1 00:00:00,080 --> 00:00:13,320 Speaker 1: M hm okay. Welcome to the Therapy for Black Girls podcast, 2 00:00:13,840 --> 00:00:18,720 Speaker 1: a weekly conversation about mental health, personal development, and all 3 00:00:18,720 --> 00:00:21,400 Speaker 1: the small decisions we can make to become the best 4 00:00:21,400 --> 00:00:25,760 Speaker 1: possible versions of ourselves. I'm your host, Dr joy hard 5 00:00:25,800 --> 00:00:30,560 Speaker 1: and Bradford, a licensed psychologist in Atlanta, Georgia. For more 6 00:00:30,640 --> 00:00:34,640 Speaker 1: information or to find a therapist in your area, visit 7 00:00:34,680 --> 00:00:38,760 Speaker 1: our website at Therapy for Black Girls dot com. While 8 00:00:38,800 --> 00:00:42,479 Speaker 1: I hope you love listening to and learning from the podcast, 9 00:00:42,960 --> 00:00:46,080 Speaker 1: it is not meant to be a substitute for relationship 10 00:00:46,159 --> 00:00:57,040 Speaker 1: with a licensed mental health professional. Hey, y'all, thanks so 11 00:00:57,120 --> 00:00:59,520 Speaker 1: much for joining me for session to five of the 12 00:00:59,520 --> 00:01:02,520 Speaker 1: Therapy a Black Girl's Podcast. We'll get run into the 13 00:01:02,560 --> 00:01:14,520 Speaker 1: episode after a word from our sponsors. As black women, 14 00:01:14,959 --> 00:01:17,560 Speaker 1: many of us are often drafting and revising our vision 15 00:01:17,560 --> 00:01:21,040 Speaker 1: boards to include our career aspirations and our financial goals. 16 00:01:21,560 --> 00:01:24,160 Speaker 1: But how many of us are also including our reproductive 17 00:01:24,160 --> 00:01:28,520 Speaker 1: desires in our five year plans? Consider this question, what 18 00:01:28,640 --> 00:01:32,080 Speaker 1: does reproductive health look like for me? What would I 19 00:01:32,120 --> 00:01:34,880 Speaker 1: like my parenthood plan to be? And how can I 20 00:01:34,959 --> 00:01:38,800 Speaker 1: make steps towards the future I want? For many people, 21 00:01:38,920 --> 00:01:41,399 Speaker 1: the process of creating a family comes with its own 22 00:01:41,480 --> 00:01:45,720 Speaker 1: unique set of challenges for those dealing with infertility, issues 23 00:01:45,760 --> 00:01:50,040 Speaker 1: with their fertility, or even those considering fertility preservation methods. 24 00:01:50,320 --> 00:01:53,320 Speaker 1: The process of becoming are not becoming a parent begins 25 00:01:53,320 --> 00:01:56,880 Speaker 1: with asking yourself a series of questions, often in partnership 26 00:01:56,920 --> 00:02:00,480 Speaker 1: with a health professional. Joining us today to chat about 27 00:02:00,480 --> 00:02:04,120 Speaker 1: some of these questions is Dr Ta Jackson Bay. Dr 28 00:02:04,240 --> 00:02:07,920 Speaker 1: Jackson Bay is a Black reproductive intero chronologist and infertility 29 00:02:07,960 --> 00:02:12,080 Speaker 1: specialists in Brooklyn, New York. As a dedicated fertility expert 30 00:02:12,120 --> 00:02:15,880 Speaker 1: focused on non traditional family building, Dr Jackson Bay knows 31 00:02:15,919 --> 00:02:19,760 Speaker 1: the unique challenges Black women face while navigating infertility and 32 00:02:19,840 --> 00:02:24,680 Speaker 1: processes like egg freezing and in vidual fertilization. Dr Jackson 33 00:02:24,720 --> 00:02:28,359 Speaker 1: Bay and I chatted about patient options when faced with infertility, 34 00:02:28,919 --> 00:02:32,960 Speaker 1: demystifying the egg freezing and IVF processes, and some of 35 00:02:32,960 --> 00:02:36,680 Speaker 1: the economics, social, and psychological hurdles black women face in 36 00:02:36,680 --> 00:02:40,600 Speaker 1: the fertility process. If there's something that resonates with you 37 00:02:40,639 --> 00:02:44,200 Speaker 1: while enjoying our conversation, please share with us on social 38 00:02:44,200 --> 00:02:48,639 Speaker 1: media using the hashtag TPG in Session, or join us 39 00:02:48,639 --> 00:02:50,680 Speaker 1: over in the sister circles to talk more in depth 40 00:02:50,720 --> 00:02:53,880 Speaker 1: about the episode you can join us at community dot 41 00:02:53,919 --> 00:03:00,799 Speaker 1: therapy for Black Girls dot com. Here's our conversation. Thank 42 00:03:00,840 --> 00:03:02,919 Speaker 1: you so much for joining us today, Dr Jackson V. 43 00:03:03,360 --> 00:03:05,679 Speaker 1: Thank you. So. I'm happy to be here. Yeah, very 44 00:03:05,720 --> 00:03:07,480 Speaker 1: excited to chat with you. So I'd love for you 45 00:03:07,520 --> 00:03:09,520 Speaker 1: to just get us started by talking about what you 46 00:03:09,600 --> 00:03:14,080 Speaker 1: do as a reproductive indochronologist. Absolutely so, I'm a reproductive 47 00:03:14,080 --> 00:03:18,720 Speaker 1: intochronologist and infertility specialist. For most people, that just means 48 00:03:18,760 --> 00:03:22,519 Speaker 1: that I'm an infertility doctor. I usually see persons who 49 00:03:22,560 --> 00:03:25,840 Speaker 1: are actively trying to get pregnant in realizing that they're 50 00:03:25,840 --> 00:03:29,880 Speaker 1: having some difficulties. But along that spectrum, I also see 51 00:03:29,919 --> 00:03:33,480 Speaker 1: persons who may have issues that affect their fertility. So 52 00:03:33,600 --> 00:03:38,920 Speaker 1: things like uterine fibroids or endometriosis or even different indocrine 53 00:03:38,920 --> 00:03:42,760 Speaker 1: conditions that can affect your fertility in the future. We 54 00:03:42,840 --> 00:03:45,040 Speaker 1: may work on those in the process so that we 55 00:03:45,080 --> 00:03:48,240 Speaker 1: can avoid some issues later down the line. I also 56 00:03:48,280 --> 00:03:50,800 Speaker 1: see a fair amount of patients who are seeking what 57 00:03:50,840 --> 00:03:54,560 Speaker 1: we call fertility preservation, and so these are ways of 58 00:03:54,720 --> 00:03:58,280 Speaker 1: kind of holding onto your current fertility for your future use. 59 00:03:58,760 --> 00:04:02,720 Speaker 1: So that may include raising eggs, sperm, or embryos to 60 00:04:02,840 --> 00:04:06,640 Speaker 1: use later. Got it? Okay, at what point would someone 61 00:04:06,800 --> 00:04:09,560 Speaker 1: see someone like you? So I'm guessing it probably comes 62 00:04:09,560 --> 00:04:12,440 Speaker 1: to referrals. So that is a great question because once 63 00:04:12,520 --> 00:04:16,640 Speaker 1: upon a time it was very referral based, and many 64 00:04:16,680 --> 00:04:19,440 Speaker 1: subspecialists will probably remember you had to always go through 65 00:04:19,480 --> 00:04:21,839 Speaker 1: your primary care to get a referral to go on. 66 00:04:22,400 --> 00:04:25,880 Speaker 1: Depending on insurance companies, you can book consultations with a 67 00:04:25,920 --> 00:04:29,719 Speaker 1: subspecialists without a referral, and so it is important for 68 00:04:29,920 --> 00:04:33,280 Speaker 1: individuals to realize when they should seek care or not. 69 00:04:34,000 --> 00:04:36,839 Speaker 1: And so for persons who are trying to get pregnant 70 00:04:36,880 --> 00:04:40,279 Speaker 1: and realizing that there may be an issue, typically under 71 00:04:40,320 --> 00:04:42,960 Speaker 1: the age of thirty five, if you've been trying for 72 00:04:43,120 --> 00:04:46,640 Speaker 1: one year and they have not achieved a pregnancy or 73 00:04:46,720 --> 00:04:49,360 Speaker 1: have not had a successful pregnancy that's gone on to 74 00:04:49,440 --> 00:04:52,320 Speaker 1: a live birth, that would be an adequent time to 75 00:04:52,520 --> 00:04:56,039 Speaker 1: be seen by a reproductive into chronologist for any one 76 00:04:56,080 --> 00:04:59,719 Speaker 1: thirty five or older. Six months is the time limit 77 00:04:59,800 --> 00:05:03,000 Speaker 1: that give, and the reason being you could have more 78 00:05:03,120 --> 00:05:06,000 Speaker 1: issues trying to get pregnant as you age, and in 79 00:05:06,120 --> 00:05:08,480 Speaker 1: thirty five is where we start to see that happen, 80 00:05:09,080 --> 00:05:10,840 Speaker 1: and so we just don't want you to go too 81 00:05:10,880 --> 00:05:13,440 Speaker 1: long without us seeing maybe if there are some issues 82 00:05:13,480 --> 00:05:16,520 Speaker 1: that we can address sooner. For persons who are over forty, 83 00:05:16,600 --> 00:05:18,920 Speaker 1: I actually recommend for them to be seen right away 84 00:05:19,400 --> 00:05:21,760 Speaker 1: and not to wait more than two or three months 85 00:05:21,760 --> 00:05:24,640 Speaker 1: of trying. And again that's really just because they could 86 00:05:24,760 --> 00:05:27,360 Speaker 1: have more issues trying to conceive, and so we may 87 00:05:27,400 --> 00:05:30,520 Speaker 1: want to intervene sooner. For anyone who's considering something like 88 00:05:30,560 --> 00:05:33,640 Speaker 1: fertility preservation, they can see us right away so they 89 00:05:33,640 --> 00:05:36,680 Speaker 1: can book consultations. They may have to have a referral 90 00:05:36,800 --> 00:05:40,600 Speaker 1: or not. Sometimes we do these consultations on an urgent basis. 91 00:05:40,720 --> 00:05:44,920 Speaker 1: Maybe if someone's having emergency surgery or even have a 92 00:05:44,960 --> 00:05:48,960 Speaker 1: cancer diagnosis and needs treatment before their cancer treatment starts, 93 00:05:49,320 --> 00:05:52,480 Speaker 1: then we would see them quickly. Got it? This asia 94 00:05:52,560 --> 00:05:55,800 Speaker 1: thirty five comes up quite often. Can you tell us 95 00:05:55,880 --> 00:05:57,960 Speaker 1: what is it about the age of thirty five that 96 00:05:58,040 --> 00:06:00,320 Speaker 1: indicates there's a higher level of concern and or we 97 00:06:00,360 --> 00:06:03,880 Speaker 1: need to be paying more attention In your peak fertility 98 00:06:04,000 --> 00:06:07,000 Speaker 1: or what we call fecundity, is your ability to achieve 99 00:06:07,040 --> 00:06:12,120 Speaker 1: a pregnancy. Really occurs sometimes when persons aren't really concerned 100 00:06:12,120 --> 00:06:15,920 Speaker 1: about becoming pregnant, So in your early to mid twenties 101 00:06:16,000 --> 00:06:18,599 Speaker 1: all the way up to maybe early thirties. It's really 102 00:06:18,640 --> 00:06:20,840 Speaker 1: when you have the best chance for success on a 103 00:06:20,920 --> 00:06:24,839 Speaker 1: month to month basis. Around age thirty five, that chance 104 00:06:24,880 --> 00:06:28,680 Speaker 1: starts to decrease, and over age thirty seven it decreases 105 00:06:28,720 --> 00:06:31,640 Speaker 1: a little bit more rapidly. So we use thirty five 106 00:06:31,760 --> 00:06:34,400 Speaker 1: is that inflection point to say, Okay, we know that 107 00:06:34,440 --> 00:06:36,760 Speaker 1: it may be a little bit harder around this time. 108 00:06:37,279 --> 00:06:41,520 Speaker 1: At that same age, miscarriage starts to increase, and also 109 00:06:41,640 --> 00:06:43,960 Speaker 1: the number of eggs that you have, as well as 110 00:06:44,000 --> 00:06:47,200 Speaker 1: the quality of the eggs that you have, does change. 