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- The Role of Fertility Clinics in Supporting Breast Cancer Patients
October is Breast Cancer Awareness Month, a time dedicated to raising awareness about breast cancer, promoting early detection, and supporting those affected by this disease. In the United States, over 11,000 women under the age of 40 are diagnosed with breast cancer every year (1). While most conversations about breast cancer focus on diagnosis, treatment, and survivorship, it is crucial to address the impact breast cancer can have on a person's fertility and reproductive future. Unfortunately, Oncologists (cancer specialists) do not always discuss the options for pregnancy after breast cancer treatment, leaving patients fearful that they will not able able to one day have a family of their own. We are here to chance that and educate you on how you or a loved one may have a beautiful fertile future despite the disappointment of a devastating diagnosis. In this blog post we will explore the intersection between breast cancer treatment and fertility, highlighting the vital role fertility clinics and resources play in supporting patients through their journey. Understanding the Impact of Breast Cancer Treatment on Fertility Standard breast cancer treatments can have a detrimental impact on reproductive health and may reduce a woman's ability to conceive in the future. Many women hesitate to undergo treatment due to concerns that the time required for treatment may further delay conception, potentially lowering fertility. Cancer treatment options include: Chemotherapy: Many chemotherapy drugs used to treat breast cancer have a direct impact on fertility. One of the major consequences of using chemotherapy agents in what is know as "Chemotherapy Induced Amenorrhea" (2). This essentially means the absence of a menstrual period. It is important for you to speak with your doctor about the side effects of the medications they hope to incorporate into your treatment plan and if it will negatively impact your fertility. Radiation Therapy: The chances of the ovaries being exposed to radiation to the breast/axillary region during treatment is relatively low. However, the ovaries are still at risk of exposure and it is recommended that the pelvic region is carefully protected to minimize damaging effects. Hormonal Therapy: Hormonal treatments for breast cancer such as the medication, tamoxifen, may require patients to avoid pregnancy during the course of therapy. This delay can reduce fertility, particularly for those diagnosed at a later age. Surgery: Certain surgical procedures, particularly those involving the ovaries or uterus, carry the risk of organ damage, which can directly impact a woman's ability to conceive. Understanding those potential impacts is crucial for patients diagnosed with breast cancer, especially those who have not started or completed their family building journey. This is where fertility clinics can play a pivotal role. The Role of Fertility Clinics in Breast Cancer Care Fertility clinics provide essential services and support to breast cancer patients who are concerned about their fertility. Here's how they can help: Fertility Preservation Counseling: Upon a breast cancer diagnosis, one of the first steps for patients should be consulting with a fertility specialist. These specialists provide detailed information on how various cancer treatments might impact fertility and will discuss options women have to preserve their fertility before beginning cancer treatment. Egg and Embryo Freezing: One of the most common fertility preservation methods for breast cancer patients is freezing eggs and/or embryos. This process involves stimulating the ovaries with hormones to produce multiple eggs before they are retrieved and frozen for future use. If the patient has a partner or chooses to use donor sperm, embryos can also be created and frozen to be used in the future. Ovarian Tissue Freezing: This is a newer technique where ovarian tissue is surgically removed and frozen before cancer treatment begins. After treatment, the tissue can be re-implanted in the hope that it will restore hormonal function and fertility. This option is often considered for younger patients or those unable to delay cancer treatment for egg retrieval. However this treatment is not commonly done at most clinics at this time. Collaboration with Oncologists: Fertility specialists work closely with oncologists to ensure a coordinated approach to treatment. This collaboration is vital to timing fertility preservation procedures around cancer treatment schedules to minimize any delay in cancer care. Emotional Support: A breast cancer diagnosis is overwhelming and the added stress of fertility concerns can be significant. Many fertility clinics offer counseling and support services to help patients navigate the emotional aspects of fertility preservation and future family planning. Support for Male Partners: While breast cancer predominantly affects women, men with partners undergoing treatment may also have fertility concerns. Fertility clinics can offer sperm banking for male partners who wish to preserve their fertility before their partners starts chemotherapy or radiation. It is also important to note, while very rare, breast cancer can also impact men. Less than 1% of all breast cancer cases impact men. Resources to Help Here at Grain Fertility, our goal is to empower you on your fertility journey and help connect you to organizations that working to educate breast cancer patients and survivors. Here are a few groups that help provide everything from grants, education, counseling, and other resources: The Chick Mission Founded by a cancer survivor whose fertility preservation was denied by her insurance company, their mission is to ensure every young woman newly diagnosed with cancer has the option to preserve fertility through direct financial support, education programs, and advocacy efforts. RESOLVE: The National Infertility Association RESOLVE works to ensure that all people challenged in their family building journey reach resolution through being empowered by knowledge, supported by community, united by advocacy, and inspired to act. The Alliance for Fertility Preservation AFP works to increase information, resources and access to fertility preservation for cancer patients and the healthcare professionals who treat them. Livestrong The Livestrong Foundation helps thousands of fertility cancer patients gain access to life-changing services by alleviating the burden of costly fertility preservation. The Livestrong Fertility Discount Program works with over 150 clinics across the country that have committed to at least a 25% service discount for qualifying patients. How Grain Fertility Can Help One of the goals of Grain Fertility is to help fertility patients navigate the complexities that come with their journey and cancer patients often have more complex journeys that require additional coordination. Our team at Grain Fertility strongly advocates for a holistic approach to breast cancer treatment that includes fertility preservation as a standard part of care, ensuring all patients have access to the information and services they need. The Grain Fertility application is specifically designed to help onco-fertility patients organize all of the information they collect during their cancer and fertility treatments so they and their care team have all of the information they need to make informed decisions. Our Patient Empowerment Coaches are here to support you, helping you navigate this frightening time. If you or a loved one is fighting a battle against breast cancer, our Patient Empowerment Coaches are here to discuss your options with you. Fertility is a deeply personal and important aspect of life that shouldn't be overlooked, especially in the face of a breast cancer diagnosis. Fertility clinics play a crucial role in providing information, options, and support to those navigating this challenging path. (1) Shah NM, Scott DM, Kandagatla P, et al. Young Women With Breast Cancer: Fertility Preservation Options and Management of Pregnancy-Associated Breast Cancer. Ann Surg Oncol. 2019;26(5):1214-1224. doi:10.1245/s10434-019-07156-7 (2) Ruddy KJ, Guo H, Barry W, et al. Chemotherapy-related amenorrhea after adjuvant paclitaxel-trastuzumab (APT trial). Breast Cancer Res Treat. June 2015;151(3):589-596.
