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April 6, 2022 24 mins

Sometimes the path to pregnancy is harder than people anticipate. Shazi shares what she’s learned from her experience with IVF — and checks in with friend and CNN Entertainment reporter, Chloe Melas, and her husband, Brian Mazza, who share the story of their own fertility struggles, and their realization that infertility is a condition that affects both men and women. We also hear from fertility physician, Dr. Daniel Kort, on what the latest fertility research says, why infertility is on the rise, and how advances in the field may be deployed in the future. 

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Speaker 1 (00:01):
The Healthy Baby Show is a production of My Heart
podcast Network and Healthy Baby dot Com. I really thought
things weren't going to be okay when I was going
through IBF the first time, So I wish I could
just tell myself that it's going to be okay, and
as long as you cry for a day, but then
pick yourself up, just yourself off and go back to

(00:21):
the drawing board. There are other options. It doesn't have
to just be exactly the way that you thought it
was going to be. There's so much about having a
baby that I wasn't prepared for, and I feel like
I've learned a lot. I want to let you in
on what I've discovered and save you the time and effort,

(00:42):
give you a shortcut through the hours of research, correspondence
with experts, the roller coaster of it all, so that
you can walk away with new knowledge that you can
act upon. Every episode, this is The Healthy Baby Show.
I'm Chassivas from you just heard from my friend Chloe

(01:06):
Email us CNNs entertainment reporter. Chloe and her husband Brian
Maza conceived both of their sons through IVF after spending
more than a year on the process. Their story is
an increasingly familiar. One. In fact, according to the CDC,
one in eight couples in the US have trouble getting
pregnant or sustaining a pregnancy. I did IVF myself for

(01:27):
more than three years, and I think that it's really
important for people to understand the options that are available
to them, because a lot of times you're told, oh,
you can't have a baby, and then you think you
really can't, but actually you can't, or actually their surrogacy,
or actually you can adopt, and I feel like it's
just really limiting to talk to one person, and it's

(01:48):
really important to hear other people's stories. And I really
appreciate you guys doing this obviously very much. I'd love
to hear about, you know, what it was like for
you to decide to have a baby and then get pregnant.
M In my mind, it was just an understood thing
that we were going to have kids as to when
that was never a timeline that we discussed. I got

(02:11):
married when I was twenty eight, Brian was thirty, and
a bunch of my friends were having babies and I
was seeing all the posts on social media. We started
talking about having kids, and immediately we started having sex
and it wasn't working, and I was really worried that
it wasn't working. Brian, I don't think you were. You

(02:31):
liked the process we were saying. I was like, this
is fun. We can make this happen for another year two,
But the fun quickly left me. Yeah. Then, really it
wasn't fun after a while because there was a lot
of pressure that was leading up to failure after failure,
and then it became scientific, right, like we have to

(02:55):
be home at this time in order for this to work.
And as much as having sex with your life is great,
it's not great when it's on your calendar to come
home at a certain time to do it, and when
it's not working. And when Chloe and Brian weren't getting pregnant,
you know, they thought at first, like most couples do,

(03:17):
that there must be something going on with her. I
went to go see my O B G y N
and she did just routine blood work on me and
said that I was ovulating, everything looked fine, and that
Brian should go get his sperm tested, to which I
was like, Oh, that is not going to go over well,

(03:39):
that's going to be an awkward conversation and It wasn't
really a great conversation. He was kind of like, why
do I need to go get tested? Like, isn't it
like probably like you like, it's not going to be me,
Like I didn't even really understand. I was naive and maybe,
you know, I didn't care enough about the situation for
me to look internally and say, wow, maybe this could
be me right. Finally, actually, under pressure from Chloe, Brian

(04:06):
did agree to get tested, but he wasn't happy about it.
I went to go get my sperm checked and it
was a very awkward thing to do, essentially masturbating in
a little closet office where the secretary's outside and you
hear everything they're doing. So it really wasn't fun. It
was very weird. And then we went to a urologist

(04:26):
that information was not good. This news was a real
shock for Brian when he was someone who prided himself
on his health. He even appeared on the cover of
Men's Health before they discovered this news, and he couldn't
believe that this was something that could happen to him.
There's no groups for guys. Men don't talk about this
right ever, it's usually hey, you're trying to get pregnant

(04:48):
with your wife. Yes, And then is Lebron James playing
basketball tonight? Now we know it's basically between male and
female partners with this infertility issue. My doctor called with
his results his seamen analysis, and she said that they
were way below normal. His sperm count was incredibly low.

