1. What exactly is covered — and what’s the cap?
Start the conversation with a clear question: “What services are included under our fertility benefit?” For instance, are consultations, diagnostics (hormone panels, ultrasounds, sperm analyses), medications (oral and injectable), treatments like IUI or IVF, and embryo freezing/ storage all covered? Many plans restrict fertility benefits to “infertility diagnosis” only, or exclude advanced treatments altogether. Also ask: Is there a dollar maximum, a limit on number of cycles (e.g., two IVF cycles), or a lifetime cap?Knowing the boundaries upfront prevents surprise costs later.

2. Are the clinics, drugs and labs in-network (and how flexible is the network)?
Even if the benefit says “IVF is covered,” you’ll want to know whether your preferred fertility clinic is in-network, and whether your plan allows you to choose outside-network providers (and what the cost difference might be). According to benefit-experts, “Is there a large number of in-network fertility clinics?” is a critical question. Also ask: Are specific pharmacies or labs required for medications or diagnostics? Some policies have narrow provider lists which can limit your choices.

3. Is the policy inclusive of all family-building paths?
Infertility and fertility-care needs are diverse. Ask whether the benefit applies to single parents by choice, LGBTQ+ couples, egg/sperm donation, gestational carriers, and embryo freezing. Plans that define “infertility” narrowly (e.g., “tested and unable to conceive with partner for 12 months”) may exclude many people who nonetheless need fertility treatment. Inclusion matters — because the treatment pathway you need may depend on your individual situation, not just a generic definition.

4. What are the out-of-pocket costs, and where do I start?
Coverage is important — but so are the details of your financial responsibility. Ask: What are the deductibles, co-pays or coinsurance for fertility services? Is there a waiting period before treatments start? Does the cap apply per year, or lifetime? Will medications (especially expensive injectable fertility drugs) be covered or paid separately? The more you know ahead of time, the better you can budget, plan and avoid being blindsided mid-cycle.

5. What support and resources does the benefit include (and how easy is it to use)?
Fertility journeys can be emotionally and logistically complex — clinic visits, monitoring shots, labs, scheduling, decisions about embryo freezing, etc. Ask your employer: “What support is included in this benefit?” This might include patient navigators, fertility-treatment coordinators, telehealth options, access to advocacy or coaching, and clear authorization procedures. Also ask: “If I want to challenge a denial or explore a less-common route (e.g., donor egg, surrogacy), who can I contact for help and how?”

Final thoughts
Asking these five questions will give you powerful leverage as you move forward with your fertility and family-building plan. It will help you identify gaps in your employer’s benefit package, clarify what you can realistically access, and guide your decisions about timing, cost, and clinical choices. At Talking Fertility, we encourage you to come prepared, take notes, and don’t be shy about asking for clarity. Because when you understand your benefits, you’re more empowered to focus on what matters most: your plan, your path, and your future family.

IVF involves the creation of embryos outside the womb, and the decision to categorize these embryos as children raises questions about custody, legal rights, and potential restrictions on the number of embryos that can be created during a single IVF cycle. The Alabama Supreme Court, comprised entirely of elected Republicans or those appointed by a Republican governor, emphasized that there’s no “unwritten exception” recognized for frozen embryos located outside a woman’s uterus.

Reproductive rights advocates argue that this decision could pave the way for restrictive legislation that may impact the availability and accessibility of IVF procedures in the state. Critics of the ruling worry that it could be a step towards more stringent regulations, potentially limiting the choices available to individuals and couples struggling with infertility.

The court’s decision has put the complex legal and ethical considerations surrounding reproductive technologies at the center of heated debates across the country. Questions about when life begins, the rights of embryos, and the balance between individual autonomy and state intervention have been reignited. Legal experts and ethicists are grappling with the implications of extending legal personhood status to embryos.

IVF clinics in Alabama may face challenges in adapting their practices to comply with the new legal landscape. Fertility specialists and legal experts are likely to collaborate to navigate the implications of the ruling and seek potential avenues for legal recourse. Additionally, lawmakers may face pressure to either support or challenge the decision through legislative measures.

The implications for IVF procedures in the state raise significant concerns about the potential curtailment of reproductive choices and access to assisted reproductive technologies. At least three providers: the defendant in the case, the University of Alabama at Birmingham Health System and Alabama Fertility have said they are pausing IVF treatments, citing potential civil and criminal liability in response to the ruling.

Resolve, the National Infertility Association, responded to the ruling calling it a “terrifying development for the 1 in 6 people impacted by infertility who need in-vitro fertilization to build their families… this anti-family ruling will likely have devastating consequences.”

A bipartisan effort is underway in the Alabama House and Senate to draft “clarifying” legislation that would “protect” in vitro fertilization treatments. Alabama Attorney General Steve Marshall said in a statement that he, “has no intention of using the recent Alabama Supreme Court decision as a basis for prosecuting IVF families or providers.”

As the legal and ethical debates unfold, TalkingFertility.com will be closely watching for further developments and potential challenges to this landmark ruling.

Many people are worried that their right to use in vitro fertilization (IVF) or a surrogate to grow their family could be in jeopardy. That’s because current legislation pending in the US Congress, as well as new laws in several states around the country could affect the right to utilize reproductive technology.

In addition, the US Supreme Court will soon revisit Roe v. Wade, which could likely impact the future of abortion rights. A leaked draft opinion by the conservative majority on the court indicates that it will overturn the 1973 landmark ruling. That would mean the states would determine whether or not abortion will remain legal. If Roe v. Wade is overturned, 13 states that have “trigger laws” in place that would immediately ban abortions. Fourteen states could adopt bans on abortion, at 22 weeks or earlier – before fetal viability.

There are two bills in committee in the US House of Representatives that would essentially give legal rights to a fertilized egg, known as “Personhood” legislation. HR 681, “Life at Conception Act”, is sponsored by Congressman Alex Mooney (R-W.Va.) and co-sponsored by 59 Republicans and 1 Democrat (Rep. Collin Peterson of Minnesota).

The same bill was introduced in the Senate as S231 by Senator Paul Rand (R-Ky.), with 9 Republican co-sponsors.

A similar bill, HR 586, the “Sanctity of Human Life Act”, was introduced by Rep. Jody Hice (R-Ga.). It’s co-sponsored by 29 other Republican men from 14 states and the list of co-sponsors continues to grow.

There are currently 10 states – Alabama, Arkansas, Indiana, Iowa, Kansas, South Carolina, Missouri, Washington, Tennessee and Texas – with Personhood legislation pending.

This type of legislation is nothing new and has been introduced in some form every year since the mid-1990’s. In January of 2017, Mike Pence became the highest ranking US official to ever speak at the March for Life rally in Washington.

