Embracing Motherhood After 40

Marlena always dreamed of being a mother, but throughout her 20s and 30s, the stars never seemed to align. She hadn’t managed to find the right relationship at the right time to start a family. She also spent much of her late 30s caring for her ailing parents which shifted the focus away from her family-building goals. Regardless of all the circumstances, she never gave up hope that one day she would be a mom.

At nearly 40 years old, Marlena wanted to know if having a baby was even a possibility for her, so she did fertility testing to assess her reproductive potential. During a consultation with Dr. John Rapisarda, she learned that her egg quality had diminished due to her age.

Still, Dr. Rapisarda was confident that she would be able to have a baby with fertility treatment, a prognosis that was comforting for Marlena to hear. “I just loved Dr. Rapisarda,” she shared. “From the beginning of my fertility journey, he was informative and realistic about my fertility prognosis and my chances of having a baby. He discussed the plan for me to have a successful pregnancy and he helped me feel supported. He was compassionate and professional.”

Following their discussion, Marlena had to make a life-changing decision and she knew time was of the essence.  “It’s a very emotional experience,” she said. “I was wondering if I could even do it. Have a child on my own.” Then there was the matter of undergoing invitro fertilization (IVF). She knew it was a big commitment physically, emotionally, and financially. Her mind raced with thoughts like, “Will I be able to do these meds by myself? Navigating appointments and time off [could be a challenge]. Also, there’s a chance it won’t work.”

Ultimately, she was ready to be a mom and knew it was time to take matters into her own hands by moving forward with IVF. “After my consultation, I felt very empowered to start my fertility journey and I felt comfortable continuing treatments at Fertility Centers of Illinois,” she recalled.

Nevertheless, getting started wasn’t always easy. “Everything happens so quickly. There were so many first steps. I had to get a mammogram, a physical, and see the OBGYN. Later, I had to start a thyroid medicine. You have to deal with insurance for the medicine. It felt overwhelming at times. I had to remind myself to take things one day at a time. Then I had to pick a donor, which was a lot.”

While searching the donor pool was easy enough, choosing one was a bit of a challenge. Marlena had criteria for a donor based on their medical history, interests, and physical features. She also wanted her child to have the option to contact the donor after they turned 18.

Then there was the matter of Cytomegalovirus (CMV) status. “I thought there would be tons of options for donors. I was CMV-negative, so I needed to pick someone else who was CMV-negative. That eliminated a lot of choices.”

She narrowed down her search and had a handful of donors to pick from. She explained, “When I looked at all those there weren’t that many. There were about 15. It’s a really big choice. You’re wondering, am I making the right choice about the traits and their background?” To help make her decision, she got to know her donor options better by looking at their writing samples and listening to audio of them speaking. After much deliberation, Marlena made her choice.

Before she could make embryos, though, she needed eggs to fertilize. She ended up doing two egg retrievals before she had an embryo to transfer. After her first egg retrieval, the embryology team performed Pre-implantation Genetic Testing (PGT) on the embryos created to check for chromosomal abnormalities. Sadly, all embryos came back abnormal. Marlena remembered receiving the disheartening news during the day via a portal message and later a call from her doctor. “Dr. Rapisarda called me on the phone and told me he was sorry. He told me a lot of times it doesn’t work the first time.” She added, “When it came back abnormal it was hard. I told myself when the first round came back abnormal that I didn’t think I would do another round. But once I had started this process, I realized, I couldn’t stop and really had hopes that it would all work out in the end.”

The second egg retrieval left Marlena with two healthy embryos. However, before transferring any of her embryos she underwent an endometrial biopsy and discovered that she had endometrial hyperplasia, meaning that her uterine lining was thicker than it should be. To improve her chances of achieving a pregnancy, she opted to have an Endometrial Receptivity Analysis (ERA), a diagnostic test that seeks to identify the ideal time for embryo transfer.

