Preservation
Fertility - Part 1
In 2023 I had a hunch that something might be "off" and asked the expensive but available GP in the city to run a test.
“Off?” she looked at me from the top of her nose.
“With my fertility” I held her gaze.
She nodded, clicked her pen, scribbled the letters ‘AMH’ on a sticky note and slid it across to me.
“There is a test that we can run called the anti-müllerian hormone test. It measures the amount of AMH in a blood sample. The ovaries make AMH in women. A read of your AMH can tell us the number of remaining eggs that you have and whether your ovaries are ageing too quickly.”
The hunch felt like it was sitting in the room with us now.
Two weeks, and a surprising number of vials of blood later, the test was done.
I found myself sitting back across from the expensive and now stony faced GP feeling like I was about to wake up only to find I’d slept through my alarm.
“So, the good news is that we haven’t caught your fertility issue too late. The bad news is that it’s what you expected, your eggs are not good for your age” She delivered the news as dryly as the finance section. The statistics came next. I zoned out and let her medico lingo dance around the room.
“You’re in the tenth percentile. I’m unsure what could have caused it. Possibly the trauma from the accident, the stress, genetics. In any event, you will need to freeze a good number of eggs to have chance of a live birth if you go down the egg freezing route. A higher chance if you look into embryos.”
“Are you partnered?” Her next question, opening up thoughts I hadn’t needed to turn my mind too. My newish relationship was no where near a discussion about children.
“Yes.”
“How old are you?” I was 26 at the time.
“26. Right. Ok. Well your eggs are the age of someone in their mid thirties. It would be prudent to consider IVF egg freezing or embryos, for… preservation…at least. ” She printed off a referral to a gynaecologist and I accepted it weakly.
I returned to my office on the 21st floor of a flashy law firm in Collins Street and closed the door.
Work happened around me. I sent the emails I needed to send and people blew in and out of my office to tell me the things they needed to tell. It was one of those ordinary days where nothing changes but everything does.
I left work round 8:00pm, blowing off the tram and opting to walk the hour long city-heavy walk home.
I tried to think about what might come next - appointment with the gynaecologist, more tests, confirmations, the need to determine how much time.
In truth, the hunch of my poor fertility was born from my spinal cord injury on New Years eve in 2016. I suffered a catastrophic accident which left me with permanent neurological damage, a head injury, metal bolts in my spine, a shopping list of broken bones and the almighty challenge of learning to walk again.
That year, as the clock ticked over to 1 January 2017, time stopped and turned into a mirage. Each day felt like walking across a desert, singing the same sad slow song of rehabilitation; one step forward, one step forward, one step back.
Somehow, I reached the other side. Miraculous recovery, the doctors began to say.
And it was.
Miraculous that my vertebrae exploded into my spinal cord from a four metre fall through a skylight and I lived to tell the tale.
Miraculous that I went back to university with a fractured skull and ongoing concussion syndrome caused by the bleeds in my brain.
Miraculous that I passed my subjects and a year later sat the Law School Admission Test and got into law at Melbourne University.
Miraculous that from 2017 to 2019, the depression and PTSD were, for the most part, short lived. I only experience mild bouts of insomnia now.
Not so miraculous was the fact that I lost my period for over a year. By the end of 2017 I realised that it had never come and decided it might be time to find it.
My doctor sprang into action with the usual questions - pregnant? contraception? STDs? She ordered tests to cover the bases and I laughed. My year of recovery had undoubtedly been the least sexy of my life. There is no dignity in hospital stays - you give up your body to the medical system. Catheters, commodes and enemas coloured each part of my day.
“So do you plan to have kids?” she took me in very seriously.
“Kids?” I stammered. I was 21. The thought was moons away.
“I only ask because people will tell you that you won’t be able to do it. They will tell you that you won’t be able to carry a baby because of the pressure it will put on your spinal fusion. But they are likely wrong. With the right care, you should be able to. It will be difficult. But not impossible.”
I swallowed. Another ‘difficult but not impossible’ causality from the accident to add to my growing list.
I wondered why I hadn’t been told about this sooner. But my physical recovery had been so all consuming, there was no space left for the in-between medical issues - even the PTSD fell to the wayside in the beginning. Each day I woke up and put all my effort into getting stronger.
“And the lost period?” I asked the GP, breaking an invisible tension.
“Likely ‘endocrine disorder’ and ‘amenorrhea’ - when the body goes into shock after a spinal cord injury and the menstrual cycle will sometimes temporarily cease. It will come back. I am almost sure of it. All you can do is wait.”
Another small price to pay for my life.
Seven years later, in 2023, I am two years out from law school and getting my ass kicked at a highly reputable law firm in Melbourne city.
In 2023, my days revolve around urgent work, long hours and the usual steep learning curves that junior lawyers face. Stress is my middle name. My imposter syndrome swallows me up. I am convinced that I am an idiot. I work in litigation and I agonise over drafting the most mind-numbingly simple emails to the Court. I forget all about my chronic health issues. My fertility clock ticks on by.
I get to the end of 2023 and go home for Christmas. My eccentric dad sings in the kitchen and stirs prawn risotto with practiced patience on the stove.
My mum flits around us, getting a million things done.
I talk to mum about the decision - this new monster under my bed. I let myself feel frustrated that there is a choice to be made.
The pros of freezing eggs or embryos are preservation - buying time and protection for the future.
The cons were are cost, at about $12,000, the process is certainly not cheap.
But beyond the cost the cons are the physical and mental demand the IVF process places on your body. My mum went through it five times.
We talk about the embryos versus eggs. Embryos have a higher chance of success of resulting in a live birth, but they literally put your eggs ‘all in one basket’.
I tell my parents that my gynaecologist talked me out of embryos and into eggs.
“She told me that even the strongest relationships can be fragile. She told me that if you go with eggs then they are completely your own, your back up, your security. If you go with embryos and your relationship ends, you generally always agree to destroy the embryos and so both walk away with nothing.”
I think about how there’s both cynicism and wisdom wrapped up in that.
I let my heart break for the past me who lived in happy ignorance and for the present me who has to walk back into the arms of a medical system that saved my life but also brought me to its knees.
I flick an email off to my gynaecologist expressing an intention to start IVF in the new year, resolving that at this stage, wisdom is the safest bet.
Honest, eloquent…poignant.
Sending love 💕 thank you for sharing so eloquently