April 23, 2014

National Infertility Awareness Week: Dr. Eve Feinberg's Story

People often ask me if I went into the field of reproductive medicine because I was infertile.  I actually think the opposite was true, I became infertile because of my medical training.

How It All Started
I met my husband in high school. We dated for 10 years before getting married.  I have always considered myself a healthy person. I am athletic, I work out, I eat well and am a normal weight. When I started medical school, I was extremely stressed out.  I went from living in a cozy apartment surrounded by good friends to living on my own in a studio apartment in the heart of downtown Chicago.  Classes went on for 10 hours a day and I was up most nights well past midnight studying.


Months after I started medical school I noticed that my period, which had always been fairly regular, suddenly disappeared. 5 home pregnancy tests and a doctor’s visit later I was diagnosed with hypothalamic amenorrhea, stress induced loss of period.  I was started on birth control pills to regulate my cycles and told not to worry about a thing, all would normalize one day. Fast forward 6 years, I was married for 3 years and we decided to try and start our family. I went off the pill and still had no period. I was working 100hours/week with irregular sleep patterns.  There were weeks on end I worked from 5PM – 7AM and then would flip back to a regular sleep schedule on the weekends. There was no end in sight; I still had 1 more year of residency before my schedule would potentially normalize. I was busy and while I really wanted to get pregnant, I just did not have the mental energy to devote to the process.

I finished my residency training and moved to Washington DC to begin my fellowship training in Reproductive Endocrinology and Infertility.   My schedule normalized but my periods did not.  I decided it was time to take action and sought the help of a trusted colleague and friend.  I used the same mental strength that had gotten me through sleepless nights, 36 hour shifts and marathon study sessions to carry me through fertility treatments.

Time For Fertility Treatments
Fertility treatments were a challenge on multiple levels. I found it extremely difficult to not exercise.   For me, running is therapeutic. It’s the time when I feel most at peace and most connected with my inner voice. With each passing month of not exercising and eating more (high progesterone levels are an appetite stimulant) I found I was starting to look pregnant. Colleagues were gossiping and family members were suspicious.  The hormone shifts were terrible and I found days where I would literally burst into tears over minute issues.

With the help of Clomid followed by 21 days of injectable gonadotropins, I finally conceived.  I went on to have an uneventful pregnancy and healthy newborn baby girl. My fertility journey, however, did not end there. When my daughter was 18 months old, we began trying for a second. I was now back in Chicago and had joined my current practice. Getting pregnant was way more challenging the second time around. After 7 grueling months of injectable gonadotropins, I finally conceived again. The ultrasound did not look normal from the very first scan. Sometimes knowing too much is not a good thing. I went on to miscarry at 8 weeks and had a D&C. As soon as my hCG levels dropped, we tried again. Another 6 months and I failed to conceive. I was tired, frustrated and never felt more isolated. The isolation could not have been more ironic as I am surrounded by infertiles. However, my world is focused on others. I could not and would not share my struggles with my patients. I was there to take care of them and not vice versa. Looking back, I am not sure how I held it together.

My husband and I eventually decided to pursue IVF and after another miscarriage we then made the decision to do pre-implantation genetic screening to test our embryos prior to implantation. I was going to be 35 and we decided to transfer 2 embryos. Both implanted and I went on to deliver healthy twins at 38 weeks without complications.

While trying to get pregnant, there were many days when I wanted to give up. Perhaps if I was not in the field, I would have given up. However, I kept asking myself whether I could continue to practice and help others if I quit? I could not. I drew strength from those around me. I laughed with my patients and I cried with them. Though they did not know it at the time, my patients helped me through those dark days. When they got pregnant, I rejoiced. I knew that the challenges I faced were all fixable and that I had the tools to overcome the issues.

How Infertility Helped Me
I know this sounds crazy, but I am thankful I struggled to conceive and went through the full range of infertility treatments. It has made me a more empathetic physician, a stronger individual, a better wife and a more appreciative mother to my children. I am thankful every day for my kids, the joy and laughter they bring and the fullness of life they create. On a fundamental level, I understood that all who want to become parents will become parents. It is just a matter of how and when. I know that now and I knew that then. I just had to remind myself of it on a continued basis.

Dr. Eve Feinberg is board certified in both Obstetrics and Gynecology and in Reproductive Endocrinology and Infertility (REI). She serves as the Medical Director for Fertility Centers of Illinois Center for Fertility Preservation. Dr. Feinberg is an Editor for Fertility and Sterility, she sits on the Practice Committee of the Society for Assisted Reproductive Technology and is on the Membership Committee for the Society for Reproductive Endocrinologists and Infertility Specialists. She has also published over a dozen research papers in peer-reviewed journals, has written book chapters and is a frequent media resource on the topics of infertility and fertility preservation.

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