Dana (35), from Central Israel, suffers from chronic inflammatory bowel disease (IBD) diagnosed a few years ago. She had just become engaged when the couple heard the sentence every woman fears to hear: “The chances of you having children are nil.”
After two failed fertility treatments and a rejected request for adoption, Dana came to the IBD MOM Clinic at Shaare Zedek, headed by Dr. Ariella Shitrit.
And there, she heard the voice of optimism she needed to hear.
Dana became pregnant.
Dana’s story is similar to the stories of many women suffering from inflammatory bowel diseases who often – after deterioration in their situation, complicated surgery that caused fertility problems or because they took a drug that wasn’t appropriate for use during pregnancy – need a more comprehensive response to their illness, one that also deals with the issue of fertility in the wake of their medical condition.
“A few years ago, I had some bowel surgery that went wrong due to contagion in the pelvic limbs. The disease had spread. I then had to have another operation to fix my Fallopian tubes,” says Dana. “A fertility expert from another medical center looked at the results of the ovarian reserves tests and declared, quite adamantly, ‘Dana, I’m sorry, but I see no chance of pregnancy here’.”
Moreover, after those results and further deterioration in her IBD, the doctor even suggested that Dana check out surrogate mother or adoption options. Despite the doctor’s surety, Dana asked for a second opinion. But the second specialist also confirmed that her chances of becoming pregnant were very small.
“We went through a tough time,” says Dana. “Instead of deciding what color scheme to have at the wedding and drafting the invitations, we were asking existential questions about continuity. Eventually, after much deliberation, we decided to go for fertility treatment.”
In the first round of treatment, all five embryos removed were not sustainable. In the second, they did manage to get pregnant but it didn’t last. The couple’s frustration increased until they submitted a request for adoption. But that too met with opposition because Dana is categorized as permanently disabled (due to the disease) and limited in her working capabilities.
The couple did not give up.
Dana contacted Dr. Shitrit to ask her advice about drugs safe to use during pregnancy. During their meeting, Dana told Dr. Shitrit the whole story – the earlier diagnoses, the disappointments, the failed fertility treatments. “It was a very emotional meeting,” recalls Dana. “I was crying most of the time. But a gynecologist was also in the room with us and she looked at the test results as well.
“Those doctors made the wrong diagnosis,” she said.
“Suddenly, for the first time, I was hearing a voice of hope, of optimism. And at the end of our conversation, Dr. Shitrit looked me in the eyes and said in no uncertain terms, ‘Dana, you will be a mother!”
So Dana began at Shaare Zedek and after tests, monitoring, drugs-based optimized treatment and an accompanying dietician, Dana’s situation improved.
Within a month she was pregnant!
Today Dana and her husband have two children, a 4-year-old daughter and a 2-year-old son.
Dr. Shitrit emphasizes the importance of the treatment approach for women suffering from IBD. “On the one hand, we need to be optimistic so as not to affect the woman’s overall state, which can also impact fertility. On the other, there are life-threatening situations we have to be wary of, and even forego the chances of pregnancy in favor of the woman’s long-term health.”
“It is important to note that IBDs do not necessarily cause fertility problems in and of themselves, at least when they are treated and stabilized. Nevertheless, in active and severe Crohn’s Disease for example, there may be damage to fertility due to various factors, including Fallopian tube dysfunction, ovarian failure or pain and discomfort during relations due to infections in the pelvic area. Hence the huge importance of stabilizing the disease before deciding whether to become pregnant or not.”