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

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.

How the inconceivable inspired one woman to get on stage and laugh through infertility

Photo of Meirav Zur by Tomer Lupasco

Meet Meirav. (Pronounced may-RAHV). This is her story and what led her to put herself out in the spotlight in to unburden the pressures of her own experience with infertility and provide some relatable comedic relief to others going through the fire. Meirav in no way makes light of infertility, instead she takes to the stage to highlight the absurd situations that members of the infertility community may find themselves in and does so with levity. Her sketches are also an educational training of sorts for others who want to understand their partner, friend or family member who may be faced with the challenges of infertility. Read on to get to know Meirav and what inspired her to do the Inconceivable (Show).

And if you are in New York City on September 22nd, you can check out Meirav’s award-winning show Inconceivable: The Totally True One-Woman Semi-Fertile Quasi-"Musical" at the United Solo Theatre Festival at 6pm. Tickets may be purchased here or you can enter for a chance to win at @Fertilust.

First off, we would love to hear a little bit about you.

I grew up in Atlanta, and now live in a town near Tel Aviv, Israel. My extended family lives in Israel and we would visit them almost every summer while I was growing up. I always felt some sort of connection to Israel, and after university studies in the U.S., I decided to move to Israel and serve in the army. I wanted to be part of what every person in Israel around my age at the time was experiencing. I met my husband, fell in love, and stayed.

What are 5 fun facts about you?

1. If there's a good song on, I will karaoke anywhere.  No lyrics necessary. 

2. I love making people laugh, especially my husband and daughter.  Jokes, characters, funny voices or faces, anything goes.

3. I like to draw.

4. The kind of shopping I love most is for office supplies. 

5. I like to make birthday rap-o-grams for my friends.

What is your fertility story?

My husband and I have experienced unexplained infertility and unexplained secondary infertility for over 11 years. I never shared that with anyone until recently.  When we first started trying, it took about four years and a couple of miscarriages until we went to a fertility specialist.  Nobody else around us spoke about any of this, and this was before the era of Googling anything for more information. We kept thinking “it'll just happen”.  

The day I was meant to start my first hormone injection in preparation for an IUI, I found out I was pregnant naturally.  We were of course overjoyed, and I got to "graduate" the fertility clinic without ever actually knowing what it was all about.  I thought maybe it was because we finally went to "get help," and that I felt taken care of, had a plan, and that must have lifted the load and stress. We had our amazing daughter, and she was about a year or so old when we started trying again.  We wanted her to have a sibling and figured it might take a while again. 

This time the magical whatever-it-was didn't work.  I had to go through many rounds of hormones, IUI's, and we also had an unsuccessful IVF.  The stress and hormones and everything was unbearable. It put a big strain on our marriage and family.  I really think that these intense emotional roller-coasters and the PTSD that comes with infertility is incredibly underestimated and overlooked. After the failed IVF, my husband and I decided that we had to step out of that all-consuming pressure cooker of infertility in order to let ourselves just be a family. We are now a happy family of three, and we're good.

What inspired you to create the Inconceivable Show?

About 3 years ago, which was a couple of years after our failed IVF, I went through a 2-week or so time period when I was pregnant naturally (found out quite late into the pregnancy), heard the fetus heartbeat for the first time, went to get an initial full scan, heard no heartbeat, then got a D&C a few days later.  It was intense for me and my husband. It was really heartbreaking. 

A little while after that, it dawned on me that maybe I should tell someone about everything that has happened, because in the last few years, especially those recent months, I was even more withdrawn from social events, work projects, etc.  But I didn't know how I could bring myself to say anything.

I figured out that the only way I could talk about my infertility was through comedy, so I decided to invite some friends over and tell them. They didn't know why they were coming over. I told them (about it) the only way I knew how, with silly songs, characters, odd thoughts, and lots of humor.  I was so nervous. And when I was done I was so relieved that I got through it. I figured that they would all just go home and that would be that. But instead, they all told me I needed to make my comedic sketch an actual show. And even more surprisingly, they stayed over for a long time afterwards, because everyone started TALKING. They talked about their own infertility-related stories, that other friends in the room didn't really know about. And suddenly there was this deeper understanding and connection. That's when I knew that THIS was worth exploring. It got people talking about this thing nobody ever REALLY talks about honestly. And it got people LAUGHING, too. That's how I was inspired to develop that night into a whole show.

What are 5 reasons why someone should see the show?

1. You will laugh.  Laughing is something that's good for all of us and we can never laugh too much.

2. You will learn about yourself and others. You'll learn a bit about what your friends or family members have gone or are going through (and everyone knows somebody, whether they're aware of it or not).  

3. You might be part of the show.  It's interactive, in a non-threatening way.

4. Just in case reasons 1 - 3 didn’t convince you, the show won an award and got great theatrical reviews (from men)!

5. You'll have a new perspective on sex-ed(ucation).

Meirav Zur is an actor, writer, and producer currently based in Israel. Meirav was born and raised in the U.S., where she first began to pursue her theatre and education studies. In 2005, Zur founded the independent English-language professional traveling theater in Israel, English On Stage, subsequently writing, directing, and acting in its various original productions. The theatre's extensive repertoire includes original musicals, children's plays, and improv shows, with productions having been performed across Israel, including at the Habima National Theatre of Israel. Zur's most recent production and first solo show, Inconceivable: The Totally True One-Woman Semi-Fertile Quasi-"Musical", had its U.S. debut at the 2018 United Solo Theatre Festival in New York City, where it was awarded Best Interactive Show.

