IBD Motherhood Unplugged: Exploring Natural Procreative Technology

Chronic illness can feel all-consuming, especially while you’re trying to balance work and your personal life. According to 32-year-old Allison Wade of Texas, living with ulcerative colitis since 2008 prepared her for the struggle of infertility after living through a four-year flare. Yes, you read that right. Allison was hopeful her and her husband, Nick, could begin their journey to growing their family. Unfortunately, just as she felt the relief of getting her IBD under control, she found out she would be dealing with another condition where there is not a “one size fits all solution.”

This edition of IBD Motherhood Unplugged looks at juggling the mental and emotional struggle of coping with and mourning your body failing you not only with ulcerative colitis, but also infertility, while also being your own advocate for your care plan. As Allison says the question of “WHY” she’s unable to achieve something that women have been doing forever, haunts her.

Allison is a healthcare worker. Her world came crashing down during the pandemic when she found out bringing a baby into this world would be more complicated than she ever thought.

“When I received news that I was in remission after the four-year flare, I was told we needed to get pregnant right away to capitalize on my IBD finally being under control. I underwent an HSG procedure to make sure that I didn’t have any adhesions or blockages in my fallopian tubes due to the chronic inflammation in my colon. We were told everything was normal,” explains Allison. “I also had blood work completed to ensure that I was truly ovulating and that was also normal. We tried for a year and were not successful.”

Allison and her husband met with a fertility specialist in April 2020. The nearest fertility specialist was two hours away, so they set up a telemedicine visit. During the initial consultation they were told it sounded like they were dealing with unexplained infertility.

“My cycles were like clockwork, I was getting positive ovulation tests, my hormone levels after ovulation suggested that I was truly ovulating, there was no reason as to why I had never seen two lines on a pregnancy test.”

The fertility game plan

Allison and Nick set up a game plan with their fertility team that involved three rounds of Intrauterine Insemination (IUI) plus Clomid. If she was not pregnant after that, the next step was IVF. Allison says she felt overwhelmed but was confident that they were going to be pregnant after the first month. Looking back, she says she was naïve to think that way.

“Emotionally, each month is a roller coaster that comes and goes quickly. Each month that passes you feel the gravity of emotions that come with each negative pregnancy test. Financially, it has been difficult because insurance does not cover my fertility treatments and rarely covers my medications. Let me just tell you that every ultrasound and every blood draw adds up. I have to remind myself regularly of how it will all be worthwhile in the end.”

Keeping stress in check

As anyone with IBD knows, managing stress is imperative for helping to keep symptoms at bay. Along with the worry about getting pregnant, Allison has the fear of flaring with her ulcerative colitis.

She explains, “The biggest area of stress has been managing all the appointments and arranging my work schedule on the days I have to unexpectedly drive to Houston for a 15-minute ultrasound. I am very lucky that my job has been understanding through this time.”

Not to mention she also has to take time away from work to receive her Remicade infusion.

“I would advise other IBD women to find ways to manage all the stress and emotions that come along with infertility and chronic illness. I highly recommend seeking counseling services. It is nice to have someone to talk to who is not emotionally involved in the outcome. It is a difficult time for all women, however when you also have IBD, I feel like you are now adding all these supplements, medications, and appointments to your existing list of treatments for your IBD. Find a way to organize everything so that you’re able to manage everything without getting too overwhelmed.”

Utilizing Natural Procreative Technology instead of IVF 

After two failed IUIs, Allison knew IVF was on the horizon. She didn’t feel as though all her concerns were being addressed or that her needs fit into the typical cookie cutter approach.

“I felt like we were being rushed to IVF without any real answers as to why my body was unable to conceive. My husband and I were not emotionally or financially prepared to begin the process of IVF, so we decided to get a second opinion and look at other options.”

This is where Natural Procreative Technology or NaPro comes into play. Allison liked that NaPro doctors look to diagnose the root cause of what is causing your infertility, in hopes that you can conceive naturally without the use of IUI or IVF. The success rates are comparable and often exceed those of IVF, without the increased risk of multiple pregnancies or birth defects.

The Creighton Model of FertilityCare System™(CrMS) is the method of observing and charting important biomarkers in the female cycle. The charting and observational work is the basis of evaluation and treatment in NaPro Technology. Allison has been charting her cycles for the last six months. 

