Interview with Karissa Stelma — Author of “1000 Needles: How to Increase Your Odds and Take Control of Your IVF Journey”

Ms. Karissa Stelma is a patient of the hospital and has successfully conceived through her treatment at Conceive Gynaecology & Fertility Hospital. It is our utmost pleasure to present you with this interview of her post-delivery and just as she has “birthed her other baby” – her book detailing her journey through infertility.

Have you always wanted to be a mother ? Did you always envision yourself as pregnant and giving birth ?
Quite simply, no. A big family was not something I dreamed of, per say. Travel. Adventure. Professional success. Love. I dreamed of those things. Although children were never a defined goal (at least up until the last one), they are the best things that ever happened to me. All three of my children embody more love and adventure than I could have imagined. My first daughter was a lucky accident; my second was planned; my son – I envisioned myself pregnant – and staying pregnant – nearly every minute of every day for over 2 years.
Touch upon the moment(s) you realized that getting pregnant naturally without assistance wasn’t going to be easy/doable ? Can you recall the exact emotions at the time ? And what about your husband ? How did he feel ? Was communication between the two of you easy at first when it became apparent that you’d need to pursue infertility treatment ?
I speak about this quite frankly in the book. I knew before the sperm test. I just knew because of the ease with which I had gotten pregnant previously. Because of that, I was prepared. I don’t think my husband was though. An eternal optimist, he thought everything would be fine. After the results came back a heaviness set in. We didn’t hide anything from each other. We pushed forward. We wanted a baby together. There was no room for pride or disappointment or blame. There was only room for ‘fight.’ We knew we were going to have to fight to make it work. So, we doubled down. All or nothing.
Once you’d made the decision to approach a medical specialist, how easy was it for you to find one ? Did you speak to friends/family or was it via internet searches ? Looking back now, what material do you think is relevant and not necessarily highlighted that would enable patients to be able to find an appropriate/suitable doctor more easily ?
Dubai is a small city in this regard. There were only a few clinics to look at and in hindsight we didn’t shop around enough. We quickly picked a doctor that seemed very European in their approach and was highly optimistic. We were unsuccessful. We looked around more. And more. We looked in Europe. Back home in the US. Consultation after consultation. As time passed, desperation set in. It was when I started to open up and ask around that Dr. Pankaj came highly recommended. We were told he was the doctor who got you pregnant when everyone else failed. Which, for us, turned out to be true.
You speak about a fear of needles – do elaborate of how that felt as you embarked on this journey ? Are you now a pro at handling needles ? Do you remember any particular anecdotes you’d like to share on this topic ?
Keep your eye on the prize. I still don’t know how I had three children when I think of all the needles involved – from the blood draws through to the c-sections. I had a deep, almost hysterical fear, of needles my whole life. How did I feel about this during IVF? I can’t even remember. All I could see was a baby. The daily stimulations, trigger shots, progesterone shots -they were hard. I also did intralipids. Those were excruciating. Physically and psychologically, the whole process chipped away at me. Every. Single. Day. The overarching theme here is simple – no pain, no gain. None of these things matter if you keep your eye on the prize.
Infertility is now slowly beginning to become a mainstream subject of discussion but even now the narrative often excludes the men/husbands. Can you share an insight on how your husband felt? Was he supportive? Were there ever moments where you felt you weren’t on the same page? How has your relationship changed/altered in this course?
This is such a loaded question. Was he supportive? Unbelievably so. He held me up. He held us together. He was the bedrock of our family. However, couples need to be aware that those elephant does of drugs have different effects on people. Maybe you’ll have a smooth ride. Limited mood swings. Luck early on. We did not enjoy that luxury. Those hormones hit me hard. We continued month after month until we got pregnant, without stopping. The effects were cumulative. Were we always on the same page? Broadly speaking, yes. Were there days we weren’t even in the same playbook? Absolutely. Remember, that no matter with whom the fertility issue may lay (and often it is both, whether realized or not!) the woman bears the brunt of the burden. The man – no matter how supportive – can never, ever understand the depths of anguish IVF can entail. From the stimulations to the harvesting of eggs to the side effects of the drugs to the miscarriages to the perpetual state of constantly thinking about getting, being or, staying pregnant – men simply cannot share in that burden to any alleviating degree. Relationships change and evolve. Hopefully they broaden in a depth and scope the more you endure. Diamonds from fire. But that doesn’t happen every time. Thankfully, for us it did. However, there are several moments I can look back on say that I wasn’t sure we’d have a happy ending.
Talk a little bit about the failed cycles. Were you prepared for those? What effects did they have on your well-being?
