An IVF Cycle Built for Two

Our patient Lisa Pontzious tells her story of a long struggle with recurrent miscarriages that ends with the remarkable arrival of two biological children from two pregnancies.

“I can be changed by what happens to me but I refuse to be reduced by it.” – Maya Angelou

I sit here in anticipation of motherhood, times two. Actually, frozen may be a better description. Motherhood. Mom. Dad. Children. Words I thought would never be associated with my being.

Yet here I am, after a very long journey filled with expectations, shots … lots and lots of shots, happiness, disappointment and tears. It’s finally here. My delivery date is set. My head is screaming, I’m having a BABY!!! Wait, what?

I can’t help but reflect on the journey that brought me to this point. This was not just my journey, but a journey shared with my best friend, love of my life and my soul mate.

Knowing the future will bring more questions about how this came to be, let me share our story with those who will understand more than anyone.

Should I mention that I have a 4-week-old newborn old at home?


Everything was going great, then it went horribly wrong

Five years ago, my fiancé and I decided to start a family. A few months later, I was pregnant! Already a health nut, I stepped it up. I wanted to do everything right: Eat healthy, take the necessary vitamins, exercise, follow up with doctor’s appointments, the works! Everything was going great! Easy street … then, it all stopped.

I went to my 12-week appointment and heard the phrase that would soon become all too familiar: “There is no heartbeat.”

I held it together as I scheduled the D&C (dilation & curettage) and talked to the doctor. I lost it when I got to my car. I couldn’t control myself, the tears were uncontrollable.

I called my fiancé and told him the news, but could not speak or bring myself to say the words out loud again, so I resorted to texting the news to family and friends.

Not to be deterred, we decided to try again. After all, it was not uncommon for a first pregnancy to result in miscarriage, nothing to be overly concerned about.

Shortly after my miscarriage, my dad was diagnosed with stage IV prostate cancer.

My parents have been dreaming of grandchildren – probably since I was born. I had to make the dream come true, especially for my dad.


Being referred to Dr. Wachs saved my life

Fast forward … nearly a year had gone by … still no positive pregnancy test. The wait was torturous! I pleaded with my OB to send me to a specialist, but the protocol is to wait a year before a referral. Each passing month seemed like an eternity. Then, good news! A positive test just before the year was up.

Unfortunately it was short-lived. The first ultrasound showed that the sac was empty. The physical pain was nothing compared to the debilitating mental struggle.

“Give up” is not a phrase in my vocabulary, so as soon as we could, we started to try again.

Alas, the yearlong protocol timer started again. This time we were not so lucky. We hopelessly tried for a year without any luck.

So, one year to the day I marched into my OB’s office requesting a referral to a specialist. I didn’t know it at the time, but the day I was referred to Dr. Deborah Wachs at Reproductive Science Center in San Jose changed my life.

I wildly anticipated my first appointment. Somehow I just knew this was going to work and our dreams would soon be a reality.

After going through numerous tests, we decided to move forward with IVF (in vitro fertilization), ICSI (intracytoplasmic sperm injection) and a chromosome check on the embryos.

After what seemed like hundreds (okay, what really felt like thousands) of shots, it was time for the embryo transfer. Dr. Wachs performed the procedure and nine days later we found out I was pregnant!

My fiancé and I went in for my first ultrasound and there was a heartbeat! I couldn’t wait to call my family and tell them the good news.

Third time’s a charm, right?

We were overjoyed. The idea that this was not going to work never crossed our minds.


Recurrent miscarriages lead to repeated devastation

Elation quickly turned to despair when three weeks later the ultrasound revealed a heartbeat was no longer present. Devastated was an understatement. Why was this happening? We were forced to ask ourselves that very question five more times over the course of the next two and a half years.

In the meantime, our friends were having children (some were on their second child) and we had not been able to carry one past the first trimester. This was heartbreaking! But that was not the worst part. The questions from people who just wanted to make simple conversation didn’t know they were breaking my heart. Simple questions like, “Do you have any children?” followed by, “Why not?” I just put on a smile and would say simply, “Maybe someday.”

“Someday” happened two and a half years later.

Despite our positive, never-give-up attitudes to carry our own child, we decided it was time to use a gestational carrier – to bring in a professional! I told Dr. Wachs of our plan, but told her that I didn’t want to give up myself and I wanted to continue to try to get pregnant on my own too.

Dr. Wachs was supportive of our decision, and continued to try different treatment methods to help me overcome my struggle to conceive and get pregnant.

After a couple months of getting our gestational carrier ready, she had her transfer using an embryo. The transfer was a success! Four weeks later it was my turn. We used an embryo from the same cycle.

