The Long Road to Motherhood - (Summer 2010)
Printer-friendly versionTHE LONG ROAD TO MOTHERHOOD
Gloria Montoya Solarte
PART I 2008
At 18, while living in my native Colombia, I began to experience severe menstrual cramps and heavy bleeding. Every month I would suffer for 4 to 5 days with heavy bleeding and such intense pain that I could not leave the house. I could not eat well. I was weak, dizzy; I would vomit, writhing in pain, covered in cold sweats. This would happen every time my menstrual cycle would begin and it would last for days. The pain could be slow and moderate, then it could come in waves and sometimes it could be unpredictably sharp and sudden. I began to dread that “time of the month”. I would not go out nor engage in any social activity. I was afraid I might have some important exam or function that coincided with my cycle. I could not plan nor commit to any events because I was not sure how I would be feeling.
In 1999 I had a sudden pain and saw many doctors who thought it was appendicitis. During one of the numerous medical tests I had endured, this time a laparoscopy, a cyst was discovered on my ovary. I had a laparotomy to remove the cyst. But there were complications: I ended up with internal haemorrhaging and lost my right ovary. For about a year and a half, my situation improved and the pain was more bearable.
But in June 2001, the pain returned and it was worse. Doctors diagnosed me with a hernia but a laparoscopy revealed that the problem was that there were adhesions and an accumulation of blood in the fallopian tube (a hematosalpix) so they severed the fallopian tube by way of a salpingectomy.
In July 2003, I started to experience more intense pain and nausea; I could not eat. A laparotomy (an operation to open the abdomen) revealed that I had adhesions from my left ovary to my intestines. I was told that this mysterious and cruel pain was due to endometriosis. I was also told that I may not be able to have children.
Fifteen days later I developed a haematoma (a localized swelling filled with blood resulting from a break in a blood vessel). I was experiencing a burning pain under my surgical scar. Despite repeated visits to the clinic with my complaint about this burning pain, no one took me seriously enough to treat me and they kept sending me home. One morning the pain was so intense that my neighbour, a doctor, had to come over to help me. He realized that the scar was opening and that there was fluid underneath it which was building up pressure. He could see the pain I was in. He had no choice but to make a small incision in the abdomen at the site of the scar. Fluid came gushing out; in fact, the scar had to be opened all the way and for over an hour he was draining the fluid. This was done with absolutely no anaesthesia and for two weeks I had to clean the incision with an antiseptic which burned this open wound.
After every surgery, I would feel better for couple of months, but again, in July 2004, there was another painful development. The scar from my previous hematosalpix and haematoma issue had a strange pimple on it. Further investigation revealed that the doctor would have to open the entire area around the scar immediately. Since there was no anaesthesiologist available, he had no choice and neither did I. I had to be held down by a nurse to restrain me from the reflex of the pain as the scalpel cut into my flesh around my lower abdomen. Even the surgeon was stressed that he had to do this to me, stopping and saying “oh my God” between incisions. Once the entire area was open there was a large structure that protruded outward and when he touched it I screamed in pain. This was the thing that had been hurting me lately. It turned out to be a part of my intestine (a fistula) that had fallen victim to the endometriosis. There was tissue wrapped around it, squeezing it and preventing me from eating and digesting.
A year later, I came to Canada as an exchange student. I was both excited and nervous. Excited to have the opportunity to study here but worried about how this pain may affect my life. I prayed that it would go away. I was alone here on a very modest student budget; I could not afford to interrupt my studies. But, in 2005, I found myself in such excruciating pain that I had to go to the hospital and Dr. Tulandi at the McGill University Health Centre (MUHC) confirmed that I had endometriosis, and recommended treatment with medication because he felt that I had gone through too many surgeries. He also told me that there might be a way to preserve my fertility but that I must see the fertility specialist before I started treatment. He sent me to Dr. Tan at the McGill Reproductive Centre (MRC) who evaluated my fertility. I was under so much stress at the time: I was alone in a foreign country, I had very little money, my studies were being interrupted by my condition, there was a strong possibility that I may never have children and I ached all the time. What’s more, my student visa was about to end. I was devastated. Family is the most important thing to me; it is part of my heritage. Up until now motherhood was not a priority to me. I don’t think most young people my age think about becoming parents until that possibility is threatened. My life’s dream included having my education, a husband, my own kids and my parents as grandparents. This is tradition in my culture; it is important to me, and now it was slipping away. I was depressed just thinking that I could never have my own little babies. I was living in a huge fragile bubble of uncertainty.
