Preservation and Parenting Pathways

In the final episode of our infertility series, hosts Meaghan Repko DeShong and Rachel Nicks are joined by reproductive endocrinologist, obstetrician-gynecologist, and infertility specialist Dr. Tia Jackson-Bey for an empowering conversation about fertility preservation and family-building. 

Together, they discuss fertility preservation both in the context of a cancer diagnosis and for anyone who wants to better understand their reproductive options. They explore why these conversations should happen early, what options are available for people at different stages of life, and how advances in fertility care are creating new possibilities for patients, survivors, and anyone planning for the future. 

Whether you're navigating a diagnosis, considering your future fertility, or supporting someone you love, this episode offers practical guidance, hope, and the knowledge to help you advocate for yourself. 

Education is power, and understanding your options can make all the difference. 

Connect with our guests:  

Rachel Nicks
https://www.instagram.com/rachelenicks/  

https://www.instagram.com/birthqueenorg/    

Meaghan Repko DeShong 
Instagram: https://www.instagram.com/marepko/   

Dr. Tia Jackson-Bey 

https://www.instagram.com/drtiajacksonbey/?hl=en  

tinaswish.org/whattoknow 

tinaswish.org/whattoknow

Transcript

Welcome And Why This Matters

SPEAKER_00 0:05

Welcome to What to Know Down Below by Tina's Wish. We're here to empower you with the knowledge and tools you need to advocate for your own gynecologic health. Knowledge is power, and we encourage everyone to join us in learning more about what you need to know down below.

SPEAKER_03 0:21

Hello and welcome back, everyone. I'm Megan Refko Deshong, and I am here with my good friend Rachel Nix. And we're also joined by another special guest today, who we'll be introducing you two shortly. I wanted to briefly just introduce myself. I'm a board member of Tina's Wish. I am a strong believer in knowledge and education and awareness, and that's part of why we do this podcast, What to Know, down below. So I would encourage you also. This is the third episode in a series, so please go back and listen to earlier episodes where I tell my fertility story and Rachel tells her fertility story. It's really important that we all have this knowledge. With that, I'm gonna turn it over to Rachel.

SPEAKER_01 1:07

Hello, everybody. I am Rachel Nix. I am a mama, doula, trainer, actor, lactation counselor, and overall advocate for women being empowered and knowing about things down below. My favorite muscle group is the pelvic floor, and I am so happy to be here with a very, very, very, very, very special

Meet The Fertility Specialist

SPEAKER_01 1:27

guest, um, Dr. Tia Jackson Bay from RMA that rhymes. She is a fertility specialist, and Dr. Tia Jackson Bay, I would love for you to introduce yourself to our listeners and also, which I don't think I know the answer to, what led you to this pathway um in medicine. Like what's your why?

SPEAKER_02 1:49

Absolutely. Thank you guys so much for having me. I'm so excited for today's episode. Um, my name is Dr. Tia Jackson Day. I'm a reproductive endocrinologist and infertility specialist at RMA. I know that's a mouthful. Essentially, what I do is help people to achieve the families that they want. So sometimes that looks like you know, couples who are trying to get pregnant and unable to have a successful pregnancy. Sometimes there's no pregnancy at all, or sometimes it may be recurrent miscarriages. We also see anyone who has a medical condition that could threaten their future fertility. So sometimes we're seeing patients who are either dealing with cancer diagnosis now or are cancer survivors or previvors, as well as any medical condition like polycystic ovary syndrome or endometriosis, even uterine fibroids, anything that has to do with your reproductive organ function could very well fall in our wheelhouse. And something else that we're seeing more and more people who know that they want to have children or want to have the option for children, but know that they're not ready just yet. They may undergo different types of processes called fertility preservation. How can you hold on to your current fertility for your future self? And so we see lots of different combinations of patients all day. It's never a dull moment. Um, and I really enjoy the work that I do.

SPEAKER_01 3:18

Amazing.

