Dr. Jeff Wang’s Kindness Makes the Different for Patient

Greta is a Sher patient who through Share Your Story talked about her time spent with Dr. Jeff Wang and how his, and the clinic’s, kindness made a big difference in her care.

My husband and I met when I was in my late 30s, and we began trying to conceive in December 2011, shortly after I turned 41. For that first year, we tried naturally, on the advice of my PCP. She recommended trying for a year before moving on to ART treatments, and suggested Chinese Herbs and homeopathic remedies. I also started acupuncture. I had one chemical pregnancy at the end of that year.

In January 2013, we went to Australia (where I grew up) to get married. A few days later, we started IVF there. In my first cycle, we collected three Day 5 embryos, and I got pregnant with the fresh transfer of one. However, I miscarried at 8.5 weeks, and then had to have a D&C afterwards. It was traumatic. A couple of months after that, we tried again with an FET of one more embryo. (Australian health policy discourages the transfer of more than 1 embryo at a time). Unfortunately, the transfer didn’t stick. My doctor there transferred our third and final frozen embryo, prescribed blood thinners for the long flight and we returned to NYC. Back in America we found out there that I’d had another chemical pregnancy. After that, we tried “naturally” using Clomid for 4 months, all with negative results.

In November 2013 we returned to Australia to try a second stim cycle and collected two Day 6 embryos. We froze one, transferred one fresh and I flew back to NYC. I found out just before Xmas 2013 that I had had another chemical pregnancy.

It was a bleak holiday season. I felt angry, depressed and frustrated with my body. Despite the statistics we’d been told about women my age and pregnancy, this was not at all what I’d expected would happen. I thought, ever optimistic, that somehow we’d be lucky. Diagnosed with “unexplained infertility,” it seemed that aging, poor quality eggs were the cause of our problems. Still with a good number of eggs in reserve, we were just looking for one good quality egg, like a needle in a haystack.

Around the same time that I was experiencing this depression and sadness, I was told by a friend about the website Resolve.org and the forum on it called Inspire. There I began researching our options for doing IVF in the USA. I found the members of that online community extremely supportive, encouraging and helpful. I learned so much. There was one woman in particular whom I met with for coffee, who recommended I look into working with Dr. Jeff Wang at SIRM. We began to look into that and made an appointment for March 2014.

Meanwhile, I really needed some time off from TTC, and I immersed myself in musical projects and traveling in Jan/Feb 2014. It was an amazing relief to take some time off, regroup, reconnect with my body, and focus on feeling grateful for all that I had. I came to realize that motherhood for me was only visible to me over a huge wall that I had yet to climb. The wall seemed large and insurmountable, even though so many friends and family around me had leaped over it easily. I processed and learned a lot during this period of time. Mainly, the time off gave me the energy and will to keep trying.

In March 2014 (I was now 43) we met with Dr. Wang and almost immediately experienced a surge of hope. He spoke with us empathetically, intelligently, and realistically. He helped us to craft a plan for achieving success with IVF. We decided to try “embryo banking” over several stim cycles, and to genetically test each embryo in batches before transferring any more. Over the coming months we had varying but generally good results from our stim cycles. Our successful egg retrievals were due both to good fortune (my AMH and FSH levels were good for my age) and to Dr. Wang’s ability to tweak our stimulation protocol based on how my body reacted.

I don’t know if it helped, but throughout this process I was taking a number of supplements. These were supplements recommended by Doctor Wang, or that I discussed with him after reading studies published online or discussed on Resolve. At various times throughout the year I was taking DHEA, Ubiquinol (CoQ10), Vitamin D, Vitamin C, Pre-natal, a concentrated supplement of folic acid and other B vitamins, melatonin, Inositol and more. Throughout that year, we retrieved over 140 eggs over five stim cycles. We started with an antagonist protocol for the first 3 cycles, plus added HGH (steroid) for the latter two of those. Then we switched to micro-dose Lupron cycle, followed finally by a long Lupron cycle. We made 11 embryos, tested 9 and out of those, we found 1 PGS normal embryo. So – out of 140 eggs, came 1 potentially good embryo, according to testing. We also had two “inconclusive” embryos on which the testing lab could not complete satisfactory testing. These two embryos were given about a 1 in 8 chance of being genetically normal. We kept them frozen.

During the year, I had also done a lot of research on Resolve.org about other possible conditions (eg. Immune issues or problems with my uterus) that might have been contributing to our infertility, even though we were pretty sure it was just my age and thus poor egg quality that was the issue. Dr. Wang found and removed some scarring on my uterus (a result of the D&C the year before). We also did a test called an E-Tegrity test, which checks for the level of the protein Integrin at a crucial point in the menstrual cycle, which is necessary for implantation to occur. This test was not covered by my insurance, but we opted to do it anyway (I believe it’s only offered by one clinic in the US, and it cost us $615 out of pocket). We discovered that I indeed had a borderline deficiency. Dr. Wang treated it (with antibiotics and Leterozole) and the following month we retested and my levels had dramatically improved.