“There is strong support for the introduction of pro-life legislation,” Los Angeles Reproductive Law Attorney Lori Meyers says, “There is a feeling of momentum … that has buoyed support for the introduction of bills with this kind of broad, strong and sweeping language, which I don’t think most people are necessarily aware of, or understand the complexities of.”

“There are unintended effects that could … tremendously impact the services performed at IVF clinics around the country.”

Congressman Jody Hice sent TalkingFertility.com this statement: “Today, with the right to life under attack, now more than ever before, we must stand up as advocates for the unborn. Our culture must affirm the value of the weak and vulnerable in our society, beginning with our children. With that in mind, I introduced the Sanctity of Human Life Act, which rightly defines life as beginning at conception.”

Melissa Brisman, New Jersey Reproductive Law Attorney: “This proposed law flies in the face of the United States Constitution. Representative Hice’s diatribe is nothing more than an attempt to derail reproductive freedoms, curtail abortion and impact in vitro fertilization. While the law would have on obvious effect on abortion and a woman’s right to choose, there are unintended effects that could be far reaching and could tremendously impact the services performed at IVF clinics around the country.”

Those who support the bill say it’s a declaration, not a regulation and does not mention or prohibit IVF or any other assisted reproductive technology, it simply states that life begins at conception. Even so, many in the fertility community are very concerned.

Dr. Andrew Toledo, a Fertility Specialist in Atlanta, was part of a coalition of physicians who fought 2009 Georgia state legislation which intended to recognize and give legal human rights to embryos. “For these pro-life politicians, this is the way to eliminate abortion and Roe v. Wade. However, I don’t think the majority of politicians realize the impact it will have on the reproductive field. The process of in vitro fertilization creates embryos. Doctors can’t know how many eggs will fertilize. If I have ten eggs, will all fertilize, or just two? We don’t know. Additionally, not all of the embryos created will be genetically normal. So, would this legislation force a couple to implant all embryos, whether or not they are normal, because discarding them would be illegal?”

Fertility Specialist Dr. Eli Reshef has been an active part of the fight against “Life at Conception” legislation in his state of Oklahoma. While Oklahoma does not support Surrogacy and has numerous laws restricting access to abortion, previous attempts at passing Personhood legislation have failed. “It creates a significant risk to family-building,” Reshef says. “Giving embryos the same rights as adults creates various situations that place the practice of IVF at risk. If a lab technician accidentally drops a dish with embryos, they may be prosecuted for manslaughter of “persons”. Which IVF practice, in its right mind, would be willing to provide services if they entail risks of legal prosecution? What about ectopic pregnancies that are viable and place the pregnant person’s health at risk, yet surgical or medical intervention may be construed as killing a ‘person’?”

Attorney Lori Meyers says the proposed legislation would also impact surrogacy in states where it’s legal: “We may be unable to put directed sections in our legal contracts for abortion or selective reduction as the unborn fetus would have rights.  Currently, if a surrogate’s life is ever threatened, her life comes first and she decides the outcome of the pregnancy. In the event an abnormality is detected, the Intended Parents have the right to determine the outcome of the pregnancy, as well as to make selective reduction decisions in the event of multiples, or triplets, or more, which is considered a very high-risk pregnancy, endangering the lives of the fetuses and surrogate. It may put lawyers in the position of having to eliminate these sections and the rights of Intended Parents completely, causing them to lose control of the outcome of the pregnancy.”

National organizations like RESOLVE The National Infertility Association, Center for Reproductive Rights, Society for Assisted Reproductive Technology and the American Society for Reproductive Medicine all have a long history of lobbying against Personhood legislation on the Federal and State levels.

Barbara Collura, President and CEO of RESOLVE, says: “Since 2008, more than 26 states have introduced Personhood bills or ballot initiatives. Personhood is anti-family, and it negatively impacts the medical treatments people need who are struggling to build their family. Our community needs to show up to ensure these bills and ballot initiatives don’t pass.”

“Obstetricians, gynecologists and fertility specialists need to work together to make their voice known to legislators, because they will listen to whoever is talking,” Dr. Toledo says.  “It all starts with education – educating people who would be affected by this legislation and the Congressmen who represent them.”

“I’m genuinely worried about the speed and power of bills that could wipe out fundamental rights before most people are aware of it.” Meyers says, “Decisions involving pregnancy and infertility are highly personal and private.  As attorneys in this field, we have to be prepared to fight for the rights of our clients and patients struggling to create their families in a safe and private environment, uncontrolled by governmental influence.”

“It all starts with education – educating people who would be affected.”

“Given the current political climate, I think that the fertility community must assume that Personhood legislation is going to gain traction,” Brisman says. “We cannot sit back and wait for it to be put up for a vote –we must start protesting now.”

“People should be reaching out to their lawmakers to share their perspective and expertise so that the bill does not move,” Collura says. “You never know who will support Personhood, as we have seen pro-life state lawmakers oppose it once they were educated about the far-reaching implications. I like to think that given the chance to tell them the impact, reasonable people will oppose it. So far no Personhood bill or ballot initiative has passed at the state level despite the appearance of overwhelming odds favoring it.”

Dr. Toledo has advice for physicians, particularly in the red states where this type of legislation has come up for debate before: “You need to be organized and have a lobbyist who can get the ear of the party in power, one that has connections and the ability to get inside the offices of the Governor and state legislators.”

Dr. Reshef says it’s also important how you approach the discussion: “Appeal to the sense of decency- most people, including legislators, have some left. Appeal in the name of core values like family-building and the right to raise children. Most people, no matter their political affiliation, understand and support these values.”

Collura encourages people who are concerned about their reproductive rights to use this as an opportunity to get to know their representatives and senators: “Share with them why you are opposed to Personhood. And if you are pro-life, that is a powerful message for them to hear ‘I am pro-life, but against Personhood!’ Your voice can make a big difference.”

We want to know what you think! We’d love to hear about your personal stories regarding limited or challenged reproductive services in your city or state. We’d also like to know if you plan to protest or reach out to your representatives.

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Many of us are always looking for new ways to improve our health. But it can be overwhelming figuring out what’s just a flash in the pan fad, and what might really work. Case in point: celery juice.

Celery juice recently began blowing up all over my social media feeds. A few of my friends, and lots of celebrities including Pharrell, Gwyneth Paltrow, Debra Messing and Jenna Dewan have posted about drinking the green juice. Even the hashtag #celeryjuice – has nearly 200,000 followers.

People post dramatic before-and-after pictures showing how celery juice has cured their health issues. On Instagram, more than 68,000 posts are tagged with #celeryjuice and #celeryjuicebenefits has more than 300,000 followers and 50,000 posts.

