Finding a Way Forward with Low Ovarian Reserve: Tam’s Infertility Journey
“We’ve been married for 12 years and for the first eight years of our marriage, we purposefully worked to prevent a pregnancy and I was on birth control. When I came off birth control, my doctor said we’d wait a year and see what happened. A year went by, and nothing happened and that was when I first started to think that this could be something to worry about. However, I was also hopeful because I knew the Lord had told me we were going to be parents.”
“If we are dealing with infertility, and we’re one in six, then you know, seven houses down somebody else is probably going through and dealing with the same thing. We’re in this world together, walking through similar situations.”
When Tam got her official diagnosis, she was shocked. She had an expectation and a hope of becoming a mother easily and then she was given the news that being pregnant might not happen. She was diagnosed with low anti-Müllerian hormone (AMH) or diminished ovarian reserve and when she was first told, she had no idea what it entailed, what it was or how it happened. She learned that it meant she had a low number of eggs available and the eggs she did have were not as healthy as they should or could be to have a viable pregnancy. She also learned that it’s just her makeup and she was born with a certain number of eggs with no opportunity to get more with age, just less. From her perspective, there was nothing that could really be done.
What is AMH? AMH is a key hormone involved in developing a baby’s sex organs while inside the womb. In women, AMH is produced by the cells inside the follicles of the ovaries. The follicles are small, fluid-filled sacs in the ovary that contain and release eggs. Therefore, the level of AMH detected in your blood with a blood test corresponds to the number of eggs you have. This is also referred to as ovarian reserve. If you have a high AMH level, it indicates more eggs and a higher ovarian reserve. A low AMH level indicates fewer eggs and a lower ovarian reserve.
FINDING A REPRODUCTIVE EMBRYOLOGIST
“My gynecologist was the one who did my initial infertility testing and did the blood test that showed the low AMH. She recommended me to a reproductive embryologist (RE) and the first RE we met with was at a local fertility clinic here in Raleigh. Infertility clinics can be intimidating, especially if you’re not versed and you don’t clearly understand everything they are explaining to you. The first appointment went well but when we were ready to set up our follow-up appointment, COVID hit in March 2020 and the facility shut down for a temporary period of time.
When the fertility clinic opened back up in June 2020, they gave priority to couples or families who were already in a treatment cycle at the time they had temporarily closed. We were told their next availability for someone like me who was just getting started was October/November 2020. When I called back in November 2020, the original RE that I had seen retired and left before we could do our follow-up.
That’s when I started to do my own research to find a new RE in the Raleigh area. I found a lady and in January 2021 at my annual appointment asked my gynecologist about her and the UNC Fertility Clinic. When I pulled up the picture of this new RE who had just moved from the west coast, it ended up that my gynecologist had done her residency with this new RE.
It took until April 2021 for me to finally meet with the new RE and she was great. She gave recommendations for what she thought we should do and then sent us over to the finance department where we found out how much everything would cost with my insurance at the time. Our insurance would cover certain things, like certain IUI treatments, but would not cover any medications or IVF.
“When I got my diagnosis of low AMH, it hit me hard, but it also impacted my husband and especially on an emotional level…He wanted to have a say in all of this, too.”
Once we found out how much everything would cost, my husband and I had a discussion and we decided to put a pause on moving forward with treatment for the time being. The top two reasons were finances but also time to focus on our marriage. We wanted to make our marriage a priority over starting a family and focused on our marriage through the end of 2021. That got us to a great place where we are once again talking about our future for family planning. I plan on following up with our RE again to do further testing and see where my numbers are now and determine how best to move forward. We’ve been at a standstill, which can be frustrating, but I’m also content knowing we aren’t rushing anything but trying to do what’s best for us as a family.”
WHEN INFERTILITY STRAINS YOUR MARRIAGE
“I was adamant about us starting to have children since the day we got married. My husband has always wanted children, as well but he’s also very conscientious and intentional about planning so we can fully provide for our children. Sometimes that’s been frustrating because I say that we’ll make it happen when the time comes. People do it every day. At the same time, I had to take a step back and really respect what my husband was saying.
