Want Pregnancy at Age 47

Answer (Part A, by Sheila St. John)

Dear Lisa,

Your situation is one that illustrates well the importance of cooperation and communication between the couple, the NFP Practitioner, and the Physician. I am going to address your question from the perspective of the NFP Practitioner part of this team, and I have asked an NFP Medical Consultant, Dr. Mary Davenport, to address it from the Physician’s perspective.

You mentioned that you used NFP, but did not say if you worked with an NFP Practitioner, and continue to do so. Your knowledge of NFP is crucial in the correct timing of hormone evaluations, and your hormonal therapy. If you are not seeing an NFP Practitioner, you need to make an appointment to see one immediately, so that you may accurately determine when to take the medication your doctor has prescribed.

You mention taking the Prometrium mid cycle, and this concerns me. It is important to begin the progesterone supplementation AFTER you have ovulated, to support the luteal phase of the cycle. If you are arbitrarily beginning the medication mid cycle, you may not have ovulated yet, in which case the treatment may actually be counterproductive to your goals of achieving a pregnancy.

As you are aware, time is of the essence at 47, so I encourage you to contact your NFP Practitioner to correctly time the progesterone therapy, and maximize your timing of Intercourse to achieve a pregnancy. You may make use of our toll free line to be referred to a teacher anywhere in California.

Answer (Part B, by Dr. Mary Davenport)

I empathize with your desire to become pregnant at age 47. There is always some measure of hope, especially if you are cycling. The statistics on women over 45 who attempt pregnancy, however, are sobering; less than 5% will become pregnant whether they use NFP, fertility drugs or IVF (with their own eggs). Pregnancy is always up to God and there are only a very small number of women over 45 who are blessed with a pregnancy. Pray hard and optimize your hormones; you might consider pursuing adoption simultaneously even as you are hoping for a natural pregnancy. The Prometrium you are using is not harmful even if taken for many years. As Sheila St. John indicated, it should be taken in cooperation with your own cycle from approximately three days after the peak through twelve days after the peak. To evaluate your hormone levels, it is necessary to know the normals in your local laboratory, what cycle day they were taken, and better still on what day in relation to the peak mucus day. The progesterone level presumably reflects the Prometrium you were taking. Ideally, the estradiol should be 11 or 12 and the progesterone over 15. The FSH is not menopausal; the TSH may indicate a borderline thyroid problem (more studies should be done). Most physicians working with women desiring to be pregnant over 45, including those sympathetic to NFP, do not do diagnostic surgery for this group of women. Also, it is not clear in this age group if any of the conventional fertility therapies such as Clomid or more powerful drugs offer any advantage over NFP, intercourse at the time of ovulation, and progesterone. I think in your situation your approach at this time with progesterone is a good one. Best wishes to you in your difficult situation.

Sheila St. John & Dr. Mary Davenport