HOPE for low AMH

Hello everyone and welcome back. Today I have a special guest. I am talking with Erica Hoke and she's going to tell us about her amazing story of overcoming infertility. Welcome Erica.

Hi, thanks for having me.

Absolutely. Now Erica, tell us a little bit about yourself. Who are you and what do you do?

Well, I'm gonna, I'm gonna do a spoiler alert for everybody. I'm a mom of 4 very rambunctious boys, 12, 9-year-old twins, and a 5-year-old who runs the whole house. And, and I'm a health and wellness coach that specializes in fertility.

Awesome, that is amazing. So yes, she spoiled the story just a little bit, but that's okay because this episode is all about hope and triumph, and I'm really, really excited for her to tell her story. So Erica Hoke, can you take us back kind of to the beginning? When did all of this crazy journey kind of start for you?

Well, I think that the, I think that the starting point was when I got a DVT in my leg. A DVT is a deep vein thrombosis. It's a blood clot in your leg. And I knew, I knew I had some other health issues related to my fertility, but that was kind of a pinnacle moment for me to realize that that I had some other things going on too. And had I not gotten that blood clot, had I not gotten the diagnosis that I did prior to trying to conceive, I'm 100% convinced that I would never have— I would never have been able to conceive my kids because the thing that I advocate the most for is testing for this thing that I have. It's a genetic, a genetic mutation called Factor V Leiden that actually affects up to 80% of the population are carriers, can cause blood clots. I had some things, some lifestyle choices I was making that was contributing to that, but then also can cause infertility, miscarriage in the first, second, and third trimester, stillbirth. And also secondary infertility. So it really is the thing that I'm most passionate about because it's, it's pretty easily fixed and with some blood thinners during either during conception or and then on to pregnancy or early on into pregnancy. So the rest of that nutshell is in addition to having this factor V and having the blood clot and knowing then, you know, having the DVT, knowing that I have Factor V. In addition to that, I had stage 4 endometriosis, PCOS, low AMH, sorry, uterine fibroids. I also had some thyroid disease going on as well. And then unbeknownst to me at the time, I also was a double mutation for MTHFR. So both mutations on both genes. But I didn't find that out until I was done having kids. So a lot of cards stacked against me.

Wow. Oh my gosh. Okay. So you have all of this going on. And then of course you guys started to try to conceive and what happened?

Well, you know, I knew I had the fertility issues prior to getting the Factor V diagnosis. But I didn't know, I didn't know that that was going to prevent me from having IVF. So in the back of my mind, I had kind of just said to myself, I know I have these issues, but gosh, you know, as a last resort, resort, and I kind of feel like that is, you know, what most people think, I'll go and do IVF. Surely the doctors will be able to help me. And much to my dismay, at 35, after, you know, the typical year-long trying to conceive, you know, period, we went to see a fertility expert and were told that we were not a candidate for IVF. I was already hyperovulating, so they couldn't stimulate me anymore for egg retrieval. And my chances for IUI, even though we didn't have any male fertility, were still really, really low. And we just decided that that was not a path that we wanted, that we wanted to go on. I think instinctually I knew that the medication would not be, you know, I feel like I got a nudge that that was not going to be good for my body. So and then come to find out that I have the MTHFR. So we couldn't do IVF. And I really felt strongly, you know, I'm a believer and I very, very much felt strongly that I was called to carry my own children. So I said, to work just finding out how, how I could affect my own infertility through lifestyle changes, what affects fertility, and just any, any crumb of information about how I could improve my chances to conceive naturally.

Wow. Okay, so you guys have gone through all of this. You've been told that you're not a candidate for IVF, and then you start to go on this journey. And I think that's one of the things that leads most most of us that have dealt with infertility down this healthy lifestyle, healthy living, um, type of path, and we just completely change our lives because we're trying to have kids. Um, so you started on this journey of health and you somehow learned some things along the way.

Yeah.

And then you got pregnant, right?

