May 10 is Dr. Miller Day!
Did you know May 10th is Dr. Miller Day? Neither did we, until our patient, Jamie, shared that she created this special day to remember her fertility journey, the support she received from her “village” and of course the doctor who helped her become a mom!
Jamie writes:
Our fertility journey started as most do, with a lot of hope and a lot of disappointing negative pregnancy tests. During my initial testing, I found out I had 2 fibroids and one was very large. Although I kept asking about the large one, I was told by 3 different doctors that they weren’t an issue and was encouraged to start IUI or IVF.
Although reluctant, we started planning on how and when to move forward. Through that process, we started applying for grants. While looking at the grant application, I started reading into how it would be scored. In the fine print, I noticed certain types of fibroids would disqualify us from the grant, and that is because they can make IVF less successful. This made me, once again, question my fibroid. I told my husband that I wanted to find an expert opinion to rule out the fibroid causing my fertility issues before beginning any treatment. I started to research fibroid experts, and one name kept coming up again and again in my search, Dr. Charles Miller.
In April 2022, during my consultation with Dr. Miller, I expected to hear, once again, that the fibroid was “fine.” Dr. Miller recommended surgery, and on May 10th, 2022 he successfully removed both fibroids. We spent the next few months healing, trying to enjoy life, appreciating what we have, and planning our next steps to bring home a baby of our own.
In August 2022, I returned to Dr. Miller’s office, and he told me that things healed well and we could start trying again. During that same month, I was on pins and needles hoping to hear that we got the IVF cycle grant. However, less than three weeks after my follow-up visit with Dr. Miller, our jaws dropped when we got our positive pregnancy test! It was clear that the fibroid was what had been causing my infertility, and if we hadn’t done our research and sought out Dr. Miller’s expertise, we would have spent thousands on IVF without any success.
On April 17, 2023 our miracle baby girl, Fontana, was delivered via c-section. We cannot thank Dr. Miller enough for taking his time to listen to our concerns, truly evaluating the fibroid and its impact, and for his flawless surgery. Without Dr. Miller, we wouldn’t have had a first birthday to celebrate last month.
This Friday we will celebrate our second Dr. Miller Day. This year we took the time to reflect and appreciate those who were a part of our village by writing cards to family, friends, and those strangers who supported us during our darkest days of infertility. Each person is represented by a house, and when we put them all together, it was empowering to see just how many people helped us along the way. No two infertility journeys are the same, but for those still in the trenches, trust your gut and advocate for yourself.
Ovarian Pexy- A Simple Procedure to Help Improve Egg Retrieval Outcomes
We posted a video of Dr. Miller discussing a recent surgical procedure he performed called an Ovarian Pexy that helps improve egg retrieval outcomes. We figured this was a procedure many were unfamiliar with, so we asked Dr. Miller for more information. Get ready to understand how this simple procedure can make a big difference on your road to becoming a parent.
Q: What is an Ovarian Pexy?
Dr. Miller: A laparoscopic procedure to move the ovaries closer into the pelvis so that the follicles can be more easily identifiable.
Q: How do you know if you are a good candidate for Ovarian Pexy?
Dr. Miller: The procedure would be performed on someone whose ovaries are out of position. A woman can be born with her ovaries misplaced, making IVF difficult. Additionally, another potential cause is adhesive disease – whether from infection, endometriosis or prior surgery, the ovaries are simply pulled away from the pelvis.
However, keep in mind that you don’t know whether or not there is room for improvement until you look at the anatomy. If I cannot see the ovary, I will not take the patient to stimulation. Generally, we have indications that the ovary is not in the right place and see this while the patient is undergoing transvaginal ultrasound or when I perform a saline infused sonogram. At that point, I recommend surgery. Pexy of the ovaries is ultimately a game time decision at the time of surgery, when the anatomy can be seen.
Q: Why does this procedure improve your chances for a more successful egg retrieval?
Dr. Miller: It gets the ovaries to a place where they can be easily visualized via ultrasound and thus, makes egg retrieval easier.
Q: What is the recovery time and how soon can you do an egg retrieval after the procedure?
Dr. Miller: The recovery time is 5-7 days at home and the patient can start preparing for an egg retrieval with her next cycle.
Q: How common is an Ovarian Pexy?
Dr. Miller: Since most reproductive endocrinologists do not perform surgery, this procedure is not routinely performed. Instead, patients settle for a lesser amount of eggs. Oftentimes, Dr. Miller sees patients who have gone through cycles with other physicians and have not had eggs retrieved on one side because of the ovary position. After the ovarian pexy procedure, patients can go from not being able to retrieve eggs to having a comparable number of eggs retrieved from either ovary.
Interested in scheduling a consultation with Dr. Miller? Call 630-428-2229 to set up an appointment or request a consultation online.
