Hidden Hope in Fertility Stats for Women 40+

Why we’re looking for luck in all the wrong places

Current conversations about fertility are failing the millions of women around the world who are 40 or over and trying to get pregnant. When we talk about when women should get serious about trying to conceive or of how much fertility declines with age, we talk past a huge community of women who are hoping to become mothers after age 40.

I remember the recurrent sorrow and crazy-making frustration of trying to get pregnant, starting when I was first ready to become a mother—not until I was 41—and lasting until I was lucky enough to conceive my first child at age 45. She was born when I was 46 and she is, I’m incredibly grateful to report, now a healthy, happy 3 and a half year old. I also remember how unhelpful much of the discussion around fertility and age was, during those years when I was trying and failing to get pregnant or to carry a pregnancy to term.

Because here’s the thing: Women like these, and like I once was, are not in the position of deciding when to have a baby or whether they should try before reaching “advanced” or “very advanced maternal age.” The ship has sailed on that one. The reality is, they are already in their 40s. And the teeth-aching desire to meet and hold their baby has not declined with age.

But I’ve realized recently that, surprisingly, the most relevant—and it turns out, most hopeful—information for my fellow 40+ year olds isn’t even found where people tend to look during discussions of fertility. Instead of focusing on studies comparing fertility at various ages or surveys of ART successes and failures, we should look to US census data on births and, perhaps paradoxically, to statistics on abortion, menopause, and sterility.

To be clear: I’m not arguing women should wait. I’m not arguing they shouldn’t. I’m saying, is that if a woman happens to be in her 40s and trying to conceive, she should know there actually is some hope, tempered though it may be. The chances are certainly smaller than when she was 25, and even 35. But that’s immaterial now. And it doesn’t by any stretch mean there is no chance. This point bears stressing and examining in the absence of comparisons with younger women.

Besides having given birth to a healthy baby conceive naturally when I was 45, I’ve also been unusually lucky to have heard from over 500 women, aged 40+ who are trying to conceive or who are already pregnant and who have found me through this blog and  left comments here or contacted me directly. I love hearing from all of you and am grateful to be privy to some of the uncensored thoughts, concerns, questions, and emotions being shared among this population.

Especially for those women 42 and older who get in touch, I hear frequently that they’ve either heard or just feel they have “no chance,” a “0%” likelihood of becoming mothers with their own eggs. A significant number also tell me they feel ashamed, have been told they’re “crazy” for thinking they might have a shot. These are the women I’m writing this for now. (And you go, ladies, for trying!)

Overlooked Stats Show Hope for Women 40+

Census statistics on live births & medical abortions

https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_03.pdf: According to the Center for Disease Control and Prevention, in 2015, there were 111,611 births, (1.1% of population) to women 40-44. This covers all births, not just births to women who were trying to conceive, suggesting that if all 40-44 year olds in 2015 tried to conceive every month, the percentage of women in this age group who’d had babies would be considerably higher. To women between 45-54 (with the great majority falling between 45-49), 8,827 babies were born.

Combining these stats with those on abortion in the 40-44 age group, (20,962), the latest age group for whom statistics were collected, and then dividing this number by 3 (accounting for expected 33% miscarriage rate), we could expect to add almost 7,000 babies, totaling close to 120,000 births. This number would actually be a low estimate, since many miscarriages occur before scheduled abortion dates.

All together, we could expect between 125,000-130,000 live births in 2015 to women 40-49. Put into context, that’s a population of babies likely greater than the total population of most of our hometowns.

Perhaps most significantly, these statistics hold steady or decline only somewhat when viewing births before egg donation was available in the US (See births 1933-1998 @ https://www.cdc.gov/nchs/data/natality/mage33tr.pdf.)

Sterility & menopause

https://www.ncbi.nlm.nih.gov/pubmed/12268772: According to a review of the literature pertaining to declining fertility with age, the likelihood of permanent sterility at age 40 is about 40% and at age 45 is about 80%, meaning one of out every five 45 year olds should be able to become pregnant at some point during their 45th year.

http://www.healthline.com/health/menopause/pregnancy#1: As explained by executive director emeritus of the North American Menopause Society Dr. Marjory Gass, pregnancy even in the mid-to-late 40s is not impossible for most women. “Never assume, ‘Oh, I’m too old to get pregnant,’” Gass has said. “Unless you have gone a year without a period–the technical definition of menopause—pregnancy remains a possibility.”

Birth defects & miscarriage

I get a lot of questions over email and on this blog about whether getting pregnant in the 40s, especially in the mid-40s, guarantees a miscarriage or a child with a genetic abnormality. Many women, myself included, field questions from family members about whether it’s even wise to get pregnant or hope for a positive outcome given the dire statistics on Downs, etc., for older mothers.