When I got my diagnosis of low AMH, it hit me hard, but it also impacted my husband and especially on an emotional level. I was still of the mindset that we’d figure this out and should still try treatment, which caused a lot of tension. He didn’t think we could force things and he didn’t feel like I was considering how he felt but was wanting to do what I wanted just so I could have a baby by any means. He wanted to have a say in all of this, too.
It was a lot and we had to take the time to have hard conversations. I didn’t want to force anything, but I also felt like if we don’t move forward now, we will never get pregnant. And with each conversation, more time was passing, and we were only getting older. I hadn’t hit 35 at the time but with my diagnosis of low AMH, I felt like we were losing time.
I started sharing a lot of our challenges on social media to the point where my husband pointed out I was sharing with the people online before I would even share it with him. That’s not how we operated. I realized that ever since I received my diagnosis, things were shifting in our communication in a way that was not healthy for us. So, I took a step back to focus on us and get us back on track.”
THE MENTAL BATTLES OF INFERTILITY
“Being a mother, outside of being a wife, is the second thing I’ve always wanted. I’m currently in this age bracket where everyone is having a baby around you. So, to go through my cycle every month, maybe be a few days late and think that this might be the time we are pregnant only to find out we are not, is incredibly hard. The continuous cycle of being disappointed really wears on you. There are also the people who get pregnant unexpectedly or the people who have kids and might complain about parenthood when you are struggling just to get pregnant.
The emotional burden is multifaceted, and I really have to depend on my faith. I also depend heavily on therapy, and I journal a lot. I can get really bogged down in my thoughts of whether I should have been on birth control for as long as I was because maybe I could have found out about the low AMH sooner and my numbers wouldn’t be so bad. Or I think about if there was something I did to cause this to happen or if I really don’t have the motherly qualities I thought I did since this is happening. It’s a constant mental battle of what if’s or maybe I could have done this, or maybe I could have done that, and it can all really bring me down.
“When I first joined [the community], there weren’t many women of color sharing their stories and now we are everywhere. I’m so proud to say that because it’s so needed.”
I have gotten to the point where I have to take time to process my thoughts, especially once I’ve heard that someone is pregnant. It gets to the point where I feel like people are scared to tell me that they’re expecting, which I understand. But I don’t want people to feel like I’m so fragile that I can’t hear their news or that I’ll break.”
FINDING COMFORT IN COMMUNITY
“Being a part of the infertility journey is something you never want. But, once you are here, you are surrounded by an amazing club.
We got our official diagnosis in February, and we didn’t officially share publicly until that October. My husband started a podcast, and I would join him on episodes to talk about our marriage and relationship and it was on one of these episodes that we officially announced our infertility. When I started looking for other stories of infertility, Instagram is where I found the core community. When I first joined, there weren’t many women of color sharing their stories and now we are everywhere. I’m so proud to say that because it’s so needed. People see infertility treatment, and IVF in particular, as an elective and it’s why health insurance doesn’t always cover it. You hear about celebrities and others with many resources have the option to just go and get IVF, paying easily out of pocket. Then there’s someone like me and others that I know who actually have issues and we struggle to figure out how to finance treatment because our health insurance doesn’t think it’s necessary. It’s an uphill battle.”
FINANCIAL CHALLENGE TURNED INTO CREATIVE OPPORTUNITY
“Financially, it’s to the point where you must wonder how far you are willing to go to get what you want. We’ve looked at loan options, grants, and scholarships because financially, we feel limited on treatment options in a lot of ways. But it also makes you creative in trying to figure it out. It’s all about perspective and my husband helps me out a lot with that because I’m more of a glass half empty viewpoint, while he sees the glass half full. He believes we will figure it out and he comes up with ideas that I never would have thought about. Maybe you spend your time finding grants or scholarships or you reach out to clinics that are doing free trials. Maybe you participate in content creation and paid partnerships, or you find a way to use something that you love, like my photography to raise money. If you choose, you can change your perspective and see the financial challenge as an opportunity to be creative.”
SCHOOL OF GOOGLE AND YOUTUBE
“If you choose, you can change your perspective and see the financial challenge as an opportunity to be creative.”
