Weight has always been an issue for Jennifer. But when it became the prime obstacle in trying to have a baby, Jennifer decided it was time to make significant lifestyle changes.

Marrying at age 30, Jennifer knew to seek advice from a fertility expert after one year of unsuccessful attempts at conception. Jennifer was referred to Dr. Melissa Esposito in Shady Grove Fertility’sFrederick office by her OB/Gyn who had been a college classmate of Dr. Esposito. Jennifer’s Day 3 blood work and examinations revealed a potential reason for her inability to get pregnant: polycystic ovarian syndrome, or PCOS.

Dr. Esposito recommended that Jennifer and her husband Tony began their fertility journey with a couple rounds of Clomid and timed intercourse, but when both cycles ended in “chemical pregnancies” – meaning the egg fertilizes and implants in the uterine wall but the beta hCG levels don’t progress, indicating lack of embryo development – Dr. Esposito felt their next best option was In Vitro Fertilization or IVF.
After two failed cycles and nearing the end of their insurance benefits, the couple decided to take a break from treatment to rest and ponder their next steps. During their break, Jennifer received some surprising news in the form of an insurance plan change at Jennifer’s employer. This fortunate turn of events meant that her infertility benefits would start over at “square one.” Jennifer and Tony decided in January of 2010 to return to Shady Grove Fertility to talk with Dr. Esposito.

Dr. Esposito recalls that post-break consultation in which she addressed an issue that she says may have been an additional factor to Jennifer’s infertility – her weight. “I had a heart-to-heart with Jennifer and Tony about her weight,” said Dr. Esposito. “While she did have PCOS, there was no particular reason for the losses she’d had in treatment so far. From research, we know that a certain level of body fat works against a person’s fertility, so I asked her to try and lose 10 percent of her body weight and come back in six months.”

The research that Dr. Esposito discussed with the couple confirms that reducing even as little as five to ten percent of a person’s body weight can help their hormonal levels balance toward an optimally fertile state. “Ten percent of my weight at that time was 30 pounds,” Jennifer says. “I was in the right frame of mind to hear this directive. At that point, I thought to myself, ‘I haven’t really done anything on my end to help this process along.’ So I was ready to make the necessary changes to help increase my chances of getting pregnant.”

On Dr. Esposito’s recommendation, Jennifer consulted with a nutritionist at Pulling Down the Moon, Shady Grove Fertility’s complementary medicine partner, in their Rockville location. She was surprised to find that she wasn’t given a strict, regimented diet or exercise requirements to accomplish losing what they felt was a safe two pounds per week.

“They taught me about the foods that help women with PCOS, like cruciferous vegetables, and told me to cut back on red meat and avoid low-fat dairy. I used a daily intake goal of around 1,600 calories per day, and we decided that based on my schedule, lunch should be my biggest meal every day.” Jennifer remembers initially thinking that she could “‘just eat a frozen Weight Watchers meal for lunch,’ but my nutritionist at Pulling Down the Moon said she’d rather see me eat a sandwich because of the high amounts of fat and sodium in processed frozen foods.”

To increase her activity level, Jennifer started walking for 10 minutes on a treadmill three days a week. Each week, she added 10 minutes to her walk, and then she added days to her weekly exercise routine. Currently she is walking up to four miles a day, five days a week.

Jennifer also credits her husband’s supportive ways, like when he gave her a digital food scale for Valentine’s Day. “At first, I was taken aback,” she says now, “but when he explained his thinking that this would simplify my life – instead of trying to estimate how many calories I was eating, I would actually know for sure – I thought it was just the sweetest gift.”

“At first, the weight fell off,” she recalls, “so it was easy.”Jennifer stuck with her diet and exercise regimen, and by the time she saw Dr. Esposito in May (one month earlier than their initial plan), she’d lost 70 pounds. Her body mass index (BMI) dropped from 42 in January to 32 in May, a very healthy difference she says. “Dr. E freaked out when she saw me in the waiting room,” Jennifer laughs.

Jennifer began her second IVF cycle in July nearly 90 pounds lighter then when she had met with Dr. Esposito in January. This time she produced 14 eggs – 11 of which fertilized – and she and her husband decided to transfer two day 5 embryos back. The result of this cycle is a healthy singleton pregnancy which Jennifer says she is ecstatic about.

Jennifer describes her pregnancy so far as “absolutely perfect.” She’s still walking, having cleared it with her OB, and she believes the routine has resulted in more energy during this pregnancy than she would have had otherwise. “I have upped my calories to about 2,000 per day to keep up with the pregnancy, but I still keep an eye on what I eat.”

In a way, Jennifer’s experience with infertility has led to some very positive changes in her whole life. She says she was the heaviest she’d ever been when they first sought fertility treatment, partly because of sadness since her father’s death the previous year. “I am a person who placates my feelings with food.”

She adds that going through infertility also prompted “a cycle of ‘okay, well here we go back to the doctor’ and it feels like it never ends. But now,” she says, “if I’m worried or anxious, I do something other than eating five cookies – like get on the treadmill.”

She also credits the honesty and support of Dr. Esposito who not only wanted to see her successful, but also helped in providing the resources necessary for her to be able to reach her ultimate goal. “While I knew my weight was an issue, I think it was the honesty that Dr. Esposito had to basically say that by shedding some weight I could be successful,” Jennifer says. “I had an amazing relationship with her, and trusted her through this entire process. I couldn’t be happier right now.”

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