Understanding reproductive health and fertility can be a complicated topic. In this conversation, we’re talking about family planning options for those who are considering having biological children.
Our guest is Dr. Tiffanny Jones, OBGYN and reproductive endocrinologist at Conceive Fertility Center in Dallas, Texas. She earned her medical degree from Meharry Medical College in Nashville, completed her residency in Obstetrics and Gynecology at LAC+USC Medical Center in Los Angeles, and completed a fellowship in Reproductive Endocrinology and Infertility at the Mayo Clinic in Rochester, Minnesota.
In this episode, we discuss the unique considerations Black birthing persons may want to be aware of when trying to conceive.
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We Also Talk About…
- What the egg-freezing process entails, and the ideal age to begin the process.
- How treatments such as IVF can help those experiencing certain fertility challenges.
- How conditions such as PCOS and endometriosis can impact fertility.
- Tests patients can ask for to learn more about their fertility status.
- How the occurrence of fibroids impacts Black people more than other communities.
Resources:
- Learn more about Dr. Tiffanny’s practice at Conceive Fertility Center
- Follow Dr. Tiffanny Jones on Instagram @tjonesivfmd
- Learn more about Black Maternal Health Week by the Black Mamas Matter Alliance.
- Episode 11: Reframing Fertility with Bri Braggs
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Understanding Fertility and Reproductive Health
How to Determine If Egg Freezing Is Right for You
Egg-freezing can be a valuable option for those looking to press pause on the biological clock. According to Dr. Tiffanny Jones, “The biological clock doesn’t pause unless you press pause. And that’s what egg freezing can potentially do.
You freeze those eggs at that age–ideally in your late 20s or early 30s–because your egg quality at that time in your life is really good.”
Dr. Jones emphasizes that egg freezing can be an option to consider for those who want to focus on other life goals before embarking on family planning. “We know that there is a natural course that our biological clock might not line up to what we desire,” she says.
Those who embark on the egg-freezing journey are given medication to prepare the eggs for retrieval. The mature eggs are then extracted from the ovaries, and frozen until ready for fertilization.
Fertility Treatments for Those Trying to Conceive
The most common fertility treatment for those who need support while trying to conceive is in vitro fertilization, commonly known as IVF. The process of undergoing an IVF treatment is similar to that of egg freezing. A patient is given hormonal medication to prime the eggs for retrieval. After the eggs are retrieved, they are then fertilized to create an embryo. The embryo can then be placed into the uterus, or frozen for a later date which is also known as embryo banking.
How Fibroids Can Impact Fertility
Fibroids are non-cancerous tumors that can grow inside or outside of a uterus. Many people with uteruses experience fibroids during their reproductive years. Common symptoms of uterine fibroids include abdominal pain and heavy menstrual bleeding. Some people can have fibroids and experience no symptoms at all.
Depending on the size and location of the fibroids, they can impact a person’s ability to conceive because the presence of fibroids can impact the sperm’s ability to reach the egg, as well as the fertilized egg’s ability to attach to the uterine wall.
In the U.S., Black women are two to three times more likely to experience fibroids than white women and are more likely to experience more severe fibroids symptoms. Research hasn’t identified why Black women are more likely to suffer from fibroids. Dr. Tiffanny Jones shared that there is a hypothesis that Vitamin D deficiency may be a factor, though there haven’t been any studies to confirm this theory.
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Music.
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I am your host and I appreciate you sharing space with me today
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it's on this podcast I produce many seasons or series will focus on a central theme or topic for six weeks.
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And today we're kicking off our new life series and honor of spring the season of New Life.
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And in honor of black maternal health awareness so in this series we're going to be diving into reproductive Health fertility motherhood supporting the mothers in our lives and giving birth to new ideas.
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Is a series that's been on my heart to share with you for a while and this is probably the most.
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Thoughtful intentional series that we've put forth today.
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So I really hope they are able to tune in for all six weeks of informative conversations that are really important for us to have.
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At the time that this episode is being released its April 20 22.
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April is National minority health month which is dedicated to advancing Health Equity in the US and the week of April 11th through 17th is black maternal Health Week.
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Which aims to amplify the voices of Black Mama's to Center reproductive health and birth
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Justice and I'm really proud to say that balanced black girl is going to be a sponsor a black maternal health.
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And we're going to be donating a portion of all of our ad revenue from this series to the Black Mama's matter Alliance which is a black woman LED Alliance that drives policy change research and advancements in care for black mothers and their families.
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So you can help support by tuning in to the podcast
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sharing these episodes with your people Wellness just doesn't happen on an individual level it happens on a collective level and the more people who hear these messages the better.
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So we're kicking off the series with an open conversation about understanding and demystifying reproductive Health with dr. Tiffany Jones OB-GYN and reproductive endocrinologist based in Dallas Texas.
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After earning her medical degree at dr. Jones completed her residency at USC Medical Center in Los Angeles
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she then gained a wealth of knowledge and fertility research and patient care after completing a fellowship in reproductive endocrinology and infertility at the Mayo Clinic in Rochester Minnesota.
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She's earned many awards including induction into the Alpha Omega Alpha Medical Honor Society
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d magazine best doctor 2020 and 2021 and Texas Rising Stars list 2020 and 2021 and she's also on the medical board for flow health.