IVF Basics In Plain English

SPEAKER_01 3:19

So today we're talking about preservation and parenting pathways. That also I think is a mouthful and a little like nebulous. I often um refer to my father who's uh 75, but he looks amazing. And when my cousin had IVF, he finally admitted in a same face that he was like, I don't know what that means. So can you just break down the basics of IVF fertility? Like what are what even this is the science of that and the pathway within that? Because you may be having issues, but there's multiple pathways that can allow you to achieve the outcome you desire.

SPEAKER_02 4:00

Yeah, absolutely. So again, you know, it all depends on what brings you into CME. And, you know, the majority of the patients that I see are actively trying to get pregnant, but it's not happening. So month after month of a negative pregnancy test. And in those cases, if it's been going on for one year, that absolutely is the time to come in because your highest chance for success may be in that first year. But if you're age 35 or older, we don't want you to wait a whole year. We actually want you to come in at six months because we know that there can be additional challenges to trying, and so you don't have to wait a whole year. Um, and so we may see people at various stages, you know, depending on what exactly is going on in their life. If it is deemed that, you know, you've been trying and unsuccessful, then the next step is to do an evaluation. And so, based on the results of that evaluation, it may be deemed that IVF is like the most appropriate treatment plan for you. So IVF stands for in vitro fertilization, which essentially is growing multiple eggs at a time instead of just growing and nurturing one egg per cycle, which is the norm for women. You would grow multiple eggs with the help of injectable medication. Those eggs are removed from your body with a surgical procedure. They are made into embryos, so each egg is inseminated with a sperm cell, and then those fertilized eggs grow into embryos over the course of a week, and then the embryo would have to be later implanted into the uterus in order to achieve pregnancy. So it may be the first line of fertility treatment for many people, depending on what their issue is. It could also occur if maybe lesser fertility treatments are unsuccessful, or if a couple has to use, you know, extra sperm or eggs from another source, um, or even use someone else's uterus, like a gestational carrier or surrogate, that's all gonna fall under different, you know, permutations of IBF.

SPEAKER_01 6:07

Thank you in your introduction for touching

Cancer Diagnosis And Fertility Timelines

SPEAKER_01 6:10

on oncology. And I think in the context of this conversation, being it Tina's wish, who is you know trying to find the early detection for ovarian cancer, can you uh guide us through when a woman receives a cancer diagnosis? No one wants that phone call, but if you are pre-menopausal and receive a cancer diagnosis, that absolutely will impact your fertility. Um, as someone who just traveled through that, can you just guide us through like what your advice would be as a clinician of like where do you start? Because it can feel very overwhelming.

SPEAKER_02 6:52

Absolutely. And so a big part of what I do is not only educate patients, but educate other doctors. And so we spend a considerable amount of time working with um obstetrician gynecologists, breast surgeons, gynecologic oncologists to make sure that they know that they must ask the question: do you want children? And if that's the case, we need to make sure that the patients are seen by us preferably before treatment or surgery. Sometimes that's not always possible. But you know, even many physicians that do the same kind of work that I do will get a call about a patient and see them the same day, if not the next day, because that's how important it is to us, and we know that it's very time-sensitive. So if you're someone who has received a cancer diagnosis, you know, sometimes it depends on what the diagnosis is and what the treatment plan may be as to whether or not, you know, how urgently we need to consider a fertility preservation, but it's never a bad idea to have the consult. And these consultations can be done quickly, sometimes they can even be done via telemedicine, which is kind of like a video chat, just to make sure that you're aware of all of the options and know what part or which you know, time this part needs to come into play. So the first thing first is to make sure that the cancer doctors or the doctors who are making the diagnosis ask this question. Super important, but also it's important for patients to know that they can bring it up as well. Oh, this is a huge, you know. I mean, receiving a cancer diagnosis is probably one of the most devastating things that anyone will go through in their life, and they are not thinking of everything all at the same time, but it's important for maybe other people in their lives, family members, friends, um, colleagues, you know, support group members to say, hey, did you bring this up to your doctor? Did you ask about this? Because it may be something that we want to do as soon as possible. So bringing it up is important. Um, finding a fertility specialist in your city, or as I mentioned, it could be outside of your city because it may be at a distance, and you can do your consultation via telehealth, is the next most important thing. If booking a consultation, it's also important to say I was recently diagnosed with cancer and my doctor wants me to be seen soon. So that this consultation is not a month off or even a few weeks, it's really important to get that information in as soon as possible. I do a lot of coordination with cancer doctors in terms of how quickly we can see someone, how quickly we can get treatment, is it safe to do a fertility procedure before or during their treatment course, and we'll work together on timelines. I've found that with time and with the demographics that are changing, even amongst cancer doctors, many of them are reproductive age women or you know, have understood the importance of having this choice for their patients later in life. We see so many more people who are survivors, we're seeing pre-vivors. We understand that this is a really important aspect of, you know, anyone's humanity in life. And so we work really hard to make sure that we can get them whatever treatment is most appropriate.

