It was near the end of the afternoon. I was dealing with the typical catch up that punishes all of us for having the nerve to take a vacation for the holidays.

The medical assistant called in and told me that my next patient was ready to be seen. I looked at my schedule to see who it was and to my surprise it was a patient I knew very well after years of mutual struggle to help her conceive. I was surprised to see her on my schedule. For a moment a chill went down my back as I feared that maybe something bad had happened. I quickly looked at her chart to see what was going on. As is my custom, I clicked on her photograph before turning to her medical record. I knew what I would see before the picture loaded – a smiling face that never fails to lift my spirits. As the picture loaded, I smiled. I then opened her medical record and began to review her 10 year journey to realize her dream of having a family.

She had tried for a year before coming to us at age 27. Initial evaluation indicated that her biological clock might be a little advanced for her age but that everything else was normal.

Five cycles of simple treatment showed that she was a good responder to common fertility medications. A diagnostic surgery to evaluate her pelvis showed a mild case of endometriosis. After one more cycle she decided to do IVF. She proved to require high doses of medication to stimulate her eggs and in the end, though she had a reasonable number of eggs, there was concern about the quality of the eggs. She did not get pregnant after the fresh cycle and two frozen cycles. She then dropped out of treatment for 3 years because of illness, personal issues and significant stress.