Posted by Lisa Rosenthal on Wed, May 16, 2012 @ 10:30 AM
The Type A Personality: What's a Great Grade for You?
I am not a Type A personality. Summing myself up, I believe that a 92, 94 or 96 is a great grade. It's an A plus even. If most of us (except for the super Type A personalities), got a 96 on a test, we'd feel we'd done well. Even very well.
Okay. Except it's not 100%. Ask my husband. I clean the kitchen, 94%. That means, invariably, that there is a dish or two not done, sitting in the sink. Or a glass or two still sitting on the dining room table. Or the napkins haven't made it down to the laundry room. Sometimes I clean the kitchen 98%. That's a pretty high percentage for me. Still, it's not 100% done. When Bill cleans the kitchen, it's scoured. Top to bottom. He's the one who earns 100%, plus 4% extra credit.
I learned at the American Fertility Association (AFA), as the Editor-in-Chief of inFocus magazine, that 92, 94 and 96% done with the magazine did not end up being delivered to our members mailbox. 96% done meant that they weren't mailed and addressed and delivered. Even 99% didn't have them in the readers' hands. (Check them out: the content is available in AFA's online library and many of the articles are written by the top doctors, scientests, clinicians and mental health professionals in the field of infertility.)
Sometimes the only time you can say you've finished something is when it's 100% or more done. Finished. Complete. And sometimes, 96% is very, very good. Good enough.
During Infertility Treatment, How Do We Judge?
With infertility treatment, your clinical staff will guide you about what needs to be done, in terms of fertility testing, procedures that need to be done and more. They will let you know what foods and activities to avoid and embrace and to what extent. No caffeine or less caffeine? No sugar or healthier choices 94% of the time? Should you not exercise at all? What's a healthy heart rate? How many miles can you safely run, if at all? Listen carefully to your health care providers and ask the questions that you need to find out what you, as the unique individual that you are, need to know.
Make healthy decisions for yourself. How completely do you need to finish something today? Is it a work in progress so that 20% today is a great step forward? Will you allow yourself to feel complete, give yourself a high grade with a 96%?
I just finished cleaning the kitchen. It's bright and sparkly. The counters are wiped down, the sinks are empty and clean, the stove has no dirty pots.
I'm still me. I'm looking into my dining room. And sure enough, there are two water glasses on the table.
I give myself a 94%. And I'm good with that.
Posted by Lisa Rosenthal on Tue, May 15, 2012 @ 10:49 AM
Big Fertility News
Fertility news is big the last few days. I read some of the conversation online. As you need to be a subscriber to Time Magazine to read the full cover story, I have not done so. I do not want to subscribe to the magazine; I prefer the way that the news has been coming into my consciousness, deliberately.
It's unusual for me to be attracted to the news, I'm embarassed to admit. I've been avoiding the television and the newspapers for quite a while.
Still, the news seeps in. Sometimes it's called to my attention, like it was yesterday about egg freezing.
Time Magazine Cover
What else is all over the news? The new Time Magazine cover. A 3-year-old nursing. Standing up, breastfeeding.
Yep.
Think it's controversial?
You bet it is.
And, as usual, I'm not going to enter it. I'm a huge believer in live and let live these days.
How does it relate to infertility?
It has to do, once again, with judgement and inflicting one's point of view on someone else. Whether it's political, moral, psychological, or religious, when do we stop assuming that we know better for another human being what's best for them? Or even what's best for their families?
Here's the relationship to infertility: fertility treatment. How many times over the last twenty two years have I heard similar comments and conversations about the fertility treatments that men and women experience as a process to create their families?
Too many times to count.
I've heard the same comments. Identical comments, especially after major technological breakthroughs in fertility treatment. Here are a few:
- It's not natural;
- I would never do that;
- There will be something wrong with those children;
- If God intended . . . (a personal favorite, fill in the blank);
- It should be illegal.
The name of the article, the cover, is "Are You Mom Enough?".
For those of us going though infertility, we are already Mom and Dad enough.
That's how dedicated and determined we are to have our families. Despite what someone else might question, we are already enough.
And we don't have to let anyone else decide for us whether fertility treatment is moral or what God intended.
On a political side note, we should keep an eye out about the legal piece of it. There are many in political office that would make the decisions for us. Careful who you vote for.