SPEAKER_01 10:14

You know, it's interesting that you say that. I have to give kudos to my male breast surgeon who was adamant and very encouraging of me preserving my fertility at 42. But he also referred to me as a young woman, which also gives me like goosebumps because he was very sensitive to um that piece of it for me. He was never like, you have kids, or why would you want more? Like it was just like you're a beautiful young woman, you should preserve your fertility. Like it and he was great. What was interesting, my oncologist, who's retiring, who's a fabulous and female at a different stage of life, was kind of like, what's the big deal? You just need to go on toxic to prevent cancer, right? Reoccurrence. And so her take wasn't quite, you know, lesser, wasn't quite as sensitive. So I think and the other thing is your cancer positions are very disjointed, like you kind of go down like a conveyor bell of like different doctors when you're in that journey. So, you know, I think thank you so much for uh opening that line of communication. But I think it is important that we all as a community emphasize that every piece of uh you know of that journey, everyone needs the same amount of information and sensitivity. Um, you know, my radiation nurses were super supportive of preservation and all of those things. But not everybody quite understands because most people will tell you you're 42, you have kids, what are you tripping about?

SPEAKER_02 11:48

Um I think that the the research has changed a lot over time too. You know, I mean, obviously we've had huge breakthroughs in cancer treatments in the past few years, even this year, with um the new medications being used for pancreatic cancer, which um, you know, got stand in ovation at one of the cancer conferences this year. You know, survivorship is real. There are going to be younger people with cancers, which means survivorship is for a longer period of your life. Um, and so I think from a cultural standpoint, societal and even medical, we have to kind of look more toward what is life going to be like after cancer. And so, you know, same thing. Providers also have to kind of change their shift and change their focus on that too, um, to make sure that yes, we are doing every single thing that we can do to address cancer now, but we want you to have a good quality of life later. And this is part of that, then it's possible. You know, there are protocols where you take tamoxifen for a certain period of time, stop the tamoxifen, and have a little window where you can pursue family building. And that was not something that was commonplace even five years ago. Right. You know, the data is changing. I was just at a conference last year and it was presented, and everyone was taking pictures because it's really exciting. But even as physicians, we have to kind of keep up with the the latest information as well. And so there's less fear and less resistance to know that yes, you can safely carry a pregnancy, you know, even after undergoing cancer treatment.

SPEAKER_01 13:26

Yeah, and that was what settled me because I chose not to preserve to get treated. And then the tamoxifen was really my issue of prohibiting, you know, future pregnancy. And once my oncologist was able to say, no, I just want you to take it for two years, and then you need to wait six months. Then I was like, if a baby's meant to be at 44 and a half, then that's what it is. So, you know, I look back to like my earlier years of like seeking and finding, you know, a someone to procreate

Destigmatizing Fertility Checkups

SPEAKER_01 13:53

with. Um and as liberal as I am and being in the environment in New York, I I still felt culturally and just in general, there was stigma around egg freezing or pres preservation, um, probably for numerous reasons. But can you just educate our audience about the import of preservation and preservation at a certain time in your life?

