IVF

The convergence of infertility x race. An interview with Dr. Loree Johnson

Photo courtesy of Dr. Loree Johnson

Photo courtesy of Dr. Loree Johnson

Amid protests and a long overdue breaking point resulting in a world crying out to address racial inequalities and injustices, I was incredibly moved when I came across a heartfelt video that Dr. Loree Johnson shared discussing the intersection of infertility and race trauma. Up until that point, I am embarrassed to admit that I hadn’t realized that race might play a factor in access to quality health care let alone infertility treatment. That is a privilege that I am now addressing.

After listening to Dr. Loree and many other black women in the infertility community, I was floored as I pieced together research from studies conducted relatively recently which revealed that black women have lower IVF success rates and are more likely to suffer from a pregnancy loss. According to research, infertility affects at least 12% of all women through the age of 44 and black women may be almost twice as likely to experience infertility as white women. Yet only 8% of black women between the ages of 25 - 44 seek medical help. A survey of more than 1,000 women highlighted that black women are 2x as likely to avoid talking about their fertility challenges.

During our upcoming Sunday Session on July 19th, Dr. Loree will discussing some of the drivers of these issues including harmful stereotypes that black women are hyper-fertile and a general mistrust by the black community of the medical community based on historical experiences. We will also discuss how infertility impacts relationships.

Through becoming educated, advocating for representation and research, together with the BIPOC community, non-BIPOC communities have the ability to become an ally in supporting ending the flagrant disparity that not only exists in the infertility space but also the healthcare community at-large.

As we shed light on the global impact of race and infertility trauma, I am grateful that Dr. Loree shared her personal experience which has shaped her outlook and experience on this very important topic.

Did your infertility journey impact your career? Your own relationships?

LJ: Sadly, I’m not immune to feeling the effects of fertility struggles. Being around babies has been especially hard since I experienced my first miscarriage. It has been challenging watching other couples grow their families and seeing children that would be the same age as mine. My family and friends have been as supportive as they know how to be; it’s hard when you’ve never experienced fertility struggles or pregnancy loss. 

It has also been particularly challenging being a mental health provider who is also undergoing the struggles that I treat. However, normalizing my experiences and feelings have immensely helped me heal, which has only had a positive impact on my work as a clinician and coach. I can relate to my clients as a member of their community and not simply as some “expert.”

Can you share something that you learned about yourself as a result of your fertility journey?

My fertility journey helped me find purpose in my pain.

LJ: I learned that I could wade through various stages of overwhelm and still thrive. My process didn’t always feel graceful, and I felt awkward most times, but it was mine, and I am so proud of it.

What brings you joy?

LJ: The color purple, my dog Amore, traveling to places off the beaten path with my hubby.

You have been transparent about your recurrent pregnancy loss; how did/do you cope, and do you have any words of wisdom to share with others who have also suffered loss? 

LJ: Whenever I hear about someone experiencing a pregnancy loss or child, I experience a sinking feeling in my gut. The pregnancy/child loss club is one membership that no one ever signs up for. Each grieving process is going to be different, and the process is far from linear, where you reach a place of “acceptance,” as most grief models suggest.

I usually tell others what other bereaved mothers told me, “Your grief, your journey!”

Hearing those words allowed me the freedom to feel sad for as long as I needed to, to experience joy in whatever ways I could, to honor the depths of my anger that frustrated the heck out of me and appreciate the need to vacillate between seemingly opposing feelings as part of my pattern.

What gets you out of bed every morning?

LJ: My strength and resilience get me out of bed every morning. When I was heavy in the grieving process, getting through my day felt like a chore. When I turned a corner, I felt light again in a way I never imagined.

Recognizing how far I’ve come inspires me to push forward and show others how they can too.

Recently you have shared about the intersection of racial trauma and infertility trauma. Are you open to sharing about an experience you’ve had?

LJ: While the link between stress and fertility issues have long been challenged in science, I never fully believed it was not a factor. When I think about the everyday experiences of BIPOC, I always wondered how stress- mainly stemming from racial trauma, could NOT impact one’s fertility. If we know there’s a mind/body connection that helps improve our chances of conception, how would overt or covert negative messages about one’s race/ethnicity not impact one’s ability to conceive? 

In a conversation with a colleague from graduate school years ago, I mentioned my struggles with recurrent pregnancy loss and wondered about the connection between racism and infertility. She immediately affirmed my hypothesis, citing a friend of hers, making the same assertion. There was very little data out at the time, but the concerns were there.

To understand my infertility trauma, I think it’s important to understand my experience with racial trauma. I grew up in Richmond, VA, which used to be known as the Capital of the Confederacy. I went to school with descendants of many Confederate war heroes who were memorialized throughout the city. I was called the “n-word” a few times as a child and endured questions/comments from well-meaning white people about my hair, skin color, and manner of speech, which seemed like ways to join or relate but were only veiled racist ideas about who I was. After high school, I naively left the South thinking that life would be more progressively elsewhere. 

I spent my undergraduate and graduate years in Upstate New York, where I first encountered a doctor who I later believed held assumptions about me. After months of pelvic pain, she diagnosed me with Pelvic Inflammatory Disease, when, in fact, I had grapefruit and lemon-sized fibroids growing outside my uterus. After discovering that information, I felt suspicious about why she could not feel them when she completed my pelvic exams, which also included rectal exams each time (which I had never experienced before going to her or since). I had only one sexual partner and told her such, but she floated that diagnosis for a while until I pushed for more tests. 

I moved to the Los Angeles area almost twenty years ago and was shocked to see covert racism, bubbling beneath the surface. I worked in community mental health for several years, where most of the providers were white and the communities served were of color. I continued to endure well-meaning white colleagues commenting on my hair, skin color and that just became the norm. I brushed it off, but these microaggressions persisted and still do. 

Early during the Obama era, I had a sticker on my car, and it was vandalized.

Shortly after moving in with my now-husband, I was walking to the beach when a car slowed down, and one white man yelled to me, “White Power! The KKK will rise again!” Now we live down the street from a house that proudly hangs a confederate flag in the garage.

When in a group with my white family members, I’ve been carded when making purchases, and they haven’t. 

I can’t even tell you the countless number of people who still take liberties in reaching out to touch my hair. 

I’m sure there are more experiences that I can’t recall now, but the feelings of heaviness are still there. 

I’d also like to add that being the point person for all things racial for well-meaning white people is emotionally exhausting.

It’s tiring to try to explain why someone touching your hair or being carded is tiring, especially when people look at these experiences through their lenses of privilege where it might be happening innocently.

The statistics are staggering, and clearly the health care community needs to do better. Do you have any words of wisdom to share with BIPOC women suffering from infertility prior to seeking treatment?

LJ: Rest. Give your body what it needs and block out challenging things whenever you can. Go where you feel supported and feel seen.

What are one or two ways in which the infertility community can be an ally to black women in it? 

LJ: I have been telling my white stepdaughters how much power they have as white women to change the conversation and demonstrate allyship.

Being a good ally isn’t just about providing space to discuss racial issues. It’s about recognizing your privilege and using it to support your fellow women.

For those of us who don’t have the luxury of not being subjected to racism, it’s crucial to find ways to change the system the supports and perpetuates racist ideas. I think it’s important to get educated, as many of us (including myself) need to do. Generally, we were all taught the same history, and we need to relearn how we got here to envision a different system. 

Now that more data is coming out about the impact of racism and infertility, therapists and coaches can provide more space for their BIPOC to discuss their fertility experiences from a racial lens.

To learn more about the convergence of infertility and racial trauma, read Dr. Loree’s recent published piece in Thrive Global.

Dr. Loree Johnson is a Licensed Marriage and Family Therapist (LMFT) and Coach in private practice with more than 25 years of experience as a clinician, educator, and clinical supervisor. Specializing in women’s mental health and reproductive health, Dr. Johnson helps her clients overcome the emotional challenges that come with fertility challenges - including pregnancy loss and emotional trauma. She also helps couples, who have become divided by their fertility journey, strengthen their connection. Dr. Johnson is a clinical fellow of the American Association for Marriage and Family Therapy, and has served on both its state and national boards. She lives in Hermosa Beach, CA with my husband and toy poodle. In her spare time, she enjoys salsa dancing, traveling, reading, and riding my motorcycle.

Get to know more about Dr. Loree Johnson here and find her on IG @drloreejohnson

Pride and the Path to Parenthood

Credit: Jess and Heather Camarillo

Credit: Jess and Heather Camarillo

Heather and Jess Camarillo met in the early 2000's on MySpace! They were friends online for years and in 2010 it took a romantic turn. They were destined to become the Camarillo’s of Camarillo, CA!

Heather is a Systems Engineer at a leading tech company in California and Jessica is a former Security Engineer turned Real Estate agent. When they aren’t working you can find them at the beach or barbecuing in their backyard. They love being at home with their family, friends and fur babies, Lucy & Betty.

Together Heather and Jess share their story to not only de-stigmatize infertility and also to support the LGBTQ+ community with resources for the path to parenthood.

In honor of Pride month, I asked Heather and Jess to share their ongoing fertility journey with us.

HC: We started our journey in February of 2018 and discovered that I have extremely low AMH (0.12) which means I have Diminished Ovarian Reserve (DOR). We did two retrievals and were able to get two (2) viable embryos. We transferred the first embryo in October of 2018 and it did not implant. We transferred our second one in February of 2019 which also did not implant. We then went on to do 3 more IVF's. One of those IVF’s was canceled due to ovulation and on the other I had ovulated again at retrieval. During our last IVF we only retrieved 1 egg and it did not fertilize.

Luckily for us, in the summer of 2019 we met an amazing couple who had three (3) embryos to donate. We formed a very quick bond with them and they gave us their remaining three embryos!

We are now moving forward with the transfer hopefully in July of one of those donated embryos.

Our donated embryos are/were in Idaho since that is where they were frozen so we planned to do the transfer there. We didn't want to disturb the embryos at all by shipping them to our clinic in CA. However, due to the Covid-19 pandemic, travel has become difficult so we had one of the embryos shipped from the Idaho clinic to our clinic in Encino, CA!

We were very nervous about shipping our embryo. Our RE (Reproductive Endocrinologist) told us from the beginning that there was a chance that our embryo's would not survive the trip. That was why we had ultimately decided to do our transfers in Idaho. While it is rare that the embryo does not survive, we wanted to make sure we did everything in our power to get it here (to our clinic in CA) safely. We went with a courier who was recommended to us by both clinics and also purchased the additional insurance. It was very stressful especially during the couple of days when we knew it was in transit, but everything worked out perfectly. It was a super smooth process and we couldn't be happier with the transportation company.

You recently shared that “IVF wasn’t the quick fix you thought it would be”. What do you wish you knew now about your journey that you didn’t know when you started?

HC: At the beginning especially before finding out about my DOR, we thought that this would be easy. We are just a same sex couple who needed some help introducing my eggs to some sperm. I always had very regular cycles so there were never any indications that there might be a problem. Even after our consultation with our RE we still felt like this would happen since age was on my side. Other than the DOR I am very healthy and my RE let us know that even patients with DOR can still have a perfect, little baby.

It wasn't until after the first transfer that it really sunk in that this was going to be anything but easy or quick.

I wish I knew exactly how much of an impact my low reserve was going to be on this process. What we really wish is that we were aware of all of this years ago and even if we weren't ready to have kids, I could have still frozen embryos when I was younger; when I most likely had more eggs. We wish we knew then what we know now.

Based on your experience, is there anything you wish your healthcare provider knew about the needs of the LGBTQ+ population?

HC: Our RE was actually very well informed and had worked with other LGBTQ+ couples previously. We are very lucky in that aspect that our RE knew how to work with us.

What can straight people learn about the LGBTQ+ community dealing with infertility?

HC: We feel not everyone understands that it's not always easy for the LGBTQ+ community to come out of fertility treatment successfully. It is very easy for some and they are so lucky and blessed, but, others like Jess and me it has been anything but an easy journey. 

Has the infertility journey changed you in any way?

HC: I don't know if it has changed me or if it has just made me realize things about myself that I didn't before we started.

I have realized that I am much stronger than I thought; I have never failed at something so much. Usually when I put my mind and all of my energy into something I come out successfully. This has been different, I have failed multiple times, but I pick myself back up and keep going.

Jess doesn’t feel changed really but definitely feels more educated in regards to infertility, treatment and has learned how to be supportive for someone who is going through the treatments. Jess has also become an expert with administering injections which is something she never thought she could do!

We have both stepped outside of our comfort zones in so many ways on this journey and it has only made us stronger than we ever thought we could be.

Has infertility impacted your relationship?

HC: I think if anything it has brought us closer. I have heard that this can unfortunately impact relationships in a negative way. Jess and I want the same thing, we talk through everything and always make sure we are on the same page and are still aligned. Jess has been so supportive through all of this, she rarely misses any of my appointments and I feel very lucky to have such a supportive partner by my side.

How has your infertility experience amplified your pride in any way?

HC: So many in the LGBTQ+ community have believed the antigay rhetoric in our culture and have put off their dreams of parenthood.

I feel it's important that we help each other (in the LGBTQ+ community) feel empowered to try and have the families we have always wanted.

We heard and saw stories from others where they were treated poorly or even told they wouldn't be helped because of their sexuality. We felt that we wanted to help our community from having to go through this so we have built out a document with LGBTQ+ friendly clinics. We have also thought about creating an app where this information is easily accessible and up-to-date.

What resources can you share with others in the LGBTQ+ community who are considering expanding their families?

HC: There are many wonderful groups on Facebook actually that are specific for the LGBTQ+ community wanting to start families. They are extremely informative and supportive. Also, if you would like to look at our list of LGBTQ+ friendly clinics (national and international), here is the LINK. 

Support Heather and Jess’ journey by following their story @camarillosofcamarillo on IG.