111 00:06:47,400 --> 00:06:51,120 Speaker 1: And this is a continuous process. It's not an unnatural thing. 112 00:06:51,200 --> 00:06:54,600 Speaker 1: It actually is a natural biologic function of our ovaries, 113 00:06:55,120 --> 00:06:57,560 Speaker 1: but it doesn't always match up with how we're living 114 00:06:57,600 --> 00:07:00,800 Speaker 1: our lives today. Because of that, we'd like to see 115 00:07:00,839 --> 00:07:04,320 Speaker 1: people around that age or see them sooner over age 116 00:07:04,320 --> 00:07:07,039 Speaker 1: thirty five, just with the anticipation that there could be 117 00:07:07,120 --> 00:07:09,680 Speaker 1: some more issues around that time. Got it. And so 118 00:07:09,800 --> 00:07:12,679 Speaker 1: when you're twenty two, you likely may not be thinking 119 00:07:12,680 --> 00:07:15,560 Speaker 1: about like, Okay, do I want to have a baby later? 120 00:07:15,600 --> 00:07:18,560 Speaker 1: But sometimes that measures up with peak fertility. So can 121 00:07:18,640 --> 00:07:21,200 Speaker 1: you share more about what that conversation is that you 122 00:07:21,280 --> 00:07:24,080 Speaker 1: like to have with your clients. Absolutely. It kind of 123 00:07:24,120 --> 00:07:27,240 Speaker 1: starts with the dichotomist question of do you want children 124 00:07:27,400 --> 00:07:30,360 Speaker 1: or not, because for some persons, I think he'll feel 125 00:07:30,440 --> 00:07:33,160 Speaker 1: pretty convicted that no, that's not part of my life plan, 126 00:07:33,240 --> 00:07:35,920 Speaker 1: and that can be helpful. But if it is part 127 00:07:35,920 --> 00:07:38,160 Speaker 1: of your life plan, I feel like the next question 128 00:07:38,240 --> 00:07:41,520 Speaker 1: is do these children have to be biologically related to 129 00:07:41,560 --> 00:07:44,080 Speaker 1: you or would you be open to something like adoption 130 00:07:44,800 --> 00:07:47,720 Speaker 1: or embryo or egg donation as a way to achieve 131 00:07:47,800 --> 00:07:50,920 Speaker 1: your family because that also helps us to know which 132 00:07:50,920 --> 00:07:53,679 Speaker 1: way may make the most sense for you. For persons 133 00:07:53,680 --> 00:07:57,520 Speaker 1: who feel strongly about having their own biologic children, either 134 00:07:57,600 --> 00:08:00,920 Speaker 1: alone or with a partner, then I think it's helpful 135 00:08:00,960 --> 00:08:04,280 Speaker 1: to have just an idea, a road map of plan 136 00:08:04,640 --> 00:08:07,720 Speaker 1: in place about when you would want that to happen, 137 00:08:08,280 --> 00:08:10,760 Speaker 1: and how you want it to look, how many children 138 00:08:10,840 --> 00:08:13,640 Speaker 1: you want to have. To think about these things very 139 00:08:13,720 --> 00:08:16,280 Speaker 1: much in the way that we think and plan our education, 140 00:08:16,560 --> 00:08:20,720 Speaker 1: in our careers and finances. Everybody talks about like your 141 00:08:20,760 --> 00:08:23,679 Speaker 1: five year plan, but your five year plan really should 142 00:08:23,720 --> 00:08:27,280 Speaker 1: include what does reproductive health look like for you? What 143 00:08:27,480 --> 00:08:31,440 Speaker 1: is your parenthood plan or strategy, and how are you 144 00:08:31,680 --> 00:08:34,720 Speaker 1: making steps towards the goals that you want, and you 145 00:08:34,760 --> 00:08:37,840 Speaker 1: mentioned some of the societal issues that sometimes impact this 146 00:08:37,960 --> 00:08:40,920 Speaker 1: for black women differently. Can you say more about that. Absolutely. 147 00:08:41,000 --> 00:08:45,679 Speaker 1: One thing that it's interesting is a worldwide women are 148 00:08:45,920 --> 00:08:50,720 Speaker 1: delaying childbearing. People are having less kids overall, particularly in 149 00:08:50,720 --> 00:08:55,200 Speaker 1: industrialized countries, but people are also starting their families later, 150 00:08:55,640 --> 00:08:58,959 Speaker 1: and this is due probably in most part to increase 151 00:08:59,080 --> 00:09:03,520 Speaker 1: education for in then increased work outside the home, increase 152 00:09:03,720 --> 00:09:08,160 Speaker 1: higher education for some person seeking masters in doctorate degrees, 153 00:09:08,640 --> 00:09:12,880 Speaker 1: and unfortunately it's just still not as easy to start 154 00:09:12,880 --> 00:09:15,959 Speaker 1: a family or build your family while you're doing all 155 00:09:15,960 --> 00:09:19,960 Speaker 1: of these different things. Persons also get partnered later, and 156 00:09:20,000 --> 00:09:22,560 Speaker 1: so for all of these reasons, the average age at 157 00:09:22,640 --> 00:09:26,079 Speaker 1: first child has now shifted, and so some persons may 158 00:09:26,080 --> 00:09:29,520 Speaker 1: find themselves in their thirties considering their first child, whereas 159 00:09:29,520 --> 00:09:33,240 Speaker 1: a hundred years ago people were wrapping up reproduction in 160 00:09:33,280 --> 00:09:36,800 Speaker 1: your late thirties, certainly by early forties. And so that's 161 00:09:36,800 --> 00:09:41,439 Speaker 1: a major cultural shift that is actually not our o 162 00:09:41,559 --> 00:09:45,800 Speaker 1: baries haven't really caught up with that. Just acknowledgement of 163 00:09:45,880 --> 00:09:49,079 Speaker 1: this kind of contrast between how we're living our lives 164 00:09:49,160 --> 00:09:52,199 Speaker 1: and what our bodies are programmed to do. Is really 165 00:09:52,200 --> 00:09:56,960 Speaker 1: important because you have to honor it and be aware 166 00:09:57,000 --> 00:10:00,959 Speaker 1: of some of the limitations of age on reproduction. Similarly, 167 00:10:01,040 --> 00:10:05,960 Speaker 1: for persons who on career tracks, on different education tracks, 168 00:10:06,080 --> 00:10:08,640 Speaker 1: or just don't feel like they are where they want 169 00:10:08,679 --> 00:10:11,040 Speaker 1: to be in a life in order to start a family, 170 00:10:11,440 --> 00:10:14,040 Speaker 1: I think kind of happened an idea of maybe what 171 00:10:14,120 --> 00:10:17,199 Speaker 1: are some ways that they could preserve their fertility may 172 00:10:17,200 --> 00:10:19,800 Speaker 1: be important. So one of the ways that you've talked 173 00:10:19,800 --> 00:10:23,079 Speaker 1: about preserving fertility is through the freezing of eggs. Can 174 00:10:23,120 --> 00:10:25,520 Speaker 1: you tell us more about what that process is and 175 00:10:25,559 --> 00:10:29,559 Speaker 1: how it works. Yeah, So egg freezing the technology that's 176 00:10:29,600 --> 00:10:33,640 Speaker 1: come about from really in vat your fertilization and so 177 00:10:33,800 --> 00:10:36,080 Speaker 1: a lot of times when persons want to know if 178 00:10:36,080 --> 00:10:38,160 Speaker 1: I freeze my eggs so I have to do ibs 179 00:10:38,240 --> 00:10:41,120 Speaker 1: in the future, the answer is he actually already did 180 00:10:41,120 --> 00:10:45,120 Speaker 1: it because the processes are very similar. It involves taking 181 00:10:45,240 --> 00:10:48,680 Speaker 1: injectable medication for a little over a week about a 182 00:10:48,679 --> 00:10:52,080 Speaker 1: week and a half, and during that process, the injections 183 00:10:52,160 --> 00:10:55,800 Speaker 1: helped your body to create multiple eggs in a one cycle. 184 00:10:56,280 --> 00:10:59,480 Speaker 1: Your default is actually to grow and mature one egg 185 00:10:59,520 --> 00:11:03,120 Speaker 1: for obuls nation each month, but using these medications we 186 00:11:03,160 --> 00:11:05,560 Speaker 1: can help the ovaries to grow many eggs that in 187 00:11:05,640 --> 00:11:09,400 Speaker 1: one cycle, so that the eggs can be removed frozen 188 00:11:09,559 --> 00:11:12,280 Speaker 1: and say it's for use in the future. In order 189 00:11:12,320 --> 00:11:14,960 Speaker 1: to access the eggs, you'll have to go back to 190 00:11:15,000 --> 00:11:18,240 Speaker 1: your provider, let them know they would saw the eggs, 191 00:11:18,280 --> 00:11:21,480 Speaker 1: inseminate them with sperm to create embryos, and then the 192 00:11:21,640 --> 00:11:24,280 Speaker 1: embryo would be placed inside of the uterus in order 193 00:11:24,320 --> 00:11:27,760 Speaker 1: to create a pregnancy. It still involves quite a few 194 00:11:27,800 --> 00:11:33,400 Speaker 1: steps in freezing eggs. The whole goal is that hopefully, 195 00:11:33,520 --> 00:11:36,360 Speaker 1: even if you use these eggs at a later age, 196 00:11:36,559 --> 00:11:39,760 Speaker 1: your reproductive potential should be that of the age at 197 00:11:39,800 --> 00:11:42,400 Speaker 1: which you froze the eggs. And so that can be 198 00:11:42,520 --> 00:11:47,760 Speaker 1: a very important kind of fertility preserving strategy for someone 199 00:11:47,880 --> 00:11:51,079 Speaker 1: who maybe is in their late twenties or early thirties, 200 00:11:51,480 --> 00:11:54,840 Speaker 1: knows that they don't want children maybe for a few years, 201 00:11:54,880 --> 00:11:57,560 Speaker 1: but doesn't want to fall into some of those issues 202 00:11:57,600 --> 00:12:00,280 Speaker 1: that you can encounter in your late thirties early four dates. 