Environmental Toxins 101 with Lara Adler

Photo Credit: Lara Adler

What we don’t know (and can’t see)can hurt us.

When I started thinking about environmental toxins and how they impact long-term health and fertility, all roads led to Environmental Toxins Expert, Lara Adler. After two minutes during our interview and discussing her deep love for matcha tea, two things were clear. One was I would immediately give matcha another chance, and two was that Lara is leading a movement by spotlighting how unseen chemicals are making us sicker and infertile. Lara’s credentials speak for themselves and she has been trailblazing in the area of Environmental Toxins before it much of a focus. She is a natural born truth-seeker who is constantly learning, understanding and most importantly, distilling the facts amongst other educators to create awareness and action around the topic of environmental toxins.

If I have done my part, this discussion will leave you more informed on how to live a happier, healthier life beginning today. I couldn’t get enough of the research Lara shared. So much of it blew my mind and inspired meaningful action, which is why I’m excited to share it with you. The topic of silent and colorless, harmful carcinogens might easily create paranoia because there isn’t a whole lot of information out there on what to actually do about it. Knowledge is power and Lara arms us with the knowledge to action change, and do so in achievable steps.

And a quick spoiler alert… I am now a bulletproof matcha convert. Once you read this, you may very well be too.

Your love for matcha runs deep. Why? 

LA: It's really complementary to what I teach. I consider it an everyday detox tea. Matcha has a tremendous amount of antioxidants. In fact, it has the highest amount of all foods - more than blueberries, spinach, raspberries and other foods that we consider to be of high antioxidant value.

Matcha also contains a compound called EGCG (epigallocatechin gallate) which is a powerful antioxidant that supports the body’s ability to combat some of the effects of exposures to toxins that we're getting. EGCG helps our bodies process them and is rich in chlorophyll which helps bind to heavy metals like lead and mercury to help excrete them out of the body. Matcha is also extremely high in l-theanine which is an amino acid that slowly releases caffeine and has a very calming effect. It provides an energy bump similar to caffeine does, but without any of the jitters and crash. In fact, matcha tea has been used for centuries by Zen Buddhist monks for extended, day-long meditations to provide a calm focus. I drink it latte bulletproof style with high fat coconut milk and collagen peptides which helps slows the absorption and caffeine delivery even more. 

I love it so much named my cat, Matcha. 

How do you spend most of your time?

LA: On my laptop! I spend a lot of time working and researching to stay current with what's happening in the constantly evolving environmental medicine space. It’s a full-time job to stay updated on all the articles and papers that are published every week! My goal is to translate and share that information to my students.

I try to spend some of my weekend hours working on non work-related projects. I have a love for wood projects and refinishing furniture. I like to refinish vintage pieces and recently reworked a pair of early 80’s vintage speakers from a sought-after brand that my dad gave me! I like having different ways to occupy my mind and need things to work on that take me out of the online space that I am in so much of the day. You’re never done even when you complete a course or complete a program; it's never technically done. There’s always more to know. More to do. It feels important for me to have something that I work on that I can say “It’s done and I did that. I fixed that. I made that and now I can just enjoy it.” It’s a very intentional project. 

I listen to music and a lot of podcasts like Joe Rogan, NPR’s How I Built This and True Crime (but only once in a while because it can be really heavy). My podcasts are usually for long drives, walking, and cleaning the house. I really like the long-form (like 3 -4 hour long) podcasts because to me that's how you really get into the conversation. I also read non work-related books. They're like mental floss and not something that I have to think about.

Was there a moment or experience when you knew that you wanted to pursue a career in Environmental Toxins? 

LA: There were a series of moments that stacked up to bring me to the space. I was always interested in health and nutrition. As a teenager I became a vegetarian the summer between middle school and high school and then two years later, I became vegan. I'm neither of those things anymore, but at that time I was obsessed with reading all about nutrition and wellness. I also wanted to appease my father with facts so he knew I had the knowledge not to become malnourished on either diet. I actually never really considered pursuing a career in the nutrition space until many years later when I was well out of college and eight years into another career.

The Health Coaching program I did never really discussed toxins outside of pesticides being “bad”, and there was very little discussion about environmental toxins in all of the health and nutrition books that I’d read. The turning point was when I was health coaching clients that were interested in weight loss. Some had great results following my direction and guidance, but a couple of people did all the things, and they didn't lose any weight. I felt like it was my responsibility to figure out why so I started digging into what I might be missing around resistant weight loss. That’s really where I knocked on the door of environmental health. I learned that there were many chemicals that were linked to resistant weight loss and even weight gain. I was shocked that this had never been discussed in any of the education I’d had to that point… it was a giant elephant in the room.

At the same time that that was happening, my sister-in-law was pregnant with my now 10 ½ year old niece. I started looking into the products like baby mattresses and baby products that my sister-in-law was planning to buy and was horrified by the amount of chemicals that were known to have health effects, yet were being used in these baby products. These two things made me realize how important this topic was and how infrequently they were talked about. I was shocked.

At that point I didn’t know what I wanted my business to be, but I knew I needed to talk about toxins. I wanted to read all THE things, talk about THIS all day. I knew I was going to make THIS my job somehow. So I reverse-engineered my job by asking “who in the world would benefit from my being able to talk about this” (environmental toxins) stuff at the level that I want to talk about it. 

I realized I was surrounded by friends and colleagues who had also gone through the same health coaching program that I had graduated from, and they were all hungry for information about toxins… they said they felt like they should probably know about this stuff!

