Thursday, October 18, 2012

Adoption After Infertility

My husband and I have spent the last six months discussing adoption. We have talked at great length about embryo adoption and domestic and international adoption. Next month is National Adoption Awareness month, and I hope to blog in great detail about all three options.

I feel like so many people shake their heads at infertile couples struggling with infertility treatments and say, “Why won’t they just adopt?” Honestly, I believe in high school I said, “If I can’t have children, I would just adopt. I would never do fertility treatments.” But after a couple of years of difficulty conceiving naturally, we followed our Reproductive Endocrinologist’s’ advice and decided to try IUI and IVF. Another great question is, “Why are you putting your body through all of those hormones and procedures when there are children who are already born and in need of homes?” Adopting after infertility seems like the obvious and simple choice. Why then does this choice sometimes seem so difficult?

I wish that my husband and I were looking to tackle the issue of adoption eight years ago when we first started trying to conceive. Back then, we were different people. We believed that love conquered all. I was faith-filled, fearless, courageous and strong. I was certain that if you stayed the course, if you tried and hoped and believed in your dreams and goals, they could and would come true.

Then infertility came into our lives. Luckily, relatively early in the journey, we got pregnant with my daughter with the help of IUI, after a surgery to ablate my endometriosis. We were blessed with this amazing little girl, whom medical professionals have now deemed a miracle given my conditions of endometriosis and genetic translocation.

However, we desperately wanted another baby. On the very day we went to see our fertility doctor about having another child, I was having a miscarriage and didn’t even know it until my blood results came back. I then had another IUI, which led to another miscarriage. So my doctor recommended IVF, which led to my third miscarriage in 5 months. I was finally diagnosed with a balanced translocation, a condition in which many of my pregnancies will result in miscarriages. But the doctors told me there was a solution, IVF with embryo biopsies. My husband and I tried that twice only to have all 28of our embryos confirmed positive for the translocation, which made them unviable. Add three separate abdominal surgeries to address other medical conditions, and another unexpected miscarriage, and that sums up the last four and a half years for us.

It seems ironic to me that the reason why people think it is so obvious that we should adopt a child--our struggle with infertility-- is the very reason why my husband and I find it completely overwhelming to start the adoption process. Being in the grips of infertility is like being in a terrible maze. There are so many more dead ends and false hopes than there are ways out of the maze, and when you are in the maze, you cannot see the bigger picture. Obviously, we would have pursued adoption earlier had we known that the IVF and embryo biopsies that we had done after our “miracle” daughter was born would only lead to grief and loss. We would talk about adoption at the time, but being overwhelmed already, we kept concluding, let’s just get through these fertility treatments first.

Now, six years after we had our first appointment with a fertility specialist, we are finally finished with fertility treatments, but they have taken their toll on us. My husband and I are not the same people we were when we started this journey. I am certainly not that fearless 25-year-old anymore. I feel like when you have experienced as much loss as we have, it is really hard to start a process that requires a lot of faith and the possibility of more disappointment.

I fear that my husband and I do not have the emotional or spiritual resources to tackle our fears concerning adoption. But I am going to continue learning more about it and will be blogging about what I discover about the process and about myself. Mariska Hargitay, an actress who stars on Law and Order SVU, has a great quote on adoption, "Adoption was a bumpy ride-very bumpy. I'm not gonna lie. There were wrenching moments. I say to everybody, 'Adoption is not for the faint of heart.' But God, it was worth the fight." Only time will tell if I will one day have that fight in me.

Monday, October 15, 2012

October 15: A Day of Remembrance

October 15th is a day of remembrance for pregnancy loss and infant loss. So many of us women experience pregnancy and infancy loss, and yet it is something that is never spoke of in our society due to its private and painful nature. When I came out and started talking about my miscarriages, I was overwhelmed by how many others I knew had experienced similar situations. Today I think about all of us who have endured these losses. Please know that you are not alone and you are loved and thought of, especially today.

I Love You Still
I honor you, my lost little one, on this special day.
I often think what life would be like, if things had gone our way.
I miss you at the milestones, and in moments ordinary.
I miss you when I am happy, and especially when I am weary.
Would you have had your mommy’s laugh?
Would you have been tall like your dad?
The fact that we will never know, still makes me so sad.
I loved so very much, though brief was our time.
In my heart and in my soul, you will always be mine.
I’m not sure where you are right now-- or when we will meet again.
But the love we had was so very real, and that will never end.
So know my thoughts are with you, on this and every day.
May peace and happiness find us, That is what I pray.

