My Numbers Sucked But I Made This Baby Anyway

Hi, so my name is Whitney Erin Boesel, and my title of my talk is My Numbers Sucked and I Made This Baby Anyway. Given the title, it is no surprise that the story ends with a baby. But it actually begins in the summer of 2014, when I got a nasty concussion injury.

I've struggled with post-concussion syndrome since then, but by the summer of 2015, it was clear that there was something else going really wrong with my health and none of the doctors I had could tell me why.

For a number of reasons I suspected something hormonal, and so I started turning my capillary blood, saliva, hair, and even blood serum into data hoping it might be able to find an answer. I looked at my pituitary hormones, sex hormones, thyroid hormones, and adrenal hormones in addition to a number of other substances.

One thing I never intended to start tracking, however, was my Anti-Mullerian Hormone AMH. I’d never even heard of AMH until August 2015, when I found it at the bottom of the lab requisition order by one of my doctors.

I looked up AMH, and I learned that in an adult woman it comes from eggs that are sort of half way right. Primordial Follicles which are what’s an ovarian birth don't really say AMH, and neither do fully ripe eggs that are about to be ovulated,

The AMH test is therefor ordered for two main reasons, and the chronologist order is looking for a high AMH because these can be an indicator of Polycystic Ovary Syndrome or PCOS.

Fertility specialists also order it looking for low AMH because some clinics won’t accept patients with an AMH below 1.1 because those patients don’t respond well to the medication needed to harvest eggs.

At the time I thought it was really funny that my doctor had ordered a fertility test, but I was also angry because I was sick of being dismissed with "You probably have PCOS." Spoiler, I don't.

So when my results came back, I got some really shocking news. My AMH was really low for my age, which was 35 at the time. And I was passed the point of being able to benefit from either IBF or egg banking technologies if I needed them. In the context of my other hormone results, it looked like it was too late for me to have children.

Now, I had told myself years before that having a kid just wasn't going to work out for me and that that was okay. But what I learned from my first AMH result was that I am full of lies. I still wanted to have a child, and I was just distraught to think that it might not be possible.

This led to some really difficult conversations with my partner, who already has two kids from his first marriage and did not want any more children at all, never, done. And of course he didn’t want to end our relationship, so this left us in a really awkward limbo.

After reading as much as I could about AMH, I had this theory that maybe fixing my really low vitamin D levels would help. I also started taking vitamins and supplements to improve my overall health. But neither worked, in fact, my AMH got worse.

In November of that year I brought in an acupuncturist, who focusses on fertility. She poured over all of the data that I collected about my body which was a lot. And she admitted that she didn’t expect to see numbers so bad in someone my age. She revised my vitamin and supplements regiment and started treating me in a general way to support hormone balance.

By December some things were looking better, my vitamin D for example, was good but my AMH was still getting worse. At this point, my acupuncturist gave me a choice. She could change her treatment to focus specifically on fertility but did I want to have a child, and the answer was yes, but it really wasn't a good time.

In truth, what I wanted was to improve and preserve my fertility, so that I could still have a child later when things would be a lot less complicated. "If you want a child," she said, "I wouldn't bank on later."

I had another theory that maybe all the same age decline was just due to the differences between laboratories, so when I had a chance to retest at the same lab that did my first test I jumped on it. Unfortunately, those results were the worst yet.

I was now 36 years old, and I wasn't even within the reference range for women aged 36 to 40. I felt like I was helplessly watching the door shut forever on something that I come to realize was actually critically important to me.

As I talked through these numbers with my acupuncturist, however, I realized that what I was searching for in all my hormone data was not the possibility of becoming pregnant, but permission to become pregnant. I wanted a child, and I knew that I wanted a child, and I knew that I was ready to become a parent.

What I was searching for in all of my hormone data was either permission, to keep putting off making a really difficult decision, or permission to seek extra help and becoming pregnant despite the really bad timing. But these were social questions, and in the end, no blood test was going to be able to answer them.

I decided to refocus my acupuncture treatment on fertility, and on my acupuncturists advice, I abandoned my really ambitious plan for monthly and quarterly blood hormone monitoring.

The only things I tracked was my basal body temperature and my cervical mucus. Meanwhile, my partner slowly warmed up to the idea of another child.

My cycle is regular again, so I started scheduling both plane flights and acupuncture treatments around when I expected to be fertile. I took what seemed like a ton of herbs and supplements, and I got acupuncture treatment right before and right after each ovulation.

In April 2016, I managed to become pregnant despite my really poor ovarian reserve, and since I am a giant diet nerd, when I went for the blood test to confirm the pregnancy I got my AMH tested again just for fun because that’s my idea of fun and it was up. Granted, it was still below my first measurement, below average for my age and below the cut-off for being an IBF or egg banking candidate. But it also didn’t really matter because I was able to carry that first pregnancy to term.

I was a little bit late for having children and my child was a little bit late to getting born, which is how I came to spend my 37th birthday, at home giving birth to my daughter Avon, who is so full of life and personality and who has made me happier that I could have ever imagined.

So to recap what did I do? I watched my AMH go from bad to worse to a little bit less worse.

How did I do it? Through acupuncture and supplements, I think.

What did I learn? For starters, I learned that it is possible to raise my AMH. The AMH test is increasingly being promoted to young women as a predictor to future fertility, but there is so much about this test that we don't know. It maybe that AMH only reflects the last three months of ovarian functioning.

I als learned that egg quality is more important than egg quantity. Through balancing my other hormones and getting the acupuncture treatment, I was able to make the most of the eggs that I still have left.

I need to acknowledge of course that I really have no direct idea of how I did any of this. My engagement with AMH was a desperate problem-solving attempt and bears very little resemblance to any kind of well-controlled experiment. But I'm okay with that, because really the real lesson I learned from confronting my low AMH and then tracking it, was that I still wanted a child. And I'm ready to become a parent, and I wanted this baby enough to risk my relationship with my partner and to risk disappointing my family.

In the end, it all worked out. The baby is here, my mother has not disowned me, and my partner and I even wound up engaged.

I was annoyed when I saw AMH on that first lab requisition, but as a wise friend once said of his own daughter, I can’t believe I almost missed this.

Thank you.