Mindful Fertility: Meet Simone Tai

Simone Tai. Photo by @unicornproductionsla

Simone Tai. Photo by @unicornproductionsla

Right now more than ever, we need hope. Hope that this new world and all of the mental/emotional hardships that come with it. It’s hard to live a life on pause with constant concern for family, friends, and community, then add the complexities of infertility - cancelled cycles or feeling a sense of guilt to still be in it and/or possibly even scared that it might be cancelled at any given moment, or possibly even the anxiety of being pregnant after so many disappointments during the journey.

Enter Simone Tai, a beautiful soul who found her purpose during her infertility journey. Inspired by serving others and comforting herself, Simone left the film industry and became a meditation teacher. During this time of uncertainty, Simone’s kind heart and expertise remind us that above all hope and gratitude are not cancelled.

It is my sincere pleasure to introduce you to Simone.

Describe yourself in 5 - 7 words. 

ST: Liverpudlian lass with an adventurous compassionate soul.  (Liverpudlian means from Liverpool, England and ‘Lass' is slang for girl in the North of England) 

Quote that you live by?

“My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.” – Maya Angelou

What is your purpose and how did you find it? 

ST: To help women learn the tools to suffer less and know their true value, power and purpose. I’ve always naturally done this with friends but discovered it was my purpose during my own fertility journey.

I realized if I could learn how to get out of the way of my own pain and suffering and feel as fulfilled as I do today then I could truly help others do the same.

I learned how to harness these skills and see it in full effect when I became a meditation teacher. 

You've been on a fertility journey of your own, would you mind sharing a bit about it?

ST: Of course. It's a LONG story but I’ll try and keep it snappy.

My husband and I started trying for a baby soon after we married in 2012. Over the next 8 years we did everything and anything you can imagine (8 rounds of IVF, 5 rounds of IUI, clomid, supplements, acupuncture, energy work, plant medicine, crystals, multiple tests and procedures such as hysteroscopy for a septate uterus, immunology testing, laparoscopy, & recent diagnosis of endometriosis). No stone left unturned…  It was one of the hardest things i've been through and I’d never felt so worthless and broken. It became cathartic for me share my story by blogging about it in ‘bubblesandbumps’ and going on to do a TEDx talk. Hearing from supportive, kind women in the same boat made a big difference to me. 

After nothing but miscarriages and chemical pregnancies we did our final final frozen embryo round in January of this year which wasn't viable and have decided on no more medical intervention.  We will continue to take care of our health and will try naturally of course, but we are now really excited to be going through the adoption process and can’t wait to see how our baby will come to us.

The journey has been messy, it broke me, my husband and our marriage BUT we got help and healed.

Today, we have never been stronger, happier, more in love or more ready to have a family. A few years back I would never have thought this was possible. 

How has meditating taught you how to cope with the roller coaster of infertility?

ST: On a physiological level, meditation taught me the power of our thoughts and the mind-body connection. Research shows how mindfulness balances our hormones and regulates our monthly cycles (a crucial part of fertility that’s often ignored in Western medicine). I also use mindfulness to help me sleep and to feel energized in the day - a lifeline when taking meds and feeling overwhelmed and stressed!

On an emotional and spiritual level meditation taught me that I am more than my fertility story.

It showed me that I had the power to heal and soothe my suffering. That no matter what obstacles come my way in life I have all of the tools to navigate them. I now know how to live a life where I THRIVE and not just survive. 

What has this time of uncertainty taught you that you would like to pass along to readers?

Like so many others right now my job (at a local meditation studio) stopped abruptly and therefore so did my income.

I panicked and felt isolated at first but then asked why is this happening FOR me?   It gave me chance to PAUSE, look around and ask, how can I do this differently?

I embraced my fears and started my own online meditation classes and events, within 1 week I was booked by 2 big clients: NBC studios and CBS to be their regular mindfulness coach. IF I had stayed in the safety of my studio I wouldn't have braved something new.  Sometimes we are pushed in a new direction but it feels wrong at first, but the terrifying new road might just be the route that makes you.

What keeps you going? 

The feeling in my heart. The power of compassion.  The desire and ability to help transform suffering (mine and others) and into a life of love and beauty. 

As Thich That Hanh wrote ’No mud, no lotus'  The secret to happiness is to acknowledge and transform suffering, not to run away from it. The beautiful lotus flower needs the mud to grow.

If you could have dinner with anyone, who would be and why?

I’d have a dream dinner party! It's my nature!

Oprah for her wisdom and stories for days, John Lennon, fellow Liverpudlian to sing at the party, Martin Luther King to share his profound wisdom and compassion. I'd ask how he would handle modern day conflicts and corona virus! Prince Harry to share the royal gossip and because of his fun, cheeky side. I’d also have ‘Moira' from Schitt's Creek. She cracks me up! We all need humor in our lives, it's healing. 

About Simone Tai:

Simone Tai is a British Meditation Instructor and dedicated practitioner for over 14 years. Her qualifications include: 400hr Mindfulness Meditation teacher training, 200hr Vinyasa Yoga TT, Mindful Self-Compassion TT, Google’s Mindful Leadership SIYLI, and Reiki levels 1 & 2. 

Coming from a background of 15 years as a TV Producer, Simone first turned to meditation to help with work related anxiety and pressure. But it was an emotional 7 year fertility journey (shared in the blog 'Bubbles and Bumps) that led her to dive deeper into the practice. After seeing the immense benefits in her personal life and career, Simone now combines all her training and experience into her classes, workshops and courses to help others build inner strength, resilience and happiness. Her aim is to offer kindness and support whilst making meditation accessible and digestible to all!

Try this free 15 minute fertility meditation that helped soothe my anxiety and build my inner strength. 

Learn more about Simone through her site and Bubbles and Bumps fertility blog. For more meditation tips, please visit Simone’s YouTube channel. You can follow her on Instagram here or email her to find out about private sessions at simonetai@me.com

Photo credits: First photo: @unicornproductionsla. Others: @jacquelinepattonphoto

Pregnancy on Pause: Dr. Anate Brauer talks about infertility treatment & coronavirus

Dr. Anate Aelion Brauer A. Brauer, M.D., FACOG and Shady Grove Fertility - New York’s IVF Director

Dr. Anate Aelion Brauer A. Brauer, M.D., FACOG and Shady Grove Fertility - New York’s IVF Director

I never anticipated that we would be having the conversations that we are having now about the implications of a worldwide pandemic on infertility and fertility treatment. I often wonder what the world will look like in the (hopefully) not so distant future once we get past this pandemic; locally, nationally and globally.

What I have noted in these past few weeks is that humanity can be beautiful when we come together. Community empowers us to set aside our own fears and anxiety in support of one another and those on the front line. To support the mental health of other infertility warriors on hold with kindness and simply checking in, to feed hungry children who relied on getting a meal each day at a school which is now closed, to protect and nourish our healthcare workers with personal protective equipment (which is is dire shortage) and feed them healthy food to fuel their immunity during extensive shifts so that they can continue to save lives.

What you may not know is that in certain places around the country including NYC, our fertility doctors are also being asked to volunteer to be on the front line to fight against Covid-19. The same doctors that you know help create life are now being asked to sustain it. I had the opportunity to catch up recently with Dr. Anate Brauer, one of our healthcare heroes who is ready to the answer the call if it comes.

I cannot wait for a nation no longer on pause, to see Dr. Brauer live and thank her for her empathy as well as lending her support and expertise to both infertility and in relation to a cause that none of us saw coming.

Dr. Brauer, what does your work day look like now versus two weeks ago?

AB: Wow. Where to begin. Two-three weeks ago my office was bustling with patients excited to embark on their journeys to parenthood.  My day was filled with in-person consults, retrievals, embryo transfers and other procedures aimed at achieving the ultimate goal, PREGNANCY.  Over the past couple of weeks, following state local and national guidelines, we have quickly shifted to remote practice of medicine.  SGF (Shady Grove Fertility), as an organization, quickly developed and adopted an efficient telemedicine protocol which has been absolutely crucial in our continued delivery of care. Currently, my days are spent mostly on video consults as well as many calls and emails surrounding specifics of Coronavirus as it relates to fertility and pregnancy. As IVF Director of the New York region, I am also on SGF’s Coronavirus task force, which meets almost daily as situations change.  

What has changed about patient protocol and office visits since ASRM released its view on treatments?  

AB: Shady Grove Fertility - New York is now fully operational as a remote practice. It has been pretty incredible to see how quickly we made this happen. A patient calls to schedule a new patient or follow up visit, is registered into our secure portal where he or she will receive instructions on how to set up a link to a video consult.  That link is then placed in to my daily schedule. We both simply click on the link and we are connected on a HIPPA compliant platform on our phone, tablet or computer. The patient can also upload our patient questionnaire and any records into the portal with help of our patient coordinators so that I am able to review prior to our consult. We are not currently doing any non-urgent testing or treatment, however are working on abilities for remote testing.  We are continuing necessary in person care of our medical fertility preservation (for cancer) patients and our pregnant patients, and have very specific screening and social distancing protocols in the office. 

Is testing included in your screening for patients that may have been exposed to Covid-19?

AB: We are not currently offering coronavirus testing in our office. If patients have been exposed, they are directed to contact their primary care physician. 

What is SGF's view on pregnancy right now? How long does the medical community anticipate that it will take to understand any potential implications of pregnancy?

AB: The first reported cases of Coronavirus came out of China in November of 2019.  Since this is a novel virus, there is little data about its effects on pregnancy. Data existing about other Coronavirus is reassuring, however. This is why the American College of Obstetrics and Gynecology and the Society for Maternal Fetal Medicine have NOT come out with statements that women should avoid pregnancy.  

Does a pregnant patient have the potential to become more ill from the virus and could it affect a developing a fetus?

AB: We do not have any reason to believe that a pregnant patient will become more ill from the virus. We also have no data to suggest that the virus can affect a developing fetus. It is important to note that any virus that causes high fevers, such as the flu for example, can cause pregnancy complications. Coronavirus is no different. 

Is SGF still planning to continue with new egg freezing, retrievals and transfers?

AB: SGF - NY is no longer initiating new, non-urgent fertility treatments. We are, however, very committed to taking care of our patients who require time sensitive fertility preservation, and therefore, will remain fully operational for those specific cases. 

Will there be any impact to the embryo if mom tests positive during the cycle?

AB: Not that we know of. 

Will SGF- NY proceed with treatment situations that require immunosuppressants?  

AB: We do not generally use immunosuppressants as part of our protocols as they are not evidence based, and in the current environment, likely cause more harm than good. 

What happens if someone had to cancel a treatment mid-cycle? Can their financial investment be recouped?

AB: There are clinical protocols in place of what to do medically if you must stop in mid cycle. These protocols revolve around decreasing risks of OHSS in the setting of no retrieval.

Financial investment is a whole different issue. Just as in the case of cancelled cycles for other reasons most clinics will only charge for what had been done thus far and therefore patients should be able to recoup the bulk of the cost that comes from the retrieval itself. Another option is crediting part of their current cancelled cycle to their resumed cycle after the virus is under control.

Anything else you would like the (in)fertility community to know?

AB: This is a very difficult time. As IVF director of a large center in the heart of NYC, I am faced with new challenges daily during these unprecedented times. Remember, we, as an IVF community have to not only protect our current patients, but protect our precious eggs and embryos in our freezers during a time of crisis and possible shut downs. We know and understand that infertility in and of itself is an extremely anxiety provoking state which makes the current situation even more unfathomable.

We are right there with you. We are a team that now more than ever needs to (and are) working together to find the safest and most practical solution(s).

This. Will. End.  You will build your family. And when you do, you will cherish it in a way the world has never experienced. That’s what crisis does. It makes you stronger and opens your eyes to new appreciations for everything around you. 

Dr. Anate Aelion Brauer A. Brauer, M.D., FACOG, is a board-certified reproductive endocrinologist with extensive experience in treating all medical and surgical aspects of infertility. She serves as Shady Grove Fertility - New York’s IVF Director. Learn more about Shady Grove Fertility - New York here, and Dr. Brauer on IG: @dranatebrauer

*Note: Clinics may be operating slightly differently based on ASRM guidelines and where they are located in conjunction with the epicenter (NYC) and other US hot zones.

More About Dr. Brauer. Dr. Brauer earned her medical degree from the George Washington University School of Medicine, where she was elected to the prestigious Alpha Omega Alpha medical honor society. She completed her residency in Obstetrics and Gynecology at New York Presbyterian Hospital-Weill Cornell Medical Center. Dr. Brauer subsequently completed her fellowship training in Reproductive Endocrinology and Infertility at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine and Infertility-Weill Cornell Medical College. Prior to joining Shady Grove Fertility, Dr. Brauer was an Assistant Clinical Professor at NYU School of Medicine.

Dr. Brauer has expertise in ovulation induction, in vitro fertilization (IVF), egg freezing, pre-implantation genetic testing and third-party reproduction including donor egg, donor sperm, donor embryo, and gestational surrogacy. She applies the latest clinical data, state-of-the-art technology, and extensive clinical experience to optimize pregnancy rates while minimizing patient stress with her supportive approach to care.

Dr. Brauer has published and presented at numerous national meetings on the topics of optimizing fertility treatments in patients with diminished ovarian reserve, polycystic ovarian syndrome (PCOS), or those using a gestational surrogate; fertility preservation; and complementary therapies in infertility. She is especially passionate about helping young patients with cancer build families, which has led her to serve on the Advisory Board of the Young Survivors Coalition. Dr. Brauer is a regular contributor on a variety of women’s health topics to local and national media such as Parents, Reader’s Digest, Refinery 29, Woman’s Health Magazine, Byrdie and Shape, to name a few. For Shape, she serves on their expert Brain Trust.