I recently noticed signs at Trader Joe’s posted below the organic celery that read: “Only one package per customer.” Our local Costco has trouble keeping their organic celery in stock, and just started selling bottled organic celery juice. Companies like Pressed Juicery, Juice Press and Suja offer pricey bottled versions. One friend told me that she and her husband sometimes have to drive over an hour to find organic celery in bulk – so they can make their celery juice every morning. So, is celery juice the new kale? Not exactly. But the hype over this latest health craze is real.

Where did celery juice mania start? Turns out, there is one guy credited with starting the celery juice movement. His name is Anthony William, and he calls himself “The Medical Medium”. The New York Times bestselling author has a dedicated group of followers. He’s not a registered dietician or a medical doctor. William says he speaks with the “spirit” who he says provides him with “extraordinarily accurate health information that’s often far ahead of its time.”

William’s first book talking about natural remedies for chronic illnesses, including celery juice, was released in 2015. But celery juicing really took off in May of 2020 after William’s latest best seller came out called Celery Juice: The Most Powerful Medicine of Our Time Healing Millions Worldwide – turning him into a wellness superstar.

In his latest book, William says you should drink at least 16 ounces of fresh, undiluted, plain celery juice every morning, on an empty stomach. If you do, he claims that the juice can cure a wide variety of chronic illnesses and symptoms including: gut issues, thyroid disorders, diabetes, acne, ADHD and even multiple sclerosis. Williams says celery juice contains “sodium cluster salts” that repair your stomach and destroy pathogens.

While William’s assertions seemed a little “out there” to me at first. I mean how can juice from one vegetable cure some really serious medical issues? And if celery juice is a cure-all elixir, then why aren’t any doctors or registered dieticians shouting from the rooftops that everyone should be drinking it every day? William says medical science hasn’t yet caught up to what he already knows.

I was sold, and decided to give it a try. I needed to know if celery juice was truly the new fix-all miracle elixir that I had been missing my entire life. I have chronic digestion problems, so maybe this was the natural solution I needed.

I needed to know if celery juice was truly the new fix-all miracle elixir that I had been missing my entire life.

First, I bought a juicer – and then lots and lots of organic celery. Then, every morning for 30 days, I drank plain celery juice, on an empty stomach, to see what would happen. I started out drinking 16 ounces, or two cups, every morning. Then moved up to three cups and then finished off at four cups.

On the first day, I was worried about what celery juice would taste like- since it was my first time trying it. I like eating celery (especially with peanut butter or hummus), so fortunately the juice went down easily – on most days. I quickly learned that all celery doesn’t taste the same. Some stalks can be quite bitter. After some trial and error, I figured out that the lighter the color, the milder it tastes. So, if I used pale green color stalks, instead of the darker green ones, it made the juice much more palatable.

Adding another thing to my morning routine wasn’t an easy feat, with two young kids in the mix. But I was determined to see this experiment through. Even so, about half way through, I was close to giving up.

Drinking the juice was easy – taking the time to make it, clean it, and find it – was not. To make 2-4 cups of celery juice, you need about one and a half heads/stalks of celery. Locating mass amounts of organic celery became quite stressful. I needed to be strategic.

Costco has the best organic celery, already washed and pre-cut. But, they were often out of stock. I had to call ahead, to see when the shipment was coming, and plan to get to the store within the first two or three hours after they opened, or they would be gone. Our local chain supermarket always had enough in stock. However, the quality wasn’t great and I had to take extra time to cut and wash each stalk before juicing.

Once you have your celery lined up, you need to take time to make the juice every morning – since you’re supposed to drink it fresh to get the maximum benefits. The only thing you can do to save time, is prep the celery a day or two before using. Keep in mind, to make enough juice, it takes about 5-10 minutes, depending your brand of juicer.

If you use a blender, you’ll also need to strain the celery pulp before drinking it. Then after you make it, you need to clean the juicer for the next day. And let me just say, those celery strings are not easy to get out. Most mornings I just didn’t have the time, and had to clean it after the kids went to bed that night.

The other factor to consider is cost. Costco charges about $5 a bag, and the local supermarket sells them for a few dollars each. Buying enough fresh organic celery to make juice each day ended up costing between $20-$40 a week.

So, what happened after 30 days of drinking celery juice every single morning? Nothing. Two weeks after starting the celery juice, I started to cut out added sugar, dairy and processed foods. Only then did I notice an improvement in my digestive system. My skin was a little clearer too. For me, the best part of this experiment was when it was finally over.

I still wanted to understand why celery juice seemed to work wonders for so many people. Was I the exception to the rule? Or did I buy into a big social media scam? I got a reality check from two experienced registered dieticians in Los Angeles.

Both dieticians I spoke with agreed that swapping out celery juice for something like a morning doughnut, would likely make a big difference in a person’s health. But, not only is there zero medical evidence to support celery juice as a cure-all, they say it could even cause an adverse reaction for some people.

Jodi Dalyai, MS, RD says, “It’s likely not going to hurt you, but it’s also not necessarily going to help either. You’re better off eating whole celery, to help your digestive tract. When you drink it, you’re not getting any of the bulky fiber your body needs. Also, if you have an allergy or sensitivity to celery, a few stalks may not be an issue, but drinking it in a condensed higher volume form could cause a reaction.”

“Celery has some health benefits, but also some big issues,” says Kim Shapira, MS, RD. “Celery has antioxidants, it’s good for hydration, it’s a good source of vitamin K and sodium, it can aid in balancing your PH and help digestion. But large amounts of celery can be harmful to people who have high blood pressure. Celery can also make you more prone to rashes from ultra violet lights. The quickest way to destroy a vitamin or mineral is to chop it, blend it or grind it.”

Celery juice is just one of the many food fads out there. My issue is with the many people who don’t have any formal education, or even research-based expertise who are making millions by selling their food plans, books, and supplements to people who really need help.

Dalyai makes a valid point that people want a quick fix. “It’s hard to change behavior. People would much rather eat whatever they want, and not do any exercise. That’s why the diet and health industry is a billion-dollar business.”

“I think there is a collective cult-like thinking that happens when a diet fad hits Instagram or the news.” Shapira says. “I think most people are looking for a quick way to get healthy or lose weight. But the truth is, it’s more of a seamless transformation when you do the right work. You just kinda wake up one day saying to yourself, ‘Wait! When was the last time I worried and that food or health problem?’”

But here’s the thing. It was absolutely harmless to try celery juice for 30 days – except for spending money on celery and a juicer I didn’t otherwise need. It was good for me to force myself to drink 16-32 ounces of liquid first thing in the morning to rehydrate. Now that I have stopped celery juice, I find it much harder to down that much plain water in the morning.

Even so, the only way celery juice would ever return to my morning ritual would be if I had noticed major improvements. It’s just way too much of a hassle for a busy working mom on a budget.

