Patient Story

Keri & Gerry

Obstructive Problems
Ricardo A. Yazigi, M.D.
Towson, Maryland
In Vitro Fertilization (IVF)
Gerry and I dated for five years before we were married. We were married for almost four before we decided to start a family. We were both very active with sports. Gerry and I were both athletic and involved in sports like softball, baseball, golf and running. In fact I was in the midst of training for my first triathlon.
After trying to start a family for a year, with no success, I met with my OB-GYN. She ran some bloodwork and thought my progesterone levels were off so she prescribed me Clomid. After three unsuccessful rounds, she suggested that Gerry have his semen analyzed and I make an appointment with Shady Grove Fertility at their GBMC office. She wrote Gerry an order for his semen analysis.

Surprising results

A few days later, my OB-GYN called me with the results of Gerry’s semen analysis. She said “You will never get pregnant. Your husband does not have sperm in his ejaculate.” I was shocked and asked her if she would be calling my husband to tell him. She said “No, I don’t do male issues.” I could not believe her response. I hurried home to read up on what I quickly learned was azoospermia (zero sperm count) before Gerry got home. I needed to figure out how I was going to tell him this result and also needed to have some alternatives to discuss. That was a horrible day. I never went back to that OB-GYN.
When Gerry came home, we discussed the results and decided we needed to make a follow-up appointment with his urologist. We met with his doctor and he inferred that it was a long-shot for us to have a baby that was biologically both of ours, due to Gerry’s azoospermia. He spoke to us about in-vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI). He was also very frank, implying that we would most definitely need a sperm donor. He suggested approaching Gerry’s brothers or father for their semen to ensure the baby had Gerry’s traits. I could not believe my ears. All of these years I tried so hard to not get pregnant and now when we want to, we were being told it was going to be a long process. Gerry’s doctor referred us to Dr. Karen Boyle, a urologist specializing in male factor infertility, who would take over our case.

Plan B

After the New Year in 2010, I began the testing process at SGF. Because we knew Gerry did not have sperm in his ejaculate, Dr. Boyle recommended that he undergo a treatment called testicular microdissection to search for sperm in his teste. Since we were unsure whether she would find sperm, all of the doctors recommended that we have donor sperm back-up since I was going to go through IVF.
This was a struggle for both of us at first and we were both against it. It did not take long for Gerry to change his mind. He felt that even if we needed to use donor sperm, the baby would still be half of me and we would go through the process together. It took me a little longer to come around to this idea, but by the time we needed to move forward with IVF we were on the same page with donor sperm sitting at the SGF GBMC office.
Sperm donor selection was such an interesting experience. We searched on line for a donor using similar traits to Gerry. We wanted to have the baby look as close to Gerry as possible if that was the route we would have to take. There were options to buy photographs of the donor, but Gerry was not keen on this option and so we made our decision based on the cryobank’s staff assessment of the donor. We hoped for the best, but had many talks about how we would tell the child, when we would tell the child, etc. There was never a time that we thought we would not tell the child if this was the path we needed to take to get him or her here.
Prior to Gerry’s procedure and the IVF cycle, we decided to make some lifestyle changes. I gave up running completely (I was in the middle of training for my first marathon) and training for more triathlons. We both stopped drinking alcohol and curbed caffeine consumption. We investigated holistic approaches and found the Wellness Center at Shady Grove Fertility. We began going to weekly acupuncture appointments. Acupuncture provided more relaxation and centering for me and we were hoping it would facilitate sperm production for Gerry. Throughout each cycle I continued with acupuncture and the time of each transfer we made the trek to Rockville the day before for pre-transfer treatment and the day of transfer for post-transfer treatment.

Starting treatment

In May 2010, the end of our first IVF cycle came. Gerry had surgery and Dr. Boyle found sperm!! So much that she was able to save some extra tissue to freeze and possibly use later. Long story short – we were beyond excited at this news and that I got pregnant on our first try with IVF using ICSI. Two embryos were transferred, but we were pregnant with a singleton.
About five weeks in, I began to spot and have horrible pains up my side. Although my HCG numbers were rising a bit, the doctors knew it was not a viable pregnancy and thought the pain could be from an ectopic pregnancy. It was such a struggle for us the next couple of weeks because the HCG numbers kept creeping up, but I needed to and consented to having two methotrexate shots to stop the increasing numbers to ensure the embryo did not grow bigger and burst my fallopian tube. I felt like we were ending the pregnancy that we wanted so badly.

Over the next year we focused on ourselves, as Dr. Boyle would not even consider doing surgery on Gerry again for at least nine months. I think the break in between helped our minds. I got back to running and tried to get back to our life.