When viewed from the perspective of high the risks are compared to pregnancy at 25, the numbers do look grim. But when viewed from the perspective solely of the chances for a healthy baby at various ages throughout the 40s, the numbers are much more hopeful (and again, relevant):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071156/: “For women at 42 years of age, more than half of the intended pregnancies (54.5%) resulted in fetal loss…The risk of spontaneous abortion [was] 84.1% by the age of 48 years or older.” So yes, these are scary statistics, and they aren’t great, but they are better than many people fear and assume, especially if we look at them in reverse, from the perspective of a positive outcome rather than negative: a 45% chance of success for a 42-year old to carry a pregnancy to term, and even a 15% chance of success for a 48-year old.

https://www.ncbi.nlm.nih.gov/pubmed/6455611 & https://embryology.med.unsw.edu.au/embryology/index.php/Genetic_risk_maternal_age : The estimated rate of all clinically significant cytogenetic abnormalities at age 40 is 15.8 per 1000, meaning we can expect between 98-99% of all babies will be born genetically healthy. For age 45, it’s 53.7 per 1000, or between 94-95% of babies. Even for women giving birth at 49, only 12.5% of babies will carry a genetic abnormality, meaning 87 out of every hundred babies will be born genetically average.

So if you’re out there now and are trying to conceive in your 40s, please know that I’ll be keeping you in my thoughts and hoping you have the same good luck I—and almost 9,000 other women aged 45-49 in the U.S. last year—had. And please know that I and thousands of other women are out there, pulling for you.

The fastest way to get in touch with Tracy is here.

(Note: For more about trying to get pregnant, you can also see An Honest Take at Getting Pregnant Naturally at 45Getting Through to Getting Pregnant at 45 and On Delivering My First Child at 46, other blog posts I wrote in the hopes of supporting people slogging through infertility, although some of the content from these is reproduced in this post. I’ve also gotten quite a few questions about my pregnancy and birth experience, and I’ve written a bit more about those in the Washington Postonline and in Brain, Child Magazine online — although please note that the picture in this latter article is not my daughter! It’s a stock photo the magazine used. In any case, I will continue to keep you all in my thoughts. Finally, if you’re *still* interested in my story [bless you for your patience if so!], the story of how I met and fell in love with my husband–a bit late in life– and then went through years of IVF and finally got pregnant naturally, is in my book The Good Shufu.)

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Navigating a Safe Pregnancy in Your 40s

I’m so touched by all the emails I get from women trying to conceive in their 40s and from people interested in pregnancy at a later age. One person I loved hearing from through this blog is reporter Kristine Crane, who writes about women and health for US News & World Report‘s Wellness section. Her latest piece is “Navigating a Safe Pregnancy in Your 40s,” and it starts with our story, then goes on to look at those of other women, couples, and doctors involved in later-life pregnancies and the quest to conceive in your 40s:

At age 45, Tracy Slater, an American expat writer living in Osaka, Japan, resigned herself to the fact that she might never be a mother. After a few years of failed fertility treatments and two miscarriages, she and her husband continued trying to have a baby – but shifted their focus to Slater’s husband’s dying father.

So when Slater developed what they assumed was a stomach bug, they figured she had picked it up at the hospital while visiting him. But it turned out she was seven weeks pregnant. “They already saw a heartbeat,” Slater says. “And I’d been drinking one or two glasses of wine a night, and a cup of coffee everyday.” In addition to drinking alcohol and caffeine – not advised for women trying to conceive – Slater was also overwhelmingly stressed over the prospect of losing her beloved father-in-law.

In other words, she was not in ideal fertile conditions – and yet, she had become pregnant with her daughter. “I still have dreams they made a mistake. I still can’t believe I carried to term this healthy child,” says Slater, author of “The Good Shufu.”

While Slater’s outcome is certainly not the norm, and one she attributes to good luck, it’s increasingly common to see women in their 40s have successful pregnancies – through IVF, egg freezing, donor eggs or more rarely, as in Slater’s case, natural conception.

According to the Centers for Disease Control and Prevention, pregnancies among women in their 40s has increased by about 2 percent per year since 2000. In 2014, there were 10.6 pregnancies per 1,000 women in this age group.

Read the full article here at US News & World Report

 

The fastest way to get in touch with Tracy is here.

(Note: For more about trying to get pregnant, you can also see An Honest Take on How I Got Pregnant Naturally at 45,  Getting Through to Getting Pregnant at 45, and On Delivering my First Child at 46, other blog posts I wrote in the hopes of supporting people slogging through infertility. I’ve also gotten quite a few questions about my pregnancy and birth experience, and I’ve written a bit more about those in the Washington Post online and in Brain, Child Magazine online — although please note that the picture in this latter article is not my daughter! It’s a stock photo the magazine used. In any case, I will continue to keep you all in my thoughts. Finally, if you’re *still* interested in my story [bless you for your patience if so!], the story of how I met and fell in love with my husband and then went through years of IVF and finally got pregnant naturally, is in my book The Good Shufu.)