She is a fellow of the American Congress of Obstetrics and Gynecology and an active member of the American Society for Reproductive Medicine and the Fertility Preservation Special Interest Group.

Dr. Brauer enjoys spending time with her husband and their three children. She also enjoys cooking and running or spinning for exercise in her free time.

Dr. Brauer, who is also fluent in Hebrew, joined SGF in 2019, and sees patients at SGF's New York office, located in the heart of Manhattan.

Both Sides: A couple's perspective on their infertility journey

Photo Credit: Filipa Jackson and Sameer Walji

Photo Credit: Filipa Jackson and Sameer Walji

As high school sweethearts, Filipa Jackson and Sameer Walji spent countless hours daydreaming of their future. They saw a house, a dog, and five kids. Being a young and healthy couple, they didn't foresee any problems once they were married. With the house and a dog checked off their list, their next move was to have kids. Little did they know that this would be the start of a long journey…

After three years of undergoing countless fertility treatments, they finally got their positive pregnancy test after a round of IVF + ICSI and FET with their only embryo. Though their story has been filled with heartbreak and letdowns, they found their way through - with the support and encouragement of each other.

Here is a rare glimpse into both sides of the story.

Filipa, what went through your mind when you decided to start fertility treatment? 

FJ: I felt a weird mixture of disbelief and relief. I was scared and excited all at the same time. It seemed like I was finally on the right path.

What do you know now that you wish you knew then?

FJ: That DNA Fragmentation tests are so important. I just can't imagine the amount of unexplained infertility cases that might have been helped. They should be given to a man at the start of the fertility journey, there just isn't enough testing for men, it's all on the women. We would have saved thousands of dollars and countless months of heartbreak if this test had just been done at the beginning.

Who was your support system and how/did you feel supported?

FJ: My husband, Sameer, was my greatest source of support. Through all of this we became super close. No topics were off limits. The good, bad, and downright ugly. We saw each other at our lowest, and were there to hold one another.

What was your low and what kept you going?

FJ: My lowest point was during IVF. We were waiting for our last two embryos to become blastocysts. It was day 5 and my fresh transfer was cancelled. Why? Well because my little embryos were only at 90 cells, they needed 100 cells, and if they didn't grow over night, it would be game over. Thank goodness they made it. But I remember those loooooong 24 hours of waiting in hell. I was a heap on the floor, but my darling husband and fluffy forever puppy Coal joined me there. They validated my feelings and let me cope the only way I could in that moment.

Was there a silver lining?

FJ: I had lots of silver linings, but the one that I cling to most is connections. Through this I became closer to my husband, my family, and I truly found myself.

First thought when you found out that you were pregnant?

 FJ: What?! We were in pure disbelief. I had done a sneaky test about 5 days prior and it was negative. We just couldn't believe that the beautiful second line was real.

You have been upfront in sharing that you didn’t publicly share about your infertility journey to protect yourself. In hindsight, is there anything that you know now that you wish you had known going in?  What would you have shared/said to those battling infertility?

I wish I had spoken out sooner. I would have realized how therapeutic it is, I would have also seen that I wasn’t alone and that the fertility community is a wonderful supportive place. So if you need to reach out, don't be afraid to, yet also know that on the opposite side, it's ok to be quiet. There is no wrong or right way to deal with what you're going through. You find what works best for you. 

Sameer, what went through your mind when you went through the first infertility treatment with Filipa?

SW: Fear was my main emotion! Fear of the unknown. I'm not one to visit a doctor for anything, now I'm letting them in on the most sensitive of topics.

What do you know now going in, that you wish you knew then?

SJ: Well the cat’s out of the bag, my swimmers aren't as great as we were led to believe. So I would've done the DNA Fragmentation test right away. I can't recommend it enough.

Did you do and/or change anything to support Filipa during the process?

SW: We were both going through lifestyle changes. My main ones were trying to be more active, eating healthier and kicking my daily beer to the curb.

Who was your support system and how/did you feel supported?

SW: I think as a man, you feel like you are the one providing the support. I didn't really have anyone apart from Filipa. It's not something the guys chat about down at the pub. But Filipa was there for me, she kept me sane.

What do you think holds most men back from discussing infertility? 

SW: Pride. It feels like your masculinity is questioned when you're going through fertility treatments. Pathetic I know. I didn't have the strength to talk about it before, but this is something I avidly want to change.

First thought when you found out that you and Filipa were pregnant?

SW: Disbelief. We had gone through all of this for YEARS! My mind was pre-programmed for failure. So it took a while to sink in, but boy once it did... pure joy!

If you were going to do an infertility PSA for men, either dealing with male factor and/or supporting a partner undergoing treatment, what would it be?

SW: It may sound cliché but communication really is key. It makes comprehending issues so much easier. Filipa and I would talk for hours, not only about fertility but everything really. It was super therapeutic and brought us a lot closer. So don't be afraid to be vulnerable in front of each other, you are a team, you are in this together.

Please support Filipa and Sameer as they continue their journey! Drop by their site PlayingWithApparel where both Filipa and Sameer candidly share about their experience and don’t forget to say hello. You can also find Filipa and Sameer on IG at @filipajackson and @playingwithapparelmen

Q & A with Kelly McLay: on early menopause, marathons and motherhood

Photo courtesy of Kelly McLay

Photo courtesy of Kelly McLay

At the age of 24, Kelly McLay was diagnosed with the seemingly impossible - premature ovarian failure (early menopause). This is the story of how a marathon helped her journey take on a new meaning - keeping her running towards the finish line and her family.

You were diagnosed with hypothyroidism at 10. Did your doctor recommend any lifestyle or diet changes? Was there any discussion about your future fertility?

KM: Thyroid (disorders) run in my family so it was almost inevitable that someone in my immediate family would have one.  My grandparents, my mom, my two uncles, my cousins and my sister and I all have a thyroid condition.  We are an overall healthy family so there were no discussions about diet. While women with thyroid issues have greater fertility issues, I was only 10 at the time I was initially diagnosed and usually any major complications from the disorder begin around age thirty so infertility was not the focal point in my youth. To entirely lose my infertility in my early twenties was a shock.  It’s also rare that a thyroid condition would result in complete (ovarian) failure. My sister has a thyroid condition and has had two babies naturally, with a third on the way.   

Was there a tipping point in your early twenties or an experience that pushed you to seek medical assistance?

KM: In the (Women’s Health) article I reference that I was a hot mess.  I was truly out of control, both physically and mentally.  I had sought support from a medical professional for over a year who upon my third visit asked, “Why are you here? Your symptoms haven’t changed”.  That pushed me over the edge. I remember saying, “I understand that I am not bleeding profusely but this is not me. I don’t go to bed at 8pm and then wake up tired twelve hours later”.

I had always been athletic but gained over 45 pounds that year alone.  I was tired all of the time, cranky, crying and acting irrationally. My doctor advised that I was just getting older.  I sought a second opinion and that doctor finally listened. She asked if I had ever had my thyroid tested so I shared that I had a thyroid issue when I was younger but was told that I no longer needed to take the medications. Loaded with this background, my new doctor retested my thyroid.

The tests revealed that my metabolism was that of a 90-year-old woman.

My new doctor was so supportive and prescribed thyroid medication for me to take daily, advising that the medication should fix my symptoms, but if I noticed anything else to please let her know.  I felt crazy sharing seemingly irrational symptoms, but did anyway. I had been crying about a lot of things, I felt off balance, at some points happy and then immediately sad. I would sweat through my bed(sheets) every night and then have to change them because they were soaked through. Upon hearing this, my doctor offered to run some blood work. Neither of us had any idea what information I would soon receive. My FSH levels revealed that I was well beyond menopause.  I asked where someone my age was on the scale and she said they’re not.

The results were definitive, I had gone through menopause.

How many doctors did you see before you received the diagnosis of menopause?

KM: Two.  One who didn’t listen and one who took the time to hear what I was saying, even though my symptoms were not at all typical for someone my age. 

You mentioned that the ultrasound tech described your ovaries as “shriveled raisins”. Do you recall your first reaction?

KM: Do I ever.  My eyes are tearing with the memory.  I would expect that when most people think of ultrasounds, they might correlate it to pregnancy and seeing an outline of a baby. At least that is what I associated ultrasounds with…

At my first-ever ultrasound the technician volunteered out loud, that my ovaries looked like shriveled raisins. I just laid there quietly on the exam chair as the tears dripped from my wide open eyes and off of the sides of my face. I will never forget that moment.  I wish I had said something but in the moment I remained stoic until she left, and then cried more. 

At what point were fertility options discussed and how did you feel when you were told that you would have to use an egg donor? 

KM: After the diagnosis I saw a series of doctors. They all began with a discussion of diet and maintenance.  We spoke about potential side effects of long-term use of estrogen (during cancer treatment) and also possible effects of not being on not being on estrogen (bone density loss and increased cardiac concerns).  I was advised to increase soy into my diet, to add supplemental estrogen, and use kegel balls (to strengthen my vaginal muscles). All of this was a shock, I didn’t fully grasp all that was happening,

Almost immediately, I had an appointment to see if there were any follicles remaining and if they could be stimulated.  I was desperate to hold onto any flicker of fertility. But there here wasn’t an option. Egg freezing didn’t really exist at that time. Regardless, the results of the follicle exam indicated that there was no amount of stimulation which could result in any eggs to freeze.

One (fertility) doctor said to me point blank “At the end of the day I can get you pregnant but it won’t be your baby”.

I burst into tears.  Her delivery landed coldly and harshly. It was then that I realized that the only opportunity in which I could carry would be via donor. It was a stark reality at the age of 24.

It took a long time to advocate for myself and find a medical team that cared and understood. I now have an amazing team who are almost like family. My endocrinologist and fertility doctors have truly been on this journey with me; I am so grateful for their support. When my husband and I were ready to do the egg donor process and begin fertility (treatment), the first clinic we went to had their own agenda and not ours in mind. It was important for us to find a place where they had our best interests in mind so I am grateful we looked for a second option and found what we were looking for.  

I can now tell that person who is considering egg donor that my baby is every bit mine and even acts like it too. Friends always say “are you sure she is not your DNA”!

You wrote that running inspired you to own your diagnosis of early menopause. What attracted you to running? What was it about running that created a release?

KM: I needed a goal. I was young and had always been an athlete but actually hated running. I had been tired, depressed, and just needed motivation. My sister and her friends had begun training for the Boston Marathon and I threw myself into their goal. Thankfully they welcomed me. It was not pretty and it was not easy but I did it. 

I spent over a month trying to jog one three-mile loop. I cried. I was in extreme pain. My legs and lungs stung and I thought if I couldn’t run three miles, 26.2 seemed ridiculous.

But it was that commitment, that pain, the pounding the pavement and seeing the progress that inspired me to keep putting one foot in front of the other. So much of what had felt like failure and the part of me that had died, now felt alive. It was really powerful.  I was motivated to do more, to go further.  

How has running changed your life?

KM: In so many ways.  This passion became my profession. I started out taking runners around the world to run marathons, and then it turned into the company that I started called Fitness International Travel (FIT).

Running has brought me around the world to all 7 continents four times. Even more so it has opened up a community of people and individuals who are incredible.  We are all so different but the marathon unifies us and unites us through both the hardships and celebration of the accomplishment.

I never expected that from those moments of solitary winter training for the Boston Marathon that I would be here today. Had I not gone through menopause, I wouldn’t have started running and I wouldn’t have had all of these positive experiences. 

How many marathons have you completed? And you mentioned that you ran 7 marathons on 7 continents in 7 days… That is amazing. Where were they and how did you keep going?

KM: I keep telling my husband I have to go back and track all the marathons!  I have about 70 under my belt in total.  The World Marathon Challenge – 7 marathons, 7 continents, 7 days – was and is amazing.  I still pinch myself.   We started in Antarctica, then went to Cape Town, Perth, Dubai, Lisbon, Cartagena, and finished in Miami.  I did the marathons untrained 13 months after the birth of my baby.  It was painful but so much growth comes through navigating pain and with each finish, I was closer to the goal.  Trust me there were moments at 2am in the rain when I wanted to quit. But I didn’t.

“Living isn’t about quitting, it’s just about trying one more thing, even if you have to walk or crawl to do it.”

You shared that thirteen years to the day after you found out about having premature ovarian failure/early menopause, you crossed another marathon finish line in Dublin with the new title of mom. How has becoming a mother changed you? What would you say to anyone contemplating going the egg donor route?

KM: I had so many fears about the egg donor process.  There were so many unknowns.  If you sat with any financial advisor and stated the amount of money that you planned to spend on an unpredictable outcome, I can almost guarantee that they would likely not recommend that investment.  It hasn’t been easy and there were more unanticipated speed bumps than I could have imagined.  I am grateful to have an incredibly supportive husband who is completely in it with me, and we lucked out with a beautiful and intelligent little girl. 

There were all sorts of fears of carrying “someone else’s baby” and what if “the baby didn’t look like me,” or what I would say if someone said, “she has your eyes.”  So many doubts and fears.

My daughter has blue eyes.  The donor had brown. My husband has green.  Everyone says “ah she has your blue eyes!” And I just smile and giggle and say “yes, she does!”

I had so much bonding when I carried my daughter, Scarlett. I ran with her throughout 28-weeks of the pregnancy and she now loves running too.   My husband and I have also kept our lifestyle mostly in tact with the (addition) of our baby.  Scarlett has already traveled to four continents and while she is our first priority, she is part of our life and has adapted easily to our interests.  If anything, Scarlett allows us to see the sheer joy in the simplest acts of life.  

We also have this amazing woman that helped us get to where we are (by donating her eggs). Seriously, how incredible is that sacrifice for someone else to help give you the gift of life?  When we decided to go the donor route, we were not sure about whether or not we wanted to meet our donor.  Now we are glad that we had the opportunity to meet her, Our donor is absolutely stunning woman inside and out and we are forever indebted.  It also  adds an additional layer to the story about the evolution of our family.