For more resources on pregnancy and infant loss please go to:

Monday, April 23, 2012

Don't Ignore the Pain of Secondary Infertility

This week is National Infertility Awareness Week, a week dedicated to talking openly about infertility and the impact it has on millions of men and women worldwide. For my first post of the week I have decided to write about Secondary Infertility, a taxing emotional and physical reality for millions of couples.

Secondary Infertility is a tricky subject in the infertility community. There are so many women suffering from primary infertility, women who are doing all they can to have one child, pining for and lamenting about the desire to have a second child can seem greedy and unappreciative to some. I can remember seeing women with young children in my fertility specialist’s office. I remember thinking, “Seriously? I would just be happy with one baby. Is that too much to ask, just one baby? Please just give me a baby. I will never ask for anything else again.”

Fast forward the time it took me to finally conceive my daughter and give birth to her. When I took her from the hospital I was asking, “Please let me just get two hours of sleep in a row? I promise, I won’t ask for anything else again.”

Fast forward 6 more months after that and there I was “THAT” greedy patient in my fertility specialist's office with an infant (whom I was lucky enough to be able to leave with my husband during my doctor’s visits as not to antagonize other patients). That is right. I wanted another baby. I was pleading with the universe, “Please just let me have one more baby? My daughter needs a sibling. I don’t want her to be alone in the world.”

There is nothing like the pain of not being able to have a baby when that is all you want with all your heart. I know that pain all too well and carried the weight of it for many years before we had our daughter. Not being able to have another baby is also difficult for some of the same reasons, but also there is the pain of not being able to easily provide your child with a sibling, if that is what you have always wanted for your family.

I recently sat down again with Dr. Michael Blotner, Medical Director of Westchester Fertility, who covered the basics for me regarding Secondary Infertility.

What is Secondary Infertility?
The inability of a couple to conceive after having a child is termed secondary infertility. The time interval that this becomes as issue is dependent on the age of the woman. Just as in primary infertility, for a woman under this age of 35, the time interval is one year. If the woman is 35 years or older, the definition applies after 6 months, as time is of the essence!

What are the most common causes of secondary infertility?
Secondary infertility can arise from either the male or the female. Environmental toxins, as well as cigarette smoking, excessive alcohol intake, and certain medications can have a progressive negative impact on sperm quantity and quality. Physical conditions, such as chronic illness, or varicocele (a varicose vein in the scrotum) can similarly cause a progressive decline in the sperm over time, to the point that the male fertility potential is affected. In the female, the most common cause is a decline in egg quality and/or quantity. These phenomenon often occur simultaneously, and are a natural result of aging. Each woman has her own endowment of eggs at birth, and this is highly individual. Unfortunately, we are seeing several younger women with a decline in their egg reserve, based on hormonal and ultrasound evaluation. On a more positive note, if the problem is discovered early, and fertility treatment instituted, the chances of a successful pregnancy improves.

Physical factors can also include tubal damage from prior undiagnosed infection (which is often without symptoms) and endometriosis, a non-infectious inflammatory condition of the pelvis, both of which can progressively worsen over time. Uterine fibroids, while not directly impacting fertility, can affect the blood flow to the uterine lining, which may lead to early or late pregnancy loss.

What treatments are available to help couples with secondary infertility?
The most important step a couple can take is to seek the help of a reproductive endocrinologist. Of course, the treatment will depend on the factors involved in the couple’s infertility. Evaluation of the egg reserve, semen, and fallopian tubes are critical. If the woman is suspected to have tubal disease or endometriosis, a laparoscopy with CO2 laser may be indicated. For the more common sperm and egg factors, the simplest approach is to stimulate the ovaries to produce more than one egg per cycle and perform a well timed intrauterine insemination. This approach can affect a 40-50% pregnancy rate by the third treatment cycle. For more severely compromised sperm and egg issues, or if insemination fails, an in vitro fertilization may be required. IVF allows for direct fertilization of the eggs in the laboratory with the partners’ sperm, and development of embryos that can be transferred to the uterus. The pregnancy rate per transfer is approximately three times higher than intrauterine insemination, and the number of embryos transferred can be limited to avoid high order multiples.

