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Alison Boden, MPH, Registered Dietitian

Alison received her undergraduate degree from UC Davis, followed by graduate training in nutrition and public health from the University of North Carolina at Chapel Hill.  As a practitioner of integrative nutrition she takes a holistic approach to wellness, recognizing that the foundation for optimal health and healing begins with a health promoting diet. Her emphasis is on using medical nutrition interventions to create a basis for health promotion and healing.

A lover of good food, Alison believes that a healthful diet should be thoughtful, enjoyable and satisfying.  Each meal does not only provide calories, but is an opportunity to supply our organs with the nutrients and building blocks needed for health. When the body is out of balance, as in the case of infertility, proper food choices can correct deficiencies and bring balance back to the system. What you eliminate from your diet is often as important as what you include. Consultations with Alison will help you address the key components of your diet that may be affecting your fertility and wellbeing, as well as help prepare your body for pregnancy.

Alison has experience assessing and counseling clients related to pregnancy and fertility, weight management, lipid control, food allergies, digestive health, sports nutrition, and chronic diseases such as cardiovascular, kidney disease and cancer. She views each person as a unique individual, and is dedicated to educating patients on natural ways to achieve optimal health and allowing them to take an active role in their health care decisions.

Alison is a member of the American Dietetic Association and the Women’s Health and Integrative and Functional Medicine practice groups.

My husband and I never thought having a family would be a struggle.  His siblings and my cousins were all VERY fertile… why shouldn’t we be the same?  Little did we know, as we said our “I Do’s”, that a condition called endometriosis was wreaking havoc on my reproductive organs.

Such was its devastation, that our 1^st pregnancy was an ectopic, resulting in the rupture of one of my fallopian tubes.  Had we not gotten to surgery in time I could have died.  My husband still reels from the memory of me handing him my wedding ring as they wheeled me into surgery. 

My doctor at the time didn’t see my other symptoms, (missed menses, constipation, heavy menses) and the ectopic as a problem.  The solution therefore was to put me on Clomid.  After a year of trying, a family member recommended finding a new doctor. 

My new doctor stated that my symptoms were consistent with endometriosis but could not be certain without “going in” to make sure.  Thus began the 1^st of 8 laparoscopies (over 6 years) to “clean me up”.  I had 2 surgeries in one month. My endometriosis was so bad that I had organs being pulled together.  After the 1^st surgery my doctor had me begin the Clomid regimen. After 4 cycles of treatment she said that I would need IVF to get pregnant.  Here is where the true shock began.   

My husband and I live modest lives… I’m a Kindergarten teacher and he works in construction.  Although we lived comfortably, the cost of IVF seemed unattainable.  We discussed our options.  IVF meant no more vacations, no more upgrades to our home, and no more “let’s buy it” spending.  It also meant facing the dark reality that we may never have children.  After getting our finances in order we visited the Pacific Fertility Center in San Francisco, which our doctor had recommended.  It was a good visit and was our first step.  We made our plans to undergo IVF that summer, when I would be off from school. 

When the medications arrived we were in awe at the number of needles we had.  We were ready to begin this process… I had but one condition… since I was the receiving the injections, my husband had to give them.  I felt it only fair and would enable him to be very involved in the whole process.  He cried before giving me the first shot in my stomach.  He said he didn’t want to hurt me.  So I cupped his head in my hands and said, “If we want to have a baby, you have to give me the shot”.  He did.  I really didn’t have that many side effects.  What was more bothersome was the bruising and pain at the injection sites.  Of course as blood work and ultrasounds were done along the way, more meds were needed, bye- bye money.  Unfortunately, round 1 was unsuccessful and we discovered that I was not a top egg producer.  Of course my hubby had no problems with his soldiers… it was all me.  Ugh!  I think we had some extra embryos and did a frozen cycle right after… but to no avail.  Since we were committed to not only sticking to IVF but, also only doing it during the summers we had time not only to regroup, but save money.  Sadly, round 2 was also a dud.

