April 1, 2025 • 28 mins
Having health benefits is crucial when taking steps to build a family.
In episode 4 of The Visibility Gap, Dr. Jen Ashton talks to Kelly Donahue about her personal experience that included many setbacks but ultimately led to a beautiful family. This discussion highlights the importance of emotional well-being and support for those navigating this challenging journey.
Later in the episode, Dr. Alana Biggers and Dr. Margaret Rutherford discuss the role businesses play in ensuring their employees are seen and supported. And together, they explore changes needed to make family-building opportunities more accessible and inclusive.
All Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group. © 2025 Cigna Healthcare
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_02 (00:00):
Hi, and welcome to the Visibility Gap.
Today we're talking about familybuilding and the critical role
that workplace benefits can playin supporting people on this
journey.
Here's a fact that you might notknow.
According to Maven, 57% ofemployees say they would
(00:21):
consider switching jobs forbetter fertility benefits.
57%.
In this episode, you'll hearfirsthand from someone who
experienced this all andbenefited not only from the
support of friends and lovedones, but benefited also by
being seen and supported throughworkplace benefits.
Then we'll bring on a panel ofexperts to discuss the big
(00:43):
picture and how businesses canhelp employees feel more seen.
Our guest today is KellyDonoghue.
Kelly is a realtor from LosAngeles.
Kelly credits her partner'semployer-sponsored health
benefits as, quote, one of theonly reasons why IVF was
possible, end quote.
Kelly is normally optimistic andstays healthy, but through the
(01:04):
process, she started askingherself, Is there something
wrong with me?
Kelly, welcome to The VisibilityGap.
Thank you so much for beinghere.
SPEAKER_01 (01:12):
Thank you for having me.
I
SPEAKER_02 (01:14):
can't wait to hear about your story because every
person's journey to parenthoodis unique and individual and
specific to them.
But I would love to hear yourstory and what led up to your
decision to become a parent.
SPEAKER_01 (01:30):
Sure.
Well, I decided in 2020, mypartner and I wanted to give it
a shot at having children.
And so we decided, well, the wayto do this is through IVF.
And we thought, okay, let's justget started.
It's going to be a piece ofcake.
Go in, go have a baby.
Easy preasy, you know.
(01:50):
And that was not the case.
I went through 11 rounds of IVFand two
SPEAKER_02 (02:00):
IUIs.
When did it become obvious toyou and your partner that your
jobs covered IVF benefits?
SPEAKER_01 (02:09):
Well, when we started trying in 2020, we knew
that we had three cycles withinsurance.
So we thought, okay, we've gotthree shots here.
Let's Give it the college tryand get it done.
And three shots was not enough.
Three rounds of IVF.
That's three egg retrievals.
That's three, you know, goingunder anesthesia three times,
(02:32):
which I went under 11 times.
So I kept on going down the roadwhere we would—my partner
actually got a better job offer,and so— We switched jobs, and
then there was a whole new roundof IVF available to us through
that insurance.
She didn't switch the job justfor IVF or for anything of that
(02:53):
matter, but it afforded me theopportunity to have another
three shots through theinsurance company to do IVF.
SPEAKER_02 (03:03):
And when you were going through, let's say, the
first round and then the secondround, did you feel...
increasing stress and pressurethat, you know, you knew that
it's three of three.
Now I'm O for two.
Everything is riding on thislast cycle.
And what was that pressure andstress like?
SPEAKER_01 (03:22):
The first time I did IVF, I told my mom and all my
sisters and my aunt, all right,I'm going to be pregnant, blah,
blah, blah.
Here it goes.
And then when you have to be theone to say, oh, by the way, it
didn't work.
And then The emotions of that,like having to deal with that to
tell other people that it didn'twork rather than just you and
(03:43):
your partner knowing, being in aprivate situation, was so much
worse.
So then after that first roundof IVF, I didn't tell people
that I was going through IVF.
And yes, it was very taxing.
And, you know, come the thirdround, it's this or nothing.
Or you pay out of pocket, whichis very costly.
SPEAKER_02 (04:04):
You say that you started to be more secretive
about it, which is totallyunderstandable.
With that must have come alittle bit of loneliness, right?
I mean, you're trying to keep anumber of balls in the air at
the same time, juggling work andall of your professional
responsibilities with all ofthis physical and psychological
(04:26):
process.
Did you feel...
at that point, you know, thatloneliness added to the stress?
SPEAKER_01 (04:35):
I think the only loneliness I felt was the
sadness that I couldn't share itbecause I didn't want to, in
case there was, it's notsuccessful, that I would have to
let everyone down again.
You know, it's quite the rollercoaster.
But I have a very wonderfulpartner, so she was going
through that with me andsupporting me emotionally
(04:57):
because I, The physical thingsyou have to go through, which,
you know, the injections in yourstomach, they hurt and they
leave scars, scar tissue.
So it's kind of a permanentthing.
And also the hormones that youhave to take, you know, it
really does affect you.
You gain weight.
You get tired.
SPEAKER_02 (05:17):
I mean, I'm interested to hear your
experience because I think a lotof people, you know, hear or
think assisted reproductivetechnology is, family building,
IVF, and they think, it's likegoing in for a haircut.
So what were the, you hit onsome of the physical kind of
(05:39):
consequences or experiences thatyou had, but talk us through
both the psychological,emotional, and physical
experience that just one roundof IVF was like, let alone
SPEAKER_01 (05:53):
IVF.
