I am not a medical expert. The information I am sharing below is from my own research and personal experience. The following is a personal account of my experience with infertility and IVF.
Infertility and IVF Facts
- Infertility effects 1 in 8 couples in the U.S. and 1 in 6 couples worldwide.
- The causes of infertility are evenly divided: 1/3 of all infertility cases are unexplained, 1/3 are male factor, 1/3 are female factor
- Most fertility treatments, including IVF are typically NOT covered by insurance (nor are the medications) and can cost anywhere between $10,000-$25,000 per cycle (including the cost of medication).
Common fertility treatments include:
- Oral medication to induce ovulation (such as Clomid or Femara)
- IUI – intrauterine insemination where sperm is collected, “washed”, and then deposited directly into the uterus at the time of ovulation
- IVF – in-vitro fertilization where injectable medications are used to stimulate the ovaries to produce multiple eggs. Once the follicles are an appropriate size, they are retrieved and fertilized in the embryology lab with your partner’s (or donor) sperm. IVF can be done with or without ICSI (intracytoplasmic sperm injection) in which a single sperm is injected directly into an egg to assist in fertilization. Once the embryo(s) develop to the appropriate stage in the lab, they are then transferred back into the woman (in a procedure similar to an IUI), or frozen for transfer at a later date.
For over two years, I have dreamed of the day that I could share our story about beating infertility. Now that the time has come, I’m struggling with where to even begin. I suppose my story starts out very similar to most women. I was on oral contraceptives for 15 years. When I met my husband at 21, we were not ready to start our family. We were just starting our lives together and wanted time to travel, settle into our careers, and enjoy time as a married couple. There wasn’t even a fleeting thought that becoming pregnant would ever be an issue for us when the time came. Fast-forward 7 years and we were finally ready in 2014 to start our adventure into parenthood.
Our Journey Begins
I love to research and be fully prepared, so before I stopped taking birth control, I read “Taking Charge of Your Fertility” by Toni Weschler, which was an absolute game changer. I wondered why I hadn’t read this when I was a teenager! With my newfound knowledge on all-things related to reproduction and trying to conceive (TTC), all we had to do was follow the simple steps outlined in TCOYF and be patient. And just 3 short months later, I saw my first positive pregnancy test! We were ecstatic and blissfully unaware of the looming storm on the horizon. Sadly, we unexpectedly lost that baby at 18 weeks gestation in March 2015. To say we were devastated doesn’t even begin to describe the pain we felt. Initially, we weren’t aware of anyone in our social circle who had experienced a miscarriage or pregnancy loss. However, in the coming weeks we experienced an outpouring of love and support from friends, family, and colleagues – many of whom shared their stories of loss with us. We were surprised by the number of people we knew that had also experienced a loss. We took comfort in knowing that time would help heal the pain, as it has done for so many others. As we began to pick up the pieces, we discussed TTC and (naively) thought it would be as simple and straightforward as it had been just a few months prior. I remember my OB saying to me “If you aren’t pregnant by September (this was March), come in to see me and we’ll talk about next steps”. To which I replied “Oh, I’ll be pregnant well before September!”
Seeking Fertility Treatment
October of 2015 rolled around and I was still not pregnant. I decided it was time to meet with a reproductive endocrinologist (RE) to do some additional testing and come up with a game plan moving forward. The first step in fertility testing is typically a hormone panel to see if your ranges are within the “normal” limits. When my tests all came back normal, my RE decided to start me out on Femara (similar to Clomid), to induce ovulation or stimulate “hyper-ovulation” where your body may produce more than one follicle each month, and therefore increase your chances of becoming pregnant. After a few unsuccessful months on Femara, I asked my husband if he would consider going in for a semen analysis (SA) to make sure everything checked out so we could dive further into our infertility diagnosis. After our failed Femara cycles and after my husband’s SA results, our RE told us the likelihood of us conceiving naturally were quite low and that we had two choices to increase our chances: IUI or IVF with ICSI. It took us awhile to come to terms with the fact that we may need assisted reproductive technology (ART) to make our dream of having a family come true. However, we decided to go ahead and move forward with giving IUI a try because it is less expensive and less invasive than IVF. After seeing yet another negative pregnancy test at the end of our IUI treatment in February 2016, we both decided it was time for a break from fertility treatments and to reconvene and discuss IVF when we returned from our summer vacation in June of 2016.
Infertility and IVF: The Decision to Move Forward
I made an appointment with a new RE for the week we returned from vacation in mid-June. I wanted to get a second opinion to make sure that there were not any other treatment options we should try before IVF. After our consultation, we concluded that IVF with ICSI was the best option with the highest success rates for our diagnosis. I underwent the stimulation and egg retrieval portion of IVF in August (which involves multiple injectable medications for 7-14 days, several ultrasounds and blood draws, and finally a procedure to retrieve the eggs). Once the eggs were retrieved, the embryologist combined my husband’s sperm with my eggs and developed them in a culture within the lab for 5-6 days before they were frozen for use at a later date. There is typically quite a large attrition rate between the number of eggs retrieved and the number of viable embryos available for transfer, which adds to the emotional rollercoaster of the entire process. We were aiming for what they call a “fresh transfer”, where they implant the embryo (or embryos) 5 days after the eggs are retrieved, however, my progesterone started rising prematurely which would’ve caused a less than ideal environment for an embryo, therefore significantly decreasing my chances of becoming pregnant. So we froze our viable embryos and started the process of our frozen embryo transfer (FET) in September.
FETs are much simpler and more straightforward than the IVF procedure – most protocols require daily estrogen (pills or patches), a few ultrasounds to make sure the uterine environment is ready to receive the embryo(s), and then the addition of daily progesterone injections or suppositories. The actual transfer is very similar to an IUI, except instead of sperm, the embryo(s) are deposited directly into the uterus. Our transfer took place on October 6th (two days after my 30th birthday). I had an hCG blood test scheduled for 11 days after the procedure, at which time we would find out if the transfer was successful. Patience isn’t one of my best virtues, so I took a home pregnancy test a few days after the transfer and to my delight, I saw a very faint second line! My husband didn’t believe me at first – I woke him up and in his half-dazed state he said he couldn’t see the second line so I insisted he squint a bit harder because it was definitely there! I took another test the next morning and it was much more clear… it was definitely positive! The blood test the following week confirmed that I was indeed pregnant, as did subsequent ultrasounds to verify that the pregnancy was progressing normally.
Although our story may not be “typical”, there are so many couples out there struggling with infertility, many of whom suffer in silence. Chances are, you know someone who is struggling. If you do know someone who has been brave enough to share their story with you, give them a big hug and let them know you are there to listen and support them on their journey.
A special thank you to Dr.’s John Park, Bill Meyer, and Grace Couchman of Carolina Conceptions for assisting us in making our dream of having a family become a reality.