Episode Transcript
Polly Gill (guest):
I was super excited. But you know how many times we had negative after negative after negative. It was like, there’s no way we can be pregnant. Like this is just not going to happen. And that line started getting, we started seeing double lines day by day by day, and we just didn’t want to celebrate yet. But when we found out, when those were two solid blue lines and the pregnancy said positive, we just bawled. And we just said, you know, we’ve been working on this for four years, trying to have our family and it was the best moment of my life.
Cassie Alvine (announcer):
This is “Her Kind of Healthy,” a podcast series by Sanford Health. The conversations highlight topics from fertility and pregnancy to postpartum, managing stress, healthy living, and so much more. In this episode, hear one couple’s story about starting a family through in vitro fertilization. Our host is Alan Helgeson with Sanford Health News.
Alan Helgeson (host):
Being able to share stories and inspire hope and joy is important when first meeting Polly and Nikki. Their story has so much to share and like all good stories, it has to have a beginning.
Nikki Gill (guest):
So, Polly was like a really big volleyball star in high school, and when I was in high school, my team actually played against hers. And her senior year, she’s from Pierre, and they were undefeated all season. And she was a senior and I was a junior. And from our high school, in Rapid City at Stevens High School, we ended up beating them in the state championship. So that was like the first encounter and to this day she does not get to live that down. And so yeah, we played volleyball in college together and then like she said, we were roommates and then became more than roommates and fell in love and yeah, got married and had a baby (laugh).
Alan Helgeson:
So when you decided to start having those serious talks about having a family, was it hard to find the resources or figure out how to go about doing that?
Nikki Gill:
So I had always just imagined like a really traditional way of being able to start a family. So when her and I fell in love and when we got together, we really had to sit down and think about like which avenue we would want to take in order to have a family.
We knew that we wanted to, in a perfect world use like a sperm donor. So what we actually did with Theo was we had Polly get her eggs ready, so we kind of like split the IVF process together. So Polly had her eggs retrieved for the IVF process, and then those eggs were created, like the embryos were created with her eggs and the sperm donor. And then those were put into me. So like Theo would not have been able to exist without either of us put together, which is like what we were really hoping for in a perfect world.
Alan Helgeson:
Ok, so at what point did you go to Sanford and say, Hey, here’s what we want to do. We want to start a family?
Polly Gill:
So once me and Nikki decided that that’s what we wanted to do, and we started at Sanford Health, because I believe that they’re the only fertility clinic in the whole state of South Dakota. So we’re very, very blessed that they’re nearby and we couldn’t ask for the better doctors. So we kind of went back and forth, and from the very start we just worked as a team and they said, we’re going to get you guys through this.
Alan Helgeson:
At Sanford Health, Dr. Keith Hansen and his team are part of a larger group of specialists in women’s health.
Dr. Keith Hansen (guest):
I’m a what’s called a reproductive endocrinology and infertility specialist, which means that we take care of hormonal issues and some other issues like to try to help couples to achieve their dream of starting a family and having a baby.
Alan Helgeson:
With your clinic and your expertise, you’re very specialized in what you do. So where do your patients come from and how do they hear about your services in your clinic?
Dr. Keith Hansen:
Our patients usually are referred to us. Sometimes they come as primary, they make an appointment to come in and be seen, but a lot of times they’re referred to us either by their family medicine doctor or by an OB/GYN. And we then evaluate them once they come to see us. And then we do get couples to just hear about it and call and make an appointment so they don’t have to have a referral to be seen in general. Usually when we have couples who are trying to get pregnant, one of the things we really want to do is try to help them conceive with the least invasive process that’s available to us.
Alan Helgeson:
For Nikki and Polly, they had to navigate other changes as well.
Nikki Gill:
I also have PCOS, so I have polycystic ovary syndrome and that means that like my hormones are just like imbalanced in my body, which can make it harder for like my lining to get really good. So when we started IVF, we had Polly’s eggs retrieved, but my lining couldn’t get thick enough to put the embryos in, so we had to actually freeze the embryos that we had until my body could get where it needed to be to hold the embryos.
Hear Dr. Hansen explain the IVF process
Polly Gill:
And that was a long process.
Nikki Gill:
That was a really long, a lot of like failed rounds of trying. Yep. We hadn’t put any embryos in at that point.