And so, um, the things that I started off with, um, right away. Well, first of all, I want people to know I was given the diagnosis that a lot of women are given, and it's like death. Anybody that has come out the other side knows that it feels like a death sentence, right? Less than a 1% chance for— I'll get to this in a second, but less than a 1% chance to conceive. My son. So one of the first things that I did was consult a fertility acupuncturist. She helped me quite a bit. I was going 2, sometimes 3 times a week to her, and within 6 months we were pregnant. And then just massive— I thought that I was eating well, but it was my definition of that changed. I started with my proteins because I knew that they had a lot of hormones in them. So things like milk, meat, and cheese, anything that was a protein— sorry, not a plant-based protein, but, you know, a meat, an animal-based protein. I started switching those out to organic and then just kind of went step by step, progressively just switching things out through my diet, going more organic, um, and just, and just learning, you know, about my body and listening to my body. So we had baby number one. Yeah, I had baby number one at 36. And, um, so then at about 17 months, we did a second consult and, um, that was even a worse prognosis. They looked at my, my egg count and it was even worse. And they said, not only can we not help you, but we're going to kick you out of the practice. You're going to have to use donor eggs. That's it. So I came to find out, you know, fertility doctors are rated on their success rate. So if they don't feel like you're a good candidate, then they dismiss you out of the practice so that they are not— you don't affect their numbers, right? So we made a really, really hard decision to bring me home, even though financially it was not an easy thing to do. We sold our house, we moved into a rental. I quit my job so that we could downsize Um, and then with 2 months of going on sabbatical for my job, I was pregnant with my twins.

Wow. Yeah, now that's amazing because again, here we are, low AMH, and so many people get that diagnosis. I had it. Um, yeah, and you know, you think, oh my God, there's no way I can conceive. I had my daughter with low AMH before I even knew that it was a thing.

Yeah, yeah.

No, you know, we're walking around with all of these diagnoses and you're eating well, and then come to find out, you know, maybe it was just the stress of the lifestyle that you were living at that time, and you get pregnant with twins after this fertility clinic has told you, we can't help you, we're done, we're done.

And not only that, you're going to need donor eggs. Yeah. Wow. So I was 39 also at this point, and I really want to encourage people because so many people at 39, at 40, we were just getting started. I married my husband later in life, and so, so many people look just at their age. They don't even, they don't even go for the test. They just kind of feel collectively that their chances are so poor. That they don't even, they don't even go there. They can't, you know, they don't even try. And so I want to encourage women that, um, you know, it definitely is possible. So wow.

Okay, so now you have your oldest, you have the twins, and tell me about your last pregnancy. So how did this come about? Was it just a surprise or Well, it's always a surprise, right?