Posted by Lisa Rosenthal on Mon, May 14, 2012 @ 10:22 AM
Egg Freezing: What to Consider
You don't get more basic than the egg. The egg, only available in the female half of the human species, is the largest cell in the body. It's also fairly fragile. For years, specialists have been able to freeze embryos, but not eggs. There were too many ways that an egg disintegrated or became damaged in both the freezing and the thawing.
Although the Society for Assisted Reproductive Technolgy (SART) and the American Society for Reproductive Medicine (ASRM) haven't completely come on board about the efficacy of egg freezing yet, it's starting to become standard of practice in the United States. It's become more and more effective to freeze eggs as the technology has been developed to do it safely.
Vitrification: The Egg Freezing Process
Reproductive Medicine Associates of Connecticut (RMACT) explain vitrification, the egg freezing process, in more detail on their website:
Freezing and then thawing human eggs is a complicated process. The egg is relatively large and made mostly of water. Managing the process so that ice crystals do not form and damage the egg is a major challenge. The procedure used to freeze eggs at RMACT is called vitrification. Vitrification involves cooling eggs to a very cold temperature for a brief period of time (minutes) with sugar based cryoprotectants that protect the inner workings of the egg while at the same time allowing them to be frozen.
Who Should Freeze Their Eggs and Why?
Egg freezing is something that should be considered when medical treatment will or could destroy a woman's eggs--keeping in mind that a woman has all the eggs she will ever have at the time of her own birth. We don't make new eggs during our lifetime, so protecting and preserving those we have becomes of paramount importance. Many types of cancer and cancer treatment threaten a woman's fertility and eggs; egg freezing should be seriously considered, and always offered, when that type of diagnosis is made.
Our eggs age along with us. While women in our 30's, 40's, 50's and older are often fit, strong, healthy and even youthful, our eggs are not. As our lifespans become longer, we may think our reproductive years become longer as well. This is simply not true. Our reproductive years are more limited than our lifespans would indicate. If that sounds gloomy, read on. There's lots of hope and possibilities for women to have their babies, sometimes it just means a little extra planning and help.
Cost of Egg Freezing
Yesterday's article on egg freezing in The New York Times by Elissa Gootman profiled grandparents paying for their daughters to cyropreserve (freeze) their eggs (Thank you Terri Davidson for posting the article on Facebook!). Many of the stories in the article were about parents and daughters recognizing that as the daughters aged, their chances of creating their own biological families became smaller. Proactively, these families chose to have the difficult conversation about future offspring and how to protect those chances.
Not always an easy conversation to have, between adult parents and adult children. Bringing up the subject of babies when there is no partner can be very indimidating. Yet these families did it. Both generations put aside issues of privacy and opted to be open about how to move forward. If you're an adult daughter, you know how it can be to talk about things that you feel sensitively about with your mother. Oh, like age, husbands, babies. Not easy conversations. Yet these families broached the subjects, not just to discuss but to plan options.
What a loving gift. The gift of a possibility of a future generation. Of a child. And a grandchild.
Posted by Lisa Rosenthal on Fri, May 11, 2012 @ 10:47 AM
Mother's Day Dreams
Holding that dream close enough to feel
in your heartbeat
and your breath
That you will become a mother
Your heart singing with the truth
That you will hold your child
first in your mind's eye
where your intuition reigns
against all odds
Allowing that dream
space to evolve
to become fertile
in ways that you can only see the edges of
right now
Believing fully and completely
that you will hold your child
in your arms
That you will see into each other's eyes
That you will become the mother
that you are destined to become
That you are dreaming of
That you already are
Posted by Lisa Rosenthal on Thu, May 10, 2012 @ 10:21 AM
Fertility Blog Favorites
At Ladies Night In last night in Norwalk, we discussed this blog. PathtoFertility quietly celebrated its second year last fall. We are just about two and a half years old.
It's often surprising to me which blogs create ripples of conversation, emotional responses or elevate understanding of an issue. Here are a few that I've chosen that I know have been popular over the last several years.
Angry infertile woman at a baby shower with only one bathroom. You could cry or you could laugh. Or both.
Fertile Yoga at RMACT was created three years ago by Lisa Rosenthal and supported by RMACT, open to the public. See the television interview!
Fertility Doctor Mark Leondires, MD, in an interview about prize-winning CCS, Comprehensive Chromosomal Screening. CCS screens all 23 pairs of human chromosomes from several embryonic cells, drastically reducing rate of miscarriage.