SPEAKER_02 (05:54):
Nine.
SPEAKER_01 (05:59):
Sure.
Plus.
You are creating as manyfollicles as you have, and
(06:21):
they're becoming enlarged, andso you feel bloated all the
time.
You feel exhausted.
You also feel very emotional asfar as things could trip you up
very easily or make youextremely sad or extremely
happy.
The things that you wouldnormally be regulated on are not
regulated.
Shorter fuse.
Shorter fuse.
SPEAKER_02 (06:41):
You hit it.
Yes.
And your baby was born...
Yes, she
SPEAKER_01 (06:46):
was.
What was that experience like?
It was wonderful.
It was wonderful.
We really didn't know the roadwe were going down.
I mean, you really don't knowanything when you're going into
IVF.
You expect something, and thenit's something else.
But working with a surrogate wassuch a wonderful thing.
We lived in the same city.
We got to go to all theultrasounds.
(07:06):
We went to the hospital.
We had our own room.
She was right next door to us,and it was a wonderful birth.
We were there when the baby wasborn, and just the emotional
impact of what this womanexperienced did for us, I will
forever be grateful to her.
SPEAKER_02 (07:25):
Yeah.
Yeah.
I can hear the emotion in yourvoice.
Yeah.
What would you say now thatyou've been through this process
several years, you have ahealthy baby, what helped you
and what didn't help yousocially and functionally
throughout this process?
Because it can be very isolatingfor anyone who male or female
(07:51):
going through this process, butparticularly, I think, for
women, it can be very hard.
You know, it can seem like,well, what do you mean?
This should be the most naturalthing ever.
Why is it so difficult?
What's wrong with me?
What helped you get throughthose kind of moments?
SPEAKER_01 (08:10):
Taking time for myself, going for massages,
meditation, Love meditation.
Yes.
Talking about it with mypartner, being kind to myself,
and letting myself know that,you know what, this is not a
rare thing.
So many people go through thesejourneys, you know, whether
(08:31):
you're a man and a woman, twowomen, two men, whoever it is,
whatever you're going through,you
SPEAKER_02 (08:40):
just need to be kind to yourself.
So now that I'm putting you onthe spot and making you kind of
the voice of family building forthis one moment, hypothetically.
If you could close your eyes,institute a new either policy or
system or just vibe, ethosaround family building, and
(09:02):
start with the advice you wouldgive to the inner circle of the
person going through it, whetherthat's caregiver, immediate
support system, what would youradvice be?
SPEAKER_01 (09:13):
I wish I would have known that it might not be that
easy.
And you have to have patience.
You really, really have to havepatience.
And I'll tell you this.
When I went through my firstround of IVF and it failed, I
cried tears.
And you just have to tellyourself, listen, what will be
(09:36):
will be.
I will be just fine no matterthe outcome.
And you have to have thathealthy mentality and you have
to keep on telling yourself thatbecause I'll tell you this, it
will slip in where you have thedark days where you're like, oh
my gosh, there must be somethingreally wrong with me.
And there might not be somethingwrong with you.
It might just, who knows, couldbe something else.
SPEAKER_02 (09:59):
That blame is so insidious, but it really can
creep in.
What about, can I ask you,Kelly, did you and your partner
ever, at any time consider othernon-biologic paths to
parenthood?
SPEAKER_01 (10:14):
Yes, we are very open to adoption.
There are many different typesof adoption.
There's embryo adoption.
You know, the people who havegone through IVF, couples or
single people, who have extraembryos and they don't want to
discard them, but they want tojust donate them to a family to
adopt.
There's that option, which we'reopen to.
(10:35):
We're open to adopting childrensomeone who is maybe not a baby,
maybe someone who is a littleolder.
The main thing is we just wantto grow love, and so there are
many avenues for that.
SPEAKER_02 (10:48):
Do you remember, I want to call it the finish line
moment, even though it's reallyjust the starting line, the
second you held your baby inyour arms for the first time?
SPEAKER_01 (10:58):
Yes, yes.
SPEAKER_02 (10:59):
What was
SPEAKER_01 (11:01):
that like?
I was the first one to haveskin-to-skin with her, and as
soon as she came out of thewomb— And I just remember
thinking, I cannot believe thisis real.
Is this really real after whatmy partner and I both have gone
through for the last four yearsof our lives?
Is this really happening?
And it was, and it did, and itis, and it's really wonderful.
SPEAKER_02 (11:28):
Well, I am certain that there are so many people
who feel seen as feel morevisible, feel more validated
after hearing your story.
I just cannot thank you enoughfor being here, Kelly.
SPEAKER_01 (11:45):
It's my pleasure.
Thank you for having me.
SPEAKER_02 (11:49):
We have an amazing panel of experts joining us
today.
Dr.
Margaret Rutherford is aclinical psychologist with over
30 years of experiencespecializing in treating
individuals and couples fordepression, anxiety, and
relationship issues.
She is the author of PerfectlyHidden Depression, How to Break
Free from that Perfectionismthat Masks Your Depression.
(12:13):
Welcome, Margaret.
Thank you.
And Dr.
Alana Biggers is an internalmedicine physician and public
health researcher dedicated toadvancing health equity and
improving chronic diseaseoutcomes.
She is an associate professor atthe University of Illinois
College of Medicine in Chicagoand specializes in general
internal medicine for adults,preventive health, chronic
(12:33):
disease management, and women'shealth.
Welcome, Alana.