- Switching Fertility Clinics: A Guide to Help Patients
Unfortunately, a large number of today's fertility patients will leave the clinic where they started treatment. Data shows this number can be as high as more than half of all patients will discontinue treatment at their current clinic. Grain Fertility founder Joe Cody and his wife experienced this first hand, switching clinics over 2 years into their journey. The reasons for switching clinic can vary from seeking different results after multiple failed rounds, relocating to a new area after moving, or experiencing poor communication with your current clinic. No matter what the reason, switching clinics can be an incredibly hard decision that should not be taken lightly. To help empower patients to make the most informed decision possible, Grain Fertility has created a cheat sheet for switching clinics available to our Premium Members. This article is an excerpt from our resource available exclusively to our Premium Members. Before Scheduling Second Opinion Appointments One of the first steps every person should take is ensuring this is the correct course of action and everyone involved in the process (partners, surrogates, intended parents, etc.) are on board. Try to identify what you like and don't like about your current clinic, care team, and process. Finally, it helps to get organized and have your medical history, including previous cycles, available for the other clinic to look at. This process can take time, so we recommend starting this process early. Note: Grain Fertility's application is designed to help ensure you have access to the most important health and fertility information you need and our Patient Empowerment coaches are happy to help with this process. Questions to Ask During Second Opinion You should always go into second opinions with a strategy to help compare your options and this includes putting together some questions and topics to discuss. These can include: General information about the clinic including their processes, availability, staffing, and any restrictions Find out more information about how the clinic communicates with their patients, how you can contact their care team if you have any questions, and finally how do they take into consideration patient input and considerations during treatment Asking about their pricing structure, whether or not components of the care are covered by insurance or other benefits, are there grants or other financial assistance mechanisms available, and if they have flexibility on their pricing Learn more about their testing process, medication protocols, and treatment plans. Sometimes clinics, specifically reproductive endocrinologists, have a specific based protocol they use and it is helpful to know more about their process and training Do they offer specific and special considerations for different populations such as single parents by choice, underrepresented or historically marginalized populations such as minorities or LGBTQ+ people Do they provide additional patient support such as counseling, patient navigation services, or support groups Choosing a new fertility clinic is a deeply personal decision that requires careful consideration of many factors. By taking the time to research, ask detailed questions, and reflect on your priorities, you can find a clinic that aligns with your needs and increases your chances of success on your fertility journey. This list is by no means exhaustive and our Premium Member cheat sheet has even more to help give you a starting point for making a truly informed decision. If you want to get access to this and other exclusive resources, you can sign up for Grain Fertility for free and receive a 30 minute consultation with our Head of Patient Empowerment by going to www.grainfertility.com/signup today. If you are using the free version of our app and want to take advantage of our Premium Member benefits including custom guides like this and one on one coaching, you can go to your Account to upgrade your service today and begin meeting with our coaches regularly.
- Mosaic Embryos: What They Mean for IVF and Your Fertility Journey
When undergoing in-vitro fertilization (IVF), couples often encounter a wide range of terms and concepts that can seem complex and daunting. One such term is "mosaic embryos." If you are on a fertility journey, it is essential to understand what mosaic embryos are, how they differ from normal embryos, and what their presence means for your chances at a successful pregnancy. In this blog post, we will explore the topic of mosaic embryos In detail to help you become a more informed patient and advocate for your care. What is a Mosaic Embryo? A mosaic embryo is am embryo that contains a mix of normal and abnormal cells in terms of their genetic make up. In a mosaic embryo, some cells have the correct number of chromosomes (46 total, 23 from each parent cell), while others have an abnormal number (less or more than 46). This is known as "mosaicism." There are a few terms you may hear associated with this such as "euploid" or "aneuploid." An euploid embryo is an embryo with the correct number of chromosomes, 46, while an aneuploid embryo has an abnormal number (more or less than 46). Mosaicism can occur during early embryonic development when an error happens in cell division. For example, a cell may begin as euploid, but as it continues to develop and divide, some of the cells may undergo abnormal chromosomal divisions, leading to a mix of normal and abnormal cells. How are Mosaic Embryos Identified? Mosaic embryos are typically identified through a process called Preimplantation Genetic Testing for Aneuploidy (PGT-A). During this test, a few cells are removed from the embryo at the blastocyst stage, usually around day 5 or 6 after fertilization. These cells are analyzed to determine their chromosomal makeup. The results of the test lead to the categories of: euploid- cells with the correct number of chromosomes aneuploid- cells with an abnormal number of chromosomes which usually leads to a failed implantation, miscarriage, or a genetic disorder mosaic embryos- a mix of euploid and aneuploid cells What Does it Mean to have a Mosaic Embryo? The presence of mosaic embryos can be confusion and emotionally challenging for couples. The implications of transferring a mosaic embryo depend on several factors, including the percentage of abnormal cells and which chromosomes are affected. Chances of a Successful Pregnancy Research shows that mosaic embryos have a lower implantation rate compared to fully euploid embryos (1). However, they do have the potential for a successful pregnancy, particularly when the percentage of abnormal cells is low or when certain less critical chromosomes are affected. Today, fertility specialists may suggest additional genetic screenings for birth defects throughout your pregnancy if you transfer a mosaic embryo, although at this time evidence-based guidance is lacking. An amniocentesis, a procedure used to take a small sample of amniotic fluid from the uterus to test cells directly from the fetus is the gold standard for prenatal follow up tests (2). This fluid surrounds the fetus during pregnancy and can provide powerful information about the baby's health. Remember, it is important to discuss with your doctors the risks associated with amniocentesis. Risk of Miscarriage or Genetic Disorders The main cause of failed pregnancy or a miscarriage in both natural conception and assisted reproductive technology is an aneuploid embryo (3). This occurs at the first stage of fertilization, known as meiosis. Even if an embryo starts off as genetically euploid, as it continues to multiply, divide, and grow, there is a risk for abnormalities that rise to a mosaic embryo. "Compared to euploid embryos, mosaic embryo transfer (MET) has also been shown to be associated with increased risk of miscarriage in multiple studies" (4). Should You Consider Transferring a Mosaic Embryo? Deciding whether to transfer a mosaic embryo is a deeply personal decision and should be made in consultation with your fertility specialists and genetic counselor. To help you with this decision, here are a few things you could consider when making a decision: How many available embryos are there? If you only have mosaic embryos available or if you have a few euploid embryos, you might consider transferring a mosaic embryo, especially if the mosaicism involves a low percentage of abnormal cells. Type of Chromosomal Abnormality Some chromosomal abnormalities are less likely to result in severe outcomes than others. Your fertility clinic and genetic counselor can provide more detailed information on the specific abnormalities detected. Personal and Ethical Considerations Some individuals and couples may feel more comfortable only transferring embryos with a higher chance of being chromosomally normal. Others may be willing to take the risk if mosaic embryos are the best option of achieving a pregnancy. Take the time to talk through this important component. Cost and Availability of PGT-A The cost of PGT-A and the potential need for additional IVF cycles if mosaic embryos are not transferred can also play a role in the decision-making process. Make sure to talk to your fertility care team and try to determine what you can afford, what may be covered, and your chances of needing to do additional cycles. What Does the Future Hold for Mosaic Embryos? The field of reproductive medicine is quickly evolving and research into mosaic embryos is ongoing. New studies are helping us understand more about the potential outcomes of transferring mosaic embryos and this knowledge may lead us to more refined guidelines and better predictions of success. Currently, many clinics are cautiously optimistic about the potential of mosaic embryos. As testing methods improve and more data becomes available, the ability to counsel patients on the risk and benefits of transferring mosaic embryos will become even more precise. We Are Here to Help The discovery of a mosaic embryo can be both hopeful and a challenging moment in your fertility journey. It is important to stay informed, ask questions, and work closely with your medical team to make the best decision for you. Every single fertility journey is unique and with the right support and information, you can make choices that align with your values, needs, and goals. If you want someone to help you better understand your options, assist in creating questions or resources so you feel more confident in your understanding of your embryos, or simply want someone to talk to you, Grain Fertility Patient Empowerment Coaches are here to answer your questions. If you are a new member, simply go to www.grainfertility.com/signup to create your account and schedule an initial consultation appointment with one of our Empowerment Coaches. If you are using the free version of our app and want to take advantage of our Premium Member benefits including custom guides and one on one coaching, you can go to your Account to upgrade your service today and begin meeting with our coaches regularly. Citations Greco E., Greco PF, Listorti I, et al. The Mosaic Embryo: what it means for the doctor and the patient. Besser, Andria G et. al. Evidence-based management of preimplantation chromosomal mosaicism: lessons from the clinic Hassold T., Hunt P. To err (meotically) is human: the genesis of human aneuploidy Munne S., Spinella F., Grifo J., Zhang J., Beltran M.P., Fagouli E. Fiorentino F. Clinical outcomes after the transfer of blastocysts characterized as mosaic by high resolution Next Generation Screening- further insights.