An Honest Take on Getting Pregnant Naturally at 45

If you’ve landed on this page after a random web-search, you aren’t alone.  The topics of “natural pregnancy at 45” and “getting pregnant at 45” draw more visitors than any other to this blog, although I initially started it because of a book I wrote about my marriage, not about infertility or TTC per-se. I only have  few other posts on this whole blog solely devoted to trying to conceive in my 40s, and together they get thousands of views each month (which is a lot, for me!) and have encouraged over 500 women to reach out directly over email to share their stories, or sometimes just their fears and frustrations. (You can do so here.)

So I’m compiling most of the information from them and adding a little more here to make it easier for readers to find all in one place. And if you’ve landed here because you are struggling with infertility, I hope this post gives you some comfort and especially helps banish any guilt you may be feeling about what you are or are not doing to have a baby. Please know that although I (probably) don’t know you personally, I’m keeping you in my thoughts.

The Basic Story

I got pregnant naturally at 45 and a half, and I delivered a healthy baby girl four months after I turned 46. She is my first and only child. I conceived her after more than four years of IVF and other fertility treatments in Japan, where we live and where my husband is from. During this 4 years, I’d had 2 miscarriages and a whole slew of diagnoses for my infertility.

“How did you get pregnant naturally at 45?” people often want to know. Here’s how, I’m assuming: We got really lucky.

My husband and I both longed for a child, but we didn’t consider using donor eggs or surrogates, because they are not approved in Japan, and because we desperately wanted a child that came from both of us biologically (a feeling I wrestled with and felt very conflicted over, but that was true, and that I wrote about for the New York Times). I’d been diagnosed with high FSH, a luteal phase defect, a blood-clotting disorder, low progesterone, and inconsistent ovulation. As well, of course, as being old. I tried acupuncture, herbs, fertility yoga, and multiple fertility diets and dietary restrictions to try to make my maternal age “younger.”

When I turned 45, we decided I’d stop all medical treatment, because the statistics on pregnancy at or past 45 with a woman’s own eggs were so dire. (My husband is 5 years younger and was in good procreative health, according to our doctors, so the issue was me, I felt sure.) I stopped all the fertility diets and acupuncture, too, as well as the special fertility yoga, although I continued to do regular yoga. I started drinking wine again and coffee whenever I wanted. I felt freer in some ways, but also very sad.

I had a deep, gnawing yearning to meet our baby, and I felt sure that our baby existed somewhere, but I was trying hard, after my 45th birthday, to adjust to the fact that I was probably never going to meet our baby or hold our baby, because of my age and all of the factors my doctors had said would prevent me from getting pregnant and giving birth to a healthy baby.

Still, my husband and I continued to try to monitor my body’s cycles and to try to conceive a child naturally, mostly because my husband is an optimist and he convinced me there was no reason not to keep trying, and I couldn’t find a reason to disagree with him exactly.

When I was 45, my father in law got very ill. I loved him deeply, and I spent every day at the hospital in Osaka with him. My husband and I were both stressed and sad and very, very tired, so when I thought I might be ovulating, we tried to conceive but were so exhausted and overwhelmed we only managed to try once or twice a month for a while.

But one of those months I got pregnant. And now our daughter is 2, and she is perfectly healthy.

How My Pregnancy Contradicted Some of the Myths or Rules You May Be Struggling With

I’d be lying if I told you now that I know how I got pregnant naturally and delivered a healthy baby girl after I turned 46. And, no offense to anyone, but I’d guess that most people are lying–or at least are wrong–when they say they know the key to getting pregnant at an advanced age.

I tried really hard to be a good fertility patient–to eat the right foods and to avoid all the wrong ones, to stay healthy, to do the right things and not any of the wrong ones, etc.–and I always felt every month like I was failing. I was never 100% perfect with my diet, and of course I was never pregnant, or pregnant for long.

