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[msparticularity]

Hmm, from what I can tell, Mirena is even lower dose than Implanon.  That doesn't work.
And that's a good point, msP.  I've only just started looking into this - are ooferectomies done for sterilisation?

I assume they don't.  Damn things are too necessary for bones and brains and so on.

Sigh.

By "doesn't work," do you mean it doesn't help with menstrual problems, or that it "doesn't work" as a contraceptive?  If the latter, the physical presence of the IUD covers that issue pretty well.

Both.  Depo is a fairly bulletproof contraceptive, and it also prevents menstruation.  I'm not at all interested in having periods ever again.  I have no idea why most women put up with it.

Actually, the Mirena is 99.9% effective re: prevention of pregnancy.  Maybe you meant it "doesn't work" for you?  I've found that my period is very light and lasts only 1-2 days on the Mirena.  It's not gone all together but I barely have to deal with it. 

I mean it doesn't work for me if it means having periods at all.  I haven't dealt with periods as long as I've been an adult, and I see no reason to start again.  Mine were heavy and painful to the extent that I occasionally had to take a whole day off school to lie in bed curled up with a hot water bottle.  If I bled on Implanon, I'd almost certainly bleed more on Mirena, given the lower dose.  Not interested.  Periods are just nasty.

And I'd never even heard before that sex is improved around the time of ovulation, though it makes sense.

Froggy, I'm coming back to this because I think it reveals a drastic misunderstanding of the Mirena. A lower dose of hormones delivered directly to the uterine lining, is far, far more effective than an implanted dose under the skin of one's arm where it has to circulate through the whole system. The Mirena is used in the UK and much of the EU precisely for the combination you are talking about: reliable birth control and dealing with heavy bleeding and unmanageable menstrual pain. I fought to get it nearly a decade ago when I was going through this, and ran into the FDA approval cr@p still not being complete. Now, however, it is fairly readily available--especially in metro areas.

[frogfactory]

Well, technically it's the ovaries that are doing the responding, but I guess it's true that the Mirena is geographically closer to them nonetheless.

[msparticularity]

Well, technically it's the ovaries that are doing the responding, but I guess it's true that the Mirena is geographically closer to them nonetheless.

For whatever reason, though--at least as I understood it--the latest theory is that menstrual dysfunction is the product of things happening directly in the uterine lining. It is the lack of progesterone that causes the lining to proliferate, so delivery of the synthetic form in Mirena directly to the problem area apparently has life-altering effects.

[barred_owl]

From the Mirena website:

"Once Mirena is placed:
--The levonorgestrel in Mirena reduces the monthly thickening of the lining of your uterus.
--Less thickening means less menstrual flow.
--Eventually your menstrual flow may stop completely."

As far as the contraceptive effects, Mirena doesn't necessarily prevent ovulation, but it thickens cervical mucus and makes the uterus inhospitable (insufficient endometrium) to implantation, in addition to possibly blocking any sperm from getting beyond the uterus--or a combination of all three effects.

[shrimp]

I have the Mirena IUD and have no period, no cramping, etc.  I love it!  I also had one before deciding to TTC, had shrimpette, and then went back on it, so it's great as a non-permanent method of contraception.
Also, I get migraines from the hormones in the pill but the Mirena doesn't seem to have that effect.
I realize it effects each woman differently but definitely worth exploring for your needs.

[menotti]

Frogfactory, the risks do not skyrocket after 35. I had linked to this before, gotta search and find it again.

It's a gradual slope. The first acceleration (the change in the slope) shows up around 40-42, not 35. The "skyrocket" meme is not based on data but just the fact that doctors need categories and they used 35 because it sounds like a nice midway point. If you just look at the charts or the data, you wouldn't pick 35.

Anyway, IUD sounds ideal for you in terms of birth control. Don't know about the rest.

This.  You've been going downhill since you were about 25.  They won't take your eggs (as a donor) after about 27.  For women thinking about later-in-life pregnancies, the risks of infertility and miscarriage should be a bigger concern than chromosomal abnormalities.  And, of course, social outcomes (education, jobs) tend to be better for children of older mothers.  By all means, make whatever decisions you like for yourself, but put a lid on the judgment of others. 

[theblondeassassin]

This.  You've been going downhill since you were about 25.  They won't take your eggs (as a donor) after about 27.  For women thinking about later-in-life pregnancies, the risks of infertility and miscarriage should be a bigger concern than chromosomal abnormalities.  And, of course, social outcomes (education, jobs) tend to be better for children of older mothers.  By all means, make whatever decisions you like for yourself, but put a lid on the judgment of others. 

Did you mean 35 for maximum age rather than 27? Or are you thinking of some special circumstances?

[menotti]

This.  You've been going downhill since you were about 25.  They won't take your eggs (as a donor) after about 27.  For women thinking about later-in-life pregnancies, the risks of infertility and miscarriage should be a bigger concern than chromosomal abnormalities.  And, of course, social outcomes (education, jobs) tend to be better for children of older mothers.  By all means, make whatever decisions you like for yourself, but put a lid on the judgment of others. 

Did you mean 35 for maximum age rather than 27? Or are you thinking of some special circumstances?

Depends on the clinic, I think, but some won't take older than 27.

[theblondeassassin]

This.  You've been going downhill since you were about 25.  They won't take your eggs (as a donor) after about 27.  For women thinking about later-in-life pregnancies, the risks of infertility and miscarriage should be a bigger concern than chromosomal abnormalities.  And, of course, social outcomes (education, jobs) tend to be better for children of older mothers.  By all means, make whatever decisions you like for yourself, but put a lid on the judgment of others. 

Did you mean 35 for maximum age rather than 27? Or are you thinking of some special circumstances?

Depends on the clinic, I think, but some won't take older than 27.

That may be perhaps true for commercial egg donation in the US, but certainly in the UK the HFEA's recommended upper limit is 35 (and under some circumstances, such as egg-sharing, the age of the donor may be higher).

I certainly know altruistic donors who've been well over 30.

[menotti]

Altruistic will almost certainly be higher than commercial.

(I'm an editor for a journal that publishes a lot of fertility stuff, so I see the spectrum of practice, pretty much.)

[theblondeassassin]

Commercial oocyte donation is illegal in the UK. Even expense repayment is pretty parsimonious.

(My interest is academic rather than personal, and focused outside the US, but I occasionally get to see the practice.)

[ideagirl]

Commercial oocyte donation is illegal in the UK.

I wonder how they rationalize that, since of course selling sperm is totally legal.

[concordancia]

Commercial oocyte donation is illegal in the UK.

I wonder how they rationalize that, since of course selling sperm is totally legal.

I imagine that it has to do with the fact that egg harvesting is a major medical procedure, involving sedation, whereas sperm harvesting isn't.

[irhack]

Another vote for the Mirena, I've had it a couple years now. I get a couple days of spotting quarterly. It's awesome. We don't want more kids, and I'm over 35, but I'm more comfortable than with sterilization, I'm just not in favor of unnecessary medical procedures, I fear irreversible complications. The Mirena is 100% reversible, no worries on that account. My only concern has been as a former Catholic some slight vague lingering worries God might consider preventing a fertilized egg from implanting = abortion = Hell for me. I think my other sins outweigh those though.

[ideagirl]

Commercial oocyte donation is illegal in the UK.

I wonder how they rationalize that, since of course selling sperm is totally legal.

I imagine that it has to do with the fact that egg harvesting is a major medical procedure, involving sedation, whereas sperm harvesting isn't.

But they do not ban egg donation. They only ban COMMERCIAL egg donation. That's what I'm trying to get my head around. Women can take the (negligible) risk for free, but not for money.