30 Something and the Clock is Ticking

'Thirty-something and the clock is ticking' by Kasey Edwards http://www.kaseyedwards.com/

I came across this book completely by chance - I had previoulsy ignored an article about it in one of those trashy gossip style magazines dismissing it as 'just another sensationalist IVF story'. But a month later accidentally I bought the book that the article was about ... I say accidentally because I didn't make the connection between the book and the article until after I had bought the book when seeing it randomly on the shelf of a little bookshop.

Anyway, I'll cut to the chase as you aren't interested in how I came to find it.

What's it about?

It is the story of a woman in her early thirties who is told by her gynaecologist that she has a year in which to get pregnant and have a baby or else her 'fertility window' will be gone. In the book, she tells her story: how it made her feel to hear those words, deciding whether she wanted a baby or not, the fact that woman don't realise the facts of their own fertility and that it really is a 'window', and the treatments and path that in her case, led her to a successful pregnancy and the birth of her daughter.

It is a short novel but it is well worth reading as it makes many valid and important points about the challenges of infertility and being a woman on the 21st century - you'll read it and probably think it is no revelation - it says many if not all the things women that have been blogging about for many years now - she tells of the importance of making sure women today are educated correctly as to their own fertility so as to make informed decisions as opposed to being caught out; as well as talking of her own challenges of IVF and those of the people she knows and how there is no guarantee that it will be successful.

The surprising thing is that she was able to convince a publisher to take on such a story and publish it as a book commercially. I think much of her success in convincing folk to print her book relates to how she tells the story - it is very upbeat and ends with a 'happy ending' - in her case she got to give birth to her daughter. There is a sad and unfortunate downside to this though (and it is by no means a criticism of her writing) - as a result, many of the important messages advocating fertility awareness and recounting the abyss that battling with IVF and infertility is, can get lost on the reader. I wonder how much those points will really stick in the mind of a person who has never 'been there'.

It made me sad to read some of the online comments in response to articles in various newspapers talking about this novel a few months ago. Some women posting comments online seemed to attack and criticise Ms Edwards as opposed to being thankful and acknowledging the important message. I guess this comes from a multitude of places and emotions:

It can't help to feel 'lectured' by someone or to see them making money out of it. Did they feel that she was 'tooting her flute' about her own 'happy ending' and so in no place to comment to others?

How do you deal with the sadness or bitterness of the fact that some women can't even meet someone with whom to try for a baby for - this is a very sad reality of being a modern woman today - meeting a guy who you can settle down with or who you would like to be your 'baby-daddy' isn't that easy!

The comments which concerned me the most, however, were the ones who said that they knew all the facts and seemed to feel she was 'teaching them to suck eggs'. You see, there may be some women out there who know about the facts of how fertility declines with age, but I think many think they know more than they really do. Do they really know the statistics about IVF and chances of success resulting in a livebirth? Is this the naivety or arrogance of youth? Or women not really want to hear - and burying their head in the sand. If so, how do you get the message across to a set of men and women who don't really want to listen?

With respect to this last group, there will always be nay-sayers to anyone trying to do the right thing and prevent people from going through the heartache and difficulties that we have suffered; so however disheartening it may be, we have to continue with the push to improve education. Even if it may feel like pushing water uphill. Kasey Edwards got her 'happy ending' of having a baby that is genetically hers via IVF but not every woman doing IVF comes away with a baby at the end of the process if they can't do it on their own. And so we can't rely on IVF as a fall-back option as women to allow us to delay having a baby if that is what young women today think. And they do - I was contacted last week about someone who thought exactly that and was now facing the stark reality that she may not even be a candidate for IVF due to age.

It is hard being a modern women - we 'grow up' and are ready to 'have a family' later than before nowadays but unfortunately fertility hasn't evolved with us. So we have to educate women to realise that if they want to have a baby, they probably can, but unlike men we may not be able to put it off a few years in the same way. Because if you need fertility treatment it is better to be doing this in your more fertile years (i.e. before 35). Harsh as it sounds, sadly this is the case. And yes, it completely sucks that some women haven't met Mr Right at the 'right time' - and oh how I wish we had a magic wand to make that right ....

Update

How do you tell your friends that are struggling with infertility that you are having a baby? I don't know how you do it.... it is as simple as that....

In April I had a baby but I can't tell you how sad it made me that others remain struggling, battling with IVF, to do another round or not, could they afford to do it or not, whether to start adoption, or starting that process.