Would you feel comfortable sharing your fertility journey and how it has continued?

KM: Yes of course. This is part of who I am and part of this entire process.  Our egg donor cycle was very successful resulting in 17 embryos, all of which made it to day five. We then implanted two embryos resulting in a successful singleton birth with Scarlett. We froze 13 remaining high quality, high scoring embryos. 

Scarlett arrived early at 32w6d due to pre-eclampsia.  I went into the hospital, shared that I wasn’t feeling well and then surprise, I was induced and delivered Scarlett. Funny enough, we had the baby on the Wednesday before my planned (baby) shower that  Saturday. We spent 4-weeks in the Special Care Nursery where despite prior genetic testing results from the egg donor and my husband, we were advised that Scarlett had a rare genetic disorder that would lead to feeding tubes and wheelchairs. They took a test, told us we would find out for sure in three months, and that we should enjoy these moments with her prior as she would start to miss milestones. We were devastated.  We left the hospital with medicine and educated on how to administer daily injections to our new baby girl.  Turns out, she is completely fine.  But what a scare! Although nothing is perfect, running completely helps me tackle all of these moments of spontaneity and unpredictability.  

After successfully getting pregnant the first time, we thought, what are we going to do with all the embryos?!  How naïve were we! We decided to try for another child in February of 2018.  We went in for the transfer and 10 days later found out that we were pregnant. The blood work and HCG escalation were fantastic. We told my parents and then BOOM, miscarriage. 

After our first miscarriage, we thought, not all of the embryos must be good.  We watched my HCG descend, just as we had initially monitored my HCG rise along with our hope. Each (blood) draw was a stark reminder of the loss. Still, we were optimistic because we had additional embryos.

On my birthday, May 1st, we did another transfer but it didn’t take.  On June 12th we opted to transfer two embryos. Although the idea of twins scared us because we had a premature delivery with Scarlett, the increasing transfer attempts, losses, and the preparation each transfer was becoming more difficult so we transferred two more embryos. Both took and the numbers looked incredible. Our enthusiasm was short lived when we learned of another miscarriage which would need to be followed by a surgery. 

After multiple tests for natural killer cells, blood clotting disorders, thyroid levels, scans of my uterus and then some, the results all came back normal without indication of a larger issue.  On October 4, 2018, we did another transfer, and once again miscarried twins.  Then we did one more transfer and that embryo didn’t take either. Pregnancy test after pregnancy test revealed a big fat negative. 

Our last effort without testing embryos was to do a cycle where we did an ERA, a biopsy of my uterine lining in hopes to find the perfect transfer time post-introduction of progesterone.  Once we received results, we did a transfer on May 8, 2019. At the time I was taking Lovenox injections daily, five estrogen pills vaginally and orally, an estrogen patch every three days, intramuscular progesterone oil injections every three days (later nightly), along with B12, selenium and pre-natal vitamins, a thyroid pill, baby aspirin. I also applied Crinone (progesterone) lotion twice per day. This time we got pregnant with twins and celebrated the day after we made it past our furthest miscarriage date. Then I bled the next day and my husband and I were convinced that once again, we had lost both babies.

Fortunately, one baby is still with us and we are 23-weeks as of today.  I recently found out that I have a vasa previa, where the baby’s blood vessels are exposed over the cervix and if they rupture the baby is at risk. I will be hospitalized at 32 weeks if not sooner with an emergency c-section planned for no later than 35 or 36 weeks, if I make it that far.  

It hasn’t been an easy pregnancy.  I am scared daily something will happen.

It’s never quite simple is it?  I hold on to being fortunate to have a chance at having this second baby.  Despite how hard it is to go through (infertility), science is pretty incredible. Years ago I wouldn’t even have these opportunities at all.

You recently penned an excerpt in the book, Tales from the Trails. What inspired you to contribute? What do you hope that readers will take-away once reading your fertility story?

KM: I was honored to be asked to include this excerpt on Why I run, by a great friend and mentor Michael Clinton who is the author of the collection. It was entirely scary to be so vulnerable but so much of who I am has been shaped by this experience that I believed it to be important to share. I have always been open about my struggles despite the fact that so many other people are not. I believe that sharing these experiences may potentially help one or two people in the same situation. At least that is my hope. So I shared our story with the hope to inspire a few -  women, men (husbands), a few families to continue to take one step forward despite what feels like constant failure because of the relentless obstacles.  

What I love about the book is that they are a collective of inspirational stories from so many different perspectives. Many people might find inspiration that resonates with them within the book. As mentioned earlier, running unifies people from different backgrounds and experiences. I think that this book exemplifies that.  

At the end of the day, there is nothing greater than to get home to my little girl and her daddy.  Scarlett has motivated me to be an even stronger person and role model. I am grateful of all the obstacles that we have faced because I have learned so much through them.   We are still at a scary point right now, and we hope that we have a successful outcome. Only time will tell between now and then.

In the meantime, we will just take one step forward and continue to lead by my mantra of “Happy Days.”  Life is too short not to.

It’s important for me to share that however someone becomes a mom or a dad, that baby is theirs. My fears, ugly thoughts and doubts on what move to have taken, or even how far I should have kept going disappear when I come home from a long day and my baby greets me at the door shouting “Mamma”!  



About Kelly McLay: Mom, wife, marathoner, and traveler, she values living by the mantra, "happy days," trying to live life to the fullest every day.

A two-time seven continent marathon finisher with 65+ total 42K courses under her belt, Kelly is passionate and respectful of the marathon distance. Kelly has 10 years of experience in guiding and developing sports travel to all seven continents.

In 2018, Kelly completed earned her World Marathon Majors’ 6th star as well as the World Marathon Challenge, 7 marathons on 7 continents in 7 days. She is one of 41 women globally who have finished the challenge. Kelly resides just north of Boston with her husband John and baby Scarlett. Outside of her family, there is nothing she takes more pride in than designing destination travel around the world, especially to marathons. To learn more about FIT borne out of Kelly’s incredible journey, click here.

The 5 things to never say to anyone with infertility

Photo by Kristina Flour on Unsplash

There are unspoken rules related to (in)fertility. And since you may not even know that someone is struggling, it’s best to avoid asking some of these all-too common phrases and questions which no matter how well intentioned will likely not be taken as such.

Rule 1: Never tell someone to “relax and it will happen”

I remember beings so stressed out about the needles, distracting myself with the stress of my job and then stressing about being stressed. It made it worse when people would tell me not to stress. It is basic science that if the body is hyper-stressed (and releasing high quantities of cortisol hormone), it can signal to the body that the focus is survival, and not on making a baby. How is that in and of itself not stressful? 

And you or your sister, cousin, or friend Denise who got pregnant by taking a vacation likely did not have scar tissue obstruction, PCOS, endometriosis, an unexplained diagnosis or the myriad of fertility challenges that are still being discovered. You may have the best of intentions because you just don’t know what to say, but do not bring up those two words (don’t stress), no matter how well intentioned. Ever.

Rule 2: Do not say you “just know that it will happen”

The self-pressure is already so incredibly significant. Do not promise that you know a future which the person or couple, their doctor, and you do not in fact know.

Rule 3: Avoid any consolation with “why don’t you just adopt”

Adoption is a beautiful option. However, the mental process to get there requires that someone make peace with not fulfilling a potential dream of being pregnant. Your comment may be construed as asking someone to give up on their dream. There are also many other aspects emotionally, mentally and financially that the intended person or couple will have to think about and plan. So while absolutely incredible, if a person or a couple wants to expand their family with adoption, they will likely do so without your surface suggestion.

Rule 4: Do not ask “do you want to have kids”

How do you know someone hasn’t been painstakingly trying for months or even years? This question can be a dagger in the heart and is just plain nosy. This question is just as rude as asking someone how old they are. It’s personal and if someone wants to tell you whether or not they want, or are trying to have children, they will let you know.

Rule 5: Delete this phrase from your vocabulary: “You’ll understand one day when you’re a mom (or dad)”

This is so obviously insensitive to the person or couple who is/are trying their hardest to be a parent. And since most people don’t reveal their fertility journey, better to just strike this from your playbook all together.

Don’t know what to say?

Share that your friendship is important and you are always there to listen. Please don’t try to relate with your experiences if you have never been through infertility. And if you have, ask for permission first or wait to be asked before you share your journey.

Infertility affects one in eight couples in the US. Resolve, Pregnantish, Robyn, It’s Conceivable by Rebekah Rosler or even this blog to share as resources if and when someone is ready. From that point, sending positive good vibes and little thoughtful gestures are the best words to remind someone that you are there and thinking of them.

Any other unspoken rules that you want to share? Please feel free to leave them in the comments!

From Bumps to Baby with Liz Shaw

Liz Shaw and her baby girl. Photo provided by Liz.

Liz Shaw and her baby girl. Photo provided by Liz.

Although you wouldn’t know it, I only recently met Liz Shaw. Liz has quickly become a friend, confidante and source of nutritional expertise for me. I met Liz as she was launching her Stress-Free IVF Nutrition Guide and am so grateful that I had the opportunity to recently review it during my recent (fourth) IVF cycle. (You can read more about the Guide here.)

Liz is a Registered Dietician, Certified Personal Trainer and owns a nutrition consulting business. Based on her own experience with infertility she has bridged the gap between diet/nutrition and the process. Liz lets us in on all of her secrets with her recently published Stress-Free IVF Nutrition Guide and also her Fertility Foods Cookbook.

Liz is someone that you need to know. Not only because she may be the world’s kindest and gentlest soul but because her understanding of nutrition as it relates to fertility and overall health is an absolute game changer. I caught up with Liz the other day and am excited to share our discussion with you!

What does fertility warrior mean to you?

LS: That’s a great question! I have a whole series devoted to the women (and men!) who’ve gone down a path that’s not so easy to expand their families. A warrior in the sense that they continue to persevere despite the challenges of their “battle” with infertility.  I have a colleague who’s trying to open up and change the negative connotation around warrior and instead focus on the strength and power of the women (and men!) and I love that vision too! 

Since you are a RD, were you surprised when you struggled with your own fertility?

LS: Yes! But then again, even doctors get cancer and dentists get cavities, so we are all human!  As we know, infertility doesn’t have a type. It affects all of us, health professionals and athletes and people of faith, there’s no discrimination. What’s important for people on the outside to remember is that infertility is not something someone can control. It’s often caused by so many factors in which there is no one size fits all approach to treatment.

I like to try and remind people that finding the right treatment plan for them, the right professionals to guide them on THEIR path is what will make this entire process that much more bearable in the long run. And let’s be real, sometimes this is a VERY LONG RUN! 

Please share your story

LS: My husband and I started our journey to expand our family about a year after we got married in 2012. Realistically, we didn’t intend to get pregnant right away, but I had been on birth control since I was 13 years old and we knew it would take some time for my body to regulate.  Lo and behold, we waited, and waited some more. 

I was finally diagnosed with unexplained infertility related to my hypogonadotropic hypogonadism  (HH), which is a lack of hormonal regulation in which little to no sex hormones are produced. You can read more about that experience here, but essentially it was the beginning of a long road for my husband and I which also coincided with entry into the assisted reproductive technology route to expand our family. 

I truly believe any period of waiting is challenging for a want-to-be-mama. Be it a two-week-wait or a trial time for your body to “figure itself out”, neither is a desirable scenario. Thus, we did a mix of both. We started with an IUI, entering full force with the notion that this was our ticket to baby. After our first failed attempt, I was crushed. I never fathomed the emotional pain of that particular experience and surely wasn’t ready to jump into another emotionally, financially, and physically exhausting experience. Side note, because of my HH, I was placed on the IVF medication regimen for my IUI round.

Our doctor at the time assured us that the highest rate of success would be to start IVF. In February of 2016, we decided that was our next step. We took some time off since we had been on this rollercoaster since 2013 and knew we needed to find the joy in our marriage again. We signed up for a Spartan Race in Hawaii, dominated that race and came home to start our first round of IVF…

It was during this time of waiting, I began to feel lost, alone and so confused. I knew I needed to seek help, and through that formed the community known as Bumps to Baby. This community has been my rock, my outlet to share the innermost thoughts I’ve felt on this journey to baby and most importantly, a safe place for others to find security and friends through. While it began as an Instagram account, it quickly morphed into a private Facebook Community and a full website with a special feature for others to share their stories, too, known as Warrior Women Wednesday. 

After our IVF retrieval, my body responded very poorly and we were unable to do a fresh transfer. Of the 15 eggs retrieved, only two embryos were viable for cryopreservation. As bad as that day was getting the news that our 15 had turned into two, the worst was yet to come. The two days in which we received the news that both embryos didn’t take (during the transfer) was by far the lowest of the low in our 4.5 year journey to baby. Honestly, it was during our final failure in August of 2017 that I knew I needed to take a step back from ART treatments. I needed to regroup, find a new sense of peace with my body and begin to remember, baby or not, I (needed to know that I) was enough as a person, a wife, a woman.

Fortunately, my husband was also traveling back and forth between Switzerland and the US for work during this time. I was blessed with the opportunity to join him for the remaining part of 2017 and so we packed up our belongings and moved to Locarno from the end of October through mid-December of 2017.

During this time, I was able to find that sense of peace. I was able to mourn our losses, the trials and tribulations that infertility had taught me and began to refocus on the community of Bumps to Baby and the messages that I wanted to help communicate. It was also during this time the passion project I had worked on with a close colleague and friend was released, The Fertility Foods Cookbook. The cookbook helped merge my love of nutrition and heart for the fertility community into one.

This experience, this break, this opportunity to learn to trust my body again is ultimately what led to the greatest twist and joy in our journey to baby. I’m happy to report our miracle baby made her way into our arms August 4, 2018. A true testament to the powerful role stress can play in your health and most importantly, the importance of finding trust and healing your relationship with your body, remembering you too are enough! 

