A woman who struggled with infertility became a mom of 7 through surrogacy, IVF, and adoption

• After years of assisted reproductive technology, Josephine Atluri had a late-stage pregnancy loss.
• She and her husband then adopted a son, and later returned to ART to conceive twins.
• They now have 2 more sets of twins through surrogacy, she shared on the Pregnantish podcast.

Josephine Atluri knew early on that she wouldn't be able to conceive children the traditional way since her husband had survived a terminal illness that affected his fertility.

But she didn't know her path to parenthood would involve three alternative methods, at points devastate her mental health, and ultimately bring her seven children. Rather, she thought using assisted reproductive technology would be straightforward and "guarantee" her a baby right away.

Atluri, now a mindfulness and meditation coach who helps other people dealing with infertility, shared her story with Andrea Syrtash on Syrtash's podcast "Pregnantish."

Atluri and her husband first tried assisted reproductive technology

Atluri and her husband first used intracytoplasmic sperm injection, a form of assisted reproductive technology where a single sperm is injected into an egg in a lab before being transferred back to a woman's uterus. (In vitro fertilization is similar, but involves putting tens of thousands of sperm next to an egg in a lab until one fertilizes the egg itself.)

It didn't work.

"The more and more we progressed with the cycles, the more defeating it was, and the more it started to really impact my mental wellness and how I looked at myself," Atluri said on the podcast. "I started to look inwards and wonder if there was something wrong with me because my body wasn't able to work the science to create a child."

Eventually, Atluri and her husband switched to a different fertility clinic, where they felt more supported. Through it, she become pregnant with twins. By the time they reached the second trimester, "we finally felt like we could exhale," she said.

But then, Atluri experienced a pregnancy loss at 17 weeks. All doctors could tell her was that it was "unexplained," a word she called "devastating."

Atluri took months to grieve and reflect, and realized she couldn't bear to go through the ART process again. "I was exhausted, and the thought of possibly going through another loss, I didn't think I would be able to survive it."

That's when she and her husband pursued adoption.

The couple adopted and then used ART to conceive twins

Atluri and her husband flew to Kazakhstan to adopt their now-teenage son. The country was appealing because the wait time for getting a baby was far shorter than the two-year average of other places. On the other hand, it was a leap of faith because they didn't know anything about their match until they got to the country, where they were required to stay for a month.

"We decided to just go for it," Atluri said. "We had come to a point where we felt like we had nothing to lose."

A year after gaining their son, the couple decided to go for it again - this time trying assisted reproductive technology once more. With the help of a third fertility clinic, Atluri got pregnant again with twins. She underwent a procedure to close her cervix and was put on bedrest for part of her pregnancy in order to carry the babies to term.

But Atluri's family-building wasn't over. About five years later, the pair decided to use some of the embryos they'd frozen during ART process. Atluri couldn't carry them herself, based on her history, so they found a surrogate to carry her now-five-year-old twin sons.

That process was complicated too - taking about a year and a half to sort through potential surrogates and fill out all of the paperwork. In that way, Atluri said, surrogacy is like a combination of adoption and IVF.

"You'll hear things like, [using a surrogate] is 'out of convenience,'" Atluri said, "as if it were not a difficult proces or a difficult decision." She'd experience a mix of happiness, sadness, and jealousy, for example, after hearing about the surrogate's doctors' appointments.

"Just because you decide to do one path doesn't mean that everything else in the in the past has gone away, and it's wiped clean and that now you're going to become a parent and so you should feel better," Atluri said.

The family now has a third set of twins

On May 20, Atluri's family welcomed a third set of twins, who were also carried by a surrogate. She didn't elaborate on the decision to have them on the podcast, but did reveal how her journey to parenthood affected her mental health - and career.

Atluri developed an eating disorder after her second set of twins, a manifestation of the unresolved trauma of infertility. Now, she prioritizes mental health, and has made a career helping other parents and people dealing with infertility.