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So in this episode we talk about everything from testing you can ask for to better understand your reproductive status how fertility challenges can present differently in black folks.
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Egg freezing and IVF process and what happens after the age of 35 that we've heard so much about.
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We also talked about how conditions such as PCOS and fibroids can impact fertility we get into all of this.
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I also want to acknowledge that at times some of the language in this episode is very gendered and focused on says gender experiences
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and as the host and facilitator in this space I really take
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the responsibility seriously and want this to be an inclusive space and will do better about making sure we use more gender inclusive language in future episodes.
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Okay that's enough for me.
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We have a jam-packed episode to get to so let's get into the interview so that you can hear from dr. Tiffany Jones.
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Dr. Jones thank you so much for joining me at balance flag girl I'm really excited to have you today thank you so much it's a pleasure being here with you.
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Absolutely I could not think of a better way to kick off this new series talking about reproductive Health fertility motherhood than bringing on yourself I mean you are a very celebrated.
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Doctor you are a leader in your space as a Reaper.
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Of endocrinologist I'm having a hard time saying those big words because I'm a marketer and I'm a marketer not a doctor but I just could not think of a better way to kick off this series and having a conversation with you so thanks again
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you're so welcome yeah so I would love to learn a little bit more about your background and what made you want to work in the reproductive Health space.
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So to become an we going you go through you know undergrad.
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Medical school and then you get to go to residency and I chose I'll be going because I loved women tell.
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I loved that you know you could kind of go throughout someone's life with them I like the surgical aspect of it but you have a real relationship with your patients with women.
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Then when I did The Residency I got to get exposed to other subspecialties.
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Like Urology or urogynecology high-risk pregnancies guide oncology but
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REI and infertility was just like a wow factor it's relatively new the oldest IVF baby is only 42 years old so it's very new very new field lots of new advances so I felt like I could still be on the
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Forefront of like a new frontier but the women who.
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Usually come to these for these services are really these goal-driven people who have you know just kind of done everything they wanted to do with their life and sometimes had to put
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family on maybe a back burner and they do when they're finally ready
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for someone to tell them that they're infertile is really hard and for a physician for me being there physician to help navigate.
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Through that course in their life and help them achieve the family that they desire is just so fulfilling you know I couldn't ask for a better job
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absolutely that's beautiful helping people be able to create their families is definitely a very special experience.
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So from a reproductive Health standpoint you know I would love to talk a little bit more about what that looks like.
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Kind of throughout the lifespan so we have listeners who are various ages we have some folks who are a little bit on the younger side and may not necessarily be wanting
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plan their families intentionally I also have quite a few listeners who are my age maybe in their 30s interested in Family Planning but I would love to talk about ways that we can kind of understand our
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fertility no matter where we're at
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so are their insights that we can get either when it's when we visit our gynecologist annually or from understanding our menstrual cycle that can just give us kind of an idea of what's going on when it comes to our fertility health.
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Absolutely I think the first piece of advice I would give to your listeners and to all women is just really to understand our fertility is natural life course you know.
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We are born with all of the eggs we're going to have as opposed to men who make new sperm.
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No woman makes a new egg so when we're born and where you know going through this life we're losing eggs are fertility,
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is going to Peak and then it's going to decline.
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And I think that's a hard concept for us to Grass even before you get to an OB guy in this should be taught
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you know when we're learning about our menstrual cycles and high school and middle school or that we don't you know like you should know you don't produce more eggs I mean it is like really
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completely my patients are God's back and when I say that because people don't know that and so it's just important and understanding that and understand that we are all going to menopause and menopause has a natural age the average age is 51.
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But it's considered normal.
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After 40 so when I have women who are older who come and their ovarian reserve for their egg count is lower it is no surprise to me
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because I understand that this is a natural course of life and if we understand that then we can prepare ourselves better and plan just like I know to get this job I need to do XY and.
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To make this family I need to know
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okay I'm in my mid-30s I need to make some decisions now the conversations and the testing that someone can.
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Undergo when they're trying to make these decisions or get more information about you know themselves personally because those are statistics right it's the average age is 51.
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But for you personally there are
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test that you can ask your OB guy nor your family medicine there are even companies where you can go direct and order them yourself so amh or anti-mullerian hormone
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is a fairly new hormone that we run but I use it all the time every patient that comes into my office gets it
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and it tells us how the ovaries are functioning and specifically how the follicles in the ovary that hold our eggs how they're functioning
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and it usually should be around 1.5 to 2.5.
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If it's lower than that really should let someone know okay my ovarian aging is probably a little bit
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faster than I would have predicted or it slower and you should anticipate it being lower because you're you know in your 40s or your mid-40s or your 50s.
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And ultrasound can also let us know what those follicles are doing
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so those are two very easy testing modalities to give you some information the caveat is you shouldn't use that information and have it scare you or make you fearful
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because what the studies show is that an amh that is very low does not mean someone is infertile
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okay it just tells us that our eggs may be running out but I know women who had very low amh has and got pregnant spontaneously
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okay because fertility is really you have to try and so if you're not trying you can't really get that diagnosis but you can use it as long as you're using it to empower your decisions like
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freezing eggs or banking embryos or just saying okay maybe I'm not going to wait so long but don't let it say All Is Lost.
