Fertility Patient Success Stories
These are the stories of some of our patients. While all are inspirational, each is also unique and informative, allowing us to view the way in which these couples handled the challenges of their infertility.
PROFILE: Lynda & John
“Trying to stop a woman from wanting to have a baby is like trying to stop a freight train” This is how Lynda described her own feelings about the struggle that she and her husband John went through when they first began to try to have a baby. “I’m the kind of personality,” she adds, “that – if it is not happening yesterday—then I want to move along to the next thing and get things done.” But in spite of her determination, as well as the fact that both Lynda & John are accomplished physicians (in specialties unrelated to fertility) the path that led them both to IRMS and to parenthood would not be easy.
Because she was already in her mid-thirties (and her husband was in his early 50s) when they first began trying to become pregnant, Lynda didn’t wait long before consulting her regular OB/GYN about fertility treatments. He prescribed a common fertility medication as well as timed intercourse— which in many cases is a standard first approach to treating infertility.
For John and Lynda, however this approach was stressful. “It takes a lot of the spontaneity out of things” says Lynda with embarrassment. “It was like: ‘OK—the doctor said we had to have intercourse now—it’s 6pm—let’s go…’”
But far worse than just being a mood-dampener, John and Lynda found that this first line approach was also ineffective. So they made the decision to seek out a fertility specialist near their hometown in Florida. “I had a feeling that things were going to have to ramp up” says Lynda. After consulting with their new physician, the decision was made to try intrauterine insemination.
Lynda remembers the process vividly: “we went through one cycle [of intrauterine insemination] that didn’t work—and then we went through a second cycle that resulted in a pregnancy… and everyone was overjoyed , it was wonderful, we went in, we had a six-week ultrasound… we had a heartbeat…we had a pregnancy.” Elated, Lynda did what any expectant mother would do—she went shopping for her new baby. “And I bought a little toy—a stuffed animal or something—just to kind of kind of commemorate it. “
But all of Lynda and John’s joys were dashed just days later, when a subsequent ultrasound revealed that the heartbeat had ceased, and the pregnancy had spontaneously aborted. “I can remember that when we lost that baby that it was unfortunate that I had bought that present for myself or the baby or whatever… it just wasn’t meant to be.”
Stunned with grief, Lynda and John paused to reconsider their options, but ultimately persevered in their efforts to become parents. Hormone treatments and repeated cycles of intrauterine insemination eventually resulted in still another pregnancy—with triplets. But tragically—this pregnancy also ended in miscarriage. This time, a genetic analysis of fetal tissue was performed, and revealed serious abnormalities in each of the three embryos. Their physician was stumped. “I knew that he really wanted to help us” says Lynda, “but he looked us in the eye, and basically admitted that he didn’t think he could… And that is when he talked about those letters P.G.D.”
Lynda still becomes emotional when she recalls the day that she was implanted with two of her own healthy embryos. She was fully awake during the procedure, and recalls that after the implantation, her doctor handed her photographs of each of the newly implanted embryos.
“You know what?” she said, “I’m not sure I really want these.” And she started to cry. “I don’t know if this is going to work, and I am not sure if I want these sorts of memories.” But in spite of her fears, Lynda decided to keep the photos. Nine months after the procedure, twins Catherine and Elizabeth were born – completely healthy and as photogenic as the day they were implanted. Three years later, Lynda has no regrets about holding onto the images—“They are the first pictures in our photo album of our kids. I’m glad I kept them—they’re really cool.” Likewise, Lynda and John are more than satisfied with their decision to come to IRMS. “They are the best in the country” Lynda explains, “In my estimation; they wrote the book on this technique, and why not go the place where they wrote the book?
PROFILE: Claudia & Ethan
My journey to parenthood began with my marriage in 1999. I had just celebrated my 30th Birthday and popular wisdom dictated that there was “no rush” to conceive as a woman’s fertility didn’t start to decline until the age of 35. After six months of trying I sought the advice of my OB/GYN who implored me to “relax have a few drinks and it will happen naturally”. He warned me that a “Fertility Doctor” wouldn’t evaluate a woman of my age unless I had been attempting conception for over a year.
