Another Curveball

CMV: Cytomegalovirus


I navigated infertility, and thank God, after the many ups and downs, I now have 4 children. I still speak openly, to anyone who will listen, in the hopes that my story may help others on their fertility journeys.

I AM NOT A DOCTOR

I write that in bold because I do not dispense medical advice, I just thoroughly research topics  to make informed decisions for myself.

Lately 3 little letters have come up in conversation relating to pregnancy that I had some SCARY experience with. So I decided if someone wanted to google it, and not speak with me, that they could get some information that will help them out.

I CONTRACTED CMV FOR THE FIRST TIME IN MY LIFE WHILE I WAS PREGNANT.

Now, what’s important in that statement is twofold: I never had CMV before, and it was clear I got it for the first time while I was pregnant.

I know this is important because the three specialists that I saw commented that they had never seen such a clear cut case of CMV contracted during pregnancy.

So let’s backtrack a bit. I got pregnant with twins and then lost them at 10 and 11 weeks. I was devastated. I had a D&C to find out what caused this loss, and it turned out they each had different trisomies. From that point on my husband and I decided to do Preimplantation Genetic Diagnosis, PGD, (genetic testing of the embryos and to only transferring genetically “normal” embryos so I would not have to endure another loss for THIS reason).

Before my next retrieval I wanted to be sure I didn’t have any other issues so I requested a full workup from my RE (reproductive endocrinologist). These tests were performed January 2012 and I received the all clear. I went ahead with my retrievals: one in January, one in February and another in March. During the March retrieval they decided to transfer two fresh genetically normal embryos. One embryo implanted and after several weeks of monitoring we graduated from the RE to my regular OB.

At my first appointment with my OB, he did his regular prenatal blood panel. When the results came back he called me immediately.   Apparently, I had CMV and all my blood work from my RE showed that I had never had it before. CMV, if transferred to the baby from a mother who doesn’t have the antibodies in her system already (hence you never had it) could result in: blindness, deafness, mental retardation or stillbirth.

The earth stopped for me. I had already had a number of miscarriages, therefore we only transferred normal embryos this time and we still had a complication? WHY US??

So the researcher in me needed to find out all that I could. I went to high risk OB’s in Manhattan, CHOP in Philadelphia, and New Jersey.

The first thing I learned was there was a blood test called an AVIDITY test that could narrow the window to find out when I got the virus. For me, I knew from the January blood work that it happened sometime between February and April, so the AVIDITY test would not help me (but that ruled it out for others I spoke to after.)

The second thing I learned was that there was a SLIGHT chance it could be transferred, and IF it was transferred to the baby there was a smaller chance the baby would get sick, but I like dealing in “worse case scenarios” and having all the information.

So I decided I wanted a CVS, an invasive procedure where they take cells from the placenta for testing. This is done earlier in a pregnancy than an amnio. The results would not be definitive, but it was the earliest test I could do to either get good or bad news. The CVS came back that they didn’t see the virus. Not definitive, but good first hurdle.

The next step would be the amnio. The reason the amnio results are more definitive is because in children, they test the urine, and amniotic fluid is urine for a baby in utero. The amnio was what I was waiting for. In the meantime, I could not sit idly by and do nothing. So thank G-d, I had a great team of  doctors who found ONE STUDY in Italy that showed POSSIBLY by doing an IVIG infusion of CMV antibodies to the mom while pregnant, perhaps they would cross the placenta and give the antibodies to the baby. So in the two months before my amnio, I would do that.

My first infusion was a horrible experience, they had me do it with people undergoing chemo. The nurses asked me what kind of cancer I had and I cried. It took forever (6 hours) and I was hungry, depressed, worried and alone. After that infusion I called my OB who suggested next time we do it at the ANTEPARTUM LOFT with Labor and Delivery Nurses and not as depressing. That was a much better experience.  Still long, but not as sad.

It was finally time for my amnio, I knew this was a risk to the baby, but I needed to know. Thank G-d, the results came back fine. The baby never got the virus, and we were all clear.

My son was born healthy with a lot of tefillot around him.

When I was getting ready for his bris, I wanted to thank all those who davened for me during my pregnancy. I also wanted to thank Hashem since he was a true partner in this process. I wanted to quote the Gemara that mentions the three partners in making a baby and I was floored when I found it.

In Messechet Niddah, Daf Lamud , Amud Alef, it talks about what it takes to make a child. Our Rabbis taught: There are three partners in creating a child: Hashem, the father and the mother… We know from the Gemara Hashem’s role is 1/3 of the job, but I know that in our situation, his portion was more than that, to which we are thankful.

Now, what we didn’t say in the bris speech was more specifically what the Gemara says Hashem brings to the table in creating a child. The Gemara says “God provides the spirit, the soul, the beauty of the features, eyesight, the power of hearing, ability to speak and walk, understanding and intelligence“

When I read this I said to myself “OMG, those are the things that CMV effects!” So for me, Hashem listening to our prayers, of those who prayed for me and the tears and tefillot I cried out. It illuminated the importance of what Hashem’s role is in this area. And because of those constant reminders, I know Hashem took care of our son.