What pieces of advice would you share with someone on their (in)fertility journey?

LS: I think I would sum up my advice in the hashtag #NeverLoseHope. Infertility can feel like such an isolating journey when you’re in the thick of it. I was there for years before I decided to break the silence and find comfort from my #ttcfamily. And believe me when I say, we are not alone! We know the statistics show that 1 out of 8 couples struggle and lets be real, likely someone close to you is going through the thick of this disease too.

When you feel comfortable enough to share your story, to seek help, know we are here for you. Join the Bumps to Baby Private Support group and begin feeling a new sense of peace and warm welcome into the family you never wanted to have, but are blessed to be a part of!

How do you feel about the word “journey”? Love, hate or both and why?

LS: Love the word journey! It shows that it’s not a start and stop point but a continuous path, especially once the individual does see their rainbow and begins the new journey of motherhood.

You recently wrote the Stress-Free IVF Nutrition Guide, what was the inspiration? 

LS: It was a way I could give back to the community that has been such a rock for me time and time again over our five-year journey. As an RDN, it was everything I wish I could help tell patients who are lost, confused and consulting Dr. Google before beginning their cycle. Truthfully, it’s the guide I wish I had when I was going through our cycle, too. You can pick up your guide here. Use the code fertilust for a 10% discount.

Favorite fertility foods ranked

LS: Tough call! I love variety so really a plethora of fruits and veggies in nourishing bowl or pile high on thick, seedy whole grain bread!

This  Amaranth Buddha Bowl and these Beet Burgers recipes are some of my favorites!  

Pineapple core pre-transfer. Myth or reality?

LS: Myth, to some degree! Little to no scientific evidence exists on this. Every Friday a group of RDNs and I debunk myths and share fertility nutrition information! We actually covered this one here, and you can follow the weekly series here!

What gets you out of bed in the morning?

LS: My sweet little pineapple, aka my rainbow baby! Even before her arrival, I was driven in my career and lucky enough that my passion is able to be pursued each day by helping women and men understand the important role nutrition can play in their bodies. 

What keeps you up at night? 

LS: The endless tabs I have open in my brain! Whether it’s work, parenting, family, the Bumps to Baby community, or what I want for breakfast, I have a hard time unwinding and closing down at night! 

 

About Liz Shaw: Liz is a Registered Dietitian and Certified Personal Trainer in San Diego, California. She owns a nutrition consulting business in which she works with brands to help disseminate key health messaging to practitioners and consumers at large via national speaking, TV segments, and through her strong social media presence. Liz also runs a maternal health private practice in which she specializes in fertility nutrition. She is an author of the Fertility Foods Cookbook published last fall and a blogger at both Shaw’s Simple Swaps and Bumps to Baby.

Liz is also a freelance writer and serves as a nutrition expert for many national publications, such as Shape, Women’s Health, Men’s Health, Muscle and Performance, Fit Pregnancy, Parentsand others. Her current position has led her to what she loves most, educating the public at large about the importance of nutrition and health in daily life while connecting individually with those struggling to build their families. Helping to empower others through nutrition is truly what brings Liz joy!

 

 

The misconceptions about IVF conception

Photo by Nine Köpfer on Unsplash

National Infertility Awareness Week may have finished but the need to understand and support (in)fertility is a year-round topic. It prompted me to reflect on my own expectations going into my journey and what we can do to support individuals or couples undergoing (in)fertility treatments. Here are some common misconceptions:

Misconception #1: Getting pregnant by IVF is a sure thing

I wish it was, but sadly it is not. I went into two rounds with high hopes because everything “looked more than fine.” I came out on the other side with multiple fails and a non-diagnosis of “unexplained”. Doctors can have great success rates, high hopes, and by doing so, may raise your expectations. Know that they have the best intentions but they are only human after all, and science has only hit the low hanging fruit at this point. This (in)fertility process can reveal many things but not always a baby. After a glowing prophecy of a beautiful embryo that doesn’t take or worse miscarries, it can feel like someone just punched you in the face (multiple times).

Please be sensitive if someone tells you that they are undergoing IVF. To give some perspective, imagine sticking yourself with medicine/hormone filled syringes that make your emotions a roller coaster, your bloat world-class, and the bottom half of your body weighed down by giant egg follicles growing in your ovaries.

Be supportive, even if that just means listening, and/or sending good thoughts and positive vibes. Please do not heighten the expectation and pressure by talking about the future. The patient and doctor don’t know the outcome yet, please don’t pretend to either. 

Misconception #2: The patient is just along for the ride

IVF is a team sport. It always takes two, right? Biologically, you need an egg and a sperm but in the IVF case, the outcome is also assisted by a doctor. While it is on the doctor to choose the right protocol based on a patient’s medical history and needs, the patients still need to take care of themselves. Think about planting anything. The foundation and the conditions need to be right for anything to grow and healthfully. Same applies here. And the partner isn’t off of the hook, the patient’s well-being and the long term success of the relationship depends on it. 

Misconception #3: There is only one path to a child.

How an individual or couple gets there may not be the way that they envisioned but the end result can still be the same. Options exist and ultimately one day this will be readily available to everyone who wants and has the capacity to be a parent.

After my second IVF failed, my doctor shared that she thought it was a good idea to try again. In the same breath, she shared that if I failed a third time, she wasn’t sure that she could help me. Initially I was stunned, and that feeling turned to despair. I thought that I was a failure, blamed myself for not doing enough (acupuncture, eating enough greens), and that I might never be a mother. Yes, there were a lot of waterworks. So ugly. And yes, I found a new doctor.

What I wish that I would have known then was the comfort of knowing that there are options including egg donors, surrogates and adoption. Although it’s a lot to think about when you are determined to go about one path, it can be a relief to at the very least be aware that there are possibilities to achieve the end goal of having a baby if the general IVF route doesn’t work.

Misconception #4: If I share my (in)fertility story, people will think that there is something wrong with me.

There are 7.3 million (documented) cases of (in)fertility* and this is will continue to grow and impact future generations as we continue to live in a polluted, endocrine disrupting world. (Sorry for the Debbie Downer moment.) The (in)fertility topic is about to become so much greater than just our personal egos.

(In)fertility isn’t punishment for something, it just is the reality for many individuals and couples. In fact, (in)fertility affects 1 in 8 couples*. Many people that you know are grappling with (in)fertility, they may just be in the closet because of the many emotions borne out of the shame created by the silence around it.

The sooner that we stop hiding behind a perfection that doesn’t exist, accept that (in)fertility is a topic that we need to embrace, the sooner that we will be able to rally support from our workplaces to make the conversation safe and resources available for (in)fertility. After all, happy, healthy employees and families make happy companies, which in turn creates a happy economy.

*Source: 2006-2010 National Survey of Family Growth, CDC

NIAW Feature: Finding a Voice

Jane Jolis captured by photographer, Alexis Mera. Shirt design by Kayla Kleinman.

Jane Jolis captured by photographer, Alexis Mera. Shirt design by Kayla Kleinman.

Although National Infertility Awareness Week (NIAW) has completed this year, I thought it was important to close out the week with Jane Jolis’ powerful story of advocacy. It’s a message that we should carry with us all year long. Jane reminds us that nothing is promised, including a baby, and that when we listen to inner voice and advocate for ourselves, we are set up for success to arrive, and confront the root of the issues that may be standing in our paths to parenthood.

However nebulous and out of our control this journey is, using our voices to advocate for ourselves is paramount. Jane and I discussed that If something doesn’t feel right, it probably isn’t. There is something to be said about following our gut after all…

Jane’s story

I’ve always wanted to be a mother, ever since I was a little girl. I was the three-year old stuffing my shirt with pillows to “play pregnant”. So it came as a particularly painful shock when, after six months of trying, my husband and I learned that we should try IVF. I have diminished ovarian reserve, and my husband, low morphology/motility. We skipped over IUI and went straight to IVF.

Despite our challenges we had success in creating healthy embryos right from the start. However after transferring a total of four in the span of one year and having no success, we realized that something was wrong. I had to push hard and advocate for myself in order to have the laparoscopy which is ultimately the reason I am now a mother.

In December of 2017 I had the surgery to uncover suspected endometriosis, and not only did they find endometriosis but they also found that both of my (Fallopian) tubes were damaged and had hydrosalpinges. Hydrosalpinges meant that fluid was leaking into my uterus and could be toxic to the embryos. Damaged tubes also accounted for why I’d never been able to get pregnant naturally.

My Fallopian tubes were removed and after a canceled cycle, heartbreaking in its own right, I did my fourth IVF cycle and a fresh three-day embryo transfer, ultimately resulting in the birth of my son, now four months old. Although my situation turns out to be somewhat rare given that nothing ever came up on any scans indicating that my Fallopian tubes might be damaged, it speaks to the fact that if I hadn’t advocated for myself, I am not sure how long it would have taken, or if we would have been able to tackle the problem directly.

Your High?

My true high was the birth of my son, and still is. Also just seeing that first positive pregnancy test with a strong line was incredible. However I’d say another high, as crazy as it sounds, was learning that my tubes were severely damaged, and that they’d likely been impeding my success all along. As sick as that sounds, when you’re deep in the darkness that is unexplained infertility and IVF, any answers are positive because it may mean a solution to fix it.

Your low?

There were honestly so, so many. Every failed transfer was a huge low. The lowest was probably after my second transfer when I was in fact pregnant but lost the pregnancy after only a week or two, (a chemical pregnancy). I’d been watching the HCG rise, but not enough… and I spent the worst weekend of my life obsessing over (pregnancy) pee sticks and texting pictures to my doctor. At one point I found myself on the bathroom floor at 3 am surrounded by sticks. My husband had to physically come and remove me from them and from the bathroom. I was a wreck. Watching the HCG rise but not ultimately rise enough was one of the slowest tortures that I could ever have imagined. I truly felt broken after that, and had no idea how I was going get past that (moment).

Do you have a silver lining?

This experience has led me to build a fertility coaching/advocacy consultancy as I feel called to work with women and families struggling with (in)fertility. There is such a need to support those in the deepest thick of this who are trying to navigate the darkness with no end in sight. I can relate to that feeling of sheer panic and fear because I have been there. I’ve realized that this is the work I’m meant to do, and I’m working to build this business. 

Do you have any words of wisdom?

Stop trying to pressure yourself to “stay positive.” This was the hardest part for me; trying to maintain hope and optimism when all I felt was panic and dread. Sometimes you just need to feel your feelings and lie in the darkness and cry. And that’s okay. You will eventually make it to the other side, but that “other side” may not look the way you’d originally thought it would, and that’s okay too. Letting go of maintaining a falsely positive outlook was integral to my survival (during the journey).

There were many times that I thought I would never be a mom, but had I felt that my doubts were further holding me back from getting pregnant, it would have made me even crazier. The truth is, feeling good and relaxed is ideal, since stress (during IVF) is real. If you don’t always feel positive, don’t beat yourself up over not feeling that way. Whether or not your attitude is 100% positive all of the time is not going to be what does, or does not get you your baby.

Jane lives in Brooklyn with her husband and four month old son. As a direct result of Jane’s experience, she is currently building an (in)fertility advocacy and coaching practice. Please stay tuned for details or reach out if you would like to be connected with Jane.

NIAW Feature: The Waiting...

Jennie Monness photographed by Alexis Mera. and shirt design by Erin Halper.

Jennie Monness photographed by Alexis Mera. and shirt design by Erin Halper.

I was first introduced to Jennie recently and I was immediately struck by her kind and gentle energy. She literally radiates positivity, and that is why it makes it difficult to believe that she has ever had a difficult day. Infertility wears many masks and Jennie has been brave enough to shed those by sharing that both getting pregnant and pregnancy itself weren’t a walk in the park for her.

There is a reason why “waiting is the hardest part” is a tried and true quote. Like many of us, Jennie put a lot of pressure on herself to get pregnant, and when it wasn’t happening, she took action by finding a mentor and advocating for herself to try to find out why.

Jennie’s story:

I remember hearing that once you want to have a baby it goes from 0 to 100 really quick. That’s what my relationship was like with infertility. Starting at a zero anxiety level, in no real rush, I went off of birth control in November 2015.  My husband is younger than me and he was nervous and not totally “ready.” So, I told him we could wait but that first I needed to know that we didn’t have any issues getting pregnant, as I wanted to stay at 0. I was 32 and slightly hesitant about waiting and having a potential issue. So I got checked, and he did too.

Sure enough, we found out there were some issues. We were told that we could still get pregnant naturally but that it may take a bit longer. That is when it went from 0 to 100 for me. I soon felt that I couldn’t get pregnant quickly enough and I needed it to happen yesterday. We gave it five months and nothing happened. We decided that with no real remedy for our “subtle” issues, we should visit a fertility doctor. The doctor told us he’d try an IUI. Two failed IUI’s later we decided to move onto IVF. I remember one doctor telling me “you decide how fast you want to ride this train,” and I jokingly told my mom, I wanted the freaking ACELA express. 

I spoke to a close friend who had done IVF and asked her for advice as I stepped into this uncharted territory. She told me that before I start the process of IVF I should ask for a saline sonogram. I humored her and asked my doctor for one. I got the saline sonogram and the results showed that I had a septate uterus and needed a surgery called a hysteroscopy. I had to postpone our IVF process for this surgery. I felt so impatient and as if time was running out. Once the hysteroscopy was done, we started egg retrieval. After retrieval and ICSI, we had created successful embryos and were lucky enough to get plenty. We were hopeful and excited for our first transfer. It failed. The same friend who advised me to ask for a saline sonogram, mentioned a reproductive immunologist.

