Indiana couple shares their struggle with infertility

Tim and Sam Cross think about where they want their cribs to be placed as they unpack and decorate their babies' room Aug. 13 in their new home. (Photo courtesy of Chris Howell for The Associated Press)

Tim and Sam Cross think about where they want their cribs to be placed as they unpack and decorate their babies' room Aug. 13 in their new home. (Photo courtesy of Chris Howell for The Associated Press)

BLOOMINGTON, Ind. (AP) — In the Cross family nursery are two white cribs, side by side for baby brother and sister, that almost never existed. At least, not in this home for this couple.

The room was decorated with care weeks before the babies arrived and just days after Tim and Sam Cross moved into their newly constructed, two-story home a couple miles north of Bloomington.

Easygoing Sam, a critical care nurse at Indiana University Health Bloomington Hospital, would have been OK waiting to work on the nursery, since the twins would be sleeping in bassinets in the couple’s bedroom for weeks. That was not an option for Tim, even as the rest of the house was covered in piles of clothes and unopened moving boxes.

On a bookshelf in a corner of the room, near a pair of rocking chairs, are books from their own childhoods. A stuffed Mickey Mouse doll rests on the shelf above, just under a globe painted with the words “You’re our greatest adventure.”

A “Be Fearless” framed poster hangs next to another that reads “Be Brave,” adjacent to yet another with one of the couple’s favorite Bible verses — Joshua 1:9 — “Be strong and courageous. Do not be afraid or discouraged, for the Lord your God will be with you wherever you go.”

Above each crib hangs a name, decided months before.

This is a room Tim, 34, and Sam, 27, have wanted since the start of their marriage in the fall of 2014. But after struggling with infertility and undergoing risky and expensive in vitro fertilization, it was a dream they weren’t sure they’d ever get the chance to live out.

So, as soon as they could, on the wall went the names of their much-anticipated babies. Brigham and Ruby, big and bold. Brave and fearless.

One in eight couples

For years they endured the questions, putting on a brave face.

Delivered innocently enough by friends and family, and old acquaintances at the grocery store.

“When are you having kids?”

“Any kids on the way?”

“When the kids coming? You need a few of your own.”

Very few people knew Tim and Sam had been trying to get pregnant for years, and those who did gave the worst advice.

“Go out and get drunk and it’ll work,” one acquaintance said. Another told them to “just stop worrying about it and it’ll happen.”

They looked for resources to help them through this process and found plenty for women, but not much for men. But they did find interesting statistics: One in eight couples in the country struggle with infertility, according to Reproductive Medicine Associates of New Jersey.

Although they often felt alone in their struggle, they knew that wasn’t the case. People just weren’t talking about it.

The couple wanted to change that, and decided to share updates of their journey along the way and perhaps serve as a resource for others.

“I think that’s when we finally decided, OK, one in eight couples goes through this, (but) it’s not really talked about. It’s a lot more common than people think. If we can help just one other couple struggling with infertility, then it would be worth it,” Sam said.

On Jan. 5, Tim posted a long explanation on Facebook about the couple’s inability to conceive, what they were doing about it and the need to release themselves from the burden of privacy. He created the hashtag #aCROSSbetweenloveandscience to document the road ahead.

“No one ever seems to think maybe they’re trying and they’re not getting there. So, outside of our immediate friends and family, no one really knew we were struggling,” Tim said. “We were just like, we’re about to do this huge endeavor; we have no idea what we’re getting into. Let’s just throw it out there.”

The response was immediate. Prayers, well wishes and even photos of IVF babies flooded the comment section. Love and support came from all corners of the internet.

The road to starting a family was a bit more winding. But at least they weren’t alone anymore.

A long struggle

They’d been trying for a year before any doctor would see them. It’s standard practice, but it was still frustrating.

“We thought it would be easy. I was in nursing school, so we thought I’d be pregnant through nursing school, have a baby and then get a job,” Sam said. “Obviously, that didn’t work out for us.”

As soon as October 2015 rolled around, the one-year mark since they started trying to conceive, Tim and Sam went to their first infertility appointment. Each time another potential cause — Tim’s sperm count was fine, Sam’s ovulation tests were positive — was cleared off the list, their frustrations only grew.

Why isn’t this happening for us? Will it ever?

“I think that infertility in couples can kind of go either way. It’s either going to hurt a marriage or make you guys closer. For us, it definitely brought us closer,” Sam said. “All of the struggles we went through, he was right by my side — at all the tests, all the procedures, doctors’ appointments. He was definitely very supportive, and I’m thankful for that.”

Tim, the area director of business development at Southern Care Hospice, worked remotely as often as he could and used paid time off when he couldn’t so he was there for Sam.

“I couldn’t physically take any of the load, and that was the hardest part for me,” Tim said. “For me to kind of just sit on the sidelines and be the cheerleader was tough. So whatever I could do, I tried to do.”