- Progesterone in Oil: Making Shots Less Painful
Whether it's your first time or you are a seasoned pro, the progesterone in oil (PIO) shot is often one of the most dreaded parts of the IVF process. But don't worry- you've got this! And if you are feeling a bit anxious, our Patient Empowerment Coaches (PECs) are here to help. Why does the PIO shot get such a bad reputation? Big Needle: The PIO shot uses the largest needle among all IVF injections Thick Medication: The oil-based medication is thick, so it takes longer to inject Intramuscular Injection: PIO shots are injected into the muscle of your buttocks, rather than the fatty tissue, making it more painful. Quick Tips to Make the Process Earlier: Warm Up the Vial Pro-Tip: You can rub the vial between your hands. The friction creates the right amount of heat to thin the medication, making it a little easier to inject. Warning: Don't use a microwave or submerge the vial in warm water as this could affect the medication's effectiveness. Have an Injection Buddy Having a partner or friend to administer the shot can be a huge help. It's challenging enough to give yourself an injection, especially from behind. An injection buddy can ensure you hit the right spot. You can also look to see if there are local services or nurses that will help you administer shots. If you need help finding someone qualified and can trust, our Patient Empowerment Coaches can help you find someone local! Confirm the Spot Injecting into the wrong area is far from ideal- PIO must be injected into the muscle of the buttocks for maximum absorption. To find the right spot, place your hands on your buttocks and feel where the back pocket of your jeans would be. The ideal injection location is where the upper outer corner of the pocket would be. Still need help? Talk to your nurse in person or schedule a call with a Patient Empowerment Coach who can help show you exactly where to inject. Relax- Don't Flex Your Buns Laying down on your stomach helps ensure your glutes aren't flexing. Staying relaxed will make the shot less painful. Remember to breathe in and breathe out. Apply Warmth at the Injection Site After injecting, use a warm compress can help the oil absorb better. Simply soak a washcloth in warm water and place it on the injection site. Massage the Injection Site Massaging the injection site for a few minutes afterward will help break up the oil and increase absorption into the muscle. Alternate Sides Switching which glute you inject each time helps reduce the risk of swelling and soreness. Additional Resources to Help! Registered nurse, fertility patient, and founder of 412 Fertility , Megan Kukic, wrote another blog post with tips, tricks, and techniques to help make shot administration a little easier. You can read the post here . We also know shot administration can be overwhelming and are proud to partner with MyVitro, a medication organizer for IVF and other fertility treatments. You can go to their site and get $10 off your order with the promo code Grain to help organize your shots and make them a little less overwhelming. Finally, our Patient Empowerment Coaches are here to help with any questions you may have. New Premium Members get a 30 minute call with our Head of Patient Empowerment, Kimberly Schamroth, RN, to better understand your journey. You can sign up for an account today at https://app.grainfertility.com/signup .
- A Guide to Starting Your Fertility Treatment Journey
Embarking on your fertility treatment journey can be both hopeful and overwhelming. When founder Joe Cody and his wife were starting their own journey, they didn't know where to start or what to expect. As a fertility nurse and Head of Patient Empowerment for Grain Fertility, we created this guide to help you through the initial steps of your journey and give you a better idea of what to expect and how to prepare for this significant phase in your life. Phase 1: Initial Consultation Your journey will begin with an initial consultation with a fertility specialist, which includes: Medical History : Be prepared to discuss your medical history, lifestyle, and any previous fertility issues you have had. It is also important to discuss the history of your partner as well to ensure any other issues that could contribute to infertility can be addressed. Diagnostic Testing : Your doctor and care team may recommend tests such as blood work, ultrasounds, semen analysis for male partners, and other assessments to identify potential fertility problems. Treatment Plans : Based on the results, your specialist will outline a personalized treatment plan. This can include everything from lifestyle changes, medications, or more advanced procedures like IUI (intrauterine insemination) or IVF (in vitro fertilization). Step 2 Understanding Your Options There are various treatments available, and understanding each an help you make informed decisions. You should discuss all options available to you in detail with your doctor, factoring in your age, medical history, partner's history (if applicable), and your financial situation. Medications : Fertility drugs like Clomid or injectable hormones stimulate ovulation. IUI : During an IUI procedure, sperm is placed directly into the uterus around the time of ovulation. IVF : During an IVF cycle, eggs are stimulated with injectable hormones and then are retrieved from the ovaries, fertilized in a lab, and the resulting embryo(s) are transferred to the uterus or stored for future use. Other treatments : Depending on your diagnosis and other factors, options like egg or sperm donation, surrogacy, or surgery may be discussed. Step 3: Preparing for Treatment Once you and your doctor agree on a treatment plan, preparation is crucial: Emotional Readiness : Infertility treatment can be emotionally taxing. Our Patient Empowerment Coaches are here to support you throughout your journey. Financial Planning : Unfortunately, fertility treatments are often not covered by insurance and are costly. It is important to understand and plan for the costs associated with your treatment plan and explore the best options for you. Our team is here to discuss options that may work best, help you understand how to maximize your existing benefits, and work to ensure you are not caught of guard by unexpected expenses. Lifestyle Adjustments : Adopting a healthy lifestyle can improve your chances of success. Focusing on a balanced diet, regular exercise, reducing alcohol and caffeine intake, and quitting smoking can all help. Grain Fertility is proud to partner with people who can help address these needs. Step 4: Treatment Depending on your treatment plan, a typical cycle involves several stages: Monitoring : Regular blood tests and ultrasounds monitor your body's response to medications and track ovulations. Your doctors will use these appointments to track your progress and make adjustments to maximize your chances of success. Procedure : IUI's are a more simple procedure that places sperm in the uterus while IVF procedures such as egg retrievals and embryo transfers are more involved procedures that require sedation. Post-Procedure : Depending on the treatment you received, you will receive designated instructions to follow to optimize your recovery. Your doctor may schedule follow-up appointments to monitor your progress. Our Patient Empowerment Coaches can meet with you throughout your treatment to ensure you understand all of the aspects of your own journey and are as prepared as possible. Step 5: The Two Week Wait After treatment, you will enter whats known as the two week wait (TWW) before taking a pregnancy test. This is often an emotionally overwhelming time for patients, but we have a few suggestions to make it easier. Self-care : Focus on self-care activities to manage your stress and take your mind off as best you can. Staying active with gentle exercises, maintaining an healthy diet, meditating and/or journaling can all help. Avoid Early Testing : This is really hard but it is important to wait for the scheduled blood tests to confirm a pregnancy. Home tests can lead to false positives or negatives due to lower sensitivity levels, which can cause unnecessary anxiety. We know this is harder done than said so our Coaches are here to help talk through any anxiety you may have. Spend Time with Loved Ones : Fertility treatment is incredibly personal and often we don't share a lot with our friends and family. However, bonding with your good friends and family can improve your mood and decrease stress. It is important to surround yourself with a positive support system, especially during the two-week wait. But, if you feel like it is too much to be around people, it is also ok to take time to yourself and honor what you think is best. We know it can be anxiety inducing to be around other people, especially if they have children. Step 6: Results and Next Steps Your fertility clinic will schedule a blood test to determine if this cycle was successful. While it is hard to not think of these results in absolute terms, it is important to remember that it often takes more than one try. Positive Results : If you are pregnant, your doctor will discuss the next steps for monitoring and supporting the early stages of your pregnancy. Negative Results : If the treatment was not successful, your doctor and care team will review what happened and discuss the next steps, which may include adjustments to your protocol or exploring other options. No matter the outcome, our Patient Empowerment Coaches are here to help and can help you determine your next steps. Starting the infertility treatment journey is a significant step towards achieving your dream of parenthood. With the right information, support, and preparation, you can navigate this journey with confidence and hope. Remember, your health care team is here to support you every step of the way. We are happy to help in any way we can. If you are looking to explore fertility options further and gain a better understanding of the fertility treatment process, our Patient Empowerment Coaches are here to help. Our coaches are trained fertility nurses with years of experience and Grain Fertility is here to help empower you through your journey. You can sign up for Grain Fertility and meet with our team with a risk-free initial consultation by signing up here . If you are using our free version of the app, you can go to your Account to upgrade your service today and begin meeting with our coaches regularly.