My solution was to see if I could translate everything that I was reading. It took me about two years to read all the things and teach myself because I don’t have a science background. I needed to understand what I was reading and make sure that I was interpreting and understanding it correctly. Then I stepped into the space of teaching courses on this topic to my peer community of health coaches.  Over the years it’s expanded to all types of health professionals from medical doctors to occupational therapists, to doulas and midwives, etc. The courses are for anybody and everybody who's working with clients or patients, or customers around health. 

If you were a superhero, who would you be and why?

LA: Probably Captain Marvel just because she's such a badass and I appreciate badass women. 

What has been the most rewarding moment in your career?

LA: I think it's a series of little moments not just one that makes it worth it. When I hear from my students that they're having successes and they're having opportunities presented, and doors opening for them because they have this fluency in environmental health that they didn't have before, THAT feels amazing.

Sometimes I hear from clients who are celebrating successes based on the programs that I lead. And I hear from people that are not practitioners but that listened to a podcast that I was on, or saw something on my Instagram feed. They tell me that they made this one change because of something that I said and that the chronic illness or health issues that they'd been dealing with completely turned around. I get DM's all the time from people who say that they have been lurking on my Instagram. They thank me because they did all these things I recommended - they write that they’ve gotten rid of the plastic, cleaned out their personal care products, swapped out their cookware. And I didn't even do anything other than post and share! It’s really exciting to see when information that I have shared has had an impact. 

It’s been very rewarding to see the conversation evolve publicly in the broader (general market) space. I feel like I've participated in some of that and seeing this huge movement of awareness around environmental chemicals that didn't exist when I started this conversation has been incredible.

It’s always been my goal to help as many people as possible get hip to these issues to make and demand changes. I chose to work with the health professional community because together they have contact with a lot more individuals than I could on my own. It’s a one- to-many model, that allows me to better leverage the message.

What are some of the most shocking finds that you’ve made working in this space?

LA: The average pediatrician, obstetrician, primary care doctor is 15 years behind the current research, unless they are taking the time to do the research. The current medical model doesn't really allow them the time to do it. Medical school curriculum, on average, offers only 7 hours of training in environmental health, and some schools don’t cover it at all. To put it in perspective, the average MD gets only 19 to 21 hours on nutrition, which we realize is paltry (and environmental toxins education is about 1/3 of that). The World Health Organization and the CDC and NIH recognize that environmental toxins are a huge burden to our health, yet health professionals aren’t being educated on the issues. 

There is almost no curriculum on Environmental Health in the medical school programs and a 15 to 20-year gap between what the research is publishing and what actually makes it into standard of care practice.

The medical school programs that do cover environmental health are typically looking at occupational exposures. They're looking at really high dose scenarios like cigarette smoking, or workplace exposures, but what about the low levels of endocrine disrupting chemicals that we are constantly being exposed to? That is just not addressed in these programs.  One solution is more education but how many more hours of education can you jam into medical school?

The whole paradigm needs to shift, and my concern is that if we have to wait another 15 years, we're always going to be 15 years behind at a minimum-in-standard of care practice. We need more Allied Health practitioners like health coaches, nutritionists, registered nurses and dieticians to support primary care practitioners around helping individuals make the necessary lifestyle changes. Those are the people that we need to educate so that we’re not continuing the trend of being so many years behind.

I talk about environmental toxins as if it were a foreign language because it's awkward and there are new words, and they're hard to pronounce. So just like with a foreign language, practitioners need to develop fluency. The reality is that as more and more people are being confronted with health issues, people are starting to explore outside of the conventional approach by reading news. Consumers are seeing headlines about lead, or perfluorinated chemicals in the drinking water and links to cancer, plastics in baby bottles, and they are freaked out because these articles can be scary. Most of those articles don't provide practical, actionable solutions so people walk around with a mid-to-low level of anxiety about everything. It causes them to question every purchase that they make and if they are even buying the right thing. And they can't talk to their doctor or pediatrician about it because they (their doctors) don't have the training, so people have this anxiety that builds up.

What toxins are the most detrimental to overall health?

LA: That's a good question and it takes a little bit of gymnastics to answer it because the worst toxins aren't necessarily the ones that we are exposed to every day. So there's the ones that are going to punch you in the gut really hard and are really bad like dioxins and PCBs, flame retardants, arsenic, lead and really any kind of heavy metal. And yes, we are being exposed to those and those are really problematic. And then there are those that won’t necessarily punch you in the gut but will be “death by a thousand cuts”. Those (death by a thousand cuts) are chemicals like endocrine disrupters which we are being exposed to day in and day out.

So how do we prioritize? It becomes a how do we stop the thing that's punching us in the gut periodically, or do we slow the death by a thousand cuts? There are well over a thousand endocrine disrupting chemicals that have been identified. In the home environment those are plasticizers like phthalates, BPA, plastics, and VOCs that are off-gassing from our furniture. Chemicals can be found in items like scented candles, air fresheners, and flame retardants in our electronics and upholstered furniture. We are also looking at contaminants in our drinking water, whether it's heavy metals like lead or Perfluoroalkyl (PFASs) chemicals that are now contaminating our drinking water. PFASs chemicals can be found in nonstick cookware and house dust. Those are just some of the chemicals that we are being exposed to every day.

Because each one of those categories is complicated and nuanced, the goal is to start reducing our exposure to as many of those endocrine disruptors as possible in the home. We spend 93% of our lives in the built environment that is divided between our homes, offices and in our cars.

Of the three, we spend close to 60% of our lives in our homes, so let's start with reducing toxins in that place because that's where we are the most.