But Dr Tan provided me with a ray of hope. He said that there was a way to stimulate my remaining ovary to produce some eggs and these eggs could be frozen and fertilized later when I was ready to have a baby. My remaining ovary was failing fast and I had to do this procedure quickly.
At last some good news, but I still had the hurdle of how I was going to pay for this and whether I could even remain in Canada. I was overjoyed to learn that the McGill Reproductive Centre was able to help. McGill’s clinical psychologist, Dr. Takefman, listened to my story, and through my tears she understood how much I wanted to have my own children. She contacted my university and through the kindness and compassion of Concordia University and the MRC, my exchange program, as well as my student visa, was extended and they even helped me financially so that I could have the fertility preservation treatment that I needed.
As I said before, most people my age are not thinking about becoming parents. They are thinking about school, finding a good job or a having a career, spending time with friends, traveling – things like that. But then, most people have not lived with the kind of pain I have had… a pain so strong you need to take morphine to cope with it, a pain that made me tolerate a scalpel cutting through my abdomen without taking anaesthesia, a pain that robbed me of my confidence, my social activities and interfered with my studies. I had to deal with the threat of a disease that could prevent me from having a child one day, and I had to react and make decisions quickly.
I am grateful to the scientists and doctors who are working so hard in the area of reproductive medicine and fertility. I encourage you - implore you - to do more research into diseases like endometriosis. It is a devious disease, hard to diagnose, hard to treat. What’s more, there is no cure yet as it continues to threaten a woman’s fertility. Because of researchers and doctors like you, I have one less thing to worry about and I can have a family of my own someday. I can study without severe pain now, and actually go out. Thank God my family has always been on my side giving me love, care and emotional support in any decision that I make. I have found a wonderful man who has been with me during the process, supporting me and taking care of me. He shares my values about family. He too loves children and wants to be a father. We got married in December of 2007 as a symbol of our love for each other. Also, we both agree to start our family very soon. This will be possible because of the research in this field and the experts at the McGill Reproductive Centre.
PART II 2010
After three very difficult cycles of fertility preservation at the MRC, some positive results were finally obtained in February 2007. I should say they weren’t very encouraging, but nevertheless we had some hope. In my first cycle, four out of eight eggs were frozen, in my second one, five were collected, and out of those, four more were frozen. Finally, in my last cycle, 13 out of 16 eggs collected were successfully preserved. In my three cycles different protocols and medication were used. Whatever medication I used, I had to take the maximum dose. In total, I had 21 eggs frozen, to be used at the moment when my husband and I decided to try our luck.
My husband and I were married on December 29,, 2007, in Colombia. At the time, my husband had just begun his PhD in finance at Washington University in St. Louis, Missouri, and I was an independent student at Concordia University, following my two years as an exchange student.
During the period when my eggs were being collected, I couldn’t get any treatment for endometriosis, and my endometriosis got worse and worse. It came to a point where I couldn’t bear the pain, even though I was taking morphine. Dr. Tulandi prescribed me 3 injections of Lupron in 2-month intervals starting in April 2007. The Lupron prevented me from having my period, so the pain was somewhat less. However, I started having hot flashes, dry skin and a calcium deficiency. Then I started taking Marvelon contraceptive pills every day without any stop for as long as my period was suppressed. The doctors estimated that this treatment would remain effective for around eight months to one year.
In September 2008, I started bleeding with very bad cramps, and this went on for 42 days. With the guidance of Dr. Demirtas we decided that it was the best time to start a fresh cycle of IVF and try to have a baby. If I got pregnant, this would also help to treat my endometriosis.
