"This article was previously published on Atrium Health's Daily Dose."
The Bouchard family recalls their fertility journey, and says it was hard to talk about. They didn't want to admit something might be wrong. After trying to have a baby for years, they turned to Atrium Health CMC Women's Institute for infertility and reproductive care and learned there was reason to have hope.
It was a five-year long emotional path to parenthood for Caroline and Robbie Bouchard. Five years of ups and downs and confusion as to why they couldn't conceive. And a lot of loneliness. "We didn't really talk about it," Caroline says. "It's hard to talk about and no one really seems to discuss infertility." In 2019 the Bouchard's met Dr. Ashley Eskew, who specializes in reproductive endocrinology and infertility (REI) at Atrium Health CMC Women's Institute. After speaking with Caroline and Robbie and gaining a better understanding of their family building goals, Eskew initiated a thorough infertility evaluation, and all the test results came back normal.
Unexplained Infertility
"It's called unexplained infertility," Eskew says. "It's one of the more common diagnoses we encounter. Approximately one in four couples with infertility will ultimately be diagnosed with unexplained infertility—where all the testing checks out normal and we can't necessarily pinpoint a single contributing factor to why they haven't conceived yet. And while it's reassuring on the one hand, it can also be extremely frustrating for couples. Thankfully, there is good data to show what treatment approaches are most effective for couples with this diagnosis."
It's not exactly what Caroline and Robbie wanted to hear. "It was frustrating because there was nothing Dr. Eskew could fix, but at the same time we were glad there was nothing wrong," Caroline said. "So, the next step was ovulation induction and intrauterine insemination (IUI)."
Intrauterine insemination is when highly concentrated sperm is placed in a catheter and the catheter is inserted into the uterus around the time of ovulation, which gets a higher concentration of the best sperm closer to the egg by bypassing the cervix (one of the biggest barriers to sperm penetration). It is a less invasive and less expensive procedure than in vitro fertilization (IVF) and is often the starting point for younger couples with unexplained infertility. "We did one round but then COVID-19 hit, so it was put on hold for a few months while the clinic was closed," Caroline adds. "That was actually a blessing in disguise because we could take some time off and not stress about it for a while." But after three rounds of IUI, the Bouchard's still didn't conceive.
Eskew adds, "Data has shown in couples with unexplained infertility, after three to four rounds of ovulation induction IUI, success rates start to decline which is when more advanced treatments like in vitro fertilization may be recommended."
The Decision to Move Forward
The Bouchard's almost didn't go through IVF. "It is a long financial, physical and mental commitment," Caroline says. "We took some time and eventually thought if we don't go through with this, we may regret it. But it was hard to stay hopeful, so they met with an IVF support coach. "It was so helpful. I learned that it is possible to experience joy even through what can be a heartbreaking journey. Just enjoy the process."
The process started in January of 2021 with minor surgery to retrieve her eggs, 55 of them, and inject them with Robbie's sperm to create the embryo and then implant one back into Caroline's uterus. After genetic testing she had five viable embryos in all-five chances at pregnancy. "During the embryo transfer an ultrasound is used and I could see the moment when the embryo was implanted into me. It's something that couples that conceive 'naturally' do not get to experience. Then we had to wait 10 days for the bloodwork to confirm if it worked or not."
The first attempt didn't work. "Unfortunately, it resulted in a chemical pregnancy," Eskew says. "The embryo started to implant but didn't continue to develop—an early type of miscarriage. But after some additional testing we moved forward with another embryo transfer."
Baby Louis
The second embryo was the charm. At 37 years old Caroline was finally pregnant. She graduated from Atrium Health CMC Women's Institute after eight weeks gestation and had what she thankfully calls an uneventful pregnancy. In May of 2022 precious Louis, pronounced Louie, was born. The Bouchard's are grateful for Eskew's treatment plan, support and personalized care, so much so they sent her a birth announcement.
"Caring for individuals and couples going through fertility treatment is one of the most rewarding but also challenging and humbling careers I could ask for. Seeing pictures of baby Louis, and hearing stories like Caroline and Robbie's is what keeps me so impassioned about what we do every day to help individuals and couples build their families—which is what it's all about. Hearing these types of stories also gives other couples hope and a sense of less loneliness."
Atrium Health offers a full spectrum of fertility and reproductive care to support couples and their dreams of growing a family. Learn more about our full line of reproductive services, fertility screenings and tests, and high-quality care and success rates here.