Thank you for having me here.
Thank you both so much for beinghere.
So you both heard Kelly's story.
Yes.
What jumped out at you?
What jumped out to me was, youknow, her not knowing what it
was going to take to actuallyget into this process.
Wow.
I was like, okay, one, I'm sureshe went in there not knowing
(12:56):
that she was going to do this 11times, but actually everything
that went along with it, theemotional toil that it took, the
weight gain that she had, youknow, not being able to get
pregnant each time.
The pain, the physical pain.
SPEAKER_00 (13:12):
Exactly.
So, yeah.
I've been through IVF.
So I remember feeling exactlylike she did.
And in some ways, I think it'ssomewhat self-protective to not
necessarily know all the gorydetails of what's going to
happen because you might chickenout.
So that was very interesting tome,
SPEAKER_02 (13:31):
too.
I love getting into the mentalhealth aspect of any physical
process or journey or issue ordisease.
I feel like in medicine...
unfortunately, mostly Westernmedicine.
We tend to disconnect thephysical from the mental, right?
I'm sure you agree with that,Alana.
(13:52):
But I want to ask you, Margaret,more about the, you said the
It's almost protective to kindof go into it not knowing.
SPEAKER_00 (14:26):
more eloquently than me.
But I wanted to do this, and Iwas willing to take that risk.
And so that motivated me morethan fear.
It had its own version of fearto be expressed.
But it was something I was, aswe'd say in Arkansas, bound,
(14:48):
bent, and determined to do.
Oh, I love that.
SPEAKER_02 (14:50):
Bound, bent, and determined.
Do you feel...
that when we talk about theability to reproduce fertility,
whether you're looking at theparadigm of fertility or
infertility, that it's aparticularly charged topic
psychologically as well asphysically.
(15:11):
Yeah.
It's almost like we assume...
Both men and women just assumethat it can happen.
I'd taken birth control
SPEAKER_00 (15:19):
for years.
And I was the one with theinfertile issues, not my
husband.
And so I felt my body hadbetrayed me.
I was less of a woman because Iseemed to struggle in this way.
And yeah, my self-worth took abig hit, took a big hit.
And I had to grieve a lot aboutthat.
(15:40):
I mean, I had
SPEAKER_02 (15:41):
a similar experience as well.
I'm an older mom.
Parietic mom, as they would say.
Horrible term.
I hate that term.
(16:14):
with me, or maybe I waited toolong because, you know, my
career, and just having thatguilt attached to it.
So guilt segues a lot of timesinto stigma.
And I know a lot of your career,Alana, is about dealing with
inequities in our healthcaresystem.
(16:35):
But let's just start on a microlevel, individual guilt and
stigma.
Okay.
For fertility, right?
For having a miscarriage, fornot being able to conceive, for
needing or wanting IVF.
How quickly does that go down arabbit hole?
Yeah.
Very quickly.
(16:56):
I know personally, for me, youknow, again, the guilt of, oh my
gosh, why did I wait so long?
Why did I put my career, youknow, ahead of family planning?
Whereas, you know, it wassomething that I don't feel have
any regrets being a doctor.
I love being a doctor.
I love what I'm doing.
(17:16):
But when it came down to familyplanning, I, you know, doubted
myself in that moment.
When you try to connect the dotsbetween the mental and the
physical, mental health,physical health, and well-being,
and where that disconnect oftenis, you can see what's at stake
when it's not there, when itgoes wrong.
(17:38):
You can see Kelly's case.
She had so much support.
She felt seen by her partner, byher family, by her loved ones.
In the workplace, they hadsupport.
But when they don't, Right.
Right.
(18:11):
I agree with you completely.
And people lose sight of eventhe relationships that they're
in as well.
So I think that that would be agood idea for people to have a
pledge to each other and toactually really sit down and
talk about what this could looklike.
And as you alluded to, thinkingabout how it would look like
(18:34):
without a child if the processdoesn't work out the way that
they want to, and then hopefullygetting to a place where they're
okay with that.
Which is a task.
Yeah, absolutely.
SPEAKER_00 (18:46):
You know, as I was listening to Kelly, too, I kept
thinking, and I experienced thismyself because we tried for
three and a half years and thengot IVF and were successful.
I remember thinking, I need togrieve.
I've lost—another cycle has comeand gone.
Another IUI was tried.
(19:06):
Another drug was tried.
And yet you think, but I can'tgrieve because maybe next month
or next cycle it'll bedifferent.
So you're stuck in this spotemotionally where all aspects of
grief are there, sadness, anger,fear, and yet you— You don't
(19:26):
know if you really want to gothere because next time it might
all be just fine.
And so it's this balancing offeeling, forward thinking and
saying, I've got to remainoptimistic.
I've got to remain positive.
I want to do that, just likeKelly was talking about.
And also balancing out orbeginning to connect with when
(19:49):
it's appropriate.
the harder emotions that you canfeel.
SPEAKER_02 (19:55):
And giving yourself permission to have that full
amplitude of highs and lows.
Exactly.
Even though it is probably aprotective, coping defense
mechanism to say, I'm just goingto keep it right here.
How many times have we heardpeople or even ourselves said, I
don't want to get too excited,but dot, dot, dot.
But Kelly said something elsethat I thought was interesting
(20:17):
and I want to get your take on.
She believes in meditation.
She practices meditation,mindfulness.
I'm a big believer in thatmyself.
I know you are, Alana.
How underutilized do you thinkmindfulness practices are?