The internet proved to be a valuable resource as it enabled me to return to such office six weeks later armed with facts about the basic fertility workup as well as the various types of treatment available. My questions prompted him to prescribe three months of Clomid treatment. After such failure he reluctantly referred me to a local Reproductive Endocrinologist.
My first visit to this RE was reassuring. He explained how my age, coupled with a low FSH, virtually guaranteed that I would become a mother with the use of injectable medications and Intra Uterine Insemination. He explained that it was a low cost, minimally invasive method for those who just need “a little help” conceiving.
The next three years proved that I needed more than a little help conceiving a healthy pregnancy. I suffered through eight IUI’s, a polyp removal, three miscarriages, a hysteroscopy, two D & C’s and even a few breaks. I began to feel hopeless when my physician apologetically told me he could “no longer help” me. I cried as I left his office. I can best describe the RE, patient relationship as one with forced intimacy and the thought of repeating so much of the above with a stranger frightened me. This fear resulted in my procrastinating for several months before looking for an RE who could perform my much needed In Vitro Fertilization.
I again credit the internet with empowering me to research IVF providers. I am lucky that I live in NYC and have many of the nation’s top facilities at my disposal. I scoured the CDC stats as well as many fertility websites and chat rooms in search of a provider who would meet my needs. I was fortunate that my insurance had a reasonable IVF benefit but I found it challenging to find a respected facility that would accept my plan. My research proved IVF is a big business and many facilities had a cash only policy. Out of frustration I began calling every one of the top rated centers to inquire about insurance participation. I was thrilled when, after many calls, a friendly voice at IRMS at Saint Barnabas told me they had just signed a contract with my insurer.
I wish I could say that my first IVF cycle at IRMS was my last. Instead, it marked the beginning of many more years of heartache and disappointment. These years witnessed my presence not only at St. Barnabas, but at also virtually every one of the highly esteemed programs in NYC. After my seventh cycle, the Director of one such program told me he could “no longer support” further treatment without the use of donor eggs.
For us this was not an option. I was despondent as I was statistically a repeated failure and the programs that had treated me eagerly no longer wanted to sacrifice their statistics with such a challenging case.
In a life altering moment I remembered a lovely physician at IRMS who had exhibited compassion which seemed to extend beyond her professional scope. In a moment of optimism I called Dr. Natalie Cekleniak and asked her if she would agree to see me again. I was trembling as I walked into her office, I was afraid she would not remember me but I was also petrified that she would. We made eye contact and she jumped from behind her desk to hug me in a moment that I now remember with profound joy. After reviewing my history she cautioned me that a successful pregnancy using my own eggs was unlikely but not impossible. She agreed to cycle me one more time.
My seven year journey was wrought with sadness frustration and despair. Each negative pregnancy test was followed by a period of depressive mourning. Every procedure, blood draw and injection left what seemed to be a permanent scar on both my body and soul.
At 8:55 am on July 24, 2008 I heard a melody far too beautiful for the human ear. My son William’s first cry instantly washed away all of the above heartache. At 9:00 am Connor was born and I was gifted with the feeling that my family and my life would forever be complete.
The intense emotions associated with this memoir are still so powerful that it has taken me over a year to process. I now view my journey through infertility as a gift without which I wouldn’t be able to truly value my role as a mother. When I tuck my children into bed at night I thank God that people like Dr. Natalie Cekleniak and the wonderful people at IRMS at Saint Barnabas have dedicated their lives to completing families.
PROFILE: Elaine & Dave
Elaine never imagined that she and her husband Dave would have difficulty starting a family. As she puts it: “You just grow up, and you think you’re going to have kids when you want to have kids… but it didn’t work out that way.”
The problem, it seemed, was time. To listen to the effortless way in which they complete each others thoughts, one might easily assume that Dave and Elaine had met as high school sweethearts—they sound as if they’ve known each other for a lifetime. But in fact, it wasn’t until both were in their thirties that they discovered their special bond.
