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In Vitro and Me

Talia Liben Yarmush and her family

I always imagined having a large family. I was the middle child of five, and although I can’t honestly claim to have loved every moment I’ve had with my siblings, I feel immensely blessed to have them. Growing up, they were always my biggest role models. I emulated the way my older brothers spoke, I listened only to the music they listened to, and I even wore their hand-me-downs. My younger siblings were my most treasured playmates; we climbed trees in the front yard and played make-believe in the basement. My brothers and sister were allies against our parents, they were my confidantes and they were my refuge. Today, they are my closest friends. And when I need advice on something, I know just who to ask for each problem.

Six years ago, when I was hit with the shock of infertility, and I knew it would be difficult to have children, my expectations of family size changed dramatically. A little after a year of marriage, I was diagnosed with endometriosis, one of the leading causes of infertility. I had two surgeries to remove the growths inside of me, but they grew back with full force each time. My doctor was clear: in vitro fertilization was the only way I would get pregnant. I went into my first cycle of IVF without a clue I thought, This is it! I’m about to grow the family I always dreamed of! I suffered through the daily injections and the blood drawings and the vaginal ultrasounds, because I knew that in the end, I would have my baby. But after two full cycles, I was left alone with just another negative pregnancy test and I thought maybe I was asking too much. I stopped dreaming of a large family.

Then, two years ago, after my third cycle of IVF, when we were finally blessed with the birth of our son Ezra, hope was renewed. Fertility had not come easily to me, but it had come, and it could come again. Sure, I had gone through two surgeries, three cycles of IVF, and countless other painful procedures. But, then, eight months later, after just one more round of IVF, I was pregnant again. This isn’t too bad, I thought. An average of two rounds of IVF for each pregnancy. Even though, after every round of IVF, I thought to myself, I can’t do this again, I always changed my mind. And, if money was the only impediment, I would think to myself that I would carry on, debt and all.

But then came Asher, our second son. I was diagnosed with complete placenta previa early on in my pregnancy. The placenta that was nourishing my baby was also covering the opening of my cervix, thereby blocking the baby’s exit from my womb. Often, this is a condition that sorts itself out throughout the course of pregnancy. However, if the placenta does not move away from the cervix, then a C-section is the only way out for the baby, in and of itself, not a tragedy, although not ideal. The real problem occurs when the placenta then attaches itself to the uterine lining, as it does in many cases of placenta previa. This is a problem because exercise, heavy lifting, and contractions, can all cause the placenta to shift, precipitating a tear.

And when a tear came, at 3:00 in the morning, my husband rushed me to the hospital, where, 12 hours later, a second tear caused me to hemorrhage a third of my body’s blood supply. That kind of blood loss that would have killed me if I hadn’t already been in the hospital. Within minutes, I was on the operating table undergoing an emergency C-section. I was 28 weeks pregnant at the time.

When I woke up from the anesthesia, the first question I asked wasn’t if the baby was okay. How could he be? He was three months early. The first question was, how not okay was he? Was he even alive? He was 3 pounds of skin and bone, hooked up to wires and feeding tubes and oxygen, lying in a heated incubator in the NICU, where he would stay for the next seven and a half weeks.

Talia and Asher in the NICU.

The second question I asked was whether or not they had removed my uterus. You see, when there is massive bleeding from placenta previa, sometimes the only want to stop it is with a hysterectomy. No, they had not removed my uterus. Yes, I could theoretically have more children.

“When are you two going to have a baby?” is just about the worst question you can hear when you are going through infertility treatments. After six years of infertility, four rounds of IVF, and a premature baby who spent seven and a half weeks in the NICU following a traumatic labor, “Are you going to have more children?” is also a pretty bizarre question to hear. Seriously, who is even thinking about more children after all of that? As it turns out, I am. Constantly.

Because the thing is, I want more children. And, as long as the IVF works, I can have more children. But the thought of it is, frankly, terrifying. My chances of having placenta previa again are now increased. What if I do get it again? What if my placenta tears? What if I bleed out and die? What if my baby is born too early? What if he or she needs to spend weeks, months, in the hospital? What if my baby dies? Is the desire to have a large family really worth the risks?

Simply, no.

We’ve all had monkey wrenches thrown our way. Some more than others. But we adapt, we change our plans, and we establish new dreams. I am blessed with two beautiful boys. At one point I didn’t even think their lives would be possible.That should be enough for anyone. So here I am, 30 years old, and I might be done having children. My family doesn’t look like the dream I had when I was a child, surrounded by my own brothers and sister. But my reality is more than enough.

You can find more by Talia Liben Yarmush on her website She is currently writing her first novel.

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