I know what you would say,Margaret.
Very.
I mean, right?
In regular internal medicine,preventive care, women's health.
(20:40):
Yeah.
In general, definitely notutilized that much.
And then even when we look atdifferent segments of our
population, too, whether we'relooking at people of color is
utilized even less.
So, yeah, I actually do researchon mindfulness meditation And
I'll be honest with you,recruiting has been a challenge
(21:03):
to get people enrolled in thestudies.
However, once I get peopleenrolled, they love it.
Like my focus groups, they'relike, oh my gosh, I wish I was
doing this before.
So it's very underutilized, butit's very helpful once people
finally get into that practice.
And it doesn't have to be like30 minutes, an hour.
(21:25):
I think that mental blockactually stops people from
engaging, but it can be justfive minutes.
It can be two minutes in theshower, anything.
I mean, the costs...
They're significant.
Yes.
Yeah.
They say, I think, the averagecost is anywhere between$12,000
(21:46):
to$20,000 per IVF cycle.
And only insurance, about 43% ofinsurances in general pay for
IVF.
So people, many people arepaying
SPEAKER_00 (21:58):
out of pocket.
I'm sorry.
Some of that decision making isnot something they do if they
had a whole lot of money.
I mean, they have to say, we'vegot to quit because of money.
And so I do think that that's ahard one.
And yet, there's so many peoplethat are in that boat.
SPEAKER_02 (22:18):
But financial economic costs, productivity
costs,
SPEAKER_00 (22:23):
in
SPEAKER_02 (22:23):
and out of the workplace, ability to advance in
one's career, do one's job,relocate if necessary.
I mean, there are real financialand economic costs.
Right.
Right.
(22:53):
think it's like going into anail salon.
SPEAKER_01 (22:55):
You know, oh, I'm going to do an IVF cycle.
SPEAKER_02 (22:58):
Not that simple.
How many do you want to put backin?
Three or five?
Not that simple.
So physical costs.
You know, logistical factors,social factors, some cases
religious or ethnic orpsychosocial factors.
I mean, it is such a loaded,issue that you can really say–
(23:20):
to say it's high stakes is anunderstatement.
You
SPEAKER_00 (23:24):
know, it also– When it happens over a long period of
time, just like any chronicproblem, chronic pain, chronic
anything, people begin to notknow what to say.
And they don't know whether tosay, well, are you still trying?
Or, you know, how are you?
And so the people that mightnormally be there for you
(23:46):
because of the chronicity of itand their discomfort with that,
people stay away.
from the idea that their ownlives could get out of control.
Yeah, of course.
And so they don't particularlylike it.
And so it's, again, we're sortof talking about the loneliness
you talked with Kelly about.
But having that someone thatdoes know, having that, it could
be your partner, but it couldalso be sometimes your partner
(24:10):
is going through their own griefand their own feelings.
And so sometimes having someonewho, either a therapist, a
friend, someone who canregularly talk to you about it.
SPEAKER_02 (24:19):
So we all know in medicine and science and
healthcare, you start with theobservation first.
So I think we've done a good jobof that, kind of identifying a
lot of the issues.
Now to take it to the granular,actionable, someone's listening
right now, they are anindividual on a fertility
(24:39):
journey.
What should they know to have abetter experience?
Well, I mean, I would say startearly with your planning and
your mind in, you know, processor, you know, getting your mind
wrapped around the wholejourney.
Do your homework, do yourresearch, what it entails, the
(25:00):
cost that it entails.
Also seeing whether or not yourinsurance company actually does
pay for it.
And if not, then having thatplanning ahead for the financial
cost.
Average, they say anywherebetween three to five years.
And I would say have thisconversation, if possible, with
(25:32):
your employer sooner rather thanlater, right?
I mean, this is—you might— inyour mind think this is way down
the road, but there is no harmin starting to acquire
information, find out what ispossible through your employer,
what's not possible, startasking questions, normalize this
whole process, would you say?
SPEAKER_00 (25:53):
What I was going to say was that there was a book,
and basically the author tookpeople who wanted to be parents
through a decision-makingprocess about what was most
important to them about being aparent.
UNKNOWN (26:07):
Right.
SPEAKER_00 (26:07):
Was it the biological connection like you
and Kelly were talking about?
Was it I get to see them walkdown the aisle or I get to put
up with them when they're 12 andtry to get through those years?
Is it heritage?
What is it about being, do youreally need to feel pregnant?
(26:29):
Is that part of the desire?
Because if you line those up,And you both do that, both
people in the couple, then youcan begin to see how that's
going to affect yourdecision-making process.
And again, and then compromiseor negotiate about those things,
which, you know, that can be aninteresting discussion in and of
itself.
(26:49):
And imagine,
SPEAKER_02 (26:50):
if you will, that you were single-handedly
responsible for making onechange in the workplace and that
could help a person or a couplegoing through a fertility
process?
Alana, what's your one change?
I would say...
(27:11):
support before even gettingpregnant, whether or not it is
to get someone prepared forhaving a family, whether or not
it's remote work or just theflexibility of having that
entity in your life where youcan be in a space where you can
(27:33):
have a family.
And I would just say, if it wereup to me, Talk, talk, talk,
acknowledge, normalize,communicate.
I know that our communication,this conversation has definitely
helped people today.
Thank you so much for sharingyour professional insights, both
(27:53):
of you.
This has been incredible.
