Diminished ovarian reserve

Prior to starting a family, my husband, Chris, and I enjoyed an incredibly exciting life. We met in 2013 in my home state of Hawai’i. He was a Navy pilot stationed at a nearby military base, and I was just starting my career as a music teacher. We met for a breakfast date and have been inseparable ever since. We spent our time traveling the world, competing in triathlons, trying new restaurants, and giving our parents a few extra gray hairs every time we went skydiving or bungee jumping. We weren’t ready for kids yet—Chris was deploying every other year, and I was applying to Ph.D. programs.

Eventually, Chris wanted to leave flying for something more stable that would allow him to be home for our future children. We took orders to Northern Virginia so he could finish his active-duty career in Chantilly while I was a full-time Ph.D. student at the University of Maryland, College Park. Once we knew Chris wouldn’t be deploying or moving again, and I was on track to defend my dissertation, we stopped preventing pregnancy.

It was no surprise that we might have trouble conceiving. I experienced a damaging bilateral ovarian hernia at four months old, which is a pretty rare occurrence. Although a talented surgeon happened to be on call to do the repair, he warned my parents that my ovaries were badly damaged and that I might not be able to have biological children. My parents were open with me about this growing up, but it wasn’t concerning or relevant until Chris and I wanted to build a family. I would periodically ask my OB/GYN if she thought I’d have trouble conceiving, but I was assured that since I had regular cycles and was young, I’d probably be fine. In retrospect, my situation was so unusual that the standard guidance about cycle regularity probably wasn’t accurate.

Our journey to parenthood

Despite applying my data analysis skills to the elusive act of trying to conceive, I wasn’t getting pregnant. This was the first time in either of our lives that we couldn’t make something happen through hard work, and it was devastating. My OB/GYN referred me to Dr. Levens not only because of his skill, but because she felt his kindness would make a huge difference in an overwhelming process.

We first went to SGF shortly after I turned 29. We felt incredibly at ease meeting Dr. Levens, who was every bit as kind as we’d been told. Chris learned that Dr. Levens was a former military officer, and the two of them immediately started talking about planes, which I think put Chris at ease. We were so impressed with how organized and efficient the entire process was! Unsurprisingly, my egg supply was drastically lower than expected for my age, but we felt good about starting with a few rounds of intrauterine insemination (IUI). We were getting excited to begin our first round when my cycle didn’t start as expected. After feeling off all weekend, I took a pregnancy test and was in disbelief when it was positive.

Unfortunately, our excitement didn’t last long. Our first couple of ultrasounds left a lot of questions, and I ultimately miscarried and needed a D&C sometime after 8 weeks. We were gutted, but we knew this meant pregnancy was possible. The next couple of IUIs didn’t work out, and just as we were beginning to start a third, COVID-19 hit. The weekend that schools closed, we were in New York City for a wedding, and I ended up getting COVID. There was so much uncertainty, but Dr. Levens never wavered in his approach and recommended that we move to in vitro fertilization (IVF) as soon as possible. It was wild being, at times, the only one in the waiting room in April and May of 2020, but that first round of IVF was a home run—leaving us expecting our first son and with three beautiful embryos frozen for the future. In February of 2021, we welcomed our incredible son, Russell. He is pure joy in human form!

Unexpected news

We were starting to think about returning to Shady Grove Fertility to try for a second child, but we weren’t in a rush. I was still breastfeeding, and we were enjoying being a family of three. Then, late one Friday afternoon, Chris found out that not only had he been picked for a year-long deployment, but that he would be supporting an elite special forces unit in Northern Iraq. We knew deployment was a possibility for him, but we personally didn’t know anyone who had been selected for such a dangerous job in an actual war zone. Our life was upended, and I couldn’t imagine raising Russell or having another child without Chris by my side. In addition to getting legal, financial, and logistical items in order, we immediately spoke with Dr. Levens about what we would need to do to try for a second child with Chris on the other side of the world. 

Going back for round two

We thought we were in the clear—our embryos were already created and waiting for us in a tank of liquid nitrogen! Just to be safe, Dr. Levens suggested that we do a sperm freeze before Chris deployed, in case the embryos didn’t work out and we needed another retrieval, as time was not on my side with such low ovarian reserve. He even found some funds to cover the cost since Chris would be a deploying servicemember, which meant so much to us and saved a ton of money during a very expensive year.

I was sure Chris would be returning to me being pregnant, making for the sweetest homecoming photos and one heck of a story. But that’s not how our story went. Transfer after transfer failed, and I was so confused—why was this happening when it had been relatively easy, all things considered, to get to Russell? I would spend a day after each transfer feeling down, but didn’t have much time to wallow—I was raising a child, keeping a home (with a lot of help from my parents!), and working full-time. In a way, the hardship of Chris’s deployment was a welcome distraction from the tumultuous nature of infertility.