Normal versus the twilight zone when it comes to infertility and fertility treatment: What becomes normal in our own worlds?
Infertility Lab Director discusses embryo identification and safety. How do you know you are getting the right embryos?
On the path to fertility, I discovered I'm insulin resistant. Fertility Treatment is Actually Saving My Life. A real fertility success story.
Learn how surrogates and gestational carriers help couples realize their family building dream.
Know Someone Infertile? Top 5 Things to say. Top 10 Things NOT To Say. Hand this list to friends and family if you are struggling with infertility challenges. English and Spanish lists!
Your Feedback Matters
If your favorite is not here, please write to me and tell me which it is. When you write to me here at the blog, your questions and comments come directly to me, they do not post to the blog itself. If you prefer that your comments do not get posted to the blog, let me know.
Posted by Lisa Rosenthal on Wed, May 09, 2012 @ 10:35 AM
Can We Test Ovarian Reserve?
How do we, as women, know our ovarian reserve or how many eggs we have left? Is there one way to know? The answer to those questions is we don't know. We have ways of predicting and getting a very good idea, but we don't know for sure. We do know that some of our fertility tests help us know what we can expect if we are starting a fertility treatment cycle. Read below about one of the most standard tests available and used regularly by board-certified reproductive endocrinologists.
Fertility Testing: The Basal Antral Follicle Count
The Basal Antral Follicle Count test is a transvaginal ultrasound test that measures a woman’s ovarian reserve, or her remaining egg supply. The ovarian reserve reflects her fertility potential.
Unlike males, who produce sperm on an ongoing basis, females aren't born with a full lifetime supply of eggs in their ovaries. When a girl reaches puberty, her eggs are released on a monthly basis; by the time a woman reaches menopause, her egg supply (and potential fertility) is exhausted.
An antral (resting) follicle is a small, fluid-filled sac that contains an immature egg. The follicles can be seen, measured and counted on Cycle Days 2, 3, and 5 by using ultrasound. The number of antral follicles varies from month to month.
Estimating Pregnancy Chances
The Basal Antral Follicle Count, along with the woman’s age and Cycle Day 3 blood work levels, is considered one of the best indicators for estimating ovarian reserve and the woman’s chances for pregnancy with in vitro fertilization. In other words, the antral follicles are a good predictor of the number of mature (dominant) follicles in a woman’s ovaries that can be stimulated by medications leading up to IVF. The number of eggs retrieved correlates directly with IVF success rates.
When an average to high number of antral follicles (eight or more) are visible on the ultrasound, fertility specialists expect to be able to retrieve a good number of eggs and the pregnancy rates are higher than average. If few antral follicles appear, a poorer response is expected and the IVF cycle could be cancelled to try for better results the following month.
Contact us for more information on the Basal Antral Follicle Count and fertility testing in general.
Posted by Lisa Rosenthal on Tue, May 08, 2012 @ 10:30 AM
Mother's Day During Fertility Treatment
There are four plates in my cabinet from Mother's Day 1991. I had no children and I was not pregnant. In fact, I had just found out that an IUI cycle had failed. Fertility treatment had not worked--again.
I decided I needed a present. I went to Pottery Barn and bought these four plates. They went with absolutely nothing that I owned. They were definitely not anything that I needed. Back then, Pottery Barn still gift wrapped.
The upside? They were calorie-free. They didn't contain alcohol or other drugs, illiicit or over-the-counter. They had no nicotine or caffeine. There were no horrible artificial sweeteners. They didn't raise my pulse too high or make my metabolism sluggish either.
My buying them didn't cause my credit card to blow up, nor did they get me near to reaching my credit limit. Nor did they even create a blip on my credit card bill. They were astonishingly inexpensive and therefore affordable.
When Being Kind to Oneself Can Save Everything Else
They may have saved my husband's life. Or my marriage. He was wise enough not to ask anything. He was even wiser not to say anything. He knew to just let me be.
Astonishing what four blue, lovely, yet still not extraordinary plates could do.
I had them wrapped. I opened them on Mother's Day. They made my heart happy. They made the corners of my lips turn up.
They made me happy on a day that was destined to be unhappy.
It turns out that they were magical plates after all. Completely not ordinary. Completely extraordinary.
Buying and giving myself those plates had no down side.
Please consider a gift for yourself for this Mother's Day. Something as innocent and healthy and inexpensive and non-guilt-forming as my four plates.