- Coffee, Fertility, and Pregnancy: A Guide
Many people rely on coffee to start their day, but if you are trying to conceive or are pregnant, you may wonder whether it is safe to consume caffeine. This resource discusses the relationship between coffee, fertility, and pregnancy outcomes. It contains excerpts from our Caffeine and Fertility guide available to our Premium Members. What is caffeine? First, it is important to know what caffeine is. It is a natural stimulant found in coffee, tea, soft drinks, energy drinks, chocolate, and some medications. Potential benefits of caffeine include: Stimulating the nervous system: increasing alertness and energy Enhancing cognitive functions: improving memory, mood, and general cognitive functions Physical performance: boosts endurance and performance in athletes Antioxidant properties: it contains antioxidants that combat oxidative stress and inflammation. Potential risks of caffeine include: Sleep disruption: it can lead to insomnia or disrupted sleep patterns if consumed late in the day Dependence and withdrawal: regular use can lead to dependance and stopping suddenly can cause withdrawal symptoms such as headaches, irritability, and fatigue Health health: high consumption may Increase heart rate and blood pressure, which can be problematic for Individuals with cardiovascular conditions Digestive issues: it can cause gastrointestinal discomfort such as acid reflux or upset stomach Dehydration: caffeine acts as a diuretic, which can contribute to or cause dehydration Caffeine and Fertility Most research does not conclude that caffeine is unsafe for pregnancy, but it is recommended to limit intake to 200mg per day. There are some historical concerns, including a 1998 study that suggested women who drank coffee had lower conception rates, but subsequent studies have not confirmed this finding. No conclusive evidence indicates caffeine affects the ability to become pregnant or the time to conception. However, excessive intake (300 mg or more) has been linked to higher miscarriage rates. Caffeine and Pregnancy When you are pregnant, your body metabolizes caffeine slower than non-pregnant women. Caffeine may also increase nausea and dizziness during a pregnancy. Caffeine can also contribute to hypertension (high blood pressure) and tachycardia (a sped up heart rate). This occurs when caffeine crosses the placenta and can increase catecholamines (a neurohormone important in stress responses), potentially raising your blood pressure and heart rate. Recommendations People always want to know what they can or should do to limit the impact caffeine can have as they try to conceive or are pregnant without having to give up their morning cup of coffee to get the day started. It is recommended that you do not exceed 200mg of caffeine per day to mitigate the chance of complications. Below are a few common drinks caffeine content to help you decide what you should or should not have: Drip Coffee: 95 mg per 8 oz Starbucks Pike's Place: 235 mg for a tall coffee (12 oz) Espresso: 63-75 mg per shot Latte/ Cappuccino/ Americano: 75 mg for a tall or 12 oz coffee Cold Brew: 200mg for a tall or 12 oz coffee Decaf Coffee: 2-5 mg per 8 oz Starbucks Earl Grey Tea: 40 mg Green Tea: 55 mg per 12 oz Conclusion Balancing your caffeine intake is important while trying to conceive and during pregnancy. You can enjoy your coffee in moderation, adhere to the recommended limits, and always consult with your healthcare team if you have any concerns. If you are interested in learning more about the impact coffee and caffeine can have or want to become a Grain Fertility member to get a more comprehensive version of this resource, you can sign up here or, if you are a member using our free version, go to Your Account to upgrade your service today!
- PCOS: Understanding the Basics
PCOS, short for Polycystic Ovarian Syndrome, stands as one of the most prevalent hormonal disorders affecting females of reproductive age on a global scale (1). It is a metabolic dysfunction of the ovaries that impacts approximately 5% to 15% of women worldwide. In this blog post we will dive into what PCOS is, its potential causes, common symptoms, diagnosis, and available treatment options to help individuals navigate this often complex and misunderstood condition. What is PCOS? According to the World Health Organization, PCOS is a hormonal condition that can cause hormonal disturbances, irregular periods and multiple cysts in the ovaries. The Science Behind PCOS Let us back track a bit. Women are born with all of the eggs they will ever have. The greatest number of eggs one would have is before they are born, at 20 weeks gestation (approximately 6 to 7 million). This number drops significantly at birth to 1 to 2 million and continues to decline from infancy all the way through menopause. Eggs within the ovary undergo growth and development in response to a cascade of hormonal fluctuations across the body. The brian communicate with the ovaries, prompting growth and maturation of a follicle- a fluid-filled sac housing an egg. Upon reaching optimal size, the brain triggers the ovary to release the egg, a process known as ovulation. In PCOS, hormonal communication is disrupted, resulting in irregular or absent periods. Follicle Stimulating Hormone (FSH) is dispersed among multiple follicles, impeding the proper growth and development of individual follicles. Consequently, the failure of one egg to mature and release occurs, which is crucial for conception. These accumulating follicles in the ovaries manifest a distinctive appearance on ultrasound imaging, this leading to the term "polycystic" ovary syndrome. What Causes PCOS? The exact cause of PCOS remains unknown, but several factors may contribute to its development, including: Hormonal Imbalances Fluctuations in insulin and androgen levels can disrupt the normal function of the ovaries and lead to the symptoms associated with PCOS. Genetics PCOS tends to run in families, suggesting a potential genetic predisposition to the disorder Insulin Resistance Many women with PCOS also have insulin resistance, a condition where they body's cells do not respond effectively to insulin, leading to elevated insulin levels PCOS Symptoms PCOS symptoms can often be overlooked due to their nature, but it is important to watch for and document these symptoms if you suspect you have PCOS. Symptoms include (2): Missed periods, irregular periods, or very light periods Ovaries that are large or have many cysts Extra body hair, including the chest, stomach or back Weight gain, especially around the belly Acme or oily skin Male-pattern baldness or thinning hair Infertility Small pieces of extra skin on the neck or armpits, also known as skin tags Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts Diagnosing PCOS If you suspect you may have PCOS, it is important to speak with your OBGYN or Fertility specialist. Your doctor will be able to order the appropriate tests to evaluate if you have PCOS and then would be able to curate a treatment plan to help restore hormonal equilibrium. Because PCOS is a cluster of symptoms and it is not a one-size-fits all, it may look different to you than to someone else. PCOS is diagnosed based on the presence of two out of the three following: Irregular/Absent Menstrual Cycle Cycles exceeding 35 days or no menstrual cycle at all Elevated Androgen Levels Blood tests revealing increased levels of testosterone Typically women with elevated testosterone present with increased facial hair, male pattern baldness, acne, and increased abdominal fat Polycystic Ovaries on an ultrasound scan An OBGYN would be able to evaluate these signs/ symptoms through a set of blood tests and an ovarian ultrasound. It is possible for your OBGYN to conduct further diagnostic tests to rule out other potential conditions that may mimic PCOS, such as hypothyroidism, hyperprolactinemia, and nonclassical adrenal hyperplasia. Other abnormal hormonal lab values that could be tested include: Estrogen Luteinizing Hormone (LH) Insulin Anti-Mullerian Hormone (AMH) Treatment Options for PCOS While there is no cure for PCOS, various treatment options are available to help manage symptoms, improve reproductive health, and reduce the risk of long-term complications. These include: Lifestyle Modifications to reduce stress and inflammation throughout your body Diet: the Mediterranean Diet has gained popularity as a means to manage PCOS due to its anti-inflammatory properties and reduction of chronic inflammation (3). This includes foods such as health fats like olive pils, walnuts, and full fat cheeses. You can also increase protein intake with salmon and reduce red meat consumption. Sleep: aim for 7 to 8 hours a sleep Exercise: moderate cardio and strength training is ideal to build and strengthen your muscles. However, it is not necessary to stress out your body with high intensity interval training workouts. Acupuncture Therapy/Mindfulness Medications can help regulate your hormones and reduce symptoms and restore your menstrual cycle Hormonal birth control may be