So there's actually a story in between my, my book and baby. So I had 3 under 3. My oldest son was 27 months old when my twins were born. And then fast forward to another 17 months past that, I unexpectedly, very much to my surprise, got pregnant with we didn't know it at the time, got pregnant with twins again. And I want to stop here and talk a little bit about Factor V, if that's okay with you, because there's a lot of confusion around the condition. So for me, I was an early clotter, so I was not getting— I was only getting chemical pregnancy tests or pregnancies, so I wasn't getting positive pregnancy tests. But, you know, as a woman, you know, the changes in your body and you feel like for sure this is the month. And then you take that test and it's negative and it just doesn't feel right. So it took me years to realize that I was getting a lot of chemical pregnancy tests. So what happens is, is that, you know, spike in your estrogen caused— spike in my estrogen caused enough of the clotting disorder to come into effect that the embryo wasn't able to implant. So therefore, no, you know, spike in your HCG and no positive pregnancy test. So for some people— and I'll get back on track with the twin story here in a second— but for some people, what happens is if you're younger, by the way, if you're younger, Factor V affects you less because your body handles the estrogen a little bit better. So some people will get pregnant in their 20s, um, you know, with 1, 2, 3 children, go to have that consecutive baby, and then have secondary infertility because they have Factor V, and now their body at, you know, whatever age is not able to handle it, and they miscarry repeatedly. Um, and then sometimes, unfortunately, what happens is it's a second trimester loss because of a blood clot in the placenta or a blood clot in the umbilical cord, um, or even, you know, right up until delivery, sometimes those things come into play and cause, um, you know, cause stillborn— stillbirth, which is just gut-wrenching. I, I have personal friends that didn't know that they have had Factor V and lost a baby or lost twins at, you know, right, right at the point of viability. Of 24 weeks. So that's why I'm super passionate about it. So knowing what I know and doing all the things that I could do, I unexpectedly, when my twins were 17 months old, that was my body's okay spot to get pregnant again. So I get pregnant with twins and I did not— it was a holiday weekend. So like I got a positive pregnancy test on a Friday morning and the office closed at noon and then didn't open until Tuesday and I miscarried over the weekend because I didn't get the blood thinner on board. So I actually lost a set of twins. We didn't know it was twins until, until we had the ultrasound. So then, you know, we deal with that, that, and that's why I'm passionate about, you know, trying to explain to people the different ways that the clotting factor comes into play. And so we still, you know, just didn't feel like we were done. And I'm 41 at this point, you know, when I have the miscarriage. And we had kind of said to ourselves, you know, the little timelines that you put in place for your mind, right, that we're going to stop at this time, we're going to stop at this time. So I had some physical complications from the twins where I was going to need a surgery. I had a really bad diastasis recti from carrying the twins. So I was mentally trying to walk that fine line. And I know that people that are watching your show understand this of when do we keep going and when is it better for us just mentally to say we can't deal with another loss, we can't deal with another treatment, we can't deal with another month. Waiting. We can't prolong this anymore, right? So we had kind of given ourselves a deadline of, um, January 1st of 2015. And, um, we had been out with the kids that day, um, that like New Year's Eve we had been out with the kids, um, at a theme park. And I got a message from my friend, she had just delivered her baby And the holidays are a busy time of the year, right? And so I dropped my family off. I went to the hospital to visit my friend, saw her new baby, and then a little light bulb went ding in my head. I'm late. I was late and I had just in the busyness of things. So literally on, you know, on the 11th hour of kind of, you know, giving up on our dream to, um, have another child, we found out that we were pregnant with our fourth son.

Wow, wow, yeah, wow. Your story is absolutely amazing, and I want to say that I'm sorry for your loss. And I know that this happens to a lot of people, um, because even myself, like, I've been late multiple times and just knew, you know, your body just tells you, okay, you're absolutely pregnant. Um, I was only able to confirm one of those chemical pregnancies, but, you know, I never knew about Factor 5, so that could have been something that I was dealing with. Um, and I have a friend that has had multiple losses since having her son, so I wonder why this isn't something that fertility doctors test or something that is done routinely, you know, that it would be something that would be talked about or even discussed if you're a person that is dealing with infertility. Because we hear about low AMH or a thyroid issue, or it could be this fibroid, you know, you're giving all— given all of these reasons why, but we never hear about genetic mutations or, you know, some type of issue that could be causing a problem. So maybe this is something we need to advocate for.