If not celery juice, is there something else we should be adding to our daily diet to improve our health? According to Dalyai, you should eat dark, leafy greens – like spinach, kale, broccoli and bok choy – every day. While you’re at it, try to eliminate or at least reduce the amount of processed foods and sweetened beverages you consume.

“My suggestions are to learn to have a normal relationship with food.” Shapira added. “Stop focusing on what your friends and colleagues are doing and focus on your own health and body.  Pay attention to how certain foods makes you feel and go from there.  Healthy is not the same for all of us!”

Editor’s note: For some, paying attention to what you eat is always top of mind. For others, it might take a change in health status to put a focus on food. Experts often recommend diet and lifestyle changes for couples struggling with infertility, and for women preparing for fertility treatments, like IVF. That’s why TalkingFertility.com investigates the latest health trends, as well as new developments in reproductive technology. Look for more articles like this one, if you’re looking at ways to boost your fertility through diet and lifestyle.

The great news is that there are many things you can do at home – without the need for medication -that can reverse insulin resistance, stop pre-diabetes – and even help you to lose weight! We had a fascinating discussion with Jodi Dalyai, MS, RD, co-author of The Everything Guide to the Insulin Resistance Diet about what you can do to take control of your health today.

Q: Your book is about insulin resistance. Can you explain to us what that is and how it is related to diabetes?

A:  Insulin is a hormone made in the pancreas and its job is to help move glucose, or blood sugar, from the bloodstream into cells where it can be converted into energy. In insulin resistance, changes are taking place at the cellular level in response to insulin attaching at the surface and trying to let glucose in which render the insulin inefficient. The body then calls on the pancreas to make more and more insulin, in an attempt to control rising blood sugars. Over time, the pancreas can become less effective at making insulin, leading to rising blood sugars, prediabetes and diabetes. In advanced type 2 diabetes exogenous insulin, or insulin shots, are needed to control blood sugar. Insulin resistance is an indicator that someone is at risk for diabetes if attempts aren’t made to reverse or manage the resistance.

Q: Insulin resistance is associated with lower rates of fertility. Tell us about the impact insulin resistance can have on both female and male fertility.

A: Insulin resistance can disrupt ovulation. Either ovulation can become irregular, or it may cease entirely. With men, there is evidence that sperm count is reduced with insulin resistance. Insulin resistance is also one aspect of metabolic syndrome, and if a person has other indicators of metabolic syndrome, such as high blood pressure and cholesterol, then a host of changes to the bodies endocrine system and levels of stress hormones, can affect male and female fertility. Insulin resistance is seen in possibly 50% or more of women with PCOS. What’s interesting is that insulin resistance can both precede PCOS and also be a symptom of it.

Q: Explain the importance of managing your insulin resistance in order to avoid further health implications.

A: In our book, The Everything Guide to the Insulin Resistance Diet, my co-author Marie Feldman and I discuss common risk factors associated with insulin resistance, such as being overweight or having high triglycerides. Utilizing data, labs or your own lifestyle observations can help you and your doctor determine when it’s time to focus on improving insulin resistance. Since as many as half of people with insulin resistance will go on to develop prediabetes and diabetes, further increasing the risk of infertility, it’s beneficial to make lifestyle changes earlier on. While there are some genetic factors and autoimmune changes that can take place leading to type 2 diabetes or variations on type 1 and type 2 diabetes, in many cases if insulin resistance, or even prediabetes, is caught early, it can be reversed.

Q: Insulin resistance can affect anyone – not just those who are overweight, as some people assume. Can you talk about how many people struggle with insulin resistance?

A: Estimates suggest as many as 60 to 70 million Americans have insulin resistance. While a majority may be over 50 years of age, it affects those younger, and without symptoms, it can go undiagnosed.

Q: Let’s talk about ways that people can manage insulin resistance – before they start trying to conceive.

A: One of the most important things to do is get moving. Sedentary lifestyle is common in people with insulin resistance. By increasing the demands of insulin, by using your muscles during walking, biking or weight training, you are forcing cellular mechanisms involved in insulin resistance to work. The more you make them work, the better they will work.

Q: Tell us a bit about your new cookbook and guide that can help people who suffer from insulin resistance get on the road to improving their blood sugars – and their overall health.

A: As the title suggests, it really is a guide, and that is one of its benefits. We walk you through the science, discuss goal setting for behavior change, and then move into improving insulin resistance with food choices and increased activity. We have an easy to follow 10-week plan, and offer a wide variety of recipes that fit into the guidelines we recommend. Nutritionally, it is very in line with two ways of eating that show amazing benefits to all people- The Mediterranean diet and DASH (Dietary Approach to Stop Hypertension).

Q: What is the most important thing you want people to come away with from your book?

A: That slow and steady wins the race. There is no one overriding factor that confers health, but small, repeated changes and practices that add up to a healthy lifestyle. I think our book is the perfect companion on the three month, six month, and one year journey needed when we want to improve health for the long term.

Fertility health issues and insulin resistance are both common, and often treatable with lifestyle change. Get support to start your journey to health because no one is in it alone!

I held back my tears until I reached my car, and then grieved the loss of this cycle the best I could.

These are unprecedented times. Our lives have all changed since COVID-19 became a reality for Americans in recent weeks. A world is in mourning as this pandemic continues to take its toll. Many of us are becoming shut-ins, in an effort to try and slow the spread of the virus. Those of us watching the news, are bracing for the worst.

Last week, a task force with the American Society for Reproductive Medicine (ASRM), which includes top physicians and embryologists, called for an indefinite suspension of procedures like: in vitro fertilization (IVF), intrauterine inseminations (IUI), egg retrievals and transfers. Now fertility clinics are closing across the country, and canceling all procedures except for urgent care. For the hundreds of thousands of Americans struggling with infertility, many without the luxury of time to waste, having to postpone fertility treatments adds to an already painful situation.

Dr. Lora Shahine, of Pacific NW Fertility: “We are finishing cycles that have already started, but I had to tell patients who were planning treatment soon, that we need to delay. It’s the right decision, for the greater good – supporting social distancing, saving medical resources. But the right decision can often be the hard decision.”

Tara Engelberg and her husband have been trying to conceive for more than three years. “We didn’t share our struggles with our friends or family for two years. It was a big secret we carried in our hearts for a long time. We had finally found the right doctor and the right clinic, and it felt like the stars had aligned just right for us to get started.”

But that all changed at Tara’s doctor’s appointment last week, which was scheduled a day or two before her Intrauterine Insemination (IUI) procedure: “When I went in for my ultrasound, a nurse brought me into a private room to discuss the new guidelines they received overnight. I was asked to cancel my cycle based on their recommendations. I had the option to disregard their medical advice and complete my IUI by signing a waiver, since I was so close to finishing that round of treatment. But, their recommendations were clear. I sat there completely stunned and unsure of how to move forward. My head and my heart were at war.”