SPEAKER_00 (27:55):
Thank
SPEAKER_02 (27:56):
you.
UNKNOWN (27:57):
Thank you.
Thank you.
SPEAKER_02 (27:58):
And thank you, our listeners.
We hope that this episode of TheVisibility Gap helps you and
your loved ones feel seen.
If you like what you heard,please share, like and
subscribe.
Hi, and welcome to the Visibility Gap.
Today we're talking about familybuilding and the critical role
that workplace benefits can playin supporting people on this
journey.
Here's a fact that you might notknow.
According to Maven, 57% ofemployees say they would
(00:21):
consider switching jobs forbetter fertility benefits.
57%.
In this episode, you'll hearfirsthand from someone who
experienced this all andbenefited not only from the
support of friends and lovedones, but benefited also by
being seen and supported throughworkplace benefits.
Then we'll bring on a panel ofexperts to discuss the big
(00:43):
picture and how businesses canhelp employees feel more seen.
Our guest today is KellyDonoghue.
Kelly is a realtor from LosAngeles.
Kelly credits her partner'semployer-sponsored health
benefits as, quote, one of theonly reasons why IVF was
possible, end quote.
Kelly is normally optimistic andstays healthy, but through the
(01:04):
process, she started askingherself, Is there something
wrong with me?
Kelly, welcome to The VisibilityGap.
Thank you so much for beinghere.
SPEAKER_01 (01:12):
Thank you for having me.
I
SPEAKER_02 (01:14):
can't wait to hear about your story because every
person's journey to parenthoodis unique and individual and
specific to them.
But I would love to hear yourstory and what led up to your
decision to become a parent.
SPEAKER_01 (01:30):
Sure.
Well, I decided in 2020, mypartner and I wanted to give it
a shot at having children.
And so we decided, well, the wayto do this is through IVF.
And we thought, okay, let's justget started.
It's going to be a piece ofcake.
Go in, go have a baby.
Easy preasy, you know.
(01:50):
And that was not the case.
I went through 11 rounds of IVFand two
SPEAKER_02 (02:00):
IUIs.
When did it become obvious toyou and your partner that your
jobs covered IVF benefits?
SPEAKER_01 (02:09):
Well, when we started trying in 2020, we knew
that we had three cycles withinsurance.
So we thought, okay, we've gotthree shots here.
Let's Give it the college tryand get it done.
And three shots was not enough.
Three rounds of IVF.
That's three egg retrievals.
That's three, you know, goingunder anesthesia three times,
(02:32):
which I went under 11 times.
So I kept on going down the roadwhere we would—my partner
actually got a better job offer,and so— We switched jobs, and
then there was a whole new roundof IVF available to us through
that insurance.
She didn't switch the job justfor IVF or for anything of that
(02:53):
matter, but it afforded me theopportunity to have another
three shots through theinsurance company to do IVF.
SPEAKER_02 (03:03):
And when you were going through, let's say, the
first round and then the secondround, did you feel...
increasing stress and pressurethat, you know, you knew that
it's three of three.
Now I'm O for two.
Everything is riding on thislast cycle.
And what was that pressure andstress like?
SPEAKER_01 (03:22):
The first time I did IVF, I told my mom and all my
sisters and my aunt, all right,I'm going to be pregnant, blah,
blah, blah.
Here it goes.
And then when you have to be theone to say, oh, by the way, it
didn't work.
And then The emotions of that,like having to deal with that to
tell other people that it didn'twork rather than just you and
(03:43):
your partner knowing, being in aprivate situation, was so much
worse.
So then after that first roundof IVF, I didn't tell people
that I was going through IVF.
And yes, it was very taxing.
And, you know, come the thirdround, it's this or nothing.
Or you pay out of pocket, whichis very costly.
SPEAKER_02 (04:04):
You say that you started to be more secretive
about it, which is totallyunderstandable.
With that must have come alittle bit of loneliness, right?
I mean, you're trying to keep anumber of balls in the air at
the same time, juggling work andall of your professional
responsibilities with all ofthis physical and psychological
(04:26):
process.
Did you feel...
at that point, you know, thatloneliness added to the stress?
SPEAKER_01 (04:35):
I think the only loneliness I felt was the
sadness that I couldn't share itbecause I didn't want to, in
case there was, it's notsuccessful, that I would have to
let everyone down again.
You know, it's quite the rollercoaster.
But I have a very wonderfulpartner, so she was going
through that with me andsupporting me emotionally
(04:57):
because I, The physical thingsyou have to go through, which,
you know, the injections in yourstomach, they hurt and they
leave scars, scar tissue.
So it's kind of a permanentthing.
And also the hormones that youhave to take, you know, it
really does affect you.
You gain weight.
You get tired.
SPEAKER_02 (05:17):
I mean, I'm interested to hear your
experience because I think a lotof people, you know, hear or
think assisted reproductivetechnology is, family building,
IVF, and they think, it's likegoing in for a haircut.
So what were the, you hit onsome of the physical kind of
(05:39):
consequences or experiences thatyou had, but talk us through
both the psychological,emotional, and physical
experience that just one roundof IVF was like, let alone
SPEAKER_01 (05:53):
IVF.
SPEAKER_02 (05:54):
Nine.
SPEAKER_01 (05:59):
Sure.
Plus.
You are creating as manyfollicles as you have, and
(06:21):
they're becoming enlarged, andso you feel bloated all the
time.
You feel exhausted.
You also feel very emotional asfar as things could trip you up
very easily or make youextremely sad or extremely
happy.