I really encourage people to start systematically reducing exposures to these toxins one at a time. That helps dial down what the body has to process. The goal is to reduce exposures while simultaneously increasing the body's capacity to detoxify the compounds that we can’t avoid. That actually goes full circle back to the matcha tea because it is one of the things that helps us open up our detox channels. Regularly supporting liver function by eating nutrient dense foods with antioxidants for example, along with foods like cruciferous veggies and Brazil nuts high in selenium, help support the natural detox process.

How can toxins adversely impact fertility? What toxins should we avoid?

The first thing is to focus on is avoiding endocrine disruptors with the emphasis on anything that's going to mess with your thyroid hormones. That includes any chlorinated chemicals found in our drinking water, Polybrominated diphenyl ethers (flame retardants), and fluoride in our oral care or in our drinking water which is really common in this country.  All of these things can block the uptake of iodine into our thyroid which can in and off itself can cause or contribute to a tremendous number of hormone and fertility related issues.

For people that are dealing with fertility issues, the most important things to do are: 

Filter your water. I recognize it’s not the easiest step because it takes some homework and it can be expensive, but water is something that you're ingesting every single day. 

Emphasize organic foods as much as possible. A number of studies have looked at what happens when people switch from a conventional diet to a mostly organic diet, (not even 100% because that's pretty hard) and they found that circulating pesticide levels dropped by 80 to 90% in just three to five days. When we start avoiding these exposures, they can work their way through the body pretty quickly. That's not to say that they're not doing damage while they're working their way through because they may be, so we want to avoid them as much as possible. Organic food is the way to go for anybody who's trying to conceive or having trouble conceiving naturally.

Ditch all home and synthetic fragrances. Lose the scented candles, air fresheners, swap your laundry detergent and don’t use dryer sheets. All of those products contain chemicals that mess with our hormones and fertility is a hormone driven process. Replacing home goods with safer fragrance-free, phthalate-free, paraben-free products is a great place to start. I would also add to get rid of the plastic that comes in contact with the food in your kitchen. Swap out the plastic (Tupperware) containers for glass containers. Use old-school stainless steel, enameled cast iron rather than non-stick pans, and wood cutting boards. It's really the way to go to reduce exposures to endocrine-disrupting chemicals.

The last big category is addressing the personal care products that we're putting on our skin every day. From shampoo, body lotion, deodorant, to make-up and shaving cream. All of these things are made with these endocrine disrupting chemicals and our body does absorb a fair amount of them. These are much easier to change than swapping out our couches. (Most couches have flame retardants, yet they are a large investment to replace).

Start with the things that are easily actionable like purchasing organic food, evaluating personal care and household cleaner products, and ditching plastics in the kitchen.

For some that might be enough to overcome the fertility obstacle by getting rid of these things that are causing disruption in their hormones. This applies to men too. It's not just women who have to shoulder this responsibility. In fact, perfluorinated chemicals in our drinking water and food packaging, mess with sperm count and motility.

So I have to ask the question, is the packaged quinoa that I purchase in plastic at the store bad?

LA: Not bad, but not exactly great either. In 2005, the FDA approved the use of perchlorate chemical used in jet fuel as an anti-static agent inside food packaging. Foods like quinoa can get staticky inside the bag so perchlorate is often used to prevent this static build up. After the FDA approved its use, levels of perchlorate in humans has increased, so that’s a potential issue. 

Plastic itself is another issue. Not all plastic is the same, and not all plastic contains BPA (the plastic chemical people are most familiar with). Most plastics aren’t great, the chemicals in them can migrate out into the foods they are in contact with. Things that can increase leaching include heat, oil, acidity, and abrasion. So avoiding foods packaged in plastic that are acidic, like sauerkraut for example, is a good idea. The plastic bag that your quinoa is in likely doesn’t pose too much of a health issue itself because quinoa is a dry food.

Is there a link between infertility and future generations? Is there hope?

LA: There's definitely a link, we're seeing fertility rates around the planet drop precipitously and that's concerning for a lot of reasons. Dropping fertility rates don’t just have social implications; it also has global economic implications. We need healthy fertility rates. 

Otherwise we're going to end up in some ‘Handmaid's Tale’ nightmare. Incidentally, that book was written in 1983 and the author shares that the reason why people are infertile is because of all the chemicals. 

There is a degree of hope though because awareness is shifting and because more and more people are starting to pay attention. And that right there I think is the silver lining. If we actually do something about all of this, we can actually turn things around. 

About Lara Adler: Lara Adler is an Environmental Toxins Expert & Educator and a Certified Holistic Health Coach who teaches health coaches, nutritionists, and other holistic health practitioners how to eliminate the #1 thing holding their clients back from the results they are seeking; the unaddressed link between chemicals and chronic health problems. She trains practitioners to become experts in everyday toxic exposures so they can improve client outcomes without spending hundreds of hours researching on their own. 

Combining environmental health education and business consulting, she’s helped thousands of health professionals in over 25 countries around the world elevate their skillset, get better results for their clients, and become sought out leaders in the growing environmental health & detoxification field.

For news and tips on environmental toxins, find and follow Lara on IG, Facebook, Twitter and Pinterest.

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!

The morning ritual that sparks joy

Photo by Nara Gaisina. Organic cotton sleepwear by Leena & Lu. Toothpaste by RiseWell.

Lately everything is about sparking joy. After meeting with Kori Estrada, co-founder of RiseWell, I am convinced that our first morning ritual of brushing our teeth should be too.

Think about it. From product to packaging, toothpaste that our grandparents used is similar to what we are still using. Big industry toothpaste works but is laden with chemicals including possible endocrine disruptors like triclosanand fluoride. And even though organic toothpastes make us feel better about ourselves and the environment, its efficacy is questionable and possibly counterproductive. In fact, natural toothpastes may be as effective as brushing with water, and toothpastes with activated charcoal have been noted to damage enamel due to its abrasiveness. 