“I sat there completely stunned and unsure of how to move forward. My head and my heart were at war.”

Tara ultimately decided to cancel her IUI procedure, even though she may not be able to start it up again in the future, “I knew there was a chance the clinic may need to close in the coming future. I’d also be increasing my exposure to the virus and potentially putting others at risk as well. When our fertility clinic reopens we are unsure if we’ll be able to afford care at that time. Before COVID-19, we had set aside money for treatments. But with a partial loss of income due to the virus, we may need to reallocate that money for essential needs.”

Many of us are feeling the loss of plans we were excited about. We might even be sad about canceling plans we weren’t looking forward to – like those painful hormone injections, or getting your blood drawn for the gazillionth time. So what can you do during this pandemic if you’re trying to conceive and can’t start fertility treatments? We have some suggestions:

Educate Yourself

This is a great time to be learn about your body. You might want to start with the fundamentals, like understanding how your reproductive system works. I didn’t know how much I didn’t know, until I struggled with infertility. For example, if you haven’t already figured out when you ovulate each month, and if it happens regularly each month, is an important first step in cracking your personal fertility code. You can track your cervical mucus, and cervix position – which changes throughout your cycle – and can tell you when you’re likely the most fertile. There are many fertility testing options available to do at home – like using a basal body thermometer, or ovulation predictor kit.  

Beyond the basics, you can get at home tests that may be able to help you discover why you haven’t been able to conceive. Two FDA approved options we found and really like are: Proov and Yo Sperm.  The Proov test confirms that you are ovulating by measuring PdG – a metabolite of Progesterone, 7 to 10 days after ovulation, so you’ll know if you have healthy ovulation and PdG levels.  YO Sperm is a kit that tests sperm health with a device you attach to your smart phone which analyzes sperm count and motility.

“If their procedures are delayed a few months, that is a few months they can use to improve their odds and time to conception.” Eric Carver, General Manager of the YO Home Sperm Test says, “Learning to predict ovulation, confirming ovulation, checking and improving sperm health, and learning to time intercourse during the month- are all best practices for a couple that does not have an underlying infertility condition.”

Amy Beckley, Founder and CEO of Proov agrees that this doesn’t need to be wasted time for people who are trying to conceive, “These are uncharted territories for essentially everyone. If you have decided to stay on the path to try to conceive as soon as possible, there is a lot you can still do from home. While you wait for the clinic to open, try a few home-based test kits to help you answer what might be preventing you from conceiving. That way, when clinics do open back up, you are that much more prepared to hit the ground running.”

Another option to consider is a do-it-yourself insemination kit. For some people, it’s a good time to try to do everything you can on your own, before moving on to more invasive and costly procedures. Maureen and Marc Brown struggled with unexplained infertility for years, which led them to develop Mosie Baby. Their safe, comfortable, and affordable home insemination kit includes a specially designed syringe that transfers sperm to the cervical opening.

Maureen Brown, Mosie Baby CEO/Co-founder: “Family planning in a newly uncertain world is something we’re all navigating together. Whether you’re actively trying or hitting the pause button, we hope everyone can find a way to make the most of this time. That means planning, budgeting, and mastering your ovulation cycle so that you’re ready to seize the moment when the time comes!”

Get Healthy

Another challenge, one that I’m personally battling, is: “The Quarantine 15”. It’s not easy to avoid packing on the extra pounds when your gym is closed, you’re working from home, and you’ve been trying to eat your worries away. Here are some great tips from health experts that can help stop the cycle of stress-eating:

• Plan your meals out each day – so you know exactly what you’re eating throughout the day, including snacks. Then write down what you actually eat, so you can keep track.
• Try not to graze all day. Have a start and end time – for example only eat between 9am and 7pm.

• Don’t eat out of the bag or container. Put snacks on a plate or into a bowl, so you can see exactly how much you’re consuming. And don’t go back for refills.

• Try to fill up on the healthy foods first. Wash and cut up vegetables and fruit ahead of time, so they’re just as easy to grab as those cookies and chips.
• Wait 30 minutes after each meal, before going back for more. That way you’ll know if it’s really hunger, or it’s just boredom.
• Make sure you’re moving your body in some way every day. Get outside for a walk, try out an exercise video, join the “push-up challenge” on social media, or turn up your favorite playlist and have a 10-minute dance party. This is going to help manage your stress, improve your mood, and keep you out of the kitchen between meals.
• Take time to meditate. I’ll admit, this has been a tough one for me to practice consistently, but I know it’s important. Meditation is key to alleviating the stress and anxiety we’re all experiencing right now. It’s a perfect time to try out one of those apps that guide you through the process.

Do the No-Pants Dance

Sex is much more than just about procreation. Even if trying the old-fashioned way doesn’t lead to pregnancy, it’s important to make time to connect with your partner. Showing how much you love and appreciate each other is another great way to relieve stress, relate, and get your heart rate up.

There’s a lot to deal with right now. We need to be kind to ourselves. So, don’t be too hard on yourself for eating some comfort food, and binge watching Netflix. But these ideas to get healthier – physically and mentally – can really help when you’re an isolation-induced funk. Maybe just try one of the above suggestions each day. Or if that’s too much, just incorporate one new thing each week. That is enough to make a big difference.

You are not alone – Even when it may feel like it

This situation is hard and unexpected. I understand it, I accept it, but that doesn’t erase the pain.

-Tara Engleberg, IUI Procedure Was Canceled

Like Tara, we’re all feeling pain and heartbreak for those plans we can’t reschedule, and also for the many people fighting for their lives. We’re all trying our best to stay healthy and sane right now. It’s completely normal to be feeling a range of reactions including: depression, frustration, helplessness, anger, and sadness. If you’ve been struggling with infertility, or experienced a miscarriage, these are emotions you’re already very familiar with.

I’m going to be honest with you. I am typically an optimist. When things are hard, it always helps me to focus on the light at the end of the tunnel. But I don’t see the end of this pandemic right now. So, I’m going to work hard every day, to find that light within – so it can lead me and my family down this path we’ve never traveled before. But I can’t do it alone. Will you join me?

Please visit our COVID-19 Fertility Forum – and let us know what’s in your head right now, and what you’re going through. Are you going to try to conceive at home? Do you have any tips, or advice to share about how you’re dealing with the lock down? We’d all love to hear from you. We are all in this together. We need to keep talking, sharing, connecting, and supporting each other.

Every day is a new chance to do better, be better, and feel better.