For round 3 we had 3 embryos implanted.  And on 7-7-07 we discovered I was pregnant.  My husband said the date was a sign of good luck.  We were so happy and relieved.  We were finally going to expand our family.  Each month went by with no problems.  We had some stress… my work life was getting chaotic and my father was being a difficult patient recovering after heart surgery.  But my pregnancy was flawless.  On week 20 we discovered we were having a boy and by the end of the evening we had named him Lucius. 

However, one week later, while talking with some parents at school about the Halloween Parade guidelines, my water broke.  Even now I weep remembering that very moment.  The hospital sent me home to wait it out, hoping the hole would close.  However, by the third day I developed a fever and was going septic.  I had to deliver my little boy.  I begged with the doctor for a way to save my baby.  She said the waiting 4 more weeks until his lungs might be mature enough for survival was not possible since now I was also in danger.  There I was in the maternity ward waiting to deliver a dead baby. 

All I could think of was that I had failed my husband again.  In the months that followed I wished I had died with my baby.  I felt it was the only way I would feel less of a failure and the pain from my loss would be gone.  My husband would hold me and remind me that if he’d lost both of us he would be all alone.  I even offered to let him divorce me so he could find a wife that would be able to give him children.  I don’t think I’ve ever seen him as angry as when I said that.  He was willing to keep trying if I was.  And he felt that if we couldn’t have a child, then that’s just the way it would be.

So along came rounds 4 and 5, both of which failed.  The strain of infertility on our marriage was slight… but was there.  We were lucky to be able to talk it out.  What was difficult was the loss of Lucius.  There was pain there that lingered in each of us in different ways.  My husband started drinking more than usual and I found myself very resentful of others that had children/babies.  Amazingly, we made it through, pulling each other out of it.

When round 6 came along, with all we had been through, neither of us really expected it to succeed.  But amazingly we struck gold and were on our way to a family again.  However, this time we were on pins and needles.  I honestly don’t think I would have mentally survived another loss.  So we took every precaution possible, my mom even went to work with me 2-3 days a week to help out.  After the first trimester I decided that to be afraid was unfair to my unborn child.  Therefore, we started planning for this baby.  Registering and decorating.  Once we discovered we were having a girl… OMG!  Our joy could not be contained.  Every doctor visit that pronounced us healthy was fantastic.

Other than gestational diabetes, everything was great. Our little Lyra was born March 13, 2011 weighing 7lbs. 8 oz. and 20.5 in. long.  She was perfect!  We were perfect!

So after 10 years of trying, 6 years being IVF, 3 acupuncturists, body talk therapy, an ectopic pregnancy, and our Angel Baby Lucius, our family is now complete.  When I gaze into Lyra’s eyes and see her in awe of me I know she was worth all the sacrifices and tears.    

- Martina & Leandro

Growing up in a small town in New England, where the population of dairy cows outnumbered townspeople and the nearest neighbors were miles away, gave me the desire to work with people. As an Amherst College student in Massachusetts, my anthropology studies led me to an economic development project in eastern Africa. Upon my return the social and economic needs of people right here in the United States became more clear to me. My honors thesis included field work with homeless populations in southern California documenting their remarkably savvy ways of engaging in local politics and with the media to meet their basic needs and improve their quality of life.

As a graduate student at the University of Southern California I studied visual anthropology and media production in the schools of Anthropology and Film and Television. I received a Masters Degree in Film Production with an emphasis on ethnographic film.  My focus then shifted to interactive communications. I spent several years working for companies in Northern California that were developing low-cost and easy to use interactive technologies that would enable increased communication among distributed populations. I worked in usability and market research, which meant discovering how people interacted with these products in order to improve their usability and user experience.