(05:10):
His motility and his morphology so how fast his swimmers
move and the shape of them was irregular. We were
so upset. I was devastated. I thought we wouldn't have
biological children of our own. I knew nothing about IVF,
nothing about egg donor. Nobody and my family had ever
talked about infertility. Nobody had a miscarriage that I knew of.

(05:34):
It just people had kids, people had babies. This was
a really difficult time for Chloe and Brian, as it
is for many couples. Before we started at the fertility process.
Our marriage was in a really bad shape because of
all of this, and I was just growing more obsessed
with getting pregnant, and it was like I was walking
around in a tunnel every day where it's all I wanted.

(05:56):
And I also hated everybody who got pregnant. I felt
like sick about it, and then I was on a
hunt to try to figure out what specialists we could see,
and what Chloe and Brian found out was that IVF
is not the only option here. There are less costly
and less invasive options, and doctors generally suggests those first.

(06:17):
Pretty immediately we met with this really one owned doctor
who said that he would get as pregnant and it
wouldn't be a problem. All he needed to do was
to monitor my ovulation with two different blood tests a month,
put me on some hormones estrogen and lett resolve, and
that I would get pregnant. So we did that for

(06:38):
a few months. We went from the depths of despair
to then all of a sudden becoming hopeful again, and
then I wasn't pregnant. So he then said, let's do
a u I intrigue or a insemination, essentially a turkey
baster with Brian, sperm I u I is a common
next step if hormone treatments alone don't work. It's a
procedure where sperm that have been washed and concentrated or

(07:01):
placed directly in your uterus around the time your ovary
releases one or more eggs. The hope is that the
sperm will swim into the fallopian tubes and fertilize the
awaiting egg. This can work with your normal cycle or
with fertility medications like lect resol. It's less invasive and
costs less than IBF, but the success rate is generally lower.

(07:24):
So we did two rounds of by u Y and
it didn't work. At this point, I am on every
single message board for IBF that exists late into the night.
At that point, I wasn't aware of like Resolve, the
National Infertility Foundation. I wasn't aware of any support groups,
not celebrities, and I felt like I was just being had.

(07:45):
I felt like I was in a factory. I felt
like they were just taking my money, and I felt
like this was just fruitless. So I remember sitting at
my desk at CNN googling around and I saw that
Savannah Guthrie had supposedly done IVF at Wild Porn. I
called over there. They had a list of like twelve doctors,
so I literally just picked the youngest, cutest one, and

(08:08):
again he looked at our numbers and he said he
wasn't sure if we needed to do I v F,
and that he wanted us to do some more testing,
and he wanted to retest Brian's sperm, and so at
that point I was actually fully medicated to do another
round of I U I with the old clinic in
just a few days. And he said I had so
many eggs and so many follicles that I was at

(08:30):
risk of having twins or triplets and to not go
through with it. And I didn't go through with it.
Immediately switched clinics, which I know a lot of people
are reticent to do that because it's like, oh, but
they have all my files. I don't want to switch
in the middle of a process, and I did. It
was the best thing I ever did. He called us
a few days later to say, yeah, Brian's sperm is

(08:52):
really not good, and the only way you're going to
get pregnant in a efficient amount of time if you
want more than one child is i F. That to
me was the worst thing I could have heard. I
thought it was a death sentence because I felt like
we had now exhausted our options. Now we're at IVF
store step and if IDF doesn't work, this is just terrible,