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Because that is not how these tests can be used it cannot predict when you're going to go into menopause and it cannot predict.
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Who is going to be infertile and who's not going to be infertile.
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But it can give you a little bit of information if it's normal or abnormal on maybe how you prepare yourself.
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That is super helpful to be able to pinpoint those different areas that we can talk to our doctors about I really loved what you said about not being fearful because I think sometimes conversations regarding fertility can be
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fearful and seeing this knowledge as power and giving us just information so that we know what
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to do and what's going on with our bodies and what to do with that information can be really empowering so I love that you said that.
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So you mentioned a couple of things just now.
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Just around some potential options that people could consider if they you know wanted to have children maybe weren't quite ready yet things like
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egg freezing or I believe you also use the term embryo banking which I'm not familiar with but I have a feeling I'm about to.
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Familiar with when you tell us more about it so egg freezing is actually I think a process that is being talked about more.
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I know some people who are interested in those options I followed people online who are going through that procedure
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and so it's interesting to see people document their experiences with that because I think that that also helps the rest of us be more informed and so I appreciate when people share that can you walk us through
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you know when someone may want to consider doing something like that or what a good who a good candidate could be for those types of procedures or options.
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Yeah so I personally think that egg freezing,
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should be an option for everyone and I emphasize the word option I don't think that every woman needs to freeze their eggs absolutely not.
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Okay because a lot of people even if you freeze your eggs won't ever need them
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and it's not being done because you know you're going to be infertile but it's really to give you a little bit of peace of mind and to do a little bit of due diligence if you're on a life course that you know
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I'm going to get this law degree
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it's going to take me this long I gotta buy this house first and I need this car first I want my first Chanel bag you know you might have all these stipulations on how you want to navigate this one life that we get
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and that is your prerogative I'm all for that.
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But because we know that there is a natural course that our biological clock might not line up to what we desire
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the due diligence has let me do something that may pause this and give me a better chance if I am going to wait okay.
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People used to have babies in their early 20s.
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Right now we're having babies in our 30s mid 30s even 40s some people 50s.
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I can't get a 50 year old pregnant with her own eggs if she starts at 50.
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But if she froze her eggs at 30 then she probably can get pregnant at 50 if that's her desire.
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And so that's the that's the purpose of just knowing that option because sometimes life just escapes us right you're just going you know doing your business
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living it up traveling and you look up and it's like oh I'm 35 I'm still single you know and.
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The biological clock doesn't pause unless you press pause.
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And that's what egg freezing can potentially do you freeze those eggs at that age right and so we'll be better to do it in your late 20s early 30s because your egg quality at that time in your life is really good.
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Right that's the ideal time to start your family biologically but it might not be emotionally financially or any other number reasons.
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But if you push pause at that time those eggs are that age and so if you want to come back.
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When you do meet that partner or if you want to pursue it as a single mom by choice you have something that if you need them and again the emphasis is on if.
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You have really given yourself a better chance embryo banking is taking it another step further.
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Usually women who are either you know like you could be married you can have a partner a life partner you can just be someone who you know knows you want to do this by yourself but are not you're not you're still not ready to get pregnant.
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It means you fertilize those eggs instead of freezing them at the egg stage which still has a potential to be fertilized with any source of sperm.
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If you make the embryos that we know.
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We have embryos eggs we don't know if they're going to make embryos we have to follow them and then fertilize them and it's not one egg one embryo sometimes even at 26 eggs may get you one live birth.
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But if you have embryos you're much closer to that so usually I tell women who are coming in their late 30s and early 40s with the idea of still they want to wait that you may consider.
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Banking embryos to protect your own
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you know genetics because that's what we're doing you know it's not that a man because he makes me sperm he can have a baby in a 70s if he wants to.
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But us know it's not going to happen so if you want to protect your genetic material to make it more likely that at a later age you will have a biological child if that's important to you.
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Then making embryos later may be more beneficial because you know if they're viable or not.
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You don't freeze eggs at 40 do them at 43 and then find out that those forty-year-old eggs weren't viable in the first place because now you're back to square one.
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Got it got it that makes sense and if someone were to freeze their eggs and decide you know maybe a few years later that they wanted to use them
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what does that process like is it essentially like experiencing IVF how do those eggs typically get fertilized and then
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used once and embryos created absolutely IVF or in vitro fertilization is a process by which we stimulate some ones
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ovaries to produce more eggs than they typically produce a natural ovulatory cycle produces one maybe two eggs in an IVF cycle we're trying to stimulate all the resting eggs that someone may have and
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like let's see someone who's like 25.
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They may have 25-30 resting follicles so there's a potential to bank that many eggs at that at that age
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and remember I said you know sometimes it may be six eggs to get to one embryo
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so the medications that we use to stimulate those follicles or hormones that your body naturally produces but we have to give them to you in a much higher dose because your body only wants one or two and I want to 125
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so you take those medications usually for two weeks so it's the same as if you're trying to get pregnant with IVF if you're trying to get.