I can’t say for sure that none of the acupuncture or fertility exercise or diets I followed had no impact, because I did end up getting pregnant with a healthy baby eventually. But I wasn’t following any of this for at least six months before I ended up conceiving, so I certainly won’t say that any of these myths or rules proved true for me, either, at least not for the month I got pregnant and the half-year or so leading up to it:

  • If you’ve never had a child or carried a pregnancy to term, you can’t get pregnant naturally and deliver a healthy baby after you turn 45.
  • Drinking coffee will stop you from getting pregnant.
  • Drinking wine and/or beer will stop you from getting pregnant. I’ve never been a heavy drinker and I hardly ever have hard alcohol, but I drank a glass or two of wine or beer almost every night from my 45th birthday on, up until I was about six weeks pregnant–until the moment we learned I was pregnant, or actually about a week before that, when I started to feel nauseous (which at the time we attributed to a stomach bug I assumed I’d picked up visiting my father-in-law in the hospital).
  • Being stressed out will stop you from getting pregnant. As I write above, I got pregnant during one of the most stressful times of my life. And seriously, who isn’t stressed out when trying to conceive after, about, the first month or two of trying.
  • Thinking negative thoughts will stop you from getting pregnant. Let’s just say I’m not an optimist. I had negative thoughts all the time while I was trying to conceive and I always felt irked by the advice to think positively (more about this below). Struggling with infertility sucks and is incredibly hard, so go ahead and forgive yourself a negative thought or two–or two thousand.
  • You will get pregnant once you stop trying. As I write, we were still trying every month, just not with medical intervention anymore.

Resources & Ideas to Support You if You’re Trying to Conceive

Although I don’t know exactly how or why I got pregnant at 45, I do know what helped me get through my years of infertility and losses, and get through it with my marriage enough intact that my husband and I were still happy to keep trying naturally after my 45th birthday. In the hopes that some of these things may help or at least give solace to some of you, here they are:

  1. Accepting both the sadness and the freedom that corresponds with realizing I didn’t have much control at all over my own body: The number one thing that helped the most was actually something my dear friend Jenna said, which was roughly something like, “The most important thing to remember is that you have basically no control. Your body is just going to do its thing, and there is not much you can do to affect that one way or the other.” When she first said it, it sounded harsh and maybe even a little hopeless, but then when I thought about it, I realized both how true and also how freeing it was to accept that, for the most part, there was very little I could do to control–and thus very little I could do to ruin my chances of–getting pregnant. This may not be true for people who have structural impediments to conceiving or carrying a baby, but for many of us, whether or not our body produces a healthy egg and releases it at the right time and nurtures it the right way is something we cannot master. As I’ve mentioned, my doctors had so many reasons why I couldn’t produce or release or implant an egg normally without shots, pills, weeks of medical preparation, or another woman’s eggs, but in the end, my daughter’s first little cells formed, released, and took hold all by themselves. I didn’t even know about it until she was 7 weeks past conception.
  2. Accepting some negative or sad thinking while balancing that with an effort to take good care of myself as much as possible. Plus a podcast: I could never deal with the “positive thinking” movement–something else I write about a bit in my memoir.  First of all, unbridled optimism just isn’t my thing. But even more than that, it felt crushing to me to force myself to think happy thoughts about how an embryo was implanting or how I’d be pushing my baby in a carriage soon, and then every month to not get pregnant again.But I was able to find a resource that helped me combat negative thinking, which in turn helped keep me grounded in a space that balanced honesty with the tough odds I was facing, with solace and assurance that I was doing everything I could to stay healthy–and that I could feel good about that. I used podcasts by Belleruth Naparstek (especially the ones on fertility, anxiety, and general well-being). I liked these because they didn’t force false hope down my throat but enabled me to focus on staying healthy, but I think you could use anything meditative and it would help.
  3. Keeping up with my yoga as much as possible: Related to this, I did yoga almost daily, sometimes fertility-centered yoga but mostly just whatever kind of yoga routine I felt like I needed to feel best at the moment. I’m not saying that helped me get pregnant physically–or emotionally, for that matter. Plenty of people do yoga and still don’t get pregnant, and arguments about doing certain kinds of exercise (or diets, or thinking regimens) in order to get pregnant are specious at best, I believe, and dishonest at worst. But the yoga helped keep me strong and as relaxed as possible (which of course wasn’t very relaxed at all, especially not during treatment).Perhaps most of all, when I turned 45 and started to try to accept that my odds of getting pregnant with my own eggs had statistically dwindled to zero, the yoga really helped provide solace while I mourned. It also left me feeling like I hadn’t completely lost 4+ years of my life to infertility, because one thing the experience had given me was the ability to do so many more yoga moves than I’d even been able to do before. That, of course, wasn’t nearly equal to the pain of thinking we’d never be able to meet our baby, but it was something I was still grateful for, and finding anything I could be grateful for, at that point, helped.
  4. Keeping my focus on the love in my marriage, and on how lucky I was to have found my husband–child or no–also really helped me. Even after my husband and I gave up trying medically, remembering my love for my husband enabled me to know that we would be OK, that I would be OK, even if we never got to meet our baby. This was hugely helpful especially as I started to mourn the idea of having a child, when I turned 45 and we stopped all medical treatments and I thought my chances were basically nil. And if I hadn’t been able to get through all this with our partnership intact, then essentially I would never have been able to have my baby girl, because we wouldn’t have still been trying naturally.