Sam began taking Clomid, an estrogen modulator that helps women ovulate. Clomid was, to put it mildly, a four-month disaster. Sam’s mood would swing wildly, once so badly that they got into a huge fight when Tim picked her up at the wrong door at Walmart. And the drug didn’t work.

They decided to see Dr. David McLaughlin, a specialist at the Men’s and Women’s Specialty Health Centers in Noblesville, who agreed to run some more tests. He was more diagnostic, they say, willing to go over every potential cause again instead of just prescribing more drugs.

In April 2016, Sam underwent an exploratory surgery. She learned she had stage 4 endometriosis, with 150 adhesions on her ovaries, fallopian tubes, bladder and bowels. The adhesions, which McLaughlin promptly removed, had been acting like toxic cobwebs, stopping normal bodily functions from happening as they should.

“That’s got to be it. It was kind of like the ‘Aha!’ moment. Like, here it is, we’ve figured it out. We cleared it and we’ll be good now,” Tim said.

The couple immediately moved on to another round of intrauterine insemination, or IUI, in which sperm is injected directly into the uterus. They’d tried several rounds of the expensive procedure before, spending up to $2,000 a month, but had high hopes after the discovery and removal of Sam’s adhesions that it would now work. They were told two-thirds of couples conceived within the first six months. They were met with failure, frustration and mounting medical bills yet again.

They agreed it was time to find another solution.

‘Every possible option’

Sam, tired of doctors’ appointments and medications, started to research adoption. Tim asked Sam to consider at least one round of IVF.

“Before I was able to accept that, I had to be able to check off every possible option,” Tim said. “If it didn’t work, then so be it.”

In vitro fertilization is often the last resort, the option people turn to when timed intercourse, Clomid, IUIs and all other attempts at conception fail. The Crosses had tried them all.

During the IVF process, several eggs are removed from the woman’s ovaries, then combined with sperm in a laboratory (inspiring the term “test-tube baby”). The fertilized egg, or zygote, is transferred into the woman’s uterus with the hope that it will result in a pregnancy. Often, more than one fertilized egg is implanted to increase chances of at least one resulting in a successful pregnancy.

In 2015, less than 2 percent of all live births in the U.S. were the result of IVF, resulting in 72,913 live born infants, according to the federal Centers for Disease Control and Prevention’s 2015 Fertility Clinic Success Rates Report. There were nearly 232,000 cycles of the procedure performed at 464 clinics across the country in 2015 — a nearly 73 percent increase in procedures from 2005, during which 422 clinics performed 134,260 cycles, resulting in 52,041 infants being born.

The Crosses agreed to give IVF a shot.

They went to a fertility clinic in Indianapolis, where they were quoted anywhere from $18,000 to $24,000 for one round of IVF — with no guarantees and no more than one embryo transferred at a time. They went straight from the doctor’s office to the business office, where they were shown payment options as if they were buying a car.

Sam had started picking up extra shifts at the hospital. Tim was crunching the numbers each month, watching their savings dwindle until he began to think about selling his beloved 2014 Dodge Ram pickup truck.

They looked for another clinic.

Sam mentioned to Tim a place she’d heard about called CNY Fertility that costs about a third of what they were quoted in Indianapolis. But it was in Syracuse, New York, nearly 700 miles away, and they’d have to make multiple road trips.

CNY Fertility is the brainchild of Dr. Rob Kiltz, known for taking on challenging IVF cases and treating his patients in a spa-like atmosphere at a reduced price. The average price of an IVF cycle is $12,400, according to the American Society for Reproductive Medicine. CNY Fertility charges $3,900 per cycle. The clinic’s website says much of its business comes through client referral.

Still, Tim was skeptical. Why should they have to go all the way to New York? How could it possibly be this cheap?

Tim put aside his concerns and trusted Sam’s judgment, knowing she’d done the research. He’d also seen the medical bills piling up, so a third of the price sounded great.

Kiltz talked with Sam over the phone for a consultation and went over her full medical history. She had to find a local doctor who could monitor her more closely; all visits were paid for out of pocket. She routinely gave herself dozens of shots of medications shipped from London. When her local doctor, again up in Indianapolis, said she was ready for the IVF cycle, Kiltz told them they had 48 hours to get to New York.

This past January, right about the time Tim first posted on Facebook, they made the 12-hour, two-day trip to Syracuse for a 45-minute procedure in which several of Sam’s eggs were retrieved. Three weeks later, they made the trip again for the transfer of two frozen five-day embryos.

“That was in January and February, so it was a busy two months,” Tim said.

The waiting game began.

‘This is real’

Tim was at the gym early one morning when Sam texted him. Come home, she told him, I’ve got some news. She had taken an at-home pregnancy test, four days after the embryo transfer, almost a week earlier than recommended.

Tim, slightly worried because his night-shift nurse wife was never up that early, rushed home and found Sam standing at the top of the stairs. She was smiling the kind of smile you get when your dreams are in the palm of your hand. She showed Tim the test and the faint line down the middle.

