August 12, 2016 I went to the OBGYN for a regular well woman visit. Everything went pretty good ( as good as a GYN visit could go). When my doctor asked me if I had any questions I said “Yeah, um you know I’m 35 and I want to know what it looks like for me having kids this late?”
Doc: “ Have you been trying?”
“No, I haven’t been pregnant, I just know chances get slimmer as I get older…”
‘Okay, I’ll send you to lab for some blood work, and AMH which is Anti Mullerian Hormone, and if it is low then I’ll get you over to the fertility clinic.”
“Okay!” I said… and then then the downward spiral began.
I saw the fertility specialist Dr. Z on the 19th of September. He is the one who helped me realize why I was so tired and informed me that I have insulin resistance.
“Great,” I thought, we know what the problem is, this can be fixed with some meds.” That day I was fortunately able to have my first trans vaginal ultrasound to scan for follicles. I was put on Vitamin D3 for a few months and then started Metformin December 2016 and referred to an endocrinologist.
I had not told my parents anything for months. I think I told my mother around November of 2016 and only because my family was coming to town for a wedding and I was just not myself and I was taking some medications. I knew she would know something was wrong and I just told her to so that I wasn’t facing a barrage of questions when they did come. My brother and one of my Aunts also knew. I happened to tell them the day I got the news from doctor Z from that first appointment, on the way to a work conference, which made the conference just plain suck!
By my December visits, my weight was dropping, my sleep got better and I was feeling a lot better than I had in at least 2 years. I was exercising more regularly. I felt like I was really making progress. In the meantime, I had trans vaginal ultrasounds and appointments with Doc Z’s office and an increase in metformin dose. In December, I saw the endocrinologist; who—I felt—was not incredibly attentive to me for a first time visit. Everything with the endocrinologist was about weight and diet and for the life of me I could not get him to listen to me; about the changes I made in the last few months, or the weight that I had lost. Needless to say I didn’t go to him for the 3mo follow up. The last appointment I had with Dr. Z was on Feb 2017. At this appointment, I was told that I had no real chance of getting my own eggs, since every ultrasound showed 0-1 follicle. He told me that I would have to have a donor egg, which is not what I wanted at all. At this time, I was 36 years old. I decided to give going to the doctors’ offices a break and gave myself a mental break for a couple months. In reality, I seriously lived in denial. I wasn’t any happier in denial, I just didn’t know what to do.
From Feb 2017 to maybe early April 2017 I saw no one—not even a therapist (none of the doctors referred me to anyone). I just worked and came home. I didn’t even have brunches or go out much. I was broke honestly. My insurance didn’t pay for fertility appointments, so the majority of it was out of pocket. The emotional pain of it all really was taking a toll on me.
Then one day in April at church, during announcements, I saw that there was a support group for people who wanted to be parents and they were going to present all the options that they could to help people become parents. It was very informative and I was able to meet a physician who I felt would give me a chance. There I met Dr. N. A woman who is also of African descent, and I felt more comfortable with her.
My first appointment with Dr. N was great. She listened to me. She was excited to help me. I felt that she was very aggressive with my treatment. She kept me on my metformin, she prescribed more supplements and acupuncture. By this time, I had been practicing Yoga regularly and feeling even better. She was so encouraging and she was hopeful for me! I felt like I had a chance. Under her care, I had ultrasounds that showed between 3 and at most 8 follicles total. I wanted so badly to start with this office, but the cost was astronomical to me ( even with my military/veterans discount) , I had to tell them I needed to wait, when they suggested that I start stimulation meds.
I took a break again, but it wasn’t long. I had started a new job and well, you know… insurance—STILL DIDN’T COVER IVF. I had to continue to try to figure it out. So I was fiscally prudent, saving whatever I could from every check to make a difference.
Did I mention that I didn’t have and still don’t have an active partner in all this?
Dr. N’s office wanted me to see a financial counselor who presented all my options to include a donor egg (again) because Dr. N. wanted to be prepared for that, but lucky for me, she was willing to try even with a few follicles. So, I listened to the counselor. She quoted me about 17K, but with my veteran status, I got 5k knocked off. It was still too pricey for me to handle on my own. By this time, it was May 2018 and again—I was stuck.
When I got that quote, I happened to have the day off. I spent it mulling over all the numbers, all day until… I. Broke. Down. It was a slow cry… then a wailing that I could never believe would come out of my body… to an out right yelling at God, asking what I did to deserve all of this?
What could I have done? I obeyed my parents, I finished all of my school with two bachelor degrees even! How is it that people who hurt their children can continue to make them and I can’t even have one?
I called my cousin and asked her to come because I couldn’t take it any longer. She helped as much as she could with prayer and a clearer head than I had to see what it was that I could do to reach my dream. I didn’t want to take a loan. I was very close to being out of debt and it was just a daunting task to even start looking. That’s when I went back to my therapist ( who I saw for career counseling) and began seeing her for this whole issue, monthly.