The things that you wouldnormally be regulated on are not
regulated.
Shorter fuse.
Shorter fuse.
SPEAKER_02 (06:41):
You hit it.
Yes.
And your baby was born...
Yes, she
SPEAKER_01 (06:46):
was.
What was that experience like?
It was wonderful.
It was wonderful.
We really didn't know the roadwe were going down.
I mean, you really don't knowanything when you're going into
IVF.
You expect something, and thenit's something else.
But working with a surrogate wassuch a wonderful thing.
We lived in the same city.
We got to go to all theultrasounds.
(07:06):
We went to the hospital.
We had our own room.
She was right next door to us,and it was a wonderful birth.
We were there when the baby wasborn, and just the emotional
impact of what this womanexperienced did for us, I will
forever be grateful to her.
SPEAKER_02 (07:25):
Yeah.
Yeah.
I can hear the emotion in yourvoice.
Yeah.
What would you say now thatyou've been through this process
several years, you have ahealthy baby, what helped you
and what didn't help yousocially and functionally
throughout this process?
Because it can be very isolatingfor anyone who male or female
(07:51):
going through this process, butparticularly, I think, for
women, it can be very hard.
You know, it can seem like,well, what do you mean?
This should be the most naturalthing ever.
Why is it so difficult?
What's wrong with me?
What helped you get throughthose kind of moments?
SPEAKER_01 (08:10):
Taking time for myself, going for massages,
meditation, Love meditation.
Yes.
Talking about it with mypartner, being kind to myself,
and letting myself know that,you know what, this is not a
rare thing.
So many people go through thesejourneys, you know, whether
(08:31):
you're a man and a woman, twowomen, two men, whoever it is,
whatever you're going through,you
SPEAKER_02 (08:40):
just need to be kind to yourself.
So now that I'm putting you onthe spot and making you kind of
the voice of family building forthis one moment, hypothetically.
If you could close your eyes,institute a new either policy or
system or just vibe, ethosaround family building, and
(09:02):
start with the advice you wouldgive to the inner circle of the
person going through it, whetherthat's caregiver, immediate
support system, what would youradvice be?
SPEAKER_01 (09:13):
I wish I would have known that it might not be that
easy.
And you have to have patience.
You really, really have to havepatience.
And I'll tell you this.
When I went through my firstround of IVF and it failed, I
cried tears.
And you just have to tellyourself, listen, what will be
(09:36):
will be.
I will be just fine no matterthe outcome.
And you have to have thathealthy mentality and you have
to keep on telling yourself thatbecause I'll tell you this, it
will slip in where you have thedark days where you're like, oh
my gosh, there must be somethingreally wrong with me.
And there might not be somethingwrong with you.
It might just, who knows, couldbe something else.
SPEAKER_02 (09:59):
That blame is so insidious, but it really can
creep in.
What about, can I ask you,Kelly, did you and your partner
ever, at any time consider othernon-biologic paths to
parenthood?
SPEAKER_01 (10:14):
Yes, we are very open to adoption.
There are many different typesof adoption.
There's embryo adoption.
You know, the people who havegone through IVF, couples or
single people, who have extraembryos and they don't want to
discard them, but they want tojust donate them to a family to
adopt.
There's that option, which we'reopen to.
(10:35):
We're open to adopting childrensomeone who is maybe not a baby,
maybe someone who is a littleolder.
The main thing is we just wantto grow love, and so there are
many avenues for that.
SPEAKER_02 (10:48):
Do you remember, I want to call it the finish line
moment, even though it's reallyjust the starting line, the
second you held your baby inyour arms for the first time?
SPEAKER_01 (10:58):
Yes, yes.
SPEAKER_02 (10:59):
What was
SPEAKER_01 (11:01):
that like?
I was the first one to haveskin-to-skin with her, and as
soon as she came out of thewomb— And I just remember
thinking, I cannot believe thisis real.
Is this really real after whatmy partner and I both have gone
through for the last four yearsof our lives?
Is this really happening?
And it was, and it did, and itis, and it's really wonderful.
SPEAKER_02 (11:28):
Well, I am certain that there are so many people
who feel seen as feel morevisible, feel more validated
after hearing your story.
I just cannot thank you enoughfor being here, Kelly.
SPEAKER_01 (11:45):
It's my pleasure.
Thank you for having me.
SPEAKER_02 (11:49):
We have an amazing panel of experts joining us
today.
Dr.
Margaret Rutherford is aclinical psychologist with over
30 years of experiencespecializing in treating
individuals and couples fordepression, anxiety, and
relationship issues.
She is the author of PerfectlyHidden Depression, How to Break
Free from that Perfectionismthat Masks Your Depression.
(12:13):
Welcome, Margaret.
Thank you.
And Dr.
Alana Biggers is an internalmedicine physician and public
health researcher dedicated toadvancing health equity and
improving chronic diseaseoutcomes.
She is an associate professor atthe University of Illinois
College of Medicine in Chicagoand specializes in general
internal medicine for adults,preventive health, chronic
(12:33):
disease management, and women'shealth.
Welcome, Alana.
Thank you for having me here.
Thank you both so much for beinghere.
So you both heard Kelly's story.
Yes.
What jumped out at you?
What jumped out to me was, youknow, her not knowing what it
was going to take to actuallyget into this process.
Wow.
