“Defining Moments”
The Knapp family and their little miracle, Hendrick; Pasadena, CA

In my 41 years I have known great joy and unspeakable sorrow. While this journey has the happiest of endings let me tell you how I got there. As I put words to paper this story seems unbelievable even to me. But it is my life blanket, woven together by threads of experience.

I was adopted at birth. That was the first of several defining moments in my life. I realized at a young age that families were created in different ways; an understanding that would serve me well four decades later.

My older brother and I were in a car accident when I was eleven and he, fifteen. He was killed and I spent a year in a body cast recovering from my injuries. That was defining moment number two. The childhood I’d known was over. And, at that tender, impressionable age, my heart was heavy, knowing that my children would never know him.

Fast forward to my completion of graduate school when I took an entry level job in the staffing industry and began a career with a trajectory that I couldn’t have imagined; defining moment number three. It would also delay my dream to be married with children by 30. I was young and healthy so I could hardly complain. My career spanned 11 years and I rose to Vice President. As a woman in a field largely dominated by men, I was proud of my accomplishments, awards, and promotions. I was also acutely aware that I was getting older, older than I thought I would be, without a boyfriend in sight, much less the prospect of having children.

At 33 I met the man I would marry. Interestingly, he was also adopted. We both shared the feeling of not having biological roots and wanted that connection with our own children. At 37 I was elated to discover I was pregnant. That elation was short-lived when I miscarried. Unbeknownst to me, fibroid tumors had grown into my uterus, forcing out any embryo trying to implant. I met with my OB to determine how to remove the fibroids without jeopardizing my fertility. He decided to remove them laparoscopically. The surgery was only partially successful and the threat of the fibroids coming back was high.

I conceived and suffered another miscarriage. My OB recommended trying again as “these things happen”. I managed to conceive a third time only to endure another miscarriage. It was becoming painfully clear that the fibroids were back and standing in the way of maintaining a pregnancy. I had an MRI to better visualize my uterus and requested a meeting with the radiologist to review the results. It was a cool fall evening when we met him at the hospital. He first put up slides of a normal uterus. Then he put up my slides. There was not even a visible outline of my uterus. And then he said these crushing words, “you have good ovaries but your uterus is compacted and severely distorted by fibroids. Have a hysterectomy and hire a surrogate.” I swallowed back the tears and numbly walked out to the car with my husband. Hysterectomy? Surrogate? Me?

I immediately sought the opinion of a renowned fibroid surgeon who, with great conviction, said he could remove my fibroids. But, at 39, even with a fibroid-free uterus, my fertility, based on my age alone, was questionable. I knew in that moment, defining moment number four, that the career I loved and had poured my talents into, was over. How could I undergo major surgery, recover and try to conceive, while managing a demanding career that required my full attention? I chose to retire and dedicate myself to having a baby.

I had the fibroids removed and then consulted with an RE. His recommendation was to proceed immediately to IVF. In fact, he was involved in a clinical trial sponsored by Ferring Pharmaceuticals to test a new form of progesterone. If I participated, the costs of the IVF cycle would be greatly reduced and the medications, Bravelle + Menopur, would be supplied by Ferring. I needed to decide immediately in order to secure a place. After three naturally conceived pregnancies I could not fathom that I would need artificial reproductive technology to have a baby. However, I knew the clock was ticking with no way to turn it back so my husband and I decided to proceed.

I responded well to treatment but was not successful in getting pregnant during the clinical trial. The good news was that I had three frozen embryos. The bad news was that my doctor was concerned about adhesions from my fibroid surgery and wanted to remove them. It was back to surgery as I rapidly approached my 40th birthday, a milestone, especially in the word of infertility.

The frozen embryo transfer that followed by recovery from surgery was also negative. I decided to postpone IVF #2 until after my 40th birthday celebration. In June, 2006 I cycled, again using Bravelle + Menopur. I utilized PGD (pre-implantation genetic diagnosis) and transferred two blastocysts. This time, success!

My pregnancy was fraught with peril. I had three major bleeding episodes during the first trimester. At 17 weeks my cervix began to dilate and funnel requiring an emergency cerclage. My OB bluntly told me he hoped we’d make it to 24 weeks, the minimum age of viability. I was put on strict bed rest at home—only allowed up to the bathroom and one, six minute shower every other day. The funneling persisted. At 24 weeks my OB said he hoped I’d get 28, and that every week thereafter would be a gift. I was blessed with many weeks thereafter.

On March 6, 2007, at 38 weeks and after five grueling months of bed rest, Hendrick Thomas (Thomas, after my brother) was born weighing 8 lbs 9 oz and measuring 22 inches. It was defining moment number five—the greatest, most humbling, deeply fulfilling, and worth-the-wait moment of all!