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A Fertility Specialist on Pregnancy Struggles

Dr. Sandy Chuan, partner at San Diego Fertility Center, discusses taking the emotion home from the hospital


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Photo by Priscilla Iezzi

When I went to medical school, I was 24 going on 25. So by the time I started residency, I was already 29 going on 30. I saw all these women in the clinic who looked really young and healthy, but they were having trouble with diminished ovarian reserve and really struggling to achieve pregnancy, even with in vitro. It broke my heart.

Prior to that, I’d told my husband I wanted to wait to have children until after residency, because residency is so rigorous. I wouldn’t have been that old, maybe 34, which in my mind was fairly young. But my fertility rotation really opened my eyes. In medical school you learn about ovarian physiology, but you’re looking at it from a scientific perspective. You don’t truly grasp the fact of how quickly your ovaries can age, and how difficult it is to predict where your fertility is going to go.

So I decided to have a baby my intern year, which is unheard of. My friends were shocked. And it was hard work to do both. But it’s the best decision I ever made. After I became a mother, I realized how much you could love someone, and how awful it would be if I never got to experience that.

My friends were also really surprised when I decided to go into fertility. They said, “Wow, that’s a really stressful field, because patients are often very emotional and that can be challenging.” But at the end of the day, medicine is not a nine-to-five job. You do take the emotion and the challenges your patients face home with you.

With some patients, everything is aligned appropriately, but along the way, things don’t turn out the way you want. It’s just biology. When bad things happen to good-prognosis patients, that’s really hard.

At the end of the day, family is love. And that’s what we’re trying to do, build families and help people find love.

But the hardest thing is when patients are struggling at the end of their fertility, trying to hold on to that golden window. Maybe they’ve never had a child, or maybe they’ve lost a child and are trying to have another baby, but the treatments have limitations.

I try to help them take that next step, to change their mindset and show them they can find family in a different way. But it’s quite a journey to go from mourning the loss of their own fertility to trying to find another path. I see the end product all the time, where patients can cross over to the next stage and become open to another option. I see many happy families at the end of it.

I always say, “Listen, who is your family? Who is the person you go to for everything you count on?” And they’ll often say it’s their husband or partner who’s there with them. So then I ask, “Are you related to them by blood?” And they say no. It’s an aha moment. Sometimes family is the person that you choose.

So much of what we do is not just medical, it’s also helping patients with the emotional aspect of these difficult decisions. What we do is about love. Family is love. And that’s what we’re trying to do, build families and help people find love. It’s a privilege to have that kind of impact on people’s lives and help them fulfill the most basic of human needs—to connect and be loved, to be a parent.

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