“I went to the school of Google and YouTube to get information and to do more research on my diagnosis. About 70-80% of the information was tangible, that I could hold on to, but I was still not completely sure I fully understood my diagnosis and what to do. So, I would bounce bits of information off another lady within the community that I knew who had a similar diagnosis and get their perspective and experience. It’s been a balance of doing my own research and then following up with questions to other women in the community and if I had a good relationship with our RE or my gynecologist, I’d take questions to them, as well. For as long as infertility has been in existence, there’s still not a lot of useful resources out there.
When my gynecologist gave me my diagnosis of low AMH, it was more just informing me what she saw and following it with the statement that she wasn’t saying I couldn’t get pregnant but that it was likely going to be difficult. I heard that and immediately wondered what I was supposed to do with it. It was truly just delivery of the diagnosis and then handing me off with a recommendation to the RE. It felt like I was being told to move on, but with a sweet voice. I guess she felt like there was only so much she could do.”
SHOCKED AT THE STATISTICS
“I have been most shocked at the statistic of how many families deal with infertility and also how many families and individuals deal with miscarriage. One in six couples deal with infertility and then there’s one in four couples who deal with miscarriage. That blew my mind because when I think of six couples right now, that means that probably half of those that go to our church or that I work with have experienced a miscarriage or one of the six are dealing with infertility, like we are.
When I sit and think about who has told me they had a miscarriage, it’s only two people. That then means that more than likely there are two more couples that I don’t know about who might have dealt with loss and haven’t said anything. That idea blew my mind because I think about how if we are dealing with infertility, and we’re one in six, then you know, seven houses down somebody else is probably going through and dealing with the same thing. We’re in this world together, walking through similar situations.”
BUILDING ARMOR TO PROTECT YOUR PEACE
“Some people feel like they can’t share their struggles, even with their families, because their family won’t know what to say or their family will say something crazy, and they will feel bad. Because, when you haven’t experienced infertility, or when you haven’t had to go through it yourself, you don’t know, and you may not know how to respond. If you’re sensitive like myself, you have to prepare for all sorts of comments or else your feelings end up getting hurt and you question who you can share with. That concern leaves us walking along this path, dealing with all that it holds on our own.
Not sharing when you go through a miscarriage, or any part of your infertility journey is armor to protect yourself and armor to protect your peace.”
FINDING A WAY FORWARD ON A HARD JOURNEY
“My faith is what keeps me moving forward on this incredibly hard journey. When I first got my diagnosis, me and the Lord were not on good terms. I was mad and I was upset with him. I’m a Christian and a believer of Jesus Christ and I really depend on that in this journey. At the beginning of our journey though, I was like okay, Lord, you told me that we would have kids, and you told us to prevent for a certain number of years. Now that we’re here trying to have kids, I questioned why the Lord would let me go through this, knowing the whole time that I would have the issue.
But throughout the process, God really has given us glimmers of hope that the promise is not in vain. It’s not null and void and it will still come to pass. It may not be exactly how we thought but it’s still going to happen. That idea is what keeps me going.
“God really has given us glimmers of hope that the promise is not in vain. It’s not null and void and it will still come to pass.”
I’m also motivated to keep moving forward by the community that I’m surrounded by. When I’m having a tough day, I can text my personal community, my girls, my best friends, my husband, or my mama and tell them I need them to hold me up today because today is hard day. And that’s exactly what they do.”
FOR THOSE WOMEN WALKING THE PATH OF INFERTILITY
“You are still worthy of becoming the mother that you desire to be.
Regardless of your diagnosis,
Regardless of how things may look,
Regardless of what the numbers may say,
Regardless of what your finances may say,
Regardless of the support that you have and the support you don’t have…
YOU ARE STILL WORTHY.
If the desire is in your heart, if you feel that you still want to be a mother or a parent, you are worthy of that.
You have the strength within you to push through and get to your goal. You can do it!”
You can continue to follow Tam’s journey and feel the light and encouragement she exudes through her continued support of others battling infertility on Instagram @thisistam_.