After my experience in communications, I returned to a more anthropology focused career.  I joined a UCSF research team studying fertility decision-making.  For the next 8 years I worked in the field of medical anthropology with an incredible team of experts that included a distinguished Reproductive Endocrinologist and a pioneering Medical Anthropologist conducting research into patient experiences and decision-making with reproductive technologies and third-party reproduction. I worked with scores of patients who had experienced infertility and benefited from reproductive technologies to build their families. This turned out to be a great synthesis of my interest in people in their personal and social contexts and my love for technology which has continuously motivated me to better understand how social and technological innovation can be used to improve the quality of peoples’ lives.

I am privileged to now work with the amazing talent at Pacific Fertility, where as a Research Analyst on Cynthia Willson’s team, I shepherd clinical studies that continue to increase our understanding of human reproduction and the ways in which new and old technologies may improve fertility outcomes and patient experiences. One of our current studies investigates how the use of Traditional Chinese Medicine such as Acupuncture may affect birth outcomes and patient quality of life during treatment. Patients enrolling in this study may have the opportunity to receive acupuncture treatments before and during IVF at our in-house acupuncture clinic as well as having some IVF medications donated while they are in the study. I also have the honor to be helping conduct a trial of a ground-breaking imaging technology that is designed to predict which embryos at early stages of development will be most likely to result in viable blastocysts and subsequent pregnancies and births. Patients enrolling in this study are helping future IVF patients improve their chances for success while they also may be eligible to receive some reimbursement of IVF expenses. New studies are in the works that will be expanding our knowledge about the role of genetics in treatment as well as aspects of patient decision-making. Stay tuned for updates as research opportunities become available.  I am incredibly excited to be at the crossroads between the highest standards of treatment and patient care and new technological innovation that will continue to allow more people to create their treasured families.

Embryo freezing is a routine part of the IVF process.  Approximately 60% of patients have embryos in frozen storage after their cycle is complete.  These embryos can be used at any time; but it is common that some embryos remain after couples have completed their families.  This situation leaves patients facing a very difficult decision regarding the final disposition of any embryos still frozen.  Quite often patients are not prepared to make such a decision, nor are they aware of their disposition options. Patients were so focused on simply getting pregnant, they had not considered what to do with any remaining embryos after the cycle was complete. This article provides a brief explanation about the three disposition options available at PFC for surplus frozen embryos: disposal, research (and then disposal), or donation to another couple for use in achieving pregnancy.

Disposal of your embryos means they are removed from the storage tank and placed in a biohazard waste disposal container. Once the embryos are removed from the liquid nitrogen storage tank, they lose all viability in a matter of seconds. The embryos are not used for research purposes, not donated to any individual or company, and are not cultured beyond the stage of development at which they were frozen.  They are disposed of as medical waste.

Donating your embryos for use in research requires that the embryos be shipped to a company called Reprogenetics, LLC, based in New Jersey (www.reprogenetics.com). At Reprogenetics, the embryos are studied to understand normal and abnormal development.  Donating embryos specifically for stem cell research is also possible.  Reprogenetics offers a stem cell research option, however,  some additional paperwork must be completed directly with Reprogenetics  Whether donating to Reprogenetics for stem cell research or basic research, a PFC Research Disposition form must be competed.

Donating your embryos for use by another couple can be broken down into three sub-categories: known donation, open donation and anonymous donation. Known donation, also called directed donation, is the donation of your embryos to a person or couple that you know personally, perhaps a good friend or family member.

Anonymous donation of your embryos means that you donate your embryos to an organization, and the organization places your embryos with a family that you do not know and will not meet. The identity of both the donors and the recipients is not disclosed to either party. Through the PFC Embryo Placement Program, only anonymous embryo donations are accepted. Any stipulations about to whom or to what type of family situation the embryos are donated cannot be accommodated (i.e.: that the embryos be donated to a two-parent household, or a household of a certain income level, or living in a certain geographic area). The placement of anonymously donated embryos operates on a first-come, first-serve basis. At the moment, we have a very long list of patients wishing to receive donor embryos. Currently there is nearly a two year wait).