203 00:12:00,440 --> 00:12:04,000 Speaker 1: And where are the eggs held after they're frozen. Is 204 00:12:04,040 --> 00:12:06,800 Speaker 1: that in your office or some other facility. That is 205 00:12:06,840 --> 00:12:10,760 Speaker 1: a great question. So if the eggs are actually frozen, 206 00:12:10,880 --> 00:12:13,920 Speaker 1: the same day that they're retrieved from the body, and 207 00:12:13,960 --> 00:12:17,040 Speaker 1: then they can be stored long term, either at the 208 00:12:17,080 --> 00:12:20,440 Speaker 1: facility where you do your egg freezing. Some places will 209 00:12:20,480 --> 00:12:24,520 Speaker 1: store what we call offsite in larger kind of prior 210 00:12:24,600 --> 00:12:30,280 Speaker 1: preservation warehouses, similar to how sperm is stored in major 211 00:12:30,360 --> 00:12:33,920 Speaker 1: locations all around the country. Eggs and embryos can also 212 00:12:34,000 --> 00:12:36,880 Speaker 1: be stored long term in the same way. And is 213 00:12:36,920 --> 00:12:40,120 Speaker 1: there a date by which you have to use the 214 00:12:40,160 --> 00:12:43,840 Speaker 1: eggs if you're planning to Technically there is no expiration date. 215 00:12:44,320 --> 00:12:46,600 Speaker 1: I do like to tell patients to have a plan 216 00:12:46,679 --> 00:12:49,200 Speaker 1: in place, as you see, there's a theme, right, and 217 00:12:49,280 --> 00:12:51,600 Speaker 1: just have an idea of what you would want to 218 00:12:51,640 --> 00:12:53,719 Speaker 1: do with the eggs, you know. I tell a lot 219 00:12:53,760 --> 00:12:56,160 Speaker 1: of patients that you may not need these eggs in 220 00:12:56,200 --> 00:12:59,800 Speaker 1: the future. Many of my patients are either single or 221 00:13:00,040 --> 00:13:02,560 Speaker 1: partner but unsure if they want to have a family 222 00:13:02,600 --> 00:13:05,400 Speaker 1: with their current partner, and so that's why they're choosing 223 00:13:05,440 --> 00:13:08,640 Speaker 1: to freeze eggs. And so they're not people who have 224 00:13:08,679 --> 00:13:10,960 Speaker 1: tried to get pregnant on their own. So you don't 225 00:13:11,000 --> 00:13:13,839 Speaker 1: know if you're fertile or not, and so in the 226 00:13:13,880 --> 00:13:17,960 Speaker 1: future you may just perceive without any assistance. And have 227 00:13:18,080 --> 00:13:20,640 Speaker 1: your family that way, But if you ever need the 228 00:13:20,640 --> 00:13:23,079 Speaker 1: eggs in the future, then they would be there for you, 229 00:13:23,679 --> 00:13:26,400 Speaker 1: having some sort of plan in place to say, Okay, 230 00:13:26,400 --> 00:13:28,560 Speaker 1: would I come back for these eggs in five years? 231 00:13:28,559 --> 00:13:30,760 Speaker 1: Would I come back for these eggs? And ten years? 232 00:13:30,800 --> 00:13:33,199 Speaker 1: What am I comfortable with doing with them if I 233 00:13:33,240 --> 00:13:35,600 Speaker 1: don't come back for them? Things like that, I think 234 00:13:35,640 --> 00:13:38,200 Speaker 1: it's important. Are those things you have to have answers 235 00:13:38,240 --> 00:13:41,079 Speaker 1: for before you start the process. You don't have to 236 00:13:41,160 --> 00:13:44,520 Speaker 1: have this magical plan in place from the beginning. And 237 00:13:44,720 --> 00:13:47,800 Speaker 1: in most cases there may be some sort of annual 238 00:13:48,120 --> 00:13:51,920 Speaker 1: storage fee for the eggs, and so I think that 239 00:13:52,040 --> 00:13:54,880 Speaker 1: in a way that paying that fee may also serve 240 00:13:54,920 --> 00:13:57,880 Speaker 1: as a reminder of eggs are there, they're doing Okay, 241 00:13:58,000 --> 00:14:00,839 Speaker 1: they're frozen, and fuel I need them. How much longer 242 00:14:00,880 --> 00:14:04,240 Speaker 1: do I want to continue to have them frozen? Maybe 243 00:14:04,240 --> 00:14:07,440 Speaker 1: you already had your children, or you met your family 244 00:14:07,440 --> 00:14:10,679 Speaker 1: building goals, and you say, Okay, maybe I don't feel 245 00:14:10,679 --> 00:14:12,480 Speaker 1: like I need these eggs any longer, and you would 246 00:14:12,520 --> 00:14:15,600 Speaker 1: just contact the facility to let them know. Got it. 247 00:14:15,960 --> 00:14:18,640 Speaker 1: So you mentioned the fee that they're sometimes like an 248 00:14:18,679 --> 00:14:21,360 Speaker 1: annual fee for like storage. What are some of the 249 00:14:21,440 --> 00:14:25,960 Speaker 1: other fees associated with this process, and are they covered 250 00:14:25,960 --> 00:14:30,440 Speaker 1: by insurance. Typically that's a great question too, So egg 251 00:14:30,480 --> 00:14:34,760 Speaker 1: freezing is not typically covered by health insurance. There are 252 00:14:34,800 --> 00:14:38,640 Speaker 1: an increasing number of plans that are covering egg freezing, 253 00:14:39,160 --> 00:14:43,440 Speaker 1: and sometimes it's covered if it's what we call medically indicated, 254 00:14:43,920 --> 00:14:47,840 Speaker 1: so a medical indication, maybe if you're having a surgery 255 00:14:48,000 --> 00:14:51,640 Speaker 1: or a cancer treatment with chemotherapy that we feel will 256 00:14:51,680 --> 00:14:54,520 Speaker 1: be toxic to your ovaries, and so in order to 257 00:14:54,600 --> 00:14:58,320 Speaker 1: preserve this fertility potential for the future, we may freeze 258 00:14:58,320 --> 00:15:01,160 Speaker 1: the eggs in advance. You go head and have the treatment, 259 00:15:01,520 --> 00:15:03,440 Speaker 1: and then we'll figure out how to help you achieve 260 00:15:03,480 --> 00:15:07,280 Speaker 1: a pregnancy in the future. Some other medical conditions can 261 00:15:07,440 --> 00:15:11,040 Speaker 1: qualify for insurance to cover it too, but unfortunately we're 262 00:15:11,080 --> 00:15:14,280 Speaker 1: at the mercy of the insurance company's rules, and so 263 00:15:14,400 --> 00:15:17,600 Speaker 1: at this time, egg freezing remains something that is paper 264 00:15:17,640 --> 00:15:21,280 Speaker 1: out of pocket by most people. There are some employer 265 00:15:21,360 --> 00:15:25,360 Speaker 1: provided plans that also provide egg freezing benefits you may 266 00:15:25,400 --> 00:15:29,520 Speaker 1: have heard of in like big tech companies, some healthcare companies, 267 00:15:29,920 --> 00:15:33,680 Speaker 1: even big financial and law firms started adding this as 268 00:15:33,680 --> 00:15:37,240 Speaker 1: an employee benefit, which I think is great because these 269 00:15:37,280 --> 00:15:42,400 Speaker 1: young people are working incredibly hard, would like to pursue 270 00:15:42,440 --> 00:15:44,800 Speaker 1: their careers and really give a lot of themselves. But 271 00:15:44,920 --> 00:15:48,400 Speaker 1: these are actually during your prime reproductive years, and so 272 00:15:48,560 --> 00:15:51,120 Speaker 1: by affording them the option to freeze eggs or create 273 00:15:51,160 --> 00:15:54,680 Speaker 1: embryos or freeze embryos, that gives them some sort of 274 00:15:54,800 --> 00:15:58,240 Speaker 1: backup plan for the future. So do you know of 275 00:15:58,440 --> 00:16:00,680 Speaker 1: price range? Like, if I want to pay out of 276 00:16:00,680 --> 00:16:02,800 Speaker 1: pocket for this, how much should I be expecting to 277 00:16:02,800 --> 00:16:06,400 Speaker 1: have to be? So it depends greatly based on the market. 278 00:16:06,520 --> 00:16:08,880 Speaker 1: So location where you live or where you choose to 279 00:16:08,920 --> 00:16:12,040 Speaker 1: do your egg freezing. I would say anywhere on the 280 00:16:12,080 --> 00:16:15,320 Speaker 1: low end from maybe five thousand dollars per cycle to 281 00:16:15,480 --> 00:16:18,920 Speaker 1: upwards of maybe ten thousand dollars. But that does not 282 00:16:19,160 --> 00:16:23,040 Speaker 1: often include the medication that is required for egg freezing, 283 00:16:23,440 --> 00:16:25,880 Speaker 1: and so that could be another three to five thousand 284 00:16:25,880 --> 00:16:29,360 Speaker 1: dollars just for the injectable medication. So this is by 285 00:16:29,400 --> 00:16:33,560 Speaker 1: no means uh cost effective kind of a process, right. 286 00:16:33,640 --> 00:16:35,720 Speaker 1: This is not something you can just save a couple 287 00:16:35,760 --> 00:16:37,880 Speaker 1: of hundred dollars for. This is something that you would 288 00:16:37,880 --> 00:16:41,200 Speaker 1: probably need to do some long term planning for. Yeah, 289 00:16:41,280 --> 00:16:44,400 Speaker 1: And that's why I think it's worthwhile to really introduce 290 00:16:44,480 --> 00:16:49,520 Speaker 1: this early because we talk about families who maybe put 291 00:16:49,560 --> 00:16:51,840 Speaker 1: their kids through college because they don't want them to 292 00:16:51,880 --> 00:16:54,960 Speaker 1: have debt, or help you with a down payment on 293 00:16:55,000 --> 00:16:57,640 Speaker 1: your first home or something like that. In the future, 294 00:16:57,720 --> 00:16:59,880 Speaker 1: we may be helping our kids with the egg freezing. 295 00:17:00,720 --> 00:17:03,640 Speaker 1: Maybe that's a college graduation gift instead of a new 296 00:17:03,720 --> 00:17:06,800 Speaker 1: car or something like that, And it could take planning. 297 00:17:06,960 --> 00:17:10,000 Speaker 1: Sometimes I have patience, say speak to your family members. 