(09:14):
and we're approaching almost a year of this process now.
Chloe was finding her research on the message board. She
was scouring that IVF can be stressful and expensive, and
we do need to acknowledge here that unfortunately, it's still
not an option that's easily accessible for all couples. I
am one of the few lucky people in this country

(09:34):
that had fertility insurance coverage, and I'm very grateful for that,
and we know that that is so not the reality
for people in this country. The US does not have
mandated fertility coverage. If you look at other countries, Canada, Israel,
parts of Europe, they cover things. In the United States,
they won't cover any type of fertility coverage if you

(09:58):
are same sex couple. I mean, just talk about how
discriminatory that is. And speaking of New York, we're so progressive,
right it was only recently that New York legalized surrogacy.
So there's so many obstacles for so many different people.
It's time for a quick break. But we'll be back
in a minute. Welcome back to the show. Even with

(10:32):
insurance coverage, IVF can be a daunting process. I can
also attest to this. My experience with IVF was really
challenging and basically took up four years of my life.
It isn't a decision to be taken lightly. I was
really not happy about the IVF process, but I like
a project, so I jumped into it. We started IVF

(10:53):
less than a month later, and Brian was there for
every doctor's appointment, every round of shots. He was literally
my number one cheerleader. I went through a deep, deep
depression and had to see a psychiatrist while doing this.
I think it was just the gravity of it all
and all the medication I had been on for so
many months, and just this realization that it felt like

(11:16):
you only get one shot pun intended. It was just crazy.
And then the surgery it's just wild. You have to
go into an o R and climb up on the
table and you're surrounded by doctors and I hate being
put to sleep, and they're going in and extracting eggs.
For those who don't know, an IBF cycle begins by
using synthetic hormones to stimulate the ovaries to produce multiple

(11:40):
eggs instead of a single egg that typically develops each
month because some eggs won't fertilize or develop normally after fertilization.
I asked after Daniel Cort, the associate medical director at
New Way Fertility, a leading fertility clinic in New York,
to explain the ib F process in detail. To me,
if that's a siren you hear, it's because he took
time out of his busy day to join us from

(12:02):
the hospital. How the process works is that women will
take shots sometimes some combination of pills and shots, for
approximately nine to ten days. The whole idea is to
stimulate eggs to grow and to monitor. The process in
my practice is typically every two to three days over
the course of about two weeks. Once the eggs have

(12:22):
developed to the appropriate stage, patient undergoes what's called an
egg retrieval, typically done under sedation, so it's a light
anesthesia where the patient's sleeping in the office. So essentially
a needle goes vaginally into each ovary the size that
draws your blood a little bit bigger withdraws the eggs.
The eggs are processed the same day and frozen the

(12:42):
same day. These days, we have sperm selection techniques, or
we can actually choose the best sperm for the best egg,
place sperm directly into the egg, and we actually grow
an embryo. So an embryo starts out as one cell
that ultimately duplicates till several hundred cells when it implants
in the body and ultimately can become a pregnancy and

(13:04):
we hope a live birth. Historically, even in the best candidates,
every embryo that was transferred probably had a thirty percent
chance of becoming a baby. But not only have our
abilities to develop embryos improve, the selection has improved Nationally. Now,
when we transfer a single embryo that's tested to be normal,

(13:24):
pregnancy rates are between sixty and sev so nearly double
of what they were just ten years ago. Chloe's embryo
transfer was done at day three. They started their IBF
process before some of the new breakthroughs that Dr Court
refers to. In Chloe's case, despite the risks associated with

(13:46):
an early embryo transfer, her IVF was a success. She
carried her first child to term and had a beautiful
baby boy. Then Chloe and Brian decided to go through
the same process again only a year later. This led
to the birth of their second son. I asked Chloe
and Brian how their IVF experience was the second time
around and why they decided to do it all over again.

