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My name is Tehila Sabo, and I struggle with infertility and miscarriage.

My husband and I have always loved children, and always looked forward to the day we would become parents. We got married young, when I was 21, and as many do, we planned for hold off on children until after I finished with schooling.  I graduated PA school at the age of 24, at which point my husband and I decided we were ready to start trying for children. I had come off of birth control, and for some reason was not getting my period. After three months, I decided to seek out care from an OBGYN. Many people told me I was too quick to seek out help, and I needed to wait a year before seeking out professional assistance. I had remembered from my OBGYN course in PA school that it is abnormal for women to not shed their lining after a 90 day period, and decided to go with my gut, and seek out help. I went to a local OBGYN who had given the same advice as our friends and family- wait and don’t stress. He put me on progesterone to shed my lining and try to jump start ovulation, but it didn’t work. We did this for 9 months, and then I said, enough, it’s time for a specialist. I shockingly didn’t know about reproductive endocrinologists!  We went to a local clinic that recommended IUI- intrauterine insemination. This is a process where ovulation is induced via medication, the sperm is cleaned, and healthy sperm is placed into uterus via a catheter, thereby increasing chances of conception. Once the IUI is complete, there is an infamous two week waiting period, where you either get your period or find out you become pregnant, and my friends- that’s two week wait is torture. So many emotions- both hormonal and real.  Are we finally going to be pregnant, or will this end with a period, and lots of crushed hopes. We did this process four times, and each time the IUI failed. It was devastating.  With each failure it became emotionally harder to try again, to get our hopes up, and then end with a big fat negative. We were then told we should consider IVF. We decided to get a second opinion from a more experienced reproductive endocrinologist, and this time I did my research. (One thing I tell my friends, family, and patients, is that not all specialists are created equal! Do your research!) 

We met with a fantastic specialist, the catch was- he wouldn’t be covered by insurance. Infertility is not currently considered a disease- and therefore treatments are out of pocket. Another blow to our already depressing reality. After much discussion, we decided it was our only option, if we wanted the chance to become parents. We went through numerous tests which confirmed our only chance to conceive would be through IVF. We were devastated. We had already gotten our hopes up with each IUI. What if IVF didn’t work as well? Each cycles is about 20k.  How much money were we going to sink into this? Our new specialist explained that IUI generally has a 20% success rate, were as IVF at his clinic had about a 60% success rate. He also explained that with our diagnoses chances were about 1% to conceive with IUI, and we really had no shot doing IUI at the other clinic. 

We decided to go through the daunting process of IVF. I was prescribed numerous injectable medications to increase the production of egg follicles, which were then removed by a procedure called an egg retrieval. I then waited to see how many eggs were removed, matured, were inseminated, and continued to grow for a few days. We sat by our phone anxiously awaiting the call every day to see if our precious embryos would make it. When we found out we luckily had healthy embryos, I was placed back on different injectable hormones, and went through another process called a frozen embryo transfer. They placed our little embryo into a catheter and inserted it into my uterus. And then once again, we had to wait to find out if it worked. Thankfully our first frozen embryo transfer was successful! But what I did find out was that I was at high risk for miscarriage. I carry antiphospholipid antibodies. I was placed on aspirin and Lovenox (yay more shots!) which I would take throughout the entire pregnancy. I also carried natural killer cells which additionally increases the likelihood of miscarriage. We went on to have a successful pregnancy and had a beautiful baby boy! 

One year later we were excited to try again- we felt like we could avoid all of the previous heartache now that we knew IVF was our answer! We went through some testing again to ensure my hormone levels were back where they needed to be, and we started the IVF hormones once again. We felt so blessed to know as hard as this route was, there was a way to grow our family. I did get pregnant with this next embryo transfer. I heard the little heart beat at 6 weeks, but devastatingly found out there was no heart beat at 8.5 weeks. I was in utter shock. I was on all the miscarriage protocols. It was a genetically tested, healthy embryo. What happened?! And there were no answers other then, let’s try again. Sometimes it is a fluke and science can’t explain it. If it happened again, they would do further digging. We were crushed. 

We decided to immediately get back on the IVF train, and try again. But this time, my energy and hopes were totally drained. We did another embryo transfer, and thankfully had a healthy pregnancy. But the burden of the whole infertility and miscarriage battle, weighed heavily on me. I was constantly anxious, would I lose this pregnancy too? And to add to the anxiety, this pregnancy was during the COVID pandemic.  My husband was not allowed to come to any appointments with me. (I must add, that I was also dealing with stress of two family members being diagnosed with stage four cancer, my husband having a brain aneurysm rupture, and all three of them having COVID, all during this pregnancy!)

I was being monitored weekly by a perinatologist and my OBGYN. With each appointment my anxiety peaked. Would they find anything wrong? At 38 weeks pregnant my fears were confirmed. The baby wasn’t moving. But there was still a heart beat! I was rushed to the hospital, and was blessed to have my healthy baby boy number 2!

My sons are now 2 years old, and 5 months old.

I don’t think I really knew how heavy this burden was until now, as I look back and reflect on all it took to get here. As I hug and kiss my sons each day, I think about how fortunate I am to have them, and how others aren’t as lucky.

 

Infertility and miscarriage is an all consuming road. There are no guarantees that treatments will work, or if they work that it won’t end in heartache with a miscarriage. I was fortunate to be blessed with two beautiful boys who I cherish every day. They give me so much meaning. That being said, so many others aren’t as fortunate, and go through these challenges, spend thousands of dollars, and do not come out on the other end as parents. The yearning to become parents, or grow a family can feel like a dagger ripping through your heart. For me, the support of friends and family made a big difference. I had friends send chocolates or dinners right after the miscarriage with notes saying thinking of you. I also joined support communities for infertility and miscarriages which helped me realize I was not alone. 

For those of you trying to grow your family, you do not have to wait a year to seek out help! That is a myth. Save yourself some time and heartache and get an evaluation if you suspect something is wrong, and do your research! I would have saved a year of treatments that wouldn’t have worked, and a whole lot of heartache.

If you have a friend or family member going through infertility or miscarriage, there are dos and dont’s as to what to say. Below is a link to a well known organization called resolve with dos and donts: https://www.verywellfamily.com/things-not-to-say-to-someone-infertility-1960012

 

Tehila Sabo, PA-C

Inernal Medicine

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