Luke Schall is at that 6-month-old “interactive phase” says his mother.
“He is sitting up on his own now,” says Dena Schall of Lancaster. “We’ve been eating some solid food for a couple months. He is clapping his hands. He loves swimming and loves water.”
Shall's bundle of joy didn't arrive easily. It took three rounds of in-vitro fertilization. Maybe Schall and her husband were “a bit naïve” on what to expect at each turn, she admits. Their little boy made it all worthwhile, but the ride to delivery day was “quite a roller coaster.”
The word from doctors and patients on surviving the roller coaster: Know what to expect, and be prepared.
Assess your means
Sarah Kurtz is a midwife with Ephrata Community OB/GYN (www.ephratahospital.org). She and her husband conceived their daughter, now 7 years old, through intrauterine injection.
Her advice: Know your boundaries. What are you willing to spend? Which procedures can you endure? Check insurance coverage before seeing a specialist, because “It’s very easy to go to your appointment and get caught up, and before you know it, you’ve got a bill of a couple thousand dollars.”
One round of IVF averages $12,400, according to the American Society for Reproductive Medicine (www.asrm.org; www.reproductivefacts.org). Many insurance plans don’t cover it.
Though much has changed in terms of available options over the years, all patients arrive with the same “fears and concerns and feelings of isolation,” says Dr. Robert B. Filer of the Fertility Center (www.thefertilitycenter.com) in York. “They feel they’re the only one going through this problem. It’s a very common problem.”
Some patients approach the Ephrata Fertility Center just to gauge their chances of conception when the day arrives that they want to start families, says Dr. Heather Sholtis, of Ephrata Community OB/GYN.
Make lifestyle adjustments
Before treatments start, doctors might recommend that patients, male and female, lose weight and quit smoking. Both can improve the chances of conceiving naturally and the success of fertility treatments.
“It’s important that the couple try to maintain an overall healthy lifestyle, which translates into good nutrition, good sleep habits, good work habits and exercise,” says Dr. Michael I. Sobel, Abington Reproductive Medicine & Lancaster Fertility (www.abingtonreproductivemedicine.com).
Undergo tests and treatments
Physical exams. Family and personal medical history. Imaging. Sperm analysis. Catheterization of the endometrial cavity, looking for obstructions.
The doctor who simply dispenses meds without thorough testing could be wasting the patients’ precious time and money.
“The diagnosis will define the treatment,” says Sobel. The Schalls’ tests, for instance, indicated that intrauterine injections wouldn’t work and sent the couple straight to in-vitro fertilization.
Although male problems cause 40 percent of infertility, treatments are likeliest to target the female. Some men might have dilation in the sperm-carrying tube, prompting referrals to urologists who specialize in fertility, says Sholtis.
However, Filer admits that “there’s a lot we can do for females, but not a lot for males. The treatment ends up trying to get the sperm closer to the egg.”
Hormonal “injectables” such as Clomid can stimulate ovulation, but Clomid “doesn’t make you feel real good,” says Kurtz. She halted treatment after four months of hot flashes and the disappointment of failing to ovulate week after week.
Intrauterine insemination, the solution that worked for the Kurtzes, involves injection of sperm directly into the cervix or uterus. The woman might or might not be on ovarian stimulation.
For her IVF, Schall took the powerful injectables, injected by her mother, a registered nurse, because neither she nor her husband could muster the emotional strength, to generate eggs. She also underwent general anesthesia for egg-harvesting procedures.
Prepare to be disappointed
The first round of the Schalls’ IVF didn’t take. Neither did the second. “Third time’s the charm,” they hoped.
"This was our shot at it," says Schall. “We felt blessed because there are some people that aren’t able to afford it.”
There may come a time when funds have run out or treatments simply don’t work. That’s when fertility specialists become resources, perhaps sharing information on adoption or helping arrange a “gestational carrier,” a woman who carries the couple’s embryo to delivery.
Prepare to be overjoyed
When their third, and final, treatment failed, Dena Schall and her husband were devastated. They booked a getaway, a time to “change gears and regroup, and figure out where to go from here.” Except that she began not feeling well. She took a home pregnancy test, just to rule it out on the way to a diagnosis of this problem. When the result appeared, she called for her husband.
“Dan, what does this say?” she asked.
“Oh, my God,” he said.
Communicate openly with your partner, Schall advises. “It is so emotional that you want to be able to talk about what you’re feeling, and feel comfortable talking to your spouse about it, and just be there for each other.”
Find a confidant, Kurtz agrees, “because otherwise, you feel alone and like you’re going crazy.”
“Looking back,” she says, “our little girl was definitely worth the emotional and physical hardships.”
Because of what they’ve endured, the successful couple “wants everything to be perfect,” but in every pregnancy, “there will be little bumps in the road,” says Sholtis. “It’s very rewarding at the end when they are able to deliver. They’re so thankful.”
The infertility-treatment roller coaster was “worth every ounce of pain and emotional trauma,” says Schall.
“It was the wildest ride we’ve ever been on, but when I look at this little man here, it was 100 percent worth it. It’s worth it all once you get to hold your baby.”