On September 6, 2022, her mom’s birthday, she transferred one of the embryos and then had to wait an excruciating two weeks to find out the results. “The two-week wait was really hard. I was looking for signs and definitely wanted to take the test, but I heard you can get false positives. I forced myself to wait until that appointment.”

She took this time to practice self-care and do whatever she could for a successful pregnancy. “I did acupuncture a lot because I heard that could help during treatment.” However, despite doing everything she could, she didn’t “feel pregnant,” which led her to believe it didn’t work. “The woman who did the acupuncture would ask me if I was feeling certain things because she focuses on fertility and I wasn’t, so I was feeling really down.”

Marlena was over-the-moon to find out her worries were unfounded. When it was finally time to take a pregnancy test, it was positive! “When I found out it worked, I was in shock. I was overjoyed,” she shared.

Up until this point, Marlena had only shared her IVF journey with close members of her family and other women whom she met via her fertility online support groups. Now that she was pregnant, she was ready to let a few others know about her exciting news. “I told a trusted friend over lunch. I said I have something big to tell you. She was not sure what I was going to tell her, and she was shocked. After that, I just told a select group of close friends and family. A lot of people didn’t know until I was late in my pregnancy. My friends were very supportive but very shocked.”

In May 2023, Marlena welcomed her baby girl, Lula. Marlena gushed, “She is happy, healthy, affectionate, and growing every day. She is a dream come true.” Lula has also brought her family joy after the devastating loss of her mother in December 2022. “My sister and I are very close. We’ve had a lot of grief and loss with the loss of our father in 2020 and then our mom recently, so for me to have a baby, her niece, she’s just so in love with her and its’ such a blessing to have her.”

She has also been open and honest about life as a single mother. “It’s been great. There are some moments when some tasks have been challenging. However, I believe that these challenges come up in any type of family situation. Parenting is rewarding, but it can also be hard. Especially being a first-time parent when everything is so new. Things are getting easier though. Those first few weeks and the lack of sleep are hard during the newborn stage. Especially being on my own. But I have a great support system. I have my sister and people who love babies and want to babysit. That’s been really great. And one friend helps with my laundry. I never realized there would be so much laundry!”

Marlena hasn’t let being a single mom slow her down, either. She has kept plenty busy with her little one while she has the summer off work. “I love taking walks with her and going to the farmer’s market. I want her to be outside and explore different surroundings, so we go out and run errands. I signed her up for a music class at Old Town School of Folk Music. I also joined two mom support groups for myself and there are other babies there, so she gets that interaction.”

While Marlena couldn’t be happier to have her little miracle, she still recalls how the IVF process was difficult at times. She shared how she coped throughout the process by practicing self-care and seeking out the support of other women struggling with infertility and single mothers by choice through online forums.

“Self-care has always helped me, so I spent time doing crafts and reading to help myself relax. I also joined many Facebook groups and was able to find information from others who were in similar fertility situations. I joined the Single Mothers by Choice support group offered by the Fertility Center of Illinois and I found that to be helpful.”

Marlena also had help from those closest to her. “My family was a huge support system and helped me with the highs and lows during the journey. I have a trusted therapist that I see regularly, too.”

Having a care team that she trusted helped her throughout the process as well. “I was confident that Dr. Rapisarda was making the right medical choices for me throughout the process. Dr. Rapisarda is an expert in his field and I trusted his opinion throughout my journey and I’m so grateful to him.”

For others struggling with infertility or going through treatment themselves, she has three pieces of advice. “First, I would say don’t hesitate, to take those first steps and go for a consultation. The second piece of advice I would give is to take the fertility journey one step at a time. The fertility journey is a very emotional process and there can be ups and downs. It is important to take things one day at a time not to get overwhelmed. Thirdly, I would also say seek out resources throughout your fertility journey whether they be support groups, blogs, Facebook groups, podcasts, or books to educate yourself and find helpful information.”