I was like, okay, one, I'm sureshe went in there not knowing
(12:56):
that she was going to do this 11times, but actually everything
that went along with it, theemotional toil that it took, the
weight gain that she had, youknow, not being able to get
pregnant each time.
The pain, the physical pain.
SPEAKER_00 (13:12):
Exactly.
So, yeah.
I've been through IVF.
So I remember feeling exactlylike she did.
And in some ways, I think it'ssomewhat self-protective to not
necessarily know all the gorydetails of what's going to
happen because you might chickenout.
So that was very interesting tome,
SPEAKER_02 (13:31):
too.
I love getting into the mentalhealth aspect of any physical
process or journey or issue ordisease.
I feel like in medicine...
unfortunately, mostly Westernmedicine.
We tend to disconnect thephysical from the mental, right?
I'm sure you agree with that,Alana.
(13:52):
But I want to ask you, Margaret,more about the, you said the
It's almost protective to kindof go into it not knowing.
SPEAKER_00 (14:26):
more eloquently than me.
But I wanted to do this, and Iwas willing to take that risk.
And so that motivated me morethan fear.
It had its own version of fearto be expressed.
But it was something I was, aswe'd say in Arkansas, bound,
(14:48):
bent, and determined to do.
Oh, I love that.
SPEAKER_02 (14:50):
Bound, bent, and determined.
Do you feel...
that when we talk about theability to reproduce fertility,
whether you're looking at theparadigm of fertility or
infertility, that it's aparticularly charged topic
psychologically as well asphysically.
(15:11):
Yeah.
It's almost like we assume...
Both men and women just assumethat it can happen.
I'd taken birth control
SPEAKER_00 (15:19):
for years.
And I was the one with theinfertile issues, not my
husband.
And so I felt my body hadbetrayed me.
I was less of a woman because Iseemed to struggle in this way.
And yeah, my self-worth took abig hit, took a big hit.
And I had to grieve a lot aboutthat.
(15:40):
I mean, I had
SPEAKER_02 (15:41):
a similar experience as well.
I'm an older mom.
Parietic mom, as they would say.
Horrible term.
I hate that term.
(16:14):
with me, or maybe I waited toolong because, you know, my
career, and just having thatguilt attached to it.
So guilt segues a lot of timesinto stigma.
And I know a lot of your career,Alana, is about dealing with
inequities in our healthcaresystem.
(16:35):
But let's just start on a microlevel, individual guilt and
stigma.
Okay.
For fertility, right?
For having a miscarriage, fornot being able to conceive, for
needing or wanting IVF.
How quickly does that go down arabbit hole?
Yeah.
Very quickly.
(16:56):
I know personally, for me, youknow, again, the guilt of, oh my
gosh, why did I wait so long?
Why did I put my career, youknow, ahead of family planning?
Whereas, you know, it wassomething that I don't feel have
any regrets being a doctor.
I love being a doctor.
I love what I'm doing.
(17:16):
But when it came down to familyplanning, I, you know, doubted
myself in that moment.
When you try to connect the dotsbetween the mental and the
physical, mental health,physical health, and well-being,
and where that disconnect oftenis, you can see what's at stake
when it's not there, when itgoes wrong.
(17:38):
You can see Kelly's case.
She had so much support.
She felt seen by her partner, byher family, by her loved ones.
In the workplace, they hadsupport.
But when they don't, Right.
Right.
(18:11):
I agree with you completely.
And people lose sight of eventhe relationships that they're
in as well.
So I think that that would be agood idea for people to have a
pledge to each other and toactually really sit down and
talk about what this could looklike.
And as you alluded to, thinkingabout how it would look like
(18:34):
without a child if the processdoesn't work out the way that
they want to, and then hopefullygetting to a place where they're
okay with that.
Which is a task.
Yeah, absolutely.
SPEAKER_00 (18:46):
You know, as I was listening to Kelly, too, I kept
thinking, and I experienced thismyself because we tried for
three and a half years and thengot IVF and were successful.
I remember thinking, I need togrieve.
I've lost—another cycle has comeand gone.
Another IUI was tried.
(19:06):
Another drug was tried.
And yet you think, but I can'tgrieve because maybe next month
or next cycle it'll bedifferent.
So you're stuck in this spotemotionally where all aspects of
grief are there, sadness, anger,fear, and yet you— You don't
(19:26):
know if you really want to gothere because next time it might
all be just fine.
And so it's this balancing offeeling, forward thinking and
saying, I've got to remainoptimistic.
I've got to remain positive.
I want to do that, just likeKelly was talking about.
And also balancing out orbeginning to connect with when
(19:49):
it's appropriate.
the harder emotions that you canfeel.
SPEAKER_02 (19:55):
And giving yourself permission to have that full
amplitude of highs and lows.
Exactly.
Even though it is probably aprotective, coping defense
mechanism to say, I'm just goingto keep it right here.
How many times have we heardpeople or even ourselves said, I
don't want to get too excited,but dot, dot, dot.
But Kelly said something elsethat I thought was interesting
(20:17):
and I want to get your take on.
She believes in meditation.
She practices meditation,mindfulness.
I'm a big believer in thatmyself.
I know you are, Alana.
How underutilized do you thinkmindfulness practices are?
I know what you would say,Margaret.
Very.
I mean, right?
In regular internal medicine,preventive care, women's health.
(20:40):
Yeah.
In general, definitely notutilized that much.
And then even when we look atdifferent segments of our
population, too, whether we'relooking at people of color is
utilized even less.
