Preserving my Fertility

by Gloria Montoya Solarte, Christine Pagé St-Cyr & Stacey Bolton

I had the honour of meeting these young ladies and hearing their amazing stories at the ISIVF Meeting held here in Montreal last fall. It is inspiring to think of what they have endured and the courage they have shown. I knew I had to ask them to share their experience, strength and hope with you. I salute these women who have overcome tremendous obstacles to preserve their fertility. - Bev Hanck

I am now 26 years old and studying electrical engineering at Concordia University. I would have already completed these studies had I not spent the last 8 years living with chronic pain, having multiple surgeries and countless treatments to treat a disease that eluded doctors. Endometriosis!

 

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 or 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 or commit to any event 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 hemorrhaging and losing 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 hematoma (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 neighbor, 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 anesthesia and for 2 weeks I had to clean the incision with an antiseptic which burned and stung.

 

After every surgery, I would feel better for a couple of months, but again, in July 2004, there was another painful development. The scar from my previous hematosalpix and hematoma issue had a strange pimple on it. Further investigation revealed that the doctor had to open the entire area around the scar immediately. Since there was no anesthesiologist 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 himself was stressed that he had to do this to me, stopping and saying “oh my God” between incisions. Once the entire area was opened 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 might 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 pain, 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 the possibility of being one 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 anesthesia, 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.