Due to a family history of immunological issues, we made the tough decision to postpone our next transfer until I visited this reproductive specialist. I couldn’t get an appointment right away, so this meant about a two month delay in this process that already couldn’t happen quickly enough. Against everything I felt in my heart, my head told me that I needed to do this, and give this next shot everything I could. I finally had my blood appointment, where they took a ton of blood. A few weeks later, the doctor put me on a protocol of steroids, blood thinners and intralipids.

My next transfer was a success and I was pregnant by March of 2017.  I now have the most incredible 16 month old girl and know that this whole journey was because SHE was meant to be my baby. 

Your high?

The moment Tess was born!

Your low?

My failed FET because it meant more waiting. Waiting was the hardest part. Patience and getting pregnant don’t really go hand in hand when you want it. There were doctors who told us to try for 6 months and come back, or doctors who had “black out” periods, or medical necessities we had to go through (the IUIs, the hysteroscopy, the reproductive immunologist, the intralipid protocol, etc.,) and the waiting was torture.

Not only that, but we had no idea if the waiting would result in a pregnancy and it brought on questions like “am I too old?” or “what if I cant ever get pregnant?” I had never had a pregnancy before in my life so the waiting was especially hard because we were living in this unknown period of “will we ever be parents and how long will it take?”

Do you have a silver lining?

Infertility let me know that there are some things that I can’t control. I’ve lived my entire life mapping out when and how things were going to happen, and they always seemed to fall into place. Infertility taught me that just like I anticipated motherhood to be, life doesn’t always happen according to plan. I’ve learned to accept that and I felt stronger and more ready to become a mom because of it.

Any misconceptions that you had on journey?

Once I was on the route to IVF, I thought that I would be guided along the way until pregnancy. While I had incredible doctors, there were a handful of things that I had to ask for, advocate for, and fight for in order to find the right treatments. What took me a year and a half, with most approved by insurance, could easily have taken 5+ years with an insurance denial, had I not quickly learned that I had to be my own advocate. I had to fight hard for what I knew was right.

Do you have any words of wisdom?

Be your biggest advocate and never give up. Our journey would have taken some couples years, but because I asked for specific things early on, and had an incredible support person telling me what to advocate for, my process took us just one year. No matter how many delays and disappointments there were, I just kept trying and kept going. Although a year seems like an eternity during this process, I got through it knowing that by being my voicing my needs and concerns, I was already advocating for my future child and moving closer to becoming a mom. 

Jennie Monness is the founder and creator of Mo' Mommies and Union Square Play, a place go meet, socialize and build community for moms and their babies. Jennie studied Psychology in Education and received her Master’s Degree from Teachers College, Columbia University. She completed the Foundations to RIE® course and is currently completing her practicum in the approach as well. Visit momommies.com and @momommies to learn more.

NIAW Feature: Finding Community

Rebekah Rosler, photographed by Alexis Mera. Shirt Design by Ko Im.

Rebekah Rosler, photographed by Alexis Mera. Shirt Design by Ko Im.

Rebekah Rosler is a professional licensed master social worker (LMSW) and therapist, who has always had a passion to lift others. That passion became a mission after Rebekah’s own fertility experience. Rebekah has used her strength and voice to create (the Warriors) community for other women on their (in)fertility journeys by creating a safe, online community of support and empowerment.

Read on to learn more!

Rebekah’s story

Interestingly enough, I never thought that I wanted children. I spent my life making sure that I could not and would not get pregnant… Only to find out that when I met my husband and my life changed, I wanted children. I also discovered that I wouldn’t be able to (without assistance). In retrospect, it makes sense to me because there had been fertility challenges for both my mother and grandmother. I didn’t think that children would be on my life path so I hadn’t really thought about it much before (that point).

I met my husband at 33, we got married at 35, then tried to get pregnant for a few months. When we didn’t have success, we wanted to proactively find out if everything was alright. Per the recommendation of my doctor, I got a HSG (hysterosalpingogram), and found out that one of my Fallopian tubes was blocked. That meant that every other month my chances of a pregnancy were at zero. As a result, we decided to seek (medical) help right away.

I had heard about good outcomes from New Hope so decided to go there. The reality is that although I got the desired results I was looking for, I saw my doctor once in the three years that I was there. All communications were through the nurses and through email correspondence. Initially, my protocol was as follows, month one: timed intercourse, month two: medicated intercourse, and month three: IUI. When that didn’t result in a pregnancy, we took the doctor’s counsel of doing Mini IVF. (The focus of Mini-IVF is quality over quantity.)

In my first round of Mini-IVFI got six eggs, five made it to the blastocyst stage. I transferred two freshly at day three, and froze three. One of those two embryos transferred stuck and became my now three year old daughter. A year later, I transferred two embryos that were day 5 and 6, getting pregnant with twins.

I realized that my experience gave me the ability to start create a community and start a group (called Warriors) to support others on their journeys. Having run Warriors (closed Facebook group) for over three years and seeing the years of struggle, sadness, heartache, and financial distress, I am aware that every (in)fertility journey is unique. I was lucky to have conceived quickly after treatment with the outcome of having healthy babies. Although my journey wasn’t filled with heartache, I had to go through it myself to understand the importance of talking about (in)fertility, and how to support others going through it.

What did you learn from your journey?

I never wanted kids, decided I wanted kids, took action immediately and got lucky. I never had the true struggles that so many people go through with (in)fertility. What I had was a life changing experience that allowed me to support and help other women (during pre-conception). It introduced me to a different version to help and support women during their experiences which were more often overwhelming, challenging, disheartening and at times tragic. It also allowed me to create a career to continues that platform of support through Mom MeetUps.

After starting Warriors, I started Mom MeetUps to help women on their journey of motherhood. My fertility experience was my initial earth shattering, aha moment that showed me that what I was called to do, was to help people through their fertility journeys. That lent itself to supporting the motherhood journey later on.

Your high?

I feel so lucky that I got pregnant and have a three year old daughter, that I am mildly obsessed with. My next high after a terrible pregnancy, was carrying two incredible babies to term and having a healthy labor. After all three of them were born, my third high was leaving my paying career to create a company to help other women along their journey. Through the means that I had, I was able to offer support groups to the Warriors group, and also create tailored Mom meet-ups to those who had fertility challenges prior to conceiving and then had a baby, twins, or multiples. We have since created meet-ups for single, first-time, second-time, stay at home, and working moms, as well.

My educational background is in social work and I always knew that I wanted to be a therapist or help in some way. My own fertility journey brought me to this; health and women on the path towards creating their family. I had always been on the “this is what I am supposed to do” track; from high school, college, to graduate school, without intention or true personal passion. I put one foot in front of the other until this happened to me. This gave me the ability to do something for others and hold their hand through their journey. Being able to add any light to this dark place has been incredibly rewarding.

Do you have a silver lining?

Perhaps the silver lining was the group created for women who are hoping to be, or are already moms, to have a safe space to share personal experiences. I have heard that the Warriors community has been helpful because even women who are desperately trying to become moms are still able to support each other when they are going through some of the most trying times in their own lives. Warriors (group) has proven to be a place that people come for kindness, to share, seek resources and support. There is something that needed to exist in this (fertility) space that didn’t before.

Your truth?

Even when our stories go exactly the way that we envisioned or hoped, having a group of other women that are there to support, empower and show kindness, has made all of the difference. I have learned that it is not only about us, it’s just as much about participating in a greater community.

Rebekah is a 30-something infertility warrior, mom to three babies (a 3-year-old and a set of twins), Licensed Master Social Worker, doula, and co-Founder of Mom MeetUps. Rebekah leverages her blog bexhasbabies.com, social channels and Warriors group to share her experiences and help normalize the message of infertility, breastfeeding and postpartum challenge.

If you are looking for a community to support your or a friend’s (in)fertility journey, please reach out to hi@fertilust.com to be connected with Rebekah’s safe Facebook group called Warriors.

NIAW Feature: Options are Valuable

Anthea King-Pascual captured by Alexis Mera. Shirt designed by Kayla Kleinman.

Anthea King-Pascual captured by Alexis Mera. Shirt designed by Kayla Kleinman.

I had the opportunity to sit down with fertility warrior, Anthea King-Pascual to discuss her journey of secondary (in)fertility, IVF and the relief she found in the egg donor option. Read on to find out how Anthea is redefining the conversation around (in)fertility through her story of loss, heartache and love.

Anthea’s story:

I got pregnant with my daughter when I was 35 after three months of trying. When I was 37 and my daughter was one, we tried again for a second. We got pregnant after trying for a while and discovered at five months that the fetus had trisomy which meant it wouldn’t be a viable pregnancy. We then turned to IVF and after four times, had an ectopic pregnancy that resulted in a miscarriage, DNC, and chemotherapy to flush out my fallopian tubes. After the ectopic, we took the mandatory break from treatment for six months.

We decided to try (IVF) again by bundling embryos over three more rounds (of retrievals) and banked a total of 11. Our embryos were sent for genetic testing and every single one came back abnormal.

I was now 42 years old. Our insurance had been covering up to 80% up until that point and we were about to go entirely out of pocket. We consulted with our Reproductive Endocrinologist (RE) and he shared that the chances of a viable pregnancy was about 1% based on my age and our history. As a result, our RE recommended that we consider the egg donor route which I hadn’t really thought about up until that point.

We decided to move forward and initially had two failed attempts with possible egg donor candidates. As a result, we decided to go the frozen rather than fresh egg donation route and purchased multiple eggs from one donor. The first egg that we transferred resulted in my son, Simon!

The media gives a false sense of expectation and hope by covering celebrities who get pregnant at 45 or 50. It is very likely that these pregnancies could be the result of donor eggs. It’s so important to voice the option about leveraging donor eggs. In fact, our clinic, RMA NJ does approximately 2,000 egg donor transfers a year!

What was your high?

My high was making the decision and the plan to go the egg donor route. It was the hope in knowing that there was an option (to have a baby), and that it wasn’t the end of the road for us. It wasn’t the original way we thought that we were going to (have a baby), but it was the way that it happened for us.

What was your low?

The low over my entire journey was after banking multiple eggs over three cycles. After all the emotions, medications and money, and then finding out that none of them were viable. My husband and I felt completely defeated.

Do have a silver lining?

My husband. He was so supportive of everything that I was doing, wanted to do, and the decisions that I made. I felt like I really wanted to have another child and give my daughter a sibling.

I knew that I married the right man because we hit rock bottom and were able to get through it together by supporting each other. I know my husband very well but we had never been in this situation before. There is no way of knowing how a partner may be or react during an extremely trying experience, and he was beyond supportive.

Do you have any words of wisdom?

I think that it is important to remember that there are options. I remember someone sharing with me that “only you are going to know when/if you need to change your path”. Be honest with yourself and don’t give up hope. Consider going about the process a different way such as donor egg or adoption. It could save you a lot of heartache, time and money.

People also question whether they could love their (donor egg) child as much as their biological child. Speaking from experience, the answer is YES, you most definitely love that child just as much!

Anthea, her husband and her two children live in New Jersey. Anthea’s love for her children’s care and safety inspired her to launch Homepaired, the first online marketplace connecting families with motivated and talented American students, with the goal of making live-in childcare affordable, accessible and ethical.

Trailblazing with Andrea Syrtash



Photo of Andrea Syrtash by Alexis Mera.

Photo of Andrea Syrtash by Alexis Mera.

During National Infertility Week, Alexis Mera and I had the opportunity to meet with six fertility warriors who have been bold enough to share their stories publicly. Please meet Andrea Syrtash a fertility force and trailblazer. Although I have known Andrea for years, our first in person meeting was only very recently when our group of fertility warriors got together for this NAIW project.

Andrea has been a trailblazer in the fertility space and has been actively supporting fertility warriors since she founded pregnantish, the first online lifestyle magazine dedicated to helping singles, couples and LGBT navigate (in)fertility treatments. Andrea’s background as a relationship expert and coach regularly featured on national TV shows including Good Morning America and The Today Show, and as the author of He's Just Not Your Type (And That's A Good Thing) and Cheat On Your Husband (With Your Husband), combined with her compassion for the fertility journey, has made her an unwavering authority in the world of fertility.

I had the privilege to connect with Andrea on some of the aspects of her personal journey that I am so pleased to share in our recent interview here:

Andrea, what is your story?

How much time do you have?! Approximately 18 fertility treatments, one open-stomach surgery to remove a large fibroid, eight years of trying to get and stay pregnant, and eight reproductive doctors. I always knew it might take a while to get pregnant because I was diagnosed with endometriosis as a teenager, but I never imagined that it would take as long as it did to meet our baby (in December 2018)! 

After IVF transfer after transfer, and after learning we miscarried a 'heatlhy' baby in 2013 after a D&C, a doctor told me not to do anymore embryo transfers until we genetically tested our embryos. In 2016, I did many more retrievals to try to create enough Day 5 embryos to send away for PGS (now called PGT-A) genetic testing. Once we had healthy embryos, we knew we should try to find a gestational carrier (a surrogate who would use my embryo) to carry our baby to term.

This was another big chapter! Two surrogates dropped out on us and I had no idea how we were going to afford to keep going through this. In January 2018, my first cousin Elana stepped up and offered to carry our embryo. I was so emotional I couldn't respond! We transferred one into her in April 2018, during National Infertility Awareness Week. I remember telling my audience at pregnantish that I had no idea if I'd meet our baby this way, but I was hopeful. In December of 2018 of my cousin delivered our baby girl Arielle (into the world). I'm so grateful and in shock that I'm her mom!

Your High?

I created and launched pregnantish.com to help others navigate this incredibly stressful process right in the middle of my own treatment/IVF. At the time, I was not sure if or how I'd have a baby. Finding a deeper purpose during an experience I was really struggling with was a high for me.I was not only able to use my voice to help others, but I learned so much from others in the community. So often when you're dealing with infertility, you feel alone.

Your Low? 

