November 8th, 2023 | 9 min. read
Trying to conceive is filled with unknowns, especially for couples who continue to see a negative pregnancy test month after month. For Juliana and Ryan, the journey to parenthood was a years-long struggle through unexplained infertility and unsuccessful treatment cycles.
In this article:
- Meet Juliana & Ryan
- The Struggle of Trying to Conceive
- Step 1: Initial Fertility Testing
- Step 2: Taking a Closer Look
- Step 3: Ovulation Induction
- Step 4: Transitioning Care to a Fertility Clinic
- Beginning Fertility Treatment
- Moving Forward with IVF
- Will we have any healthy embryos?
- Embryo Transfer & Pregnancy Test Results
- Are IVF pregnancies any different?
- Parenthood After Infertility
Meet Juliana & Ryan
Originally from Rio de Janeiro, Brazil, Juliana met her husband Ryan (a Los Angeles, CA native) in the bustling West Coast city in 2015. It was an instant connection. "We started dating right away," Juliana says. "In 2017, on the first day of fall, we got married in South Lake Tahoe."
From the start, the couple knew that they wanted to build a family together. "Our plan was to buy a house first, then have babies," Juliana shares. What they didn't expect was a difficult, multi-year journey to making that dream come true.
An Unexpected Change of Plans
Around the couple's 1-year wedding anniversary, Juliana accepted a job offer on the East Coast, leading to a cross-country move to Connecticut. The couple started to focus on saving to buy their first home and start their family.
"When the COVID-19 pandemic hit in 2020, I got laid off and was out of work for nine months, until I was unexpectedly re-hired by the same company," Juliana says. "During that time, I realized that it didn't really matter if we lived in a small rental or a big house, I was ready to be a mommy and have little ones to care for."
The Struggle of Trying to Conceive
In the fall of 2020, the couple took a trip to Vermont to see the foliage. Juliana realized she would be within her 'fertile window' while they were away, and expected they might conceive while traveling. "I really believed that it only took one try to get pregnant," she recalls. "I thought for sure I was going to get pregnant on that trip."
A few days after they returned home, Juliana excitedly took a pregnancy test. To her surprise, it was negative. "I was SO sad," she says. "We tried to conceive [on our own] for another two months, and then decided to take the next step and see my OB/GYN."
Step 1: Initial Fertility Testing
Juliana's OB/GYN checked her anti-Müllerian hormone (AMH) levels, which came back within the normal range, at 3.7. Ryan also underwent a semen analysis, which came back normal.
"The doctors told us what everyone already knows, keep trying and come back after a year if you don't get pregnant," Juliana says. "So we just kept trying." Unfortunately, by the spring of 2021, the couple still hadn't successfully conceived.
Step 2: Taking a Closer Look
When they hit the 9-month mark, Juliana felt it was time to go back to her OB/GYN to ask for more fertility testing. Her doctor agreed, and sent Juliana for a hysterosalpingogram (HSG) and a saline sonogram (SHG). Both test results were normal.
Because Juliana had regular, 28-day menstrual cycles, open fallopian tubes, no uterine scarring or endometriosis, her OB/GYN was puzzled by the couples' inability to conceive.
They were eventually diagnosed with unexplained infertility, a frustrating term for those who aren't able to conceive on their own, but have no discernable underlying fertility issues.
Step 3: Ovulation Induction
Their next step was ovulation induction, a process that uses fertility medications to stimulate the release of one or more eggs from the ovaries in the hopes of increasing the chances of success. For some couples, a low-intervention solution like this is all they need.
But after three cycles of Clomid, followed by three cycles of Letrozole, Juliana still wasn't pregnant. "That's the moment my OB referred me to Illume Fertility," she recalls.
Step 4: Transitioning Care to a Fertility Clinic
Like many hopeful moms, Juliana felt anxious about having to go to a fertility clinic. "I didn't know what to expect," she says. "I felt a little bit of embarrassment - like having issues getting pregnant was some type of taboo that I needed to hide."
Because of societal and cultural stigma around infertility, the couple decided to keep their struggle to themselves. "We didn't even tell family or friends, we were both so shocked that we needed help," Juliana shares. "Now we know that millions of couples go through the same thing."
To her surprise, Juliana immediately felt comfortable at Illume. "I felt like everyone there understood what I was going through, and I didn't have to feel different or 'broken' anymore."
Beginning Fertility Treatment
After discussing their medical histories and goals with their new reproductive endocrinologist, Dr. Alexander Kucherov, the couple decided to proceed with intrauterine insemination (IUI) treatment. Unfortunately, their attempts at IUI were unsuccessful.