Polly Gill:
Yep. And it got to a point where we were very frustrated, so we just had to take like a year off.
Alan Helgeson:
OK, so for Nikki and Polly, having patience is important and working with the right team is key.
Nikki Gill:
So we started with our fertility doctors.
Alan Helgeson:
Dr. Hansen, can you please talk about the IVF process?
Dr. Keith Hansen:
Usually for in vitro fertilization, first we have to do testing so we can figure out the best medications and all that kind of stuff.
Then the first part of the process is ovulation induction, where we’re giving her medications to stimulate the ovary to try to make more follicles to grow. And so what we do is we start the shots and the gals have to take shots a couple times a day, I’m afraid.
Once the follicle gets to a certain point and her estrogen’s at another point we have to start her on even another medication to try to prevent her from ovulating. And once the follicles get up to a mature size, which is about 18 millimeters in diameter, then we give a shot called the HCG, a trigger shot, which completes the maturation of the egg and starts a process of ovulation. Then 36 hours after that we take the eggs out.
And the way we do that is we go back to a little room in the back here that’s attached to our laboratory and anesthesia comes down, puts the person asleep so they don’t feel what we’re doing. Once we’re asleep, we can clean the vagina out with saline, put a vaginal probe ultrasound, and this ultrasound has a little aiming guide on it.
So we put a needle down through there, we go through the top of the vagina and we just kind of pop into the follicle. Then we, it’s attached to a pump, pump the fluid into a test tube. We take the test tube off, hand it back to the guys in the lab. They’re sitting under a big microscope that’s heated. They pour out the fluid, find the egg, and put it in the incubator. And we do off other ones on one side. Then we go over and do off other ones on the other side.
Then we take everything out and then wake her up and then the lab gets the eggs ready, which probably takes them about four hours to do. They get the sperm ready, which takes about four hours to do. And then depending on the sperm, they either put a hundred thousand sperm right on top of the egg or they do what’s called ICSI, where they go in, find a normal sperm, pick it up and inject it into the egg. Then they put it back in the incubator and the next morning we get to see did it fertilize normally or not. And those that fertilize them can develop and we want them to get up to what’s called the blastocyst stage. So what we do is once we have the blastocyst, which usually takes five, six, or seven days, then we can put it back into the uterus.
Alan Helgeson:
With any medical procedure, there are always things to watch for and why Dr. Hansen and his team have many safeguards in place.
Dr. Keith Hansen:
There’s a number of risks associated with the procedure. The biggest one is multiple babies, and we like to follow the American Society of Reproductive Medicine guidelines, which tell us how many to put in to give us the least risky pregnancy and the most likelihood of a live born baby. And for most women under the age of 35, it’s usually one embryo. For those 35 to 40, it’s one or two, but no more than that. And it depends a little bit on a number of other factors, but it’s usually one, sometimes two, between 35 to 40.
Alan Helgeson:
Are there organizations that you work with to help make sure you’re providing the best care possible?
Dr. Keith Hansen:
We’re closely monitored by, you know, a number of different agencies. The FDA, the pathology group follows us closely, the American Society of Reproductive Medicine. And then we maintain certification and board certification so that we can provide the optimal care to our patients to reduce their risk and improve the chances of a healthy baby and a healthy mom.
Nikki Gill:
So typically an IVF process from beginning to end is not as complicated as mine was, but I had a lot of hiccups along the way.
Alan Helgeson:
When Dr. Hansen talked about the IVF process, the steps were a bit different for Nikki and Polly.
Dr. Keith Hansen:
In this situation, what we did was what’s called reciprocal IVF, where we stimulate the one individual’s ovaries through ovulation induction meds. We take the eggs out, then we fertilize them, and then what we do is we prepare the other person’s uterus to accept the embryo. Then we thaw the embryo and put it in, and then hopefully she gets pregnant, which in this case she did.
Alan Helgeson:
Is it common to do it this way, Dr. Hansen?
Dr. Keith Hansen:
It’s more common than it used to be. I’d say that the more common way is a lot of people decide to do the intrauterine insemination just because IVF has so much to go through. But there are a group and it’s becoming a larger group of patients where they want to use like reciprocal IVF where we stimulate the one, fertilize the eggs, then put the embryo in the other person. And it really does, you know, it’s kind of a cool way to expand a family and have a little baby.