Kori realized this gap in the market and the need for a clean toothpaste when she was battling PCOS and going through fertility treatments. During fertility treatments there is a growing school of thought that what you put in, and on your body may affect egg quality and possibly influence outcomes. During the fertility process, Kori was eating well and mindful of endocrine disrupting chemicals that mimicked harmful hormones that have been found to get in the way of fertility.  That got her thinking about the toothpaste that she used.

“The first thing that I do in the morning is brush my teeth. Toothpaste is the first thing that we absorb through our mouth and possibly ingest a little of.” Kori went on to share that there is a warning sign about ingesting most commercial toothpaste for good reason. If a child gets its hands on a tube of toothpaste with those levels of fluoride, that child’s health may be in serious jeopardy. That statement really made me think.

Anything with a poison control warning label probably shouldn’t be on anything that we ingest. Kori had already had all of these thoughts which had led to her AHA moment of creating a clean and effective toothpaste. This prompted her to call her brother, Dr. Derek Gatta who is a dentist in Florida, land of pearly white teeth. It became a family affair and Kori who runs a hedge fund by day, along with her brother and husband decided that there was a reason to “RiseWell” with that first morning ritual. They are so passionate about their craft that they researched what could bridge the gap between clean and effective. Their answer was hydroxyapatite. 

Hydroxyapatite has been used as a remineralizing agent in toothpaste in Japan for the last three decades. It has been shown in field trials as an active anti-cavity ingredient to cause a similar reduction in new cavities to that seen with fluoridation in the U.S. Not to geek-out but I will; up to 90% of enamel and 70% of bone is a modified form of hydroxyapatite (aka bone mineral).

Armed with a clean(ing) alternative to traditional toothpastes, Risewell also sought out to differentiate by backing its claims and building their credentials which resulted in the creation of its own Scientific Council with leading experts in dentistry and functional medicine including Robin Berzen, MD, Founder and CEO of Parsley Heath.

Risewell has put the traditional and organic toothpaste products on notice with a full suite of products to include toothpaste, mouthwash, and floss for both adults and children. Most importantly, Risewell stands by the fact that its product is safe for everyone which in my opinion gives it a stamp of approval for anyone looking for a clean and effective toothpaste to use during fertility treatments, pregnancy and to support long-term healthful hygiene habits. 

I was so excited about the prospect of also “rising well” and using a clean toothpaste product that I tried RiseWell and have been using it for the last four months. The verdict? I am impressed with how clean my mouth feels, how comforted my mind is knowing that I am not ingesting endocrine (hormone) disruptors and maybe I am just hallucinating, but I think that my teeth may actually be whiter. The tube is also definitely chic enough to leave out on my bathroom counter.

During our interview Kori mentioned that she wished that she had a community of support during her fertility treatments. Kori is grateful that the fertility experience opened up her eyes to what was missing and gave her the opportunity to create a truly necessary product. To that end, Kori has graciously extended her support for the fertility journey with a special offer to try RiseWell. Follow this link add in the promo code: FERTILUST20 to receive 20% off of your purchase.

Perhaps I am speculating but think that Marie Kondo would also agree that your toothpaste and your morning ritual needed an upgrade.

About Kori Estrada: Kori is the co-CIO of Axon Capital which is an asset management firm managing ~$500mm in capital globally. She has had a focus on consumer related investments throughout her career in both public and private capacities. Prior to joining Axon Capital, Kori was an Associate at Shumway Capital Partners and an Analyst in the Investment Banking Division at UBS Investment Bank. Kori received her BA from Columbia University. Based on her fertility experience, Kori made the notion of a clean toothpaste a reality together with her husband, John and brother, Dr. Derek Gatta. Kori, John and their baby Leo live in New York City.

Disclaimer: I was provided free product in return for my honest review. All thoughts and opinions herein are my own and are not influenced by the developing company, and/or its affiliates in any way. Please note that I am NOT an affiliate marketer for RiseWell or Leena & Lu and will not be paid a commission for any product purchased through the provided links.

Why male fertility matters. A conversation with Lauren Manaker.

Lauren Manaker grabbing her favorite snack.

I am so excited to share my recent chat with Lauren Manaker. Lauren is passionate about her family, nutrition, and the fertility space. Lauren is also filling the vast void in the (in)fertility space by tackling the subject and providing evidence-based nutritional counsel for male fertility.

To kick off the discussion, I asked Lauren to tell me two lies a truth and reveal the truth at the end. Read on to find out if you can figure out which of the three statements are true before Lauren shares it with us later on.

Two lies and a truth!

LM: I cried for two days when George Michael died.

I have a twin sister.

I have a rubber Duckie collection.

When did you know that you wanted to become a Registered Dietician?

LM: I knew I wanted to do something in the health sciences, and dietetics was a match for me. Unlike a lot of other dietitians, I am not a "foodie". I am a math and science geek, and nutrition is the perfect marriage of the two. I get to interpret data and do nerdy math equations every day!

What is your (in)fertility story and what made you want to share it?

LM: My story is not different from many others, but it was still a painful experience. My husband and I got married and wanted to start a family right away. Things did not go according to our timeline, and after spending a lot of time and even more money in the process, we are now parents to a four-year-old girl named Hannah. The process taught me a lot about patience and trust.

What inspired you to write Fueling Male Fertility?