Patient Story- Breda
“Not everyone will understand IVF or be able to relate, so it’s important to surround yourself with support. More people than you realize struggle with infertility.”
Today’s patient story is from Breda. After not finding success or feeling comfortable at another fertility clinic, Breda came to us. We are all glad she did! Dr. Miller was able to diagnose her with endometriosis and after surgery and IVF, she was able to get pregnant. Breda is due in January!
Breda writes:
I met my husband later in life and we got married when I was 38. I was and still am wary of the stigma of older mothers, even though being older is accepted. I’ve always wanted a family and we started trying right away, but I had three miscarriages in a year and a half. I was at a different fertility clinic for a year, but didn’t feel comfortable there. My husband’s colleague recommended we see Dr. Miller and what a difference!
We first met online during COVID and Dr. Miller told us, “You’ll be a mother, kiddo.” He was so kind, didn’t rush us, and he explained everything. He learned I was an English teacher and told me a story that put me at ease. He never stopped his storytelling, and I welcomed his personable demeanor after some bad experiences at the previous clinic. Dr. Miller found issues that the previous doctor did not, including endometriosis.
After a biopsy, Dr. Miller found abnormalities in my uterus and I was diagnosed with Level 1 endometriosis. During surgery, he removed five spots on my uterus. I also had the Endometrial Receptivity Assay biopsy to determine the receptivity of the uterus to implantation. Soon after, we had an egg retrieval and two transfers.
Throughout this process, Dr. Miller and his staff explained everything so thoroughly and never seemed irritated or disinterested when I had questions. I also got to know Dr. Miller and the nurses because they talked to me during appointments. I always felt people cared and were invested in our success. I felt so secure going into our procedures and never felt anxiety or stress visiting the office.
Even though our first transfer failed, a second embryo implanted and I will never forget that experience. Dr. Miller, Courtney, and Melody were present for the transfer, and made me feel so comfortable. Dr. Miller even told us a funny story about meeting an actor from Will & Grace. While we waited after the transfer, my husband and I held hands and prayed, and we also talked about how wonderful it would be if it worked. Many times, we dreamed of finishing our nursery and being able to move forward with our plan. The transfer worked, and our baby is due January 8, 3.5 years after we began IVF and what seems like a million doctor appointments.
I was very nervous the first 12 weeks of my pregnancy and braced myself for bad news, but at every ultrasound Courtney reassured me with her positivity. We are so grateful for everyone at the Naperville office.
It took until I was about 20 weeks pregnant for me to relax and realize we’re finally going to be parents! I’ve cried many happy tears for a change! Not everyone will understand IVF or be able to relate, so it’s important to surround yourself with support. More people than you realize struggle with infertility. Meditation and journaling are helpful (as well as long walks with our dog, my first baby). Finally, never stop hoping and praying, even if you’re an older mother!
Patient Story- Courtney
“Keep going even when it feels like you can’t… The little victories will give you strength.”
Today’s patient story is from Courtney. Courtney discovered she had endometriosis when she and her husband were not able to conceive naturally after several months of trying. After undergoing surgery with Dr. Miller, she was able to get pregnant via IVF and just welcomed a baby boy only three weeks ago! Congratulations Courtney!
Courtney writes:
My husband and I began trying to conceive in late 2017. While at my yearly gyno appointment in May 2018, I mentioned we were trying to conceive. I was told to track ovulation with an app and/or pee sticks and go from there. My period had always been like clockwork and I learned that my ovulation was too. I maybe had heavier/more painful periods but nothing that ibuprofen and a heating pad couldn’t fix. My gynecologist did an internal ultrasound and noticed that one ovary was dense, leading her to believe that I might not ovulate on that side, however my pee sticks indicated that I did.
We ended up getting pregnant on our own in the summer of 2019, but that ended in a miscarriage (D&C) as there was nothing in the sac. I then had the dye test to see if my tubes were blocked and they were not. I also did 3 rounds of clomid with no pregnancy. This was the end of the road with my regular gynecologist as she couldn’t help me any further.
I then went to another gynecologist in my hometown to move onto IUIs. He did a natural IUI with no luck. Then we tried a medicated (clomid) IUI with no luck either. During this process, he did an internal ultrasound and that’s when I first learned I possibly had endometriosis. He referred me to Dr Miller.
I had laparoscopic surgery with Dr. Miller in Feb 2021 for endometriosis. We decided to try surgery before an egg retrieval, because Dr. Miller thought he could clean me out and then we could try to conceive naturally or with clomid as he didn’t think the endometriosis was as bad as it turned out to be. However, during surgery he found stage 4 endometriosis on my ovaries and appendix. He removed my appendix and did what he could on my ovaries in order to preserve them for IVF.
