Trying? Why ovulation isn't everything

Spoiler alert, I have been focused on ovulation for as long as I can remember and as a result have likely been missing my fertile window. I don’t know about you but despite fertility treatments, I always had a small glimmer of hope that in between them perhaps I could be a part of that tiny group of women who were surprised with a miraculous pregnancy. As a result, I have purchased more ovulation prediction kits than I could ever count over the years, either in hope or because of treatments.

I recently had the opportunity to try the Pearl Fertility ovulation prediction kit and it was unlike any other kit that I had ever tried. You might be thinking, but why, what makes it so special?

It’s unique because it provides laboratory-style testing at home and taught me that the time of ovulation and peak fertility aren’t necessarily one in of the same. Having access to my own personalized data through a scientific app and the ability to throw out the generalities of a typical 28-30 day cycle that I thought of as gospel, blew my mind.

My Pearl ovulation prediction kit arrived in a beautiful box with a barcode to set up my app on my phone, (15) LH sticks and (15) FSH kits, a urine catch cup, along with a cute little coaster to set it down on (love this attention to detail especially because I veer on the neat freak side of things). It also comes with two pregnancy tests, which I saw as an optimistic and sweet gesture for the “infertile” bunch of us that are going through treatments and may want to cheat during the 2WW. All I needed to provide was my mobile phone to take photos of the provided sticks through the Pearl app. The app analyzed my cycle through the images, provided a detailed description of my fertile window. What’s more is that it cheerily reminded me each morning that it was time to test.

The testing strips provided detect different hormone levels called lateral flow immunoassays (LFAIs) in urine. LFAIs bind the hormone to biomolecules which makes them easy to measure because they change color when they come in contact with urine. Most of these tests are usually interpreted in highly specialized labs but as you can imagine, these are quite expensive. This is where Pearl’s software steps in and is disrupting the space by providing more accurate results beyond the traditional ovulation kit. Pearl’s proprietary algorithm utilizes data from the test strips to detect hormone patterns to predict the cycle. (Note that after approximately two cycles, the software can predict a cycle well in advance so that you can “plan” accordingly). 

The software detects a patern of FSH (follicle-stimulationg hormone), LH (lutenizing hormone) and PdG (progesterone), which accurately predicts the fertile window when you are actually more likely to conceive. 

And guess what? I found out that the peak fertility window is actually approximately 3 - 4 days PRIOR to ovulation…

After ovulation, an egg is only “fertile” for 12 – 24 more hours. Sperm can survive in the body for 2 – 6 days post intercourse so maximizing a peak fertile window is important. This is especially important for those of us that are trying to conceive after 35. Every opportunity counts. Am I right?

I was so intrigued by this new FemTech which is redefining what we should expect from an ovulation prediction kit that I asked to connect with Dr. Leo Martinez, Founder of Pearl Fertility. I was interested in learning more about his new FemTech business and what inspired him to create it. Read on to find out more about Pearl Fertility.

What inspired you to start Pearl Fertility?

Women are busier than ever, take more (executive and) management positions, and spend far more time outside home than what used to be decades ago. This has created a more equitable society, but has become a challenge for fertility.

Natural fertility starts decreasing with age because of ovarian reserve. Thus, for women above 35 years of age it can take on average up to 10 months to conceive. That does not mean they are infertile, it just means that the chances are lessened. We found a gap when we found many sources of misinformation during our research that weren’t serving women who are desperate in finding actual solutions.

As a result, we leveraged our scientific backgrounds to build a product that can not only help women understand their fertility better (whether they are trying to conceive, or just tracking their hormones for treatments). This was (made) possible because of our core award-winning* technology, Google launchpad, and the European Commission which has allowed us to read all kinds of colorimetric diagnostic tests (specifically three individual hormones) by way of the camera on a mobile phone.

*The Pearl Fertility ovulation prediction kit was awarded as a Top Innovation by MIT Tech Review.

How is Pearl different than other ovulation prediction kits?

Pearl helps you chart your hormone levels: No more happy faces or ranges or thresholds. Instead, you get real hormone levels tracked over time. We have developed intelligent algorithms that run over the daily hormone data to give better predictions of the upcoming ovulation and based on that of a true clinically proven fertile window (the days with the highest chance to conceive). Now there is no more guesswork. Our test strips also measure hormones independently so you know exactly what hormone you are measuring. Other apps have appeared on the market that take pictures of the strips, but they lack the scientific intelligence levels to make (accurate) predictions. Additionally, our prediction algorithms which measure more than one hormone (and how they work together) are patented. The app can read FSH, LH and Progesterone. 

Is there a misconception about ovulation prediction kits that you would like to debunk?

