Unexplained Infertility Leads to Clinical Study—and Little CJ

Sarah & Chris’ four years of unsuccessful attempts to start a family ended when they entered Advanced Reproductive Medicine’s AMIGOS study

Pregnant woman holding pair of pink shoes for baby girlThe Assessment of Multiple Intrauterine Gestation from Ovarian Stimulation (AMIGOS) study was a mouthful to say, but it was just the kind of thing Sarah Horrigan and her husband Chris wanted to hear about. They found out about Advanced Reproductive Medicine (ARM) through Chris’ mother and then found out that they would be good candidates for ARM’s national study on unexplained infertility.

Married in 2005 and trying to have a child for four years since 2006, the Denver couple had already been talking about getting medical help when they learned about AMIGOS in 2010. Chris wanted to try a little bit longer without seeking help. Sarah says she was getting impatient, so finding out about the study was perfect timing.

“We went through the screening, the blood work, pelvic exam, Pap smear, and all the other things that they do,” recalls Sarah. “It took about two months for them to get back with us that we qualified to participate. My husband’s numbers came back good and all my numbers came back good: we were diagnosed with unexplained infertility.”

Thrilled to participate in a study that could possibly solve their baby problem, they still had to wait to get going with the study.

“It was eight months later, which was a long time to wait,” says Sarah.

Infertility should not be kept a secret

Having unexplained infertility is a double-edged sword: the couple and their physician are relieved that there is no specific abnormality causing their infertility, but they are still anxious about being infertile. Many couples are embarrassed to admit that they are having problems conceiving, but not Sarah and Chris.

“Going through fertility treatment was not something I wanted to keep a secret. I’m not ashamed of it, and I encouraged people that I know who were struggling to reach out and get some help,” says Sarah. “There’s a stigma surrounding infertility, a feeling like you’re broken. But fertility treatment can be such a wonderful resource.”

The two aspects of AMIGOS were progressive oral and injectable medications, both to promote a woman to “superovulate.” The drugs were to increase the number of eggs ovulated from one to two or more, the progressive aspect meaning that the couple were given the least expensive and least invasive medicines available first.

A good deal and a great chance

“I wanted to see if the study would be a more effective treatment, and it was free. We were guaranteed up to three full cycles,” says Sarah. “So it wasn’t a one-shot deal, I had three chances. It sounded appropriate for us. It was accessible for me from work to go to the hospital for my blood draws and ultrasounds as often as needed. It was close, convenient and I was going to try anything I could at that point after years of trying to get pregnant on our own.”

April 10, 2011, on the first day of her next cycle, Sarah started the medication. She wasn’t sure which one, but in hindsight she thinks it was Letrozole. ARM kept a close eye on all of Sarah’s lab and ultrasound numbers.

Then after so much waiting—years on their own and another eight months for the study to begin—things started happening fast. She had ultrasounds on days 10, 12 and 14, and received a trigger shot to induce ovulation on day 16.

“If I remember correctly, I had four mature follicles and the doctors weren’t sure about moving forward or cancelling that cycle. I encouraged them to move forward, and told them that everything was going to be okay. I didn’t want to go through more fertility treatments. I knew what I wanted.”

What she got was intrauterine insemination (IUI) on Easter and a positive pregnancy test on Mothers Day.

“It really happened fast. I felt that we were very lucky we got pregnant on the first cycle,” says Sarah. “Now we have a little boy, Christopher Joel, who was born on January 20, 2012. He’s just over 2-and-a-half.”

Infertility sucks

Sarah and Chris now are going for a brother or sister for CJ, as they call Christopher Joel. They continued fertility treatments, doing three more cycles of Letrozole and intrauterine insemination, one ending in a miscarriage this June. But the next cycle worked and Sarah is pregnant again.

She knows way more about fertility treatment and the female reproductive system than she did when she was doing the AMIGOS study. Sarah, who sees Dr. Alex Polotsky now, says that she initially trusted that the doctors knew what they were doing. Today, she’s a well-informed proponent of treatments.

“Infertility kind of sucks, but some people rebel against infertility treatment, thinking that it’s way too expensive,” says Sarah. “But there are reasonable prices. For instance, this Letrozole cycle is costing me $530. It’s a lot of money, but it’s not IVF—I’m not selling my car to try to have a baby. I feel like I’m doing outpatient medical treatment. I’m not shy about talking about it, and I wish that more people were open to talking about it. You don’t ever know until you ask.”