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Eggs for I am for egg freezing or if you're trying to get eggs for embryo banking you all you have to take those hormones you have to stimulate the ovaries and then the second half of the process is after the eggs are retrieved it's what you do with them
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D freeze them at the egg stage do you make embryos and freeze those for later use or do you make embryos and then transfer them back into the uterus.
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If you freeze them at the egg stage they have to be thawed they have to survive the thaw.
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And because eggs are a single cell not all of them may survive the thaw usually it's about a 90% fall rate so if you freeze 10 you may get nine back.
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Then you fertilize them with a sperm source so it can be a partner.
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It can be a known donor can be an anonymous donor but the sperm is usually placed directly into the egg so that you can.
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Assure that fertilization has a chance and if the embryo is formed it's because the egg and the sperm were able to take the next steps of life.
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And then that embryo has been cultured out to grow and then potentially either genetically tested because we can do that and frozen or it's put back into the womb to help Lee make a child.
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Got it thank you for walking us through that so it sounds like kind of a similar process for those Methods at the beginning to get those eggs stimulated and retrieved and then what's done with those eggs after their retrieved is kind of the difference and.
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In those Avenue absolutely got it.
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And is it possible to have a difference between someone's like biological age and reproductive age so if someone.
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Say you know is 35 but.
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Their follicles are like on and Poppin would that be like having a slightly younger reproductive age and vice versa so.
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The quantity versus the quality is kind of what you're saying right
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really age is the best indicator of success so if I had a 45 year old whose ovaries was on and Poppin
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our success rates with still below.
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Because the age Trump's all if I had a 45 year old who had very poor
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ovarian reserve and one who has very good ovarian reserve and yeah the good ovarian reserve would be better off in that 45 year old age group if I could predict which one would get pregnant but if I'm looking at overall.
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It's much more likely that it would be successful
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and someone who's younger around 30 then someone who's at the higher end of the spectrum to even undergo IVF
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quantity helps because the more eggs I have the more chances I have of making an embryo and the more chances I have of making a normal embryo.
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But age and that's why freezing eggs can be a very valuable tool because if you can freeze them at a younger age.
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It will just help a lot if you need them at an older age but the people that I've gotten pregnant at an older age yes they've definitely had a better egg quality for their age or quantity for their age yeah.
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Super interesting I just really I love learning about this so thank you so much for for these really thorough explanations
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along the same lines you know I am I would love to just talk a little bit more about.
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Fertility challenges and some of the different reasons that can happen and some of the options that people may have if they are trying to conceive but experiencing fertility.
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Challenges so are there usually common reasons or causes that someone may be experiencing fertility challenges whether is it like
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PCOS is it you know fibroids endometriosis do those impact someone's fertility outcomes
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absolutely those are all infertility diagnosis not every woman with PCOS will have infertility but.
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PCOS is a endocrine disorder where women usually don't ovulate
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so if you don't release an egg then you are unlikely to conceive.
00:22:25.680 --> 00:22:32.281
Sometimes when we would PCOS are ovulatory especially if there's different changes in diet and weight.
00:22:32.368 --> 00:22:39.474
Sometimes you know they may ovulate twice a year but that's enough to get someone pregnant but.
00:22:39.777 --> 00:22:43.813
Endometriosis again that's another one that it's a.
00:22:44.017 --> 00:22:51.231
Kind of inflammatory disorder where the lining of the uterus has implanted outside of the uterus into the
00:22:51.030 --> 00:23:01.989
cavity or the peritoneal cavity where the organs are and then the body recognizes that as abnormal tissue because it's not supposed to be there it's supposed to be inside the uterus.
00:23:02.130 --> 00:23:04.356
Because the body's fighting it
00:23:04.308 --> 00:23:12.701
it releases a lot of inflammatory cells because that's what fights things that are not supposed to be there like cancer or infection.
00:23:13.031 --> 00:23:23.450
So that can decrease success with fertility because as the body's fighting sometimes it can leave behind scar tissue that can damage the delicate tissue of our
00:23:23.393 --> 00:23:29.851
Fallopian tubes in the Fallopian tubes are the pathway by which eggs enter the uterus.
00:23:29.956 --> 00:23:34.685
So those are damaged than there's no access point it doesn't happen in every woman.
00:23:34.736 --> 00:23:42.103
Some women even with severe disease can still get pregnant spontaneously but it can make some people subfertile or even infertile
00:23:42.073 --> 00:23:50.637
fibroids again are another that you mentioned that really the location the number of fibroids the size can all Impact.
00:23:50.841 --> 00:24:01.421
Usually fibroids that are inside the womb where the baby would grow really severely impact implantation and can increase miscarriage rates so they should be removed
00:24:01.356 --> 00:24:08.254
if they're in the other layers which is the muscle or the skin layer that's covering the uterus called the serosa
00:24:08.134 --> 00:24:16.824
those usually don't cause too many problems unless they're close to the fallopian tube where they can block again if it's block how can the egg and the sperm meet
00:24:16.777 --> 00:24:31.246
so yeah there's a lot of different diagnoses one that we didn't talk about is malefactor you know either you're single that's a malefactor you're in a same-sex relationship that's a malefactor or you have a partner and his sperm quality is.
