Keeping their faith in God’s plan and an open mind when a low sperm count from varicocele and other factors drove their fertility destiny
“We were that couple that said we would never do IVF if it came down to our only option,” says Chrissie, a TRM patient and new mom.
But when getting pregnant didn’t come easily after a year and a half of trying naturally, Chrissie and her husband, Jared, opened their minds to investigating options. “We said to each other, Well, let’s just see what all of this is about.”
Her OB-GYN referred her to Tennessee Reproductive Medicine, where she saw Dr. Jessica Scotchie. “Jared and I knew there was science behind infertility treatments, but we didn’t want to mess with God’s plan,” Chrissie says.
“But when we spoke to Dr. Scotchie, we realized there is more to it – it’s not just something controlled in a dish. There are other factors at play, and that changed our hearts. We wanted to do whatever we could to have a baby.”
Little did they know that several other factors would launch them on a four-year fertility journey of hope, sadness, joy and finally, a baby boy.
Chronic illness and a varicocele found by infertility testing played roles beyond their control
The first step was for Dr. Scotchie to perform a medical history and physical exam on Chrissie. She presented with a pre-existing condition called ulcerative colitis in which ulcers in the large intestine cause inflammation, nausea and dehydration.
“Dr. Scotchie really went above and beyond,” Chrissie notes, recalling how Dr. Scotchie called her gastroenterologist to explore how the condition and associated medication for it might be contributing to the causes of infertility.
The next step was fertility testing for each partner. One of the male fertility tests came back indicating a low sperm count for Jared. “He was open to seeing an endocrinologist,” says Chrissie. “And again, we said, Let’s just talk and see.”
They met with the endocrinologist who explained that Jared had a condition called varicocele in which enlarged veins in the scrotum can cause low sperm count and decrease their quality. Varicoceles affect about 10%-15% of men.
Related Reading: Couple Startled by Fertility Testing Results
“The doctor said he could do surgery to try to increase the sperm count,” Chrissie recalls of the varicocele correction. “He said to Jared, ‘You’re young, you’re healthy, it’ll likely do what it needs to do, but there’s also a chance that it won’t.’”
Jared was open to the surgery for the varicocele, and in the end, “it improved his low sperm count a little, but it still wasn’t where it needed to be,” she says. “That was the turning point for us. It changed his mindset to, ‘We’ve got to do whatever we have to do to give it 100%.’”
After the varicocele correction, natural cycle IVF offers affordability and hope
Dr. Scotchie was sensitive to the couple’s health conditions and their desire for a fertility treatment that was as organic and cost friendly as possible. Her approach called for natural cycle IVF (NC-IVF).
In this treatment, our fertility specialist carefully monitors the woman’s ovulation cycle through ultrasound images and estradiol (an estrogen hormone) testing as one or more viable eggs mature in the ovarian follicle. Medication may be prescribed to help bring all potential eggs to full maturity.
The goal of the meticulous monitoring is to avoid missing an early ovulation. When the eggs are deemed mature, the specialist proactively triggers ovulation with a hormone called hCG (human chorionic gonadotropin), and the eggs can be surgically retrieved. Embryologists then perform intracytoplasmic sperm injection (ICSI), inserting sperm directly into the egg and growing the resulting embryo to the blastocyst stage, at which point it is transferred back to the woman’s uterus.
The couple went through two rounds of natural cycle IVF. “After a completely failed first attempt, the second time I got pregnant but there was no heartbeat, and I had to have a D&C,” she says of the dilation & curettage procedure. “Unfortunately neither time was successful. We knew at that time that we had a very serious decision to make as far as do we quit or proceed with a full cycle IVF treatment.”
Learn about natural cycle IVF and who might be good candidates for this nearly drug-free, less costly option.
Going back on a promise not to do IVF
The time came for them to make a decision about the next step in treatment: full-on IVF (in vitro fertilization). They decided that it was worth the chance of what might come of IVF – either the risk of another pregnancy loss or, hopefully, a baby, Chrissie says.
That IVF cycle resulted in four embryos. Only one was genetically normal and it ended up miscarrying.