– Talking Fertility

On March 17 the American Society for Reproductive Medicine (ASRM) strongly recommended a moratorium on all non-critical fertility treatments. The ASRM’s expert Task Force, which includes top physicians and embryologists, wants to indefinitely suspend procedures like: in vitro fertilization (IVF), intrauterine inseminations (IUI), egg retrievals and transfers. The experts also suggested clinics move to a virtual health model, and reduce all in-person interactions.

The role of ASRM is to proactively do our share in blunting the impact of this pandemic, while recognizing the need to safeguard limited health infrastructure resources.

American Society for Reproductive Medicine

With the numbers of COVID-19 patients on the rise in the US, Tuesday’s statement goes much further than previous ASRM recommendations. That’s because of what the medical community knows and doesn’t know about the impact of the new strain of coronavirus on “fertility, pregnancy and transmission patterns.”

Catherine Racowsky, President of ASRM: “We are all facing a great deal of uncertainty, but we do know our health care system is about to be stressed in a way it has never been stressed before. Only by working together medical professionals, patients, citizens of an inter-connected world, can we hope to meet this latest challenge.”

Dr. Lora Shahine, of Pacific NW Fertility says she’s been on the phone all day, working to implement the new ASRM recommendations: “We are finishing cycles that have already started, but I had to tell patients who were planning treatment soon, that we need to delay. It’s the right decision, for the greater good – supporting social distancing, saving medical resources. But the right decision can often be the hard decision. Try telling someone desperate to start their family, who has prepared for months to finally have the opportunity to proceed, that their treatment is considered elective.”

Medical Director at the Fertility Centers of Illinois, Dr. Christoper Sipe, sent out a letter to patients today: “We understand that this news is disheartening and disappointing. We know that you may find your fertility journey temporarily halted after months of planning, testing, and trying. We truly believe implementing these changes is what is needed for each of us to help flatten the curve.”

ASRM Chief Executive Officer Ricardo Azziz says he understand how difficult these new recommendations are going to be for patients, fertility doctors, and their staff, “We know the sacrifices patients have to make under the best of circumstances, and we loath to in any way add to that burden. And it will not be easy for our members. The disruption to routines, the stress on staff members, and the very real prospect of economic hardship loom large for ASRM members all over the world.  But the fact is that given what we know, as well as what we don’t, suspending non-urgent fertility care is really the most prudent course of action at this time.”

Is it a bad time to be trying to get pregnant?

There’s still a lot we don’t know about COVID-19 – like its impact on reproduction and pregnancy. The Center for Disease Control and Prevention (CDC) says that because pregnancy causes changes to a woman’s hormone levels and immune system, it makes them “more susceptible to viral respiratory infections, including COVID-19.” The CDC also warns that based on prior cases of other related coronavirus infections, like SARS and MERS, pregnant women might be at higher risk for “severe illness, morbidity, or mortality compared to the general population.”

There’s no vaccine for this highly contagious new strain of the coronavirus. With the growing fear of getting sick – or getting someone that you love sick – one of the last places most of us want to be – besides stuck on an infected cruise ship- is in a hospital or clinic. Many people are choosing to postpone non-imperative surgeries, procedures, and visits to the doctor’s office. So, what if you’re about to start fertility treatments – like a round of In Vitro Fertilization (IVF), or you’re utilizing a sperm or egg donor? Is it a bad time to be trying to get pregnant?

We spoke with three leading fertility doctors and one Obstetrician/Gynecologist who specializes in Maternal Fetal Medicine – so we could find out everything you need to know if you’re trying to conceive during the COVID-19 outbreak.

The CDC says COVID-19 has been more difficult to contain than previous epidemics like SARS and MERS, because symptoms can be mild or non-existent. So many people are spreading the disease before they ever realize they’re sick. What advice are you giving your patients right now, besides – wash your hands for 20 seconds? Do you suggest delaying fertility treatments?

Dr. Jennifer Hirshfeld-Cytron, Fertility Centers of Illinois: As of now we are continuing treatments as usual, it is important for patients to appreciate that if a public health measure occurs in your city or state requiring a “shutdown” approach for containment that would include your IVF center. Therefore, approaching treatment needs to be with that awareness and inherent flexibility. If someone works in a high-risk environment, like a hospital isolation ward, it likely makes sense to hold off on treatments.

Dr. Edward Marut, Fertility Centers of Illinois: Remember that fertility patients are not in the high-risk group. All the common-sense measures should be followed as well as avoiding friends and family who are sick. Severity of COVID-19 increases with age and underlying medical conditions.

Dr. Lora Shahine, Pacific NW Fertility: We are recommending excellent hygiene, we are maintaining our highly clean clinic environment, we are not shaking hands or hugging (I miss that), and we are asking anyone (team members and patients) to stay home if they are sick. We are not recommending that everyone stop treatments or trying to conceive. We are screening patients for symptoms, and travel exposure, and asking sick patients to stay home. We are doing more consults and answering questions over the phone to decrease the number of people in and out of the clinic. We have not canceled any retrievals or embryo transfers to date but if someone is sick and may have COVID-19 we will most likely recommend canceling the treatment in order to keep that patient out of clinic, to reduce the risk of infecting other patients, and our team

Dr. Rashmi Rao, Assistant Clinical Professor, Maternal Fetal Medicine,
Department of Obstetrics and Gynecology, Ronald Reagan UCLA Medical Center: We know that being pregnant does not put women in a higher risk category for contracting COVID-19. With that being said, the early data is not yet conclusive and based on prior coronavirus strains, pregnant women diagnosed with the disease could be at a higher risk for complications. But, I don’t think women who are pregnant need to be in quarantine right now, unless they’ve been exposed, or have symptoms. However, it is imperative that we all focus on good hygiene, avoid crowds larger than 25 people, and practice social distancing whenever possible. I also recommend that pregnant women who are taking medications, get an extra refill or two, in case there are supply issues down the line.

What if you or someone in your family gets diagnosed, while you’re in the middle of a round of IVF, or other fertility treatment?  

Dr. Hirshfeld-Cytron: If you or a family member is diagnosed with COVID-19 it is recommended to self-quarantine at a minimum for two weeks (potentially longer if someone is ill) and during that time you would have to stop treatment. The necessity to minimize exposure to others at a clinic is a significant concern and would limit one’s ability to continue IVF treatment given the monitoring appointments.

Dr. Marut: If you get sick, self-quarantine so you don’t infect others, no matter what the source is. I don’t suggest that you scrap an egg freezing cycle. But if you are diagnosed with COVID-19, you should convert an IVF cycle to an egg retrieval, and freezing cycle.

Does that advice differ at all if you don’t have the coronavirus, but you do get a typical cold or flu?

Dr. Hirshfeld-Cytron: If you are sick with a fever or cough, you will likely be asked to suspend treatment and coming into the clinic, until your symptoms have resolved. 