Even before we began trying to get pregnant, I was very alone. I was attending all my classes as a full time student, I didn’t have any family in town and I had almost no friends. It was a very difficult time for me, and we were also very short on money. My husband and I were both paying international tuition fees – more than twice what local students pay. On top of all these challenges, we learned that we needed to try to get pregnant right away.
The MRC offered us free in vitro treatment with an ISIC injection and assisted hatching. However, we still had to pay for the medication, which was very expensive. My husband was studying in the USA, so he was not even in town. We had to have a sample of his sperm frozen in case he couldn’t be here the day of the egg collection and fertilization, and in the end he came here for a couple of days to do the fresh IVF cycle.
On November 21, 2008, on a Friday, we retrieved four eggs. Of those, two matured and were fertilized but only one became an embryo. The next day, a Saturday, we learned that we only had one embryo and my chances were really low because of the endometriosis. I had other problems as well, such as a thyroid disease. We were terribly upset and I cried so much. I felt as though the entire world was against me and my longing to have a child would never be fulfilled.
We called Dr. Tan and he decided to thaw three of the frozen eggs that we had kept. One more was successfully fertilized to become an embryo. On Sunday, these two embryos were transferred. We were all praying, along with our families; everyone supported us and shared our concerns.
The wait was very long; I was so stressed and worried – I was also writing my final exams at the university at this time. The day of my pregnancy test arrived. I was so anxious I could hardly speak. I was literally waiting for a miracle. It was December 5. The phone rang and it was one of the nurses from the MRC. My heart started beating faster than it ever had before.
God had listened to all of our prayers. He had given us what we were asking Him for. I was pregnant on the first try. We couldn’t believe it. There was so much excitement, so many plans to make and things to do. I had to start taking care of myself and the little one on the way.
During my pregnancy, a new problem surfaced. I found out that I am a carrier of Haemophilia A. We learned that our baby was a boy and that he had a fifty percent chance of being a haemophiliac. Obviously, there was no question of terminating my pregnancy or having tests that would put my baby’s life at risk. All we could do was hope for the best and prepare for the birth. Labour would be induced, and I would get a medication to prevent me from haemorrhaging. The blood in the umbilical cord would be tested and my baby would be kept in Intensive Neonatal Care until a cranial scan was performed and the results of the tests were obtained.
August 12, 2009, was the happiest day of our lives. After thirteen hours in labour, God sent His most precious angel to this world: my little miracle, Ozan David Kose-Montoya, was born. He was very healthy and did not have haemophilia. To be able, finally, to hold this beautiful baby in our arms and see his cute face made us forget about all the pain I had suffered for so long and every difficulty that we had been through. We persevered, we were courageous and no matter how bad times were, we always had hope and faith that our effort was worth it.
Today, our son is almost nine months old and we are enjoying every single day with him. We received our Quebec Selection Certificate in October 2009 and we are waiting to get our permanent residency, which we expect this summer. Now I know that coming to Canada was a blessing for me in every way. My husband is in his third year in his PhD program and he has two more years to go before he graduates. He comes and visits me and the baby as often as he can arrange to take a vacation. In fall of 2008, I transferred the credits for the courses that I had taken back in Colombia and decided to finish my degree in electrical engineering here in Montreal. I am graduating from Concordia University this June as an electrical engineer.
Endometriosis is a devious disease, hard to diagnose, hard to treat. What’s more, there is no cure yet. I am so grateful to the doctors and researchers who enabled me to survive this disease and to have a family against the odds. I am so lucky to have a family that is always on my side with love and support and to be married to a wonderful man who has supported me and cared for me throughout the process. I thank God, my family, the wonderful team at the McGill Reproductive Center, the clinic manager Anna Maria Henderson, Dr. Tan, Dr. Tulandi, Dr. Ezgi Demirtas, Dr. Elizur, Dr. Takefman, my Obstetrician Dr. Shrim, and Concordia University. My dream came true and I am truly grateful. All of you have a piece of my heart. I will never forget all you did for me, my husband Engin Kose and my little baby boy, Ozan David.