Open donation is the donation of your embryos to a party that you do NOT know, but wish to meet, and/or possibly remain in contact with, after the embryos are donated. Open donations require further legal expertise and overall guidance and handling beyond PFC’s current abilities. For these reasons, PFC is unable to offer open donations to our patients. For those interested in an open donation, or for those requesting certain criteria be met by the recipients, patients are encouraged to research third party agencies that facilitate embryo donations, both anonymous and open. One such program is the Snowflakes Frozen Embryo Adoption and Donation Program (www.snowflakes.org), operated by Nightlight Christian Adoptions. Snowflakes facilities both open & anonymous donation of embryos and can accommodate most requests from the donors and the recipients. Another possibility is Miracles Waiting (www.miracleswaiting.com), an online do-it-yourself matching program for donors and recipients. More general information about embryo donation and adoption can be found at the National Embryo Donation Center (NEDC): www.embryodonation.org.

At PFC, all embryo dispositions are handled by our tissue bank manager Alexis VonAustin.  Her contact number is 415-249-3636. She can assist you with information, paperwork, and if necessary, with the shipping of embryos to the agencies listed above.

- Alexis VonAustin and Joe Conaghan, Pd.D., HCLD.

I liken our fertility journey to the story of the woman who thought she was traveling to Oakland, California but got off the plane in Auckland, New Zealand.  We, too, thought we were in for a much shorter trip! We had achieved a pregnancy naturally the very first time we tried, a pregnancy that ended in a painful miscarriage five weeks later. Despite the emotional setback, I followed the lead of my gynecologist and other friends and family members who said that the fact of conception was a very good sign. My husband and I overcame our grief and assumed the stance that having a baby would come rather easy for us. At the time of our pregnancy, I was 33 years old and he was 37.

We tried to conceive again on our own for a year following the miscarriage. Then we sought external help. We underwent fertility analyses to determine what might be getting in the way of another pregnancy and discovered a problem with sperm motility and morphology. We engaged in Eastern medicinal treatments, using herbs and acupuncture to augment fertility as we geared up for an IUI (Intra-Uterine Insemination). When this was unsuccessful, we decided to switch gears. I was quickly edging towards 35 and my gynecologist agreed that it was better we move quickly. I also felt strongly that I wanted help from a specialist that would take my husband and my situation in a more holistic way.  That is when we found Dr. Herbert at the Pacific Fertility Center.

In November 2009, Dr. Herbert informed us of his analysis that, due to the condition of my husband’s sperm, we would have to resort to IVF to conceive a child. In addition, I would have to undergo a procedure to remove a large uterine polyp that might get in the way of a developing embryo and hence create another miscarriage. My biggest fear- that we would have to undergo invasive and painful procedures to have a baby- had come true. I felt robbed of my dream of a natural conception. My husband felt only lucky that there was a solution to our fertility problems. Our differences in the way we regarded this situation created tension in our relationship. But at each step, he gave me courage and showed me that we would get through this together.

In early January 2010, I checked into the surgery department at the hospital. My husband held my hand tightly and wiped away my tears as we waited for my turn in the operating room. I looked around the surgery prep room and reminded myself that a polyp removal was minor compared to what other people were going through. However, it was the very first time I had an IV in my arm, much less been in the hospital. I was terrified.

The polyp removal, which went well, was a test of my strength. I felt proud of myself for getting through it and began to see it as preparation for the procedures that lay ahead. A few weeks after the removal, we returned to see Dr. Herbert. My uterus had been cleaned out and prepared, and had time to recover. Or so I thought. I was ready to move forward with IVF but the results of the ultrasound showed that my uterus was still not ready.

The months to follow were ones of great introspection for me. For the first time in my life, I was at the mercy of a situation that was completely out of my control. I was humbled. I come from a family of doers who put a great emphasis on perfectionism and achievement. Because of my background, I had always pushed myself hard and been very self-critical, never knowing when I had given enough.