Extraordinary.
Posted by Lisa Rosenthal on Fri, May 04, 2012 @ 10:28 AM
Fertile Yoga Insights: Approaching Fertility Treatment
The setting was Fertile Yoga last night. Love these women, just love them!
We were doing our check ins, which we normally do in the beginning of the support piece of the class, before we chat and before we start the yoga portion.
One woman was new to the group and in a fertility treatment cycle. She innocently asked how the rest of the group stayed positive, but not too positive.
What do you think we did?
If you've been around infertility for a while, you know what we did.
And we did.
We laughed.
We laughed sympathetically. At the question. Not the person.
Loved the question.
How do you do that?
How do you stay positive and put good energy out there and manage the anxiety that most of us feel that the fertility treatment cycle won't work?
Sometimes questions stick around a long time.
Last night, the answers were variations on a theme of balance: Allowing yourself to feel your feelings, observe them without judgement and release them to the next feeling that comes along;
Feeling the brightness of hopeful anticipation of conceiving;
Noticing and then releasing the feelings of oppression that the treatment cycle might not work.
Sometimes questions do stick around a long time. And sometimes you open a book and find that an answer is right there.
The Infertility Balancing Act
Today's answer was about Too Cautious. Too Cautious is always so worried about failed results that he/she never tries anything. Never takes the vacation, starts a new career, finds a new hobby or asks a potential friend for coffee.
I've been there. And we all know that it's an easy place to be while dealing with infertility.
I don't know that I believe there's such a person as Too Hopeful, though. The results will be the same regardless. Or will they? Will being Too Hopeful or Too Cautious change the results?
I don't know.
I do know that Too Hopeful may be just too much, just as Too Cautious is too little.
I strive for balance. For those of you who know me or are starting to get to know me, my breath allows me balance.
I exhale and release. My exhalation makes room for my inhale. My inhalation brings in everything that I need in that moment. It brings in fresh oxygen and fresh prana (energy). My inhalation nourishes every cell and organ in my body. My exhalation sweeps out everything that is finished and over.
Balance.
Breathe.
Enjoy your weekend.
Breathe.
Posted by Lisa Rosenthal on Thu, May 03, 2012 @ 10:34 AM
Infertility Treatment Legislation: Close to Home
It may be tempting to dismiss this blog this morning because you don't live in New Hampshire and legislation that impacts infertility treatment may seem far afield. I encourage you to resist that urge. All over the country, fertility treatment is being threatened in the courts. What is happening in New Hampshire has happened in various forms in at least 11 states in the past six months.
Reproductive Medicine Associates of Connecticut (RMACT), with RESOLVE, is supporting the advocacy around protecting our reproductive rights. Please read on for the specifics of what's happening in New Hampshire, straight from RESOLVE New England's website.
My sister lives and works in New Hampshire. I've asked her to write to her legislators. I've asked her to ask her friends and family up there to do the same. Think about how you can help.
New Hampshire Urgent Advocacy Alert
↓ Jump to the latest updates on HB 217 ↓
Attention New Hampshire Residents:
We need you to act today to protect IVF treatments in your state!
Advocacy Alert Details
Media Coverage
Latest Updates
- 5/2/12: The New Hampshire State Senate has moved to push back the vote on HB 217 until May 9th. We still urge NH residents to contact their State Senators in the interim to express just how damaging HB 217 would be if passed as written.
- 4/30/12: The New Hampshire Senate Judiciary Committee passes an amendment to HB 217 that includes the following language:
- “[The bill] shall [not] apply to any act committed by the mother of the unborn child, to any medical procedure, including abortion, performed by a physician or other licensed medical professional at the request of the pregnant woman or her legal guardian, or to the lawful dispensation or administration of lawfully prescribed medication.”
- Defines “unborn child” as “human offspring from conception to birth”.
- Defines “conception” as “the fusion of a human spermatozoon with a human ovum”.
- Defines “pregnant” as a “female reproductive condition of having an unborn child in the woman’s body”.
Overview of Amendment HB 217-FN
It has come to our attention that a bill is being voted on May 9th, 2012 which would amend the current homicide law in the state of New Hampshire to include the death of an unborn child, where an unborn child is being defined from the moment of conception until birth. (“Conception” is being defined in this instance as the fusion of a human spermatozoon with a human ovum.)