In January 2011, testing for the next round began. Gerry had to be prepped and ready to go for surgery just in case, but Dr. Boyle was hopeful that she could find sperm in the frozen tissue from the year before. She found sperm in the frozen tissue so Gerry did not need surgery. The donor was still there for back-up, but not yet needed.
At Day 3, we had 6 embryos. We were so excited thinking of the possibilities if we did not get pregnant this time we might still have frozen embryos. SGF GBMC held the embryos to Day 5 and at that time there were five left. The embryos looked great and the doctors decided to hold them one more day. When we got to the hospital the day of the transfer, Dr. Katz looked at me and said only one embryo made it. That embryo was transferred and two weeks later we had a negative pregnancy test.

Unanticipated struggles

Throughout the whole second cycle, I was struggling with insurance to pay for the three cycles that are covered by my policy. They did not understand the IVF cycle and thought that three visits equated to three IVF cycles. It was miserable trying to work with the insurance company and dealing with my feelings of not having a little one. I cannot count the number of times I was on the phone with insurance or with SGF account managers. It was aggravating to say the least. Additionally, Gerry’s surgery was not covered by insurance and it had to be paid out of pocket before the procedure. Insurance did reimburse us for Gerry’s hospital stay and anesthesia, but we had to also pay those costs prior to the procedure and it took weeks for us to be reimbursed.
In between the second cycle and last cycle, we received word from the cryobank that there was an issue with one of the children born from our donor. We had the option to keep the sperm or get a refund and pick another donor. We decided to pick another donor so we had to go through that selection process again, which was pretty hard on Gerry.

Yoga… and success

Between the start of IVF and prior to me becoming pregnant, I had stopped training for triathlons and running. I focused my efforts on yoga and decided to obtain my 200-hour yoga certification. I also thought that adding fertility yoga to my toolbox would help so I enrolled in a six-week yoga for fertility course. During the introduction at the first class, the teacher asked us to share our yoga and fertility experience. I explained my fertility story and that I was planning to complete my 200-hour certification by the end of the year. She looked at me and said “We should talk after class.”
The instructor asked if I would be willing to teach the six-week course, as I will have the yoga certification and the fertility story that I could share with the women taking the yoga for fertility class. I said “Yes” and shadowed the next two six-week sessions with her.
In November 2011 our last and final IVF cycle began. Gerry had a second testicular microdissection surgery and Dr. Boyle found sperm – something that was not guaranteed and had only been successful once before. At the start of this cycle, my doctor, Dr. Yazigi, suggested that we try half of the eggs with donor, as we were not certain if there was an egg issue (by this time I was 37). So of the retrieved eggs in this cycle, half were injected using ICSI with Gerry’s sperm and half with the donor’s sperm. Only one embryo made it – with Gerry’s sperm!! Down to one sperm and one egg…we couldn’t believe it!
The embryo was transferred and two weeks later we received a call that we were pregnant. We could hear in our Nurse’s voice that my HCG was a good number and we should be pleased. It was just hard to grasp. We had such guarded optimism.
Shortly after our positive beta I began training and taught my first six-week session while I was five weeks pregnant. I continued to teach throughout the pregnancy. We made it to week 40 on the nose, on August 30th 2012 we were blessed with an amazing daughter we named Tallulah. After Tallulah was born, I took a hiatus until she was 3-months old. I returned to teach yoga for about 4 more months, but found it was difficult for me to juggle my full-time job, teaching and a newborn.
I still hear from the women I met through teaching and a majority have become pregnant themselves. It is such a great feeling to know I was part of the process for them. Now that things have settled down, I will begin teaching yoga for fertility in June 2014. It is part of my dharma to share our story with others going through fertility issues.

Life today

Our life is wonderful. Tallulah has made our life complete. She is the joy and light in our life that we were missing. I could have never imagined the love we have for her. We are having so much fun with her. It is like she has always been in our family. She always had a place in our hearts – she just needed to get here.

Keri’s advice to a friend

While teaching Yoga for Fertility, I meet many women who are having trouble conceiving. I first tell them they are not alone and they begin to see this when we work through the six-week program. Specifically, there are fewer male factor issues that come across to me, but when they do I can see a light in the woman’s eyes, as most of us would rather have it be a female factor issue. It just makes more sense to all of us, men and women, for it to be a female issue. I next tell them that they may not become mothers in the conventional way. Some of us may need help through IUI, IVF, donor sperm or egg or adoption, but if we truly wanted to be a mother it would come to fruition.
We would like to thank all of our doctors and SGF staff who made Tallulah possible. We would not be where we are today without you.


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Diagnosis and treatment

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In vitro fertilization (IVF)
Obstructive Problems
Male factor infertility

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Dr. Karen Boyle
Dr. Ricardo Yazigi
Towson, Maryland location
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