SPEAKER_02 14:20

So, you know, there are different kinds of types of fertility preservation for sure. I think it all is gonna start with um having the consultation. So coming in to see a fertility specialist, I know it can be a little off-putting because people are like, well, I'm not infertile, and we understand that we totally get it. Um, but just to see where things are, see, you know, what is the current status of your reproductive health. And so we do a lot more what we call fertility checkups or fertility check-in. Um, and that's where, you know, sometimes that maybe the first conversation that people are having, maybe they're having it with their primary care physicians or gynecologists, or in their friend groups, circles, sororities. So I always encourage anyone who's gone through this process, been successful, had good outcomes, talk to the people around you about it because that demystifies it, destigmatizes it, and you know, kind of can create a little social network or a kind of support group even amongst your friends or you know, church friends, or whatever the case may be. Um, so I think that's a big part of it. Coming in, having the evaluation, and then we talk about what are your family building plans. Um, is it on the horizon? Are you looking to start trying in the next year? What are the considerations there? Is it further down the road? And you know, maybe you're looking to go back to grad school, or maybe you're an actress and you want to be able to, you know, focus on your craft, or you know, all of these different factors that may come up in life that may uh lend themselves to delaying childbearing longer, then that might be an opportunity for you to consider, you know, fertility preservation. I have patients who work on Broadway and you get into a good show and you don't want to jeopardize that. And so we talk about you know what that could look like for them.

How Egg Freezing Works

SPEAKER_02 16:18

And so sometimes, you know, it may be egg freezing, and so this is probably one of the most common and popular uh methods of fertility preservation, which essentially is similar, like it's on the continuum of IVF, it's just a different endpoint. Instead of going to make embryos and going forward and transferring the embryo for pregnancy, you go through many of the same steps. You're taking injectable medication to get your ovaries to grow lots of eggs. You have to see us pretty frequently over about a two-week period where we're monitoring the egg growth based on hormones and based on how it looks on ultrasound. And then we pick a time to actually do the procedure to remove the eggs. The procedure to remove the eggs is very, you know, safe. It's simple. You know, there are minimal risks for obviously for places who do this and are feel very comfortable with taking care of patients in this way. Um, and so it's something that you can incorporate into your life. You don't have to take off weeks of work. Some people may opt to do that, but it's not required. We try to fit it around your own life schedule as much as we can. We have the visits early so that you could be done and go to work and you know get your updates in the afternoon so you know what to do for the evening. Um, and so egg freezing is that process of taking injectable medications, growing lots of eggs, having those eggs removed, and then they're frozen and they can stay frozen for years, which does not have a detrimental impact on the eggs, as far as we can tell. And if you need to use those eggs in the future to build your family, then there would be another process in the future of thawing the eggs, making them into embryos, and then using a single embryo to go into the uterus to make a pregnancy. So egg freezing is probably one of the most common. You can also freeze sperm, and so it's important for anyone to know men who may be diagnosed with cancer or have you know needs special surgeries or treatments, or someone who um again wants to uh transition and maybe take in hormone therapy, it might be worthwhile to free some sperm in advance just in case you want you know biologically related children in the

Best Timing And Realistic Odds

SPEAKER_02 18:41

future.

SPEAKER_03 18:41

I um I've sadly I've been through everything you just described. Um and while it's um a difficult process, it's one that to your point, I just want to echo it that it's I was working the whole time. Um yeah, I went home after the procedure when I got the eggs out, um, but I and I think I did it six times. So um, because if I'm gonna go, I'm gonna go big, you know, suck with one. But um I guess I and this is sort of a crystal ball question, but in talking about this, and I know there's no perfect answer here, but um maybe there's an age range, which is, you know, what's a what's an ideal time? And I guess ideal may might not be the right word, but like, you know, for people that are proactively doing this, they didn't have a cancer diagnosis or and it's really just I want a safety net, so if I were to need them, I've got them, you know, in the freezer. Um what's kind of like an ideal age range?