00:24:31.333 --> 00:24:35.297
Poor and four men we would never know
00:24:35.150 --> 00:24:49.755
you know it's not bad they have a menstrual cycle where it's like oh I haven't had a period in six months something's missing but you wouldn't know unless they're tested and I never want to get tested so you know there's a lot of reasons why people
00:24:49.599 --> 00:24:58.325
have infertility and again age is something that really not every woman who is 40 will struggle
00:24:58.187 --> 00:25:10.631
with infertility but it is quite common at that age so aging and fertility is just something I really want people to take away from this podcast because it's too many times women come to me.
00:25:10.754 --> 00:25:14.871
In there early and late 40s and they really just have no idea.
00:25:15.129 --> 00:25:23.981
That they would ever have a struggle yeah yeah I appreciate that and that's why these conversations are so important.
00:25:24.068 --> 00:25:29.995
I also appreciate that you mentioned the malefactor as well because that's that's important it is.
00:25:30.280 --> 00:25:42.004
A very important ingredient in creating a human it's about 50% of it it is very important it's needed and even though men are able
00:25:41.848 --> 00:25:49.584
produce sperm throughout their life spans as they get older does the quality of their sperm suffer and is that also a factor
00:25:49.563 --> 00:25:55.759
it can there's a lot of things you know as we age sometimes different health things come into play.
00:25:56.045 --> 00:26:06.940
This is the difference between men and women is men usually have millions upon millions of sperm we have one egg so the ratio is so skewed that Med even
00:26:06.901 --> 00:26:17.059
at older ages my father included can have children you get the right 25 year old it is.
00:26:17.074 --> 00:26:29.590
You know it's not that hard so yeah but yeah there definitely can be challenges as men age as well it's just not as you know irreversible I'll say,
00:26:29.596 --> 00:26:41.491
because with women I cannot give more eggs I cannot do it and so once we've run out you know then we have to visit things like donor eggs and for a lot of people.
00:26:41.506 --> 00:26:48.224
Especially people that look like you and I that's never an option we consider you know we don't understand it
00:26:48.123 --> 00:26:58.469
yeah yeah I actually that's the perfect segue to a question that I really wanted to ask you one just to see if in your work and I know you are far more.
00:26:58.547 --> 00:27:09.245
Knowledgeable about research than I am if it's true in to why you think it is so I was reading an article recently that studies indicated that black women.
00:27:09.332 --> 00:27:17.959
Our may be far more likely to experience fertility challenges that our white counterparts and that too,
00:27:17.965 --> 00:27:34.739
if we do experience those fertility challenges were far less likely to seek fertility treatment options and interventions based off of your work is that something that you've seen I'm curious one if we are more likely to experience fertility challenges why that is
00:27:34.502 --> 00:27:36.540
and two you know I.
00:27:36.807 --> 00:27:46.145
I could guess maybe why we may be less likely to get some of those treatment options but I would love to just hear your take on that aspect as well.
00:27:46.619 --> 00:28:00.234
Yeah I definitely think those studies are accurate as far as the disproportionality between black women and white women and diagnosis of infertility it does impact us more.
00:28:00.510 --> 00:28:04.510
And yes we do access it less.
00:28:04.651 --> 00:28:13.827
Some of that is we may be referred less we may not have access we may not have any providers that.
00:28:13.905 --> 00:28:27.160
You trust enough to see or you feel you do try to get access or you do have someone and you feel dismissed I get a lot of patients that have seen other people and you know it's just.
00:28:27.625 --> 00:28:30.868
People don't understand how to talk.
00:28:31.127 --> 00:28:38.916
Two people and you know just like other cultures we say like you know this is culturally correct black people we have a culture too
00:28:38.770 --> 00:28:50.889
you know if I'm trying to meet everybody where they are I never know why people don't think that you have to meet us right where we are too and I think that's why sometimes people go to people who look.
00:28:50.959 --> 00:28:58.037
Them so you don't have to explain every Nuance you know I just had a patient who.
00:28:58.502 --> 00:29:07.598
You know she was just cheerful through everything and even though her prognosis was super poor I knew that this was a black woman who was.
00:29:07.982 --> 00:29:13.962
Trying to put on a brave face because the first time we met a really big challenge she.
00:29:14.121 --> 00:29:28.663
Really broke and it broke my heart because I knew you know I knew she was teetering you know and I made sure I held her down because we are always the people who are trying to be Superwoman and just to let her know you don't have to wear that.
00:29:28.876 --> 00:29:36.378
You know this is hard it's hard to have these conversations about donors and it's a nuanced conversation.
00:29:36.411 --> 00:29:45.092
You know and I come from that culture so I know I know what it is to you know be at a dinner table and grandma don't know what this is and
00:29:44.990 --> 00:29:50.079
you know she got her comments and you know and you just you have to deal with all that
00:29:49.986 --> 00:30:04.177
you know why haven't you had a baby yet and why don't you have a man yet you know like I know but those are I come from this culture until these conversations can be so open and honest and let people feel so
00:30:04.003 --> 00:30:11.721
secure that they don't feel like just a number and because for black people our culture we don't we don't like that.