I had many lows over almost a decade of trying to make a baby! One happened in public at a department store after an appointment where the doctor told me my embryos were growing unevenly. (I later learned it's because I needed estrogen priming, but that's another story!)  A tourist came up to me and asked if she could pray for me. I felt awkward about it, right there in the middle of the shoe racks; we held hands and she prayed while I cried. Another low was learning that I would miscarry again in 2014. By this point, I had been trying for about 4 years and I was so depleted. December 2015 was another low because my doctor told me that I had a 'beautiful perfect looking embryo', that didn’t take. I had done everything (diet, vitamins, taking care of myself) to let it implant. When it didn't work, I felt hopeless. I called the doctor and he told me to stop treatment and suggested more testing.

What was a low then turned out to be a high because more possibilities opened for us once we got more information (as a result of the testing).

Do you have a silver lining?

I got 2 babies out of this! One is my baby Arielle, who I'm so grateful for and who is a joy. The other is pregnantish which is fulfilling because I often hear it helps others who are struggling.

Do you have any words of wisdom?

I used to tell myself and often tell our readers that so much is out of our control when it comes to goals like parenthood, and if you want to be a parent, there will be a path. You don't need to know the how, the when, the where, you just need to know the what which is that you will be a parent. There are so many paths...

Learn more about Andrea, her story and the wealth of fertility resources available through her site pregnatish.

Redefining the Conversation about Infertility

Fertility Warriors from L to R: Andrea Syrtash, Anthea King–Pascual, Jane Jolis, Nathalie Carpenter, Jennie Monness, Rebekah Rosler, Stephanie Rapp. Photo credit: Alexis Mera.

Fertility Warriors from L to R: Andrea Syrtash, Anthea King–Pascual, Jane Jolis, Nathalie Carpenter, Jennie Monness, Rebekah Rosler, Stephanie Rapp. Photo credit: Alexis Mera.

I have thought a lot about the word infertility. It sounds like such an ugly word because there is so much judgement (including self) and lack of awareness around the subject. Even for those embarking on the “journey” there is so much that is unknown. Although the science around it has come a long way, there is still not a guarantee that it will find the underlying cause, let alone solve it to produce a child. 

The word infertile goes against our very basic function as humans to reproduce. And if we can’t do that, we may admonish ourselves for not being “normal” or having tried hard enough, or perhaps not trying the right way (whatever that means). There may be shame, embarrassment, guilt, fear, frustration, jealousy, and, and, and… Societally, we have been taught that all of these emotions are bad/negative and since there is no pride in them, we naturally try to hide them, making the depths of despair associated with (in)fertility even greater. 

I am speaking about all of the above from experience because I have lived it. Do you know how liberating it is to share that publicly? The first time I announced my experience through this blog, I held my breath when I hit publish. I didn’t know what the reaction would be and whether it would be met with public disparagement or disgust, or whether I might even be let go at my corporate job for airing my so-called dirty laundry so publicly. Instead, I was met with responses from people that I knew and didn’t know; that they, their sister, cousin, friend, or colleague was going through it, and would I talk to them about it. In those moments, I understood that I was so far from being alone. I realized that I had been shouldering a greater burden than I had to; and had created more stress for myself by not talking about my (in)fertility story. I will purposely refer to (in)fertility like so moving forward because infertility and fertility are often interchangeable, however I believe that being in the community of fertility is powerful.

By being vulnerable by sharing my own story, I have come to learn that that there are other women who have been voicing their experience and encouraging others to do the same. These fertility warriors are trailblazers, and I recently had the honor and privilege of being in the same room with six incredible women who also see the possibility of change. Alexis Mera was there to capture it all on camera.

To say that it was magical being in the room with these other women is an understatement. We all “knew” each other without actually ever meeting, because although the journey was different for all of us, the end goal of becoming a mother was the same.  Our common bond was cemented in the interest of redefining the conversation around (in)fertility by breaking the silence to get it started.

The silence for all of us at one point or another was deafening. At times the path had been hell both mentally and/or physically, but I believe that we all realized that we could use our strength to give voices and faces to (in)fertility. When. the seven of us met, it was clear that we had found community through authenticity, transparency and vulnerability by sharingand as a result, the ability to pay it forward by supporting others going through the fire.

This is just the start, by creating community, we discover resources, are empowered by options, and elevate the conversation for support publicly and in the workplace. We have the power to make infertility a safe discussion and promoting its importance for financial support consideration and workplace benefits for both women and men.

Be a trailblazer. Over the course of this week during National Infertility Awareness Week, six fertility warriors will be featured on Fertilust. Each will share their story and their reflections on their experience. Some of the themes expressed by our trailblazers included empowerment, community, perseverance, resilience, options, strength, and advocacy.

We welcome you to join the conversation by sharing your constructive voice in the comments, and/or by reaching out to find out how to tap into the community. 

In collaboration with Alexis Mera who photographed each fertility warrior and provided graphic tees from her collections, you can get a sneak peek into each woman’s story here as shared on Alexis’ blog. Please also be sure to check back each day this week as we highlight each fertility warrior in detail here on Fertilust.

Together we can take the conversation about (in)fertility out of the shadows to normalize it. We can make it inclusive by building awareness and community. By giving it so many voices, we can drown out the judgement, misconceptions and silence around the topic.

Rather than focus on the negative aspects of (in)fertility, we have the opportunity to get IN to the community of FERTILITY. Please join us.

 

 

 

The Nurse we all Need

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I am so excited to share the discussion that I had with Fertility Nurse and Consultant, Leyla Bilali of Fertility Together.  Leyla bridges the gap between doctor visits, the waiting, the results and so much more.

It is no secret that (in)fertility is a lot to navigate both mentally and physically. Leyla’s services combine emotional support with the medicine that's within her scope of practice. It’s also a huge bonus that Leyla helps her patients with the administration of their medicine in the comfort of their own home and is also a constant sounding board. The result is that Leyla’s patients are much more than just that, they are individuals who receive support tailored to their needs during their fertility journey. 

Read on to find out more about the discussion that I had with Leyla, the Fertility Nurse that we all need.  I have come to think of Leyla is a fertility fairy godmother. Everyone going through fertility treatments needs a Leyla!

What is a fertility consultant and what inspired you to become one?

 A fertility consultant holds your hand during your fertility journey. This doesn’t necessarily have to just be for IVF but for all fertility related treatments including egg freezing. I work with some women that aren’t in a secured relationship or ready to have a child yet, but would like the option to potentially have a child in the future. From egg freezing to IVF, I help women navigate the whole process from who to see and what tests to take for baseline testing.

Sometimes an OB will suggest that a patient should see a reproductive endocrinologist, especially if a couple has been trying without success for over a year. I can guide that person on who to see based on their personalized medical history rather than just send them to a clinic where there is a relationship (between the OB and the clinic). A lot of this (fertility) world is not personalized. There is such a high volume at the large clinics which has its pros, but it makes it difficult to personalize care for people. My role is to help guide through all of the results and keep my patients sane.

I believe that a nurturing, knowledgeable partner like me can make all the difference as someone discovers their unique path to fertility. In my 11 years as a registered nurse, six of them in pediatrics, and five of the most recent in fertility, I have learned how to make healthcare more comfortable and human by inserting my compassion, humor and reliability.

 The medical world can feel very stiff and scary and we often need a shoulder to lean on to get through it. This is especially true for fertility patients as they are usually in a vulnerable state to begin with. Whether you are simply curious about your reproductive health, ready to take action via egg freezing or struggling with infertility, it doesn't get much more emotional, raw or intimate than this. And because of this intimacy, it's often hard for people to talk about it. As a society, we are beginning to lift the taboo of fertility but we still have a ways to go!

I have been fortunate enough to recognize my calling as a fertility consultant at the suggestion of some of my most dear patients. I thought I was supporting them medically and emotionally, and instead I was the one that was rewarded ten-fold with a great business idea. It actually occurred to me while I was at the home of one of my patients assisting her with injections. Sometimes the patient or the partner has a hard time administering or doesn’t feel comfortable.

I realized what was missing in fertility care when my patient said “I don’t know how people do this without a Leyla. You should start your own business.” No one else was doing this in the Tri-State area so I officially launched Fertility Together in August of 2017.

You mentioned personalization for each patient. Can you please elaborate?

 After looking at a patient’s medical history and understanding their personality, I make recommendations on who that patient would work well with and provide A – Z assistance from injections to on-call support. Even if it isn’t the full IVF, egg freezing is still the first full part of IVF by way of egg retrieval. I can assist the patient on what to expect from the medications and help administer it, if needed. 

What is your view on the correlation between stress and conceiving?

 Stress wreaks havoc on your body so there is no reason that it wouldn’t wreak havoc on your reproductive system and egg quality. 

 Cortisol (stress) hormones compete with progesterone hormones. Progesterone is crucial to pregnancy, specifically to conceiving and holding a pregnancy. There are a lot of indications that stress plays a role in infertility.

 One method that I like to combat stress is acupuncture. There may not be any direct studies that acupuncture increases egg quality but it does affect your nervous system, which can suppress your stress levels. JAMA recently released a report on an acupuncture study where some patients received traditional acupuncture and others received a placebo of randomly placing needles. The result showed no difference between the traditional and the placebo. However, because the participants felt that they were proactively doing something to alleviate their stress, the positive IVF outcomes were increased. 

What do you most regularly hear your patients “stress” about leading up to and during IVF treatment?

The anxiety from the medication and injections. The partner relationship also plays a huge role (of importance) because that is your support system and any potential lack of it, can also be a source of stress.

What are your top tips for patients to optimize positive outcomes and reduce stress?

  1. Taking care of your body is huge. If you have an eating disorder, are under or overweight, you are damaging your reproductive system. You can improve egg quality and support it with good whole foods, decreasing alcohol consumption, and not smoking.

  2. It is important to work with a doctor that you vibe and feel comfortable with. The doctor and the facility should be available to answer questions. You should not ever feel like a bother for asking.

  3. Communication between you and your partner is crucial. We often forget that our partner is going through this too and that they have (support) needs as well. Maybe you need a third party like me or an IVF therapist to help.

  4. Do what makes you feel sane; that could be acupuncture, exercise, or another healthy activity.

Are there any myths about stress that you would like to debunk?

 Prior to transferring an embryo, I have a lot of a patients who ask if the timing is right and if stressful life events will alter their results. For example they have a stressful work week coming up or life just happened. The answer is no. If the embryo is going to take and it’s going to be a viable pregnancy, it’s going to sustain despite your everyday level of stress and anxiety. 

There is nothing wrong with being stressed and anxious about this process. That is why it is annoying when people say “don’t stress or just relax”. I think that it would be abnormal if someone didn’t stress or have anxiety during the process. Letting yourself feel these emotions is where my services come in. I am a sounding board. You get to tell me that you are stressed out and just talking about it will make you feel better. 

Are there any resources that you think are a must for anyone going through or considering IVF?

  • Acupuncture, Liz Carlson at Common Point. I go to her myself!

  • IVF therapists

  • Resolve.org offers a resource list for consultants, therapists, support groups

I would love to get to the point where people don’t feel ashamed that they had to undergo any fertility treatment to have their baby. Ideally it would be normalized and not a taboo topic.

What moment in your career has inspired you more than you could have imagined?

I was chatting with my husband’s colleague at a holiday party who knew that I am a fertility nurse, and upon meeting me shared that he was an IVF baby. He told me that he was so appreciative of what his mom went through to have him. It brought tears to my eyes.

 

Leyla Bilali, BS, BSN, RN is an experienced fertility nurse and fertility consultant. Leyla received her Bachelor of Science in Biology at Emory University, and her BSN at the Columbia University School of Nursing. 

To learn more about Leyla and Fertility Together, please visit: fertilitytogether.com or @fertilitytogether on IG.

 

 

The Girlfriends' Guide to IVF: Part 1

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I was chatting with a girlfriend going through IVF and realized that it might be helpful to share my experience in hopes that it could help others navigate the process as well. 

During my third round last year, I made the discovery that by changing my attitude towards IVF, it wasn't as mentally and emotionally daunting as it had previously been.  Was piercing myself with needles (or letting my husband do it for me) a party?  Well no, not quite. There are however a lot of uncontrollables during IVF, so feeling emotionally stable and maintaining a positive attitude was an absolute victory.  I learned to accept the process, perhaps even embrace it rather than resent it.  I let go of being attached to the outcome, and THAT helped me make peace with IVF.

I am in no way diminishing the emotional and physical hardships associated with IVF.  I don't wish the experience on anyone.  I just made a decision to look at the process differently than I had been and set other goals (like getting mind/body healthy,) so that I could win no matter the outcome.  Perhaps three (rounds of IVF) was a charm, but I am convinced that my efforts to take care of my overall health paid off.  It still took a lot of effort on my part, and I couldn't have done it without a community and support system.  My doctor, nurse, and husband were the best team that I could have dreamed of, and the support group from CCRM provided ongoing inspiration.  

I learned to not underestimate the importance of the right doctor.  Just because a doctor did wonders for your friend does not mean that he or she is the right fit for you.  If this sounds like the position that you are in, look for a doctor with good credentials, that you vibe with, and who is attached to excellent labs.  Also make sure that you really like your nurse.  Your nurse will be your lifeline.

Only you can control how you feel.  I found my peace through prioritizing my needs.  You will likely need the support of friends, family and possibly a like-minded community during this time, but you will also need to give back to yourself.  This was a rather awkward and difficult new habit for me to embrace but it became yet another silver lining on the journey.

And one more thing... No matter what anyone else tells you, including me, nothing can really mentally prepare you for the IVF process.  It is not for the faint of heart and you are a rockstar to travel this path.  Remember that you are not alone and you do not have to suffer in silence.  

I've put together a cheat sheet of the main points that I believe helped me optimize my outcome and feel decent during the process.  My hope is that these insights will help support your journey and make the ride a little less turbulent.  Read on to Part II to get started.