I tell the story of how long we waited for our daughter, and all the ups and downs this waiting entailed, in my book (The Good Shufu). But I post this now in the hope that it gives some comfort and encouragement to anyone who reads these words and is struggling to get pregnant or feels guilt about whether you are too stressed or doing the wrong thing to conceive. And I wish the same incredible good luck for you too.

The fastest way to get in touch with Tracy is here.

(Note: For more about trying to get pregnant, you can also see Getting Through to Getting Pregnant at 45 and On Delivering My First Child at 46, other blog posts I wrote in the hopes of supporting people slogging through infertility, although some of the content from these is reproduced in this post. I’ve also gotten quite a few questions about my pregnancy and birth experience, and I’ve written a bit more about those in the Washington Post online and in Brain, Child Magazine online — although please note that the picture in this latter article is not my daughter! It’s a stock photo the magazine used. In any case, I will continue to keep you all in my thoughts. Finally, if you’re *still* interested in my story [bless you for your patience if so!], the story of how I met and fell in love with my husband and then went through years of IVF and finally got pregnant naturally, is in my book The Good Shufu.)

My Father-in-Law Made Me the Mother I Am

BC-Logo_SquareSo happy & honored to have this piece up on Brain, Child Magazine‘s homepage. It’s about how caring for my beloved father-in-law as he died made me both a sadder and a bigger person, about how he “convinced me I could care for a child, that I’d grown big enough in the shadow of his decline to be a mother.”

It begins:

My Father-in-Law Made Me the Mother I Am

By the time I married my husband, I’d already fallen in love with my father-in-law too. Not in any weird way, but alongside all the passion and love for my husband was a deep affection for the man he lived with, the man he called Otousan.

My husband, Toru, is Japanese, and in Japan, it’s not uncommon for people to live with their parents until they marry. Toru was chonan, the oldest son, the one who should care for his parents as they age. When Toru’s mother died in a car accident, he left his company-backed MBA program at the university in Boston where I taught writing, and he moved back to Osaka. Soon after, I went too.

We moved into an apartment a few blocks from Otousan’s. Most nights, I’d cook dinner either at our place or Otousan’s, and we’d all eat together. My father-in-law spoke little English, and like many older Japanese men, he wasn’t what you’d call a loquacious fellow. But in between his silent welcoming of me as family in a country where marriage to foreigners can spell shame; his kind laugh at my dismal attempts to learn his language; and his grateful head-dips towards the tea I poured him after every meal, I grew to love him.

I may have loved my father-in-law, but I was terrified of having his grandchildren—or any child, for that matter. Not because of who or how Otousan was, but simply because having children is terrifying if you go into it with eyes-wide-open. At age 40, the year Toru and I wed, my eyes were pretty wide open.

I knew it was a myth that every mother bonds easily with her baby. I knew people who’d never bonded with their child, and one who said that, if she had to do it all again, she might choose not to procreate at all. I could imagine becoming one of these mothers.

Read the full piece at Brain, Child Magazine online,

My Piece in Washington Post on how Writing & Giving Birth Have about Zero in Common

Excited to have my first piece in The Washington Post‘s “On Parenting” site, one of my favorite new columns. I originally titled the post “Let’s Keep Books & Babies Separate,” although it’s been renamed by On Parenting’s wonderful editor, Amy Joyce, to “Writing a book is like giving birth? No, not at all.”

Here’s how it starts:

As any reading parent knows, a common claim made by writers—female and male—is that ‘writing is like giving birth.’

As a woman in my 40s who couldn’t sustain a pregnancy but who finally scored a memoir deal, few comparisons rankled me more. Now, as a 47-year-old new parent with a spanking new book to boot, I’m still frankly baffled by the equation.

When, after nearly five years trying and failing to have a baby, well-meaning friends tried to cheer me with, “Well, at least you’ll be giving birth to your book soon,” I wanted to respond, Really? But I bit my tongue. I was thrilled to have a book deal. Who I was to complain? (Out loud, at least.)

But truthfully, the book deal didn’t come close to compensating for, or even seem relevant to, the experience of turning 45 and hearing doctors tell me I had statistically a zero-percent chance of ever getting to meet my baby.

Then I became pregnant naturally at 45 and half. I live in Japan, where my husband is from, and at four months past my 46th birthday, I gave birth in Osaka to a healthy baby girl. So I suppose I had one more chance to compare the experiences—the incredible good luck!—of creating a book and a baby that would both live to see the light of day….

See the full piece here at The Washington Post online, and learn why I think the experiences of pushing out a book and a baby have about zero in common.