After my surgery, Dr Miller said that the endometriosis had been there for quite awhile because the cysts were so fixed to my ovaries. He said he did what he could to minimize the cysts but he couldn’t get rid of them fully because that would ruin good ovarian tissue for IVF. After I’m done having kids, I can have another surgery to fully clean me out.
It was invaluable to have Dr. Miller as my surgeon and fertility specialist. The entire time he was focused on the goal at hand- to have kids. I felt comfortable during the process that he knew what to do during surgery to make it possible for me to have kids.
After surgery, we started preparing for IVF and I had my egg retrieval in July 2021. We ended up with 4 well graded, untested embryos after retrieval. My first FET (frozen embryo transfer) was in September 2021 and unfortunately ended in a chemical pregnancy. Shortly thereafter, we did another transfer and I gave birth to my son, Leo, on August 11.
Going through infertility takes a toll on you emotionally and physically. Here are a few pieces of advice I would give to other women dealing with infertility.
- Keep going even when it feels like you can’t do/go anymore. The little victories will give you strength. For example, the recovery from retrieval was brutal for me, but when we found out we got 4 embryos, I felt like I could do it all over again.
- Ask for help and allow help from others. I am the most organized person out there but I had to have my husband take the reins on the meds because it was all too much for me. I never prepared, mixed, set up, or gave myself one shot!
- Don’t change your lifestyle. Dr Miller never once told me what to eat, drink, do, or not do. Working out was limited with retrieval and FET, but that was the extent of it.
- Take the month off and go on vacation. Dr Miller wrote in my message on the portal that this was a must! You have to continue to live your life as best as possible!
IVF Frequently Asked Questions
What is IVF? It stands for In Vitro Fertilization, but it means a whole lot more for many women and their partners who are going through it.
Scientifically, IVF is an assisted reproductive technology in which eggs are extracted and manually fertilized with sperm in a laboratory setting. The resulting embryo is then transferred to the uterus.
IVF has created millions of successful births to couples who opted to use the technology to become pregnant. It is an option for women and men who have had trouble conceiving naturally, including older women who statistically have a more difficult time becoming pregnant. It is also a viable option for single women who are interested in becoming pregnant as well.
How does IVF work?
In most cases, women are first given fertility drugs to help stimulate egg production so that several eggs can be extracted at once to boost the chance of success. During this time, your fertility specialist will take blood samples to test hormone levels and examine your ovaries as well.
Once the eggs are ready for retrieval, the woman undergoes minor surgery to have them removed. The procedure involves the use of a needle in the pelvic cavity to remove the eggs. After retrieval, the eggs are placed in a laboratory dish along with semen from a partner or donor. In some cases, particularly in situations where fertilization chances are lower, a sperm is directly injected into an egg to encourage fertilization. Once the eggs are successfully fertilized and monitored for cell division, they are then transferred into the woman’s uterus using a catheter. This usually takes place between three to five days after fertilization.
Are there risks with IVF?
IVF has its risks the same as any other medical procedures. Some include nausea and vomiting, shortness of breath, severe stomach pain, infection to the bladder and bowel, and risk of carrying multiple pregnancies, which has its own risks.
People who choose to go through IVF should consider counseling with an IVF specialist first to decide whether it’s the right path for you. While IVF often comes with a rewarding end – a successful pregnancy – it can also have many emotional and physical, not to mention financial tolls.
How do I find an IVF clinic?
There are many doctors who specialize in infertility and IVF. Talk with your gynecologist about doctors they are familiar with and whose reputations are highly rated. Meet with a few specialists to see what their approach is and whether they seem like a good fit. While it’s tempting to go with a place that’s known to be friendly with good bedside manners, which are important, sometimes it’s best to choose a place with a high success rate because, in the end, that’s what you’re aiming for. Most importantly, when going through IVF, it’s important to have a strong support system in place. Involve your partner and your family through the process, and seek out friends or a group who understand what’s happening as well.
Choosing The Right Gynecologic Institute for You
There are many gynecologic institutes in Chicago that focus on women’s health, ranging from fertility to oncology. But because women’s health is so specific and wide-ranging, each one tends to focus on a specific issue or area. Some gynecologic institutes focus on surgery, whereas others may just be general practice. Most, however, are specialists rather than general ob/gyns. Most exist to correct an existing issue that a woman is undergoing. How do you know what to look for?
In many cases, your doctor may refer you to a gynecologic institute in Chicago, which is where you might begin your journey. If your situation is infertility, a gynecologic institute will examine and test what’s causing your problem, and you may undergo surgery to correct it. In other cases, a cyst or abnormal growth may also be removed and examined, and further treatment prescribed. Or, your situation may be preventative, in which you might undergo a hysterectomy or other removal.