The process of conceiving a child is so different. You don’t get to choose when or how quickly things happen, as the body has a rhythm of its own. The more you push the worse you make the situation. After waiting for a child for almost two years, the final months leading up to IVF felt impossibly long. I was terrified that I was never going to have a baby, and felt unspeakably frustrated and anxious. I had no choice but to master these feelings and allow my body the time to prepare and heal. I also had to trust that this was all part of a process. We would have our baby, but it was going to take time.

In April we were finally cleared to begin using the fertility drugs. The results of our egg retrieval were very fruitful: 30 eggs and 9 embryos. Unfortunately, the results of our embryo transfer were less so. I remember getting the call from the nurses at PFC. “We are so sorry. We know how much this means to you.” To make matters worse, another polyp had formed in my uterus that needed to be removed before we could try again.

I took a huge step back from the fertility process at this disappointing news. I let go entirely and shifted gears, getting back into hobbies and activities that I enjoy but had been pushed to the side in my pursuit of a pregnancy. I hiked, I read, I cooked, I traveled, and I reveled in my relationships with my husband, friends and family. Sometime in late summer, when I felt whole again, I went back to the hospital and had the second polyp removed.  A few months later, my husband and I decided it was time to try another embryo transfer. This time, I was greeted with a “Congratulations” by the nurses at PFC. After two and a half years, we had achieved another pregnancy!

Our baby girl is now 6 weeks old. Difficult as it was, I feel blessed to have gone through what we went through to have her.  It taught me the value of patience, and the hard lesson that we don’t always get to have what we want when we want it. It has also allowed me to be more kind to myself, which helps me be more in the moment with my baby. Most importantly, I learned that sometimes you need to take steps back to move forward, and that all steps, no matter how small, are still steps in the right direction. Now that’s something even our baby girl will appreciate!

-RLS

Infertility & Reproductive News featured Pacific Fertility Center and interviewed Dr. Herbert for their August newsletter issue. 

Click here to read the article in Infertility & Reproductive News.

Successful conception does not just involve eggs and sperm and the reproductive tract. The reproductive system, just as all other areas of human physiology, works best when the entire organism is healthy and balanced. This includes not just physical health, but mental health and sexual health.

With respect to physical health, most of what we should be doing is just common sense. For women, mild to moderate regular exercise is best. Although data on the level of exercise that is optimal for conception is scarce, probably no more than 4 hours per week of aerobic exercise may be best¹. Much higher levels can lead to too low a level of body fat for women (optimal body fat for women should be about 20% of total body weight). Excessively lean women (less than 10%) have more problems with proper reproductive hormonal functioning when it comes to ovulation. And while speculative, it is likely humans evolved mechanisms to limit female reproduction in times of starvation (low body fat may mimic a starvation mode) and when we are too much on the run as well. A study published in 2002 looked for associations between exercise levels and pregnancy and birth outcomes in exercising pregnant women². The study reported that women who exercised heavily during pregnancy had smaller babies, more labor inductions and longer labor and well as more colds and flu than more sedentary pregnant women. These are surprising results! Despite these studies it is likely that some moderate amount of exercise helps to promote a sense of well-being and the mental composure to deal with the stresses of every day life and the stress of dealing with fertility issues. Cardiovascular fitness can only be a good thing for pregnancy and beyond.

For men, there really are no restrictions on physical activity. The one exception would be too much bicycling for men hoping to conceive with their partner. The current bicycle saddles do affect testicular function in men who are frequent riders. In general, maintaining good physical shape enhances sexual functioning and of course, sex is important for conception! Speaking of sex, for men to have optimal sexual health, it is important to avoid excessive alcohol. While alcohol does lower mental inhibitions, it also inhibits erectile function, so excess alcohol, contrary to popular belief, does not enhance the sexual experience. Long term excessive alcohol also causes liver damage and raises estrogen levels in men. Higher estrogen levels can lead to smaller testicular volume and lowered sperm production. There is no problem with an occasional drink – just be aware of how much. Avoid intoxication, dehydration, hangovers, and the other consequences of excessive alcohol intake.

