Patient Story

Crystal

Tubal Disease
Melissa A. Esposito, M.D.
Mechanicsburg, Pennsylvania
Alabama
In Vitro Fertilization (IVF)
My husband and I met when we were teenagers working at the local grocery store. We were just co-workers, then we became friends, then we became a couple, and have been one ever since. After college, we got married, and after a year of marriage, we decided to start trying for a baby.
I thought for sure I would get pregnant right away. My mother got pregnant by accident at 17, and my grandmother had four children with no problem. I thought if the wind blew right I would be pregnant. That was far from the truth. Three years and many pregnancy tests later, there was nothing. At only 26 years old I knew I had to take the next step, and we did.

Getting a complete work-up

I first approached my OBGYN and expressed my concerns. I told her that we had tried charting, at-home ovulation kits, and every home remedy that came to mind. My cycles were like clockwork and everything appeared to be normal with me. The tests began. My doctor ordered a battery of tests for both me and my husband. In the back of my mind, I quietly blamed my husband. Since everything was so normal with me cycle-wise, I figured there was a problem with my husband’s count or motility. I would soon find out how wrong I was again.
My husband and I went to the doctor’s office, and she relayed the good news. All of our test results were normal and it seemed that maybe I would need just a bit of medication to get things moving. I was so scared but pleased. Then the doctor made her final remark, “Before I write you a prescription, I would like to do one more test on you Crystal, an HSG.” She wanted to scan my fallopian tubes and make sure there were no blockages. I said okay and thought nothing of it.
Three days later I met her at the surgical center, and we walked back to the procedure room together. I was alone and thought of this as just one more thing to check off the list. Right before the procedure began, she wrote me a prescription for Clomid and told me I could start right away if all goes well.
I was watching the procedure on the screen. She told me to watch for the dye to pass through my uterus and out of my tubes. As the dye began filling in my uterus, I knew something was very wrong; it was not passing through my tubes.
At that moment, my doctor said the words that I will never forget, “You will never get pregnant on your own”. I began crying and wondering why. As I left the procedure room, I threw away the Clomid prescription and went home in search of another way.

Moving straight to IVF

I had a friend who just went through In Vitro Fertilization at Shady Grove Fertility, so I called them instantly. I had an appointment the next day. My first encounter with Shady Grove Fertility was very comforting and so was every meeting thereafter. I felt like there was hope. For me, the only option was IVF. We started a Lupron IVF cycle in November and transferred two day-3 embryos right around Thanksgiving. I got my positive pregnancy test on December 8, 2009. We were beyond excited!
My numbers were not the highest, but I was pregnant and that was all that mattered. My first follow-up appointment was great and then things started to change. I went in for my second blood test, and I received a call from my nurse: my numbers were not doubling. I came in for a scan, and they saw an empty sac. I was crushed. I have never felt so sad in all of my life. I wanted this life so much. This was no accident or mistake; this was something I worked for. I was so heartbroken.
On December 22, 2009, Dr. Melissa Esposito confirmed that my pregnancy was over and that I would miscarry. I cried for 48 hours straight, no exaggeration. I was sitting on the floor of my living room wrapping Christmas presents and just crying. I officially miscarried on January 1, 2010.

Finding the right treatment plan

Now it was time to figure out the next step. I still have the card from my amazing nurse, Elizabeth, in which she wrote, “You are much stronger than you realize.” It was time to find this strength. Being a teacher, I decided to wait until summer vacation and try again.
I started my second IVF cycle in June 2010. At my consultation meeting, my team decided to try an antagonist approach this time since I did not respond as well as they wanted me to with the medication in my first IVF cycle. The new medication protocol made things so much better! I was able to have 17 eggs retrieved and almost all of them made it to day three. I was stunned! Then, we got word that we would be doing a day 5 blastocyst transfer, which I could not believe.
That day, my husband and I went to dinner and decided to talk about our options. I was fortunate enough that my health insurance paid for two rounds of IVF a lifetime, and I was on round two. If this did not work, we would have to pay for the next round. We wanted a family and decided to be a bit more aggressive this time.
In the middle of July, we transferred two healthy blastocyst embryos and froze the remaining four. Several days later, it was test day. I was much more relaxed this time around. I decided that nothing could be worse than what I already experienced, and I needed to stay strong. That afternoon Elizabeth called, and I was once again pregnant! Knowing the fate of my last pregnancy, I asked the important question, “What are my numbers”? A healthy singleton pregnancy should be between 100 and 200, my numbers were over 4,000. I knew they both took.
On August 5, 2010, our five-year wedding anniversary and two weeks before the due date of what would have been our first baby, we saw our twins for the first time. The first ultrasound showed two healthy sacs, which were not empty; the babies were growing. That was the best present we could receive!
On January 29, 2011, nine weeks early, Ellie and Caleb were born. They had a long road in the beginning: they both spent 42 days in the NICU one hour away from our home, but they were here and they were going to be okay. Just when we thought our family was complete, we had another little surprise in store.

A welcomed surprise

Fifteen months after the twins were born, my husband and I were planning for our first real summer with them. We were planning a trip to Florida, days at the zoo, and much more. As I was planning our vacation, I realized that something was not right. I was very tired, and my period was very late. I just thought that I was worrying myself because I did not want Mother Nature to ruin my vacation.
There was no way I was pregnant. Even though my husband and I were not using protection, every doctor I encountered said there was a one in a million shot, never gonna happen! One Sunday while shopping, I noticed a pregnancy test in the 88-cent bin at the local Wal-Mart and decided to buy one. I figured it would be negative, I would relax, my cycle would start, and I would only be out 88 cents. I was wrong yet again. I was pregnant! Shocked and scared, I made an appointment with my local doctor. They could not see a sac and thought for sure that I was going to miscarry or the pregnancy would show itself in the tubes. At this point I was in such shock that I did not know what to think.
After four days of monitoring, they were able to find a sac in my uterus and my numbers were climbing slowly, but miscarriage was still the most likely end result. That Friday, the doctor called me in. We had a conversation about miscarriage, and she prepared me for that outcome. She said let’s do one more check before we discuss our options, and there it was, the heartbeat.
On November 6, 2012, our third child, Jacob, was born. We are now a happy and blessed family of five. We are adjusting to our surprise life and soaking in every second.

My advice to other patients

First and foremost, women who suffer from infertility are the strongest women I know. It is true; we are all much stronger than we think. I also believe that women who struggle with infertility become the best mothers. We love our children and treasure them like no other. Infertility is not an ugly word or anything to be ashamed of. You are not any less of a woman because you can’t get pregnant. Take a deep breath and know that there is a child waiting for you, and one way or another, that child will be in your arms someday. Have trust in miracles; I have lived through them.



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