298 00:17:10,000 --> 00:17:13,359 Speaker 1: This is the power of potential grandparents is pretty strong, 299 00:17:14,040 --> 00:17:17,399 Speaker 1: and you know, if they understand your desires and career 300 00:17:17,480 --> 00:17:20,800 Speaker 1: aspirations and want grandkids in the future, this may be 301 00:17:20,880 --> 00:17:23,639 Speaker 1: a way to help do that. Another thing is that 302 00:17:23,720 --> 00:17:27,199 Speaker 1: I think, like so many things, it's an investment, and 303 00:17:27,359 --> 00:17:31,720 Speaker 1: you talked about cost effectiveness, but I think anyone who's 304 00:17:31,760 --> 00:17:35,479 Speaker 1: ever had to use donor eggs to concede later in 305 00:17:35,560 --> 00:17:38,199 Speaker 1: life would tell you that they wish they have the 306 00:17:38,200 --> 00:17:41,680 Speaker 1: opportunity to freeze their eggs for a much lower feet 307 00:17:41,680 --> 00:17:44,360 Speaker 1: when they were younger, so that they would essentially act 308 00:17:44,400 --> 00:17:47,639 Speaker 1: as their own egg donor. Even someone who's had to 309 00:17:47,800 --> 00:17:50,880 Speaker 1: maybe pay out a pocket for IVF or even if 310 00:17:50,880 --> 00:17:53,720 Speaker 1: it was covered used the time at a later age 311 00:17:54,000 --> 00:17:57,040 Speaker 1: for fertility treatments like I VA would wish that they 312 00:17:57,040 --> 00:18:01,040 Speaker 1: had made this kind of investment years prior. So it 313 00:18:01,080 --> 00:18:04,080 Speaker 1: sounds like you encourage like having this conversation at least 314 00:18:04,119 --> 00:18:07,080 Speaker 1: thinking about it really as soon as you can, like 315 00:18:07,119 --> 00:18:10,359 Speaker 1: early twenties when you're peak fertility kind of thing. So 316 00:18:10,440 --> 00:18:12,960 Speaker 1: would someone just talk with their regular O b G. 317 00:18:13,200 --> 00:18:15,240 Speaker 1: Y In about this and say, hey, I'm interested in 318 00:18:15,640 --> 00:18:17,840 Speaker 1: knowing more about this and then they get a referrals 319 00:18:17,880 --> 00:18:21,920 Speaker 1: to somebody like you. Absolutely, And I think primary care providers, 320 00:18:22,240 --> 00:18:25,560 Speaker 1: pediatricians and O b G. Y Ins can be a 321 00:18:25,600 --> 00:18:29,760 Speaker 1: great kind of first line about egg freezing and the options. 322 00:18:30,200 --> 00:18:32,639 Speaker 1: And just because you talk about it early doesn't always 323 00:18:32,640 --> 00:18:34,840 Speaker 1: mean that you would have to do it that early 324 00:18:34,880 --> 00:18:37,440 Speaker 1: in life, but that you should feel pressured to do it. 325 00:18:37,480 --> 00:18:39,840 Speaker 1: But just to know that it's an option, I think 326 00:18:39,840 --> 00:18:43,640 Speaker 1: it's really important to know. Maybe some transparency about pricing 327 00:18:43,680 --> 00:18:45,800 Speaker 1: in case that's something that you want to plan for 328 00:18:46,040 --> 00:18:49,359 Speaker 1: or say for could be really advantageous. I have a 329 00:18:49,359 --> 00:18:51,399 Speaker 1: lot of patients who say, oh, well, this is a 330 00:18:51,440 --> 00:18:53,600 Speaker 1: covered benefit by my job, but I didn't even know 331 00:18:53,760 --> 00:18:56,600 Speaker 1: people were doing this, and so sometimes it's nicer to 332 00:18:56,800 --> 00:19:00,280 Speaker 1: just have been exposed to it. Early more from my 333 00:19:00,359 --> 00:19:15,480 Speaker 1: conversation with Dr Jackson Bay after the break. Besides the 334 00:19:15,560 --> 00:19:18,480 Speaker 1: cause of being a potential barrier, are there other barriers 335 00:19:18,560 --> 00:19:21,440 Speaker 1: to egg freezing that you can think of? I think 336 00:19:21,480 --> 00:19:25,480 Speaker 1: there might be some kind of social cultural barriers. I 337 00:19:25,520 --> 00:19:28,520 Speaker 1: have had some person suggest that they don't like the 338 00:19:28,600 --> 00:19:32,320 Speaker 1: idea of egg freezing, that it could be unnatural and 339 00:19:32,440 --> 00:19:36,240 Speaker 1: not really how they wanted to build a family. Sometimes 340 00:19:36,240 --> 00:19:39,760 Speaker 1: it can be quite emotional, actually, and some people feel 341 00:19:39,760 --> 00:19:43,440 Speaker 1: that this isn't how they would have liked to have 342 00:19:43,760 --> 00:19:46,840 Speaker 1: their family start, or something like that. And so I 343 00:19:46,880 --> 00:19:49,560 Speaker 1: think that those are definitely some factors that can play 344 00:19:49,560 --> 00:19:52,560 Speaker 1: a role in preventing people from taking this step. Other 345 00:19:52,680 --> 00:19:56,040 Speaker 1: things is, even though it's actually a short time commitment 346 00:19:56,080 --> 00:19:59,600 Speaker 1: about two or so weeks of seeing us pretty frequently 347 00:19:59,600 --> 00:20:02,720 Speaker 1: in the fist, we do have to have some sort 348 00:20:02,760 --> 00:20:05,800 Speaker 1: of time for you to come in for frequent doctor's visits. 349 00:20:05,840 --> 00:20:07,960 Speaker 1: Early in the morning is typically when we have see 350 00:20:08,000 --> 00:20:11,960 Speaker 1: patients for ultrasounds and for lab work so that we 351 00:20:12,000 --> 00:20:14,560 Speaker 1: can monitor your progress as the eggs and grow and 352 00:20:14,680 --> 00:20:17,119 Speaker 1: determine a time to remove the eggs. You know, I 353 00:20:17,200 --> 00:20:19,920 Speaker 1: always try to tell persons make sure that you don't 354 00:20:19,920 --> 00:20:21,919 Speaker 1: have any big travel plans because we have to be 355 00:20:21,960 --> 00:20:24,199 Speaker 1: able to see you frequently. We want to keep you 356 00:20:24,280 --> 00:20:28,080 Speaker 1: safe through this process. Sometimes, especially with work from home, 357 00:20:28,160 --> 00:20:31,280 Speaker 1: I think that's been a great time to freeze eggs 358 00:20:31,280 --> 00:20:34,240 Speaker 1: as people have had a little bit more flexibility and 359 00:20:34,320 --> 00:20:36,600 Speaker 1: may be able to make these appointments, whereas if they 360 00:20:36,600 --> 00:20:38,080 Speaker 1: had to go into the office it might be a 361 00:20:38,119 --> 00:20:41,240 Speaker 1: little harder. What are you doing during these frequent doctors 362 00:20:41,280 --> 00:20:44,360 Speaker 1: dis is with you great question. It all starts with 363 00:20:44,480 --> 00:20:46,440 Speaker 1: the first day of your period. So many of our 364 00:20:46,440 --> 00:20:50,399 Speaker 1: treatments and evaluations all kind of revolve around the minstrel cycle, 365 00:20:50,480 --> 00:20:53,960 Speaker 1: because really we're trying to come and deer the minstrel 366 00:20:54,000 --> 00:20:55,879 Speaker 1: cycle to do what we wanted to do instead of 367 00:20:55,920 --> 00:20:58,680 Speaker 1: what your body's natural default is. So the default again 368 00:20:58,800 --> 00:21:03,119 Speaker 1: is to grow one egg cycle by starting these medications, 369 00:21:03,160 --> 00:21:06,600 Speaker 1: which include a harmoneent your body naturally makes it's called 370 00:21:06,640 --> 00:21:11,320 Speaker 1: follicle stimulating hormone. By starting that in those first few days, 371 00:21:11,320 --> 00:21:14,840 Speaker 1: while you're actually still bleeding, it gives the ovaries a 372 00:21:14,840 --> 00:21:18,800 Speaker 1: big rush and makes them want to produce multiple eggs. 373 00:21:18,880 --> 00:21:22,080 Speaker 1: And so when we're seeing you for these very frequent visits, 374 00:21:22,160 --> 00:21:26,080 Speaker 1: we are actually looking at the ovaries. On ultrasound, we 375 00:21:26,119 --> 00:21:28,399 Speaker 1: can't see the eggs, but we can see where the 376 00:21:28,440 --> 00:21:31,120 Speaker 1: eggs are growing in the ovaries, and so we monitor 377 00:21:31,200 --> 00:21:35,399 Speaker 1: those follicles by looking at them, by measuring them, and 378 00:21:35,440 --> 00:21:38,639 Speaker 1: then we correlate that with some hormone levels in the blood. 379 00:21:39,200 --> 00:21:43,320 Speaker 1: So it is frequent blood work. It's frequent vaginal ultrasound, 380 00:21:43,520 --> 00:21:46,840 Speaker 1: which can seem a little bit invasive, and understandably so, 381 00:21:46,960 --> 00:21:49,000 Speaker 1: but it's really the best way for us to gauge 382 00:21:49,040 --> 00:21:51,879 Speaker 1: what's going on with the ovaries and to keep you safe, 383 00:21:52,119 --> 00:21:53,840 Speaker 1: because we want you to make a lot of eggs, 384 00:21:53,840 --> 00:21:56,200 Speaker 1: but not too many so that you feel sick or 385 00:21:56,320 --> 00:22:00,320 Speaker 1: bloated or have any other complications. So that's the reason 386 00:22:00,400 --> 00:22:02,560 Speaker 1: for those frequent business and sometimes they can be as 387 00:22:02,600 --> 00:22:05,600 Speaker 1: frequent as every other day or every day. Let's say 388 00:22:05,640 --> 00:22:08,560 Speaker 1: someone has gone through the process of freezing their eggs 389 00:22:08,600 --> 00:22:11,080 Speaker 1: and then they decide five years later, like, Okay, I 390 00:22:11,119 --> 00:22:13,680 Speaker 1: think I am ready to fall the eggs. I don't 391 00:22:13,720 --> 00:22:17,160 Speaker 1: know that's the correct terminology, but I'm ready to maybe 392 00:22:17,240 --> 00:22:19,960 Speaker 1: use my eggs. What do they do? Then? The biggest 393 00:22:19,960 --> 00:22:22,800 Speaker 1: things are to get back in contact with whoever it 394 00:22:22,920 --> 00:22:25,000 Speaker 1: was that you froze your eggs with. The things that 395 00:22:25,080 --> 00:22:27,440 Speaker 1: I always like to know is what's your current state 396 00:22:27,480 --> 00:22:30,359 Speaker 1: of health? Are you ready to get pregnant? Now? What 397 00:22:30,640 --> 00:22:33,119 Speaker 1: is the source of sperm? Do you have a partner 398 00:22:33,160 --> 00:22:36,080 Speaker 1: that I need to meet? Are we using donor sperm? 399 00:22:36,240 --> 00:22:39,439 Speaker 1: Is it an anonymous donor someone who is contributed to 400 00:22:39,520 --> 00:22:42,919 Speaker 1: a sperm bank, or is it someone who's active as 401 00:22:42,960 --> 00:22:45,399 Speaker 1: what we call like a designated or a known donor, 402 00:22:45,800 --> 00:22:48,040 Speaker 1: Because there may be some tests and some kind of 403 00:22:48,160 --> 00:22:51,040 Speaker 1: proxies that we need to do in that event, and 404 00:22:51,080 --> 00:22:55,120 Speaker 1: then we can thaw the eggs cosseminate them with the sperm, 405 00:22:55,160 --> 00:22:57,480 Speaker 1: and then over the course of just a little less 406 00:22:57,480 --> 00:23:00,680 Speaker 1: than a week, the eggs will turn into embryos as 407 00:23:00,720 --> 00:23:04,639 Speaker 1: if they fertilize, and we'll have the option to assess 408 00:23:05,240 --> 00:23:08,680 Speaker 1: grading and quality based on how well the embryos developed. 409 00:23:09,400 --> 00:23:11,800 Speaker 1: And also at the same time, we can get the 410 00:23:11,920 --> 00:23:16,800 Speaker 1: uterus ready for the transferring of the embryo. So the 411 00:23:17,040 --> 00:23:20,320 Speaker 1: uterus has to have a very characteristic kind of hormonal 412 00:23:20,520 --> 00:23:24,960 Speaker 1: environment and appearance, and that's how we can determine when 413 00:23:24,960 --> 00:23:27,280 Speaker 1: it's the best time to put the embryo back inside. 