A collaborative approach to fertility care led this couple to mid-life pregnancy

Melissa and her husband, Nick, met later in life and didn’t take any time for granted. They knew they wanted children and started trying right away. Melissa had long dealt with irregular periods and ovarian cysts, so she was already thinking a few steps ahead. When their early efforts didn’t lead to a pregnancy, they quickly turned to her OBGYN and began a series of medicated IUI cycles.

“On the third one, we got pregnant, and it was super exciting,” Melissa recalls. “But I’ll never forget the second call when the nurse called to tell me that my hCG numbers weren’t progressing, and we should prepare to miscarry. That was devastating.”

For the next few weeks, Melissa experienced severe cramping and assumed she was going through a prolonged miscarriage. It wasn’t until she returned to start the next IUI cycle that her doctor discovered an ectopic pregnancy in her left fallopian tube. With that pregnancy now about eight weeks along and endangering her life, Melissa was rushed into emergency surgery, where the surgeon was able to save her fallopian tube but discovered stage 3 endometriosis, a common cause of infertility.

After additional failed IUI cycles, Melissa and Nick chose to move straight to IVF at TFC’s Austin fertility center, under the care of Kaylen Silverberg, MD.

Encountering obstacles on the road to mid-life pregnancy

Melissa was relieved to learn her ovarian reserve was higher than expected for her age. That news gave her hope as she moved through two IVF cycles at TFC over the next year, where a healthy number of eggs were retrieved. The couple opted to have the resulting embryos genetically tested using PGT-A, but the results were heartbreaking. Not a single one of their embryos was chromosomally normal or viable for an embryo transfer.

Still, the couple wasn’t ready to give up hope for a mid-life pregnancy, especially after Melissa’s employer added IVF coverage to their insurance plan. While TFC wasn’t in-network with that plan, Dr. Silverberg fully supported the couple’s transition to an in-network clinic in Houston, providing cycle monitoring close to home while they traveled out of town for two additional egg retrievals.

“We got two viable embryos this time around,” Melissa says. “I was then put on Lupron Depot for three months to suppress my endometriosis, which meant I was in medicated menopause. During that process, I developed an autoimmune disease – Hashimoto’s and an accompanying thyroid problem – which I didn’t have before. Then, I had three cancelled embryo transfers because my uterine lining was too thin and wouldn’t respond to medication. That was very frustrating.”

Back home to our Austin fertility center and Dr. Silverberg

With the hardest part of IVF behind them, the couple decided to transfer their embryos to TFC and have Dr. Silverberg take over their fertility treatment from there. Though treatment at our Austin fertility center would not be covered by their insurance, Melissa and Nick had built a strong, trusting relationship with Dr. Silverberg, Dr. Vaughn, and the team at our Austin fertility center. She also appreciated Dr. Silverberg’s collaborative approach to helping her achieve a mid-life pregnancy, both through the clinic in Houston and directly with her.

“After three years of infertility, I learned a lot about the process, how my body responds, and what works and what doesn’t,” she says. “Dr. Silverberg was very open to my opinions and suggestions, and I appreciated being listened to in those moments because I did know my body better than anyone else.”

Soon, it was time to prepare for another embryo transfer, and once again, Melissa’s body didn’t respond well to medications.

“I was put back into suppression on Lupron Depot, and I remember being about two months into menopause when I decided I was done,” she remembers. “I had been doing everything to get my body prepared, from acupuncture and supplements to giving up dairy, gluten, soy, corn, caffeine and alcohol. I was done with it. I decided I would do a couple more weeks on daily Lupron, and we’d have to find a way to make it work this time.”

Dr. Silverberg was just as committed to helping the couple achieve their dream, so he devised a different strategy to get Melissa’s body ready for an embryo transfer. He prescribed Menopur, rather than the combination of synthetic hormones that hadn’t worked for her in the past.

For the first time, Melissa’s uterine lining responded normally. After years of stop-and-start treatments, the couple was finally ready for their first embryo transfer.

The happiest end to a long journey

Melissa and Nick were overjoyed when the pregnancy test was positive, and hCG numbers continued to rise. At long last, Melissa was on her way to what would be a beautifully uneventful pregnancy. The couple welcomed baby Olivia in 2025, born from an egg that Melissa had retrieved in Houston at age 41. While the couple’s journey to a healthy daughter was long and winding, Melissa and Nick were grateful to have had the TFC team by their side along the way. Their story offers hope to women who wish to have a baby later in life: Never give up, because with the right approach and collaborative care, mid-life pregnancy is possible.