“I was 35 when I got married, and Dave was 33 …so we didn’t have a chance to start (planning a family) until I was 35… and so the troubles began…” Elaine says, referring to the series of miscarriages that began shortly after they began trying to become pregnant. Her husband Dave is both direct and compassionate in his description:
“She felt like she had failed. She felt like she was failing in the marriage. And the loss was hard, because she lost them at home. She was emotionally very broken down by the whole experience.”
“I mean, I was never ‘declared’ depressed,” says Elaine, “…but I was depressed! I went to work, I did what I had to do, but that was about it.” After a moment she adds, “Don’t think that you’re different from anybody else. I mean, you should feel devastated.” “And you are not alone” Dave says, “It is amazing how common it is…”
The tragic process repeated itself a second time, and then a third. Elaine never had any trouble getting pregnant, but after eight to ten weeks, the unbearable, inevitable miscarriage would happen again. After the third miscarriage, they began to see a local infertility doctor, who recommended artificial insemination. Once again, Elaine became pregnant. And sadly, once again, Elaine miscarried.
After this, the fourth miscarriage, they considered giving up. “We had resigned ourselves to the fact that we wouldn’t have kids” Dave says. “All these doctors were trying to do was to get us pregnant” he adds, “and we needed Elaine to stay pregnant.”
It was about this time that Elaine & Dave attended their first meeting of RESOLVE—the leading national infertility association. The meeting was held at a local hotel, and included a number of seminars on various topics. Elaine made a decision to attend a seminar on adoption, while Dave was curious about a presentation being made by Jacques Cohen, PhD—who was then Direct of Laboratory Services at IRMS. The presentation was on the topic of P.G.D.—Pre-Implantation Genetic Diagnosis. After hearing Dr. Cohen’s presentation on P.G.D., Dave rushed back to speak with Elaine.
“Elaine, listen” he said, “this group at Saint Barnabas sounds like they have the diagnostic means to possibly help us. Nobody that we have been to can do what they do— we have to give them a shot. Elaine listened, and agreed: “This is the route we need to take.”
Elaine & Dave’s initial consultation at IRMS reinforced their fragile sense of hope—but that hope came bundled with an equal dose of worry. “I think we both knew that this was the end of the road” explains Elaine. “I just feared that it wasn’t going to work—that I wasn’t going to be able to have a baby.”
But according to Dave, whatever they faced in the future could not possibly be as bad as what they had already been through: “The fact is that everything we had been through had been so horrible.” he says. “They [IRMS] had some hope—and we felt that they had a more advanced direction. We had already been through the worst.”
As Elaine & Dave began the process of in vitro fertilization and P.G.D., they were especially gratified at the way in which all of the staff took special care to address their questions and concerns. “I felt that any questions I had– I could ask” explains Elaine, and Dave echoes her sentiment: “ they explained every step of the process…” he says, “right down to the fact that when they did the P.G.D., they put a fluorescent tag on the gene so that it highlights under the microscope—I mean, they really explained it thoroughly.”
To listen to the way Dave describes it, one senses immediately that this was more than an abstract curiosity that they each felt—it seemed to be part of the healing process. “We had been through too much–” he says, “we had lost too much. We were giving up hope. We didn’t want our questions to be blown off.”
Sensing her husband’s emotion, Elaine jumps in, describing the process of in vitro fertilization: “They put three embryos in. One didn’t connect right away, so then there were two. But within a week, the second one that they had put in was an empty sac.” This left her with a single embryo—a single remaining chance of a successful pregnancy.
Without missing a beat—her husband again continues the story—as if it is one that they have each told a thousand times– “We were afraid as she lost those other embryos, that the shedding of the material would upset the surviving embryo.” “That was nerve-wracking,” Elaine jumps in. “Yeah, it was rough.” Dave agrees. But it was hardly the last of their troubles.