Dr. Marut: If severe, obviously bail on it. You don’t want to be ill and newly pregnant, if you’re even able to conceive while sick.

What if your partner gets sick?

Dr. Hirshfeld-Cytron: If a partner is diagnosed with COVID-19, they will be quarantined per CDC guidelines, which could impact ability to do a fertility treatment.

Dr. Marut: Put him in another room no matter what the illness is.

What should you do if your city has reported cases at the hospital where you’re scheduled for a procedure?

Dr. Hirshfeld-Cytron: If concerned you should ask your physician about the hospital’s policy.

Dr. Marut: Those patients aren’t going to be in the IVF center. Good reason to stick with freestanding centers.

Are there any new concerns regarding surrogacy that may impact gestational carriers or intended parents? For example, what if the gestational carrier lives in a town where there’s a COVID-19 outbreak?

Dr. Hirshfeld-Cytron: The majority of towns and cities will likely have a COVID-19 patient positive in the very near future.  If your GC is not sick, nor been directly exposed, then there is no need to stop treatment.

Has COVID 19 been detected in sperm samples – and can the virus be spread through the exchange of bodily fluids?

Dr. Marut: We don’t yet know if it’s a Sexually Transmitted Disease. It doesn’t seem to cross the placenta, but a severe systemic illness can prevent or disrupt a pregnancy.

Dr. Shahine: It’s too soon to tell if it is transmitted with semen or vaginal secretions. But we do know that close contact with respiratory droplets (kissing) can spread the virus.

Given that we don’t know when a vaccine will be readily available – do we even want to be pregnant right now?

Dr. Hirshfeld-Cytron: As of now COVID-19 is not believed to be more severe in pregnant women. Unfortunately, COVID-19 is not going to disappear in the next few months. And viruses exist today that pose increased risk to pregnant women, namely influenza, varicella, rubella, ebola, etc.  The decision to wait for pregnancy needs to be based in the reality that there is never going to be a time that is 100% safe.

Dr. Shahine: The warnings to pregnant women to be more cautious are important, as is advising people to be careful. But there is currently no evidence that suggests the coronavirus can be passed from mother to baby during pregnancy or delivery. Last month a medical study reported that babies born from women with documented coronavirus in pregnancy did not contract the virus, after blood tests on the newborns and swabs taken from placenta.

Dr. Rao: Pregnant women with heart, lung, or kidney disease, and those with diabetes should follow the CDC guidelines for people at high risk. Most of my patients are keeping pretty calm, and level-headed about the situation. I am getting a lot of patients asking whether or not they should cancel their baby shower. My advice is, if you trust that the people coming aren’t sick, and it’s not for more than 25 people, just use common sense, and go for it.

Dr. Marut: You always take a chance; cut the odds by following medical advice on prevention. But, it’s not realistic to let COVID-19 rule your life.

A joint statement from American Society for Reproductive Medicine (ARSM) and the Society for Assisted Reproductive Technologies (SART) takes things a step further, recommending that: “Patients, including prospective oocyte and sperm donors, as well as gestational carriers, who meet the diagnostic criteria for COVID-19 infection should avoid becoming pregnant. If they are undergoing active infertility treatment, we suggest that these patients consider freezing all oocytes or embryos and avoiding an embryo transfer until they are disease-free.”

It’s not realistic to let COVID-19 rule your life.

I think we can all make ourselves a little crazy as we watch COVID-19 start to impact our daily lives – and our best-laid plans. But, in times like these, I like to remind myself of something my late Grandma Sarah always used to say: “This too shall pass.” So let’s try to be kind, and help each other through this crisis. Remember, you are not alone – we are all in this together.

Water

First, let’s talk about water. Drinking plenty of water from a clean source is very important. Avoid drinking lots of bottled water, if possible. The bisphenol-A (BPA) from the plastic containers (both in many plastic bottles and in the linings of some cans) may act like a xenoestrogen, binding to estrogen receptors, and is considered a dangerous hormone disruptor. This may interfere with normal hormonal messaging, which is necessary when trying to ovulate regularly, or when a patient is doing IVF and balancing a fine ration of hormonal medications in preparation for an IVF or natural cycle. Moreover, it has been linked to increasing negative epigenetic mechanisms, such as turning on the diabetes gene, and the obesity gene, which can be passed on to one’s children (and onto ones children’s children). And most recently it has been linked to neurological disorders – something that should be avoided whether you and your partner are trying to conceive or not. Also, BPA bio-accumulates in pregnancy, and has been found in large amounts in the placenta – best to avoid exposure to these plastics throughout the entire pregnancy.

Fake Sweeteners

Another thing to consider cutting out is artificial sweeteners. Chemicals such as aspartame can be great for reducing caloric intake and sugars, which is a great idea overall, but it can also act as hormone disruptor in certain individuals. Even stevia should be used with caution, as there are some animal studies showing it may interfere with spermatogenesis, and possibly egg quality in women. One way to treat your sweet tooth is to make sure you are getting enough natural sugars into your diet, such as fruit. Drinking plenty of water will help you keep full and get cravings down for the unhealthy and potentially toxic stuff.

Smoking

Other things to avoid are smoking, for both men and women. Smoking (tobacco or marijuana) and drinking alcohol (a neuro-toxin) are things that should be completely cut out when trying to conceive, during preconception care, and in an effort to get as healthy and fertile as possible with the highest quality eggs and sperm.

Non-Organic Meat

Try not to eat foods from polluted areas, and animal protein that is not organic. Animals that have been injected with large amounts of antibiotics and fed large amounts of hormones may interfere with fertility. When you are trying to conceive, you should consider decreasing your intake of that kind of meat.

Coffee

Okay, coffee. Lots of fertility healthcare providers are fine with their fertility patients drinking coffee. But studies show decreasing caffeine and coffee can be beneficial when trying to conceive. Caffeine may decrease motility and health of sperm. In some women caffeine may encourage miscarriage, especially within the first 8-14 weeks, and is thought to negatively impact fertility. It is recommended to limit caffeine to 1 cup per day, and if it can be managed, cut out completely. Many women switch to decaf. Although the US used to use many cancer-causing solvents in the direct and indirect decaffeination process in the 1970’s, today most companies no longer use these chemicals. Carbon dioxide is still used in the direct version, but evaporates by the end of the process, so is considered safe. Sticking to naturally decaffeinated coffee, or even better, coffees that have been processed through the Swiss water process are less problematic, if it is absolutely necessary. For some people, if their body is particularly sensitive to the coffee bean itself, which has stagnating properties according to traditional theory, it would be best to cut it out completely. You might also consider switching to green or white tea – all of which are the same plant as black tea, Camellia sinensis, but with much less caffeine. There are some awesome alternatives out there that are just as yummy, and if you are supporting your system in other ways, the caffeine aspect is rarely missed if managed well – worth a shot if you are trying to optimize your fertility.

