On this blog, we’ve discussed many aspects of the decision to have children, or not have children, and the gray area in between. But for women and couples struggling with infertility, it’s not a choice, but a battle, one that leaves many feeling like they’re alone.
*Sarah and her husband *Evan were open with us about their journey to parenthood and all the many processes they went through, as well as the stress and heartache they endured. Thankfully, all their struggles did finally get them to their destination: parenthood.
In the meantime, Sarah did a lot of journaling about the process and her feelings. “This time period made us feel very alone as a couple, and me very alone as a woman,” she said. As much as Evan wanted to help her, he couldn’t feel what she was feeling.
When they got married in 2010, they knew they wanted to have children, and would wait until Sarah was finished with graduate school. She stopped taking her birth control in March of 2011 and they casually tried for a couple of months. After no results, they tried to time their attempts more strategically. She tracked her period on the calendar, and they had sex almost every other day.
Three or four months passed, and Sarah did not conceive. As their frustration grew, Sarah turned to her doctor, who recommended ovulation prediction kits (OPK) to check her ovulation, so that she and Evan could be even more strategic about when they tried to conceive.
A few months later, something seemed off with Sarah’s hormones. She was ovulating, but something about the timing wasn’t quite right. Her doctor noticed her thyroid seemed a little enlarged, and decided to check some other things – progesterone levels, thyroid, etc.
All values came back abnormal. None of her hormone levels were right for a 26-year-old woman. Sarah was started on medication to regulate her thyroid. At this point they were still using the OPKs and having sex regularly. “At least part of me had some relief – there was a problem, we were fixing it, and maybe that was the only thing,” Sarah recalls.
In January of 2012, Sarah’s doctor prescribed Clomid for her, a “first level” fertility drug, which causes the pituitary gland to release hormones that stimulate ovulation. After the third round of Clomid and still no results, Sarah was officially diagnosed with infertility.
Process of Elimination
Her doctor referred them to a fertility clinic, Ohio Reproductive Medicine. This clinic also accepted their insurance, which was very important. Fertility treatments and procedures are not cheap. They were fortunate to have a plan that covered 70% of their fertility treatments, and employers that were patient and supportive of them throughout their journey. For couples without those resources, this might have been the end of the line.
They chose the same reproductive endocrinologist used by two of Sarah’s friends who had had successful pregnancies. He was helpful right from the start, walking them through all the procedures and the chance of success with each. As awful as their situation felt to them, he was honest and didn’t give false hope, but shared how many other women had been successful with similar problems.
They hadn’t realized how prevalent infertility actually is: as they started their journey, Sarah learned of many friends who conceived on Clomid, or were seeing a doctor at the same clinic. Ultimately, it was emotionally beneficial to have these other women as an example and support through the process.
By May 2012, having had no success with hormone treatments, Sarah had a hysterosalpingogram (HSG) performed. This is a procedure in which dye is injected into the uterus to test for blockages or flow issues that might prevent the egg and sperm from meeting.
One of Sarah’s friends had this done around the same time. A month later, her friend was pregnant, but Sarah was not.
The next plan of attack was another round of Clomid with Intrauterine Insemination (IUI), aka “the turkey baster method.” Their doctor used a small catheter to inject Evan’s semen directly into her uterus, bypassing the cervix.
Each process ruled out another variable that could be keeping them from conceiving. Something wrong with chemistry/hormones? Clomid. Can the egg get through the fallopian tube? HSG. Can the sperm get in through the cervix? IUI.
The IUI was repeated in July, August, and September of 2012. Still not pregnant, Sarah hit rock bottom. She was angry, frustrated, and disappointed. So many of her friends were pregnant; she couldn’t escape thinking about pregnancy and babies. “Why wouldn’t my body do this thing that it was supposed to do?” she wondered. They decided to take a break for a few months over the holidays.
The next step was In Vitro Fertilization (IVF), in which the egg and sperm are united outside the body and, if fertilization takes, the resulting embryo can then be implanted in the uterus. Despite the cost and risk involved with IVF, they decided they would do it, with help again from their insurance.
Prior to this journey, Sarah would not have considered using IVF. “I grew up Catholic, and felt that this was playing God,” she said. She met a couple women who had children through IVF who recommended a book to her that changed her views on the process. The author, a physician, broke down the medical science of IVF, and expressed that it was a technology – not using it would be like refusing to wear glasses because she was meant to be blind. Through this book and her experiences, she decided she was willing to give it a try, because they really wanted to have children.
The Adoption Option
During this time the couple had the opportunity to have dinner with their Pastor, who had two adopted sons. The pastor and his wife had decided not to use fertility treatments and went straight to adoption. Hearing their story and being able to ask questions was helpful for Sarah and Evan, who didn’t know anyone who had gone through the adoption process.
The couple had several heated discussions during this emotionally stressful time. Sarah felt very strongly about carrying a pregnancy and delivering her own child. Evan was more open to adoption sooner than Sarah, who thought she could be “ok” with adoption if nothing else worked. Still, they were going to give IVF a try first.