used if you are not trying to conceive. If you are trying to conceive, your doctor may try to trigger ovulation induction. Women with PCOS have a hormonal imbalance. The brain is releasing too little FSH for the amount of follicles that are available inside the ovary. This prevents an egg from growing and developing. The goal is to increase FSH production for an egg to grow and eventually ovulate. Medications include Clomid, which tells the brain there is not enough estrogen and increases FSH production and Letrozole, which eats up estrogen throughout the body, signaling the brain to release more FSH. Fertility Treatments and PCOS For individuals struggling with infertility due to PCOS, there are a number of options available. In addition to the ovulation induction medications listed above, a fertility specialist may advise assisted reproductive technologies such as intrauterine insemination or in-vitro fertilization (IVF). If you suspect you may have PCOS and you are experiencing symptoms associated with PCOS, it is crucial to meet with a medical professional for a thorough evaluation, timely diagnosis, and personalized treatment recommendations tailored to meet your individual needs and concerns. Take the time to track and document your symptoms as these are important factors your doctors will consider when deciding next steps including testing and diagnosis. There is a wealth of information to explore regarding PCOS and its influence on reproductive health. If you're seeking personalized guidance, our Patient Empowerment Coaches can help. Through our Grain Fertility Premium Member Program, you can benefit from one on one support to address all of your questions and concerns. We can help you track your symptoms, prepare for appointments, and answer questions you may have. Do not hesitate to reach out and take proactive steps towards managing your PCOS and optimizing your reproductive well-being. Your journey matters to us and we are committed to empowering you every step of the way. Citations: https://www.ncbi.nlm.nih.gov/books/NBK459251/ https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos Barrea L, Arnone A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C, Pugliese G, Colao A, Savastano S. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients. 2019 Sep 23;11(10):2278. doi: 10.3390/nu11102278. PMID: 31547562; PMCID: PMC6836220.
- Five Things You Should Know After IVF Using A Sperm Bank or Egg Donor
Every year, thousands of intended parents use donated sperm or eggs to help them achieve their dream of having a child. The decision to use donated sperm or eggs often does not come easily and can have implications that are important for consideration. To help intended parents think through these implications, we are proud to feature a guest blog by Dylan Stone-Miller. Dylan is an advocate for the donor-conceived community after becoming a known donor to a sibling pod of now 46 children and their families and is founding executive director and CTO of DCPData. You can learn more about DCPData at https://www.dcpdata.org/ IVF is a journey filled with hope, anticipation, and crucial decisions, especially when using a sperm bank or egg donor. While the focus often remains on the procedure and the joyous outcome of having a child, it is equally important to understand what comes after IVF. Here are five critical aspects to consider: 1. Your Child May Have Siblings Worldwide One of the lesser-known realities of using a sperm or egg donor is the potential for your child to have numerous siblings around the globe. In the United States and Canada there are no legal limits on the number of families that can select the same donor, and major cryobanks distribute their donor's gamete internationally, so even those in countries with legal limits may not actually remain within those legal limits globally. This can result in your child having many half-siblings, a phenomenon that can have both positive and challenging implications. Implications: Emotional and Psychological Impact: There is a correlations between connecting with siblings and feeling positive about being donor-conceived . A sense of curiosity and excitement about meeting their siblings can turn to a sense of loss if they are not introduced to them. Risk of Consanguinity: When the children grow up and join the dating pool, having a large and likely unknown number of siblings means there is a risk they might accidentally couple , particularly with ineffective tracking of births in some countries. 2. Limited Access to Updated Medical History When you choose a sperm or egg donor, you typically receive a medical history that pertains to the donor and their immediate family at the time of the donation. Unfortunately, this information can be outdated, incomplete, or inaccurate. The absence of updated medical histories can compromise the health of your child, making it difficult for doctors to diagnose or anticipate medical conditions. Implications Diagnostic Difficulties: Without accurate genetic information , doctors might struggle to diagnose hereditary conditions. Potential Health Risks: Unforeseen medical issues could arise if critical genetic information is unknown . 3. Navigating the Conversation About Conception A pivotal moment for parents of donor-conceived children is explaining how they were conceived. Children naturally have questions about their origins and how you handle these questions can significantly impact their sense of identity and well-being. Using an anonymous donor or even an Open ID Donor can complicate these conversations, leaving children with unanswered questions and more. Considerations: Openness and Honesty: Being transparent with your child from an early age helps build trust and has a positive impact on their mental health . Support Resources: Utilize resources and counseling services to navigate these conversations effectively. 4. Connecting with Other Families Deciding whether to connect with other families who used the same donor is another important consideration. These connections can be beneficial for your child, providing them with a broader sense of family and support network. There are various platforms available, such as DCPData , the Donor Sibling Registry , and Facebook groups, which facilitate these connections. Considerations: How to Facilitate Connections: Connecting with other families can provide shared experiences and mutual support. Which online platform allows for the most secure and robust connections ? How might you broach the topic of connection with the other families? Structure of the Connections: Will the relationship take the form of an online interactions, in-person, or a hybrid of the two? The earlier the introductions the better, but be sure to manage your child's expectations and budget for travel if you choose to have in-person relationships between the children, which adult donor-conceived people have unequivocally said is important to them . 5. Managing Extra Embryos or Gametes Post-IVF, you may have extra leftover embryos or gametes. Deciding what to do with these can be emotionally taxing. Options include donating them to other families , participating in a cyrobank's buyback program , or destroying them. Each option comes with its own set of emotional and ethical considerations. Options: Donation or buyback: This increases the number of donor siblings, which may have implications for your child. Destroying Extra Embryos: Deciding to destroy unused embryos or gametes can be difficult. Storage Costs: Long-term storage of genetic material can be expensive. Preventing and Mitigating Issues While the post IVF journey with a sperm bank or egg donor comes with unique challenges, there are steps you can take to prevent or mitigate issues. Key Preventative Measures: Ask the Right Questions: Inquire about how the sperm bank or egg bank ensure adherence to advertised family limits. Even if they have limits that they or an outside entity enforces, consider how the lack of an international regulatory body means the true limit is the combined limits of each country that imported the donor's genetic material Understand how they verify and update donor's medical histories over time if they are not legally required to do so. Leverage Resources: USCDD , DC UK , and DC Aotearoa are organizations that offer resources and support for donor conceived families Join DCPData to access up-to-date medical histories from participating donors and donor-conceived families and connect with other families who used the same donor. Educate and Prepare: Stay informed about the implications of using donor gametes and the potential challenges that may arise. Consider professional counseling to help navigate the emotional and psychological aspects of donor conception. By taking proactive steps and utilizing available resources, you can navigate the complexities of IVF using a sperm bank or egg donor with confidence and ensure the best possible outcomes for your family. Remember, while the journey may be complex, it is also filled with opportunities for growth, connection and profound love.