“We got pregnant in the summer of 2001,” Elaine continues, “and on September 11, 2001—the September 11th … I was only about 12-13 weeks pregnant. I was talking with my sister about the events of the day—thank God we didn’t know anyone personally– and I said ‘Uh-Oh. What was that?’ And my water broke. ”
An intensive round of tests resulted in grim news. “They gave me a 2% chance of this pregnancy surviving,” Elaine says, ‘because there was no fluid around the baby. His heartbeat was fine… but the [amniotic] sac was closing in around him.”
Fearing the worst, yet hoping for a miracle, Elaine held on. She immediately went on complete bed rest—and both she and Dave focused on nothing but the impossible hope that somehow, in some way, this baby would survive.
A month of waiting brought a shred of good news—tests showed that the amniotic sac had sealed. But according to Dave, the physicians were as tense and worried as he and Elaine: “They didn’t know if he was going to be able to breathe when he was born. “ It was entirely possible that the baby might never be able to develop functional lungs — it might live to be born, only to perish within minutes or hours. Only the baby’s first cry could signal that in fact, his lungs were fully developed and the baby was able to live outside his mother’s womb.
For Elaine, the combination of fear and immobility was grueling. “The stress never gave up,” she says. “We were not at ease, and we did not did not enjoy the pregnancy… We did not breathe easy during the entire pregnancy—we were on pins and needles—it was an incredible amount of stress. I didn’t have a baby shower, and all did is—we bought a car seat and one outfit.
Dave describes the pregnancy in similar terms: “People [who are pregnant] get happy and have a wonderful nine months? We had, like nine months of stress. All of that decorating the house and being happy? There was none of that.” On paper, Dave’s words appear angry—but his voice reveals no hint of bitterness. Rather, he speaks in tones of exhaustion.
The ordeal that Elaine & Dave did eventually come to a conclusion—but not without a final complication: ultrasound tests revealed that the baby was in the breech position—that is, with the head oriented up under the diaphragm instead of pointed down, towards the birth canal. This presented an additional risk of strangulation and fetal distress during birth. Nothing about this pregnancy was going to be simple—or so it seemed. It was decided that the baby needed to be delivered by caesarean section. No one was completely sure if the baby would live– or die.
Elaine was conscious for the procedure, and like everyone else in the delivery room, she held her breath while the baby was removed from her uterus. “It was a long time before he screamed,” she says, “and then you knew he was fine, because he really, really screamed. To us, it was a complete miracle. To the doctors—it was a complete miracle.”
It was a miracle that Dave saw face-to-face. “I went to the nursery—or where they wash the baby. And I remember the first time that I held him… I looked down, and it was unbelievable joy. It was incredible—just to have him, and to have him well, and crying, and looking up at me—it was incredible.” After a pause, Dave adds an additional thought—“He is everything to me.”
Joseph was born, kicking, crying and healthy, in March of 2002. His sister Catherine followed approximately two years later. She was also conceived with the help of IVF and PGD. Elaine describes her pregnancy with Catherine as “perfect.” She adds, “I thank God every, every night.”
PROFILE: Hanna & Jack
“We started to try to have kids, and I got pregnant right away. There was no problem at all to get pregnant. And then I had a miscarriage. Right in the beginning – like two months into it… not even two months…” This is how Hanna Shapiro describes the beginning of her long ordeal.
Friends and family told her not to worry, that such things were not uncommon, but Hanna was worried. She told herself at first that it must be because of her age (although she was scarcely into her thirties), but soon enough she began to worry that there was something else that might be the cause of her miscarriage. “My oldest brother and his wife had extreme difficulty having kids. And they had an extraordinary number of miscarriages—10 or 13—something like that.”
After a second miscarriage, Hanna and her husband sought out a local infertility specialist. After a third, Hanna went for sophisticated genetic testing in New York City– it was then that she learned that she and her older brother both shared something in common: a tiny genetic ‘spelling error’ known as a chromosomal translocation. Some studies suggest that this condition affects 3 – 5% of couples with recurrent miscarriage. In this case, the genetic flaw was invisible—it caused no physical or medical problems for Hanna herself—but it made the process of having children into a dangerous roll of the dice. It was not certain that every one of Hanna’s embryos would inherit this flaw—but it was certain that any that did inherit the translocation would likely perish before birth, or in the unlikely event that the baby survived, it would be born with serious abnormalities.