People may talk about what you 'deserve' but I really don't agree with this concept. Some things in life are not fair; are quite simply a lottery. And fertility is one of those - why can a person with low chances of success get pregnant but not the person who according to the textbook has everything right?

If there is nothing else remember this - as was said to me a few months back - we cannot forget where we came from and the battles with infertility (or more positively put 'the fertility challenges') - and so we must continue with the fight not only to support those who are in that place which feels like you are perpetually 'treading water' but we must also do want we can to inform people, and in particular the young women coming up the ranks, of the challenges that women face with respect to their own fertility and being modern women of our age.

And so after a short hiatus, I am back to continue with the quest to better educate the young women of today. For my next blog I will be discussing the recently published book by Kasey Edwards - '30 something and the clock is ticking' - for now here is the link to her website so you can read into it for yourself .... http://www.kaseyedwards.com/

How late is late? You only know what you know

There has been massive radio silence from me - well there has been. Little time and no internet till a week or two ago - back to full time work, decorating and moving back to my old house in the UK. Anyway, this isn't about me so enough of my wimpering ....

In the last month there has been some excellent articles in the UK press which really deserve to be shared. The links to the articles are below and the headline points are right on the money:

• The best age to have a baby is between 20 and 35
• Don't wait too long for a baby: Women are SIX times more likely to suffer from fertility problems when 35 than at 25
• Doctors have issued the stark warning to couples as more and more women pursue careers and leave parenthood until their late thirties.

Now, of course, not all women leave or wait JUST because of their careers. Many don't meet their other halves until in their thirties so what do you do - we all love the idea of you meet and are married and get pregnant within six months of meeting but even at age 30 plus it doesn't work like that - life isn't the fairytale for all of us and it can take 2 or 3 years before you are settled enough to get married and start to have kids by which point you are out of the optimum period.

To me it highlights the massive challenge that comes with being a woman in the 21st century. They tell you to be financial independent and not to rely on men for financial security (well my dad certainly drummed that one into me and for good reason when he saw the amount of divorces around him and women left struggling to raise children with little money and relying on maintenance - he didn't want that to be me); but the flip side is you get an education and a career first in your twenties when historically and traditional women were having babies.

You'll read commentaries about how women just want to 'have it all' but that is just nonsense [my opinion]. My dad died many years ago but I am sure that he no more wished for me to have to have struggled with infertility as he did not wish for me to struggle financially because I was financial dependent on a man and left divorced. And that is a man's perspective for his daughter! Not a feminist view.

So what we need to do is make sure we educate women (and men) so that they can try and organise their lives (as best they can) to strive to achieve the two. It is harder for women possibly on this count than for men, I don't think we can argue against that. Women have more of a finite time-line to contend with than our male counterparts. But as women we have two options: to complain it isn't fair, and suffer the consequences; or do something and make sure we keep all young men and women better informed than we were by our predecessors.

I know which one I am picking and I hope you will too - share and educate our young men and women on the challenges of fertility. Awareness is key.

The Links:

http://www.dailymail.co.uk/health/article-1351237/Women-6-times-likely-suffer-fertility-problems-35-25.htmlhttp://www.telegraph.co.uk/health/healthnews/8287719

http://www.telegraph.co.uk/health/healthnews/8287719/Doctors-warn-couples-not-to-leave-it-too-late-to-have-a-baby.html?sms_ss=email&at_xt=4d4ade58d7be4928%2C0

http://www.guardian.co.uk/society/2010/dec/31/pregnancy-mothers-fertility-children

Holiday period & moving back - how people react

We have recently moved back to the UK from living overseas. One of my big concerns was always about falling back in with the old crowd of friends that we know locally, or rather not falling back in. They have all moved on and had babies who are now toddlers or young children. My anticipation was that they wouldn't want to do the same things as us anymore as their focus would be elsewhere. So it was high on my radar that I would probably have to make a big effort to make new friends whose lives perhaps didn't revolve around children - nothing personal to the old crowd - just one of those things. So people may be interested to know what the reality was?

It is exactly that: their socialising now revolves around their children, and so you aren't invited. They either view you as the people who don't want children and assume you don't want to be bothered with such functions, or else when they know of the challenges you have faced, they think it is better to not extend the offer of an invite to you.

No harm is meant, I'm know, but it is very interesting as to how people react. Rather than tell you what is going on and explain why they are being the way they are, or to give you the option to attend, you just don't get invited. Best not hurt your feelings by not telling you; and well, as someone who was already braced for such behaviours it hasn't much bothered me, but it is kind of sad. Things do come to pass as you anticipate, a little.

