Successfully Pregnant After 40: My Personal Journey

I thought that having my second baby would be easy. I had already learnt so much from 6 years of trying to have my first baby naturally with delayed diagnosis of lean PCOS. And now having both functional medicine and Natural Procreative Technology training under my belt, I thought I would know how to deal with almost any fertility challenges. Oh, was I wrong!

Having my second child was filled with even more trials and tribulations than my first. Although after having my first child, I didn’t have as much difficulty getting pregnant. I never had a positive pregnancy test with my first child. But before my second successful pregnancy, I had 4 other positive pregnancy tests that resulted in dashed hopes. Now I feel very blessed that it looks like I am finally keeping my baby with my last positive pregnancy test. At the time of this publishing, I’m now 23 weeks pregnant at age 42. And I thank God that by all measures, this baby appears healthy.  

Warning: What I am about to tell you is very personal, and may not apply to everyone. Always consult your own doctor for your individual situation. I’m sharing my story so maybe one day you could learn something from my journey.

An initial stroke of bad luck

Nearly 3 years ago, when I thought we were ready to have another baby, I experienced a stroke of bad luck. My first pregnancy was quickly ended by a ruptured appendicitis that required emergency surgery. Having a ruptured appendicitis was like a bomb that went off in my pelvic cavity. I was worried that all that inflammation could result in scar tissues that could negatively affect my future fertility. 

I took steps to curb inflammation using my functional medicine training. And I tried to conceive 3 months after the ruptured appendicitis, when I had just finished my inflammation treatment. In retrospect, I should have waited 3 months AFTER finishing treatment the inflammation. This is because while I quickly conceived, that pregnancy ended at 8 weeks gestation when I discovered in the emergency room that I had an ectopic pregnancy. I believe that the inflammation from the ruptured appendicitis likely caused adhesions/scar tissues that increased the likelihood of my ectopic pregnancy. 

Fortunately for me, this ectopic pregnancy was not life threatening. It didn’t cause me to have significant loss of blood or have low blood pressure. Miraculously, the intense pain disappeared on its own after an hour despite the ultrasound showing there is a 2cm mass near my right ovary, without evidence of gestational sac.

While I was almost wheeled off into the operating room, at the last minute, under the counsel of the OB doctor in the ER, I decided to go for medical management of ectopic pregnancy using methotrexate. I am so thankful that this was the route that I chose. You’ll discover why later. 

Tubes and tribulations

The initial month after taking 2 total doses of methotrexate, I was drained. I barely had any energy to do things outside of work. And for 3 months after the ectopic pregnancy, I had weekly blood draws to make sure that my HCG levels decreased to zero. Being poked weekly was no fun either. 

Due to my fear of having scar tissues causing blockage of my right fallopian tube (because my appendicitis and the ectopic pregnancy were on the right side), I then requested a hysterosalpingogram (HSG) to check if my Fallopian tubes were open. Much to my surprise, this study showed complete blockage of my left fallopian tube. But the right tube was completely open! I found myself being grateful that I did not remove my right Fallopian tube at the time of my ectopic pregnancy.  It would have taken a miracle to have a baby naturally if my right tube was gone and left tube was blocked.

The following month, I had a hysteroscopy to see why my left tube was blocked. It turned out that I had a uterine polyp that grew right at the entrance of my left Fallopian tube. That polyp was removed. 

Mental health and pregnancy’s

At that point, I took a break from baby making and focused on starting a new side business for a few months. When I resumed trying to conceive again months later, I quickly fell pregnant. However, at 6 weeks gestation, my heart sank when my OB was not able to see a gestational sac anywhere on ultrasound. 

My mind was racing. 

Mentally, I couldn’t deal with the anguish of another ectopic pregnancy. This is because not only could it be life threatening, it could involve losing a tube and take several months to resolve. With additional monitoring of my HCG level and passage of dark purplish tissue at the onset of heavy bleeding, it turned out that I had a miscarriage. Perhaps it was a strange thought... But I thought to myself, I’d take a miscarriage over ectopic pregnancy any day. 

My miscarriages & ectopic pregnancy were difficult for 3 reasons: 

1. I had my hopes up when I first had the positive pregnancy tests. Like many women, when I have the positive pregnancy test, I am already picturing my next 9 months, what changes I need to make. And then I had to crash land those high hopes when I realized the pregnancies were not successful.
2. The mental suffering that accompanied those losses occurred mostly in silence. I did not feel comfortable confiding to many people about my losses. 
3. I felt my body betrayed me every single time I had a positive pregnancy test (this may sound vain). Because I had a prior full term delivery, the moment I conceive, my belly will immediately protrude out. After the series of unsuccessful pregnancies, I was not able to get my flatter belly back. I changed my wardrobe to wear bigger clothes to hide my belly. 

I wouldn’t have minded the bigger belly had I actually had a successful pregnancy. But I felt it was a cruel punishment that along with my mental suffering that I also had unsightly physical “reminder” of the losses.

This last reason was was particularly difficult for me when I went on a beach vacation with extended family a month after my second miscarriage. One family member just had to comment that I must have gained a lot of weight around my waist. At that moment, I was at a loss for words. 

Miscarriages and moving on

Months later, I had another miscarriage at age 41. After grieving this loss, I decided to make peace with myself.  For the following 4 months I threw my energy into starting my own clinic. My thought process at that point was it would be great if I conceived. But if I didn’t, it really is okay. 

Looking back, I am somewhat grateful that I only had just one living child going into the craziness of 2020. I couldn’t imagine how I would have survived juggling my career and motherhood if I had an infant in 2020... especially when I couldn’t ask my mother for help with childcare for fear of her health, when childcare options were limited, and with my older child doing distance preschool learning from home. I also don’t know if I could have pulled off launching my own clinic in 4 months in the middle of a pandemic if I had two young children at home. 

In some ways, I am thankful for all my experiences--unexplained infertility, belated diagnosis of lean PCOS prior to having my first child, and then my subsequent miscarriages and ectopic pregnancy. Now I feel that I have a better sense of what my patients feel when they have one or more of these experiences. It has made me an even more compassionate physician for patients in my wholistic fertility clinic. 

Additional lessons I learnt

In my journey of getting pregnant after 40, one lesson I learnt is that it’s normal to take longer than expected. But of course, it is still possible to get pregnant naturally by having good body awareness (like knowing when I ovulate), taking egg quality supplements, optimizing all my hormones, and making sure both me and my husband are healthy. So all the knowledge I have is still very helpful. And if you want more actionable tips, check out my FREE Top 7 Tips for Getting Pregnant Naturally!

And despite all the setbacks I experienced and despite my "advanced maternal age," deep down I believed that my body still had GREAT potential to have another baby naturally. This is because of what I know about my body through functional medicine (root cause medicine) investigations, and because I know that I have optimized my health.  I believe this optimistic attitude towards my body was helpful. 

Finally, I find it interesting that both times I had successful pregnancies naturally in my “advanced maternal age”, it happened when I reached a place of peace in my heart.  I no longer set any deadline or gave myself any pressure. In fact, I waited longer than usual before checking my pregnancy test. So while I know it is difficult, I encourage any couple who is trying to get pregnant naturally (and especially getting pregnant after 40) to strive for a peaceful mind in this journey. 

If you are on your journey to parenthood, my prayers are with you. I hope you find health and peace in your life. God Bless!