SPEAKER_02 19:39

I think, you know, in the best way we would want to see women before they start to exhibit an ovarian or egg decline. And we know that that can start as early as your mid-30s. So somewhere in between that 25 to 35 time, if it's on your mind, we absolutely want to see you. You know, we talked about stereotypes and waiting until there's no other option. No, I don't want you to wait until this is the last option. You can absolutely do this proactively when you're younger, healthier, have a higher egg count, and possibly have a better response to the medication so that lower doses of medicine still give lots of eggs, and that also contributes to safety and efficacy of the whole process. You know, for most women, again, under age 35, I think it's completely reasonable. I don't want you to wait until your 35th birthday to proceed. Like you can come and start the conversation, talk about options, at least just have it on your radar. Again, for young women who are considering professional school or maybe long engagements, or you know, wanting to um pursue other things, travel the world, you hear people, you know, moving to other countries now, there might just be an opportunity here to say, you know what, let me do this for myself, my future version of myself, um, just to have more options in the future and not necessarily because it's some dire consequences.

SPEAKER_03 21:11

I keep, I said on the last one, I said when like people graduate college and they get like help for like rent, I'm gonna like to my daughter, I'm gonna be like, we freasing those eggs, girlfriend.

SPEAKER_02 21:21

I agree, and I think that's exactly where this is going to go. You know, like get a car at 16 or you get, you know, to take a big trip after college graduation. Maybe at some point this will be the college graduation gift. Um, and I don't think that that's unreasonable. And then also for women who are over age 35, it's not like the ship has sailed. You know, over 35, obviously, we always are gonna start with the evaluation and see where things are. The biggest point of discussion is it might look a little different. You might need to do it more than once to get enough eggs to really give yourself some. Sometimes we may not get as many eggs in a single cycle, and that's the reason why we may do it more than once. The egg quality also changes in your you know late 30s and early 40s, and so that's why we may require more eggs. Or some people would say, Well, maybe I will freeze some eggs and also create embryos to freeze. And that way I have some options in the future. If you know you plan to have a child without a partner, maybe you use the embryos if you're using donor sperm. And if you find a partner but now you're older and your egg quality has changed, then you would have those eggs from the younger version of yourself as an aid, essentially, as assistance for you. Unfortunately, none of it is a guarantee. It doesn't mean that having frozen eggs or embryos will guarantee you a pregnancy in the future, and that can be a really hard part of the conversation as well. But the purpose of coming younger, healthier, getting more eggs is to kind of increase the chance of success. And so sometimes that's why we talk about maybe doing it more than once, or maybe kind of diversifying your strategy, like your investment portfolio, so that you have different options available

Donor Eggs And Surrogacy Options

SPEAKER_02 23:13

to you.

SPEAKER_03 23:13

I don't want to jump here, but I do think it's also important that we talk about. So if a patient has done all of these things and it's not working, right? Like what are the other pathways that people can look at once you get to that point? Because to your point, it's not a guarantee, right? Like it's human bodies. So what other than if that's what someone's facing, kind of how does the conversation for you go with options that folks have?

SPEAKER_02 23:39

It it totally depends on you know what the circumstances are. Um, I usually encourage people, if they're able to and you know, in the right state of health, to try on their own before coming back for their frozen eggs or embryos, if that's an option, if they were just doing this in a preventative way, because then you know can have a baby for $3.99. Let's hope. Um but and then if and then if if you do, then maybe we save these eggs or embryos for a second child or a third child, whatever the case may be. Um, but if they come back and maybe they go to thaw the eggs and it's unsuccessful, or um try to implant the embryos, and that part is unsuccessful, then we have to think of other options. If they are able to and have adequate ovarian reserve, sometimes we may try to do a new cycle of IBF, and this has happened before. You know, it's harder on the other side of some treatments, particularly treatments for ovarian and breast cancer. Um, but some other types of cancers like endometrial cancer or other, you know, colon cancer may not have had the same impact, and so then we can look into options for a new fresh IVF cycle. If they're older or now they're after menopause, either medically induced, surgically, or just from age, then the option would be to use eggs from another person, and that person would be called an egg donor. And so there are options to use eggs from a donor, which are typically young, healthy women in their 20s who have good egg count, good egg quality, and then that would be combined with sperm to make an embryo for you to carry. Your donor does not have any claim to your children, it doesn't make them a parent in a third kind of way or anything like that. These are people who have knowingly donated their eggs for the purpose of use for other couples, and that's you know, can be a way as well. For some people who may have had damage to their uterus or their health status, is so that they can't carry a pregnancy themselves, then we could use those eggs or embryos to be carried in another person's womb, and that person would be called a gestational carrier or a surrogate, is one of the most common ways that we discuss it. Again, the surrogate is not a parent, they are uh a vessel to bring your child earth side, and a lot of women who do that work feel very passionately about it, they want to help, they, I mean, are like the most kind-hearted people you can ever imagine because they will go through this process of pregnancy and delivery and whatever twists and turns that may take, you know, C-section procedures to help you to build your family. And so remember that's always an option, too. If for some reason, you know, you've either had surgery to remove your uterus or having recurrent miscarriages, or just your health status won't allow you to go through pregnancy.