We're very lucky - old university and school friends are the same as ever and no change, and we have a circle of single or childless friends so we don't feel alone. But I can see how some people could feel a bit like they have been 'banished to Siberia' if they didn't have that wider network.

So if there is any young person reading this, I know having a baby may seem like a long way off to you, even when you are in your twenties, but please bear in mind that one of the challenges of leaving having a child till later is the above - to be fair, this could be the challenge even at a younger age, but the risk is higher the later you leave it. Some of your friends will easily have their children later in life with no problem, and you could be the statistical one in five that has fertility problems. This is a complete lottery - it may not be you, and for your sake I hope it isn't, but as it has to be someone it could be. Just bear that in mind next time when you think of delaying trying for a child, or dealing with any friends of yours who are childless.

Men: often overlooked in the feelings department

There are many articles, discussions and blogs about how fertility challenges (I hate the word infertility) affects women, but men and their feelings are so often overlooked. We tell people when faced with a challenge to "man up" sometimes and perhaps that accidentally points to one of issues - men are expected to be the strong, resilient and unemotional ones. So often times people take the view that they don't need support. To be otherwise is girly and, therefore, perceived as weak.

So let's start right here and now and correct the assumption - men feel the pain of struggling to conceive and stay pregnant too. I am not going to go into degrees of whether it is equal, more or less - in truth I don't know the answer but I suspect that it varies from case to case and that more often than not it is the same more or less. He wants to be a dad as much as the woman wants to be a mom. He doesn't suffer the biological interventions necessarily to the same degree, but he still feels.

I have observed many different approaches and reactions to the male component:

1) men are often less likely to discuss the challenges they are facing or emotions that they are feeling with friends or family: They are more likely to bottle up their feelings. This doesn't mean they don't feel though. The fact that they don't confide in someone can make it harder for them at times, I think. Even if they say it is their 'coping mechanism' they still struggle and suffer deep within. The lack of externalising one's own emotions sometimes can be harmful in the long run - I have seen the stress come out in physical manifestations of all kinds of ailments, such as stomach complaints, which at first blush you might assume are unrelated;

2) people often forget to ask the man how he personally is managing and coping: men often get asked by friends and relatives, particularly male friends and relatives, about how their other half is dealing with it. However, somehow people can be reluctant to ask men how they are feeling. I have no idea why this is. I know it frustrates the living daylights out of me, because to me it feels like not wanting to mention the elephant in the room. But it could also be more a reflection of the person asking in the first place: maybe they assume that because the exterior that they see is all calm and collected, that all is fine; may be they don't know how to deal with the answer they get, be it curt or an unexpected out-pouring of emotion; maybe it is because they feel that the listener will work out that it is implied from their silence?;

3) men are expected to be tough and not feel the impact of the challenge as much as women: I have observed men be told about pregnancies of persons close to them and be told they just have to accept it because 'it is what it is'. And then the person has to hear all about the details of those pregnancies with only rarely, if at all, being asked as to how they are doing, how they are coping, or do they need anything in the way of support. It may well be that the speaker does feel compassion deep within, but it isn't expressed. Being the complex creatures that we are, a man as much as a woman can struggle to interpret the silence and lack of acknowledgment - is it lack of interest, lack of sensitivity or simply that the person doesn't know how to deal with the 'softer' aspects of the situation? Is there an assumption that the man is less affected by the infertility so that he doesn't need the same level of compassion and sensitivity as a woman does?

4) the holiday season can be challenging to men too: parents may elect to visit their children with offspring ahead of their 'infertile' children. The 'infertile' children can be told they will be visited in the New Year. If the 'infertile' child is a male, there can be a habit of delivering the message in a very matter of fact way without any attempt to bolster feelings and self-worth as you would if speaking to a woman. Again, it may be that parents think that men don't need the 'soft language' or cannot deal with it. But you can never assume. It can hurt a man as much as a woman to feel excluded.

People struggle with how to respond or deal with women in this situation, so if there is one take-away, it is don't assume men are necessarily light years away from feeling the same as you might expect of a woman. They may just be better at hiding it. Boys do cry, even if they always don't shed tears or have emotional outbursts in the same way.