414 00:23:27,480 --> 00:23:30,160 Speaker 1: So that is how you would then create the embryo, 415 00:23:30,200 --> 00:23:33,840 Speaker 1: it would basically be in vidro yes, And that's why 416 00:23:33,840 --> 00:23:36,760 Speaker 1: I say that it's very much in vitual fertilization. It's 417 00:23:36,800 --> 00:23:39,400 Speaker 1: just been two parts, like a now and a later, 418 00:23:40,000 --> 00:23:42,200 Speaker 1: as opposed to persons who are going through in vitro 419 00:23:42,320 --> 00:23:46,360 Speaker 1: that they're doing it all now essentially. Okay, so let's 420 00:23:46,359 --> 00:23:48,639 Speaker 1: transition into talking a little bit more about that. So 421 00:23:48,680 --> 00:23:51,880 Speaker 1: it sounds like for the more traditional invidro you would 422 00:23:51,920 --> 00:23:54,440 Speaker 1: be going through the process of taking the hormones, trying 423 00:23:54,480 --> 00:23:57,639 Speaker 1: to create the eggs, and harvesting it all in real time, 424 00:23:57,960 --> 00:24:01,480 Speaker 1: as opposed to having the frozen somewhere yet. And there 425 00:24:01,560 --> 00:24:05,200 Speaker 1: still is the possibility for persons who know that they 426 00:24:05,200 --> 00:24:07,920 Speaker 1: don't want to have children now think that they want 427 00:24:07,960 --> 00:24:11,720 Speaker 1: to wait a few years, or maybe their partner now, 428 00:24:11,920 --> 00:24:15,719 Speaker 1: or maybe they're even choosing to make embryos with donor sperm. 429 00:24:15,760 --> 00:24:18,480 Speaker 1: But you can also go through that process up front, 430 00:24:19,160 --> 00:24:22,639 Speaker 1: make the embryos right away, and then freeze the embryos 431 00:24:22,640 --> 00:24:25,800 Speaker 1: to have for a later use. And that's something that 432 00:24:25,880 --> 00:24:28,680 Speaker 1: we've done for years at this point from m vitro 433 00:24:28,800 --> 00:24:32,760 Speaker 1: fertilization because we get so many eggs and create embryos 434 00:24:32,800 --> 00:24:36,639 Speaker 1: once upon a time, we would transfer multiple embryos, and 435 00:24:36,760 --> 00:24:39,520 Speaker 1: that's why you see John and Kate plus eight kind 436 00:24:39,520 --> 00:24:43,480 Speaker 1: of shows. But nowadays the technology has become so sophisticated 437 00:24:43,520 --> 00:24:45,880 Speaker 1: and we have so many ways of really discerning which 438 00:24:45,880 --> 00:24:49,800 Speaker 1: are the highest quality embryos from maybe lesser quality that 439 00:24:49,880 --> 00:24:52,800 Speaker 1: we really recommend to put back one at a time, 440 00:24:53,240 --> 00:24:55,240 Speaker 1: but that may mean that there are extra embryos, and 441 00:24:55,280 --> 00:24:59,040 Speaker 1: so we would freeze those and similarly, they stay frozen 442 00:24:59,520 --> 00:25:01,399 Speaker 1: and they will pretty much always think it was the 443 00:25:01,480 --> 00:25:03,760 Speaker 1: day that it was frozen until you're ready to thought 444 00:25:03,800 --> 00:25:06,920 Speaker 1: them for use in the future. So that's another option 445 00:25:07,160 --> 00:25:11,480 Speaker 1: of preserving your fertility that may be best for some 446 00:25:11,640 --> 00:25:14,400 Speaker 1: categories of women. As I mentioned, if people are already 447 00:25:14,440 --> 00:25:17,400 Speaker 1: partnered and feel confidently who they're going to have their 448 00:25:17,440 --> 00:25:22,560 Speaker 1: family with, then making embryos upfront could actually be advantageous. Similarly, 449 00:25:22,800 --> 00:25:26,960 Speaker 1: sometimes may not have the best response to the medications. 450 00:25:27,280 --> 00:25:30,520 Speaker 1: Our goal is to have as many eggs as we can, 451 00:25:31,080 --> 00:25:33,600 Speaker 1: but for women who are older, they may not make 452 00:25:33,720 --> 00:25:37,200 Speaker 1: many eggs in response to the medication, or we know 453 00:25:37,359 --> 00:25:40,199 Speaker 1: that the chance that those eggs may give rise to 454 00:25:40,560 --> 00:25:44,119 Speaker 1: an embryo with an abnormal number of chromosomes is higher. 455 00:25:44,680 --> 00:25:48,639 Speaker 1: And so sometimes having that information sooner rather than waiting 456 00:25:48,640 --> 00:25:51,480 Speaker 1: for years in the future could be helpful for them. 457 00:25:51,560 --> 00:25:54,679 Speaker 1: And so in those cases, instead of maybe freezing only eggs, 458 00:25:54,680 --> 00:25:56,800 Speaker 1: we would say, let's make them into embryos and freeze 459 00:25:56,840 --> 00:26:00,320 Speaker 1: the embryos for later use. So that's similar to the 460 00:26:00,359 --> 00:26:05,520 Speaker 1: IVF process. So we are talking about this and not 461 00:26:05,560 --> 00:26:07,600 Speaker 1: necessarily in the spirit of Okay, you do this and 462 00:26:07,640 --> 00:26:10,280 Speaker 1: then you get pregnant, but we know that there's also 463 00:26:10,320 --> 00:26:12,440 Speaker 1: a lot that can happen on the other end. Right, 464 00:26:12,520 --> 00:26:15,240 Speaker 1: the assumption can't be made that just because you freeze 465 00:26:15,280 --> 00:26:17,880 Speaker 1: an egg or freeze an embryo, that it will be 466 00:26:17,920 --> 00:26:20,480 Speaker 1: like a smooth sailing kind of pregnancy with just a 467 00:26:20,520 --> 00:26:22,600 Speaker 1: little bit of morning sickness. Right, it does seem like, 468 00:26:23,000 --> 00:26:25,280 Speaker 1: I don't know if it's a higher number of miscarriages, 469 00:26:25,320 --> 00:26:28,000 Speaker 1: but I definitely hear more people talking about that publicly. 470 00:26:28,280 --> 00:26:30,159 Speaker 1: Can you say a little bit more about like the 471 00:26:30,280 --> 00:26:33,760 Speaker 1: numbers in terms of how successful pregnancies tend to be 472 00:26:33,800 --> 00:26:37,720 Speaker 1: after in vitual fertilization or something like that. Absolutely, when 473 00:26:37,720 --> 00:26:41,439 Speaker 1: you freeze eggs, that's the start of this whole embryonic 474 00:26:41,480 --> 00:26:45,600 Speaker 1: development process. And so for that reason, we usually like 475 00:26:45,680 --> 00:26:49,120 Speaker 1: to freeze more eggs than we would need from one 476 00:26:49,200 --> 00:26:52,040 Speaker 1: child one baby that comes home from the hospital, And 477 00:26:52,080 --> 00:26:55,520 Speaker 1: so the number recommended to freeze can change based on 478 00:26:55,680 --> 00:26:58,840 Speaker 1: how old you are when you freeze your eggs, because 479 00:26:58,920 --> 00:27:01,520 Speaker 1: we know that young or women are probably going to 480 00:27:01,560 --> 00:27:04,919 Speaker 1: have eggs that are more resilient, that are more likely 481 00:27:05,000 --> 00:27:09,160 Speaker 1: to result in a pregnancy with a normal number of chromosomes, 482 00:27:09,200 --> 00:27:12,520 Speaker 1: and therefore that kind of gets this notion of higher quality, 483 00:27:12,880 --> 00:27:16,200 Speaker 1: so they may not need as many eggs to result 484 00:27:16,240 --> 00:27:19,840 Speaker 1: in one baby that comes home from the hospital versus 485 00:27:19,880 --> 00:27:23,480 Speaker 1: if it was someone who's older over thirty five, over 486 00:27:23,560 --> 00:27:27,959 Speaker 1: thirty seven, over forty, you actually may require quite a 487 00:27:28,000 --> 00:27:31,680 Speaker 1: few eggs in order to have that same chance of success. 488 00:27:31,720 --> 00:27:34,439 Speaker 1: And that is just because of the intrinsic factor of 489 00:27:34,520 --> 00:27:37,280 Speaker 1: the eggs to turn into embryos and to survive that 490 00:27:37,320 --> 00:27:41,800 Speaker 1: whole process versus if we're doing IVF. For some persons, 491 00:27:42,359 --> 00:27:45,760 Speaker 1: we're going through that process right away. Usually if someone 492 00:27:45,880 --> 00:27:49,960 Speaker 1: is going through IVF, they've already been diagnosed with infertility, 493 00:27:50,320 --> 00:27:53,200 Speaker 1: and infertility means that they've been trying at least for 494 00:27:53,359 --> 00:27:56,199 Speaker 1: a year or in some cases for six months. If 495 00:27:56,240 --> 00:27:59,240 Speaker 1: they're over thirty five and have not been able to 496 00:27:59,280 --> 00:28:02,160 Speaker 1: achieve a prior nancy, and so there may be intrinsic 497 00:28:02,240 --> 00:28:07,240 Speaker 1: factors to that population that increases their risk for miscarriage. 498 00:28:07,320 --> 00:28:10,040 Speaker 1: Even with ib F. One of the biggest is the 499 00:28:10,160 --> 00:28:13,680 Speaker 1: age of the woman that can increase your risk overall. 500 00:28:14,320 --> 00:28:18,480 Speaker 1: So it's not that it's an automatic pregnancy from any 501 00:28:18,520 --> 00:28:22,520 Speaker 1: of these processes. It doesn't take away the risk or 502 00:28:22,600 --> 00:28:25,639 Speaker 1: miscarriage that's just due to intrinsic factors. Is you know, 503 00:28:25,760 --> 00:28:29,880 Speaker 1: miscarriages very common. Probably about one and four women will 504 00:28:29,960 --> 00:28:33,439 Speaker 1: experience some sort of pregnancy loss in their lifetime, and 505 00:28:33,520 --> 00:28:36,240 Speaker 1: so this doesn't take away that risk, which is very 506 00:28:36,280 --> 00:28:39,280 Speaker 1: hard considering the amount of work that goes into it. 507 00:28:39,400 --> 00:28:41,800 Speaker 1: But it's a way to get over that first hump 508 00:28:41,840 --> 00:28:45,680 Speaker 1: and get you to the positive pregnancy tests. Sometimes from 509 00:28:45,720 --> 00:28:48,520 Speaker 1: there where wake is sure that there are different what 510 00:28:48,560 --> 00:28:52,080 Speaker 1: we call maternal factors, the uterine environment, making sure your 511 00:28:52,120 --> 00:28:55,640 Speaker 1: mom is healthy in order to continue the pregnancy. So 512 00:28:55,720 --> 00:28:59,760 Speaker 1: in theory, if I froze my eggs at twenty two 513 00:28:59,800 --> 00:29:01,880 Speaker 1: and then I decided, okay, I'm ready to be a 514 00:29:01,880 --> 00:29:06,040 Speaker 1: mom at thirty eight, is there anything just off the 515 00:29:06,080 --> 00:29:09,040 Speaker 1: top of your head that should make it difficult beyond 516 00:29:09,120 --> 00:29:11,800 Speaker 1: just the likelihood of miscarriage that everyone has right when 517 00:29:11,800 --> 00:29:14,360 