The failed transfers were almost as equally hard as the miscarriages. Your hope skyrockets in such a short time and then it’s over in that split second your blood test confirms you are not pregnant. Finding out another cycle has failed is soul crushing. Nothing prepares you for that. There are women who take it easy, and then women who take a pregnancy test every hour. I was the latter.
Miscarriages are still incredibly taboo. Did you find it easy to speak about yours ? Was the right kind of support available to you ? If not, what do you hope to achieve on this front by speaking about your miscarriage(s) ?
Miscarriages are not a topic of typical dinner conversation. They don’t come up in meetings. But it is important to remember how common they are, which means that many people in your life can relate to you far more than you may think. I did talk about mine with a select group of friends. I talked about them in order to normalize them; to somehow make them real so I could move past them.
Infertility usually has multifactorial aetiology (causes). Often it is the kind of lives we live and the lifestyles we lead. Did you and your husband have to make any conscious changes to yours ? If so, please would you share the changes and how challenging that was for you ? What was the most complex hurdle to overcome ? Did you have to actively work towards mental peace and stability to counteract the consuming nature of infertility ?
After a long and unsuccessful run, we both made drastic changes across the board. Sleep. Diet. Exercise. Stress levels (ironic, because IVF ranks pretty high up there on the ‘causes stress’ spectrum). I would be lying if I said we had mental peace during IVF. We let it consume us and it wasn’t until after my son was born that we started to heal.
How did you come by Conceive Hospital and Dr. Pankaj Shrivastav ? What were your first and lasting impressions of him?
A trusted friend and colleague – the ‘soul sister’ from my book – told me about Dr.P (as we affectionately call him). She told me he was the guy who got you pregnant when no one else could. That was enough for us and turned out to be true for her, for me, and for countless others. Some people need a therapist or a hand holder. None of those attributes mattered to us. We needed an expert who could win the fight against the lot our bodies had been cast. Dr. P has the deserved strictness of a man who makes babies happen. He has been there, done that, and tweaked the rule book. That is what attracted us to him and made us stay. I recall the look on his face after our first failure when we said we may not do it again. Let’s just say it was not one of understanding. It was a look that said he knew that we could get pregnant if we stuck the course. I can’t quite explain it, but that look is exactly what made us continue on. Beneath the veneer of experience, there is also a dad, a family man, and someone who you know is going to figure it out. Besides that, his staff is incredibly supportive and responsive and made our journey all the more bearable.
Last but not least, do tell us about when you became pregnant with your son ? How old were you when he was conceived ? What procedure was it ie IVF or ICSI ? Do share with us how you felt during the pregnancy – bliss/peace/anxiety/nervousness ? Was it an easy/difficult 9 months ? And finally if you can paint for us the moment he was born and brought to your arms … Am sure this will resonate with MANY PARENTS What was your husband’s reaction to becoming a Daddy ?
I had just turned 38 when I conceived Axl. It was a long and difficult path to our little guy. Thanks to IVF/ICSI he was born in August 2019, healthy and happy. The entire pregnancy was horrible, rife with anxiety and dread of miscarriage. I had imposter syndrome – I couldn’t believe that we deserved this miracle. The stress was cumulative and culminated with an emergency c-section – nothing related to IVF but we delivered 6 weeks early. Fortunately, thanks to some great calls by my gynecologist, Axl was born at 4 kg, strong, healthy, and didn’t spend a second out of our sight. From the second he came out he was either on my chest or my husband’s. We hunkered down in the hospital for 5 days, watching Axl’s every breath and relishing in our fortune. It was utter bliss.
As women we sadly have complicated relationships with our bodies. Talk about yours during this journey. Did you ever feel upset/let down/frustrated with your physical form ? If so how did you build back to a harmonious place with your body ? How do you view your body today ?
We do have complicated relationships with our bodies. It’s a shame. A large part of that is down to unrealistic expectations thrust on us by society and the resulting pressure we put on ourselves to be a certain way. Due to stress and diet (one to augment egg health and decrease inflammation) I did not wind up putting any weight on during IVF. This is not the case for a majority of women. Those drugs wreak havoc on your body and everyone reacts differently. During pregnancy I gained the requisite amount of weight and lost it quite quickly as I did with my other two. There were countless times I felt physically disgusting, frustrated, angry – and pretty much the gamut of human emotion. My body wasn’t performing. I wasn’t getting pregnant. I beat myself up constantly. Exhausted by that way of thinking, I finally took action and started to work with my body to fine-tune it. I did this with diet and overall lifestyle changes. I helped it along this abusive path I was taking it on. Today I view my body as this awesome creator of life. How could I not feel tremendous pride? A stretch mark here and wrinkle there pale in comparison to these three amazing human beings that my body made! I always tell my girls that women are the givers of life. We not only must recognize that but celebrate it.