LM: Once I started my business and was meeting so many women practically killing themselves trying to get pregnant, I realized that many assume that fertility is a women's responsibility alone.

“So many women carry all of the pressure on their shoulders and many men don’t make many changes to their life because they simply don’t know that they play such a role in fertility.”

A quick search will show that there are tons of resources about fertility and women, but only a handful are focused on men. I needed to fill the gap by writing an evidence-based guide for the man who wants to enhance his fertility through diet and lifestyle choices.

Why does male fertility matter?

LM: Male fertility matters because many experts say that 1/3 to 1/2 of infertility cases are due to male-factor causes. Ensuring both partners are doing what they can do to support their fertility is one of the best things a couple can do. 

What is something about you that we could never find on Google?

LM: I have one three hula-hoop contents in my life.

Speaking of Dr. Google... what is one thing that you wish people struggling with infertility would never search on Google and why?

LM: I wish people would not depend on the Internet for supplement recommendations.

“Over-supplementing can be dangerous, and every body has different needs.”

Two pieces of nutritional fertility advice that you would give to someone dealing with infertility?

LM: Make a point to eat at least five servings of fruits and vegetables a DAY for both men and women. Ideally, it would be two fruits and three veggies a day. Antioxidants, vitamins, and minerals are so important for fertility, and getting these from food is ideal. And Exercise. Moving your body is so good for your body and your mind during the process.

Favorite self-care practice?

LM: Barre class. It forces me to step away from my phone for an hour, sweat, and not think.

…And a good foot massage if my husband is up for it!

Favorite fertility food and why?

LM: Walnuts! They are an easy food to sneak in throughout the day and are super-portable. They have tons of features that are fertility-friendly: plant-based proteins, ALA omega-3 fatty acids, antioxidants, vitamins, minerals, the list goes on and on!

Guilty pleasure?

LM: Jamming out to George Michael in my kitchen with my daughter.

Hidden talent?

LM: Tap dancing and napping on-demand!

What gets you out of bed in the morning?

LM: My four year old daughter who refuses to get up without letting me know that it's morning time.

What are you most excited about right now?

LM: How times are changing and sharing personal (infertility) stories is more of the norm. There is comfort in knowing that you are not alone in difficult situations.

So which is the truth to my very first question?

LM: I cried over George Michael for two days!

A quick PSA from Nathalie and Lauren!

We liked chatting so much that we have joined forces to co-admin a private “fertility warriors” group to support the (in)fertility community on the Ellie App. We invite you to download the app today and continue the conversation with us when we launch on June 12th!

Lauren Manaker is a Registered Dietitian-Nutritionist (RDN), MS, LD, CLEC who focuses on reproductive health. Lauren authored the book “Fueling Male Fertility”, and is a counselor and consultant through her company, Nutrition Now. She is also a contributor on pregnantish.

Lauren’s pride and joy is her four year-old daughter who was conceived after many IVF cycles. Lauren's mission is to help busy people get evidence-based nutrition information that isn't based on fads or "Dr. Google".

From Bumps to Baby with Liz Shaw

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!

Review: The Stress-Free IVF Nutrition Guide by Liz Shaw

I have been around the (in)fertility block a few times. Even though I have educated myself about the role and importance of nutrition for overall long-term health, it’s amazing how I have had amnesia about how to nourish my body beyond the basics during the IVF journey. I recently did my fourth (yep you read correctly) IVF cycle at the age of 40. Although my diet is predominantly plant-based with a side of meat at this point, I was so grateful that Liz offered to let me try out her Stress- Free IVF Nutrition Guide leading up to and during my cycle. Liz said that I needed one less thing to worry about and she was right.

Under the expert tutelage of Liz who is a Registered Dietician with her own fertility story, she has created a concise, poignant, evidence-based guide aimed at elaborating on the Mediterranean diet with a Pro-Fertility diet and lifestyle. If you are anything like I was when I started all of this out, that may have just as well been written in Taiwanese. In a nutshell, Liz breaks down which nutrient-dense foods have been researched to help optimize cellular growth for egg quality. She also shares how fitness, self-care and avoiding endocrine disrupting chemicals are supportive to a possible optimized outcome. To put the new found knowledge in to action, Liz provides tips on how to easily stock your pantry with a checklist and provides sample recipes for every step of IVF, from retrieval to transfer.

I found the recipes tasty, quick and easy to make. (Just to elaborate, I am that person that when it says a recipe takes 30 minutes to make, it usually takes me an hour.) I was grateful that the length of time required for the recipes was actually accurate! My favorite recipes that I batched to last over a few days were the Berry Chia Slow Cooked Oats, and BBQ Lentil Burgers. Post-Retrieval, I enjoyed the Roasted Potato Tacos with Eggs as a healthy way to get the sodium necessary to dry out the egg follicle sacs and stave off OHSS (Ovarian Hyperstimulation Syndrome). I also appreciated that the Guide helps the reader put a nutritional plan into action at home and/or on the go. Let’s face it, while cooking at home is ideal, it isn’t always possible or convenient.

I spent a semester to get my holistic health coach certification so that I could understand the basics of nutrition to then decipher how it tied back to fertility. Liz broke down the IVF process and an IVF supportive nutritional/lifestyle plan in 47 pages. I am grateful that this Guide exists now because it is what I dreamed of finding so many cycles ago…

After reading the guide, I am also rethinking my hard and fast stance on avoiding dairy altogether during IVF. According to Liz, “the longitudinal evidence really has found it's somewhat moot, meaning it doesn't necessarily help or harm fertility. The benefits have been shown in those with anovulatory infertility, but in the long run, it's totally an individual preference. If you have difficulty digesting dairy, I always tell my patients that the best rule of thumb is to choose other calcium and vitamin D rich foods like fortified plant milks and mushrooms!” (In full transparency, I don’t consume much dairy in general as it is known to be inflammatory and I am a little lactose intolerant, however having good quality cheese from time to time in moderation is now something that I am comfortable with in my general diet.)