Speaker 1: they're trying to have a baby. Is there anything about 518 00:29:14,400 --> 00:29:17,800 Speaker 1: me being thirty eight using my twuny two zero eggs 519 00:29:17,840 --> 00:29:20,920 Speaker 1: that would make the pregnancy more difficult? Yes, if that's 520 00:29:21,000 --> 00:29:23,560 Speaker 1: because some of the different things that our bodies go 521 00:29:23,680 --> 00:29:26,200 Speaker 1: through by the age of thirty eight. So one thing 522 00:29:26,240 --> 00:29:28,760 Speaker 1: I always like to know is how healthy are you now? 523 00:29:28,880 --> 00:29:32,040 Speaker 1: How is your weight for your height? Do we need 524 00:29:32,080 --> 00:29:35,320 Speaker 1: to work on weight loss before doing an embryo transfer, 525 00:29:35,480 --> 00:29:39,160 Speaker 1: because having excess weight can increase your risk of miscarriage, 526 00:29:39,520 --> 00:29:42,600 Speaker 1: things like high blood pressure or even diabetes or pre 527 00:29:42,720 --> 00:29:46,840 Speaker 1: diabetes if they're present or if they're poorly controlled, then 528 00:29:46,880 --> 00:29:49,840 Speaker 1: that can increase your rick factor as well. We would 529 00:29:49,880 --> 00:29:52,600 Speaker 1: always do an ultrasound of the uterus to take a 530 00:29:52,680 --> 00:29:55,880 Speaker 1: look and see if there are anything like uterine fibroids, 531 00:29:55,960 --> 00:29:58,720 Speaker 1: which are over growths of the smooth muscle layer of 532 00:29:58,760 --> 00:30:03,320 Speaker 1: the uterus. Fybroids are very present and more common in 533 00:30:03,520 --> 00:30:07,800 Speaker 1: African American women, and they don't always universally cause an issue. 534 00:30:08,200 --> 00:30:10,400 Speaker 1: The ones that are most important to us are the 535 00:30:10,400 --> 00:30:13,440 Speaker 1: ones that are inside the uterus where pregnancy would grow, 536 00:30:13,960 --> 00:30:17,200 Speaker 1: and so those may require removal before we go ahead 537 00:30:17,200 --> 00:30:20,240 Speaker 1: and transfer the embryo. Similarly, if the five birds are 538 00:30:20,320 --> 00:30:25,000 Speaker 1: very large or brothersome, then we may also discuss fibroid 539 00:30:25,040 --> 00:30:28,480 Speaker 1: removal before pregnancy. Okay, so this isn't like I can't 540 00:30:28,560 --> 00:30:31,760 Speaker 1: decide my thirty birthday is coming up. I think I'm 541 00:30:31,760 --> 00:30:34,400 Speaker 1: ready to be pregnant on my thirty eighth birthday or 542 00:30:34,440 --> 00:30:36,560 Speaker 1: three months after. I can't call you on Monday and 543 00:30:36,560 --> 00:30:39,000 Speaker 1: say we're going to transfer the embryo on Friday. This 544 00:30:39,160 --> 00:30:42,440 Speaker 1: is still a series of questions and assessments that you're 545 00:30:42,480 --> 00:30:45,400 Speaker 1: making before you find like the ideal or the most 546 00:30:45,440 --> 00:30:48,320 Speaker 1: ideal time to transfer the gig or the embryo. I 547 00:30:48,360 --> 00:30:50,800 Speaker 1: would say, I think give us an elite time of 548 00:30:50,880 --> 00:30:53,920 Speaker 1: two months. Let's see you in the office. We'll do 549 00:30:54,000 --> 00:30:56,680 Speaker 1: some ultrasound, We'll do some blood work. I would like 550 00:30:56,760 --> 00:30:59,480 Speaker 1: to meet this partner if you have one, or understand 551 00:30:59,520 --> 00:31:02,320 Speaker 1: where you're firm is coming from, to make sure that 552 00:31:02,360 --> 00:31:05,760 Speaker 1: you guys aren't carriers for the same genetic conditions, things 553 00:31:05,880 --> 00:31:08,960 Speaker 1: like sickle cell or cystic fibrosis, and just all of 554 00:31:08,960 --> 00:31:11,720 Speaker 1: these different factors to consider, and then make sure I 555 00:31:11,760 --> 00:31:14,120 Speaker 1: look at the inside of the uterus to make sure 556 00:31:14,120 --> 00:31:17,400 Speaker 1: that it's smooth and easy to transfer the embryo, and 557 00:31:17,440 --> 00:31:19,440 Speaker 1: then we'll make the plan of when to do it. 558 00:31:19,640 --> 00:31:21,480 Speaker 1: We could set it for a certain day. You just 559 00:31:21,520 --> 00:31:23,320 Speaker 1: gotta come in a little while. But we've gotta give 560 00:31:23,320 --> 00:31:26,239 Speaker 1: you a little bit of LEAs time. Got it. So 561 00:31:26,320 --> 00:31:29,400 Speaker 1: you brought up something about bringing the partner in to 562 00:31:29,480 --> 00:31:32,200 Speaker 1: be able to do an assessment. So let's say somebody 563 00:31:32,240 --> 00:31:34,920 Speaker 1: brings a partner in and you run some tests and 564 00:31:35,000 --> 00:31:38,280 Speaker 1: you realize, oh, this may not actually be a good match, 565 00:31:38,680 --> 00:31:40,720 Speaker 1: so to speak, in terms of what we hope to 566 00:31:40,720 --> 00:31:43,360 Speaker 1: be a successful pregnancy. What kinds of things are you 567 00:31:43,400 --> 00:31:46,520 Speaker 1: talking with them about that come in? So you know, 568 00:31:46,560 --> 00:31:48,840 Speaker 1: when we meet the partner, we go over a lot 569 00:31:48,960 --> 00:31:51,959 Speaker 1: of and this is assuming a male partner. We go 570 00:31:52,040 --> 00:31:54,560 Speaker 1: over a lot of the same things that we would 571 00:31:54,680 --> 00:31:58,720 Speaker 1: when I met the patient years before, just overall medical history, 572 00:31:59,400 --> 00:32:03,200 Speaker 1: surgical history, things like that. Are they on any medications 573 00:32:03,200 --> 00:32:06,880 Speaker 1: for chronic medical issues, anything that you know could possibly 574 00:32:06,920 --> 00:32:11,680 Speaker 1: affect sperm quality, things like smoking or tobacco use, drug use, 575 00:32:12,280 --> 00:32:15,600 Speaker 1: or even alcohol use, you know, if it's excessive. So 576 00:32:15,680 --> 00:32:18,040 Speaker 1: we'll talk about those kinds of things and see what 577 00:32:18,240 --> 00:32:22,600 Speaker 1: ways that we can modify behavior. A standard evaluation would 578 00:32:22,640 --> 00:32:25,800 Speaker 1: be with a Seaman analysis as the first step to 579 00:32:25,840 --> 00:32:28,760 Speaker 1: make sure that there's for there, that they swim well, 580 00:32:28,800 --> 00:32:31,840 Speaker 1: that they look normal in shape, and so we use that. 581 00:32:31,920 --> 00:32:35,240 Speaker 1: It's like our first evaluated tool. Another thing that we 582 00:32:35,320 --> 00:32:37,920 Speaker 1: may do is I mentioned, is a serum tests or 583 00:32:38,000 --> 00:32:43,840 Speaker 1: blood tests to look for genetic carriers for certain inheritable conditions, 584 00:32:44,200 --> 00:32:47,480 Speaker 1: things that don't necessarily affect you as an adult, but 585 00:32:47,560 --> 00:32:51,880 Speaker 1: they could present in children if both of you are carriers. 586 00:32:51,920 --> 00:32:54,040 Speaker 1: And so that's something else that I usually like to 587 00:32:54,080 --> 00:32:57,600 Speaker 1: make sure it's done before we embark on making the embryos. 588 00:32:57,680 --> 00:33:00,880 Speaker 1: The reason being is if you're both carry us for 589 00:33:00,880 --> 00:33:03,680 Speaker 1: the same genetic condition, once upon a time, maybe they 590 00:33:03,720 --> 00:33:05,840 Speaker 1: would tell you that, hey, this is not a good 591 00:33:05,880 --> 00:33:09,360 Speaker 1: partner for you, but we do have the technology now 592 00:33:09,440 --> 00:33:13,040 Speaker 1: to screen your embryos for that genetic condition if you're 593 00:33:13,080 --> 00:33:16,920 Speaker 1: both carriers. For example, if you're both carriers for something 594 00:33:16,960 --> 00:33:20,200 Speaker 1: like sickle cell anemia, we would take blood samples from 595 00:33:20,240 --> 00:33:24,800 Speaker 1: both of you, create kind of a genetic probe that 596 00:33:24,840 --> 00:33:29,440 Speaker 1: can look for this area of sickle cell causing gen 597 00:33:29,560 --> 00:33:33,360 Speaker 1: mutation in the embryo, and we can actually screen the 598 00:33:33,360 --> 00:33:36,000 Speaker 1: embryos for that, so we can know which ones are 599 00:33:36,040 --> 00:33:40,960 Speaker 1: affected with sickle cell or not affected, or carriers themselves, 600 00:33:41,080 --> 00:33:43,840 Speaker 1: and we can make a plan to transfer embryos based 601 00:33:43,840 --> 00:33:47,920 Speaker 1: on that information. Got it so much information? It definitely 602 00:33:48,000 --> 00:33:51,920 Speaker 1: sounds like lots of conversations, lots of meetings, probably lots 603 00:33:51,920 --> 00:33:54,960 Speaker 1: of individual research for people to do when they're taking 604 00:33:54,960 --> 00:33:57,800 Speaker 1: on this process. Yeah, it can be and it can 605 00:33:57,880 --> 00:34:02,480 Speaker 1: definitely be a somewhat over main experience. I think something 606 00:34:02,520 --> 00:34:06,200 Speaker 1: that can be difficult, especially for Black women in this 607 00:34:06,360 --> 00:34:10,280 Speaker 1: space is visibility. It's feeling like maybe they're the only 608 00:34:10,320 --> 00:34:13,080 Speaker 1: person going through it. I think for so long they 609 00:34:13,239 --> 00:34:17,759 Speaker 1: thought that infertility issues did not apply to them. There 610 00:34:17,880 --> 00:34:22,719 Speaker 1: is the common cultural, social stereotype of black and brown 611 00:34:22,760 --> 00:34:27,040 Speaker 1: women being very fertile. While the vast majority of women 612 00:34:27,080 --> 00:34:30,879 Speaker 1: will not struggle with infertility, there are some who will. 613 00:34:31,000 --> 00:34:34,040 Speaker 1: And part of that maybe, as I mentioned, with people 614 00:34:34,320 --> 00:34:37,040 Speaker 1: starting their families later in life than we did fifty 615 00:34:37,120 --> 00:34:40,800 Speaker 1: years ago, a hundred years ago. So I think women 616 00:34:40,840 --> 00:34:42,960 Speaker 1: need to know that there are other women who look 617 00:34:43,040 --> 00:34:45,520 Speaker 1: like them in this space who are going through what 618 00:34:45,600 --> 00:34:48,080 Speaker 1: they go through, and so that they can feel a 619 00:34:48,080 --> 00:34:52,560 Speaker 1: little less alone and less isolated through this process. More 620 00:34:52,600 --> 00:34:55,720 Speaker 1: from my conversation with Dr Jackson Bay after the break. 