While your doctor may refer you to a gynecologic institute, you should also check out others based on referrals from peers or other physicians. The good news is there are plenty of options in Chicago, the more difficult one is how to go about making the choice. Find out what their specialty is and how many procedures they do successfully each year. Learn what hospital they are affiliated with. Talk to previous patients about their experience and whether they had success with that particular gynecologic institute. At the very least, it is always a good idea to have a second opinion as well on your situation.
If the situation is fertility and surgery is required, it may be for assisted reproductive technology, infertility treatment, or some kind of minimally invasive gynecologic surgery. It may stem from cases of endometriosis or scar tissue left behind as a result of endometriosis treatment. In other cases, it may be related to uterine fibroids, uterine prolapse, excessive bleeding, menorrhagia, cervical and uterine cancer.
Gynecologic surgery is extremely high-tech and intended to be minimally invasive. It’s a good idea to ask what kind of technology the surgeon at the referred gynecologic institute uses to perform the procedure. Smaller incisions help minimize post-surgery issues and recovery, and procedures may be even more precise. You can ask a few physicians at different gynecologic institutes around Chicago for their opinion about different types of surgical procedures and which they would suggest.
In addition, if you’re still of child-bearing age and wish to consider fertility preservation, talk to your doctor about options and when a good time to undergo that before your surgery.
From Endometriosis to Appendix Cancer: How I conquered both
(This patient suffered from endometriosis, but it wasn't until surgery that she discovered she also suffered from appendix cancer. The following is her story.)
I suspect I had endometriosis from the time I hit puberty on. While I complained about my symptoms to my gynecologist, she kept insisting my periods were normal. But I knew there was nothing normal about missing a quarter of school and work from the time of puberty to diagnosis.
When I was 21, I ended up in the emergency room with a burst 10x10 ovarian cyst. The doctor on call performed the laparotomy. Afterwards, he gave me a diagnosis: I had endometriosis. It was so obvious. The symptoms were typical. Debilitating pain that just doubles a person over. Heavy period flow that ruins underwear and ruins pants. Even after being put on birth control for endometriosis, the spotting was bad enough that I learned not to wear white pants.
After the stint in the ER, the doctors and I tried to regulate my periods. I went from one birth control to another to another. The pills never worked. I tried Depo Provera which worked best, but switched to Nexplanon (because of the way it was regulated). That’s what I’m on now. I wish that girls weren’t being taught that freakishly heavy periods are normal. Educators need to teach them about endometriosis. Their doctors should take their complaints more seriously. Too many shouldn’t suffer.
Because I was on birth control, the doctors said the odds of endometriosis returning were slim. Fast-forward 10 years from my original diagnosis. I was, once again, experiencing pain. The doctor doubted it was endometriosis, but theorized it was scar tissue and an ovarian cyst.
After my doctor and several people from a Chicago endometriosis Facebook group recommended that I visit Dr. Miller for surgery to remove the scar tissue, I made an appointment. Dr. Miller agreed that my pain was probably the result of scar tissue, but not endometriosis returning. But I couldn’t function normally with all the pain. I just wanted to get on with my life. He made a plan for surgery to remove the scar tissue, so I could get on.
Incidentally, another endometriosis specialist I had visited didn’t think surgery was necessary. Thankfully, I had decided to go forward with the surgery with Dr. Miller. Because, after I woke up from my surgery, I learned that the pain came from my appendix. According to Dr. Miller, it looked abnormal, was enlarged, and had a mass at the end of it. Dr. Miller had to perform an unexpected appendectomy.
A few days later, there was a message on my answering machine to get into Dr. Miller’s office immediately. I knew something was wrong.
Dr. Miller told me there was mucus in the appendix and that I should follow up with a colon specialist soon. He knew something was wrong, but he wanted a colon specialist to confirm it and break the news to me. The colon specialist told me: I had appendix cancer. I was only 31 years old.
The scary thing is that, not only is appendix cancer incredibly rare, I was totally asymptomatic for appendix cancer. I had trouble with constipation, but I had chalked that up to 10 years of scar tissue from the endometriosis surgery. Most symptoms don’t show until it’s fairly developed. I was so lucky that Dr. Miller caught it in the early stages. My oncologist has repeatedly told me that it’s never diagnosed this early.
With Dr. Miller’s help, I was able to retrieve and freeze eggs before my surgery for appendix cancer.
This year I celebrated two years of clean scans. The scariest time is over, according to my oncologist, and he doesn’t think the cancer will ever come back. Where am I now? I have that much more hope, yet fear and uncertainty for the obvious reasons. There’s that sense of gratitude, knowing only a miracle can account for the fact I was diagnosed unusually early. There is not a day that goes by I don’t think of how truly blessed I am, having Dr. Miller and all these physicians as my guardian angels looking over me.