(14:10):
I feel like we were more prepared this time, it
was a lot easier in terms of the mental side
of things. We're like, Okay, we know what we're up against,
we know what to do. We know our doctors are
the man he can help us out. So we said,
let's rock and roll. What I would tell any couple
that is facing this as their next option, it might
be your only option. So you have to fight for

(14:31):
really what you want. You have to go through the process.
It's not going to be easy. It's gonna ultimately bring
you together, I think, and you know, us having two
boys as crazy as it is an m M A
fight every morning, I would not trade it in for
anything in the world. It's the best thing that's ever
happened to us. For me particularly, I'm so over the

(14:54):
moon with my two children that I wish I could
have taken all the shots for Chloe or and through
all that for her. So yeah, you know, if you
really want it, it's a great opportunity and option to
have children. But Brian did say that if he could
go back in time, he would do some things differently.
For example, get as sperm tested much earlier. I work

(15:17):
with an amazing company called Legacy. It's an at home
sperm testing, diagnostic freezing kit. And I wish I knew
about this. You know, if I was eighteen, if I
were able to do that and maybe find out what
something was wrong, maybe there were some steps that I
could have taken down the road to improve that. At eighteen,
you're not really thinking of becoming a dad. You're actually
thinking not to become a dad. So I'm gonna use
my platform to continue to spread the word. And once

(15:40):
I started doing that, there were so many men that
have gone through this that I was really blown away
by Oh my god, it's not just me. There's a
ton of guys that have this issue. A ton of
women were reaching out to me as well, saying, you know,
my husband's suicidal going through this. We're getting a divorce.
I don't want to get a divorced. Can you talk
to my husband? And I try to speak to as
many people as I and about this. Chloe also said

(16:02):
there are a few things she would tell herself before
this experience if she could go back in time. I
thought that maybe my marriage wouldn't work out. I thought
that I wouldn't be a mom, and that was a
really dark reality to face, and I really did not
enjoy that at all. I like plans and I like
knowing where I'm going, so it doesn't have to just

(16:23):
be exactly the way that you thought it was going
to be. I mean, there's so many ways to climb
this mountain, and I just want to encourage other people
to share if they feel comfortable. I'm not going to
tell somebody to share something that they don't want to,
but I would encourage them to look at organizations like
resolve and support groups and read more. Follow me on Instagram,
DM me d M Brian. I respond to everyone. I

(16:45):
get on the phone with people all the time who
have never met and give them advice. And if you're
not happy with your doctor, switch clinics. It was the
best decision that ever happened to me. We'll be back
after a quick break. Welcome back to the Healthy Baby Show.

(17:06):
I talked to Dr Cord about a few things I
learned from Chloe and Brian's story, the increase and fertility
challenges in our country, and what he thinks the future
of fertility will look like. There are a lot of
trends that occur in this field. Most of these trends,
we think are societal and social rather than medical career
choices are definitely one. One major X factor in all

(17:29):
of this is in the current society, we think that
we can cure and fertility at all ages, which isn't true.
Can you talk a little bit about how fertility is
impacted by age. The peak number of eggs that a
woman will have occurs at twenty weeks just station at
the time of birth, that number is already decreased to

(17:49):
about one million, So this attrition is ongoing to the
point of menopause, where you think still about twenty or
thirty thousand eggs are still around there. What's even more
important than that is the quality or the reproductive potential
of the eggs. A good rule of thumb is that
if you take the entire country doing IVF at thirty five,
the chance of success overall looking at everyone is about

(18:14):
and you see about five to ten percent drop per
year due to egg quality. So doing the math after
forty two, our IVF pregnancy rates are unfortunately few and
far between, definitely less than ten percent. That said, natural
pregnancy rates can occur up until the mid to late
forties and even fifties, so there are probably some women

(18:35):
who beat the odds. I asked Dr Court if he
thinks women should consider freezing their eggs given that our
reproductive potential starts to decline in our thirties. Absolutely, so,
if you take someone who's years old and freezes their
twenty eight year old eggs, there's very good science that
supports doing this because whether they decide to use their