Apparently by virtue of sheer persistence, Hanna’s brother and sister-in-law were ultimately successful—they now have three children. Hanna and her husband Jack were motivated to persevere. Hanna says “We kept following in my brother’s footsteps, because obviously it worked for them. And when you can see and know people—especially people that you love—with all of these nieces and nephews, it really gives you more of a faith that this is all going to work out.”
Hanna and her husband even went as far as to work with her brother and sister-in-law’s infertility specialist. But in spite of everyone’s best efforts, nothing seemed to change—Hanna would become pregnancy, but after a period of weeks, the pregnancy was lost. “Even though it was extremely difficult to go through repeated miscarriages, I just kept thinking it would work—because it had worked for them.”
“Somewhere around that time, I started researching chromosomal translocations, and what could be done, … and there was some work being done by a researcher named Santiago Munne, Ph.D., with a procedure called PGD—Preimplantation Genetic Diagnosis. PGD is a procedure that, when performed in conjunction with in vitro fertilization, or IVF, greatly reduces the risk of miscarriage “and so my husband and I went to IRMS at Saint Barnabas…”
At IRMS, Hanna and her husband consulted with the staff, and learned that they were good candidates for PGD. They were reluctant to proceed, however, in large part because of concerns that insurance would not cover the expense of the procedure. That circumstance changed the following year, however, with the passage of a law enabling many women like Hanna to receive insurance reimbursement for PGD. Hanna and her husband returned to IRMS with renewed confidence in both the procedure and the entire team of people who would be involved in administering it.
“Not only were we committed to try the PGD there, and feeling most confident in doing it there because of the expertise—the medical expertise as well as the technical expertise of the people running the lab—but we also had the support of the bill that allowed us to get insurance reimbursement.”
The procedure that Hanna was about to undergo was complex. Because PGD must be performed on human eggs in a laboratory setting, this required Hanna to undergo hormonal treatments in order to stimulate the maturation of multiple eggs from her ovaries. Hanna was monitored on a daily basis in order to precisely determine the time when these eggs would be released from her ovaries and available for retrieval. When the eggs were mature, approximately 20 eggs were retrieved and placed in incubators in the laboratory.
At about the same time, sperm was collected from Hanna’s husband. These sperm are used to fertilize all of Hanna’s eggs in the laboratory. These fertilized eggs are now separated and allowed to begin developing for a period of approximately three days. Eggs that are successfully fertilized form microscopic embryos, which consist of approximately 6 to 8 cells by day three. This is the point where PGD takes place.
During PGD, a single cell, called a blastomere, is carefully recovered from the tiny embryo. This process is performed under very controlled conditions, and there is very little risk of damage to the embryo from this procedure. An array of genetic tests are performed on this single cell, and from these tests, embryologists can determine the genetic health, or viability, of the embryo from which this single blastomere was recovered. If the embryo is found to be viable, then there is a significantly lower risk of miscarriage during pregnancy. If genetic flaws are found, then the corresponding embryo is at a much greater risk of spontaneous miscarriage or birth defects.
Using PGD, physicians can determine which retrieved embryos are most likely to be healthy, or viable. Complete certainty is never a possibility because some rare genetic defects may not show up on PGD, and also because developing embryos may be subject to difficulties that are not caused by genetic conditions. For this reason, it is common for physicians to discuss with a couple the possibility of transferring more than one healthy embryo back into the mother’s uterus. Typically the number is anywhere from one to three embryos. This does raise the possibility of multiple births, so it is only done in consultation with the couple.
“In our case…” says Hanna, “only one [embryo] had the full chromosomal complement that would most likely make it viable… so that one was transferred. But I didn’t get pregnant— it didn’t result in a pregnancy.”
It would have been understandable at this point for Hanna and her husband to give up, retreat from the pain, and react bitterly to the experience. But something was different this time around. For the first time in years, Hanna had hope. “I was really impressed by Saint Barnabas. By the whole procedure—everything that they had told you—all of the information that they gave you; the way that you were treated as a patient; the medical expertise, the technical expertise, the whole thing was a positive experience—even though it didn’t result in a pregnancy.”