Polly Gill:
I was super excited. But you know how many times we had negative after negative after negative. It was like, there’s no way we can be pregnant. Like this is just not going to happen. And that line started getting, we started seeing double lines day by day by day, and we just didn’t want to celebrate yet. But when we found out, when those were two solid blue lines and the pregnancy said positive, we just bawled. And we just said, you know, we’ve been working on this for four years, trying to have our family and it was the best moment of my life.
Nikki Gill:
So we started with our fertility doctors and they helped to get us little baby embryos that that we were able to work with from the beginning. And then as soon as I got pregnant and we graduated from like the fertility doctors.
Then we went to Dr. Kemper. Oh. And man is she, she’s awesome. Ugh. She is just the best. She’s amazing. She’s amazing. She was our OB/GYN. And she, so then really after you graduate with, from the fertility doctors, it’s like a normal pregnancy. Right? So then you just have like a normal baby doctor.
Alan Helgeson:
For Polly and Nikki, their journey to starting a family has been anything but normal. So at what point did you learn that it was a high-risk pregnancy?
Nikki Gill:
Because it was IVF. That’s what labeled us as a high-risk pregnancy. But yeah, we just had like a normal experience from that at that point. And then at my 20-week scan, that’s when they do like the anatomy scan. We found that my cervix was shortening and funneling, which is a sign of labor like you can go into labor soon. And I was only 20 weeks at that point, so they had to put in a cervical stitch. So I remember at that 20 week appointment, they were like, you could have a baby within the next couple of weeks. And we were like that, that can’t happen.
Alan Helgeson:
This is where the expertise of Dr. Rachel Rodel and her team comes in.
Dr. Rachel Rodel (guest):
Sanford Health as a whole has a vast team of experts to help people start families and to help them be successful in their journey. Fortunately with Sanford, we have multiple avenues for patient care, including certified nurse-midwives, family medicine physicians, OB/GYNs, and us as maternal-fetal medicine subspecialists. So we take care of patients really once they’re pregnant or if they’re planning a pregnancy. And then of course for those who might need extra support in starting a family, we’re fortunate to have the reproductive endocrinology and infertility specialists.
Alan Helgeson:
For Nikki and Polly, this level of care was important with their pregnancy.
Dr. Rachel Rodel:
Often what we see here in maternal-fetal medicine is when pregnancies get unique. So for any patient who might conceive by IVF or in vitro fertilization, they are typically referred routinely to a maternal-fetal medicine specialist at the time of their anatomy ultrasound around 20 weeks to have a little bit more in-depth look at the baby due to risks associated with the IVF process. But for them, some unexpected findings on the typical screening ultrasound led our team to stay involved. And if we fast forward a short time after that, our team became even more involved as her pregnancy progressed.
Nikki Gill:
So I remember at that 20-week appointment, they were like, you could have a baby within the next couple of weeks. And we were like that, that can’t happen.
Alan Helgeson:
With the physical challenges during this time, the mental stresses weigh heavy too.
Nikki Gill:
I felt a ton of pressure, like emotional pressure to like be perfect all of the time when I was pregnant. Because it’s like if I do anything wrong, like I’m going to ruin this pregnancy. So, and I think that’s for every pregnant woman. There’s the women, there’s a lot of pressure onto, it’s like they feel like it’s your job to make their family. Everything’s on you. You have to do everything perfectly. And, and when you’ve never been pregnant before, yeah, it’s scary. It’s like, is this normal? Is this not normal? Scary.
Alan Helgeson:
So let’s go a few weeks down the road. OK, 24 weeks, five days emergency delivery.
Nikki Gill:
Ugh. You’d think you would be able to like get through it after telling the story so many times. OK.
So the night before the emergency C-section happened, I had felt pressure in my vagina and they came and did like a pelvic exam and they said, everything looks good. Theo was like reading normal on like the fetal monitor. There was like, I, I had a, the cervical stitch in. So they said if you were dilating at all, there would be blood. Like, everything looked good. So they had just said like, no concerns at this point. So we said, OK.
So I woke up that next morning and I went to the bathroom. It felt like my vagina was falling out with me. I had called Polly into the bathroom and I said, this is not normal. And so we called the nurse in and she’s like, let’s get you into bed.
