility. I had no idea that avoiding STI’s was only one very small part of the puzzle.

It was only when aged 32 that I learnt that hormones and my menstrual cycle had the power to inform me of what was happening with my fertility. In my naivety I truly believed that by being healthy and coming off the pill at 31 I was taking charge of my future family plans. I had wanted to come off the pill at 29 but for the sake of ‘convenience’ i.e. it was too much trouble to wear a condom I stayed on it. I remember in 2016 feeling like my body really didn’t want to be swallowing this pill each day. Yet I pushed down that instinct.

One reason for coming off it was to check my period came back, it did. My cycle was irregular, I put it down to coming off the pill. I used natural cycles, I read period power. I became more informed.

A few years ago I had a succession of 3 week menstrual cycles. I was concerned but figured I was ovulating so all was ok. Sure enough my cycle started to lengthen and I didn’t give it much thought. The thing is I kept saying to myself ‘I’ve come off the pill, that’s why my cycle is irregular’. I even wrote in my diary that I wanted to get my cycle back on track, this was 3 months before I would learn that something wasn’t right.

In February 2020, about a month before the world locked down I discovered that one little hormone, my FSH (follicle stimulating hormone) was too high. Before this appointment I’d never given a second thought to this hormone, then during that consultation I learnt that this little bugger indicated my egg reserve was dwindling at a faster rate than expected. The utter shock and confusion was palpable. ‘But I’m so healthy!?’ I spluttered to the doctor, I don’t understand.....This was the beginning of my journey into one of the most traumatic things I’ve ever experienced. I walked out of that doctor's office with the advice to freeze my eggs. 4 months prior to this I was journaling about wanting to call in the father of my child. Now here I was learning that becoming a mother might be very difficult for me. It was a lot to take on and my anxiety spiralled.

Part of this journey has been realising I knew so little about hormones, menstruation or fertility. I presumed, like a lot of us do, that when I wanted to have a baby it would happen eventually. It was the beginning of questioning myself and everything I’d ever believed. It’s such a weird space to be in, a space where suddenly I was questioning every step that had led me to this moment.

Did I take the pill for too long?

Was my eating disorder to blame?

Was it due to dengue fever in my 20’s?

Had I left it too late to have a kid?

Was this something I inherited?

Is this my fault?

I’ve had all the tests and there is no genetic issue that caused this. As someone who firmly believes the body has the ability to heal itself I’ve been on a mission these past two years to support my body as much as possible. I’ll share more on what I’ve been doing soon.

Before I knew of any of my issues I’d seen friends go through fertility struggles before conceiving. I empathised with them, comforted them and hoped for their miracle. Eventually their babies found their way to them. But until I found myself in a similar place I had no idea the onslaught of trauma this struggle can place on a person. This might all sound dramatic to some but this has been my reality for two years and it’s a bloody heavy weight to carry.

I’ve felt the deepest levels of shame about this. I’ve picked myself apart, reliving old narratives from my eating disorder days. Even as I write this and feel the relief of pouring these words out I also appreciate that this journey is far from over for me. I guess I was waiting for my baby to arrive before I shared this information but as the years go by I realise I can’t live with this shame anymore.

The overarching piece of advice I want to give to women is to be proactive in taking care of your menstrual cycle and fertility. Make informed decisions and learn the magical details of the full menstrual cycle. Understand not only how to prevent pregnancy but also to create pregnancy, if that’s your wish. Not everyone wants to have a child, I get that. But if by me sharing my story I can help someone else then it’s worth it. 1 in 8 people will experience fertility struggles and this is predicted to increase. For the majority of people they won’t have difficulty in conceiving fortunately. But 1 in 8 is still high, so let’s get proactive.

Here in Spain a lot of people have private health insurance. By a stroke of luck I took mine out before I found out anything was wrong. I went to the gynaecologist due to an ovarian cyst and it was at this appointment she asked for bloods to be drawn. 

A lot of gynaecologists will dismiss women in their 20’s and early 30’s if they have concerns. I think in the UK you have to have been trying to conceive for 1 year before they’ll run fertility checks. There are companies like Medichecks that will run AMH (anti mullerian hormone) and FSH tests. Seek out professional help with understanding these results. 

The only thing I would have changed in my twenties would have been to freeze my eggs. £2-3K is a lot of money, yes, but a round of IVF can cost upwards of £4K and in your lifetime most likely a couple of thousand of pounds isn’t significant. This brings me to a whole other conversation about financial privilege. I was terrified to spend money on egg freezing and can now say I’ve spent thousands on trying to help my fertility. When something is important it’s an amazing motivator. For those who can’t afford to go private then make sure you’re put on waiting lists. Insist on being taken seriously by your doctor. I've lost count of the amount of times I’ve had to advocate for myself.

Whilst all of this might sound intense I’ve also learnt so much in this process. There is also so much positivity from all of this heartache. It has made me wake up and take more responsibility for myself. It made me cook better and slow down. I had to have very hard conversations, not always in my own language. I’ve become more compassionate and empathetic in the process.

My intention with sharing part of my story is that hopefully this will help someone else. My personal case is not the ‘norm’ and I don’t want to scare people. What is happening to me is on the rarer side. However no one will advocate for your fertility like you will. If you want to check how things are and be informed then you can ask your gyneacologist to run sex hormone bloods, do an ultrasound of the ovaries and uterus and check your AMH levels.

I hope this helps.

With much love,

Alice

xx