00:30:12.033 --> 00:30:25.089
I don't want to feel like you don't see me you don't hear me because it's happened too long and I won't take it and that sometimes can you know you have one bad experience and you just say ethic.
00:30:25.446 --> 00:30:34.749
You know but what I need people to know is you don't have time sometime to say ethic you got to be proactive because the year that you took a break.
00:30:34.971 --> 00:30:38.836
May have been your best year to get success.
00:30:39.229 --> 00:30:53.842
So yeah absolutely accessed can be a problem even when you have access it can be a problem fibroids are very prevalent in African-Americans we're never not now I hate to say in totality or speak like that but,
00:30:53.849 --> 00:30:56.642
sometimes our diagnoses are late
00:30:56.468 --> 00:31:08.966
or women in general or put on birth control pills and you know you not you're not really thoroughly evaluated and then so then you have a delayed diagnosis and again if I'm saying that the time the age is the most important
00:31:08.819 --> 00:31:23.199
we don't have time for delays or oh you have a fibroid and needs to come out when you want to have a baby but why you didn't ever had a conversation about what age she should be really thinking about having a baby because she came to me at 44
00:31:23.070 --> 00:31:25.089
yeah what the same fibroids.
00:31:25.212 --> 00:31:35.037
Machine even have chicken even have a chance to have a baby not even an accident baby you know so she you know so it's just like these things you know.
00:31:35.502 --> 00:31:45.173
Not everybody understands them I I understand them and so when I see a patient you know I really have to kind of navigate all those Waters.
00:31:45.251 --> 00:31:53.932
Even the waters outside of the textbook because sometimes those are where you can save a life or in our case make a lie.
00:31:54.218 --> 00:32:09.110
Yeah yeah oh my I appreciate those insights for sure and I think that they're important to talk about and I think that's why the work you do is so important so that people can work with you and get the help they need if that's what they what they choose to do
00:32:09.080 --> 00:32:17.690
I know we also we talked a little bit about fibroids just now how they impact reproductive Health outcomes
00:32:17.507 --> 00:32:25.630
I also know that they do tend to be more prevalent for those of us who are black people with uteruses
00:32:25.528 --> 00:32:31.382
do we also know why that is why we have been more likely to experience fibroids.
00:32:31.541 --> 00:32:42.167
Now no one can really put a finger on it I would assume that it would have to be something genetic but we don't have exact jeans or anything to Target but,
00:32:42.173 --> 00:32:54.167
it is it is like 80% of us in our lifetime will have a fibroid or fibroids I think a lot of research is needed to identify that another thing is if it is genetic
00:32:54.128 --> 00:33:02.431
you have to think about things that are weeded out of jeans usually if it's life-threatening then people don't survive to reproduce but fibroids.
00:33:02.662 --> 00:33:07.931
You know they don't usually kill you and then women who can conceive.
00:33:08.027 --> 00:33:16.861
You know it so I just I think it is a genetic thing and we just have to do some more research to identify it there's also like estrogen it's a stimulant
00:33:16.769 --> 00:33:29.771
for fibroids to grow all women have estrogen if they are ovulatory and not menopausal so you know we're all set up to grow these type of tumors but why it's disproportionately
00:33:29.750 --> 00:33:41.240
acting black women you know we still just don't know some people think it could be vitamin D levels because we have melanin it blocks vitamin D production so that's a very good hypothesis but
00:33:41.075 --> 00:33:45.840
you know I just haven't seen any solid data to say like this is exactly why.
00:33:46.098 --> 00:33:57.732
Yeah the vitamin D aspect is really interesting that's a really interesting take I would definitely be curious to see you know what we can learn one more research is done on it.
00:33:58.404 --> 00:34:05.699
I also have another question when you were talking a little bit earlier about people who may have certain challenges whether you know there
00:34:05.471 --> 00:34:14.719
they have fibroids or they're experiencing PCOS and then they may you know have a care provider say okay we'll come back when you're ready to have a baby and how.
00:34:14.959 --> 00:34:20.895
Problematic that can be I was thinking about PCOS specifically because
00:34:20.775 --> 00:34:34.758
from my understanding a lot of the common treatments for PCOS while people are managing it would be hormonal birth control and or focusing on something like weight loss if that's a factor that's impacting it
00:34:34.521 --> 00:34:43.652
but for someone who say has PCOS and would like to conceive sooner rather than later where it may not make sense to get
00:34:43.604 --> 00:34:51.097
to take birth control at that time for them how would they then manage their condition if that's the typical treatment for it.
00:34:51.382 --> 00:35:01.918
Yeah so you're really you know you have to know what you're treating so when women with PCOS are put on birth control pills usually someone's not ovulating
00:35:01.888 --> 00:35:05.204
so they're not releasing an egg if you're not releasing an egg
00:35:05.138 --> 00:35:12.090
even if you're not trying to get pregnant you won't get a period you'll get a withdrawal bleed but it can be very sporadic
00:35:12.016 --> 00:35:30.446
the sporadic periods can be very heavy leading to anemia you no need for emergency surgeries so why put somebody on hormonal birth control the reason why is because you want to regulate that cycle also what women with PCOS need to know is there an increased risk about 10% increase
00:35:30.245 --> 00:35:31.860
for endometrial cancer.