By December, we felt that we had done everything we could to address any issues affecting my body and health, in addition to retrieving all those eggs. We had worked hard! It was time to transfer. We decided, after much deliberation, to lead with our strongest candidate – so we transferred our one and only PGS normal embryo, which we knew from the chromosomal testing was male. We also threw in one “inconclusive” embryo.

Leading up to the FET, Dr Wang put me on the antibiotics / Leterozole again, plus I started intrallipid infusions at Sher (infusions of soy bean & egg oil) plus Prednisone – even though no immune issues had been detected – just in case they had slipped through the cracks. I also decided to do everything I had heard of that might help chances of implantation, so long as it wasn’t harmful: I cut out gluten, dairy, sugar, alcohol, and caffeine from my diet. I went to acupuncture regularly (after I found a fantastic fertility specialist named Dr. Yan Wu who works down the road from Sher in NYC). I ate and drank foods to try to thicken my uterine lining (pomegranate, yam, walnuts, meat broths, brazil nuts). I did yoga, I rpeated mantras, I did everything I could think of. We transferred on December 17. I am now 36 weeks pregnant …. with a girl! So it must have been the PGS “inconclusive” embryo that stuck after all.

Finding others going through similar struggles – sharing your journey with them. I cannot say enough good things about Resolve.org/ Inspire and the ladies I’ve met there online and in person. Arming yourself with as much information as you can, and being your own advocate, in addition to finding professionals and doctors to help you. Every positive, kind word that someone else has shared with me has helped me keep going on this long, difficult path. Surrounding yourself with a community of positive, encouraging , hopeful, optimistic friends and family that you can talk to about your struggles really helps you feel less alone. Unfortunately, I feel that infertility is still such a taboo subject and we need to be talking about it more openly, so that those experiencing it don’t feel as isolated. Also, I highly recommend taking some time off trying if it’s not working and you are getting depressed, angry, frustrated. Vacations help. Therapy helps. Mediation and yoga help. Comedy TV shows help.

Something that someone said to me during this process, which was very helpful, was: If you really want to be a mother, you will be a mother. These days, there are many ways to get there. This helped me because, at times when things weren’t working out, sometimes I heard “it’s just not meant to be”, “you’re not worthy of becoming a mother” or “why bother trying – you’re obviously too old” and other negative voices in my head (and sometimes in reality, from others around me). So while you are trying to make it happen, I would recommend that you try to be as kind, gentle and easy on yourself as possible. Pamper yourself if you get a bad result or are having a bad day. Celebrate every tiny victory along the way. Infertility is so incredibly hard. But we are so lucky to live in a time of incredible choices / options.

I also think it really helps to always have a plan for what to do next, if things aren’t working out. It can be overwhelmingly frustrating to go through failed cycles month after month. It’s necessary to know, in concrete terms, what you’ll do next to tackle the infertility. It takes the pressure off each cycle, and allows you to be more “in the moment” with the process. There were so many times that I thought “this is never going to happen”, but having a plan to keep trying – despite the negative thoughts I was having – really helped me stay on track. If our FET had not worked, we probably would have started looking into a donor egg cycle. I was preparing for that, even though that wasn’t what I had wanted initially. I had talked about it, thought it through, worked through a kind of grief (in advance) for my lack of good eggs. I was ready to use a egg donor if necessary, as the next step in our plan.

From our first meeting with him, my husband and I were immediately struck by Dr. Jeff Wang’s incredible kindness, intelligence and pragmatism in assessing our situation. He inspired hope but also instilled a grounded sense of realism at all times. He felt like our friend immediately. Throughout the months we worked with him, we went through many ups and downs with the cycles – it was a difficult time and I had a few meltdowns – but he always kept us feeling hopeful, whilst doing an impeccable job as a doctor. I was impressed that he did all of the monitoring of the cycles, in addition to the egg retrievals, other surgery and transfer – and did everything extremely well and helped me feel at ease throughout. He was also astoundingly responsive to any questions we had via email, at any time of the day. All of the nurses were also very friendly, kind and made me feel at ease. And from the moment we walked in, the receptionists and other admin staff were great too.

I’m perhaps a little older than most women I have met who have embarked on IVF. I hope that my story – that I am pregnant with my own egg at age 43, thanks to Dr Wang and everyone at Sher – will inspire others to keep trying. I am also aware that I am lucky to have produced an unusual number of eggs for my age (even though we found very few good ones). I’ve met many women who struggle with diminished ovarian reserve, and I know that Dr. Wang /Sher has helped many of these women, and others with different fertility challenges, get pregnant too.

Learn more about Dr. Jeff Wang

Greta1

The happy mommy to be!