Trigger warning: infertility, miscarriage and loss

A couple of weeks ago, I finally began openly sharing the IVF part of our story and fertility journey. Today, I want to share our IVF story and experience. I am presently 45 years old. This is my IVF story.

No matter where you are in your fertility journey, I hope you can find peace in the waiting and hoping and planning. And, I hope, by sharing my story, you are encouraged and know you are not alone.

Rebekah Maddux El-Hakam, ElMomma.com

My history:

In 2017, we were praying and hoping for one more El-Hakam baby. We had taken a substantial break of over 6 years after having our four older children in a 5 year time span. We had three boys and one girl at the time and were praying for one more little girl. In May of 2017, I fell pregnant with our fifth baby. In July we found out that our baby was a little girl. We were all over the moon for her and so excited for this little one to complete our family. In mid August, at nearly 18 weeks gestation we found out that our daughter had died in utero. She had no heartbeat at a routine visit with the midwives. We later found out that she had died because of a fetal maternal hemorrhage- anemia due to an unknown cause.

This time in our lives, changed us. It definitely transformed me, in particular. I felt this new fire ignite in me. I knew I wanted to have another baby. That was never in question. But, I also knew I wanted to have a couple more babies. It may sound crazy. But, losing my daughter at 18 weeks gestation and then waiting an entire year and 9 months to have our baby boy solidified for me that I wanted two little ones to be close in age.

We were blessed with a healthy baby boy, Jimmie, in May of 2019. He was exclusively breastfed. I believe because of this (and possibly my age) that my cycle did not return until he was a year and a half old. It was another year and a half of trying before we fell pregnant naturally in July of 2022. To say we were blown away to fall pregnant is an understatement. We were shocked and I was only a few days short of turning 45. It felt like a real life miracle.

Sadly, the miracle pregnancy didn’t last and we miscarried at home at 9 weeks gestation on August 29, 2022. Because we believed that God had answered our prayers and provided us with our miracle final El baby, this was a particularly devastating time for us. As the momma of all of my children, I felt like it was one more loss that we all endured and it was just too much.

Moving back in time a bit to July of 2022, to just before finding out we were pregnant when I started a new job. This job is an incredible opportunity for me. I learned of this position in June when I was contacted by a recruiter and sent the job description. It was full time, at an amazing Episcopal Church, and with a job description that fits so many of my job skills. It was perfect! One funny part of the interview was when I was asked if I was okay not singing and leading worship with the band, as that was not part of the job description. I answered simply that The Lord always provides a place for me to use my gifts. In the very next part of the interview I was asked if I would be okay singing, as that was definitely going to be something they would want me to do when possible. I smiled and said, “of course!”

I learned during my first week at my new job that fertility coverage was part of the benefits package. When Mary-Linda died and we were trying to conceive, I often thought about IVF and fertility treatments. However, without insurance coverage, the cost was too prohibitive and honestly, impossible. It seemed to be even more of a miracle that I now had fertility coverage and didn’t need it, because I was pregnant naturally at 44 years old!

Obviously, things did not work out with that pregnancy, nor the next one. We did a couple of cycles trying via IUI and monitored cycles with no success. Finally, in March of this year, we began the IVF process. I feel incredibly blessed to be in a position to try to conceive this way at my age. We were not successful during our first attempt, however this is how it went:

For the March cycle, I started on suppression meds as soon as my cycle began. This is to keep my body from having only one or two dominant follicles. Apparently, this also helps the patient be on a schedule with the fertility clinic, so they can start many patients on fertility meds at the same time. *I requested to not be put on birth control again, after this first cycle. When it was time for the suppression check I had a small cyst on my left ovary. My hormone levels were checked and I was given clearance to move forward with IVF stimulation meds.

We did not end up having an embryo at the end of our first IVF cycle. However, here is what happened:

Once we started the Stim meds, I took:

• Gonal 225 units in the am for 10 days (injection)
• Dexamethasone in the am for 10 days (pill)
• Menopur (3 vials) in the pm for 9 days (injection)
• Cetrotide to prevent ovulation prior to trigger starting on day 5 through day 10 (injection)
• Triggered with Pregnyl the evening of Day 10 (injection)

I responded fairly well. I had a cyst on my left ovary measuring 18.9 at the beginning of the cycle. However, my estrogen was in normal range, so we continued. 5 follicles (including the cyst were seen at the suppression check) On day 5 of stim meds, I had three follicles measuring 9, 10 & 13mm. We started Cetrotide in the evenings on day 5 to prevent early ovulation. On day 7 of stim meds, I had four follicles on my right ovary measuring 10.6-14.4. At this point we moved to daily labs and ultrasounds and by day 10 of stim meds, 7 follicles measured between 10.3-19.8mm (I think the 19.8 was the cyst, but not sure)

We triggered that night with Ovadrel (hcg), had labs the next morning and the egg retrieval the following morning. We had 7 eggs retrieved in total. 5 of them were mature and 5 fertilized with my husband’s sperm. One made it to day 6 and began to disintegrate at that point. We met with our fertility doctor and he was very pleased with how well I did. He said I responded like a young 39 year old! 💫

After a failed IVF cycle, it’s good to regroup with your doc and discuss the plan moving forward. We decided that we would try twice more before my birthday. I will turn 46 and at that point, my fertility clinic will not retrieve any more eggs. I feel good about trying and knowing we did all we could.

Our second IVF cycle followed the same meds and protocols. On day five of stim meds, the ultrasound revealed 7 follicles growing and measuring 9.7 10 15 12.6 14.1 12.3 10.8mm. We all thought this was fantastic and awesome that we weren’t dealing with a cyst on one side this time. By day 7, I had 3 follicles measuring over 16mm, so we added the Cetrotide to prevent early ovulation. This time we triggered on Day 9, when I had 5 follicles measuring over 17mm.

The egg retrieval was a success. We retrieved 11 eggs- 5 mature and 4 fertilized. And one made it to blast! That little embryo is was frozen and a sample of cells was sent to be tested. Unfortunately, the embryo was not compatible with life. we await test results. We found out the test results during our third and final round of IVF.

Our third and final IVF stimulation cycle had the best results of the three. On the day of trigger (day 9 of stim meds) I had 9 follicles measuring 13-18mm. We triggered that evening (Thursday) and went in for blood work the next morning to confirm that the trigger was absorbed in the body. Results were good. We had our egg retrieval early Saturday morning and retrieved 9 eggs. Of those 9, 7 were mature and injected with my husband’s sperm and all seven fertilized. The embryologists watched them for the next 5 days and any that develop to day 6 would be frozen and a sample will be sent off for testing. We are praying for a healthy embryo. We had one embryo make it to testing. May God help our little embryo.