Getting Through to Getting Pregnant at 45

I started this blog because of my book, a memoir about marrying someone from another world, but I’ve noticed that the #1 search that leads people here involves pregnancy at or past 45. The last chapter of the memoir narrates the time in my life when I managed to get lucky enough to get knocked up naturally at 45, after 4+ years of infertility treatments (in a language I barely speak) and 2 pregnancy losses. But I wanted to write something quick and easy to access for all of you who come here searching right now for more information on the topic.

I remember sharply the sadness and disorientation of not being able to get (or stay) pregnant, the incredible endless-seeming limbo of it. So although of course I don’t know most of you personally, I’m keeping you all in my thoughts, and I hope you know how brave you must be to be wading through the pain of being not-pregnant.

I’ve written before about some of the myths of getting pregnant that my own pregnancy seemed to contradict. I’d be lying if I told you now that I know how I got pregnant naturally and delivered a healthy baby girl after I turned 46. And, no offense to anyone, but I’d guess that most people are lying–or at least are wrong–when they say they know the key to getting pregnant at an advanced age.

But I do know what helped me get through my years of infertility and losses, and get through it with my marriage enough intact that my husband and I were still happy to keep trying naturally after my 45th birthday. In the hopes that some of these things may help or at least give solace to some of you, here they are:

  1. The number one thing that helped the most was actually something my dear friend Jenna said, which was roughly something like, “The most important thing to remember is that you have basically no control. Your body is just going to do its thing, and there is not much you can do to affect that one way or the other.” When she first said it, it sounded harsh and maybe even a little hopeless, but then when I thought about it, I realized both how true and also how freeing it was to accept that, for the most part, there was very little I could do to control–and thus very little I could do to ruin my chances of–getting pregnant. This may not be true for people who have structural impediments to conceiving or carrying a baby, but for many of us, whether or not our body produces a healthy egg and releases it at the right time and nurtures it the right way is something we cannot master. As I’ve mentioned, my doctors had so many reasons why I couldn’t produce or release or implant an egg normally without shots, pills, weeks of medical preparation, or another woman’s eggs, but in the end, my daughter’s first little cells formed, released, and took hold all by themselves. I didn’t even know about it until she was 7 weeks past conception.
  2. I could never deal with the “positive thinking” movement–something else I write about a bit in my memoir.  First of all, unbridled optimism just isn’t my thing. But even more than that, it felt crushing to me to force myself to think happy thoughts about how an embryo was implanting or how I’d be pushing my baby in a carriage soon, and then every month to not get pregnant again. But I was able to find a resource that helped me combat negative thinking, which in turn helped keep me grounded in a space that balanced honesty with the tough odds I was facing, with solace and assurance that I was doing everything I could to stay healthy–and that I could feel good about that. I used podcasts by Belleruth Naparstek (especially the ones on fertility, anxiety, and general well-being). I liked these because they didn’t force false hope down my throat but enabled me to focus on staying healthy, but I think you could use anything meditative and it would help.
  3. Related to this, I did yoga almost daily. I’m not saying that helped me get pregnant physically–or emotionally, for that matter. Plenty of people do yoga and still don’t get pregnant, and arguments about doing certain kinds of exercise (or diets, or thinking regimens) in order to get pregnant are specious at best, I believe, and dishonest at worst. But the yoga helped keep me strong and as relaxed as possible (which of course wasn’t very relaxed at all, especially not during treatment), and when I turned 45 and started to try to accept that my odds of getting pregnant with my own eggs had statistically dwindled to zero, the yoga really helped provide solace while I mourned. It also left me feeling like I hadn’t completely lost 4+ years of my life to infertility, because one thing the experience had given me was the ability to do so many more yoga moves than I’d even been able to do before. That, of course, wasn’t nearly equal to the pain of thinking we’d never be able to meet our baby, but it was something I was still grateful for, and finding anything I could be grateful for, at that point, helped.
  4. Keeping my focus on the love in my marriage, and on how lucky I was to have found my husband–child or no–also really helped me. I’ve written about this in the past too, for the New York Times online, but even after I wrote that article, and even after my husband and I gave up trying medically, remembering my love for my husband enabled me to know that we would be OK, that I would be OK, even if we never got to meet our baby. This was hugely helpful especially as I started to mourn the idea of having a child, when I turned 45 and we stopped all medical treatments and I thought my chances were basically nil. And if I hadn’t been able to get through all this with our partnership intact, then essentially I would never have been able to have my baby girl, because we wouldn’t have still been trying naturally.

If I think of other things that helped me get through infertility, I’ll post them. In the meantime, I am wishing each and every person who reads this post the same good luck that somehow the universe delivered to me when I delivered my healthy baby girl at 4 months past my 46th birthday.

The fastest way to get in touch with Tracy is here.