In the month of June, I had a health fair with a local non-profit I helped to lead. We have so many health professionals in this group and one of the nurse practitioners I know asked how I was doing and what was going on with my IVF journey? She knew of my and a few others fertility issues and suggested that I look overseas. She actually had a patient who went to Mexico. She said that when they went, it was significantly cheaper getting treatment in than in America. That it was just like “destination surgery” places and that they promote relaxation which promotes healing. I said I would look into it. The day after the health fair, I got right on the laptop and started my search.
I looked at the clinic in Mexico, but I was not convinced that it was the place for me, so I continued and Barbados came up on the search. It definitely sparked my interest, so I investigated more. I found that they were Joint Commission International Certified and that their success rates were overall higher than the United States clinics. They had complimenting treatments such as massage and acupuncture to help with the process of IVF from beginning to end.
I called the Barbados Fertility Clinic. I talked to the coordinator who took me step by step through how the process works with treatment abroad. Then I prayed about it. Not because I didn’t know if I wanted to go there, but because I still needed the money. But I knew that by that time I wanted to go, I would have at least enough for treatment. You see, what was different about this place was that they were transparent. They post the costs on line. They help the (potential) patients prepare. I felt that previous offices didn’t tell you what you were getting into cost-wise until you were convinced they were your only hope. I won’t dwell on it , but I honestly missed opportunities I wish I had found this sooner. Anyway I talked to my parents and some family about going to Barbados in June.
There was frustration in all of the questions that they asked—questions that I already answered for myself; that’s the beauty of being a healthcare provider; however I understood their concerns.
By the first week of July 2018 I knew where I was going to have my treatment. In August, I deciding on when I was going to go to Barbados, what meds I was going to need and who was going to have to go with me. I also had to have an appointment for another well woman exam for the clinic. Even though literature states now that PAPs are not needed as often as yearly, the Barbados Clinic needed current medical records: labs, PAPs and ultrasounds, etc. My OB/Gyn was willing to do this for me. She had not heard of anyone going to Barbados for IVF and seemed excited for me that I chose this place.
I set the time for my treatment for early November. The end of August 2018 I started looking for sperm donor companies. That was hard. Some people said it was going to be fun, but it wasn’t. In September 2018, I finally found a loan to supplement my savings. My clinic sent my scripts and my parents had decided that my dad would go with me because he’s retired and my mom still works. I went back home to my parents’ for a mini vacation and found a great amount of time to choose my donor and to order my medications. I ordered the meds from the UK (it was cheaper and they had all the meds I needed in one place). It was honestly the best time I could have ever spent organizing myself for this experience. I think this is where I kicked into gear.
I sent at least half the money for the treatment and all money for the medications during this time away. I got my medications about 2 weeks later. I am happy that I took time to do those two things. I could not see myself thinking clearly at my house between work and other duties.
When I got back from my break, My IVF coordinator emailed my schedule of when I would start my meds. I was not scared at all of needles or pills. My only concerns were would this work and would I give my medications to myself the right way? In my mind I said “ I’ll just do it like I’m teaching my patients!” This worked for me, because I strive to teach the best I can, so why not treat myself the best I could, the same as my patients?
As busy as October 2018 was, I began my countdown. I purchased round trip tickets for my dad to meet me in Houston, I also completed payment for the treatment and the vacation package. I think I threw in some Christmas tickets to fly home as well—they were on sale, why not?
By this time a few more people knew I was going to Barbados, but as my date grew near, I was trying to figure out ways to inform the rest of my family. On my days off of work, I made sure I scheduled bill payments, explored options of the complimenting treatment packages and made sure I had cash for those and still try to work and put away money. I wanted to make sure I had a plan for our meals and maybe fit in an tour of the country or some activity that was not all IVF related.
As stressful as it was, I got it all done and I felt accomplished. This was so much work and I organized it, on my end, on my own! From my friends and family, I received so much support and love, and good vibes. I was not truly excited until dad and I go on the plane. It was at that point that it got real! All I thought was “with direction by God, the science of the medicine and my physical body showing up I can come home pregnant! “
AS I write this It is now 3 days until my Two Week Wait is over. I don’t plan on telling a lot of people, just my immediate family and a few friends.
I decided to work on Instagram to help others through this issue of Infertility. Though this is an issue that many men and women face. I could not find information 2 years ago on Black Women and Infertility. Now there are short articles everywhere. I have big plans for my platform to not only help women, but to specifically help Black women. As a nurse and a lover of science I have read a lot on the why my specific group has issues conceiving, but I have not seen evidence and much is speculative. I want facts. I want to help heal the pain of dealing with this alone. I want our groups to stopped being overlooked when it comes to issues of our health.
You can follow Nikki's journey to mamahood on Instagram at mochababy18