00:35:31.911 --> 00:35:41.429
Because progesterone which is released after you ovulate protects you from that if you never ovulate you never have any progesterone you just have estrogen
00:35:41.282 --> 00:35:51.980
estrogen is stimulatory just like it stimulates the fibroid it can stimulate the endometrial lining you can stimulate it to grow and also to change into change into cancer cells.
00:35:52.022 --> 00:35:57.624
So hormonal birth control can also be protective so it can stop erratic bleeding
00:35:57.567 --> 00:36:11.712
and it can prevent cancer but it also prevents you from ovulating if you were going to ovulate and it will prevent you from getting pregnant so women who want to get pregnant that's not a viable option
00:36:11.566 --> 00:36:19.184
what we want to do is to help you ovulate and there are medications that can do that so they stimulate your body too.
00:36:19.236 --> 00:36:23.433
Increase the hormones that stimulate the ovaries.
00:36:23.494 --> 00:36:32.337
And Justin just enough to then kind of push it to release an egg and an OB guy and can do that a fertility specialist can do that
00:36:32.289 --> 00:36:45.093
the medications luckily or very inexpensive which I cannot say for IVF medication so that would be the option for women who want to conceive not to prevent ovulation but to help you ovulate.
00:36:45.135 --> 00:36:57.309
But if you don't want to get pregnant then birth control pills or hormonal contraception can also help prevent that because not every woman wants to get pregnant at a certain time and that should be her right to.
00:36:57.369 --> 00:37:03.772
Definitely yeah and I appreciate the education they're just around how it works and what's.
00:37:03.842 --> 00:37:11.830
What's happening in your body if you take a tour if you don't I think that's really important and I think that that is a piece that's missing for a lot of people.
00:37:11.899 --> 00:37:13.909
It's just not understanding like okay
00:37:13.852 --> 00:37:31.680
how does this work and what is happening in my body when I do this and yeah because I think a lot of people are just placed on things and I there's a lot of I mean I'm on Instagram but I had to cool it down because it's so many people like bash in this and it says whole birth control conspiracy thing and
00:37:31.479 --> 00:37:37.234
you know I'm a really big proponent for just understanding like I don't think birth control pills
00:37:37.042 --> 00:37:52.952
our evil I use them quite frequently they're part of actually an IVF cycle but I know their hormones but I know that if I just put somebody on something and I never explain why they're taking it it's like a malpractice you know like you have to be in
00:37:52.751 --> 00:37:59.082
formed because I'm giving you something but you're making the informed decision to take it and when I come when someone.
00:37:59.242 --> 00:38:05.618
Tells me in my office I'm on X Y and Z and they don't know why it's like we've missed a step.
00:38:05.741 --> 00:38:15.377
You know and then that's why women are saying my doctor just put me on this and you know and it's like but I don't disagree with you being on it I just think that
00:38:15.167 --> 00:38:22.606
you need that education piece so that we all feel comfortable and understand the risk and the Alternatives and the benefits
00:38:22.387 --> 00:38:29.195
and hormonal contraception has a lot of benefits but it does not cause a period it causes a withdrawal bleed
00:38:29.111 --> 00:38:42.932
it does not restore ovulation you know so in some people say oh it mask your symptoms it can mask some things because you wouldn't know if you're not ovulating but it also has some really good things I've had like two or three young women.
00:38:43.083 --> 00:38:56.067
Young women with endometrial cancer nobody should have to go through that you know so it's not that it's not a benefit but educated the education is lacking then you're going to get this pushback from.
00:38:56.325 --> 00:38:59.605
The people who are you know being told to take it.
00:38:59.881 --> 00:39:09.354
Yeah I appreciate what you said they're just about being pro education and pro informed decision I think that's totally key
00:39:09.207 --> 00:39:18.618
and if someone has been taking hormonal birth control and this might vary from person to person if someone you know has taken hormonal birth control and decides to stop Maybe
00:39:18.552 --> 00:39:28.430
maybe they stopped because I want to stop but likely they stopped because they want to conceive does it take a while to start ovulating again for most people and what does that process look like.
00:39:28.634 --> 00:39:35.047
Usually not so once you stop these hormones don't last in the system very long.
00:39:35.224 --> 00:39:43.257
But why people say sometimes they can Mass things is because like if you been on birth control pills for ten years and I go back to my original
00:39:43.092 --> 00:39:51.233
if you start a birth control at 30 you been on it for 10 years and you 40 and then you come to my office and I tell your amh is low.
00:39:51.293 --> 00:39:58.678
Don't say the birth control pills cause me to go into menopause know your body was naturally aging
00:39:58.549 --> 00:40:12.073
as it it would do anyway and you wouldn't have known any different because you would have had a symptom of your periods becoming irregular because you're getting regular withdraw bleeds because when you're taking a birth control pills
00:40:11.899 --> 00:40:14.135
you have three weeks of active pills,
00:40:14.141 --> 00:40:27.827
and then you have a week of placebo and are now we go Placebo you'll get a period so you won't have a regular kind of cycle but if it was something that was going on you wouldn't have known but if you know already.
