By Dr. Mark Johnson
“Life is what happens while you are busy making other plans.” (John Lennon).
My wife Peggy and I are proud parents of three beautiful daughters. We started our family when Peggy was in her mid-30s and we did not complete our family until she was in her early 40s.
Peggy and I were in our second year of marriage when we conceived our first daughter, Olivia. Olivia was easily conceived. Peggy’s pregnancy with Olivia was every woman’s dream pregnancy…a spontaneous conception, an easy beginning to our family without difficulty, and a pregnancy that grew easily and delivered without complications.
It was an exciting, optimistic time for us as a couple. Before I specialized in reproductive endocrinology and genetics, I had practiced as an obstetrician. I had cared for more than a thousand pregnant women and I had shared in the joy (and sometimes the difficulties) of delivering their babies. Peggy was a prenatal genetics counselor. She had listened to and counseled hundreds of pregnant women through their pregnancies. Through our experiences with our patients, we had come to know the pregnancy process. This time the pregnancy experience was happening to us.
As the months passed, we watched Olivia grow and Peggy and I grew together as future parents in anticipation of her birth. We were blessed with an uncomplicated pregnancy that delivered Olivia naturally on an August Sunday afternoon in UCLA Santa Monica Hospital overlooking the Pacific Ocean. It was the perfect culmination of an easy conception and the beginning of our lifelong adventure of parenting.
By Olivia’s second birthday we had moved from Los Angeles to Florida. The private practice opportunity in Florida did not succeed as planned and we became homesick for the west coast. By Olivia’s third birthday we had moved across the country again, settling in Phoenix. A second pregnancy conception had not yet occurred. Peggy was three years older and well into her late 30s.
As the years passed since Olivia’s birth, we had been busy working, making plans, and enjoying being parents. We were not thinking about Peggy’s ticking ovarian biologic clock. Although we were very aware that a woman’s fertility declined with increasing age, we assumed that our next child would be as easy to conceive as our first. We had taken our previous fertility for granted and never thought that infertility could happen to us.
As Peggy approached 40, I finally confronted the fact that we needed to pursue fertility treatment in order to have our second child. We started with clomiphene citrate and inseminations and slowly moved up to high dose gonadotropin injections with inseminations. After a year of ovarian stimulations and inseminations, our best outcome was only a biochemical pregnancy. After repeated tearful disappointments and way too many shots, it was time to move to in vitro fertilization (IVF). Our first cycle of IVF produced embryos that went to transfer, but no pregnancy. More tears, more worries.
It was still hard for us to believe that after such an easy experience having Olivia, that only a few years had dramatically affected Peggy’s fertility, resulting in her decreased ovarian reserve and low egg quality. We intellectually knew that as a woman advanced past her mid 30s and into her early 40s that the normal aging process was associated with decreased fertility. We intellectually understood that normal aging was associated with a decline in the number of eggs available within the ovaries, We also knew that the quality of the eggs would start to suffer from increased chromosome abnormalities, resulting in a higher rate of embryos that failed to implant, miscarriages, and fetal aneuploidy (Down syndrome). Our personal emotional understanding of our reduced fertility as a couple was finally confronting our intellectual understanding of our biologic aging.
We took a break to regroup our emotions. The repeated treatment failures would have been a difficult reality to confront as a childless couple. Having our daughter, Olivia, at home in our family was a big comfort for us.
It was around this time that we considered adopting a beautiful girl in our church who was the same age as Olivia. The adoption process would be complicated. The little girl was in foster care and her biologic mother still retained parental rights and showed an occasional interest in her. We kept the possibility of adopting a child into our family as an open option.
After some time, we decided to restart fertility treatments with plans to proceed with IVF. Finally, after years of trying, our second cycle of IVF was successful. Peggy’s high HCG levels had hinted at a twin pregnancy, but it was not until the ultrasound revealed two tiny beating hearts that we knew that our hopes and prayers were answered. We were blessed with a twin pregnancy. Under the care of Dr Jordan Perlow, our Perinatal Obstetrician, Peggy carried to 38 weeks without complications and delivered Sophia and Arianna by Cesarean section. It was one of the happiest days of our lives.
Peggy and I have been blessed with three daughters. I am thankful every day for our family. I am also thankful that we have closed the infertility chapter of our lives. We are both thankful to move on to the everyday challenges of being a family: of raising three daughters and living our marriage and our lives together.
The lessons from our experience are simple: be aware and listen to your body. Your biological clock is ticking and as you live each busy day you are aging in different ways. Don’t procrastinate your health care responsibilities. Be proactive and check your biological clock with annual well woman exams and appropriate medical testing. The reproductive window of opportunity for a woman is limited in time. Your fertility is a gift that will one day fade and come to a close in your lifetime.
Mark D. Johnson, M.D. has practiced reproductive medicine and fertility in the Phoenix valley since 2000. He came to Phoenix with an extensive professional experience in reproductive medicine. His background is unique in that he is both an experienced reproductive endocrinologist and infertility specialist and a clinical geneticist. He is Board Certified in Obstetrics and Gynecology with subspecialty Certification in Reproductive Endocrinology-Infertility and is Board Certified in the specialty of Medical Genetics. To make a consultation with Dr. Johnson at Arizona Reproductive Medicine Specialists, call (602) 281- 9032.