621 00:35:05,000 --> 00:35:06,840 Speaker 1: I love you to talk a little bit more about 622 00:35:06,840 --> 00:35:09,520 Speaker 1: the mental health impact of this process, you know, because 623 00:35:09,560 --> 00:35:12,040 Speaker 1: again I've seen lots of people just share like the 624 00:35:12,120 --> 00:35:14,520 Speaker 1: toll that it can sometimes take. I think, particularly when 625 00:35:14,520 --> 00:35:16,960 Speaker 1: people are doing these ivy of cycles, and so I'm 626 00:35:16,960 --> 00:35:19,440 Speaker 1: imagining some of it is just related to like the 627 00:35:19,520 --> 00:35:23,120 Speaker 1: increased hormones, right taking all these shots and you know, 628 00:35:23,160 --> 00:35:25,799 Speaker 1: I gotta do all this stuff, but also when the 629 00:35:25,840 --> 00:35:28,360 Speaker 1: cycle may not be successful. So can you talk a 630 00:35:28,440 --> 00:35:31,439 Speaker 1: little bit about the mental health impact. Absolutely, I think 631 00:35:31,480 --> 00:35:35,799 Speaker 1: there's a huge psychosocial component to what we do that 632 00:35:35,880 --> 00:35:40,319 Speaker 1: can be neglected. I think sometimes in standard medical care. 633 00:35:40,840 --> 00:35:44,160 Speaker 1: I think anything really having to do with reproduction is 634 00:35:44,280 --> 00:35:47,920 Speaker 1: so emotional for women. There's this notion of what your 635 00:35:47,960 --> 00:35:51,359 Speaker 1: body should do, and we know the should can be dangerous, 636 00:35:51,600 --> 00:35:54,040 Speaker 1: but you know what you should be capable of as 637 00:35:54,040 --> 00:35:56,719 Speaker 1: a woman. How does it define you? And you can 638 00:35:56,760 --> 00:36:00,000 Speaker 1: really call that into question. It can challenge your relation 639 00:36:00,200 --> 00:36:04,840 Speaker 1: shift in terms of finances, in terms of goals. What 640 00:36:04,960 --> 00:36:07,400 Speaker 1: if one person wants to continue with treatment and the 641 00:36:07,440 --> 00:36:10,319 Speaker 1: other one wants to stop. Both partners can have their 642 00:36:10,360 --> 00:36:14,000 Speaker 1: own trauma from the experience, and sometimes communicating that can 643 00:36:14,040 --> 00:36:18,040 Speaker 1: be really difficult. It can add stress in unknown ways. 644 00:36:18,200 --> 00:36:21,600 Speaker 1: I think sometimes people struggle with whether or not to 645 00:36:21,719 --> 00:36:25,800 Speaker 1: disclose that they're going through this. They can be afraid 646 00:36:25,920 --> 00:36:29,600 Speaker 1: of how people will view them. Sometimes you know, in 647 00:36:29,719 --> 00:36:33,239 Speaker 1: laws or older family members can be very rough, or 648 00:36:33,320 --> 00:36:36,480 Speaker 1: even just friends and colleagues not knowing what to say 649 00:36:36,719 --> 00:36:39,879 Speaker 1: and maybe saying quote unquote the wrong things or you'll 650 00:36:39,920 --> 00:36:42,359 Speaker 1: just be okay, or take a vacation, or you need 651 00:36:42,400 --> 00:36:46,120 Speaker 1: to relax, or adding these little anecdotal things that actually 652 00:36:46,160 --> 00:36:49,120 Speaker 1: are not very helpful, whereas what would be helpful is 653 00:36:49,160 --> 00:36:51,000 Speaker 1: what do you need from me? How can I be 654 00:36:51,120 --> 00:36:55,280 Speaker 1: there for you. Another unforeseen stress is work related stress 655 00:36:55,600 --> 00:37:00,680 Speaker 1: with the frequent doctors visits and insurance coverage issues, needing 656 00:37:00,719 --> 00:37:03,160 Speaker 1: to do you disclose to your job that you have 657 00:37:03,280 --> 00:37:05,560 Speaker 1: to have some time off every morning for the next 658 00:37:05,600 --> 00:37:09,000 Speaker 1: two months or something while you're doing different testing and processes, 659 00:37:09,480 --> 00:37:12,160 Speaker 1: and that can be very stressful as well. So I 660 00:37:12,160 --> 00:37:16,160 Speaker 1: think there's definitely a role for mental health support as 661 00:37:16,200 --> 00:37:19,279 Speaker 1: you're going through this process. But again, I think the 662 00:37:19,360 --> 00:37:22,840 Speaker 1: stigma and the shame of people who are in it also, 663 00:37:22,920 --> 00:37:26,719 Speaker 1: it's just so much to manage can really prevent you 664 00:37:26,760 --> 00:37:30,000 Speaker 1: from getting that well rounded care that you need. Do 665 00:37:30,080 --> 00:37:32,719 Speaker 1: you tend to work with mental health professionals allowed Dr 666 00:37:32,800 --> 00:37:35,200 Speaker 1: Jackson Bay or do you frequently make that referral or 667 00:37:35,239 --> 00:37:38,680 Speaker 1: even have somebody in your office. Absolutely, we have a 668 00:37:38,760 --> 00:37:42,000 Speaker 1: mental health professional in our practice who's available to all 669 00:37:42,040 --> 00:37:44,200 Speaker 1: of our patients, and she'll let you know. I refer 670 00:37:44,320 --> 00:37:47,680 Speaker 1: all the time. I also have mental health professionals that 671 00:37:47,680 --> 00:37:50,480 Speaker 1: I work with in the community. Some of them have 672 00:37:50,640 --> 00:37:54,799 Speaker 1: different areas of expertise. Some do include specifically issues of 673 00:37:54,840 --> 00:38:00,520 Speaker 1: reproduction or what we call parapartum anxiety or depression, or 674 00:38:00,560 --> 00:38:03,920 Speaker 1: any kind of traumatic issues. As you can imagine. Sometimes 675 00:38:03,920 --> 00:38:06,959 Speaker 1: this also feels like trauma. If you've ever gone through 676 00:38:07,120 --> 00:38:09,480 Speaker 1: multiple cycles and it didn't work, or going through a 677 00:38:09,480 --> 00:38:12,960 Speaker 1: pregnancy loss, there's grief and trauma associated with that. So 678 00:38:13,000 --> 00:38:16,400 Speaker 1: I have a little catalog of people who are able 679 00:38:16,480 --> 00:38:19,600 Speaker 1: to help my patients through this process because I do 680 00:38:19,719 --> 00:38:24,200 Speaker 1: recognize that that plays a huge toll in your overall success. 681 00:38:24,480 --> 00:38:27,440 Speaker 1: Actually is how well you're able to navigate some of 682 00:38:27,440 --> 00:38:31,160 Speaker 1: the mental health side of things, and specifically for African 683 00:38:31,160 --> 00:38:34,440 Speaker 1: American women, they may drop out of care before getting 684 00:38:34,440 --> 00:38:37,719 Speaker 1: to a successful outcome. Because they lack those kind of 685 00:38:37,800 --> 00:38:41,919 Speaker 1: resources available to address mental health issues. We know that 686 00:38:41,960 --> 00:38:45,480 Speaker 1: like high levels of stress and stuff can determine like 687 00:38:45,520 --> 00:38:47,960 Speaker 1: whether pregnancy is going to be successful. So in the 688 00:38:48,160 --> 00:38:52,560 Speaker 1: like questioning an evaluation approach that you're taking, is that 689 00:38:52,719 --> 00:38:55,879 Speaker 1: a part of it, like evaluating whether stress levels are 690 00:38:55,880 --> 00:38:59,080 Speaker 1: okay to be able to like undergo this resist Absolutely. 691 00:38:59,120 --> 00:39:01,600 Speaker 1: I would say probably eight out of ten of my 692 00:39:01,640 --> 00:39:05,320 Speaker 1: patients are reporting stress even from having gotten to my door, 693 00:39:05,680 --> 00:39:09,000 Speaker 1: right Because if you've made it this far, you've recognized 694 00:39:09,040 --> 00:39:11,160 Speaker 1: that there's an issue, and there's a lot of anxiety 695 00:39:11,200 --> 00:39:14,319 Speaker 1: around now. And so that's why I always bring it 696 00:39:14,400 --> 00:39:17,040 Speaker 1: up closed doors. This is a safe space where do 697 00:39:17,080 --> 00:39:19,359 Speaker 1: I need to know let me know if I need 698 00:39:19,400 --> 00:39:21,960 Speaker 1: to have you here or put the partner out for 699 00:39:22,000 --> 00:39:24,080 Speaker 1: a little while so we can talk, or you want 700 00:39:24,120 --> 00:39:27,200 Speaker 1: to bring your mom short whatever kind of works for you. 701 00:39:27,840 --> 00:39:30,480 Speaker 1: But then also to make sure that I include a 702 00:39:30,520 --> 00:39:34,600 Speaker 1: mental health plan very early in the process, because even 703 00:39:34,760 --> 00:39:37,360 Speaker 1: for egg freezers take it for granted, this is a 704 00:39:37,440 --> 00:39:41,760 Speaker 1: process that should be very liberating and be very hopeful 705 00:39:41,880 --> 00:39:44,640 Speaker 1: you're doing this for your future. But for some persons 706 00:39:44,680 --> 00:39:47,880 Speaker 1: it feels like this is not how I was expecting 707 00:39:48,080 --> 00:39:50,880 Speaker 1: my reproductive plan to go. I would have liked to 708 00:39:50,920 --> 00:39:52,759 Speaker 1: be married by now, I would have liked to be 709 00:39:52,840 --> 00:39:55,480 Speaker 1: having children by now, and so it can be very 710 00:39:55,520 --> 00:39:58,840 Speaker 1: stressful in that way, and so just bringing it up early, 711 00:39:59,000 --> 00:40:01,360 Speaker 1: making sure that there are where that we have mental 712 00:40:01,360 --> 00:40:03,800 Speaker 1: health services within our practice and that I can refer 713 00:40:03,840 --> 00:40:06,320 Speaker 1: to the community as well, or if they are already 714 00:40:06,320 --> 00:40:08,799 Speaker 1: working with the therapist, I tell them, like, make sure 715 00:40:08,840 --> 00:40:11,560 Speaker 1: you bring this up so that your therapists can help us. 716 00:40:11,600 --> 00:40:14,799 Speaker 1: You go along as well. So is there anything that 717 00:40:14,840 --> 00:40:17,440 Speaker 1: we haven't talked about today that you find yourself talking 718 00:40:17,440 --> 00:40:20,200 Speaker 1: about frequently or that you think people should know. Thank 719 00:40:20,320 --> 00:40:23,160 Speaker 1: some of the biggest things, it's just the stigma of 720 00:40:23,200 --> 00:40:27,080 Speaker 1: it all. It's out here, we are here, and there 721 00:40:27,120 --> 00:40:30,520 Speaker 1: are solutions for you. I think it can be a 722 00:40:30,640 --> 00:40:34,279 Speaker 1: very scary place to find yourself in need of a 723 00:40:34,320 --> 00:40:37,279 Speaker 1: fertility specialist. The other part of it is, you know, 724 00:40:37,280 --> 00:40:41,239 Speaker 1: I do a lot of research on disparities and infertility 725 00:40:41,320 --> 00:40:45,000 Speaker 1: care and why is it that black women have different 726 00:40:45,000 --> 00:40:48,319 Speaker 1: outcomes than any other group? Like why do anybody have 727 00:40:48,440 --> 00:40:53,000 Speaker 1: different outcomes? Some of it is related to the traditional 728 00:40:53,040 --> 00:40:57,879 Speaker 1: practice of infertility care in affluent areas and therefore they 729 00:40:57,920 --> 00:41:01,600 Speaker 1: may not be physically located in areas that are more diverse. 