Handling The Emotional Load

SPEAKER_03 26:52

It can be very emotional to go all through this, like the different stages, right? Like even just the egg retrievals can be emotional. Then, you know, finding that your your path or your birth story might not be what you know you thought it was going to be. Like there's so many things, like bumps in the road. And so I guess I would ask, you know, because I'm sure you hear about this all the time. Um, what advice would you give to someone going through those emotional challenges? And if I I don't know, if you think I've missed any of them, I think because you know, you are pumped full of hormones, so you're gonna be emotional just because. But you know, what's kind of your advice? Like, are there resources people can go to? Is it just talking to your doctor? Like, what kind of advice do you give your patients in that world?

SPEAKER_02 27:42

You know, I think one thing I'll kind of go just down a list. You know, if you're doing this with a partner, involve your partner because this is not meant for you to endure alone, right? Um, sometimes there can be like this idea, and this is social, societal, like this is a woman's problem. And we're used to going to the gynecologist by ourselves. You don't invite someone in with you, but this is a different, you know, animal. And you bringing the partner in, making sure that they're present during these conversations. I don't want you to have to relay the message to someone else. Like, let's both of you hear it from a medical professional at the same time. So I think that's already kind of built-in support. I have had patients have their partners and another person there for support, and I'm okay with it. You know, bring your mother, bring your best friend, bring your aunt. I had a patient bring her husband's aunt because her husband's on, it's her person. And I'm like, sure, like, come on in, we can figure it out. But you you definitely need that support there with you, and sometimes that's at procedures or during visits or phone calls or whatever it may be. Um, sometimes it also involves having a therapist. You know, I always ask people, do you have a therapist already? Do you need a recommendation? How can we get you in? You know, what do you have? You talked about this thing with your therapist? Do you feel comfortable? What were the conversations like? All therapists are not created equal. Some of them may equally feel a little bit uncomfortable with this particular area of life, and so I may refer to some therapists that are really specific in the reproductive space. Um, there's um incredible therapists out there. Many of them have chose to focus on reproductive health issues due to their own personal experience or family experience, and so they just really get it, and so sometimes bringing that person in early, making sure that that's also part of your team is super important. Um, there's lots of you know, support groups, there's a lot of social media support, so I think you have to kind of take with a grain of salt, but there's there's some great groups, you know. Um, I've had patients in Facebook groups, on Reddit, um, just you know, getting sharing information, supporting each other, you know, look keeping each other lifted. People who may not be able to talk to people around them who get it or understand can find some solace in those ways in religious organizations as well. But I think it's important to not hold it all in, if that makes sense, because I think it's an isolating enough process, and you know this from cancer diagnoses. Even you know, there's studies that have shown that an infertility diagnosis is as devastating as a cancer diagnosis to challenge what you thought would be, challenge who you how you think of yourself, um, what you thought think of your future. Um, and so in those cases, we don't want you to be more alone. We want you to talk about it, we want you to have support around you. Everyone may not respond the way you expect them to, but sometimes in releasing it, you just feel lighter. You don't feel burdened. People ask at Christmas, like, oh, when are you gonna have a baby? Like, oh, well, actually, we're trying really hard and it's not so easy. And it's like, oh, it's out there, you know, like you don't have to kind of hold it in and pretend and fake. Um, and so it's important to kind of, you know, have that balance as well.