(Note: For more about trying to get pregnant, you can also see An Honest Take on How I Got Pregnant Naturally at 45 and On Delivering my First Child at 46, other blog posts I wrote in the hopes of supporting people slogging through infertility, although some of the content from these is reproduced in this post. I’ve also gotten quite a few questions about my pregnancy and birth experience, and I’ve written a bit more about those in the Washington Post online and in Brain, Child Magazine online — although please note that the picture in this latter article is not my daughter! It’s a stock photo the magazine used. In any case, I will continue to keep you all in my thoughts.)

On Delivering My 1st Child at 46

If you’ve landed on this page after a random web-search, you aren’t alone.  The topics of “natural pregnancy at 45” and “getting pregnant at 45” draw more visitors than any other to this blog, although I initially started it because of a book I wrote about my marriage, not about infertility or TTC per-se. I only have 2 other posts on this whole blog solely devoted to trying to conceive in my 40s, and together they get thousands of views each month (which is a lot, for me!) and have encouraged over 500 women to reach out directly over email to share their stories, or sometimes just their fears and frustrations. (You can do so here.)

 And if you’ve landed here because you are struggling with infertility, I hope this post gives you some comfort and especially helps banish any guilt you may be feeling about what you are or are not doing to have a baby. And please know that although I (probably) don’t know you personally, I’m keeping you in my thoughts:

After more than 4 years of IVF and other fertility treatments in Japan, a country where I barely speak the language, I turned 45, and my Japanese doctors turned down the corners of their mouths when I asked about continuing to try to get pregnant.

They pointed not just to my age but my high FSH as a procreative non-starter, as well as a luteal phase defect, a blood-clotting disorder, low progesterone, and inconsistent ovulation. I tried natural approaches to fertility enhancement, cutting out coffee, wine, milk, soy milk, meat from non-organic farms, even water without ice-cubes and exercise at certain times of the month (to, I was urged, “nourish my blood”–whatever that means). I tried acupuncture and traditional Chinese medicine. I subscribed to podcasts about “positive thinking.” I felt guilty that nothing I did was working because I must not have been doing any of it well or strict enough.

On my 45th birthday, my chances of getting pregnant, according to the popular statistics, reached zero. I cried, and my husband assured me we could keep trying naturally. I said “ok,” but I thought he was being foolishly optimistic.  We stopped all medical treatments, and I gave up all the alternative approaches to boosting fertility I’d been using too, like acupuncture and herbs.

There Go All the Theories about What To Do and What Not to Do

Six months later, just after mother’s day and just after I wrote this post, we learned I was almost seven weeks pregnant. At the time, my beloved father-in-law was dying, and I’d been spending 4-6 hours a day in a Japanese hospital with him, where once again, I couldn’t understand any of the nurses or doctors. So there goes the theory that we just have to relax or not be stressed and we’ll get pregnant.

My husband and I were still trying naturally every month, although sometimes we were so tired from his father’s illness that we could barely make it past 9pm. But still, we were still trying, so there goes the theory that we just have to stop trying to get pregnant.

After my 45th birthday, I’d started drinking wine and coffee again. I ate what I wanted to eat and worked out when and how I wanted to. I tried to monitor my body with OPKS and other physical signs of ovulation, but that’s it. So there go the theories that we have to monitor what we eat or how we exercise to get pregnant.

My husband and I had also decided not to adopt if we couldn’t conceive (as I’d written about here, in the New York Times online). So there goes the theory that you’ll get pregnant if you just adopt and start to love a child–which I found the most insulting of all theories, actually.

In February of 2014, I was 4 months past my 46th birthday when I gave birth to a healthy, perfect little girl. She is lying beside me now as I write this.

I tell the story of how we waited for our daughter, and all the ups and downs this waiting entailed, in my book (The Good Shufu). But I post this now in the hope that it gives some comfort and encouragement to anyone who reads these words and is struggling to get pregnant or feels guilt about whether you are too stressed or doing the wrong thing to conceive. And I wish the same incredible good luck for you too.

The fastest way to get in touch with Tracy is here.

(Note: For more about trying to get pregnant, you can also see An Honest Take on How I Got Pregnant Naturally at 45 and  Getting Through to Getting Pregnant at 45, other blog posts I wrote in the hopes of supporting people slogging through infertility, although some of the content from these is reproduced in this post. I’ve also gotten quite a few questions about my pregnancy and birth experience, and I’ve written a bit more about those in the Washington Post online and in Brain, Child Magazine online — although please note that the picture in this latter article is not my daughter! It’s a stock photo the magazine used.  Finally, if you’re *still* interested in my story [bless you for your patience if so!], the story of how I met and fell in love with my husband and then went through years of IVF and finally got pregnant naturally, is in my book The Good Shufu. In any case, I will continue to keep you all in my thoughts.)