In the winter of 2022, Juliana says she knew that it was time to think about trying in vitro fertilization (IVF) treatment. "At first, my husband and I were really scared of the process, the shots, the multiple appointments and for sure, the cost," she admits. "It all seemed too big, too unreachable, too unreal."
The couple decided to take a few months to process the idea of starting IVF treatment and kept trying to conceive in the meantime.
The Power of a Good Doctor-Patient Relationship
Although they felt overwhelmed at times, they felt well supported the entire way. "Dr. Kucherov walked us through each process, explaining everything fully," Juliana says. "Because he's funny - in addition to being a good doctor - he helped the process feel a little lighter!"
Having been through fertility treatment with his own wife, Dr. Kucherov has an added layer of personal empathy to offer his patients, knowing what it's like to be on the other side.
A strong relationship between doctor and patient(s) can make all the difference, especially when facing something as physically, mentally, and emotionally challenging as infertility.
Is IVF right for you?
Learn how much it costs, how long the process takes, and how this treatment method can help make your dreams come true.
Moving Forward with IVF
In the summer of 2022, Juliana and Ryan finally felt ready, and signed the paperwork to begin IVF. "We just couldn't wait any longer - we wanted our babies here with us," Juliana says.
On August 16, 2022, Juliana had her egg retrieval at Illume Fertility's on-site surgical suite in Norwalk. The procedure went smoothly, and Juliana was thankful to not experience any uncomfortable side effects afterwards.
After her eggs were retrieved, they were evaluated by Illume's embryology team. As soon as the embryologists determined which eggs were healthy and mature, they performed intracytoplasmic sperm injection (ICSI) and waited to see how many would fertilize.
What is ICSI? Intracytoplasmic sperm injection (often referred to as ICSI) is an in vitro fertilization procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. Often used in cases where sperm quality or quantity is a concern, ICSI offers a better chance at successful fertilization.
Will we have any healthy embryos?
The most trying aspect of the entire process was all the waiting, Juliana says. "Time, time is the hardest part of a fertility journey, because it is something no one can control."
"Those days [after retrieval] were so hard," Juliana recalls. "I remember driving to work anxiously waiting for the call to hear how many embryos we had." Because the couple opted for preimplantation genetic testing (PGT), they had to wait a few extra days to receive their results. The hours crawled by as they tried to remain hopeful.
When their PGT results came back, Juliana and Ryan learned that had chromosomally normal embryos. They were finally able to breath a huge sigh of relief.
What they weren't expecting was a surprising bit of news from their embryologist - Juliana's eggs seemed a little bit more 'sticky' than normal. "Our doctor, Dr. Kucherov, believed that this could have been impacting fertilization," she shares.
Embryo Transfer & Pregnancy Test Results
On September 15, 2022, the couple transferred one of those tiny embryos. They already knew their chosen embryo was a boy.
Like many fertility patients, Juliana had a hard time waiting for her official pregnancy test via blood work (which typically occurs 9-10 days after embryo transfer). She decided to take a test at home, and was overjoyed to see two little lines immediately appear.
On September 22nd, the couples' fifth anniversary, Juliana surprised her husband with a chocolate bar that had a Willy Wonka’s golden ticket inside. The gleaming ticket revealed that their long-awaited baby was officially on the way!
Are IVF pregnancies any different?
It's understandable why fertility patients assume that after so much struggle, heartache, and pain, pregnancy will also be filled with challenges. Thankfully, the majority of pregnancies after infertility progress smoothly - and many parents-to-be are surprised by how "normal" they feel throughout the nine months leading up to birth.
While her experience trying to conceive was difficult, Juliana found her pregnancy enjoyable. "My pregnancy went really well," she shares. "I felt great, I actually loved being pregnant!"
On June 1, 2023, Juliana and Ryan finally got to meet their sweet baby boy, George. He came into the world healthy and strong, weighing in at 8 pounds, 6 ounces, and 21 inches long. The new parents were elated.
Parenthood After Infertility
"Georgie is now five months old and life is SO much more fun with him," Juliana says. "We are forever thankful to science and all the doctors, nurses, and staff at Illume!" They are enjoying every day as a family of three - celebrating each milestone with joy and gratitude.
And while their journey to parenthood was full of ups and downs, the couple found their own silver linings throughout the process. "I always say how privileged we are to have a picture of our son at five days after conception - that little embryo, that little bubble, so small yet so rich, so full of expectations and hope!"
So, this Christmas, they'll hold their baby boy close as they hang their most treasured decoration on the tree: an ornament with Georgie's embryo picture inside, to remind them of just how far they've come.
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