This blog post is written by Dr. Lucky Sekhon, reproductive endocrinologist, infertility specialist, board certified OBGYN, at RMA of New York. Dr. Sekhon has particular expertise in fertility...
Taylor Ortiz Hershman and her husband decided they wanted to try to start a family in October of 2018. “I didn’t know if I wanted to have kids,” Taylor said, “But once we decided, it was like a lightbulb went on- I went from being unsure, to thinking, ‘I really want this’”. Although she wanted to grow her family, Taylor had a feeling that conceiving would be difficult for them. She was surprised when she got pregnant three months after trying.
Taylor’s first pregnancy ended in a loss. When she went to the doctors for initial testing, they noticed that her hormone levels had increased but not doubled. Taylor went in for more testing after that, where there would be some sort of a development or growth, but not as much as they had wanted to see. At ten weeks she had a D & C. After her loss, doctors told Taylor that this was just bad luck, that she was young, and statistics were on her side. They didn’t think that there was an underlying problem or that Taylor required more testing. This didn’t sit right with Taylor, who felt like there was a problem, but didn’t know what it was.
Taylor got pregnant two more times in 2019, both of which ended in losses. “Do you believe me now, that there’s a problem?”, she wanted to say to the doctors who had said that her first loss was just bad luck. She got referred to an RE, where they ran a recurrent loss panel, fertility tests, a saline ultrasound, and more hormone testing. It was a comprehensive round of tests. “I wanted there to be something wrong, but I wanted it to be something simple,” Taylor said. They found that her AMH was very low, indicating low ovarian reserve. Her levels were low for a 40 year old, and she was 29 at the time. The doctors also found that she has a chromosomal balanced translocation. This means that two pieces of her chromosomes broke off and switched places. This is an even swap on genetic material. Those who have chromosomal balanced translocations have normal phenotypes, but the symptom is recurrent pregnancy loss. It puts individuals at a much higher risk of miscarrying a pregnancy.
Doctors suggested IVF right away. This would allow them to test the embryos, and find out which were normal, or balanced (like Taylor). She and her husband decided to jump right in. However, their cycle was delayed due to COVID shutdowns. This was frustrating for Taylor, but she understood why they had to postpone her cycle. She was working with a big hospital, who needed to focus their resources for critical areas. Taylor decided to switch to a smaller clinic which works only with fertility patients. In June-November, she did four retrievals at the new clinic. She got three embryos out of ten that were either normal or balanced. Taylor and her husband are feeling positive as they plan their transfer.
Throughout her journey, Taylor has struggled with how to manage expectations. She believes that many others deal with this too. “Up until the point that you do your first IVF cycle, you just think it’s going to work,” she said. Taylor wished that she had known more of what to expect beginning her fertility journey. She had no idea how long it could take, how much it would cost, or how emotionally draining it can be. Taylor understands that doctors don’t want to scare people who are beginning the process of fertility treatments, but she feels like there should be an honest conversation about everything that can happen along the way. That way, those who go through infertility could have a better idea of what to expect going in.
Taylor shares her journey online, which has helped her a lot through the process. After her first loss, she “felt really desperate for answers.” She looked online and found that so many people were sharing. She read sentiments that reflected exactly what she was feeling, which she found really comforting. Taylor’s friend gave her the idea to start posting on Instagram. “It’s helped me a lot,” she said. “In a weird way, it’s kind of normalized it for me. I know now that there are thousands of people that are feeling the same way I’m feeling. It’s made my feelings feel more validated.” She’s also realized that sharing her experience helps other people. “It’s nice to receive messages saying, ‘I’m not ready to share, but I appreciate that you do,’” she said. Her openness shows others that they are not alone.
When you’re going through infertility, Taylor believes that you must stand up for yourself and your care. “When you’re going through infertility, whether it’s year five or day one, you have to advocate for yourself. You can have the best doctor in the world, but it’s your life. You really can’t be afraid to ask questions or raise concerns if something doesn’t feel right,” she said. When Taylor had her first loss, she felt like something was not right, but doctors told her it was just bad luck. Looking back on this experience, she wishes that she had asked for more answers. Too many times, fertility concerns are brushed aside. Women are told they are still young, or that what they’re going through is common, or that something was just a fluke. Taylor is passionate about helping women to better stand up for themselves, and advocate for the care they need. She suggests keeping a list of questions for the doctor, holding yourself accountable for asking those questions, and holding the doctor accountable for answering them. Taylor believes that being your own advocate is necessary on your fertility journey.
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