Experiencing Secondary Fertility is painful, stressful and often shocking to some couples who never experienced any issues getting pregnant with their first child. If you are experiencing Secondary Fertility just know that you are not alone and that there are resources out there to help you through this journey.

For more information regarding infertility and National Infertility Awareness Week check out:

Michael Blotner, MD, is board certified in obstetrics and gynecology and reproductive endocrinology. For over 15 years, he has been helping patients in his care achieve their goal of having a child through state-of-the-art infertility treatment. Dr. Blotner has dedicated himself to providing personalized professional care in a relaxed environment.

Friday, March 30, 2012

5 Signs You May Have Endometriosis

All month bloggers and tweeters effected by endometriosis have come together to talk about this terrible disease for Endometriosis Awareness Month. Endometriosis is a painful and chronic condition that affects approximately 176 million women and girls worldwide; 8.5 million in North America alone. Endometriosis is a disease where the tissue that lines and then sheds from the uterus during a normal menstrual cycle, escapes the uterus and then grows on the outside portion of the uterus, the ovaries, the intestines or other parts of the body. The disease causes internal bleeding which can lead to chronic pelvic pain, infertility, adhesions, inflammation and disruption of the digestive and urinary systems, among other problems. Currently there is no cure for endometriosis, and the only truly effective treatment is surgery, which brings only temporary relief.  Please share this post to promote awareness of this disease, which is often misdiagnosed and ignored by many medical professionals.  Listed below are five of the most common symptoms associated with endometriosis.
1) Painful periods with no relief from over the counter drugs.
      Before I was diagnosed with endometriosis, I remember my gynecologist telling me, “Oh no, pain with period and ovulation is normal.” The type of pain I feel when my endometriosis has taken over my pelvic region can only be described as a leprechaun wearing soccer cleats is doing an Irish Jig on my pelvic region for days. We ladies are really tough, but this kind of pain IS NOT NORMAL! 

2) Mysterious stomach issues that were chalked up to Irritable Bowel Syndrome.
     Good old IBS seems to be the diagnosis that a person gets when everything else has been ruled out and the doctors have no idea what is going on. Early in my twenties I had upper and lower GI series, colonoscopies and yes even blood and stool samples taken. The doctors had no idea what was causing my terrible stomach problems. Finally, after my surgery for endometriosis, I found out that it had spread to my digestive system, causing all of these issues.

3) Struggling with infertility.
      Even a small amount of endometriosis can be known to hinder the fertilization of the egg and implantation of the embryo. But because endometriosis can spread to the ovaries, the fallopian tubes and even the uterus, miscarriage, ectopic pregnancy and even problems with ovulation can be attributed to the disease.

4) Pain during intercourse.
     Pain during intercourse should not be a usual occurrence. Endometriosis can grow in spots where intercourse can cause sharp pain and soreness.

5) Allergic reactions and fatigue 
      When my endometriosis was particularly bad I noticed that a few days before my period every month I would break out into hives from head to toe. Doctors are still researching the link between endometriosis and allergies, but many women out there see a connection. Women with endometriosis get significantly more fatigued during different point in their cycle, especially during menstruation.
Many women with endometriosis, like myself, have felt for the better part of their lives that they were crazy.  Before I was correctly diagnosed, I had been to gynecologists, gastroenterologists and allergists, and none of them could figure out what was wrong with me. They attributed my symptoms to stress.  When my reproductive endocrinologist finally diagnosed me with the disease through a laparoscopic surgery, I finally felt like I had the answers to so many of my health concerns over the years. My pain and other symptoms were valid, and I wasn’t crazy after all.  If you are having any of these symptoms, tell your doctor about it. You don’t have to live in chronic pain. If your doctor doesn’t listen, keep searching until you find a doctor that will take you seriously.  For more information about endometriosis check out Padma Lakshmi‘s Foundation: .