- Ovulation Predictor Kits: What You Need to Know
Ovulation Predictor Kits (OPKs) are at-home fertility tests designed to detect a surge in luteinizing hormone (LH) levels in urine, which typically occurs 36 hours before ovulation. By identifying the LH surge, OPKs help individuals predict and pinpoint the most fertile days within their menstrual cycle, optimizing the timing for conception. This post helps you understand how OPKs work and how to use them. How Ovulation Predictor Kits Work OPKs operate by detecting the presence of luteinizing hormone (LH) in urine. LH, a hormone produced by the anterior pituitary gland, plays a crucial role in ovulation. The LH surge facilitates the release of the egg from its follicle by enhancing enzyme activity, which breaks down the follicle's wall to allow the egg's passage. Subsequently, the mature egg is released from the ovary into the fallopian tube, where it awaits fertilization. Additionally, LH prepares the uterus for potential implantation of a fertilized eg by stimulating the release of progesterone post-ovulation, creating an optimal environment for embryo attachment (1). How to Use OPKs OPKs are pretty straightforward and user-friendly. They can be found over the counter at your local pharmacy or purchased online. They normally come as test strips or sticks. To test for an LH surge, it is best to test your urine first thing in the morning on the days leading up to the days you may ovulate. For the average person who has a 28 day cycle, ovulation will often fall out between day 12-16. It is best to begin to test for an LH surge starting on day 10. NOTE: It is important to keep in mind not everyone has a 28 day cycle and a "regular" cycle may vary from 24 to 35 days. Step by Step Instructions It is important to always follow the instructions of the specific OPK you are using, but here are some general tips and instructions for using OPKs. Early morning is the optimal time to test for urine LH. This is when it will be more highly concentrated. It is essential to test at the same time each day and avoid excessive fluid intake a few hours before testing to ensure more accurate results. You can either hold the strip or stick under a stream of urine or place it in a sample cup However, it is important to make sure the container is sterile. After waiting the designated period of time (usually a few minutes), read the test results by comparing the color or lines on the test strip or stick to the control line(s) and test line(s) indicated on the package. The results will inform you if there is LH presence in the urine. Ovulation typically occurs within 24 hours of an LH surge, which is the green light to be sexually active to optimize your chances of conceiving. However, it is important to remember a positive OPK result does not guarantee ovulation and a negative test does not mean always mean you will not ovulate. If you are trying to avoid conception, make sure to use any form of contraception during your fertile window. Hormonal fluctuations, irregular cycles, and other factors can affect OPK results and ovulation. Benefits of Using OPKs OPKs offer a convenient and affordable way to monitor and track ovulation at home without the need for invasive tests or procedures. By detecting the LH surge and predicting ovulation, OPKs help individuals identify their fertile days and optimize the timing for conception, increasing the chances of achieving pregnancy. Considerations When Using OPKs OPKs are most effective for women with regular menstrual cycles. Women with irregular cycles, hormonal imbalances, or underlying fertility issues may experience unreliable results with OPKs. It is essential to use OPKs in conjunction with other fertility tracking methods and consult with a healthcare provider for personalized guidance, evaluation, and support when trying to conceive. Working with a Patient Empowerment Coach at Grain Fertility can offer invaluable support and guidance, especially when tracking ovulation. They can help you find the best OPKs to use to help you become familiarized with your cycle. They are here to ensure you receive timely, appropriate, and individualized support and guidance throughout your ovulation tracking and fertility journey. If you have any further questions or need assistance, don't hesitate to reach out to your Patient Empowerment Coach. We can help you track your cycles, develop questions for your care team, and help explain the confusing parts of your journey. If you are not a Grain Fertility Premium Member, you can sign up here or if you are a member using our free version, go to your Account to upgrade your service.
- Understanding Uterine Polyps and Fibroids
Both fibroids and polyps are growths that can develop within the uterus, but differ in terms of their composition, location, symptoms, and potential health risks. Understanding the difference between polyps and fibroids can help you make more informed decisions about your health and treatment options. In this blog post, we'll explore the key distinctions between these two types of uterine growths and how they may impact your fertility. What Are Polyps? Uterine Polyps are small, benign (non-cancerous) growths that develop within the inner lining of the uterus, also known as the endometrium. These growths are typically composed of endometrial tissue and can vary in size, ranging from a few millimeters to several centimeters. While polyps tend to be non-cancerous, they have the potential to become cancerous, specifically in post-menopausal women (1). What are Fibroids? Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop from the muscle tissue of the uterus. These growths can very in size, ranging from small, seed-like growths to large masses within the uterine wall (intramural), protrude outward from the uterus (subserosal), or attach to the inner lining of the uterus (submucosal). Key Differences Between Polyps and Fibroids Composition Polyps are made of endometrial tissue Fibroids are made of muscular tissue Location Polyps are located in the Endometrium Fibroids can be located throughout the uterus Size Polyps are small in size Fibroids are large in size Symptoms Polyp symptoms can include bleeding, irregular cycles, and infertility Fibroids symptoms can include bleeding, prolonged periods, pelvic pain, frequent urination, and constipation Risk of Cancer Polyps are often benign, however there is a small risk of malignancy (presence of cancer) Fibroids are benign in nature Diagnosis and Treatment Both polyps and fibroids can be diagnoses through imaging tests such as ultrasound, MRI, or hysterectomy. Treatment options may vary depending on the size, location, symptoms, and individuals overall health. Options include watchful waiting, medications, minimally invasive procedures, or surgical removal. Surgical Methods of Treatment Polyps can be removed with a polypectomy Uterine fibroids can be removed surgically with a myomectomy, also known as a "fibroidectomy." Both procedures may be performed either by a gynecological surgeon or a reproductive endocrinologist. Impact on Fertility While many women with polyps and fibroids may conceive and have successful pregnancies, these uterine growths can sometimes interfere with fertility and reproductive health. How Polyps Impact Fertility Disruption of Implantation The mechanism by which polyps interfere with implantation is unclear (2), however studies suggest polyps may cause inflammation similar to an Intrauterine Device creating a suboptimal environment for implantation and fetal development. Biochemical Effects The presence of uterine polyps may increase the presence of inflammatory markers causing an imbalance in the environment of the endometrium (3). Mechanical Obstruction In rare cases, large polyps may obstruct the fallopian tubes or cervix, preventing the sperm from reaching the egg and fertilization from occurring (3). How Fibroids Impact Fertility Fibroids are present in 5-10% of women struggling with infertility (4). Fibroids impact fertility by: Distorting the Uterine Cavity Fibroids can alter the shape and size of the uterus, potentially affecting the sperm's ability to reach the egg, the implantation of a fertilized egg, or the growth and development of the fetus during pregnancy. It is important to note that where a fibroid is situated impacts embryo transfer outcomes (5). Limited Blood Supply Large fibroids may interfere with the blood supply to the uterine lining, affecting its thickness and receptivity, which can impact implantation and increase the risk of miscarriage. Compression of Fallopian Tubes Subserosal or intramural fibroids may compress or distort the fallopian tubes, preventing the egg from traveling to the uterus and decreasing the chance of fertilization. Discussing With Your Doctor If you suspect that polyps or fibroids may be contributing to your struggle to conceive, it is important to discuss your concerns with you OBGYN and/or fertility specialist. It may be overwhelming and you may feel unsure where to begin. This is where we can help. Here are a few tips to help. Track Your Symptoms It is important to log any symptoms you are experiencing in detail, such as: Detailed description of symptoms How long the symptoms last Write down when they began and keep track of how long they last How intense your symptoms are Questions to Ask Your Doctor Ask your doctor to differentiate what is normal and what is not. It is important to be forceful In explaining if something doesn't feel right. Remember, severe pain or other symptoms that impacts your daily life is not normal and should be communicated to your doctor rather than just dismissed What will happen if you do not seek treatment? What are the least Invasive to most Invasive treatment options available? How long will take me to recover from each treatment and proceed to accomplish my fertility goals? The good thing is you can use the Grain Fertility application to keep all of this in one place. Capturing Your Medical History The Grain Fertility application lets you upload and track any testing, results, or diagnosis from any of your doctors so you always have accurate, timely information available to help you and your doctor accurately discuss your history. Using Ongoing Tracking Features The ongoing tracking feature in the application lets you write down your signs and symptoms, capturing in real time what you are feeling so you can accurately convey them to your doctor. You can also use this as a way to write down questions you have before any appointments. Patient Empowerment Coaching If you have any further questions or need assistance, don't hesitate to reach out to your Patient Empowerment Coach. We can help you create a customized set of questions, track your symptoms, and help explain the confusing parts of your journey. If you are not a Grain Fertility Premium Member, you can sign up here or if you are a member using our free version, go to your Account to upgrade your service. Our coaching can offer personalized advice and support tailored to your specific needs and circumstances. Trust in their expertise and lean on them for assistance whenever needed. With proper preparation and support, you can navigate the fertility treatment process with confidence and peace of mind. Early detection and intervention can help optimize your fertility outcomes, enhance your reproductive health, and increase the chances of achieving a successful pregnancy. Managing polyps and fibroids alongside the daily challenges of your fertility journey can indeed be daunting. Rest assured, our Patient Empowerment Coaches and staff at Grain Fertility are dedicated to guiding and supporting you through every phase of your journey. References: Wong M, Thanatsis N, Nardelli F, Amin T, Jurkovic D. Risk of Pre-Malignancy or Malignancy in Postmenopausal Endometrial Polyps: A CHAID Decision Tree Analysis. Diagnostics (Basel). 