(19:00):
eggs in ten years and even in twenty years, the
egg quality does not change. So the potential is great.
What are the risks, Well, taking medications for about ten
days could be unpleasant, but we don't believe that the
medications are harmful in terms of cancer risk, long term
health risk, acute injury from the medications. It's considered a

(19:23):
low risk medical procedure. It does not decrease your fertility.
It does not take eggs away that could be used
later on. It takes time, and it takes cost. Although
the price has gone down dramatically across the country, it's
still not an easy thing for somebody who's in their
twenties to do potentially, but in general, the benefits far

(19:43):
away the risks of doing it. What is the cost
of freezing your eggs today? It varies somewhere between five
and ten thousand dollars. Now some employers and some insurance
companies have started to cover it. Also, sometimes part of
the procedure might be covered, so it's different for everybody.
Someone could anticipate, somewhere in the order of five to

(20:05):
per treatment cycle, having a more youthful egg. How do
you see that affecting the potential outcome of the embryo
and then the baby. Is there a direct correlation? Yeah?
I think here's where we have a little bit of
a problem. It's been shown that the younger the woman
is that they freeze their eggs, the more eggs shall
get and likely the better quality. Flipping it over to

(20:27):
the social side, the younger someone decides to freeze their eggs,
the less likely they'll ever use them. So from a
cost benefit perspective, it's very, very difficult to say. Most
of the psycho social literature has suggested on average women
might use them, So if you look at it from
an insurance perspective, I still think it does make a
lot of sense. So I want to ask you about IVF.

(20:50):
I've experienced IVF myself and have spoken with a couple
about their experience. They talked a lot about the stress
that was involved in the process and the emotional stress
and pressure that it put on their relationship. Is this
something you also witness at your clinic? So am my experience.
Stress is a major component of this process, either struggling

(21:12):
within fertility, dealing with insurance regulations and expenses that are
out of plocket. Things to minimize that I think are
one to set expectations of what's going on. So having
a relaxed consultation on cell this is what happens. First,
The vast majority of women that walk through the door
end up happy, so that's the good news. Of course,
there are some that don't, and the major options would

(21:34):
be to consider either donor egg or egg donation or
potentially in a male factor situation, donor sperm or sperm donation.
That's typically the next step. The use of a gestational
carrier is always an option too. But so much progress
happening in recent years. I asked Dr Court what he
thinks the future of fertility will look like. There are

(21:57):
many people out there who believe that well infertility may
only affect of couples, will be moving towards a society
where the vast majority will be freezing their eggs, freezing
their sperm and achieving pregnancy essentially electively through IVF, potentially
for genetic testing, potentially to optimize outcomes. But I think

(22:21):
there's clearly something there and it will only continue in
terms of our practice. If you look at the development
of our field over the past forty three years, you've
seen advances in the ability to grow eggs, grow sperm,
grow embryos. Then you saw the ability to test these
embryos to better select which ones to give patients. On

(22:42):
a scientific scale, I think the biggest future lies in
improving the reproductive potential of poor quality eggs. So taking
women who can have eggs but are either failing to
fertilize sperm, developing poor embryos, or implanting and ultimately changing

(23:03):
the reproductive potential of those eggs. And that I think
is the holy grail of our field, trying to take
somebody who really can't develop a good embryo and change
the outcome. Well, that's it for the show this week.
Next week we'll be diving deeper into how toxins in

(23:23):
the environment from lead to plastics can impact your pregnancy
and what you can do with this knowledge to protect
yourself and your baby, So tune in and learn more
about what the research says. Join us next time. The
Healthy Baby Show is a production of iHeart podcast Network
and healthy baby dot com, where you can find a
new line of the safest baby essentials. The Healthy Baby

(23:45):
Show is hosted by Me shazias From. Our lead producer
is Jennifer Bassett. Executive producers are Nikki Etre, Anna Stump,
shazivs From and James Violette. Mastering and sound designed by
Carl Catle and Dan Bowsa, additional writing and research by
Julia Weaver. Our theme music is by Anna Stump and
Hamilton's Lighthouser. Additional music from Blue Dot Sessions. H
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