Having been a patient at RSC for over two years, there were a lot of people that we became close to. Have I mentioned the staff is wonderful? Needless to say, the room was packed with people all sending good vibes and well wishes. No pressure, Dr. Wachs!

The transfer went off without a hitch and so began the dreaded ultrasounds. Week after week I went to the office, sometimes even having a meltdown in the parking lot from the anxiety of the ultrasound and potentially hearing the dreaded phrase of “no heartbeat.”

But that day never came.


The worst best experience of my life

miscarriage | RSC Bay Area | newborn babies on heart pillowTwelve weeks later, the day came when I was supposed to “graduate” from RSC and go back to my OB’s office. The feeling was daunting. I felt so comfortable at RSC, but also I was simply afraid that we had come so far and I didn’t want any bad news. So, assuming the usual position, the ultrasound began, and the most beautiful sound filled the room: the heartbeat. On the screen we saw our baby, then heard a knock on the door.

The door opened and a flood of office staff stepped in to congratulate us. Hugs and smiles came from everyone in the room. It was one of the best moments of my life; it was so touching to know that so many people cared about us. We were so happy to share that moment with such a wonderful group of people – it is something I will never forget.

So, here I am today. After years of heartbreak, the day has come that I will be able to experience the world of motherhood. Two miracles! My parents will be able to realize their dream. The playhouse my dad built is waiting for the boys (he is still fighting his cancer).

In retrospect, five agonizing years of hope and anticipation, thousands (okay, hundreds) of shots, eight miscarriages, and countless tears. Yet, I can somehow call this the worst best experience of my life. What does the future hold? I think that is clear: More questions of course! This time, rather than dodging the questions, or feeling bad about my answer, I am proud.

Here’s my answer, “Yes, I have kids. Two boys. It was the most difficult thing I have ever done, but I wouldn’t change it for the world!”

Lisa Pontzious


A Note from Dr. Wachs

As a physician, I never know if my patients realize how much I ride the ups and downs of their treatment with them. There are the medical aspects of care that I can control: protocol choice, medication, dosing, surgical technique, etc. There are the emotional aspects of care that I can control: truly listening to patients, providing support, being available, creating a safe space, etc. But no matter how much knowledge or love goes into an IVF cycle, the roller coaster can still be very tortuous. This has never been more true than for Lisa.

The number of miscarriages that Lisa suffered through defied all the knowledge and support that I could provide. Lisa and I travelled on this long journey together for years. More years than I would ever want for any patient. But if there is any silver lining in addition to the miracle of the birth of her two beautiful boys, it is what I was able to learn about Lisa and what I was able to learn about myself.

Lisa defines the word persistence. More than any person I have ever known in my life. Lisa had every medical reason to continue to try. She had great ovaries and beautiful embryos. A single IVF cycle for Lisa resulted in many chromosomally normal embryos. This is different than many couples and I was very aware of this difference throughout her treatment.

For Lisa, the emotional toll is what would have stopped the journey. Lisa could have said many times that she needed to stop putting herself through this anguish. But she didn’t. With every miscarriage, Lisa’s first words were, “When can I try again?” And we had the ability to keep trying because we had an abundance of embryos.

Every cycle we would try to think of every possible intervention available in hopes of arriving at a different outcome. And finally we did. Times two. Persistence is what made Lisa try over and over again despite unexplained miscarriages. Persistence is what made Lisa decide to transfer an embryo into a gestational carrier. Persistence is what made Lisa transfer another embryo into her own uterus one month later. And persistence is what brought Lisa to where she is now: the mother of two beautiful sons.

I learned how incredibly difficult it is to walk that fine line between feeling the disappointment for your patient wholeheartedly yet keeping them focused on the ultimate goal. There is a mourning period for us as physicians where we need to process the outcome and then regroup for our patient and help them move forward.

The part of each of us that wants to fix things can start to feel broken when a patient isn’t getting pregnant or a patient continues to have miscarriages. Lisa taught me to put myself on the receiving end of disappointing news. If I was a patient and bad news was being conveyed to me by my doctor, I would want sincere empathy and then I would want to hear the doctor telling me what I needed to do next. That would help me process and, at the same time, help me to see what my next steps need to be. Because of Lisa, I communicate differently.

Our journey with patients who have recurrent miscarriages does not always have a happy ending. Many patients will either stop trying or switch doctors. I am honored that Lisa stayed with me and continued to trust me with her care. Knowing that we were in this together until the end allowed me to always be forward thinking. I am forever grateful for her confidence in me. For us at RSC, Lisa is truly family.