2021 Jun 15;11(6):1094. doi: 10.3390/diagnostics11061094. PMID: 34203810; PMCID: PMC8232598. Jee BC, Jeong HG. Management of endometrial polyps in infertile women: A mini-review. Clin Exp Reprod Med. 2021 Sep;48(3):198-202. doi: 10.5653/cerm.2020.04119. Epub 2021 Jul 30. PMID: 34352167; PMCID: PMC8421660. Nijkang NP, Anderson L, Markham R, Manconi F. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med. 2019 May 2;7:2050312119848247. doi: 10.1177/2050312119848247. PMID: 31105939; PMCID: PMC6501471. Guo XC, Segars JH. The impact and management of fibroids for fertility: an evidence-based approach. Obstet Gynecol Clin North Am. 2012 Dec;39(4):521-33. doi: 10.1016/j.ogc.2012.09.005. PMID: 23182558; PMCID: PMC3608270. Ezzati M, Norian J, Segars J. Management of uterine fibroids in the patient pursuing assisted reproductive technologies. Women's Health (Lond Engl) 2009;5:413–21
- Navigating LGBTQ+ Family Planning and Fertility
Insights from a Fertility Nurse & Patient Empowerment Coach If you're reading this, chances are you're exploring the wonderful world of family planning within the LGBTQ+ community. As a fertility nurse, I've had the privilege of working with individuals and couples from all walks of life, including those who identify as LGBTQ+. At Grain Fertility, we strongly believe everyone is entitled to grow the family of their dreams and families are not one-size-fits-all. The path to parenthood in this community is nothing short of remarkable and while often people do not know where to begin, we are here to guide you through the process. First things first, let's debunk a common myth that family planning and fertility treatments are just for heterosexual couples. That could not be more than false! LGBTQ+ individuals and couples have every right to pursue their dreams of parenthood. Here at Grain Fertility, we want to help you make those dreams a reality. No matter your race, religion, sexual orientation, or identification, Grain Fertility can provide you with the organizational tools and fertility navigation services you need to help you through your own journey. Assisted Reproductive Technology for the LGBTQ+ Community The path to parenthood in the LGBTQ+ community is commonly achieved via assisted reproductive technology (ART). Whether it's through intrauterine insemination (IUI), in vitro fertilization (IVF), or surrogacy, there are a myriad of options available to help LGBTQ+ individuals and couples conceive. Let's not sugarcoat it; the road to parenthood for LGBTQ+ individuals and couples can come with its fair share of challenges. From navigating legal hurdles and escalating expenses to facing societal stigma, there are obstacles that must be overcome. As a fertility nurse and a Grain Fertility Patient Empowerment Coach, part of my role is to provide not only medical education but also emotional support every step of the way. One of the things I love most about my job is the opportunity to educate and advocate for my patients. Whether it's explaining the ins and outs of ART procedures or connecting patients with resources within the LGBTQ community, I'm here to empower individuals and couples to make informed decisions about their family-building journey. A growing number of same-sex couples are turning to Assisted Reproductive Technology to have children. However, there are a number of factors to consider, including: Same-Sex Females For women who are considering ART for their family building, it is important to consider several questions when exploring fertility options, including: How will you find a sperm donor (either known or anonymous); and Is either partner is interested in carrying the pregnancy or will you use a surrogate? Same-sex femals have several options for assisted reproduction, including: Intrauterine Insemination (IUI) An IUI is a fertility procedure in which donor sperm would be inserted into the patient’s reproductive tract by the means of a catheter. This is done at your fertility doctor’s office while you are awake and can be slightly uncomfortable. Before the IUI, you may need to visit the fertility clinic multiple times to monitor the development of the follicles, each containing an egg, in order to time the IUI with ovulation. Reciprocal-IVF Simply put, this option is when one partner’s eggs are used to create an embryo and the other partner carries the pregnancy. Reciprocal-IVF is unique in that it enables both partners to be directly involved in the pregnancy journey. One partner can donate their eggs by undergoing ovarian stimulation and a surgical procedure to extract the eggs from the ovaries. The eggs are then fertilized in the laboratory through the process of IVF create embryos. At this time, the second partner may undergo preparations for the embryo to be transferred into her own uterus. Both procedures will require sperm from either a known donor or an anonymous donor. Both of these procedures will require sperm from either a known or anonymous donor. Same Sex Male Couples For men considering ART for their family building, there are several options, including: The sperm that is used; Either one or both partners are able to provide a sperm sample to fertilize eggs from an egg donor. This enables the offspring to be genetically related if you choose to grow your family with more than one child. By using donor eggs, embryos can be created via the process of in-vitro fertilization and stored for later use. The use of donor eggs to be fertilized with partner’s sperm; and How will you find a surrogate to carry the child? Our friends at Expecting.AI have drafted an amazing resource for intended parents navigating the complexities of third-party reproduction. This can be read here. Single Parents by Choice While Hollywood has sold us on the story that we are all meant to meet Mr. or Mrs. Right, fall in love and have children, that is not always the case. Your relationship status should not be a barrier to parenthood. Thankfully with modern day fertility treatment, there are a number of options for single men and women to become parents. Women: Most common path to parenthood is IUI involving donor sperm The IUI procedure may be done at home, as there are at-home kits to support this, however the majority of the time IUI is performed at a fertility clinic. Unfortunately women exploring this option may be at a later age and therefore may have diminished fertility. Do not despair, the beauty behind fertility is the opportunity to explore egg donation or embryo donation Men: Men who are interested in pursuing the path to parenthood may do so by the means of egg donation and a surrogate. If a man does not want to be genetically connected to his child there is the option for embryo donation or adoption as well. Transgender Men/Transgender Women: Prior to gender affirming hormone replacement therapy and/or surgical intervention, there are options to help set yourself up to be able to have a biological child. Transgender Men: Those born with a uterus and ovaries may consider preserving their eggs prior to gender affirming treatment. Therefore, when they want to grow their family biologically, their eggs may be fertilized with donor sperm and transferred into a gestational carrier’s uterus. Transgender Women: For a man who is transitioning, they have the ability to freeze their sperm before undergoing gender affirming treatment. The sperm may be inserted directly into a uterus via Intrauterine Insemination or sperm may be fertilized to use the embryos in the future via a female partner or gestational carrier. It is important to discuss with your Reproductive Endocrinologist where you are in your journey and provide detailed documentation and records with all of your doctors to ensure you are medically cleared to begin fertility treatments. This is something Grain Fertility can help with, as our organizational tools and timeline feature allow you to record and save your most important health information in one easy to use location. Every Journey is Unique It is important to recognize that every LGBTQ family's journey is unique. What works for one couple may not work for another, and that's okay. As a fertility nurse, I'm here to listen, support, and tailor treatment plans to meet the individual needs of each patient. At the end of the day, LGBTQ family planning isn't just about biology—it's about love, resilience, and the unwavering desire to create a family. Here at Grain Fertility, I, along with our team of Patient Empowerment Coaches, feel incredibly privileged to be a part of that journey. The application is user-friendly and can support anyone embarking on the path to parenthood through fertility treatments. Premium users at Grain Fertility are able to access 1 on 1 coaching sessions, receive discounts with our fertility partners and gain access to exclusive webinars. We are committed to providing compassionate care to all individuals and couples, regardless of sexual orientation or gender identity. So, to all my LGBTQ friends out there who are dreaming of starting or expanding their families, know that you are not alone. With the right support and resources, your dreams of parenthood can become a beautiful reality. We are here each step of the way, cheering you on. If you have any further questions or need assistance, don't hesitate to reach out to us. If you are not a Grain Fertility Premium Member, you can sign up here or if you are a member using our free version, go to your Account to upgrade your service.