Soy, Dairy, and Wheat

These are also controversial when it comes to fertility and being in the best health for conceiving. The easiest way to navigate these three food products is to avoid large amounts of highly processed versions of them. Your constitution and medical history will help your fertility health care provider come up with a customized dietary plan for you, but overall these three food groups are ones to be mindful of and greatly decrease, depending on your personal health and fertility history.

When in doubt just remember: moderation! Having a glass of wine at an important party, or a special dessert on a special occasion will not throw off all the hard work that you’ve put into your pre-conception care. And in fact, the stress that some people experience and create over constantly denying themselves of a treat now and then may in fact be even more unhealthy. Stress is just as bad, if not worse, than certain foods! They key is to strive for an overall healthy lifestyle.

The fact that I was so sad made me feel really guilty. I didn’t think I had the right to experience those feelings.

I kept my pain a secret from friends, family and co-workers and tried to bury my emotions. The fact that I was so sad made me feel really guilty. I didn’t think I had the right to experience those feelings, because I already had so much to be grateful for. At the top of that list: my wonderful husband, our amazing, healthy son and my health. I didn’t feel like I could or should talk with anyone about my feelings, except for my husband. I didn’t want to seem ungrateful for the many blessings we already had.

My husband was supportive, but he was perfectly fine with us having only one child. He didn’t want to take any extraordinary measures to have another child. But I wasn’t okay with that. I could not shake the feeling that our family was not yet complete.

I spent a lot of time trying to figure out why I couldn’t just stop trying for a second child. Especially when the process of trying was completely kicking my ass. Maybe it was because my love and connection to my son was so pure and so deep from the moment he was in my belly. Maybe it was because I cherished every moment and milestone, even the tough and scary ones. I just didn’t want it to be the only time I would ever experience that intense joy of a positive pregnancy test, or that incredible feeling of finally meeting and holding the little person you were carrying and nurturing for 9 long months. I thought of the joy of the first time I noticed my husband’s physical and personality traits in our son. And then there was all of those firsts – the first smile, the first laugh, the first time he calls you Mommy and the first time our parents held their grandchild. The list of things that I thought I might never get to experience again circled around in my head.

I also knew that my son would love being a big brother. Actually, I thought he needed to have a sibling. I could easily see myself smothering him and spoiling him with all of my best motherly intentions – because he was my one and only. I wanted him to experience that special kind of love that only siblings share. I even thought about wanting him to have someone that would share the emotional burden of having elderly parents – when that time came.

While producing a documentary television show, I interviewed two Chicago area parents. Their daughter was killed by a gunman while sitting in a lecture hall at her college campus during a mass shooting. I cried along with them as they recounted their memories of that day. But, I’ll never forget how much my heart ached when the mom said: “We will never be able to walk her down the aisle or become grandparents. I wish we had decided to have another child.”

I was thrilled for every one of my friends and family who sent a baby shower invitation or birth announcement. But emotionally, I couldn’t help but wish I had that kind of good news to share. I couldn’t avoid the pangs of jealousy on those days I’d take my toddler to a friend’s birthday party where I’d see all of the pregnant moms and parents toting younger siblings. Those were the days I wanted to lock myself in the bathroom and cry. But, there was no time for that. I couldn’t run away and release my bottled-up emotions. I had to push it all down and focus on my son. So, I put on a happy face and carried on. All while the hole in my heart secretly ached.

I finally decided to see a fertility doctor. After some basic tests the doctor said I had “unexplained infertility.” So, our options were to keep trying on our own, or start fertility treatments.

First, we decided to “try” harder. It quickly felt like a third job. We’d try every time the ovulation predictor test and calendar said it was prime time. But it wasn’t always a good time for us. Especially when you are busy parents and sometimes travel for work. I quickly realized, when you take away the spontaneity and feel like you have to have sex, even when you don’t feel like it – it’s not much fun. It all became quite stressful for both us and even started to impact our relationship.

I didn’t want to be the reason he didn’t have a bigger family.

I felt even more guilt for being the reason we were going through all of this. When we decided to start fertility treatments, my husband was incredibly supportive – even though he didn’t want to go this route. He knew it was important for me to try. So he was at every doctor’s appointment, holding my hand and trying to make me laugh, when all I wanted to do was cry. He would drive an hour to the clinic on his lunch break to give a specimen.  He also rushed home early to comfort me after our first miscarriage after a fertility treatment. The truth is, I wanted a second pregnancy for him just as much as I wanted it for us. As foolish as it sounds, I didn’t want to be the reason he didn’t have a bigger family.

I knew I was entering a dark emotional place and needed help to stop my mind from spinning out of control. I went to a therapist, tried meditation, prayed, and started reading all the books I could on how to become more spiritual. I even visited a psychic, looking for an answer to the question ringing loudly in my head: “Should I stop trying and just move on?”  In the end, I just couldn’t shake this feeling in my gut that was telling me there was another beautiful soul destined to come into our lives. No matter how many miscarriages, doctors bills, arguments, or emotional breakdowns we had – I could not let it go.

After two years, I finally hit a wall. We were pretty much out of money and time to continue invasive fertility treatments. So I decided to put all of my energy into our sweet little family of three, and come to terms with my new reality. But then a little twist of fate kept the ball rolling.

We were introduced to a new fertility doctor, who had a totally new plan and philosophy. He did some tests and found out I needed to double my folic acid intake, because my body wasn’t absorbing that important vitamin. He also told me to take DHEA supplements for a couple of months to improve my egg quality. After that he suggested doing a round of mini-IVF, which uses a lower dose of hormones. We also got new medical insurance and found out that it would cover some of the expenses of IVF. So we decided to give it one last shot. This time felt different. I knew it would be my last fertility treatment and my last attempt at having a biological child. And I was actually completely fine with that. Whatever the outcome, I was more than ready to move forward. We even started looking into adopting right before my last procedure, to see whether or not it would be the right next step for us.

When I awoke from the anesthesia after my last egg retrieval procedure, I quickly learned how much the odds were really against us. Only two viable eggs were available for insemination. Two. Even though the ultrasound showed at least 10 mature follicles. It was a blow. But this time I was mentally prepared for any outcome. After two years, five miscarriages, four failed IUI’s, and two failed IVF procedures –  I was comforted by the knowledge that I did all that I could, and now it was out of my hands. There was nothing else I needed to do, but look back on the journey that made me stronger and much more appreciative of every one of my blessings.

So, how does this fertility story end? It turns out my gut (and the psychic) were right. My third and final round of IVF was a success. It was kind of a miracle. Only one embryo survived to be transferred into my uterus. We named it Nemo. One month to the day after my son turned four, he met his little brother. Our family was finally complete.