By the time that you complete the Guide, my sense is that you will feel empowered by being able to control the one and most important thing that you can do during the process; what you put into your body. I am also willing to bet that you’ll want to be best friends with Liz because she may be one of the most kind, gracious and supportive souls that you might ever encounter.

As Liz can attest, this way of eating may not necessarily guarantee the outcome of a baby, however, you will be and feel healthier following a Pro-Fertility diet which is largely anti-inflammatory and anti-bloating. The upside of long-term health benefits is definitively also a positive. I appreciate that the Guide offers a long-term health solution, not just a fad diet.

Interested in taking your nutrition into your own hands? You can pick up a copy of Liz’ Stress-Free IVF Nutrition guide here. Use the promo code fertilust for 10% off!

*Please note that this review is entirely voluntary and no funds, services nor goods were exchanged outside of an advanced copy to read.*

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.

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.

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 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: Faces of (In)fertility

Photo by Alexis Mera. Shirt design by Erin Halper.

At first glance it would be hard to detect that Stephanie Rapp is a fertility warrior. Stephanie is young, beautiful, vivacious and currently pregnant. And while Stephanie is entirely transparent about her story and the challenges on her path to building her family, you would probably assume that she sneezed and got pregnant. During our interview, Stephanie shares how (in)fertility has many faces and also affects young women. Read on to find out why we should never judge a book by its cover.

Stephanie’s story

My story began when I went on the pill at age 15, and was on it for the next 10 years. Fast forward to high school and college, where I struggled to maintain 100 lbs and hard a hard time putting on weight. After UPenn, I went into finance, working at Goldman Sachs in Fixed Income sales & trading, (through the financial crisis) for eight years. Soon after starting at Goldman Sachs, I was working 14 to 20 hour days and feeling the immense stress and pressure of the job and culture, (which were exacerbated by the climate of the time), and I stopped getting my period. My OBGYN, who I saw at the GS health center, reassured me that it was normal to not get a period while on the pill. After witnessing fertility struggles of people close to me, I decided to take my health into my own hands.

I went searching for a good OBGYN, I started making changes to try and get a cycle back and I went off of the pill. A year after going off of the pill, my situation was still the same. I was still very slender, still working intensely in a highly stressful environment, still working out regularly, still going out often. And still without a period.

I was sent for ultrasounds, CAT scans, MRIs, rounds, and rounds of blood work and more, to no avail. My hobby and passion is nutrition so I enrolled in nutrition school in hopes that I could also find out how to get my body functioning. I changed the way that I ate (bone marrow and collagen, ghee and egg yolks, kombu and kefir, grass fed steaks and cheese), and the way I worked out (yoga and walks, pilates and rest days). I added in acupuncture and supplements. And I started to notice positive changes in the right direction. But when my husband and I got married and started to try for a baby, I never, not once, in many months had a positive ovulation test.

I felt called to share my journey with other women who, surprisingly (had experiences which) were not dissimilar. So many of my colleagues also were experiencing amenorrhea or had suffered infertility. One day, after opening up about my struggles, a friend suggested that I see her fertility specialist. My then OBGYN told me to try for a year because I was so young before proceeding down any alternate paths. I had little to lose so I went to the specialist (that my friend recommended), and within an hour she had honed in on my issue and created a path towards pregnancy.

Patches, pills, shots and six weeks later, I was pregnant with Olivia (now four years old)! Seven months after having Olivia, I went back to my fertility specialist. Four weeks later I was pregnant with Cullen (now almost three years old)! Fast forward again, I went back for number three. A few cycles in I was pregnant again, but at eight weeks had a miscarriage. I elected for a DNC days after the diagnosis which ended up being a lifesaving decision because my pathology determined that I had a molar pregnancy, placental tumor.

Had I waited to miscarry naturally, I likely would have had to have a much more invasive procedure followed by a year or more of chemo(therapy). Instead, I suffered through a long and scary six months of constant blood work to ensure the tumor was not growing back coupled with the most intense fatigue, fog, exhaustion, lack of fervor and joy. Total depletion. I was desperate to feel like me again, but was grasping at straws. Again, I went for blood work and tests and labs; to find nothing. I treated myself with alternate therapies, supplements and nutrients, rest and support, eventually coming out of the hole I was living in after six months. I'm now pregnant with number three, due early July! 

I started a wellness company, EMBODY Wellness Company just over four years ago. We are a holistic wellness and lifestyle concierge, who create customized wellness programs for our individual and corporate clients. Our goal is to clear through the clutter and help our clients accomplish (more than) their goals in a sustainable and lasting way. We specialize in fertility, pre and post-natal and getting your body back after baby, as well as weight-loss, gut repair, clean home and beauty makeovers, corporate workshops, events, talks and more! We also do wellness business consulting for budding companies and practitioners. I am inspired by my work and our clients and love being able to help others on their journey to embody wellness!

Your high?

Each positive pregnancy test and then the highest high, holding my healthy babies! 

Your low?