As many of our patients are aware, the experience of trying to conceive, especially if it’s taking a long time, can take a toll on sex and intimacy in a relationship. It is so important for partners to be patient with each other and make the effort to maintain the romance and intimacy which keep the relationship healthy. Yes, plan to have sex on the most fertile days of the month, but don’t stop having it before and after the fertile times as well! There is no medical evidence that sex is harmful during the post-ovulation or early pregnancy period. Try to keep the sex-as-fun-and-special attitude alive throughout the month, including baby-making sex days. If there are stresses associated with this issue, we can provide referrals to psychologists that specialize in counseling about sexual health and are professionals in this area. Remember that our sex lives will outlive the infertility, the new baby and the growing children experiences. So it is crucial to nurture this aspect of the relationship.

There is no question that having a good sexual relationship promotes intimacy and better communication. This is so important when it comes to supporting each other. Fertility problems can be a crisis time in the lives of young adults. Sometimes the crisis situation can bring a couple closer together and sometimes it can cause them to feel isolated, even from each other. Communication is essential. For most women, communication is usually inherently verbal; she wants to talk about it and about her feelings. For most men, dealing with painful feelings, such as that recent negative pregnancy test or that recent miscarriage can be difficult for him to verbalize. Add to this frustration, the obvious sorrow of his female partner and men can feel helpless. It doesn’t necessarily help to try to force people to talk about these feelings, at least until they are ready. Letting him go the gym or shoot some hoops with some friends might be a better way for him to initially deal with bad news. But when the time comes, talking and acknowledging each other’s feelings and understanding how each person deals with difficult situations can make a relationship much stronger.

References:

1. Effects of Lifetime Exercise on the Outcome of In Vitro Fertilization  Morris, Stephanie N.; Missmer, Stacey A.; Cramer, Daniel W.; Powers, R Douglas; McShane, Patricia M.; Hornstein, Mark D.Obstetrics & Gynecology. 108(4):938-945, October 2006.

2  Antpartum, Intrapartum, and Neonatal Significance of Exercise on Healthy, Low-Risk Pregnant Working Women. Maqgtann, Everett F., Evans, Sharon F., Weitz, Beth, Newnham, John. Obstetrics & Gynecology. 99(3):466-472. March 2002.

Senator Kirsten Gillibrand (D-NY) introduced The Family Act of 2011, S 965 to the U.S. Senate just 2 weeks ago.  This bill will provide a tax credit to offset the high costs of some infertility treatment for those trying to have a family. There is a significant financial burden associated with  infertility because of the lack of insurance coverage.   This bill would help thousands of people diagnosed with infertility overcome the financial burdens of family building. 

According to RESOLVE, they are now working to secure Senate co-sponsors for this legislation.  This does not happen unless members of Congress hear from their constituents. A letter from you to your Senators is critical.

What YOU can do

1. Contact your two U.S. Senators right now.  It takes 3 minutes through RESOLVE’s Action Alert System. PLEASE review the online letter and personalize it with your story.  Personal content is far more impactful than a form letter.  You can add as much or as little information as you want in the body of the letter. The RESOLVE Action Alert System will do the rest!

2. Ask your friends and family to send letters too! Forward this link so they can take action today.  www.resolve.org/taxcredit

3. Share the information about the tax credit on your Blog or Facebook page! 

To learn more about The Family Act of 2011, S 965, visit RESOLVE now!

In November I had the opportunity to travel to Shanghai, China to attend a conference on emerging molecular technologies (Molecular Medicine 2010). As an invited speaker, I presented a talk concerning the use of micro-array DNA analysis to evaluate single human embryonic cells for both genetic disease and chromosome copy number (see lead article in this issue). As part of my talk, I presented the case of one of the patients featured in this issue’s Patient Odyssey. She was our first patient to have her embryos screened for both myotonic dystrophy and for chromosome copy number.  As a result of this successful testing, she is due to deliver her healthy daughter soon.