730 00:41:02,120 --> 00:41:05,200 Speaker 1: They tend to be mostly concentrated on the coasts and 731 00:41:05,239 --> 00:41:08,400 Speaker 1: in big cities and not necessarily of smaller cities and 732 00:41:08,440 --> 00:41:10,719 Speaker 1: things like that. But some of it also has to 733 00:41:10,760 --> 00:41:13,800 Speaker 1: do with catering to a certain group has now made 734 00:41:14,000 --> 00:41:17,960 Speaker 1: Black women, Brown women, other persons feel like they're not 735 00:41:18,000 --> 00:41:21,479 Speaker 1: included or they're not valued, and that can actually keep 736 00:41:21,520 --> 00:41:24,479 Speaker 1: people away when they should be seeing us. And so 737 00:41:24,840 --> 00:41:27,520 Speaker 1: there has been data that's shown that black women have 738 00:41:27,600 --> 00:41:30,719 Speaker 1: a longer period of infertility by the time they come 739 00:41:30,719 --> 00:41:33,640 Speaker 1: to our door than other groups of women. Also that, 740 00:41:33,719 --> 00:41:37,760 Speaker 1: as I mentioned, they discontinued care earlier than other women. 741 00:41:37,960 --> 00:41:41,640 Speaker 1: And so thinking of how can we get more people in, 742 00:41:42,200 --> 00:41:44,719 Speaker 1: how can we normalize this, how can we make it 743 00:41:44,760 --> 00:41:47,920 Speaker 1: more acceptable? Those are the things that I'm always thinking about, 744 00:41:48,560 --> 00:41:51,399 Speaker 1: is how do we keep people engaged but also make 745 00:41:51,440 --> 00:41:54,520 Speaker 1: them aware of what's normal and what's not normal. And 746 00:41:54,560 --> 00:41:57,520 Speaker 1: so for anyone who's been trying for pregnancy for over 747 00:41:57,560 --> 00:42:02,279 Speaker 1: a year without success, now is the hotnessy treatment? Do 748 00:42:02,360 --> 00:42:04,799 Speaker 1: you know this sense? Sandra Jackson by about how many 749 00:42:05,000 --> 00:42:10,280 Speaker 1: reproductive interchnologists are black. That's a hard question. We've tried 750 00:42:10,320 --> 00:42:14,399 Speaker 1: to do this tally a few times, and honestly, I 751 00:42:14,520 --> 00:42:19,840 Speaker 1: don't know for certain. I know that overall of the workforce, 752 00:42:20,440 --> 00:42:25,000 Speaker 1: black physicians make up about five of the total physician 753 00:42:25,080 --> 00:42:28,360 Speaker 1: workforce in the US, and black women are about two 754 00:42:28,400 --> 00:42:32,600 Speaker 1: percent of that, So the numbers really get there, very 755 00:42:32,680 --> 00:42:36,680 Speaker 1: very small. There are some tools and directories that are 756 00:42:36,719 --> 00:42:39,920 Speaker 1: available where we're trying to build and make sure that 757 00:42:40,080 --> 00:42:42,759 Speaker 1: persons who want to be connected with black ari I 758 00:42:42,840 --> 00:42:45,800 Speaker 1: can do that. Just as you were talking even about 759 00:42:45,840 --> 00:42:50,200 Speaker 1: some of the cultural stereotypes around black women being superfertile, right, Like, 760 00:42:50,520 --> 00:42:54,520 Speaker 1: we know that racism in these stereotypes infiltrate all areas 761 00:42:54,560 --> 00:42:56,320 Speaker 1: of our lives, right And so if we are seeing 762 00:42:56,360 --> 00:42:59,279 Speaker 1: doctors who think that, oh, black women will just be 763 00:42:59,320 --> 00:43:01,560 Speaker 1: able to get pregnant whenever, are they not having some 764 00:43:01,640 --> 00:43:04,879 Speaker 1: of these conversations that they should be with clients. Yes, 765 00:43:05,600 --> 00:43:09,040 Speaker 1: the short answer, unfortunately is guests. And we have seen 766 00:43:09,640 --> 00:43:13,560 Speaker 1: these biases affect referral patterns, and so that's why again 767 00:43:13,880 --> 00:43:16,880 Speaker 1: I encourage people that check with your insurance provider. You 768 00:43:16,960 --> 00:43:19,279 Speaker 1: may not be a referral from your g ly in. 769 00:43:19,400 --> 00:43:21,760 Speaker 1: You may be able to book with a subspecialist directly, 770 00:43:22,320 --> 00:43:25,839 Speaker 1: but I also do a lot of education of providers 771 00:43:26,520 --> 00:43:29,640 Speaker 1: just to also kind of dispel these myths, to make 772 00:43:29,640 --> 00:43:33,160 Speaker 1: sure that you're giving everyone equal chance to talk about 773 00:43:33,400 --> 00:43:37,680 Speaker 1: different ways of engaging community. Also to you know, broaden 774 00:43:37,760 --> 00:43:41,880 Speaker 1: their scope of how they accept payment. Somewhere that's cash 775 00:43:42,040 --> 00:43:46,480 Speaker 1: only essentially may be very discouraging, whereas if you were 776 00:43:46,520 --> 00:43:51,160 Speaker 1: open to more types of insurance or empowering patients with 777 00:43:51,280 --> 00:43:54,239 Speaker 1: maybe like third party payers so that they can have 778 00:43:54,280 --> 00:43:57,680 Speaker 1: like payment plans and things like that, that broadens who's 779 00:43:57,719 --> 00:44:01,080 Speaker 1: able to access the care. So I actually engage in 780 00:44:01,280 --> 00:44:04,279 Speaker 1: a lot of that kind of education. I appreciate it, 781 00:44:04,360 --> 00:44:07,600 Speaker 1: Thank you so much. And are their resources for people 782 00:44:07,640 --> 00:44:09,600 Speaker 1: who maybe want to look more into some of the 783 00:44:09,640 --> 00:44:12,520 Speaker 1: things we've talked about today, anything that you frequently recommend 784 00:44:12,520 --> 00:44:16,280 Speaker 1: to your clients. Yeah, there's some different support groups. There 785 00:44:16,480 --> 00:44:22,239 Speaker 1: is organization Fertility for Colored Girls that is an incredible organization. 786 00:44:22,680 --> 00:44:27,719 Speaker 1: Um it's founded by someone who actually experienced infertility herself. 787 00:44:27,760 --> 00:44:31,040 Speaker 1: She's a minister, and so she had like the spiritual 788 00:44:31,120 --> 00:44:34,600 Speaker 1: component as well as being a black woman, and created 789 00:44:34,600 --> 00:44:37,960 Speaker 1: this great foundation that really serves to have support and 790 00:44:38,120 --> 00:44:40,960 Speaker 1: prayer and just like the network of support groups. Now 791 00:44:41,000 --> 00:44:43,799 Speaker 1: it's all virtual across the country, which has a lot 792 00:44:43,840 --> 00:44:46,440 Speaker 1: of information. They put on a lot of webinars throughout 793 00:44:46,480 --> 00:44:50,280 Speaker 1: the year. I'm part of American Society for Reproductive Medicine, 794 00:44:50,760 --> 00:44:54,600 Speaker 1: which has a lot of just patient information on their website. 795 00:44:54,800 --> 00:44:58,200 Speaker 1: And sometimes people start with Dr Google and it's not 796 00:44:58,680 --> 00:45:01,640 Speaker 1: all bad it. I just want to direct you to 797 00:45:02,080 --> 00:45:06,480 Speaker 1: resources that may be most appropriate and trying to understand 798 00:45:06,480 --> 00:45:09,960 Speaker 1: a little bit about what the evaluation entails. Maybe that 799 00:45:10,000 --> 00:45:12,600 Speaker 1: could take away a little bit of anxiety about what's 800 00:45:12,640 --> 00:45:16,160 Speaker 1: to come. And as I mentioned, what's normal and not normal. 801 00:45:16,280 --> 00:45:18,879 Speaker 1: Because it always breaks my heart when someone says I've 802 00:45:18,880 --> 00:45:21,560 Speaker 1: been trying for five years and I'm like, oh, that 803 00:45:21,760 --> 00:45:24,960 Speaker 1: was like four years too long. And unfortunately we can't 804 00:45:24,960 --> 00:45:27,040 Speaker 1: get those years back, but we have to start where 805 00:45:27,080 --> 00:45:29,960 Speaker 1: we can got it. But we thank you so much, 806 00:45:30,080 --> 00:45:32,080 Speaker 1: Dr Jackson By. I appreciate you sharing all of this 807 00:45:32,160 --> 00:45:35,560 Speaker 1: information with us, no problem, it's my pleasure. Thank you 808 00:45:35,600 --> 00:45:40,640 Speaker 1: so much for having me. I'm so glad Dr Jackson 809 00:45:40,680 --> 00:45:42,920 Speaker 1: Bay was able to share her expertise with us today. 810 00:45:43,440 --> 00:45:45,840 Speaker 1: To learn more about her and her work, visit the 811 00:45:45,840 --> 00:45:48,480 Speaker 1: show notes at Therapy for Black Girls dot com. Sash 812 00:45:48,480 --> 00:45:51,319 Speaker 1: session to forty five and be sure to text this 813 00:45:51,360 --> 00:45:54,319 Speaker 1: episode to two of your girls right now. If you're 814 00:45:54,360 --> 00:45:56,840 Speaker 1: looking for a therapist in your area, be sure to 815 00:45:56,920 --> 00:45:59,760 Speaker 1: check out our therapist directory at Therapy for Black Girls 816 00:45:59,760 --> 00:46:02,920 Speaker 1: dot tom slash directory. And if you want to continue 817 00:46:02,960 --> 00:46:05,359 Speaker 1: digging into this topic or just be in community with 818 00:46:05,400 --> 00:46:07,840 Speaker 1: other sisters, come on over and join us in the 819 00:46:07,880 --> 00:46:11,160 Speaker 1: Sister Circle. It's our cozy corner of the Internet design 820 00:46:11,239 --> 00:46:14,160 Speaker 1: just for black women. You can join us at community 821 00:46:14,200 --> 00:46:17,880 Speaker 1: dot Therapy for Black Girls dot com. This episode was 822 00:46:17,960 --> 00:46:21,279 Speaker 1: produced by Freda Lucas and Elie Ellis and editing was 823 00:46:21,320 --> 00:46:23,719 Speaker 1: done by Dennis and Bradford. Thank you all so much 824 00:46:23,760 --> 00:46:26,319 Speaker 1: for joining me again this week. I look forward to 825 00:46:26,320 --> 00:46:29,719 Speaker 1: continue in this conversation with you all real soon. Take 826 00:46:29,760 --> 00:46:30,200 Speaker 1: good care.