Thursday, March 29, 2012

Endometriosis Awareness

Hello my lovely Endometriosis and Infertility Ladies! I came up with this blurb and pic for Endometriosis Awareness on Facebook. So many people have never heard of Endometriosis and yet millions of women suffer from it. Please copy the information below and share it on Facebook. Hopefully it will spread and raise awareness for this awful disease which has no cure.
With Lots of Love,
Light and Happiness,

This month is Endometriosis Awareness Month. Endometriosis is a painful and chronic condition that affects approximately 176 million women and girls worldwide; 8.5 million in North America alone. The disease causes internal bleeding which can lead to chronic pelvic pain, infertility, adhesions, inflammation and disruption of the digestive and urinary systems, amongst others. Currently there is no cure for endometriosis and the only truly effective treatment is surgery, which causes only temporary relief. Please share this post to promote awareness of this disease, which is often misdiagnosed and ignored by many medical professionals.

Monday, March 19, 2012

Conversation Etiquette For Your High School Reunion

My 15 year high school reunion is coming up and I have to admit that I am excited about it, for the most part. I had a great time in high school and was actually really sad to graduate. I went to an all girls private school in the suburbs of New York, and it was the best decision my parents ever made for me. I am looking forward to seeing my classmates, some of which I haven’t seen since graduation.

The part I am not that excited about is the inevitable awkward questions that may arise from people I don't really know anymore. Recently hit with the knowledge that I cannot have any more biological children, I am dreading the seemingly innocent question, “So are you going to have more kids?” That got me thinking about all of my other classmates. I am sure there are painful and taboo topics that they all are struggling with in their own lives. Life is really hard for everyone for all different reasons. I am sure they have questions that they may be dreading getting asked themselves. It is not uncommon for women in their thirties to deal not only with infertility, but divorce, unemployment, illness, and loss of a parent, among other things. I came up with a list of ten questions to avoid asking others when mingling at your high school reunion.

Questions to Avoid Asking Others At Your High School Reunion

1.“Do you have kids? Are you planning on having kids (or having more kids)?” You never know who is struggling with infertility, lost a baby, had a miscarriage or just decided for whatever personal reasons they are not having kids. If people have kids, they will share it; if they don’t have kids, your high school reunion is not a good time to explore why, because this topic could be painful.

2. If someone has multiples, don’t ask them, “Did you have fertility treatments?” Even if you are undergoing fertility treatments yourself, that is still a highly personal question to ask someone else. The truth is that many multiples exist without treatments. And many people who have multiples with the help of fertility treatments do not want to share their story.

3. “Oh you have a baby? Are you married? Are you getting married?” People have babies and do not get married to the biological father for a multitude of reasons. Again, the school cafeteria is not a place to grill these hard working single moms about their personal lives.

4. “You have how many children? Oh my goodness you must have your hands full!” Don’t make moms who have big families feel alienated. Congratulate them on their family and ask them how they are doing, rather than assume how their lives are going.

5. “How are your parents doing?” I know many friends who have lost parents since graduation. I also have friends whose parents are dealing with serious illnesses. A better question is, “How is your family doing?” This allows room for the person to say, “They are doing great” without feeling like they have to open up.

6. “Where do you work?” I know it seems like an innocent question, but for someone who may be unemployed, whether recently or not, it could be painful and awkward conversation for them.

7. “Oh my goodness have you lost weight?“ “Have you had work done, you look so different?“ Don’t comment on people’s looks unless it is to say, “You look great.” Some women have gained weight since high school, some have lost weight. Some people have not aged at all, and some may have had a hard couple of years and look much older. Best not to say things like, “You look so skinny now” “You were so skinny in high school” “Wow I wouldn’t have even recognized you.” We all try to look our best at the reunion and we all have insecurities about how we looked in high school and how we look now. It is best not to bring any of those insecurities to the surface.

8. Don’t ask single people, “Are you dating someone?”. If there is someone special in their lives, they may talk about that person, but they also may choose not to. It is also a possibility that they just got out of a relationship or haven’t found the right person yet.

9. If a single person is dating someone, don’t ask her, “Do you think you guys will get married?” If the couple is planning on getting married or moving in together, she will choose to share that information if she wants to. I remember when a friend of mine was waiting for that engagement ring while everyone else around her was getting married. It was torture. The only thing more torturous was everyone asking, “When is he going to propose?”.