Absolutely, absolutely. It's something that I, I talk about as often as I can. And let's, let's address that. As far as like from a medical standpoint, there's a few different things that go on. One, it's just a lack of education. It's not often pinpointed as necessarily like a reason for miscarriage, although, you know, many, many women in my Factor V group have reported, you know, I mean, up to— it's gut-wrenching— up to a dozen miscarriages. And then they find out they have Factor V and they get on the blood thinners and then they carry the term. You know, so a few things happen. Either the doctor doesn't know, either the doctor doesn't believe that it is actually a contributing factor to miscarriage, even though it's been, you know, multiple miscarriages. Some doctors do know and they do test for it. But even if they do test for it, they do not put women on blood thinners all the time, which is awful. Also because, you know, the women oftentimes feel, um, powerless because they know now that they have this clotting disorder and they will not give them the medicine because they think that it's only anecdotal evidence or they don't think it's a contributing factor. There's, you know, a lot of women that have to switch doctors. They have to really advocate for themselves, which is something that I'm also very passionate about is advocating within the medical community. And I'm not, I'm not anti-medicine in any way, shape, or form. Without my surgeries, I had surgery for my endometriosis. I had surgery for my fibroids. Without those things being resolved, I know that it would have been nearly impossible for me to conceive. But you should have a doctor that you feel heard by and you should if you've done your own research, that, that doctor should at least listen to you and hear what your concerns are. Yeah. So it's, you know, even, even women who sometimes get on birth control the first time will have a pulmonary embolism or something of that nature. And then and then die. Like there's people on the Factor V pages that get tested, that their family members, you know, are in the process of getting tested. They get on birth control and then sometimes they have a blood clot and they die. It's, it's crazy. Um, but it, it's, it's actually way more common than people are aware. There's a lack of awareness. Let's say that.

Yeah, absolutely. Um, and it's not something that's even taught in a lot of fertility programs because again, we are usually taught the typical reasons why people are not able to conceive. So this is something that I think should be talked about and shared often. And I thank you for sharing it, which is why I reached out to you because your story is amazing and people need to know. So let's switch gears just a little bit. Um, how has everything that you have gone through changed you as a person?

Well, you know, I am someone who believes that everything happens for us and not to us. And so I truly believe that my infertility, um, struggle, as painful as it was, has brought me to a place of, um, I'm trying to think of the right words. You know, it's changed my life for the better. I don't know that I would have made— and again, I wasn't having— I didn't have a horrible lifestyle, but truly understanding labels, what's in our food, label reading. My page, my Instagram page is Woke to Wellness. So that feeling of kind of peeling back the curtain and seeing you know, the lack of oversight in our chemicals and our personal care products and things like that. So it for sure is a rabbit hole that I'm glad that I got pulled down. And honestly, like, as a mom, I, I'm grateful for it too, because I don't think that I would have been the mom that I wanted to be without going through the struggle to have my kids. So It's been something that's shaped me dramatically. So it's something that I'm grateful for, you know? Yeah. And that's a hard thing to say too, because I know, I know, like I know how hard it is for a woman who doesn't even know if she can get a positive pregnancy test, has never, I remember that feeling like, I mean, in some of the groups, sometimes women will express express that like, well, you had a miscarriage and that's terrible, but I don't even know if I can get a positive pregnancy test. I can't even get to step one. So I know that feeling. But, you know, my prayer is for those women that they will, they will rise up, they will feel empowered to press their doctors, they will search their hearts, you know, for something, um, maybe that God is trying to tell them a path to go down to help themselves as well.

Yes, absolutely. And I think being on the other side of it helps you to have better perspective. Oh sure, someone who's going through it, uh, because if you had said that to me 7 years ago, I would have been probably angry, or yeah, you would have wanted to punch me in the face.

Same, right?

Right.

Like, it's really, really hard. And, um, yeah, the really, really hard does not negate the information either, right?

Yeah, you know, absolutely.

So, um, yeah, yeah.

And I think that it's encouraging to be able to see people who are now on the other side, which is one of the reasons why I like to share, because, you know, you've been through it, I've been through it, and I can absolutely say that going through this journey has shaped me as a person and made me different. It made me bold. It helped me to learn how to advocate for myself, how to take better care of myself, because again, I thought I was eating well. I thought I was doing all of the right things, and I wasn't because my body wasn't functioning the way that it needed to function. So if you're out there and you're going through this, I know that what we're saying, and saying that this was a blessing, is very cliché, and it probably doesn't feel like that to you right now, but eventually, when you've gone through it and you've been able to see the changes that you've been able to make in yourself as a person, and when you get to the other side, you may feel that way as well. Hopefully.

Hopefully you will feel that way.

Yeah, yeah, absolutely. So now let's— if you had any advice for someone who is sitting here right now, they are, let's just say, 35, because I'm 35 right now. They are 35 years old, um, and they've been told that they have low AMH, there's no way that they can conceive, they have everything in the book and all the odds are stacked against them, what would you say to them?