And I said, what is this? And it was his umbilical cord that was falling out of me. They say, so like when you’re in, like when you’re waiting and you’re in bedrest, they talk to you and they say, I hope that you never have to experience an emergency C-section, but if you do, it’s like a beautiful symphony. It’s like everybody comes in and they all have their roles and it’s just like a flawless, beautiful symphony.
And there’s really no other way to describe it. Like, they pulled the cord, people came in, they took my clothes off, they put me in a gown. So they wheeled me out and I had a nurse and I just grabbed her hand and I said, I said, is he going to live? Is he going to be OK? And she said, she’s like, we’re going to get him out of there. You have to stay calm right now and like, not give yourself anxiety with everything else that’s happening.
And it was really urgent to get him out of me because with his umbilical cord falling through, that’s cutting off oxygen to him. So we go into the emergency room and they put me on the bed and one person’s at my head and she’s saying, do you give consent to be put out? And I said, yes, just save my baby. And there’s a person like down below, like down below, and she’s just like sticking a catheter. And the surgeon comes in and they have to time the procedure perfectly because they’re putting me under general. Like they’re knocking me out completely. Normally with a C-section, they can give you like a, like a, an epidural kind of paralytic. And they couldn’t. They needed to just put me out completely. There was no time. And so they’re like scrubbing my stomach up and the person by my head is saying, are you ready for her to be put out?
And the surgeon’s saying, nope, not quite ready yet. Not quite ready yet. And then I have somebody holding my hand and I, and they’re looking for the heartbeat. And I said, is, is there a heartbeat? Is he alive? And they couldn’t find one. And so they’re getting ready to like put this mask on my face. And I said, stop. Is there a heartbeat? And they said, yes, yes, we have a heartbeat. I said, OK, put me under. And so then they said, are you ready to be put under yet? And the surgeon said, almost. We’re, we’re almost ready. And so then she said, OK, we’re ready. And so then just like that, I was out.
Polly Gill:
Everybody left and I was by myself, dropped to my knees, praying to God. I had a rush of peace over my heart. And then from that moment I knew that everything was going to be okay. And then I went and saw him for the first time and it was the most beautiful thing I’ve ever seen. And he was kicking and he was sassy. And we actually got to have a delayed cord clamping because he was such a fighter. And ever since then he’s been a fighter and just kicking butt in the NICU and dodged so many bullets. And God’s just held us in our hands.
Alan Helgeson:
Baby Theo is born one pound eight ounces. Now begins a new chapter in their story, a 120-day stay in the neonatal intensive care unit at Sanford USD Medical Center in Sioux Falls.
Nikki Gill:
He was going to have to go to the NICU regardless, like if he would’ve been inside of me and stayed until 34 weeks. We knew that that was going to happen. We just didn’t know how sick he was going to be when he was in the NICU. His first week they say that like, the baby is going off of the hormones that I had provided for him when he was inside of me and it’s like a honeymoon stage. So the first week he was great. And then after my hormones like kind of leave his body and it’s up to his little body to be like, whoa, what? Like I got to do this on my own. That’s when reality sets in. And so it’s like, you, you feel like just this sense of like desperation and, and like panic because it’s like, is this, is this like all that you can do?
And I don’t think I’ve ever prayed more in my entire life just like out of just pure desperation of like just I’ll do anything. Just, just like save my baby. You know? So I think that was like really hard is just feeling like hopeless and just feeling like you don’t know what’s going to happen and they can’t promise you that he’s going to live. Right?
Like I kept asking the nurses, I would be like, he’s going to live, right? And they would say, they would say like, we’ve got really good doctors. And they would say like, we’ve got a really good team. And they would say like, he’s just doing what preemie, preemie babies do, but nobody could ever tell me like, yes, he’s going to live. Because you can’t promise that to families and you just so desperately want somebody to just say he’s going to make it. He’s going to be OK, but you, you can’t. So you just have to like, hold onto your faith that everything is going to make it.
Polly Gill:
And just seeing your little guy hooked up to that many things is just the hardest thing to look at.
Nikki Gill:
Those nurses deserve like all of the good in the world. They are not only medically taking care of your child, but then they’re like counselors to you.