10. Finally, don’t ask questions like, “Remember when you fell off the bar with your pants down and vomited all over the police officer?” or “Remember when you got your period in gym and we called you “Bloody Mary” for the rest of high school?” Chances are that person will NEVER forget the most traumatic or embarrassing day of their life, but through therapy and personal growth they have moved on from the experience. It is probably best not to re-traumatize that person.

High school reunions are one of the only times the policy, “Don’t Ask, Don’t Tell” is a good idea. Instead of talking about the present or asking about the future, it may be best to talk about the past memories and good times you had with these people in high school. Have fun and keep it light!

Thursday, January 12, 2012

Coming Home Empty Wombed: Our Final Infertility Journey

Three years ago, my husband and I found out that I have a translocation, which is a genetic mutation with the majority of my eggs that leads to recurrent miscarriages or a baby with fatal birth defects. Three months ago, my husband and I found out we are not able to have any more biological children. The first diagnosis was really hard to accept, but we were grateful that we finally had answers as to why I had suffered three miscarriages in a matter of five months. Our most recent news, though devastating, offered closure to a difficult eight year journey battling infertility.

Between the fall of 2008 and winter of 2009, my husband and I had gone through so much to get pregnant. Though conceiving my daughter in 2007 was by no means easy (we used IUI to get pregnant), I couldn’t understand why I kept miscarrying during that following year. In January 2009, my husband and I had tried, for the first time, using IVF to get pregnant that cycle. The doctor let my embryos grow for five days before transferring one into my uterus, and then he cryogenically froze the rest of them. At the time, I was grateful to not only have this one embryo implanted in me, but to have six others frozen for future pregnancies.

Needless to say, the IVF resulted in a miscarriage -- my third in five months. It was then that the doctors decided to send my blood work to be tested for a translocation, which they suspected might be the reason for all of my miscarriages. The translocation diagnosis came back positive, and the doctor said that the only option left for us to have another biological child was to undergo another IVF and then, when our embryos were three days old, get the embryos biopsied and tested for the translocation. If any of the embryos were viable, then they would be transferred to my uterus. I felt overwhelmed by the process, but grateful there was a solution. Geneticists and doctors seemed hopeful that I had a good chance of having a healthy baby with this option.

I asked my doctor about the embryos from my first IVF, the six I still had frozen. My doctor told me that they could not be tested because they were frozen on day five, which means they were too advanced to undergo the long test for translocation. If I just had the embryos transferred without testing them, I would most likely have yet another miscarriage or risk having a stillborn baby or a baby that would die soon after birth. We ultimately decided to keep the embryos frozen, with the hope that in time, medical advances would lead to the possibility of safely testing 5-day-old embryos for translocation.

Three years went by and my husband and I continued along an arduous journey. We had two more IVFs done, resulting in 28 biopsied embryos. We also had one naturally occurring pregnancy. All of the biopsied embryos had the translocation and were not viable, and the naturally occurring pregnancy resulted in my fourth miscarriage. We decided that we were done with IVF treatments. Now we only had the matter of our six frozen embryos to figure out.

According to my doctor, and many other doctors I consulted with, our only solution was still to transfer to my uterus three embryos at a time and hope they didn’t have the translocation and would lead to a viable pregnancy. Because I knew the odds were that they would not be viable, I was hesitant to sign myself up for a possible fifth and sixth miscarriage. Yet, I wasn’t ready to just assume they were not viable. I couldn’t just discard them. I still had a shred of hope; what if one of them were good? What if one of them would turn into the little person we were waiting for?

I tirelessly researched the internet trying to find another solution. I started reading about doctors in Australia who were routinely doing biopsies on five day embryos with great success. This gave me hope. I then found an amazing genetics lab in Chicago, called the Reproductive Genetics Institute. I contacted them immediately and talked to one of their genetic counselors. They are innovators in their field. They told me that not only do they routinely do biopsies on five day old embryos, but they had the facilities to test the embryos for the translocation and also transfer any healthy embryos, all on site. My dream from three years ago of testing the 6 frozen embryos was now a real possibility.

The process was not going to be easy. I had to prepare for an embryo transfer just in case there was a viable embryo after testing. Since I would be doing the transfer in Chicago, but preparing for the transfer here in New York, I had to work carefully with both teams of fertility specialists and make sure they were always on the same page. And we had to ship our embryos from New York to Chicago, which was scary and traumatizing. Talk about a fragile package!