The Girlfriends' Guide to IVF: Part 2

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Phase One/The Prep for Retrieval:

Similar to a recipe, here is the plan that I followed prior to egg retrieval and leading up to transfer.  This may also be helpful for anyone, including those doing egg freezing, IUI and IVF.

Try to take 90 - 120 days to reset your overall health and mindset to optimize egg quality and ultimately set the stage for a productive IVF cycle.  And go with your gut.  Start on your schedule.  Some doctors will try to rush you by telling you that your eggs will be 2 - 3 months older if you wait.  While true, if that is the case, I find it interesting that my results got better after hitting the pause button for 8 months. It’s really more about quality than quantity.

Here are my tips:

1. Eat clean whenever possible

Focus on a mostly organic plant-based protein diet with an equal quotient of healthy carbs and fats.  (Translation for carbs/fats: fruits, veggies, nuts, and oils.) 

Pass on dairy, refined sugars, and refined grain.  Also beware of gluten replacement foods and especially any gluten-free foods that come in a box or bag as they might be laden with refined sugars and possibly chemicals.  These items all have an inflammatory effect on the body which doesn't help the optimal egg health cause.

2. Take quality supplements 

This is in addition to eating whole foods and shouldn't be the replacement for them. Check out my recommendations here. If you already know that you are challenged with egg quality issues, consider adding an organic Acai supplement.  Navitas makes a great supplement that I use for smoothies. (Avoid any Acai that is not pure or products like Sambazon that have a high sugar content.)

3. Drink water and lots of it

Ideally 8 glasses a day as a benchmark and preferably from glass.  Avoid plastic when possible.  BPA which is found in plastic is a known endocrine disruptor.

4. Try your best to cut caffeine

You'll have to do so anyway to ensure proper labs/monitoring.  Consider replacing your coffee ritual with hot water and lemon which is alkalizing (inflammatory reducing).  Pair it with an awesome refrigerated Probiotic like Natren Healthy Trinity to promote digestion and combat bloat.  

4. Cut alcohol

I'm sorry!  This was extremely difficult for me too.  I promise that you can do anything you set your mind to for 90 - 120 days!

5. Be aware of what you put on & around your body  

Avoid products with sulfates, parabens, phthalates (fragrance) and phenoxyethanol.  All of these items are known endocrine disruptors.  Check out EWG to give you a better gauge on how products rank or to demystify ingredients in products.

Go ahead, be a sophisticated hippie with some of these awesome products that I have tested. I am not affiliated with any of these brands, I do however believe in their ingredients.

  • Skin/Hair Products: S.W. Basics, Body Deli, Rika

  • Natural Deodorant (that works): Joyous Organics and Primal Elements

  • Cleaning Products: Puracy, Meliora K, Branch Basics

  • Glass Water Bottle: BKR

6. avoid receipts

I am aware that this sounds crazy and especially if you live in a city or travel for work.  The thin powder coating found on receipt paper contains an unusually high amount of endocrine disruptor, BPA.  Not sure what to think? Search the terms "bpa receipts" and look for a credible source to learn more.

7. sleep

Try for 8 hours of uninterrupted sleep a night if at all possible.  This time is imperative to repair and restore cells.

8.Get your head on straight

Take ten minutes every morning for yourself to set the tone for the day.

Check out the 5 Minute Journal to remind yourself of what you are grateful for and/or meditate with the Headspace App.

Exercise easily.  Think yoga, barre, micro-toning, hiking/walking. The reason why cardio isn't recommended is because it promotes a fight/flight response during exercise, inducing unnecessary added stress on the body which isn't great for optimal cellular growth and creating the healthy maturation of eggs.  (The IVF process is already stressful enough, no?)

9. Consider Acupuncture

It blissed me out and has known benefits to increase blood flow.  In other words, it's good for egg heath and might also stimulate a thicker lining to promote transplantation when it comes time. However if this stresses you out for any reason to get acupuncture, take a pass because that will defeat the purpose of your going.

Phase Two/Stimming:

1. Keep on practicing self-care

This includes taking time for you, sleeping enough, staying hydrated and continuing healthy eating habits.

2. Discontinue most supplements

Continue with a daily Probiotic, Pre-Natal and Vitamin D (if you are deficient).

3. Stop any exercise outside of walking

The key is to not get your heart rate up.  If you are out of breath, chances are that you should ease up.

4. join a support group

Check out Pregnantish.  There are also plenty of private support groups on Facebook. Need some ideas - send me a note!

Many clinics also have groups available so make sure to inquire.  It's so nice to know that you can ask a burning question at 3a to a group of people that are going through the same things that you are, right now.  

Phase Three/Retrieval:

1. Try your best NOT to be attached to the outcome

I know that this is easier said than done.  Think of the many ways you have already won with a healthy mind and spirit. no matter what happens you are making strides towards life long wellness with new, good for you habits.

2. Get a post-retrieval care package ready

A heating pad, Tylenol, coconut water (I love Taste Nirvana and Harmless Harvest), Ultima electrolyte mix (please stay away from Gatorade), and a bag of salty Kettle Chips will do wonders. I am aware that the chips sound a little crazy but the high levels of sodium just following retrieval actually help drain the fluid that builds up in the empty egg sacs which can cause uncomfortable bloat. I also love enjoying my chips with guacamole - you need the healthy fats right now so dig in!

3. Go native on the day of your retrieval

You and your partner should avoid wearing perfume, deodorant, and anything with fragrance in it.  Why you ask?  Because the fragrance (phthalates) could potentially damage eggs retrieved making them abnormal. 

Phase 4/The In-Between:

Between the time of retrieval and transfer is not the time to go cold turkey on all of the incredible healthy habits that you have been practicing.  Keeping a healthy lifestyle between retrieval and transfer will reward you with a better state of mind, more energy, faster recovery, and possibly better odds of conceiving during transfer.

Phase 5/The Road to Transfer (Egg Implantation):

Congratulations on making it to the transfer stage.  You should feel really good as this is not a given.  Many of the positive habits that you have picked up or already practiced along the way will continue to serve you.

1. Continue to eat, sleep, and hydrate well

2. TAKE supplements

Specifically continue a Probiotic, Pre Natal, and Vitamin D if you need.  Add back in Omega 3s.

3. Keep taking time for yourself

If you like acupuncture, try going once a week to help promote lining growth.  Only go if it doesn't stress you out to manage it into your schedule and get there in the first place.

4. Cut out alcohol and caffeine again

Much to my dismay I was reminded that chocolate has caffeine too.  Just remember that this is not forever.

5. maintain a positive outlook

Be excited but unattached to the outcome. It is a blessing to have gotten this far.  The universe doesn't promise or owe anything; all we can control is our attitude and embrace the silver linings that we encounter along the way.

Phase 6/Time for Transfer:

1. pre/post transfer acupuncture

Many fertility outpatient facilities offer this.  If this interests you, consider it for its calming, blood flow stimulating benefits that helps the eggs get cozy in the uterus.

2. Get yourself in a good headspace 

Consider taking a restorative style yoga or meditation class the night before the transfer.

3. Wear comfortable clothes and "happy" socks

You will be looking at them for a while.

4. go fragrance free

This applies to you and your partner and will minimize any damaging exposure to your hard-earned blastocyst(s).  (A blastocyst is a Day 5 - 7 fertilized embryo.)

Phase 7/Post Transfer (AKA: the Two Week Wait):

First of all, congratulations for reaching this milestone, it is no small feat!

1. Plan for bedrest for that day and the following

I know that this is now controversial but it certainly does no harm so I did it. Either way, avoid a heating pad and hot showers/baths.

2. Eat warm, nourishing foods

This includes organic bone broth to promote a comfortable zone for the embryo to implant.  Wild salmon, dark leafy greens, ginger, and fermented vegetable are also thought to be helpful.

Hydrate, hydrate, hydrate. 

3. Eat fresh pineapple core and raw Brazil nuts

Beginning the day of transfer and continue for a few days... 

Pineapple contains an enzyme bromelain, known for it’s powerful anti-inflammatory properties.  Reducing inflammation in the uterus helps set the stage for implantation by potentially creating a sticky lining where the embryo can settle in comfortably.

Eat 6 - 8 Brazil nuts a day.  Chockfull of selenium, Brazil nuts are thought to help thicken the uterine wall promoting a healthy lining to aid with implantation.

4. Meditate and visualize your embryos getting cozy

What is the downside?

5. Binge on funny movies or shows

In case you are looking for suggestions, I liked Up Schitt's Creek and Master of None on Netflix.

6. Rest and sleep a lot

7. more about the 2ww...

This will feel like the longest week and a half of your life (so far!) to find out what your results are from the blood test.  Try to be stoic.  Unfortunately OTC pregnancy tests can potentially provide a false negative or positive.

8. Be excited but not attached to the outcome

I know that I keep saying this.  This is a friendly reminder that whatever happens doesn't define you one way or the other.  You are also not alone in this journey.

Sending positive thoughts your way! xo

 

Baby Makes Three...

I am grateful to my rock of a husband; friends and family for cheering us on; Elaine, an enormously talented healer who helped me understand my path; the designer who fortuitously sat next to me at a brunch last summer and introduced me to "the" doctor;  Claudia for helping me awaken to the concept that all of this was happening for me; Keri who taught me to look at food as fuel and medicine; Daryl for reminding me that (acupuncture) needles can actually be wonderful; and to Dr. Schoolcraft, Melanie and all of the amazing people at CCRM that I have had the great pleasure of meeting along this very long road.

Sound like an awards ceremony?  I sort of feel like I just won the greatest award in the world.  I have won the gift of pregnancy and I couldn't have done this on my own without the expertise, support, and love of so many incredible people.  I now know that every single person that I felt that tinge of energy around was meant to be in my life for a reason, whether for a season, or a lifetime.  For the first time, maybe ever, I feel like I am in alignment and exactly where I am meant to be.  

I have tried so many times to write this entry down over the last couple of months, and every time, I find an excuse to put it off.  First I had to wait until after three months to be sure, then I had to get my energy back, take care of my full time job, wait until the time felt right to share the news, and the list goes on and on...  Despite my very positive outcome, I have felt so many emotions through this process that coming back to center and sharing the news of my pregnancy has actually been more difficult than I could have imagined.

About 6 weeks after starting this blog, I got pregnant.  It’s mildly amusing that I had to expose my “dirty little secret,” and then I conceived so quickly.  The most interesting finding is that by sharing my secret, it was no longer dirty.  In fact, I found out that I was far from alone.  The path to finding fertility can mentally and physically suck the life out of you if you let it.  I am fortunate to have discovered solace and community from several groups consisting of thousands of women who struggle with their fertility.  These women bestowed upon me the invaluable gift of perspective.  And for those still on the journey, I will continue to root for you every single day.

I also thought that getting pregnant would be my end goal.  In hindsight, it is now clear that chapter was a stepping stone to the next leg of this incredible journey.  The lessons that I have learned, and continue to learn, about mental and physical wellness weren’t only the key to helping me conceive, they have become a way of life.

So as I sit here writing this at 6.5 months (26 weeks) pregnant with my little babe kicking inside of me, I am overcome with appreciation for this journey.  Being open to the possibilities, unattached to the outcome and surrounded by an amazing network is why I believe I am able to share this wonderful news with you.

A million thanks.  My cup literally runneth over in gratitude.

 

*A very special thanks to the talented Robert Grima for capturing me and my belly, as well as to Zimmerman for the beautiful dress.*

All About the Egg.

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One of the first things I learned on this path is that for someone who had an absolute obsession with a perfect outcome for every professional marketing campaign that I touched, I wasn’t practicing this behavior personally.  Case in point, nutrition and wellness.

Since I moved to NYC 9 ½ years ago, I have survived as a result of eating out and Seamless food delivery.  Beyond the taste, I had zero idea what was actually making up these meals.  From ingredients to quality control, I was not at all conscious of my daily nutritionally intake.  In fact, I really wasn’t even a fan of vegetables.  True story, I ate everything in a salad except for the greens.  Most meals were focused on an animal protein because the menu items always seemed more exciting. So if I indulged with a cheeseburger, pizza, and more cocktails and glasses of wine than I could remember, I’d solve the program with a Berocca and a spin class the next day. I figured that as long as I wasn’t putting on too many pounds, my lifestyle must be working.

Then my fourth fertility doctor told me to take a pre-natal and focus on eating a Mediterranean diet. (Seriously what does Mediterranean diet actually mean to someone that defines cuisine type based on restaurant reviews and delivery site filters?)  So I did what I was told and incorporated grilled octopus, Greek salad, hummus, and pita chips from the local Greek restaurant as staples into my diet. 

My IVF outcomes were less than stellar for my first two rounds at the beginning of 2016 and I was also plagued with a flu or cold every month for the first four months of the year.  Following my second failed IVF and sick once again, I lapsed into a slight depression fueled by an overwhelming feeling of helplessness.  I had just wanted someone to tell me what to do to get pregnant so that I could focus on the rest of my life, but clearly that wasn't working.

Then something happened…. I decided that I was going to figure out what part I could actively play because I didn't feel like it needed to be the end of this journey.  I called it after three days of a major pity party and dove head first into the sea of the Internet.  After sifting through a lot of junk diguised as schemes and products to get pregnant quickly, I stumbled across an incredible book that I proceeded to download off of Amazon.  “It All Starts with the Egg,” by Rebecca Fett, gave me hope and actual, tangible tools that got me started with my journey.

The book focuses on egg quality as the key to improving IVF odds and reducing miscarriage.  It  also has great research-backed concepts that might actually help natural conception.  I wish I had found it so much earlier and credit it as my learning springboard.  Rebecca’s personal story of trial turned to success inspired me to begin an action plan of my own centered around nutrition and wellness.

If you are interested in checking it out for yourself, you can find it here.