Armed with new hope, Hanna & Jack decided to try again. And the procedure was exactly the same—Hanna received hormone treatments, her eggs were retrieved and fertilized, PGD was performed, and again, only a single embryo was found to be viable.
That single embryo was transferred back into Hanna’s womb, in exactly the same process that had taken place only months before.
But this time, something was different. The embryo implanted itself in Hanna’s uterus. Hanna was pregnant—this time with what Hanna and everyone around her hoped would be a healthy baby. After having suffered so much loss and heartbreak in the past, Hanna and her husband told no one about the pregnancy. It was too early, and it seemed all too easy for something to go wrong. In fact, nothing extraordinary happened until it was time for a routine six-week ultrasound.
ldquo;I will never forget this—as long as I live!” vows Hanna. “They were doing an ultrasound—and this is something that has been done to you – if you have been through this process [repeated infertility treatments] – 30, 40, 50 times. During a regular pregnancy, you have a couple of them, but when you have this sort of treatment, you’re having this sort of ultrasound all of the time.” “So I am lying there, having this ultrasound…” Hanna says, “… and all I wanted at that point was for Dr. Chen to say: ‘Here’s the heartbeat’ – and I would have felt good… like everything is okay.” And instead, Dr. Chen said– very matter-of-factly– ‘I think I see two…’”
Indeed, the single embryo that had been transferred back into Hanna’s womb had spontaneously developed into identical twins. “My initial response was total denial” claims Hanna, “and I kind of thought that maybe they hadn’t changed the screen [on the ultrasound machine] from the woman before me. In my mind, I’m like: ‘Maybe it’s not me!’ Then I rolled with it, so it was pretty exciting that it was two babies.”
Over the remaining duration of Hanna’s pregnancy, her twins continued to develop normally and without incident. Her two boys, Jason and Joshua were delivered by caesarian section, very healthy and very well loved. Today the toddlers enjoy bouncing on their baby swings and playing with the family dog. It seems all they needed was a good start.
PROFILE: Pat and Barbara
Barbara was diagnosed with breast cancer when her son Drew was one year old. Doctors advised against having more children. “Hearing that was harder than the cancer diagnosis,” says Barbara, who had hoped to have three children. She and her husband, who both come from families of three, wanted Drew to have siblings.
Barbara wondered if she was being ungrateful. She had a happy, healthy child, but all she wanted was another one. “I was putting all of this guilt on myself,” she says. “But for me being able to have another child felt like life goes on, and I’m not letting the cancer control my life.”
Barbara and her sister, Nicole, were tested for the hereditary BRCA2 gene mutation, which is linked to cancers of the breast and ovaries; they learned Barbara was a carrier and Nicole was not. As a precaution, Barbara had her ovaries removed. With no means of producing eggs, and an illness that could be aggravated by a pregnancy, she and her husband began to investigate their options. Barbara approached her sister about the possibility of her carrying a baby for her. Unfortunately, both women felt the timing was wrong. “My sister hadn’t had a child yet, and she was newly married,” says Barbara.
In December 2004, Nicole and her husband had their first child. Barbara and her husband decided to adopt. Then, in April 2005, Nicole called her sister. “She said, “I’d like to take you up on your offer, I’d like to carry your baby for you,” Barbara says. “I was floored.”
There followed a series of conversations, psychological counseling sessions, and early-morning visits to IRMS. There Nicole acted as her sister’s gestational carrier coupled with the use of an egg donor, a woman Barbara and Pat brought to NJ through a donor agency.
Within 10 days of Nicole’s transfer they all learned the procedure had worked and Nicole was pregnant. Nicole gave birth to her sister and brother-in-law’s daughter Molly.
Molly will know the story of how she came to be, Barbara says. “I’m going to try to make it as normal for her as possible. And she’s got to feel pretty special, you know? All of these people wanted her to be here. Everybody just loves her so much. She’s really just a miracle.”