00:40:28.076 --> 00:40:35.209
Hey at 40 at 35 my eggs start to decline at 40 if I haven't had kids yet.
00:40:35.683 --> 00:40:42.996
I should have been ProActive at 30 but now I really need to just see what's going on I can't just stay on these birth control pills forever
00:40:42.993 --> 00:40:53.384
because you know that there is a natural process I think it was something in the media now about Kourtney Kardashian who is wanting to go through IVF and she's 42.
00:40:53.436 --> 00:41:02.423
And she said or the quote that I'm hearing is I took these IVF meds and they made me go into menopause they do make you going to menopause.
00:41:02.591 --> 00:41:14.603
Right and so we have to understand our biological clock Kourtney Kardashian had kids at a typical age and now she's in a new relationship and she wants more kids with her new partner.
00:41:14.843 --> 00:41:16.781
But at 42 it's hard
00:41:16.752 --> 00:41:31.392
your ovarian reserve is going to be much less and so we just have to like we have to have those kind of conversations but if we fear Monger then if I read that headline I'm like I'd never do IVF it makes you go into menopause hmm right.
00:41:31.587 --> 00:41:39.791
And we already don't want to go to the doctor we already have fear so it's like for me that kind of headline is dangerous it's dangerous for our people
00:41:39.788 --> 00:41:44.670
yeah because we don't trust it's going to make me go into menopause.
00:41:44.731 --> 00:41:54.636
Right and those click Beatty things just erode that trust even further right you know if like of course the Kardashian would be telling nothing that's not true.
00:41:54.804 --> 00:42:04.160
You know you just you know is I am very you know like we have to there's so much misinformation these conversations are so important to have to understand.
00:42:04.247 --> 00:42:16.961
We have to understand our bodies we have to talk to each other we have to educate our daughters our nieces you have to be empowered because if you're waiting for someone else if you're waiting for your doctor just to say hey.
00:42:17.139 --> 00:42:22.894
You know 35 this is what's going to happen it may not happen so we have to do it ourselves.
00:42:23.467 --> 00:42:32.878
Yeah that totally makes sense and that's what makes me grateful to have this space where I can you know learn from people like you and get to share that with my
00:42:32.857 --> 00:42:40.376
Community because I feel like if I have these questions I'm sure you know other people have these questions too and I'm grateful for the space yeah.
00:42:40.986 --> 00:42:47.596
Dr. Jones this is been so informative I feel like I've learned probably more about
00:42:47.512 --> 00:42:59.632
reproductive health and like my own reproductive system in the span of this conversation than all my health classes and everything else combined but I would not say that I had
00:42:59.467 --> 00:43:04.223
top-notch health class education no no shade to my my old
00:43:04.194 --> 00:43:17.754
School District but before we take off today I would just love to to have our audience know where they can find you if they want to follow your work potentially if they're there in Texas and would like to work with you where can they find you
00:43:17.742 --> 00:43:30.177
yeah so I am at conceive Fertility Center and Dallas Texas we have offices in Frisco or Irving and Dallas you can follow me on social media though I'm taking a Hiatus okay cuz
00:43:30.129 --> 00:43:36.830
please Charles getting on my nerves protecting right so it's at
00:43:36.692 --> 00:43:46.255
T Jones IVF MD yeah and we'd love to see anyone we do virtual consult you know and even if you reach out to me on social media and you're not in.
00:43:46.414 --> 00:43:57.166
My vicinity I do keep a great network of other re eyes other black re eyes that I'd be happy to link you to if someone is in need.
00:43:57.262 --> 00:44:11.056
That's incredible I'm so glad to hear that because I'm sure that will have people who will be interested in support in their areas so I'll make sure that we link your information in the show notes thank you so much for joining me today,
00:44:11.062 --> 00:44:13.181
you're so welcome thank you so much for.
00:44:13.040 --> 00:44:19.120
Music.
00:44:18.966 --> 00:44:22.606
Today's episode was informative for you.
00:44:22.666 --> 00:44:30.546
Especially if having biological children is something that you would like to do it's important to understand what your options are.
00:44:30.894 --> 00:44:38.540
What really stuck out to me was talking about the experiences that black birthing persons can have when it comes to fertility challenges.
00:44:38.654 --> 00:44:46.192
Being less likely to receive interventions and support it and treatments and I'm still sitting with that data point and really digesting it.
00:44:46.288 --> 00:44:52.160
My Hope here is that you feel empowered with knowledge to make the best choices for you.
00:44:52.338 --> 00:45:02.117
Head to the show notes for more information about talked to Tiffany Jones work and had to balance black girl.com for expanded show notes and a full transcript of today's episode
00:45:02.087 --> 00:45:10.003
thank you so much for our sponsors head to the show notes for special offers and coupon codes and of course thank you for listening today.
00:45:10.207 --> 00:45:22.174
Next week we're talking to fertility researcher dr. Cleopatra about Lifestyle Changes we can make to support our fertility outcomes and how we can minimize generational trauma being passed down through our lineage
00:45:22.171 --> 00:45:26.144
it's going to be a good one so make sure you're subscribed so you don't miss it.
00:45:26.000 --> 00:45:36.655
Music.
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