And on the Topic of Japanese People Reacting to a Pregnant Westerner…

A week or so ago, I wrote about my hospital midwife’s reaction to my being 1.5 kilos over the Japanese target weight for a pregnant woman at my stage. The encounter with the midwife happened a little more than a month ago, so now, my belly is even rounder.

I’ve actually been surprised to find that, once my nausea waned at about 19 weeks, I’ve really enjoyed having a pregnant stomach. There are two things I like about it:

  • One, I love not having to suck my stomach in after eating. I used to favor tight-ish tops before I got pregnant, and when I ate a big meal, I’d want to tuck my little belly roll in. Now I don’t even need to think about that.
  • Two, I kind of like being able to touch my own stomach in public! Is this weird of me? I realized yesterday, as I was coming home from a walk and rubbing my belly to see if I could feel the little one kick, that being pregnant is one of the only times we’re really allowed to touch our bodies in public without it seeming inappropriate. (I think this prohibition against interacting with our own bodies in public goes for both women and men, in both the West and Japan.) I didn’t realize being pregnant would provide a kind of unique bodily permission, and I really like it now, how it feels both secretive and special and public all at once.

My Japanese neighbors have seemed very sweet about my pregnancy, cooing over my belly, urging me to kiwo-tsukete, “be careful!” But they invariably seeming bowled over when I tell them that no, I am not about to give birth, I am due in about four months. (I don’t have enough Japanese skills to explain that, according to my American pregnancy books, size-wise I am right on target, so I just nod and smile and say Oki, ne? “Big, right?”) One neighbor, who has three incredibly polite kids of her own, is especially sweet, but every time she’s seen me for the past month or so, she points to my stomach and asks, in all seeming earnestness, if there are one or two babies in there.

I always smile and hold up one finger, but inside I’m always wondering, “Does she think, at 6 months, they are suddenly going to discover a hidden twin?”

OK, So I May Have Omitted Some Crucial Details

And What Do You Think of Ending a Memoir Mid-Story?

In my last post, about the very generous bloggers who nominated me for the Liebster award, I wrote that I haven’t been a very good blog-poster because I have been so busy working to meet my publisher’s deadline for the memoir. And that’s true. Sort of.

There is also a little detail I left out about the other reason I haven’t been a very good blogger: I unexpectedly got pregnant last May. Totally naturally. At the age of 45 and 1/2. After 4+ years of failed IVF treatments and 2 pregnancy losses. In the middle of my beloved father-in-law’s last months of his life, when we had just learned he had been diagnosed with acute pancreatic cancer. When I was spending 4-6 hours a day in the hospital with him to try to keep him company and as comfortable as possible. (Actually, we didn’t know I was even pregnant until I was 7 weeks, because we assumed I had either caught a stomach bug at the hospital or was sick from the sadness and stress of Otōsan’s* illness. So, on a side note, there goes the theory that women should just relax and avoid stress and then they will get pregnant.)

We had wanted Otōsan to name the baby, but sadly he passed away before he could tell us the names he had chosen. We miss him very much. And we are in awe that his little grandchild-to-be finally showed up (at least in the belly) and we got to tell him before he died.

Because of my past difficulty getting and staying pregnant and all years of medical treatments I went though in Japan (a part of the story covered in the last part of the memoir), because I was already 45, and because I was simultaneously morning the loss of my father-in law, I didn’t want to write or even talk much about my pregnancy at first. I was also so sick with morning sickness that I could barely get out of bed until I passed the 16-week mark; I even stopped working on the memoir for over 2 months.

Now the sickness is waning, I’ll be 20 weeks this Thursday, and my doctor expects me to deliver a healthy little one at the end of January.

So, the Memoir Was Supposed to End with Me, at 45, Coming to Terms with Not Having a Child…

When I sold the memoir to Putnam last winter based on the proposal and first 4 chapters, the story was supposed to end with me childless at 45, since my sweetie and I had decided against adoption (as I wrote about in the New York Times online). Well now, obviously, the pregnancy complicates things. In a great way, of course, but still. So I spoke to my editor last week about how to end the memoir now. Do I end it before I get pregnant? I can’t end it after I deliver, because the manuscript is due almost a month before my due date. It looks like the story will now come to a close with me mid-pregnancy, mourning my father-in-law while celebrating this incredible surprise of  the promise of a new life.

Sometimes I love this idea, because I’m not big on memoirs that tie up every loose end; life just isn’t like that. But sometimes the idea seems weird to me, to end so much in the middle of the action. Then again, if we are lucky enough that the baby is in fact born healthy, as is now expected, I guess that could be the makings of the second book: raising a child in a country where I still don’t speak the language (!), and where I’m a first-time mother at the crazy age of 46…

——-

*Otōsan is the Japanese word for “respected father,” what a daughter or daughter-in-law calls her father or father-in-law.