Polly Gill:
And they become like your family.
Alan Helgeson:
Four months in the NICU. Can you speak to what this was like for you and Polly?
Nikki Gill:
They say the hardest part about being in there is the beginning and then right at the end because at the end it’s like, he looks like a baby. He’s doing so good, but like you can’t go home yet. And then he’s like big enough where he just wants to be held and he just like, when he’s really little, he’s just on a machine and he’s, he’s sedated. Like when he is big enough, he is crying out and you, you want to see him and you want to love him and you want to hold him. You can’t take him home and you’re at work, right? Like you’re, you can’t just be in the NICU 24/7. So that was also a really challenging part is you still have to live NICU life with that.
Polly Gill:
That was really hard too because we’re at home with him and he, he’s just the best boy and he’s so happy and he is laughing and we finally get him to see he’s actually acting like a baby, which we were waiting for for so long and we just love him so incredibly much.
Nikki Gill:
I would do all of that over a million times if this was like the result of it.
Alan Helgeson:
In your journey, you guys have learned so much. So with your experiences, are there things you could share that might be helpful to others from your time in the NICU?
Polly Gill:
And so I think like finding your community is helpful.
Nikki Gill:
Like our NICU neighbor.
Polly Gill:
Our NICU neighbor. OK. Yes.
Anyways, and then talking to her, she, her kid, her child right next to us has gone through the same thing Theo has been. And so that was really helpful talking to her. And I think just like it’s helpful to find your community and also like, things might be really, really dark at the time and really, really tough, but like, things are going to get better.
It’s going to get better. It just takes time. And you might be in the darkest place of your life, but Sanford’s there to help you. The nurses are, the doctors are, your family is, but it does get better.
Alan Helgeson:
Dr. Hansen, you and your team have had such an important role in helping Nikki and Polly start a family. Why is it important that Sanford Health provides these services, your services and those that your peers provide for LGBTQ+ families seeking care?
Dr. Keith Hansen:
For any couple that wants to have a baby and wants to expand their family? The services at Sanford are here to supply care to patients from all walks of life to meet their dreams, to expand their family, and to stay up all night. (Laugh) I’m just kidding.
Alan Helgeson:
So what does it feel like for you knowing you are helping people become parents?
Dr. Keith Hansen:
It’s incredibly satisfying and rewarding to have a couple bring in their little one. I originally was in the Navy back when I first started, and I learned that one of the first kiddos that I helped her mom get pregnant with, his father was a Navy SEAL. The only thing he wanted to go into was the Navy SEALs. And I, I learned that he actually made it. He’s now been in, I think he’s probably getting ready to retire from it. But he was a Navy SEAL for quite a while, which is kind of cool, you know, to be able to talk to him. And some of the kids are playing baseball and it’s just really fun to see what they do with their lives.
Alan Helgeson:
Dr. Rodel, what’s it like for you?
Dr. Rachel Rodel:
You know, it’s a great feeling to see the successful outcomes such as with sweet baby Theo, given with what we do and sometimes the very unfortunate circumstances that we see, we really know that not all cases have such a happy ending and it’s, it really is a privilege to support families both in their grief and in their celebrations.
And of course it’s an incredible joy when patients can graduate from our care, don’t need us anymore. And, you know, sometimes bring us their sweet baby or babies to show off because some days can be really tricky and this is always a challenging time in people’s lives to support pregnancies. So it’s quite an honor to help families through the process.
Alan Helgeson:
And for their part, Polly and Nikki are grateful for the medical team who helped them along the way as they begin their new chapter in their life together.
Polly Gill:
They are the story. They are our beginning, our middle, and our end, and our family at the end of the day, even when we’re home. So they are our complete story and they saved his life and they helped us have a baby and our family. It’s just been a, been an awesome journey with Sanford and of course couldn’t get through this without God too. So a lot of praying and a lot of good team is what made it made this happen possible.
Alan Helgeson:
Ok, so what’s the best part of this whole experience?
Polly Gill:
Theo. That’s just it. He is like, he’s just our whole world.
Nikki Gill:
Watching her be a mom is a very close second.
Polly Gill:
You’re making me cry. (Laugh)
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Posted In Children's, Family Medicine, Gynecology, Pregnancy, Sioux Falls, Specialty Care, Women's