“I couldn’t believe it, because it was so early,” Sam said. “I think I was in shock for a really long time.”

They told their parents that night, handing a onesie purchased in New York to each set of soon-to-be grandparents — Bud and Debbie Cross and Mikel and Kathy Heck. Tim’s mom, Debbie, started to cry while Sam’s mom, Kathy, jumped up and down.

Sure, it was early, but they were determined to share every step of the journey with friends and family in person and on Facebook.

“We want to share that piece because this is real, and so many people go through this every day,” Tim said.

They started going for weekly ultrasounds and first heard the heartbeats at six weeks and two days. Yes, heartbeats. They were having twins.

“Having a baby is supposed to be the happiest time of your life. It’s not supposed to be sad,” Sam said, but she knew as well as anyone that isn’t the case for a lot of people.

Friends of friends began reaching out, hoping not to intrude or invade Tim and Sam’s privacy. The couple answered every question, and provided updates on their own journey. They’ve both continued to post on Facebook, with Sam recently posting a selfie with the caption, “Today I held a fussy baby, a sleeping baby and did the dishes all at the same time. #twinmom #aCROSSbetweenloveandscience.” The post racked up more than 125 likes in its first 24 hours, with one commenter calling Sam “Wonder Woman.”

“Once we did it and started getting so much positive support, then it kind of became fun documenting the whole journey,” Tim said.

Home at last

Pink and blue balloons hung on the banisters near the front door, which itself had been decorated with a “Welcome Home” sign by family members.

“Are you guys ready to see your house?” Sam whispered to the twins, each nearly swallowed up by the car seats in the back seat of Tim’s beloved truck.

On a Thursday afternoon in early October, the family of four entered their home all together for the first time — three years and an estimated $40,000 after Tim and Sam first started on this journey.

Together the young family crashed on an L-shaped couch in the living room. Each parent cradled an infant and a baby bottle, and enjoyed a moment of silence.

The previous month, Tim and Sam shared one full-size bed at Community Hospital North in Indianapolis nearly every night. The babies were born underweight at exactly 34 weeks, not uncommon for IVF babies but two weeks before their scheduled birth plan.

Ruby Mae arrived first at 5 pounds, 9 ounces at 1:31 p.m. on Sept. 11 via cesarean section. Brigham Glen followed a minute later at 4 pounds, 11 ounces. Both were quickly whisked away to the neonatal intensive care unit, or NICU, while Sam spent the next 12 hours recovering from the procedure.

The babies spent weeks developing under the watchful eyes of the NICU nurses. Friends and family, who had followed this journey for months, piled into Community North nearly every day. Many brought food for the tired parents, who were unable to leave the hospital.

For the new grandmothers, it was a dream come true. And not a moment too soon.

“It’s been a long time coming, from start to finish,” Debbie Cross said. “I always knew I’d be a grandma sometime, but I was getting close to 60 and wondering when it would happen.

“All-in-all, Sam had to go through hell to get them, but when you look at those babies, it’s just amazing.”

Kathy Heck, Sam’s mom, said these past few years have been a journey for everyone involved.

“Back in my day, if you couldn’t get pregnant, you just accepted that fact,” she said. “Mikel and I wouldn’t have ever thought of (IVF).”

Early on, she admits, she often said the wrong things to Sam, telling her that maybe it just wasn’t her time yet. That wasn’t what Sam wanted to hear.

But when Sam woke up from her C-section, upset that she couldn’t be with her babies straight away, her mom knew just what to say.

“Honey, you’ll have the rest of your life to hold those babies,” she whispered into Sam’s ear.

Since becoming parents, they’ve experienced a whole new level of exhaustion, Sam and Tim say, but also a whole new level of happiness.

“We never lost hope that we would have this one day,” Sam said. “It’s just a lot more than we thought it would be.”

Tim can finally allow himself to dream about coaching their Little League teams, already wrapping them in a pin-striped baseball jersey from his youth during a recent photo shoot. He’s also excited about planning their first trip to Disney World, but Sam says that’s at least five years down the road.

For now, they’ll enjoy the small moments like tummy time and bubble baths, knee bounces and much-needed naps. They’ll do it all together.

“It’s been a tough journey. Infertility; a very rough, high-risk pregnancy; the NICU; twins. I mean, nothing about this process has been easy,” Sam said, laughing about it all in hindsight. “Without his support, there’s no way I would have been able to make it.”

As they start this new journey as a family, Tim and Sam plan to continue speaking about infertility and helping other couples who are struggling in silence. They’ve both continued to post on Facebook regularly, letting people follow along on this new journey — the journey of a family of four.

“That’s definitely been the most gratifying for us through this whole thing (“Besides the twins,” Sam interjects), sharing this process and helping be messengers for something that affects so many people,” Tim said. “We know what it was like walking into this completely scared, didn’t know what to expect. Here we are three years later, and it’s all for something. We made it.

“Now we’ll share this message with people, and maybe they can see some hope. … You do have opportunity. These two are proof of that.”