“It’s a very emotional journey, and after that, we said, ‘We’re done,’” Chrissie recalls. “During the low times after we went through two natural cycles and one IVF, you feel like, Should I have done something else? Should I get someone else’s opinion?”
“But then I’d think, the doctors at TRM genuinely took the time to call our other doctors to investigate our health conditions. They’ve gone above and beyond. Dr. Scotchie is truly caring and felt genuinely sad with us. They’re doing everything that they can do. So there was no need for me to go anywhere else.”
One last shot with endometrial receptivity analysis (ERA) and testing for endometrial inflammation (Receptiva)
There is just a short window during which the inner lining of the uterus (endometrium) is biologically ready to receive an embryo. Dr. Scotchie wanted to perform a molecular diagnostic test called endometrial receptivity analysis (ERA) to ensure the new embryos would be transferred at the ideal moment. There are also some patients who have increased production of an inflammation protein called BCL6 that is thought to cause resistance to progesterone. A test for BCL6 expression is available (Receptiva) and can be useful in some patients who have had unsuccessful embryo transfers.
Chrissie and Jared went through another full-cycle IVF. This time seven eggs were retrieved and six were viable enough to be frozen. However, right at this time, Chrissie’s ulcerative colitis flared up, and the couple needed to take a break from treatment.
A family death sparks even more need for a break
Five months later, something devastating happened: Chrissie’s mom passed away.
“This was a sad and stressful time,” Chrissie says. “You want your mom there to be part of your pregnancy journey and delivery. She was always there to support me, to pick me up during the negative times. She knew what we were going through and what we wanted and she would say, ‘No matter what happens, it’s going to be ok.’”
To not have her mom’s support on top of everything else that had happened created even more stress. She needed to take an even bigger break.
“During that time, we bought a MasterCraft boat. We were doing things in the water,” Chrissie recalls. “I was thinking, Maybe this is not in God’s plan. Maybe we’ll adopt. I don’t know.”
Mom would have wanted this
Several months after her mother’s passing, Chrissie and Jared went back to TRM. Chrissie’s eggs were thawed, and this time, Jared’s endocrinologist surgically removed his sperm, just in case there might be any issues with low sperm count or motility (ability to move).
“Shan, the embryologist, couldn’t find any sperm,” Chrissie says. “They kept looking and looking, and finally found about six – just enough to put with my eggs.”
Out of potentially six pairings, three embryos emerged, and one grew healthy enough to undergo preimplantation genetic testing. After an embryo has a biopsy for genetic testing, it is frozen while the test is run. Later, if the result shows a healthy embryo, it is thawed for transfer.
“At first I thought, If we freeze this embryo, it won’t be as strong,” Chrissie says. “But I didn’t really have a choice, because we needed to do genetic testing.”
The couple was going to have to freeze their one good embryo.
Genetic testing came back normal. Before transferring the embryo, Chrissie had to undergo several months of hormonal suppression to try to decrease the inflammation in her uterus.
The reward of keeping an open mind and not giving up
Months later, after a series of medication shots for ERA and, of course, some ulcerative colitis flareups, Chrissie and Jared went in for the embryo transfer. This time, it took.
Several weeks into their pregnancy, the couple had an ultrasound exam and they heard their baby’s heartbeat. They walked back to their car after the appointment holding an envelope that would reveal the gender.
“We had never wanted to know the gender in any of our prior pregnancies,” Chrissie says. “But this time, we opened the envelope. The look on Jared’s face was just – his eyes got watery and he had a glow. This will be a baby boy to carry on his family’s name.”
From their starting stance of “we’d never do IVF” across a four-year journey culminating in the birth of her son, Maverick Lee, Chrissie learned a few things. “I’d tell someone else, first, do not give up. When and if it’s supposed to happen in whatever way, it’s going to happen.
“Also, stay positive and don’t lock in on one thing. Keep an open mind. Stay open to the doctors’ suggestions and to the fact that it’s not all going to work 100% every time. It’s really about timing, not giving up and keeping an open mind.”