Totally. Women are led to believe two things that are wrong about traditional ovulation prediction kits. The first misconception is that a positive test means the day of highest fertility. This is incorrect because the fertile window starts 6 days before ovulation and the top fertile time frame is 2 - 4 days before ovulation.

Although a (traditional ovulation) strip when positive can indicate fertility, it does not mean those are your most fertile days.

The second misconception is that a positive test means ovulation. This is incorrect because a positive test (in the case of LH) means that hormone levels are high or at their peak.

Many studies confirm that ovulation in fact happens approximately 24 hours after hormones peak. Another important factor to consider here is that not all peaks lead to ovulation as there are anovulatory cycles. 

To highlight the science behind this, please see the two figures built from a collection of clinical studies which represents the fertile window (FW) and the hormone peaks.

Pearl Fertility is innovating to allow women to better understand their cycles. What are you most excited about when you think about the future of fertility?

I think Pearl Fertility is showing the world what is possible in terms of home diagnostics in the era of digitalization. Pearl Fertility is one of the first apps to be a medical device by itself listed in the FDA, and soon will be CE certified.

We have big plans for other tests. With regulations and investment which are tough for medical devices, it requires some time and a lot of money to develop. Pearl is a pioneer in the future of medicine. Right now we only show hormones, (all tested and interpreted) at home. Imagine if you could interpret patterns to prevent disease, treat disease, or predict disease.

I think that the future is that the clinic will come to you.

About Pearl Fertility’s Founder, Dr. Leo Martinez: Dr. Martinez is a Biotech Engineer and Entrepreneur. He holds a PhD in biosensors by the University of Cambridge, has published dozens of academic papers in the fields of biosensors, photonics, mobile apps and fertility. He was listed as one of the Top Innovators under 35 in 2015 by the MIT Technology Review for the developing of the ‘smartphone-diagnostics’ technology behind Pearl. For more information about Pearl Fertility please visit pearl-fertility.com or follow them @pearlfertility

*Please note that I was not paid to review the Pearl Fertility ovulation prediction kit. I am an affiliate however which means that if you purchase a kit at 10% off with my discount code: FERTILUST10, a small percentage of the sale will go to me.

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

Photo of Meirav Zur by Tomer Lupasco

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

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

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

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

What are 5 fun facts about you?

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

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

3. I like to draw.

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

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

What is your fertility story?

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

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

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

What inspired you to create the Inconceivable Show?

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

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

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

What are 5 reasons why someone should see the show?

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

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

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

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

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

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

The 5 things to never say to anyone with infertility

Photo by Kristina Flour on Unsplash

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

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

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

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

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

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

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

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

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

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

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

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

Don’t know what to say?

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

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

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

Why male fertility matters. A conversation with Lauren Manaker.

Lauren Manaker grabbing her favorite snack.

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

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

Two lies and a truth!

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

I have a twin sister.

I have a rubber Duckie collection.

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

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

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

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

What inspired you to write Fueling Male Fertility?

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

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

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

Why does male fertility matter?

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

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

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

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

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

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

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

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

Favorite self-care practice?

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

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

Favorite fertility food and why?

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

Guilty pleasure?

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

Hidden talent?

LM: Tap dancing and napping on-demand!

What gets you out of bed in the morning?

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

What are you most excited about right now?

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

So which is the truth to my very first question?

LM: I cried over George Michael for two days!

A quick PSA from Nathalie and Lauren!

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

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

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

NIAW Feature: The Waiting...

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

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

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

Jennie’s story:

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

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

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

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

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

Your high?

The moment Tess was born!

Your low?

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

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

Do you have a silver lining?

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

Any misconceptions that you had on journey?

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

Do you have any words of wisdom?

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

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

NIAW Feature: Faces of (In)fertility

Photo by Alexis Mera. Shirt design by Erin Halper.

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

Stephanie’s story

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

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

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

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

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

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

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

Your high?

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

Your low?

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

Do you have a silver lining? 

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

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

Do you have any words of wisdom?

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

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

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

NIAW Feature: Options are Valuable

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

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

Anthea’s story:

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

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

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

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

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

What was your high?

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

What was your low?

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

Do have a silver lining?

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

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

Do you have any words of wisdom?

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

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

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

Trailblazing with Andrea Syrtash

Photo of Andrea Syrtash by Alexis Mera.

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

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

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

Andrea, what is your story?

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

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

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

Your High?

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

Your Low? 

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

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

Do you have a silver lining?

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

Do you have any words of wisdom?

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

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

Redefining the Conversation about Infertility

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

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

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

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

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

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

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

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

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

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

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

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

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