Um, I would just say don't believe, um, don't believe it. Um, I think that there's very few instances, you know, first of all, we have to say like we don't create life, right? So there's the whole, um, spiritual aspect of it. So Find hope where it speaks to you. Press on and listen to your body. Look for resources. Ask, ask God or ask the universe for resources to be given to you. And just, and just start evaluating what it is that you can actually do, what's in your control, right? We all really like to be in control. So What is it that you can actually control? What impact can you have on your own fertility? There's, you know, tons of research. There's tons of people like myself, you know, who offer you that kind of support. Most of what I do is find gaps in testing, find gaps in lifestyle where you think that what you're doing is the right thing. A lot of people take things like synthetic vitamins. Um, if you're taking synthetic vitamins and you're like me and have a double MTHFR mutation, you're poisoning your body. Synthetic vitamins are poison for everybody, but especially if you have some other underlying things going on. So, um, I wouldn't dismiss anything, um, as being too small of a contributor to your fertility because, um, the potential of your fertility. That's what I would say. It's a really hard road. And a lot of times people will say, and I remember, I remember. So don't get me wrong, I'm not saying it's easy. Okay. So I, I see people all the time, or people all the time will say to me, one cup of coffee cannot possibly affect my fertility. Well, coffee really is acidic. It causes your gut not to be able to absorb minerals, all kinds of things. The same thing with alcohol. Well, one glass of wine. And don't get me wrong, like we all, we all like fall off the wagon or go astray, you know, but you have to just say, oops, I recommit and go back on the path and not, you know, waste. A week, a month, you know, 6 months, um, you know, because you had a glass of wine, um, or you had a cup of coffee. Um, and for everybody, that's not— that's not necessarily everybody, but it could be you. You know, you could be the one that should not be having that glass of wine. You could be the one that should not be having the coffee, you know. Um, and it's, it's amazing to me that people will spend lots and lots of money on infertility treatments, but they will not clean up their diet. They will not clean up their lifestyle. They will not stop the things that could really be causing their treatments not to be as effective. So that was a lot, probably more than you asked for, but yeah, thank you.

No, it was perfect. Um, you know, as a health coach and someone who deals with people who are specifically trying to get pregnant or who are pregnant, I'm always harping on the diet piece, but it's always so difficult to get people to change their lifestyles because they say, "I want to get pregnant," or, "I want to have a healthy pregnancy." But then when you tell them that you can't have this, or maybe you should think about changing this about your diet, there's always a pushback. So to have someone else say it as well— It's amazing.

I will definitely link arms with you on that. It's important.

Yes, very, very important. And I want to thank you for sharing your story and for giving just a little bit of hope to someone who is out there. Um, so many people are dealing with infertility these days and the numbers keep increasing. So I hope that somebody that was watching was encouraged. Um, And if they want to find you, you've already given us your Instagram information, but can you make sure that you say it again just in case someone missed it?

Yeah, so I'm on Instagram at @woke2wellness. It's actually woke dot and 2 and then a dot and then wellness. And then my, my website address is just my first and last name and Yeah, so I have, um, just, I have a program to get people foundationally started, um, that just makes a huge impact in body, mind, and spirit. So it's called 5 Minute Reset on the Run. So that, uh, the next round of that will be starting soon, and the information is on my website for that. But that is, you know, we're, we all lead such busy lives, and the overwhelm is a real thing for all of us, right? So locking yourself in the bathroom is not self-care, mama or mama-to-be. We can't lock ourselves in the bathroom for 5 minutes and call that self-care. So it's really very, very impactful and intentional resets to make the biggest difference in those areas.

Awesome. That sounds amazing. So please go look for her and hopefully she can help you with some of the questions or issues that you may have. And thank you again for joining us today, Erica Hoke.

Thank you. Thanks for having me, Sierra.

All right, see you guys next time. Bye-bye.