The destruction of an unborn child, as defined by this amendment, would be viewed as criminal homicide under the amended law.
Additionally, while this amendment makes provisions to exempt medical procedures performed by licensed medical professionals such as abortion, it is worded in such a way that excludes a recipient woman waiting for embryos to be transferred into her uterus, as this amendment defines a pregnant woman as one who has an unborn child within her body. Thus, under the language of the amended law, if any embryos are discarded prior to being transferred to her womb, neither she, her partner, her embryologist or her doctor would be protected by the law.
IVF Treatment Impacts
If this bill passes, IVF as we know it in New Hampshire could be in jeopardy since not all embryos survive the IVF treatment process. In addition, the cryopreservation of embryos could be at risk for New Hampshire residents with leftover embryos, since those embryos would be defined as an unborn child under this new amendment. If this bill passes as currently written, fertility clinics would have no legal recourse to proceed with standardized IVF practices.
More information about Amendment to HB 217-FN can be found online here. You can track HB 217′s progress online here.
Posted by Lisa Rosenthal on Wed, May 02, 2012 @ 10:38 AM
Fertility Foods for Women's Health: The Avocado
Reproductive Medicine Associates of Connecticut (RMACT)'s very own fertility foods specialist, Nutritionist Carolyn Gundell, has shared her latest and greatest with us: a delicious, LOWER FAT guacamole recipe.
How is it possible to have a lower fat recipe? Are avocado's healthy with the fat content that they have? Read on, because the answer is that this is a great way to celebrate National Women's Health Week in May. Say yes to the avocado!
Keep that Fertile Avocado on your Grocery List
By Carolyn Gundell, MS, RMACT Nutritionist
“Skinny Guacamole!” I asked myself, “Could this be possible?” I love guacamole, avocado, and the fact that the delicious avocado is so very nutritious. But, buyer beware, avocado calories depend on type and serving size. One whole California avocado averages 220-240 calories and a whole Florida avocado could be up to 365 calories--mostly fat, although healthy fat. We can eat too much of a good thing.
Low-Fat Guacamole Recipe Tip
But let’s get back to this skinny guacamole idea. I was sitting reading my latest Eating Well magazine and found a low-fat recipe for guacamole. Fantastic! Could this be true and really taste good too? Yes, replace ½ of the avocado with cooked drained zucchini and save 100 calories in ½ cup serving. Add ¼ cup each of cilantro and onion, 2 minced garlic, 2 TB lime juice, ½ tsp hot sauce, ¼ tsp salt. Herbs and spices are all optional. Adjust to taste. Thank you Eating Well magazine.
The Avocado's Attributes: Nutrition for Fertility
So why is avocado so fabulous and what does it have to do with nutrition for fertility for both men and women? An avocado is high in nutrients important for pre-conception health and pregnancy. Avocados are nutrient dense with folate (folic acid), healthy monounsaturated fats, vitamin C, K, additional B vitamins, potassium and other minerals and fiber. Healthy fat (monounsaturated and omega-3 and low omega-6 polyunsaturated fats) plays a role in estrogen production and reproductive hormonal balance. Avocadoes are also rich in phytonutrients which can help protect cells from damage. When using the avocado as an ingredient in balanced menus of healthy, whole grain, low-fat protein, fresh veggies and fruit it adds fiber and healthy fat that can help keep blood sugar (glucose) levels low.
8 Ways to Eat Your Avocado and Stay Calorie-Wise
So, be calorie-wise with your avocado:
- Use as a spread in place of mayonnaise
- Try the above referenced guacamole dip in a ½ cup serving size with low fat crackers, pita, chips
- Add chunks to green salads, chopped salads, chicken salad
- Add to salsa, bean dishes, tabouleh, quinoa
- Add to sauces to saute with chicken, such as mango, avocado, lemon
- Add to slices of tomato, mozzarella for side veggie with dinner or snack
- Add to salad dressing and smoothie recipes
- Consider the avocado as one of your healthy fats along with almonds, walnuts, pumpkin seeds, peanuts, nut butters, brazil nuts, and olive and canola oil and others.
Thanks, Carolyn, for the great recipe.
Don't forget Ladies Night In at the Danbury office from 6:00 to 7:45 p.m., with Carrie Van Steen and me, Lisa Rosenthal.
We eat, we talk, we laugh, we cry, we share. And more. Come join us this evening. For more information, click here.