The trip to Shanghai itself was quite interesting. My husband accompanied me and we were there for one week. The population of Shanghai is about 20 million! The number of high-rise buildings and skyscrapers continued for dozens of miles before even entering the city center. The subway system there is excellent and street traffic was not too bad. The traffic was constant, though, with beeping horns heard 24 hours a day. The weather in November was fairly pleasant but the skies were always hazy, with a combination of marine layer and pollution. The city was full of incredible shopping destinations with rows of designer shops with every name brand designer you can think of. The local shops’ goods, however, were very low-end and left a lot to be desired.  In the usual tourist areas, street people were constantly trying to get us to follow them to view their “knock-off” counterfeit goods. We visited several parks and temples and tried to take in as much local culture as possible. The traditional Chinese architecture and culture is disappearing quickly in this fast-paced economy.

We had the opportunity to visit an IVF center in Shanghai, affiliated with one of the local hospitals. This center performs over 2,000 IVF cycles per year (compared to 800 a year at PFC). The center was not as clean as I would have hoped and there was a very crowded waiting room of patients waiting for ultrasound scans, blood tests and procedures. I did not get the sense that providing accommodating customer service was high on their list of priorities. Speaking to one of the laboratory staff there, it does seem as though they do most of the same type of IVF work we do at PFC, with the exception of ovum donation, surrogacy and sex selection, all of which are not allowed in the IVF centers in China.

Overall, it was a fascinating trip and I enjoyed the chance to tell others about the exciting new genetic technology affecting fertility patients.

-Carolyn Givens, M.D.

Andy and I married in June of 2008.  I was just turning 39 and we tried to conceive a child “the old fashioned way” for a year  before working with PFC. We didn’t expect it to be so difficult as all signs indicated that we would get pregnant.  Andy’s sperm was normal and my FSH was good.  When we moved to the IUI and IVF processes, I responded well to the drugs, produced lots of follicles and eggs, we had nice looking embryos, and we were able to do day 5 transfers.  The doctors seemed confident.  But over the course of about 15 months we experienced 2 rounds of IUI, 4 rounds of IVF, and 2 miscarriages. 

Now it is December 2010 and we’re nearing the end of a blissfully uneventful pregnancy.  Our baby boy is due to arrive on New Year’s Eve!  It looks like our story will have a happy ending, but I don’t need to tell you how difficult the journey has been.  Instead, I’m going to try to share a little bit about how we got through it all, in the hopes that it might give you some ideas or a new perspective for your own experience.

First, Andy and I knew we wanted to be parents. We absolutely knew it would happen for us, one way or another.  Although our first preference was to have “our own” child, it was only a preference.  We both knew that if IVF did not work out for us with my own eggs, we would go the route of an egg donor.  If necessary, we knew we would move to adoption.  Starting a family was our priority and our dream.  We believed that whatever baby came into our lives, that baby would undoubtedly be the baby we were meant to parent, and we would love our baby no matter what.  Have you ever heard the Buddhist saying, “Don’t be attached to any particular outcome”?  It became one of our mantras and allowed us to stay focused on the big picture plan, as opposed to the various routes or paths that might be part of that overall plan.

Teamwork was another essential element of our journey.  I’m lucky because Andy is very detail-oriented, patient, and he was completely on board with the program.  I’m more emotional. I have a short attention span, I like information in summary format, and I can manage a calendar like nobody’s business.  We make a great team because I could endure the shots and stay on top of all those doctor appointments, but keeping track of the drugs, the dosages, the ordering—that was all Andy.  At first, I worried that we would run out of a drug that we’d need, and we wouldn’t realize it until it was too late.  However, thinking like that made me nuts.  Soon we developed a system where Andy managed all the prescriptions and ordering, he prepped my needles with the right dosages, and he tracked what we were supposed to do each day.  I did my own injections and dealt with the side effects.  Those were our roles.  I didn’t want to have to think about the details.  By relying on Andy to “manage the minutia,” I was able to stay more relaxed and less stressed.

