In Infertility, Perseverance Pays

It was a hectic Saturday morning at the clinic. I was covering and had the usual schedule of egg retrievals, embryo transfers and inseminations. This is the kind of morning you do not contemplate or reflect, you just keep moving ahead to the task at hand. At the end of the morning, the receptionist came to me and said “Dr. Willman, do you remember M.?” I answered right away. “Of course!” M. had been a patient of mine for about three years. She and her husband had come to see me very early in their marriage. Their problem seemed quite simple and I thought the fix would be quick and easy. Three years, nine inseminations, three egg retrievals and five embryo transfers later, M. had finally conceived. And on that busy Saturday morning, I had an unexpected surprise: M. had brought her baby to meet me.

My patients are a loving couple. M’s husband adores her; you can see it in his eyes. Each hurdle that they had to leap, he was always there giving her encouragement. M. had the stamina and inner strength of few people I have ever met. She shed many tears and she endured many disappointments, but she never once complained to me. Every time we had a negative result, I was challenged to find a reason and also a different treatment course. And each time I offered her a new option, a new possibility, and she took it.

For M., that meant major surgery to remove a fibroid tumor. When she first came to see me, I did not think the fibroid posed a problem. It was not near the uterine cavity. Many women with fibroids conceive and have pregnancies. But when she did not conceive after several inseminations, I had to look for further, think differently. M. endured. We tried inseminations again, but still no luck, and still, no other identifiable problems.

So I recommended the next step, which was IVF. This was the standard of care. I was relying on my medical training, following guidelines from others, based on outcomes from many other patients. I relied on a collective wisdom. I relied on mine. My patients relied on me.

M. had a picture-perfect first IVF cycle. I was so excited for her. She conceived but at 8 weeks the fetus stopped growing. That was a very difficult time for them. M. was strong and her husband was the forever cheerleader. Fortunately, they had decided to participate in the ATTAIN program and the financial commitment to try IVF again had already been made. We kept trying. Each time we tried something a little different. And every time, M. and her husband said “yes” let’s try again.

Thankfully, it did pay off. And, truthfully, I am not really sure what did the trick. Was it a different protocol? Or just the chance of another cycle?

That Saturday morning I met their beautiful 6-month-old daughter with full cheeks, big brown eyes. Any outsider looking at this family would never know the pain and hard work that went into having this child. I saw M. smile and laugh and kiss her baby. She said she was able to quit her job and be home full time. She said she was in love and her daughter was the most important thing in her life. I felt her joy. Her husband joked, “I am no longer important.”

I thanked M. and her husband. These are the moments that I work for. I don’t know why it took so long for them to have this child; I don’t know what could have been done differently. I don’t even feel responsible for this little miracle. I could not have done this without them, without their trust, their faith, and their endurance. What I do know is that sometimes it takes perseverance, immense inner strength and hope. For M., her dream finally came true.