“When I went to my first NaPro appointment, the doctor spent an hour talking to me in the office and my husband on Facetime. She answered every question and explained that she would be as aggressive as we wanted her to be,” says Allison. “She wanted me to chart my cycles and to get extensive blood work completed after ovulation to look at my hormone levels. She also spoke to me about diet, stress, activity levels, and she started me on several supplements. When I left that appointment, I was so happy because I felt like she was treating me holistically and was going to find the cause of my infertility.”

Keeping her eyes focused on the future

Allison is going to have exploratory surgery next month to look for scar tissue or adhesions that may be the result of chronic inflammation from her IBD, which could be contributing to her struggle to get pregnant. She is due for her Remicade the same week as her surgery, so she must push her infusion back until her incisions are healed. As a woman with IBD, going through infertility, this is the reality that is often not discussed or thought about.

“While I try to remain as optimistic as possible about creating a baby that is genetically ours and that I can carry, our hearts would definitely be open to both surrogacy and adoption. My dream has always been to be a mother and I will do everything that is possible to achieve that dream.”

Connect with Allison on Instagram: @al_avawade

Navigating IBD and IVF During a Pandemic WITH A Toddler

When I asked 34-year-old Amanda Osowski how she’s juggling Crohn’s disease, motherhood, and IVF during the pandemic, she said “with caution.” And rightfully so! These times are complicated and overwhelming for everyone. Add some chronic illnesses and trying to maintain your health, sanity, and emotions while doing all that and trying to get pregnant with a second child through IVF, and I’m amazed she found the time and energy to write this guest post! I’ll let her take it away.

Here we are, more than 7 months into a global pandemic, still wondering if and when life may “resume as normal”. To be honest, in my house, life has in some ways paused and in other ways accelerated since the March quarantines began. As an IBD patient on Remicade (an immunosuppressant medication to manage my Crohn’s disease), I have chosen from the beginning to adhere strictly to social distancing, mask wearing, unnecessary exposure and other risk reducing options. 

This also meant that my job, my income, and my ability to support others has transitioned from mainly in-person to entirely virtual. The silver lining of this is that I’m able to work with clients all over the world. Balancing that alongside parenthood, and IBD during a pandemic requires a good bit of patience, strategic thinking, and deliberate planning.  

Gearing up for Baby #2 Through IVF 

My husband and I were diagnosed with Unexplained Infertility in 2017 while trying to conceive our first child. After several failed treatments, we had one successful round of IVF in which I became pregnant with our daughter in the fall of 2018. As soon as she was born, we knew we wanted to have another baby close in age – both for our family planning goals and in hopes that I would be able to maintain my Crohn’s remission status long enough to complete another pregnancy. 

While we began trying naturally as soon as we were ready, we knew that the recommendation for fertility treatment was to wait until 12 months passed after delivering our daughter. I desperately hoped that we’d get lucky before then, and that we’d end up with natural conception, rather than going through the physical, emotional, and financial journey of another cycle of IVF. I also knew that I wanted another baby, and that would happen however it was meant to. 

How the pandemic has impacted fertility treatments

We were scheduled to begin fertility testing in March 2020, with treatment starting in April. As I’m sure you guessed, that was immediately halted with the closing of most fertility offices and the pausing of all new treatment cycles with the influx of COVID-19 cases and concerns. Having my treatment (and my timeline) be paused indefinitely with the continuing anxiety and stress of the pandemic caused my IBD symptoms to increase – something that then caused me more anxiety and stress about its impact on my IVF plan if and when I was able to reschedule treatment. 

After an exceptionally long few months, my doctor’s office re-connected with me about getting my appointments scheduled. My IBD while not flaring, was not perfectly calm either, and that’s such an important part to me about preparing for pregnancy, so we gave it a little more time. FINALLY, this month (September), I began the treatment protocol I should’ve started five months earlier. Our daughter Brooklyn just turned 16 months old.

Today you’ll find me managing IVF medication injections around business calls, my Remicade infusion schedule, chasing a toddler and being stuck inside my home around the clock. It’s HARD, and exhausting, but it’s the only way I know how to make my hopes come true. 