Now to finish here is the ultimate piece of irony, and one to dispel all stereotypes and generalisations that I/we may ever make about men! Along our journey of challenges so far, it has been a man who has been the best at managing the right balance of level-headed 'it is what it is' approach with compassion and support. The fact that they were expecting a child was relayed to us at the same time as everyone else, and the excitement and nerves wasn't hidden from us and yet at the same time, there was never a conversation where a portion of it wasn't dedicated to being supportive, offering help to us and asking how we were doing. It was recognising the bitter-sweet nature of the situation but with equal respect to each. We felt respected for the honesty and not being treated as social lepers and also respected and appreciated for not being forgotten in our times of challenge - and very appreciative that the person still found the time to think of us even when consumed with his own busy life.

Painkillers in pregnancy and male babies

http://theafa.typepad.com/theafablog/2010/11/painkillers-in-pregnancy-and-male-babies.html - Link to AFA posting

In the written press as well as on the internet these last couple of weeks, particularly in Europe, articles have started to appear, stating that common painkillers could be linked to male reproductive disorders. It was reported that scientists had found a link between the use of mild painkillers in pregnancy and the risk of giving birth to a son with undescended testicals with the possible consequences of having both poor sperm quality, as well as the potential for the emergence of testicular germ cell cancer in later life.

The study was done by researchers from the University of Copenhagen as well as other academic and medical institutions in Denmark, Finland and France.

The study featured both an analysis of pregnant women’s medication use and also data on animal research studies which analyzed testes development in rats; one potential outcome of the study indicated that the timing and duration of the mild painkiller use during pregnancy was linked to the risk of undescended testes in male babies. The research also suggests that ibuprofen, aspirin, and other nonsteroidal anti-inflammatory painkillers act as hormonal "endocrine disruptors" thus interfereingwith normal male sexual development. The greatest window of risk appears to be in the second trimester of pregnancy in humans.

To anyone reading the headlines these articles might be worrying at first blush. For example, it seems to suggest that even paracetemol (acetaminophen) may increase the risk in male babies (to a lesser degree).

In addition, there are many women presently being prescribed low dose aspirin during pregnancy to address cases of miscarriage risk or blood-clotting disorders (it is important to note that low dose aspirin is only a quarter of the regular, standard dose). Women in this situation may feel in a conundrum about what to do when managing the relative risks of both taking, and not taking, this medication. First up the advice to anyone pregnant that has taken such painkillers and is concerned about these findings is clear: consult with your doctor.

The British NHS Choices website states: "It is preliminary but important evidence, although at the moment, it is unlikely to change the current recommendations to pregnant women. These are to: avoid medications in general and to use paracetamol rather than ibuprofen or aspirin if painkillers are needed. However, advice should always be sought from a GP or midwife before taking medication." And if your doctor has recommended that you take medication, such as low dose aspirin, consult with him or her as to what to do, if anything.

Some believe that there are shortcomings to the research, for example, small sample sizes and the number of analyses involved reducing the certainty of its finding. The direct causal link has not firmly been proven. Nor does it examine the case of women who have been taking low dose aspirin (quarter the standard dose). Also, there are many other studies which show the benefits and upsides of taking the low dose for miscarriage risk/blood clotting issues on doctor's recommendation. Therefore the reports do need to be read with caution. What is clear is that this is an important area which needs more urgent research. While the rates of undescended testes seen in the study were still relatively low, it seems, as unfortunately happens with reporting in the press, the risk factors quoted can vary from article to article and some of the headlines can be alarmist, suggesting a 'global sperm decline'.

The NHS Choices website concludes: "Overall, this study does not prove a link between use of painkillers in pregnancy and this reproductive disorder in boys but it does suggest an important avenue for more research." Let's hope this research and investigation happens swiftly. As always, it is better to be informed than ignorant, however, information such as this may put a lot of pressure on the reader to think critically as a result - which is easier said than done if it affects you personally.

No matter how level-headed you are normally, to anyone who has suffered or is suffering from primary or secondary infertility, reading such an article could prove to be quite unsettling. Whatever your situation, it is essential to consult with your doctor if you are or have been taking mild painkillers and are worried in order to address any concerns you may have.

A thought .....

Following on from the work and efforts of Dr. Mary Herbert as mentioned in the last blog entry, here's a suggestion:

How about each of us try and have a word with our nurse and/or doctor the next time we visit them to see if they will get information evenings and leaflets running in their practice on the topic of raising fertility awareness to our young men and women? In particular to raise awareness to those in their 20's and 30's who are in the age range who need the information the most.

We have a wonderful example to refer to now.

Thanks!