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'I'm Running Out Of Time.' Pandemic Halted Appointments At Charlotte Fertility Practices

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Aditya Romansa
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Unsplash

It had been Amanda and Lee Cooper’s dream to have two kids within two years of each other, so when their first child turned 8 months in the summer of 2016, the couple made a decision: "Let’s start trying for baby No. 2."

Their son, TJ, had been a surprise, but Amanda Cooper wasn’t shocked when a year went by with no pregnancy. She knew she suffered from polycystic ovary syndrome and hypothyroidism, two conditions that can make it hard to conceive.

She consulted doctors who started her on fertility medications, and she went back to work to bring in more money for fertility treatments, logging overnight shifts at a hospital as a certified nursing assistant.

She suffered a string of chemical pregnancies, or very early miscarriages, and grieved month after month as pregnancy tests came back negative.

In early March, things were starting to look up. Amanda’s body was sending signals that it was ready to accept a pregnancy, and April seemed a good time for an intrauterine insemination, where a doctor would inject sperm directly into the uterus, which ups the odds of getting pregnant.

But then, the coronavirus pandemic hit. Cooper’s fertility doctor, like others across Charlotte, halted most procedures in mid-March. She was told she’d have to put her treatments on hold, with no end date in sight.

An optimist, she tried to focus on what she could do instead of what she couldn’t.

“I did a lot of meditation, gave up dairy, got more exercise — anything I could do to improve my health,” said Cooper, age 29. “I’ve been putting my body through this stress for four years.”

Added Anxiety

For women struggling to get pregnant, every month brings a potent mix of anxiety, hopefulness and potential heartbreak. COVID-19 forced medical providers to halt many women’s courses of treatment, causing them to lose time and money, and adding to the feeling of hopelessness in their longing to get pregnant.

“In the world of fertility, these women and couples have waited so long and have struggled for so long, and I think there’s this pressure like, ‘I’m running out of time,’” said Dr. Ashley Eskew, a reproductive endocrinologist with Atrium Health.

In mid-March, the American Society of Reproductive Medicine put a moratorium on all non-emergent cases, Eskew said, and doctors like her had no choice but to close their doors to most patients.

Women who were already undergoing “stimulation,” or intensive chemical prepping of their bodies for in vitro fertilization, were allowed to continue, but other patients had to wait. In vitro fertilization is when mature eggs are retrieved from a woman’s ovaries and combined with sperm in a lab, and the resulting embryo is transferred to a woman’s uterus.

“We had patients who were basically ready to start their cycle and had to be told, ‘We have to put this on hold,’” Eskew said.

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Credit Courtesy Charlotte Ledger Business Newsletter
Amanda Cooper, shown here with husband Lee and 4-year-old son TJ, has been longing for a second baby since TJ was 8 months old. Her infertility treatment was delayed during COVID-19.

Feelings Of Loss

Johanna Hyland, a licensed clinical social worker who counsels women and couples dealing with infertility through her practice, Healing Heart, has been hearing firsthand the anxieties of women struggling with yet another setback on their road to motherhood.

“There’s very little that my infertility clients can control. They’ve planned and budgeted around these cycles, and a lot of them have been abruptly stopped,” Hyland said.

“That’s been especially hard for those clients who have taken medications and they’ve done injections, and then the clinic closes. Not only have they put their bodies through a lot, but their hearts, too.

“They didn’t just jump to IVF, they started trying naturally for awhile, and may have suffered miscarriages. Many of them tried less invasive interventions like acupuncture,” she said. “They finally get treatment and feel like the ball is rolling, and then — it’s just stopped.”

Compounding the sadness these days, she said, are the posts so many parents are making on social media complaining about having to care for their children 24/7 during the pandemic.

“When you’re trying so hard to have a baby and you hear people say, ‘It must be so easy to not have kids — you can do your workouts whenever you want!’ you just think, ‘If only I had a baby right now, I’d spend all my time and energy and love on that.’”

Restrictions Are Lifting

During the last two weeks, restrictions have slowly been lifting, and last Monday, some doctors like Eskew were able to resume most procedures and appointments.

But for many doctors, it’ll take months to reschedule the backlog. And for women who have been carefully monitoring ovulation, the lost months feel like missed opportunities to finally get pregnant.

When they do go in for their appointments, they’ll find new protocols.

Eskew’s office is requiring women to be tested for the coronavirus before egg retrieval for IVF. Women also have the option of taking a coronavirus test before starting to take the medication to prep their bodies for IVF.

In some practices, women now have to wait in their cars until called into an exam room, and in most offices, partners aren’t allowed into appointments to prevent the spread of coronavirus. So women are having to undergo procedures and receive news — good and bad — alone.

Finally, Some Hope 

Cooper called her doctor’s office as soon as she heard that North Carolina was entering Phase 1 of its reopening, and asked if she could start the process for the intrauterine insemination she was hoping to have back in April.

She was told she could come in for an ultrasound appointment to check the status of her ovulation within a few days. “I literally burst into tears,” she said. “I’m like, ‘We might have a baby this month!’”

Last Tuesday, she and her husband and son drove to the doctor’s office. Amanda and TJ waited in the parking lot while Lee gave a sperm sample.

An hour later, Amanda went in for the insemination while her husband and son watched “Zootopia” in the car.

“I wished my husband had been there to hold my hand,” Cooper said. “I kind of feel like I made the baby by myself.”

She won’t know for two weeks whether the process was successful, or what going through a pregnancy in the time of COVID-19 will be like.

“Will my husband be able to be there for the ultrasound?” if her pregnancy test comes back positive, she wonders. “I want him and my son to be able to share in these moments.”

How To Help? 

Hyland, the counselor, gives these tips for talking to friends or family members going through infertility:

  • Ask the question, ‘How can I support you right now?’ “Some people want a friend checking in, and others want to be left alone until they share the news,” Hyland said. “So that’s the best question you can ask, so that they can be in charge. They might say, ‘I’d like you to not bring it up unless I share.’”
  • If you have to share the news of a pregnancy with a friend who’s struggling with infertility, do it privately. “I recommend you do it one-on-one, not catching the person out in public place. It’s often nice to make a phone call or send an email or a text to say, ‘I wanted to share this with you, and I know you’re trying and I want this so badly for you too.’ Just be sensitive to their situation.”

If You’re Struggling

Eskew, the physician, has this advice for women and couples struggling with infertility during COVID-19:

  • Reach out to a mental health professional. The severity of anxiety and depression among women going through infertility are comparable to that of a patient given a terminal cancer diagnosis, studies have shown. One in eight women will struggle with infertility but it’s often not talked about, leading many to feel alone in their sadness.
  • Focus on what you can control. “I’ve been telling my patients to continue to focus on you and take care of yourself because those things matter in the long run. Don’t think it’s going to be never and that there’s no hope. Tomorrow’s going to come and you’re setting yourself up for your best success now by taking care of yourself, by eating healthy, getting outside, exercising, doing those things that have been associated with reproductive health. That’s going to give you something that is in your control.”

This story originally appeared in the Charlotte Ledger Business Newsletter and is republished with permission. 

For weeks, we’ve been surrounded by coverage of the havoc caused by COVID-19: the deaths, the hospitalizations, the economic catastrophe that’s been unfolding around us. In the meantime, major health care crises are unfolding, too — ones that are happening quietly, with little public attention, but with very real effects on lives of people across Charlotte. This story is the third in a Ledger series exploring the hidden health care fallout from the pandemic.