Tips for handling IBD + IVF

  1. Communication with your partner is critical. From parenting responsibilities to COVID-19 precautions to childcare to work stressors to fertility treatment planning and execution – there is an entire machine full of decisions and emotions that are part of every single day, and not being on the same page as your partner can have devastating effects. My recommendation: schedule time once a week on your calendar after bedtime to talk. Keep a list running during the week of things to add to the conversation. Ask all your questions to each other then, when you can focus and talk and connect. You’re a team, and it’s important in this season to work together. 
  1. Mental health is just as important as physical health. When managing IBD + ANYTHING, let alone motherhood, and a pandemic, and fertility treatment, taking time to check in with your mental health and care for yourself is imperative. Each of these things come with so many feelings, and burying them all will only make it harder to deal (& keep your IBD in check!) I personally recommend working with a counselor, taking time to journal or meditate or center yourself, and ensure you’re checking in with your own needs regularly. 
  1. Social Media Strategy – During the pandemic, I think we’ve all admitted to more screen time than usual. I know firsthand that the amount of pregnancy announcements, gender reveals, new baby births & seeing families with multiple kiddos can cause feelings of guilt, frustration, jealousy, anger, etc. Social media can make things feel extra difficult for those struggling to get pregnant, undergoing fertility treatments AND managing something like IBD. Here’s what I recommend. The beauty of social media is that we can choose what we do and don’t see while we scroll. This is a perfect time to click “hide” or “unfollow” on any hashtags or accounts that make you feel sad or icky. That’s not to say you don’t love your neighbor/friend/co-worker, but in my opinion you also don’t have to constantly watch their highlight reel. On the flipside, utilize social media to connect with your TRIBE. Whether that’s other IBD and IVF warriors, others struggling with infertility, etc – there’s so much more space for online communities now than there ever has been before. If you’re having difficulty finding and connecting with others, please DM me and I’m happy to make some suggestions! Also, please know that whatever you’re feeling during this experience and this season is so valid, and you’re not alone!  
  1. Give yourself grace. There will be days when you feel inadequate – as a parent, as a spouse, as a patient – these moments don’t define you. You’re juggling so much, it’s so important to know that you’re doing the best you can, even if that looks different than it used to or different than you’d like it to. 

If my story resonated with you, or you’d like to connect, please reach out! You can find me on Instagram personally as @amanda.osowski and professionally as @heartfeltbeginnings.  

From IVF to surrogacy: This IBD mom’s resilient journey

IBD and surrogacy. Those are loaded words. Both evoke emotions and opinions for unique reasons. For Jessie Magaro, 34 of Atlanta, the decision came after the unfathomable struggles she had with her Crohn’s during pregnancy and after. To provide you with the backstory, Jessie was diagnosed with Crohn’s and endometriosis when she was 15. She underwent an elective surgery her senior year of high school for her Crohn’s that put her into surgical remission for 15 years. IMG_7818

Jessie got married in 2016. While she was loving every second of newlywed life, she started feeling endometriosis pains. Less than a year after tying the knot, her doctor discovered her fallopian tubes were blocked. It was unclear if the blockage was due solely to endometriosis, or if it was a result of scar tissue from her bowel resection. Either way, IVF seemed to be the only option to get pregnant, and her fallopian tubes would need to be removed for that to be successful. In November 2017, Jessie underwent the surgery. When she woke up, she thought she would be stripped of the ability to conceive a baby naturally. But, her surgeon told her they were able to save and repair one of her tubes.

Jessie ended up getting pregnant right away, but unfortunately had an ectopic pregnancy that ended up severely rupturing her fallopian tube. During emergency surgery to remove the remaining tube, it was determined her endometriosis was severe and IVF needed to happen sooner than later. I had the chance to interview Jessie about her harrowing experience to bring a baby into this world, while living with IBD and endometriosis. IMG_7820

NH: How did IVF impact your IBD?

