Stanford Fertility and Reproductive Health Services helps couple overcome roadblocks to pregnancy
Fourteen years. That’s how long Jenny Chien and her husband, Oscar, tried for a child. The constant striving and waiting without success was excruciating.
“You don’t want to accept you have a fertility issue. Infertility feels like defeat and hopelessness,” says Jenny.
The couple started trying to conceive when Jenny was 30 years old. At the time, they were living in Taiwan. When she didn’t get pregnant, they sought help from a fertility doctor, who told them they couldn’t have kids naturally.
“We went through two rounds of in vitro fertilization (IVF) in Taiwan, and they didn’t work. All that effort with no results made it feel like the end of the world,” Jenny says.
IVF is a common, effective way to improve an individual’s chances to get pregnant. An egg is extracted and fertilized outside the body in a laboratory dish and then implanted in the uterus.
One reason IVF failed for Jenny was because her thyroid was not functioning well. Later, she would be diagnosed with Graves’ disease—an autoimmune thyroid disease. Yet there were other reasons that the couple didn’t know about at the time.
Years pass without success
Over the years, the couple sought help from fertility centers wherever they lived. But they didn’t try IVF again—it was expensive and taxing, and life kept pushing it to the back of the list. Oscar’s father got cancer, and Jenny’s mother passed away unexpectedly from brain cancer, taking a toll on the couple. Jenny was especially close to her mom, so she was heartbroken.
“When my mom passed away, she told me she prayed that God would give me a daughter like God gave her,” Jenny says.
Before they knew it, 10 years had passed, and Jenny had reached the advanced fertility age of 40. She still had not conceived or become pregnant—something she wanted more than anything.
“With infertility there is always hope that a natural miracle will happen,” Jenny says. “I couldn’t stop trying. I prayed to God to have a baby.”
When the couple moved to the San Francisco Bay Area, they decided to try one more time. They chose Fertility and Reproductive Health Services at Stanford Medicine Children’s Health.
Finding fertility answers at Stanford Children’s Health
Fertility and Reproductive Health Services is a special place at the Johnson Center for Pregnancy and Newborn Services at Stanford Children’s. It’s one of the most comprehensive and progressive fertility centers in the country, offering a large and wide array of fertility treatments, including reproductive surgery. Because of its dedication to research, the center is on the forefront of innovative fertility treatments that bring couples hope where none existed before.
“When I met Jenny and heard she had been trying for 10 years, I thought, ‘We have to give this to you.’ It was an emotional reaction for me,” says Lusine Aghajanova, MD, a board-certified and fellowship-trained reproductive endocrinology and infertility specialist.
The Stanford Children’s fertility care team got to work on the best approach to help Jenny and Oscar, turning over every stone that might be hiding a reason why they were not having success.
“Their needs were pretty complex, with both male and female factors. Sperm obstruction, Graves’ disease, and her advanced age were all adding up,” Dr. Aghajanova says.
Treating male factor infertility
While the couple knew about Oscar’s male factor infertility, it had never been fully resolved. The Stanford Children’s care team worked to get to the root of his issue. He received a comprehensive evaluation from Michael Eisenberg, MD, a board-certified and fellowship-trained reproductive urologist and director of Male Reproductive Medicine & Surgery at Stanford Medicine Children’s Health.
“There’s a tremendous amount we can do to help men with infertility,” Dr. Eisenberg always says.
Dr. Eisenberg performed a physical exam and health history review and ran laboratory tests, including semen analysis and radiological imaging. In the end, it was determined that Oscar needed surgery for abnormal sperm production.
“For us, male infertility was a major cause, so getting Dr. Eisenberg’s care was really helpful. I liked how we were both able to receive care right there for everything we needed,” Jenny says.
One of the main strengths of Fertility and Reproductive Health Services at Stanford Children’s is that couples receive expert multispecialty care that is tailored just for them in one location. After Oscar received the infertility surgery and healed, the couple returned with a plan to receive IVF. Yet Jenny still had unresolved issues.
“We were pleased that we had sperm, but we still needed to optimize Jenny’s health,” Dr. Aghajanova says.
To do so, the Fertility and Reproductive Health care team collaborated to carry out a surgery to remove Jenny’s endometrial polyps, then investigated how to best balance her thyroid. They partnered with Stanford Health Care, the interconnected adult hospital, to bring in an endocrinologist who specializes in Graves’ disease, Chrysoula Dosiou, MD.
Getting Graves’ disease under control
When Jenny was evaluated by Dr. Dosiou, her thyroid was out of balance and not in a good state to conceive and carry out a healthy pregnancy. Hyperthyroidism that is not controlled is associated with significant risks to the pregnancy and the fetus, so getting the thyroid balanced was crucial.
“The thyroid plays a critical role in a healthy pregnancy, and we needed to delay the pregnancy until her thyroid function was optimized,” says Dr. Dosiou.
Over time, she worked on normalizing Jenny’s thyroid function with medications, closely watching her lab results. Yet as months passed, it became clear that Jenny was not moving in the direction she needed for pregnancy. Her Graves’ antibodies were still too high, and her disease remained very active and not adequately controlled with antithyroid medication. That was when Dr. Dosiou recommended a thyroidectomy—a surgery to remove her overactive thyroid.
“The surgery was a success, and Jenny was finally able to achieve normal thyroid function with thyroid hormone replacement therapy. It was time to start again on her reproductive journey,” Dr. Dosiou says.
Receiving IVF for a third and final time
With all of Jenny and Oscar’s roadblocks resolved, the couple was on the right route to conceive. She was now 42 years old. With each year that passes, women have fewer viable eggs.
“Every factor that can affect conceiving really counts,” Jenny says.
Exceptional egg retrieval and egg and sperm storage is crucial for a good outcome with IVF. The IVF Lab at Stanford Children’s uses cutting-edge advanced technology to grow embryos for IVF. It has the largest LifeAire air filtration system of its type in the world, which is important for keeping embryos safe from pollutants.
“If you go looking for a better lab, you would be hard-pressed to find one. Our IVF Lab is really strong here. It’s one of the reasons patients choose us,” Dr. Aghajanova says. “It makes a big difference for good outcomes. With Jenny, we retrieved several eggs and grew two embryos—a great result for a woman in her early 40s.”
To improve the odds of IVF working, the Fertility and Reproductive Health team performed endometrial receptivity array (ERA) testing to pinpoint the best day and time for implantation of the embryo. Jenny was also given antibiotics to ensure that her body would be free of infections. All around, the team adjusted protocols to fit Jenny’s situation to give her the best chance at fertility success.
“I was ready. I prepped myself to not be too discouraged if IVF failed, but to know that I faced my fear and tried my best,” Jenny says. “I knew it was the last time I would try.”
Having a healthy little girl
Jenny could hardly believe it when she heard the words, ‘You are pregnant.’ It was what she had wanted to hear for 14 long years. Her pregnancy went without a hitch. She delivered a healthy baby girl at 40 weeks.
“The second I heard Abigail (Abby) cry, I lost all words. I had been waiting for her for so long, but she turned out to be more beautiful than I ever imagined,” Jenny says.
Abigail’s middle name is Lydia, to honor Jenny’s beloved mother. Today, she is 15 months old. Every time Jenny looks at Abby, she’s thankful. She knows all the hard work, endurance, and tears were worth it.
“I am so grateful for the entire fertility team and the IVF Lab. They were so encouraging. They helped me understand the facts and empathized with me, too,” Jenny says. “They never gave up, and neither did we.”
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