SPEAKER_01 31:24

You know, to piggyback off of that, like what are your tools or suggestions for patients to advocate for themselves? I think it's so sticky. You gotta kind of know the questions to ask to advocate for yourself. I have one more question, but first I want to give you your flowers for being a physician who is open, supportive, and creating a safe space for everyone of your patients and their family, friends, and partners. Unfortunately, not all positions are created equally. So I just wanted to lay out a disclaimer if you feel unsafe, unheard, or unsupported, do not go back to that position. It's really weird why she just had a private client go to a postpartum visit and the way her position talked to her was wow, like and she ate it and blamed herself, so we had to like walk through why that was never okay, that her position is blaming her for her traumatic birth. Um I digress. So um but I but I think it's really important that we hear that because there is White Coat syndrome, and I think you know, you know, we think about culture and all these things, like there's a deference to a physician, but there's the physician also needs to, you know, be a good be a good human.

Hope For The Future Plus Closing

SPEAKER_01 32:42

My final question for you would be like, where does your hope lie in the future of fertility? Um and what are you looking forward to, although things we're in challenging times?

SPEAKER_02 32:53

Yeah, I think that you know, one of the most important things that I'm looking forward to is reaching as many people as possible. And you know, I commend you guys for having a topic like this on your podcast because these might seem like, you know, run-of-the-mill things, obviously in my neck of the woods, and you would assume that everyone knows, but they don't. And I'm you know always humbled by that, and I never take it for granted that these are the first time that someone understands the relationship between their uterus and their ovaries and their fallopian tubes, you know, and really kind of going down to basics. I talked to a group last week and I told them, I said, okay, we're gonna start with the high school level, and we did the anatomy, and then we're going to move up to college, and we did like the reproductive physiology. And now I said this is like master's level or you know, terminal degree when we talk about what is going on with infertility. And so this, you know, kind of like re-education always reinvigorates me because it can't get old when so many people have not heard this story before, you know. Um, and also, you know, I still get lots of comments and cards and updates, phone calls, visits from people who are so happy that they didn't stop. They're so happy that they didn't take this diagnosis and just, you know, storm home and like pull their head under the covers. Um, you know, whatever way they were able to, they mustered up the courage, they mustered up the strength, they mustered up the finances, the time off of work, um, and were able to reach their goal of building the family the way that they want. And that really keeps me encouraged, it keeps my team encouraged, you know, as many good stories we have. We also have tough, you know, some really tough stories too. And so we just like to remind everyone that there's good on the other side of this, that people are happy, children are on earth because of the work that you did, the phone call you made, the hands you held, the blood you drew. Um, and so that keeps us all lifted.

SPEAKER_03 35:05

Dr. Jackson Bay, thank you so much for joining us today. I think, as Rachel and I say all the time, education is power, and so I think this is very, very helpful to a variety of audiences, different ages, all of it. Um, we appreciate you helping us to better understand fertility preservation and family building options and empowering listeners with that information. Um, to everyone listening, thank you for tuning in and taking the time to prioritize your health. We hope today's conversation helps you feel more informed, more confident, and more empowered to advocate for yourself and your future. If today's episode resonated with you, we'd love to hear from you. Leave us a comment below or send us a message on Instagram at Tina's Wish. Don't forget to like, follow, or subscribe wherever you listen to podcasts so you never miss another episode. And please go back and tune into our other episodes about this very important journey that both Rachel and I faced. Please continue to listen because we're gonna do other important topics that, you know, as we, you know, continue to build on Tina's Wish What to Know down below. So thank you all for joining.

SPEAKER_00 36:17

For more information about gynecologic health, visit Tina'swish.org slash what to know. That's Tina'swish.org slash W H A T T O K N O W. And like, follow, or subscribe wherever you listen to your favorite podcasts.