The time leading up to our trip to Chicago was grueling and emotional. Physically prepping for the transfer was difficult for me. I had to take shots of pure estrogen, which didn’t agree with my system and left me very emotional and tired. Every day would bring more phone calls I would have to make to ensure that everything would be in place for our trip. Some of what I was trying to accomplish had never been done before in this way. But somehow the logistics all fell into place. I am grateful to the countless number of people who made this difficult ordeal easier by their professionalism, their sense of humor, their positive attitude and their compassion, especially to those at Westchester Fertility in New York and the Reproductive Genetics Institute in Chicago.

Finally the time came to fly to Chicago. The first step in testing the embryos is unfreezing them and seeing if they survive the thaw. Right before we boarded the plane, we got word all six survived and were looking great. Upon arrival in Chicago, we waited in the hotel for the phone call from the Reproductive Genetics Institute. This call would tell us whether the 6 embryos that were being tested were viable. It would tell us once and for all if we had a shot at having any more biological children.

We had prepared the few people we told for bad news. The truth was that all of the pregnancies I had had, and all of the embryos that were tested, were not viable, so the chances werethat these would not be viable either. Our parents told us not to be so negative, to have hope. It could work out. The embryos could be good. We had one daughter already after all. If I was being completely honest with myself, I would have to admit that I really did have hope. On the flight out to Chicago, I couldn’t help but hope that I would have another passenger growing and hopefully implanted inside of my womb on the flight home. When I got pregnant with my daughter through IUI in 2007, I remember seeing six eggs in the scan right before the insemination. She ended up being one of those lucky six that made it. Now we had another six embryos being tested. One of them definitely could be lucky.

I also started to feel like I was in a Lifetime movie. We had been through such a difficult journey these past few years. Almost always in the movies, the characters hit rock bottom, but through perseverance, hope and determination, things seem to turn around. I had thoughts of the hundreds of people who all did their part to get me to this point, from the doctors and their staff, to the person making sure the embryos were delivered safely, to the flight attendant who got me to Chicago. This was it, the moment we all had worked for. I kept thinking how wonderful it would be to surprise our friends and family with pregnancy news around the holidays as I would be just ending my first trimester. I would then recount the epic story of how it all came to be.

My husband and I were watching "The Hangover 2" in our hotel room when we got the call, much earlier than expected. As if the movie wasn’t punishment enough, more bad news was coming our way. None of the embryos were viable. That was it. It was over.
Tears were shed for our lost embryos and ultimately for our lost dream of having a family in the way we always thought we would. We had been mourning this dream for a long time now, and mentally had expected this outcome. This was the final piece that was left to be resolved. This was our closure. We now had officially done everything physically and humanly possible to have more biological children. But it just wasn’t meant to be.

I was sad for weeks and both emotionally and physically drained from the whole experience. I have to say, though, that I also felt immediately grateful and relieved to be officially done with my journey with infertility treatments. I feel a lot lighter knowing that I am done with tests, shots, doctor appointments, arguing with insurance companies, dealing with pharmacies, surgical procedures and just feeling like my body is not mine. I have recently been talking to friends going through infertility and I can see the physical toll all of this takes on them. I was that person for over eight years.

Most of the crying I did in the hotel room in Chicago following the news was truly tears of gratitude for my daughter. I don’t know how she got here to us. She is amazing, healthy and happy, and she brings so much joy into the world. We are so very lucky to have her. If we choose not to expand our family through other ways, we still will have more love in our lives than we could have ever imagined. We are certainly blessed.

My husband and I had gone out to Chicago on a hope and a prayer that our crazy plan could work. We came home hoping and praying that time would heal our hearts and open them to whatever was next on our journey. Now that three months have passed since our return from Chicago, I can say that I am doing better. I feel stronger, more hopeful and happier than I have been in a long time. I am looking forward to a 2012 that doesn’t involve surgeries or daily vaginal ultrasounds. I was very happy to give away all of my maternity clothes. My family and I have two goals in 2012, to have more fun and to see where this broken road may lead us. And I have a feeling my Lifetime movie will not end here.