JM: “The moment we started IVF, I felt a shift in my body. A storm was brewing, and I could feel it. My completely dormant Crohn’s appeared to be waking up, but I didn’t want to believe it. I battled through the IVF process while experiencing my first flare in a decade in a half. The Reproductive Endocrinologist and GI were miffed. No one could say if this was an isolated reaction to the hormones, or if I was truly experiencing an active flare. After a lot of back and forth, and hard conversations with medical professionals and our families, we decided to proceed with implanting an embryo. The thought process was that most women tend to do better in pregnancy with Crohn’s, if they had been in remission prior. The hope was that this “flare” was an isolated incident from the IVF drugs/hormones, and that everything would calm down once I was pregnant. It was a risk, but one we decided we were willing to take. After a short round of prednisone, the flare subsided, and we proceeded with the transfer.”

NH: You now have a beautiful, healthy 13-month-old daughter to show for it. What was your pregnancy like?

JM: “My pregnancy was a terrifying whirlwind of trying to manage an awful flare while keeping the baby safe. IMG_7821I developed a new manifestation of the disease I never had before: Perianal Crohn’s. Not a pleasant situation and one that is very difficult to treat/manage while pregnant. Things got so bad at one point, I had to have surgery to drain an abscess and place a seton to help a fistula heal. No one wants to have surgery pregnant. It was one of the scariest moments of my life. The first trimester was spent hoping and praying the baby would make it with all the turmoil going on in my abdomen. The second trimester was spent hoping and praying we could keep her in there long enough to be viable outside of the womb. The third trimester was spent in an unbearable amount of pain fighting the urge to take the prescribed pain pills and being so scared about how the increased biologics, steroids and other new drugs being introduced into my system might affect her.”

NH: You must have been going through so many emotional struggles at this time, on top of all the physical.

JM: “The level of anguish and guilt I felt was unimaginable. I already felt like I was failing at my motherly duty to protect her and keep her safe. By 32 weeks it was clear I was rapidly deteriorating, and we had exhausted all treatment possibilities deemed “safe” while pregnant. I desperately needed more aggressive treatment, and that couldn’t happen until she was out. IMG_7823With the newly manifested, aggressive, perianal disease, a vaginal birth was out of the question. I held on until 36 weeks and on New Year’s Eve of 2018 we welcomed our baby girl. We were so incredibly relieved she was ok, and the focus quickly shifted to how not ok mom was.”

NH: As a fellow IBD mom, we all know how challenging the postpartum time is, along with chronic illness. How did you navigate that?

JM: “The first five months of her life were spent in and out of the hospital non-stop. At one point we were traveling down to the Mayo Clinic in Jacksonville for weeks at a time (without her) for testing and treatment. Leaving her the first few months was by far the hardest, most gut-wrenching thing I’ve ever experienced. I would sit in the hotel bathtub staring at the IV in my arm sobbing. The physical and emotional pain was unbearable. I remember agonizing over the decision to start the new meds, or continue breastfeeding her, and the doctor saying to me “you NEED these meds, Jessie. You HAVE to get better. She needs you to get better more than she needs you to breastfeed her right now …” cue the waterfall of tears again.”

NH: You started to turn the corner when your daughter was six months old. Tell us about that.

JM: “The pain had begun to subside enough for me to take care of her without help, I could finally leave the house and I was starting to feel a little more like myself again. I was, and still am a year later, in an active flare, but we’re making progress. IMG_7824After talking  to many medical professionals, we decided it was not safe for me to carry another child. We still don’t know if it was the IVF drugs/hormones that caused the flare going into pregnancy, or if hormones in general and my Crohn’s disease just don’t mix, but we’re not willing to put myself, or another baby at risk like that again.”

NH: I can only imagine what a difficult and complicated decision this has been for you and your husband.

JM: “This was not a decision that was made easily or lightly. As we go through the motions of finding a surrogate to carry baby number two, my days are filled with a roller coaster of emotions. We know we want another child, but at what price? I can’t take care of my family if I am unwell. If carrying another child myself leads me to be unwell again … is it worth it? Or, do I trust someone else, a safer vessel, to carry a precious sibling for our daughter. We’ve chosen to pursue a safer vessel. I am so unbelievably grateful that surrogacy is an option for us and will allow us to continue growing our family while keeping me safe.”

This story is not meant to scare anyone with IBD who is looking to start a family. Make sure you are in complete, clinical remission before you conceive, and know it is completely possible to have a happy, healthy pregnancy with IBD.