Happy Monday friends!
Today is a special post. I have a dear friend that is sharing her adoption story.
This is a friend that looked at me 13 years ago and said at an employee orientation “We’re going to be best friends.” We had never met before that day at orientation. And she was exactly right. We learned how to be nurses together, walked with the Lord together and traveled the world – I’m not kidding, we hiked the Inca Trail to Machu Picchu in Peru as a vacation together.
Here’s the proof!
We haven’t lived near each other for a number of years but the miles don’t keep us apart.
More recently, we have gotten to walk together as mamas. Kim’s story to becoming a mama is amazing. She worked in an infertility clinic as a nurse practitioner and understands the ins and outs of infertility. She tells it best though…here’s her journey to adoption.
My story starts back in my teens at the age of 15. This is when I started my period – still within the normal timeline range of menarche, but on the upper end of the range. Due to irregular and anovulatory bleeding throughout that first year, I was put on birth control pills to help regulate my cycles. This started my long journey of using birth control for over a decade. Jumping 15 years down the road, I reconnected with a friend that I had grown up with and ended up marrying that amazing man in March 2016. After our wedding and after 15 years of use, I finished my last pack of birth control pills, and we hopped into the “trying to conceive” season of life.
I had a feeling that due to the way my periods started out back in my teens, the length of birth control usage, and the fact that my periods were still very much irregular after stopping birth control, getting pregnant wouldn’t be a walk in the park that it is so typically portrayed to be. With the expectation that getting pregnant would be difficult, my husband and I looked into the domestic infant adoption process. We quickly found out that couples were required to be married for at least three years before applying to be adoptive parents. This was slightly heartbreaking but understandable as a couple’s foundation needs to be solid before traversing the journey of raising a child born from another woman. During this initial jumpstart to our family, I also started a new job at an infertility practice as a women’s health nurse practitioner. My background was in labor and delivery, so diving into infertility, there was a large learning curve and so much to learn and apply even to my own life and experience.
While we waited for those three years to go by and because of my oligomenorrhea, I decided to see a physician I worked with and do some testing. My total testosterone levels were elevated, my AMH was 24, my LH/FSH ratio was elevated, and I had polycystic ovaries on ultrasound. With my BMI averaging around 21, I was diagnosed with atypical PCOS due to the lack of obesity and insulin resistance in my presentation. PCOS is a difficult diagnosis to understand as it’s essentially a spectrum of hormone imbalances, and it can look different from person to person. With this being the case, my husband and I decided to look into ovulation induction and intrauterine inseminations. I was prescribed Letrozole (studies have shown that patients with PCOS respond better to Letrozole compared to Clomid) and we proceeded with pills, injections, blood draws, vaginal ultrasounds and pregnancy tests for the next 9 months. We were successful with our third IUI, but unfortunately miscarried our sweet boy at 13 weeks. We found out soon after our D&C that he was trisomy 13, a diagnosis incompatible with life. We completed an additional four IUIs after our D&C, but were unsuccessful for another pregnancy. Typically, 3-4 IUIs are recommended because after 4, the chances of pregnancy do not increase. But, because I worked where I did, our physician allowed us to try a few more rounds.
After IUI is unsuccessful in infertility, the next step is in vitro fertilization. This process is more intense, involves stronger hormones, it’s more complex, takes more time and is more expensive. With IVF, eggs are retrieved from the ovaries and they are fertilized with sperm from the partner’s ejaculate outside of the body in a lab. With PCOS, one can have several follicles and eggs retrieved, upwards of 15-30 eggs in one retrieval depending on the person. For the most part, all of the eggs are fertilized with sperm in order to give the couple the best chance of having multiple euploid (chromosomally normal) embryos to transfer and complete their family as they so desire. PCOS can cause women to have less healthy eggs which can affect the outcome of an embryo, and sperm health, of course, can affect embryo outcome. This is in addition to the chances of the embryos being chromosomally normal – rule of thumb is to cut the number in half with each phase of the process – if you retrieve 20 eggs, 10 will be mature, 5 will fertilize and grow out to the blastocyst stage, and then 2-3 will be chromosomally normal. On ultrasound, I had greater than 30 follicles on each ovary: over 60 follicles that could potentially have eggs that could be fertilized. In my experience and with the knowledge I’ve gained from working in infertility, I understand that the likelihood of that many eggs being mature, being fertilized and growing out to day 5, and THEN being chromosomally normal is not likely.
Punchline revealed: We did not move forward with IVF. We had the greatest physicians to work with, the best nursing staff to walk us through the process, health insurance coverage (incredibly rare) and a definitive diagnosis of infertility, BUT my conscious and faith came into play. This part is different for everyone. With whatever eggs were fertilized, we wouldn’t have chosen to do chromosome testing, because in our opinion, life starts at conception. That embryo has all of the DNA in it that it would have the rest of its development and life. If it grew into a full, air breathing infant, their DNA would have been the same as it was when that baby was an embryo. Remember the rule of thumb above and my ultrasound – if I had let’s say 30 eggs retrieved and 15 were mature. Theoretically, seven to eight would fertilize normally, meaning we would have seven to eight little “babies” as our responsibility, and in our case, we would feel the need to transfer all of them. Again, the likelihood that they would all be normal and “make it” is low, but the chance was still there. We opted to not move forward with IVF and once again, turned our focus to domestic infant adoption.
Come to find out, the agency that we had reached out to before had recently changed their requirements of married couples from 3 years to 2 years, which we had reached by the time all of the above had happened. Although adoption is a broken solution to a broken system, and it comes with its own difficulties, financial constraints, complexities and intense experiences, we were right where we were supposed to be. Long story short, we started the process November 2018, were approved June 10, 2019, a birth mother chose us July 24, 2019 and the sweetest boy was born July 28, 2019. We couldn’t imagine our lives any other way.
We continue to not use any barrier for birth control, and my periods have gotten more regular as I’ve gotten older, but PCOS is an ongoing syndrome that I am continuously learning about daily. There are so many paths for those experiencing infertility, and you are not alone. 1 in 7 couples experience infertility, and PCOS is the most common cause of female infertility. There are things that we think are normal because we’ve experienced them for so long, but they’re not normal. If PCOS is a part of your story and your desiring pregnancy, don’t wait. See your midwife, women’s health NP, PA, OB/Gyn or REI. If PCOS isn’t a part of your story but pregnancy hasn’t occurred in 6 months if you’re 35 years or older, or 12 months if you’re <35 years old, see your women’s health provider now. Ask questions. Find a community of support. If you’re a provider or one in training, learn the questions to ask and provide the empathy your patients are seeking.
Isn’t her little man adorable? Thanks Kimber for sharing your story! I love her advice at the end. It’s clear she’s walked the road and knows that the journey is long, bumpy and unpredictable.
One more throwback picture since it’s Monday… 🙂
Have you written down your birth story? Journaling about your story is therapeutic. You don’t have to share it with anyone. It can go in a keepsake box where no one has to know it’s there.
But, I encourage you to write your story for each birth, loss or adoption you journey through. Over time, details fade. And it’s important to pass stories on from generation to generation. It’s how women learn about womanhood. It’s how lessons, teaching and strength are taught.
If you want to share your story, you can email your story to amidwifenation@gmail.com. I can’t wait to read it!
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