- The Egg Retrieval Process: An Overview and Tips from a Fertility Nurse
At Grain Fertility, we are dedicated to providing resources to help patients understand the different parts of the fertility treatment process so they can feel more confident and empowered in their own journey. After all, how can we expect someone to ask informed questions if they are struggling to understand the basics of their care? The egg retrieval represents the culmination of weeks of physical and emotional work and fertility patients often put a lot of pressure on themselves in the build up. To help you feel more confident during your own egg retrieval, maximize your chances of success, and ensure a smooth recovery on the day of the egg retrieval, we have drafted this primer to help provide the support you need: Before the Egg Retrieval: Unfortunately, doctors cannot schedule the precise day of your egg retrieval weeks in advance. Because of this, when starting the ovarian stimulation process, it's crucial to keep several days open in your calendar for potential surgery dates. As much as we would love to have this much control over the schedule and process, unfortunately this is something fertility patients will have to struggle with throughout their journey. While this can be hard, here are some steps to help you plan ahead before your procedure: Keep days 10-14 of your cycle open for potential egg retrieval (keep in mind that this is the average date of retrieval, your retrieval may fall out before or after). You will need to arrange for someone to pick you up and accompany you home. Plan to take off the day of your procedure and reserve work or errands for the following day. It is important to talk to your doctor and care team regularly throughout your cycle to help plan for this. The Day of the Egg Retrieval: Your care team will contact you 1-2 days before your procedure with critical instructions such as: The time to arrive at the surgical site When to stop eating When to stop drinking Specific valuables they recommend that you leave at home Before your procedure, you will meet with your healthcare team, including: The Nurses The Anesthesiologist The Fertility Doctor (note that the doctor of the day may not be the same one you've been working with throughout the process) The Embryologist You may have last-minute questions that are itching to ask your care team. Go for it! They are there to answer all of your questions and make you feel comfortable before the procedure begins. It may be useful to write down questions you have before the appointment so you are organized and don't forget. We know you will have a lot going on and it can be easy for forget something you intended to ask before the retrieval starts. Post-Procedure Tips: Tip #1: Relax! Congratulations! You've done it! After numerous evenings of medication injections and feeling like a pharmacist yourself, along with a successful surgery, the hard part is behind you. Now, it's time to prioritize quality rest and a full recovery. While you might feel okay once you are discharged from the hospital/clinic, it will take 24 hours for the anesthesia to fully clear out of your system. Therefore, it's crucial to rest and take it easy. This is the ideal opportunity to indulge in binge-watching the latest show on Netflix that you've been eager to watch. Snuggle up on your couch, order some take-out, and relish the day off from work. Tip #2: Pain Management After the egg retrieval, it's common to experience cramping, tenderness, and constipation. It's essential to stay ahead of the pain and manage any discomfort effectively. Here are some suggestions: Heating Pad: Placing a heating pad on your abdomen can provide relief from cramps. Medication: Over-the-counter options like Tylenol or Advil can help alleviate post-procedure discomfort. Stool Softener: Constipation is another common issue after egg retrieval, often due to elevated progesterone levels, the use of narcotics during the procedure, and inactivity following retrieval. To alleviate discomfort and promote bowel movement, consider taking a stool softener like Colace to help relieve stress and discomfort associated with constipation. Hydration and Fiber: Ensure you stay well hydrated and consume fiber-rich foods to help combat post-anesthesia constipation. Tip #3: Protein Rich Diet Indulge in some french fries and a cheeseburger! It might not sound like typical advice from a doctor, but the truth is, after an egg retrieval, salty and protein-rich foods are exactly what you need. In the days following the procedure, patients are at the highest risk of developing OHSS (Ovarian Hyperstimulation Syndrome), a complication where excess fluid from the ovaries leaks into other parts of the body. To mitigate this risk, doctors often recommend consuming foods rich in salt. Salt helps draw out extra fluid from the ovaries, reducing the likelihood of OHSS. Looking for a healthier alternative? Try coconut water, popcorn, or fish. Tip #4: Expect a Heavier Period: You should anticipate your next menstrual period to arrive anywhere between 7-12 days after your egg retrieval, and it likely will be heavier than usual. Lupron typically results in a period about 7 days later, while hCG (Pregnyl or Ovidrel) usually leads to a period about 10-12 days later. The first period following the egg retrieval may be heavier than usual due to the increased hormone levels you administered for 10+ days, which not only facilitated follicular growth but also stimulated the thickening of the uterine lining. Once your body recognizes that pregnancy hasn't occurred, the uterine lining sheds, resulting in a heavier period than usual. We recommend using a heating pad and taking over-the-counter Tylenol/Advil for pain management, and changing pads/tampons frequently as needed. Conclusion Preparing for and undergoing an egg retrieval can be a complex and challenging process, but with the right information and support, you can navigate it successfully. It's essential to plan ahead, stay informed about what to expect, and prioritize self-care during the recovery period. Remember to keep communication lines open with your healthcare team, including nurses, who can be valuable resources for answering any additional questions or concerns you may have. They are there to provide support, guidance, and reassurance throughout your journey. It is also important to remember that while the greater the number of eggs you retrieve, the higher chance you have of developing normal embryos, retrieving a lower than expected number of eggs is not the end of your journey. If you need to, talk to your care team, a mental health professional, or a support group to help manage the psychological aspects of your egg retrieval. Our Coaches Can Help If you have any further questions or need assistance, don't hesitate to reach out to your Patient Empowerment Coach. If you are not a Grain Fertility Premium Member, you can sign up here or if you are a member using our free version, go to your Account to upgrade your service. Our coaching can offer personalized advice and support tailored to your specific needs and circumstances. Trust in their expertise and lean on them for assistance whenever needed. With proper preparation and support, you can navigate the egg retrieval process with confidence and peace of mind.