Patient Story

Rebecca & Andrew

Endometriosis
Fibroids
Lorna S. Timmreck, M.D.
Columbia, Maryland
Columbia, MD
Frozen Embryo Transfer (FET)
In Vitro Fertilization (IVF)

We got married in November 2014 after almost 5 years of dating. We never expected to go through this journey.

In August 2017, we decided to expand our family. I was not yet 30 and Andrew was 32. We followed the guidelines of trying naturally for a year since I was under 35 and like many couples, thought we would be pregnant by the end of that year of trying.

Starting fertility care at SGF

However, by September 2018 it became clear that we needed to see a specialist. After meeting with Dr. Timmreck and going through all the necessary testing, we found a few reasons we were struggling to grow our family. I had a fallopian tube that was blocked with fluid that needed to be removed and large endometriomas that also needed to be removed surgically, due to endometriosis — I had never been diagnosed before, but it made sense due to my extremely heavy and painful periods. I thought that was normal for me, but once endometriosis was confirmed everything clicked together.

We also learned Andrew had less than the required sperm count for intrauterine insemination (IUI). All these conditions pointed to in vitro fertilization (IVF) for the best chance of having a baby. I was referred to a gynecological oncologist surgeon for laparoscopic surgery to take care of my issues. When the time would come for us to do IVF, we would use intracytoplasmic sperm injection (ICSI) to address Andrew’s sperm count. Dr. Timmreck told us to just think of these as detours on our road to become parents. Little did I know just how many detours we would need to take!

During the couple of months while I was waiting for my surgery, I kept having recurring, unexplained low-grade fevers (around 99/100°F) and chills. When I went in for the surgery in January 2019, they found a gynecological bacterial infection around my ovaries and fallopian tubes (which would explain the fevers and chills). The next couple of months, I was working side by side with an infectious disease specialist, first by taking oral antibiotics and when those didn’t work, I got a PICC line put in for IV antibiotics (this was very time consuming, as I needed to take approximately 3 separate hours a day to devote to my medication).

After a few months (April 2019), which included another drain of my infection (another outpatient hospital visit, it became clear that the infection was too deep for the IV antibiotics to work, and I would need another surgery to clear out the infection. After my second surgery in May 2019 (where my other fallopian tube which had been scarred was taken out, along with more endometriomas), the IV antibiotics were finally able to do their job and within a month my infection was gone.

Ready for IVF

Once I had been cleared by my surgeon and my infectious disease doctor, I was finally ready to start IVF in August 2019.

Unfortunately, my first egg retrieval only yielded 3 eggs, and while they all matured and were fertilized, only one was implanted and the implantation failed. I needed to wait a month for the Lupron trigger to leave my system before starting a second IVF cycle in October 2019.

This time, the egg retrieval yielded over 20 eggs and I had around 10 that ended up being fertilized. The transfer failed again, but my doctor said there were 5 embryos that were good candidates for freezing, so we opted to freeze our embryos. I decided to wait a little while, maybe a few months, before my next transfer, to get in the right headspace. March 2020 threw a wrench into that plan, and I was too stressed during the pandemic to even think about embryo transfers for a while.

“Act now, don’t wait”

In the summer of 2020, when things were calming down, we were looking into adoption since I was worried another transfer wouldn’t work. However, after hearing a sermon from our Rabbi during the High Holidays whose theme was “act now, don’t wait,” we decided to test our 5 frozen embryos with PGT testing, and 3 turned out normal! We were thrilled and excited to transfer as soon as possible. But as it turned out, more roadblocks still faced us.

Another roadblock

As the year 2020 progressed, pain in my uterus became greater and more frequent. It seemed like I was bleeding for 3 out of every 4 weeks. I knew this wasn’t normal. When I went to see my gynecologist for my yearly pap, she advised me to get an ultrasound due to the bleeding. We found that I had a fibroid which had always been there, smaller before but now had grown to over 10 cm! I knew this would be a problem down the line if I were ever to get pregnant so I contacted my surgeon from 2019 and he agreed I should get it removed. In March 2021, I had my third surgery to remove the fibroid. This time, it was a laparotomy, so the recovery was much longer and harder.

After 3 months I was mentally ready to transfer again, but during a routine saline sonogram (my doctor advised me to get these monthly when I wasn’t undergoing transfers so that she could get updated pictures of my uterus), they thought they saw some scar tissue, and Dr. Timmreck advised me to get a hysteroscopy (another hospital procedure!). After the hysteroscopy, I was cleared to start IVF once my cycle returned to normal. We transferred our first frozen embryo in October 2021 unsuccessfully. This was our last cycle that insurance would cover, and we were forced to look at options for payment.

Enrolling in Shared Risk

We decided to enroll in SGF’s Shared Risk 100% Refund Program as we felt this would give us the best chance with our remaining embryos. After our second embryo transfer in March 2022 failed, I asked my doctor and nurse if there was anything different I could try for my last embryo, and they suggested a natural FET, which would sidestep a lot of the medications for a FET and instead rely on my natural hormones to increase my lining and hopefully get me pregnant. We were so relieved and excited that in May – June 2022, our “little embryo that could” stuck around and we got our first positive pregnancy test!

Finally finding good news

We couldn’t wait to see our little peanut at the six-week scan. Unfortunately, the visit didn’t go as we hoped – the doctor couldn’t see any yolk sac inside the gestational sac, and thought he saw something that looked like a yolk sac around my cervix, which would indicate an ectopic pregnancy. Everyone at SGF was super helpful in trying to calm my nerves and getting me another appointment almost immediately at another radiology center where they could take a closer look. After what felt like the longest appointment ever, they finally found the yolk sac in the gestational sac, using abdominal ultrasound. Dr. Timmreck was very reassuring that this was good news and wanted to book another appointment at 7 weeks for another scan to confirm. At this 7-week appointment, everything that we were hoping to see at our 6-week appointment was present, and we were able to graduate from SGF at 8 weeks.

Worth the wait

After a high-risk pregnancy, our beautiful miracle daughter, Reena Naomi Apt was born in January 2023. Every day with her is a true gift. We are endlessly grateful to Dr. Timmreck, our nurse Kim, and everyone who was a part of our journey at SGF for helping us get our miracle. My advice to patients is to stick with it as long as you can –it may be longer than you thought but the result was worth the wait!




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