Bianca Romualdez-Espiritu is spending most of her time now taking care of her almost two-year-old twins Eliana Blythe and Elias Bryant, as well as 7-month-old Elijah Brasen. Together with husband Eljae, they are enjoying their time as a happy family of five.
But these moments of bliss were far from the many years of hospital visits for the Espiritus. After getting married in 2012, the couple wanted to have a baby right away. Little did they know it would never be easy for them.
Diagnosed with Polycystic ovary syndrome (PCOS), Bianca had tried almost all means possible from 2013 to 2018 to bear a child. Name it, and they tried it: fertility workup management (including hormonal assays, semen analysis for her husband, and sonohysterosalpingogram to check if there are any blockages to her tubes), intrauterine insemination (IUI), in vitro fertilization (IVF), supplements, essential oils, acupuncture, hilot, even dancing in Obando.
“Every single moment of those five years was mentally, emotionally, physically, and financially draining for me and my husband,” shared Bianca. “I started to question myself, why is this happening to me? Why was it so hard to conceive while some of my friends who also had PCOS got pregnant so easily? Every time we had a ‘schedule,’ it became so stressful, not just for me, but for my husband as well. Every time we underwent an IUI procedure, I always felt disappointed whenever I see only one red line in the pregnancy test. Every time my menstrual cycle got delayed, I was hesitant to get a pregnancy test because it might be another failure.”
All her injections: “Looking back at everything I had to go through—the physical and mental stress as well as the financial challenges—they were all worth it!”Bianca’s doctors then advised her to try IVF, only to be informed after one cycle of egg retrieval that none of her eggs matured so they could not move forward with the process. It was after this that Eljae and Bianca decided to let go of their dream to become parents.
“We told ourselves that if we end up just being the two of us, then it is okay. Maybe that is God’s plan for us. Our prayers were always that everything happens for a reason and that it is up to the Lord on what He wants for us,” she mused.
After a few months of rest, the couple heeded a friend’s recommendation to see another OB-Gyne who specializes in fertility problems. “Upon giving my OB-Gyne my medical history and everything I went through in the last four years, she said that she would like for me to conceive naturally. So she did not give me any fertility medicines to observe my body in its natural form. She asked me to change my diet: no gluten, no carbs, no red meat, no junk food, and for me to go back to acupuncture and to exercise regularly. I also took Metformin plus Probiotics, Vitamin D3, DHEA. After four cycles and still nothing happened, she told me that maybe my body was ‘rejecting.’ At first, I did not understand what she meant by it. She just asked me and my husband to take a Karyotype test and take several lab tests pertaining to the five categories of the Reproductive Immune Disorder (RID).”
Bianca's intralipid infusion sessions in April 2019 (left) and October 2020 (right)The Espiritus were not quite ready for yet another heartbreak—but there it was. Bianca’s test showed that she has APAS or Antiphospholipid Antibody Syndrome. According to Mayo Clinic, this occurs when a person’s immune system mistakenly creates antibodies that make his or her blood much more likely to clot. In pregnant women, APAS can result in miscarriage and stillbirth.
“I was in disbelief! I didn’t even know that this kind of reproductive immune disorder even existed. What was even worse was that I did not only have APAS (Category 2), but my lab results also showed that I was positive in Categories 1, 3, and 5!”
Distraught and devastated by this news, Bianca had so many questions. “Why did I find out about this only now?” “Is there a chance I can conceive given that I’m positive in almost all categories?” “What should I do to finally get pregnant?”
Her silver lining though: They now know what has been hindering their desire and dream to have a baby. Now that they know the problem, it’s time to get treatment and to work their way from here. She underwent four sessions of Lymphocyte Immunization Therapy (LIT), where white blood cells from donors were injected into her skin to prepare her immune system for pregnancy. The couple flew to Taiwan to visit a highly-recommended IVF center, which helped Bianca finally get pregnant. With twins! “I could not explain the feeling when I saw those two lines on the pregnancy test. All I knew was I was filled with so much joy & happiness!” she shared.
But as anyone with APAS knows, the pregnancy chapter is equally challenging. “At 8 weeks of pregnancy, we saw strong heartbeats. Since I was carrying multiples, I was advised to take another intravenous immunoglobulin and LIT session right away. This is to ensure that the fetuses will continue to ‘survive’ and not be attacked by my own immune cells. Throughout my pregnancy, I was prescribed so many medications aside from my prenatal vitamins. A few of those are Aspirin and Innohep injection to aid my blood clotting problems. Apart from those, I need to visit my immunologist every four weeks for an Intralipid infusion. Intralipid may enhance implantation and maintenance of pregnancy when the patient has an abnormal NK cell level (in my case, I had high NK cells from the normal value). This also helps the fetuses be at par with their weight versus the gestational age. At 16 weeks pregnant, my OB saw that my cervix was shortening and a pessary was placed to hold my uterus. This is to avoid the risk of premature labor. Since then, I had been on bed rest.”
Eljae and Bianca Espiritu with their three beautiful blessingsBianca gave birth on her 34th week, so the twins had to stay in the neonatal ICU for two weeks. “Looking back at everything I had to go through—the physical and mental stress as well as the financial challenges—they were all worth it!”
When the Espiritu twins were just seven months old, Eljae and Bianca found out they were having another baby, who was conceived naturally. Bianca had to undergo the same procedures as her first pregnancy, but she was more than willing to do them all over again. "Without my husband's unending support, I would not have done all this. I appreciate and honor him even more for doing everything for me. He accompanied me in all my doctor visits, he encouraged me to do things I had to do as per doctor’s advice, and he was my constant reminder not to be hard on myself."
Her advice for women with APAS: “Do not lose hope because with the right treatment and care, and a strong support system, most APAS women have successful pregnancies. Above all, pray and believe in the Lord and keep a steadfast faith for He grants more than what our heart’s desires in His perfect time!”
With one heartbreak after another, this strong woman had to go through so much before realizing her dream to become a mom. But she was unrelenting in such desire, and she is truly one inspirational mama.