The molar pregnancy rocked me to my core. It was emotionally sad and taxing, and it physically crushed me too. Feeling joy was too exhausting. I struggled to stay in the moment and enjoy the happiness around me. Even laughter was a strain. And my two kids are so funny! I felt despair and helplessness and uncertainty that the future would clear up. The road ahead seemed rocky and unreliable. My medical bills were crazy. (My insurance covered zero percent. Not even my DNC and all of the prescription hormones that I was on for well over a year.) I felt horrible physically and mentally, and felt even worse about that emotionally. I felt guilty about not being "me" for my kids and husband who needed my support and help, and I was just so so tired all of the time. 

Do you have a silver lining? 

This is a tough question. I think I'll be able to answer that more genuinely when I hold baby number three and see that he is healthy and here! A friend recently told me the timing is great because my older two are at ages where they are so excited for baby and cannot wait to be big siblings. They are thrilled to have responsibilities and teach their little brother their favorite songs, how to eat food, pick out his diapers and clothes. They will both be in preschool so I'll have good 1:1 time with the little guy. 

I truly believe I’m an optimist but I think that some parts of infertility are not lined in silver. I didn't need to have a placental tumor (to learn a lesson or appreciate something else). I don't want anyone else to go through that. I'd much prefer every woman have a linear path to motherhood. In the end, my third healthy child will be the silver lining. That's the most important outcome. 

Do you have any words of wisdom?

There are many ways of becoming a mother. Sometimes, ways we don't plan for or expect. But trust that you will hold your baby one day, maybe after an easy and natural conception, maybe through IVF, or even surrogacy or adoption. But, If you want to be a mom, you will be. 

I also want to add that most importantly that this is your journey and your life. Allow yourself to feel however you fee; mad, frustrated, sad, defeated, joyous, excited, hopeful. Whatever your emotions, they are real and don't need to be explained or justified. Give yourself the time and space to feel and heal how you need. And you don't have to do it alone! seek help from friends, professionals, (this growing) community, family, a journal, whatever you need. Reach out and let others in! You are not expected to be the expert on everything, and you are not failing.

Stephanie, her husband and two (soon to be three!) children live in NYC. If Stephanie isn’t creating meals from her farmers market finds for her family, friends or EMBODY Wellness clients, you can find her dancing and singing along with her kids as they rehearse the complete soundtrack to Frozen. To learn more about Stephanie, please visit EMBODY Wellness or follow @embodywellnesscompany on Instagram.

NIAW Feature: Options are Valuable

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.

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.

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 sharing, and 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

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.

Get Happy

There could be a slew of reasons that might derail a day; the too-good-for-his-job guy/girl at the local coffee shop who was rude and got your order wrong to boot. Maybe you’re running late to an important meeting and a careless taxi driver just drenched you in toxic city sludge on your way to said meeting… 

Life isn’t perfect. We should allow ourselves the opportunity to mourn the big things and let go of the small things. We may not be able to control outcomes of situations but we can control how we react to them. In those moments we are presented with a choice and an opportunity.

There is something to be said about the power of optimism to combat stress and empower a positive mind-body connection crucial for any medical challenge including infertility. Poor mental stress may negatively affect fertility in ways that are not yet clinically understood. (I asked Dr. # 4 about the impact of stress and she said and I quote “we live in New York City, everyone is stressed and women get pregnant all of the time”. That statement literally crushed me at the time and now I think it is just plain ridiculous that I allowed her view to cloud mine.) Just because there isn’t enough clinical research to provide gold standard research on the affects of high cortisol levels doesn’t mean that we aren’t affected by stress. Stress is real and we have the power to either contribute to it through negative thoughts, thereby punishing ourselves, or through combating it through manifesting the positive.

There is only upside to practicing a positive outlook. A generally happy person enjoys a higher quality of life and it may also reduce disease so there’s that. Each morning is an opportunity for us to hit the reset button. While it applies to just about everything, focusing every waking moment on getting pregnant “or else you won’t have this, or that,” can create tunnel vision. (Cue that crazy spiral image from the Twilight Zone.) Being so attached to a fertility outcome may even make things worse for us mentally and emotionally should our reality not match our expectation. I’ve been there. We have a choice to be all consumed or practice counting our blessings for the things in our lives for which we are grateful right now.

So if you missed the memo on “National Happiness Day” today, remember that you’ve got another shot to get happy tomorrow. Before you go to bed tonight, reset. Close your eyes for a (whole!) minute and breathe deeply. First forgive yourself, maybe even forgive that self-absorbed barista, taxi cab driver, or your nosy colleague who keeps asking when you are going to have kids. Consider giving them the benefit of the doubt, as they are likely just unaware. Take three more minutes. Just three more! Write down three things that you are grateful for, and three moments that you are looking forward to in the new day. (Writing my thoughts and tasks in a pretty notebook gives me an insane amount of satisfaction for some reason. Maybe it will for you?) The moments that will make you smile as you think about the future may be as simple as hugging your dog, or seeing the sun/sky in the morning. On the back of the paper, dump anything else that you need to park outside of your head like calling your mom, the doctor, any work related items, and, and, and… Bonus points if you write down one self-care item (massage, manicure, etc.) that you plan to schedule for yourself, just because.. Then leave your phone in another room and affirm to yourself that you have set yourself up to get a good night’s sleep to reset and restore for the coming day ahead. Believe it when you say it.

Tomorrow, right when you wake up, read that list of six things at home and not on the run, saving the other side of the to-do’s for the office. Honor your brilliant mind and body by telling yourself how grateful you are, drink a whole glass of water and mentally prepare yourself for the day with a smile. And give yourself permission without judgement to fake that smile until it becomes real.

Wishing all of us endless National Happiness Days…

xx

Photo by Patrick Hendry on Unsplash

The Girlfriends' Guide to IVF: Part 1

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

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