Part Three: The Next Generation

Building Life

By Eileen Metheny Carlton

 

Married on Sept. 4, 2004, Yvonne and Mark, 48, Matsko knew they wanted children soon after the wedding bells tolled. But a little over a year passed with no success.

The Arlington couple began working with Dr. Andrea Williams, an ob-gyn at Women to Women Complete OB/GYN Care in Arlington. They learned that Yvonne, 38, had an elevated thyroid hormone, TSH, which is a thyroid-stimulating key to reproductive levels. She was referred to an endocrinologist who diagnosed Yvonne as having a hyperthyroid disorder known as Hashimoto disease. Williams started her on chlomid, an ovarian stimulation drug, and Yvonne did get pregnant, but had a miscarriage very early in the pregnancy.

After Williams prescribed another round of chlomid that was met with no success, she referred Yvonne to Dr. Paulette Browne, a board-certified specialist in obstetrics, gynecology and reproductive endocrinology who is on staff at the Shady Grove Fertility Center at Fair Oaks.

“People put their hopes and dreams into this, and to be able to help them do this, well, I have the best job in the world,” Browne says.

Shady Grove has 11 facilities and four satellite offices throughout the Metro-D.C. area. The staff includes sub-specialty trained reproductive endocrinologists, physicians, embryologists and geneticists. Among the procedures and programs offered through Shady Grove are intrauterine insemination, in vitro fertilization (IVF) and a donor egg program.

Statistics show that 20 percent of the world’s population has fertility problems. “We do donor eggs for people between the ages of 44 and 51,” says Browne, who estimates she sees roughly 1,000 patients a year who are between the ages of 22 and 51. “We see everything, every single possible criteria distributed throughout the population.”

Browne ran pre-diagnostic tests and was also stymied as to why Yvonne could not get pregnant. The next step was three intrauterine inseminations, after which Yvonne again miscarried in the very early stages of pregnancy. She then moved on to IVF procedures. The first two cycles with this procedure were not successful. Genetic testing was added to the mix during the third attempt, which proved successful.

That was in June of 2007. Browne notified Yvonne she was pregnant July 4.

Yvonne said it was an easy pregnancy, with minimal nausea. Toward the end, her blood pressure began to spike, so she was monitored on a weekly basis.

Following a recommendation for her to have a C-section procedure, Yvonne was admitted to Virginia Hospital Center in late February to give birth to her children. Annika weighed 4 pounds, 14 ounces; and Kyle weighed 6 pounds, 5 ounces.

“I think that it is critical to have a good relationship with all of the doctors who are involved because it’s a team effort,” Yvonne says of reproductive procedures. She also cautions that the experience is a huge emotional, physical and financial roller coaster.

“You get pregnant, then you start bleeding. You get the news you’re not pregnant. Physically, it’s a roller coaster because of the medications, tons of medications, some orally, some injections. Your body becomes a human pin cushion. Your body is going through a lot. They extract eggs which is, in itself, a minor surgery. … It’s physical, emotional, and it’s also financial,” Yvonne explains.

Insurance plays a large role in whether or not a couple can take advantage of assisted reproductive technologies, since the procedures are expensive, and only a limited number of people can afford to pay the full cost out of their own pockets.

According to data provided by Shady Grove, fertility treatment can cost anywhere from $1,000 to 18,000, depending on the patient’s diagnosis and the procedures performed.

Shady Grove does offer a program called Shared Risk, a financial option based on the premise that if the treatments are not successful, the center absorbs all costs. Couples are required to meet eligibility criteria: Women must be under the age of 39, but women over 39 may participate if they are using Shared Risk with donor eggs; couples choosing this plan may attempt up to six IVF or donor egg cycles for a flat fee.

“Virginia is not very friendly, not very proactive with supporting infertility treatments” Browne says. “Some employers offer fertility care. Fairfax County, for example, offers it. Treatment can be expensive. People can’t afford it, and I don’t want to see it become a situation where only rich people who have cash can afford fertility treatments.”

(February 2010)