In January 2013, Sarah began her injected medications in preparation for IVF. She thought, “As a nurse, I can do my own injections, no problem. Apparently, I was wrong!” She had to teach Evan how to do the injections. He was glad to support her by doing this and have an active role, “rather than being some guy who swoops in at the last minute and ejaculates in a cup,” he joked.
The IVF preparation process was demanding. Sarah felt she had to put everything else in her life on pause. The drugs were giving her regular daily migraines, and she had to go to the clinic for weekly blood draws to check levels. The doctors were manually driving her body – shutting down her hormones, and making adjustments to her drugs week by week.
A Twist of Fate
When they were nearly past the “point of no return” on IVF, Sarah and Evan got a call from a family friend, a lawyer who had a pregnant client looking for adoptive parents for her unborn daughter. They told her, “We’re not NOT interested,” and thought about it over the weekend.
After nearly two years of trying to conceive through various processes, they didn’t have too much confidence in the IVF being successful, so they took this adoption into serious consideration. They eventually decided to go through with this and meet the mother. If she didn’t choose them, it wasn’t meant to be.
At the end of January 2013, Sarah went in for her egg retrieval. She had no idea what to expect. Sarah and Evan had kept everything to themselves – they hadn’t even told their parents they were doing IVF. They didn’t want to have to get anyone’s hopes up and then have to explain everything if she didn’t get pregnant.
A few days later, they had five healthy embryos ready to become their children.
Some couples elect to only implant one embryo, to cut the risk of multiples, even if it meant going through the process again if the pregnancy didn’t take. Others implant two or more, risking multiples, but having a better chance that at least one would be successful and they would not have to repeat the process. Sarah and Evan chose to risk twins and implant two.
On February 11, 2013, Sarah had blood drawn and tested in the morning, and got a call from her nurse in the afternoon: “Your HCG levels are 366. We like it above 50. You are most definitely pregnant!” She let Evan know she had heard from the clinic, and he came up to see her (they worked in the same building). He opened up the door, and she was jumping up and down, holding a piece of paper that said “366 – Most definitely pregnant” underlined three times!
As fate would have it, just three days earlier, they had met with the mother whose daughter they would potentially adopt. They had provided an “adoption profile” about themselves as an introduction before the meeting. The meeting was awkward and kind of surreal – there was no predetermined social etiquette for that kind of situation. But by the end of this meeting, the mother decided Sarah and Evan should be the ones to adopt her daughter, whom they chose to name Elizabeth.
They had six weeks to go through the entire adoption process – a whirlwind of lawyers, social workers, payments, PAPERWORK, classes, etc. – a process that can take up to a year, but with Elizabeth’s early April due date, they were on a deadline.
In March, they went in for an ultrasound to confirm her pregnancy. Their doctor informed them that if he saw a sack, a beating heart, and a placenta, the chances of miscarriage would drop to 5%. He showed them pregnancy number one, and then pregnancy number two. “It wasn’t until he showed them side by side on the monitor that it really hit that we were pregnant with twins.” Sarah sat there thinking, “Oh boy…”
Meanwhile, the birth mother of their daughter was scheduled for a cesarean section delivery, and had arranged for them to be at the hospital for her birth. Elizabeth was a healthy 10-lb baby, born in early April. Sarah and Evan were able to see her within about an hour of her birth. They had a hospital room to stay in while Elizabeth was in the hospital, and had shared “custody” of her prior to discharge.
A hospital social worker was present to help with any gray areas in the private adoption situation. Some of the mother’s family members were pressuring her to change her mind. Sarah and Evan were as kind and polite as they could be, and trusted the system, lawyers, and social worker, that everything would work out – even though they were a mess on the inside. In the end, the mother decided the best course for her and the baby would be to continue with the adoption.
Here We Grow Again
Sarah was due to deliver her twins at the end of October, but they surprised their parents and came seven weeks early – a month before Elizabeth’s adoption was final. Once their twin boys were born, Sarah and Evan were spending nearly every waking moment in the hospital NICU with them, hoping for them to grow strong enough to come home. In just under two weeks, they brought their twins home.
“The time we were not doing paperwork and fertility treatment was spent cleaning bottles, pumping, caring for babies, doing housework, and (trying) to sleep,” Sarah remembers. “It was so strange having left the hospital with a baby [Elizabeth] – it felt real, compared to leaving the hospital empty-handed when I delivered the boys.” She had spent so long watching her friends experience pregnancy and have babies, and badly wanted that for herself.
Now, surrounded by her healthy and happy family of five, she reflects, “Elizabeth is my daughter just as much as Nicholas and James are my sons.”
Despite the long journey to Destination: Parenthood, “It was all worth it,” Sarah says today. “We will always be able to tell our kids how much we wished for them and what they mean to us.”
*names have been changed to protect their privacy