What we learned from our friend, Sheena

Dr. Rink Murray,
Tennessee Reproductive Medicine

There is a common statistic thrown around by fertility specialists, saying that 85% of couples with infertility will be able to get pregnant.  The truth of the matter is that we would have an even higher percentage if every patient were like Sheena.

Sheena is a truly special young lady, and I will never forget the first time I met her. She had been trying to get pregnant for several years and had quite a story to tell. We talked through the details and agreed that we would not leave any stone unturned, and I promised to give her the best information possible so that she could make the best decisions possible.

As it turned out, one of Sheena’s main problems was the thinning of her uterine lining. We worked with Sheena for more than a year trying various treatments to help her uterine lining grow and to help her conceive again. 

Most patients are easily managed by standard protocols, but Sheena’s uterus was different.  We worked through the setbacks and disappointments, but our goals were clear, and we were open to trying novel, less conventional options in light of her very unique case.

As a result, we expanded our thinking and had to get creative. We considered acupuncture, Viagra, and long-dose estrogen replacement.   At first, we could get the lining to grow, but these initial treatments interfered with egg growth and standard medications.

With each variation, we sat down and talked about her response. We reviewed what happened, why it happened, and how we might improve the odds of her conceiving.  That is how we identified the perfect treatment for Sheena.

The treatment we developed was a novel regimen, used by very few infertility specialists previously, but it made perfect biological sense in Sheena’s case. We started by stimulating her uterine lining for months with estrogen and Viagra. Viagra increased blood flow, and her uterine lining slowly grew to the appropriate thickness.

When we started gonadotropins (fertility shots), she initially did not respond. However, we determined that the long-standing action of estrogen had suppressed her ovaries and had caused her eggs to become unresponsive. So we primed her ovaries with low-dose hormone treatment for two weeks and then increased the fertility shots.

Her protocol was aggressive and it worked—almost too well.

Her first pregnancy ultrasound showed four sacs, and three appeared to be viable pregnancies! I had always prided myself on a very low triplet rate, and Sheena’s treatment outcome was a real double-edged sword. I was happy for her yet worried about her health and the outcome for the babies. 

After years of failure, a challenging uterus, and multiple failed IUIs, Sheena’s chances for twins as a result of her fertility shots should have been significantly lower, but there she was with triplets. Ultimately, the third pregnancy stopped growing, and she ended up with a healthy twin pregnancy, which was good in the long run because it gave Sheena the best chance for a healthy pregnancy.

I really admire Sheena and her husband. She was here so frequently that she became part of the TRM family, and everyone was rooting so hard for them to get pregnant.

Many patients would have given up long before Sheena, but she just didn’t quit. She gives TRM the credit in her story, but her iron will and supportive husband were just as important for their successful pregnancy.  Her story is inspirational to all and extremely informative for anyone who is facing the challenges of infertility.

Why TRM Is Different
Sheena mentioned that TRM had become family in her story, and it is our sincere hope that every patient will feel that way.  Dr. Scotchie and I are always there for emotional support, and Sheena’s story makes it perfectly clear that building a strong relationship with the patient increases her odds of conception.

Of course, the entire TRM staff does a lot of hand-holding, including patient education. They contribute to the rewarding experience at Tennessee Reproductive Medicine. Dr. Scotchie and I firmly believe that patients need to see their reproductive doctor frequently.  This means that one of us is present for every ultrasound, every IUI, and every procedure. As it did in Sheena’s case, this gives us the opportunity to consider each patient’s findings in context and better understand the options. This also helps us track our patient’s “emotional barometer,” which is essential to understand how much a patient can tolerate and how aggressive she should be.