Thanks to Dr. Levens’ planning, we were able to proceed with another retrieval. This time, my body didn’t respond to the meds, and it was unclear if we would even get 2–3 eggs from a cycle with high doses of stims. One morning, a sonographer noticed my left fallopian tube was blocked and filled with fluid that was spilling back into my uterus. She asked me if I’d ever had a blocked tube; to my knowledge, I hadn’t. Dr. Levens called that afternoon and told us we’d need to freeze any embryos so I could have the tube removed, then proceed with a frozen embryo transfer months later. Not only was I at very high risk for an ectopic pregnancy, but the fluid was also making pregnancy nearly impossible.

Then it hit me—there may have been nothing wrong with those three embryos; the undetected blocked tube was sending fluid back into my uterus and washing them away. It was absolutely crushing, especially since days later, that scheduled egg retrieval was a total bust and resulted in no embryos. That blocked tube hadn’t appeared on any tests prior to trying for a second child, but it had been silently sabotaging our efforts.

The next month, we proceeded with another cycle with a different protocol. My ovaries responded much better, and it was looking as promising as Russell’s cycle. The day before retrieval, my estrogen dropped, and we had no choice but to proceed. The doctor on call retrieved a single egg. Most women my age get 20–30 eggs, and I could barely make one. I was so upset I couldn’t even attend Russell’s daycare luncheon. I cried on the couch all morning—because we couldn’t give Russell a sibling, and because infertility was keeping me from being fully present for the child we already had.

Daily FaceTimes with Chris had become pro/con discussions about continuing treatment versus the emotional, logistical, and financial toll. It was an incredibly difficult and hopeless time. However, Dr. Levens called early the next morning to express his sympathy and surprise about the retrieval but told me not to rule out our one embryo—it was looking good. We talked about mini IVF as our last option using my eggs, which we felt good about. If this didn’t work, we needed to move on.

Chris and I couldn’t keep doing this. On top of raising Russell, Chris was routinely in immediate and severe danger. One day, I woke up to texts saying he was heading into the bunker due to an incoming threat and that he loved me. Then a message said it was a false alarm. Then another bunker retreat. Then he was back. This continued all day until he told me they were good—he was sure of it. Minutes later, I pulled up Google and saw that U.S. forces in Northern Iraq had scrambled a fighter jet to shoot down a suicide drone. I was witnessing the fragility of my husband’s safety in real time. In some ways, it was a fantastic distraction from our IVF struggles. In other ways, we were so overloaded with emotional strain and distance that I didn’t know how much more we could take.

The day before Thanksgiving, one lone embryo developed but didn’t have the ideal cell count. I assumed we were looking at another total failure and wrote it off. On Thanksgiving morning, our nurse called to share that the embryologist had frozen the embryo—it had caught up and started to spontaneously hatch overnight. I burst into tears, knowing this might be the child to complete our family.

The aftermath and the miracle

The next few months were a blur—Chris finally returned from his yearlong deployment. Seeing the joy in his eyes as he embraced Russell was the highlight of a lifetime. But we didn’t have much time to relax. Days later, I had my right fallopian tube removed and recovered during Christmas. Once cleared for another transfer, we met with Dr. Levens and made a plan. Soon after, we transferred that lone hatching embryo, and just a few days later, all my telltale pregnancy symptoms came roaring back. Despite a few moments of uncertainty, it was a smooth pregnancy overall, and in November 2023, a day before his scheduled induction on Veterans Day, Stanley came into the world happy as a clam with bright red hair. He was the miracle we needed after a rough half-decade. He is the sweetest soul and loves his big brother so much. Finally, our family was complete. 

Although our story did not go as planned, I would argue it turned out even better than we could’ve imagined. Russell and Stanley are the most incredible boys who are generous with their love, full of light, and are smarter, more capable, and more musical than we ever could’ve dreamed our children would be. Chris is planning their future careers as Space Force officers (not me – no more deployments, please!!!) and my favorite thing to do with them is spend time with our neighbors as all the kids play. And in addition to people wondering where Stanley’s bright red hair came from (his grandma!), they tend to have some questions when we share that he was conceived in Maryland while his dad was in Iraq! That one always gets a lot of laughs.  

Life after infertility

This morning, I woke up at 4 a.m. to Russell calling for us after a bad dream. Chris and I had fallen asleep on the couch without so much as a thought about my night guard or his cholesterol medicine—those fun things we’ve accumulated as we’ve aged. Instead of feeling annoyed by the early wake-up call, I felt so grateful for the opportunity to comfort this amazing person we created together, with a lot of help from our friends at SGF. A few minutes later, Stanley started to cry, and Chris grabbed him from his crib to join us on the couch. He immediately calmed in my arms. Life looks very different now, but we wouldn’t have it any other way. 

To current and future patients: You are in the very best hands—from the sunshiney people who check you in, to the medical assistants, sonographers, nurses, and your doctor. Every person we met gave us hope, encouraged us when we were down, and celebrated with us when we were finally successful. We’re especially grateful for the military discounts, Shared Risk 100% Refund Program, and the generous gift of covering sperm storage fees during Chris’ deployment. Lean on your people, advocate for yourself, ask lots of questions, and know that however you choose to build your family, love is ultimately what matters.