So, yeah, I actually do researchon mindfulness meditation And
I'll be honest with you,recruiting has been a challenge
(21:03):
to get people enrolled in thestudies.
However, once I get peopleenrolled, they love it.
Like my focus groups, they'relike, oh my gosh, I wish I was
doing this before.
So it's very underutilized, butit's very helpful once people
finally get into that practice.
And it doesn't have to be like30 minutes, an hour.
(21:25):
I think that mental blockactually stops people from
engaging, but it can be justfive minutes.
It can be two minutes in theshower, anything.
I mean, the costs...
They're significant.
Yes.
Yeah.
They say, I think, the averagecost is anywhere between$12,000
(21:46):
to$20,000 per IVF cycle.
And only insurance, about 43% ofinsurances in general pay for
IVF.
So people, many people arepaying
SPEAKER_00 (21:58):
out of pocket.
I'm sorry.
Some of that decision making isnot something they do if they
had a whole lot of money.
I mean, they have to say, we'vegot to quit because of money.
And so I do think that that's ahard one.
And yet, there's so many peoplethat are in that boat.
SPEAKER_02 (22:18):
But financial economic costs, productivity
costs,
SPEAKER_00 (22:23):
in
SPEAKER_02 (22:23):
and out of the workplace, ability to advance in
one's career, do one's job,relocate if necessary.
I mean, there are real financialand economic costs.
Right.
Right.
(22:53):
think it's like going into anail salon.
SPEAKER_01 (22:55):
You know, oh, I'm going to do an IVF cycle.
SPEAKER_02 (22:58):
Not that simple.
How many do you want to put backin?
Three or five?
Not that simple.
So physical costs.
You know, logistical factors,social factors, some cases
religious or ethnic orpsychosocial factors.
I mean, it is such a loaded,issue that you can really say–
(23:20):
to say it's high stakes is anunderstatement.
You
SPEAKER_00 (23:24):
know, it also– When it happens over a long period of
time, just like any chronicproblem, chronic pain, chronic
anything, people begin to notknow what to say.
And they don't know whether tosay, well, are you still trying?
Or, you know, how are you?
And so the people that mightnormally be there for you
(23:46):
because of the chronicity of itand their discomfort with that,
people stay away.
from the idea that their ownlives could get out of control.
Yeah, of course.
And so they don't particularlylike it.
And so it's, again, we're sortof talking about the loneliness
you talked with Kelly about.
But having that someone thatdoes know, having that, it could
be your partner, but it couldalso be sometimes your partner
(24:10):
is going through their own griefand their own feelings.
And so sometimes having someonewho, either a therapist, a
friend, someone who canregularly talk to you about it.
SPEAKER_02 (24:19):
So we all know in medicine and science and
healthcare, you start with theobservation first.
So I think we've done a good jobof that, kind of identifying a
lot of the issues.
Now to take it to the granular,actionable, someone's listening
right now, they are anindividual on a fertility
(24:39):
journey.
What should they know to have abetter experience?
Well, I mean, I would say startearly with your planning and
your mind in, you know, processor, you know, getting your mind
wrapped around the wholejourney.
Do your homework, do yourresearch, what it entails, the
(25:00):
cost that it entails.
Also seeing whether or not yourinsurance company actually does
pay for it.
And if not, then having thatplanning ahead for the financial
cost.
Average, they say anywherebetween three to five years.
And I would say have thisconversation, if possible, with
(25:32):
your employer sooner rather thanlater, right?
I mean, this is—you might— inyour mind think this is way down
the road, but there is no harmin starting to acquire
information, find out what ispossible through your employer,
what's not possible, startasking questions, normalize this
whole process, would you say?
SPEAKER_00 (25:53):
What I was going to say was that there was a book,
and basically the author tookpeople who wanted to be parents
through a decision-makingprocess about what was most
important to them about being aparent.
UNKNOWN (26:07):
Right.
SPEAKER_00 (26:07):
Was it the biological connection like you
and Kelly were talking about?
Was it I get to see them walkdown the aisle or I get to put
up with them when they're 12 andtry to get through those years?
Is it heritage?
What is it about being, do youreally need to feel pregnant?
(26:29):
Is that part of the desire?
Because if you line those up,And you both do that, both
people in the couple, then youcan begin to see how that's
going to affect yourdecision-making process.
And again, and then compromiseor negotiate about those things,
which, you know, that can be aninteresting discussion in and of
itself.
(26:49):
And imagine,
SPEAKER_02 (26:50):
if you will, that you were single-handedly
responsible for making onechange in the workplace and that
could help a person or a couplegoing through a fertility
process?
Alana, what's your one change?
I would say...
(27:11):
support before even gettingpregnant, whether or not it is
to get someone prepared forhaving a family, whether or not
it's remote work or just theflexibility of having that
entity in your life where youcan be in a space where you can
(27:33):
have a family.
And I would just say, if it wereup to me, Talk, talk, talk,
acknowledge, normalize,communicate.
I know that our communication,this conversation has definitely
helped people today.
Thank you so much for sharingyour professional insights, both
(27:53):
of you.
This has been incredible.
SPEAKER_00 (27:55):
Thank
SPEAKER_02 (27:56):
you.
UNKNOWN (27:57):
Thank you.
Thank you.
SPEAKER_02 (27:58):
And thank you, our listeners.
We hope that this episode of TheVisibility Gap helps you and
your loved ones feel seen.
If you like what you heard,please share, like and
subscribe.
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