Finally, I had an epiphany that, in order for this process to be successful, I’d have to stop expecting infertility to somehow fit into my life.  I don’t know about you, but I was pretty overwhelmed by all we had on our plates.  At first, I was trying to squeeze in my appointments with PFC and with my fertility acupuncturist, while maintaining a calendar filled with dinners with friends, a busy work schedule, and a significant amount of travel. It’s no surprise that I was tired and stressed out, but I also became very resentful.  I was seeing a fertility acupuncturist on a weekly basis, yet I was annoyed that she recommended I take herbs and make changes to my diet.  I was frustrated as I tried to find time for all the appointments at PFC. Then, one night I was crying and sharing my frustrations with Andy, and he helped me see things differently.  He said that none of this was going to work if I didn’t fully embrace what we were doing.  I had to take the herbs with a positive attitude and whole-heartedly believe in the power of both eastern and western medicines.  Otherwise, what was the point in going through it all?  I realized that my bad attitude could have the power to neutralize all we were doing and I had to shift my mindset, accept that this was our path, and surrender to the process.  I created a big opening in my life so that there would be space for the infertility and all the energy it would take to tackle it.  I stopped traveling, dramatically reduced my social commitments, and spent much more time resting and “nesting” at home.  This was really difficult for me as an extrovert, but it became so much easier to make the right decisions and to more graciously accept what was required of me.

The last thing I would like to mention is that we were not secretive or private about our challenges with infertility.  I’m used to being pretty open with my friends, and I think it helped us to reach out to people for support during our ups and downs. One friend in particular, who had gone through her own IVF process, was reading some message boards online and found out about a new form of preimplantation genetic testing that she thought might be helpful to us.  We brought it up to Dr. Chenette and he was happy to give it a try since our prior IVF rounds produced seemingly good embryos, but failed to result in a viable pregnancy. So, on our 3^rd round of IVF, on day 3 we had 12 great looking embryos.  PFC biopsied all 12 and Gene Security Network ran a full analysis of all 23 sets of chromosomes.  On day 5 we showed up to transfer the best ones.  We were excited because we would know which embryos were genetically viable and which were not.  As we waited to see Dr. Givens, we wondered whether we would have 2 or 3 embryos to transfer.  But when Dr. Givens entered the procedure room, we could tell something was wrong.  We were told that all 12 of our embryos were genetically defective and none were viable for transfer.  Worse yet, because all of them possessed defects from the maternal chromosomes, it was recommended that we stop trying to conceive with my eggs and to think about alternative paths.  It seemed that this path had come to an end.  None of our embryos were good and there was no point in trying to make any more.  The news was devastating for us.

Andy and I went to a dark place for a few weeks.  But I’m happy to say that after talking and crying and praying about our situation, we came out of the darkness fully ready to embrace the process with an egg donor as soon as possible.  But first, we wanted to do the same preimplantation genetic testing on the 4 frozen embryos we had saved from our 2^nd round of IVF.  As expected, 3 of those embryos were genetically defective, just like the 12 from our 3^rd round of IVF.  But, we also experienced a miracle: one of those embryos was a genetically perfect boy.  He was my last hope to have a baby with my own genetic make-up.  Amazingly, he survived the freeze and the thaw, and survived the biopsy for the testing.  We transferred him in April and today I hit 37 weeks of pregnancy.  He is now considered full term and we are excited to meet him soon!

So, that’s our story.  I know we all have one.  Andy and I wish you the very best as you pursue parenthood and aim to build your family in whatever way makes sense for you. 

~Andy and Susan Nelson

Update:

“Our son was born on 12/30/10 at 12:20 am.  His name is Boden, he weighed 6 lbs. 15 oz. at birth, was 20” long, and is completely healthy.”