A couple opens up about infertility, their IVF journey, and the joys of parenthood.
Apr 19, 2024Season 3Episode 17
The Connecticut Paid Leave Authority
National Infertility Awareness Week is April 21-27. The week is an observance that aims to raise awareness about infertility, provide support, and foster conversations around this critical health issue. Roughly one out of six people experience infertility. The chance to expand a family can take time away from work to focus on testing, diagnostics, and treatment. Dr. Maya Barsky is a lead physician at the Center for Advanced Reproductive Services and Assistant Professor in the Department of OB/GYN at the UConn School of Medicine and is an infertility specialist. Dr. Barsky talks about some of the testing that can occur when infertility is an issue. She also discusses the treatments available to her patients who want to expand their family. She said this can be a burden on a family financially, emotionally and physically. Crystal and Everett have underlying health issues that caused their infertility. Everett was diagnosed with cystic fibrosis as a child and had a double lung transplant. He knew that having children would be challenging with his condition and the anti- rejection medications. Everett and his wife Crystal went to the Center for Advanced Reproductive Services and had IVF treatments and had their first baby girl and are now pregnant with their second child due in July as a result of IVF treatments! Crystal is a unionized State of Connecticut employee and is not able to utilize CT Paid Leave. However, Everett is planning on taking CT Paid Leave for bonding with his second child. He also used CT Paid Leave when he had serious complications from COVID and was under the care of his doctor. Dr Barsky says that CT Paid Leave is a wonderful program for patients to utilize for the hardships of infertility diagnosis, and infertility and mental health treatments.
National Infertility Awareness Week is April 21-27. The week is an observance that aims to raise awareness about infertility, provide support, and foster conversations around this critical health issue. Roughly one out of six people experience infertility. The chance to expand a family can take time away from work to focus on testing, diagnostics, and treatment. Dr. Maya Barsky is a lead physician at the Center for Advanced Reproductive Services and Assistant Professor in the Department of OB/GYN at the UConn School of Medicine and is an infertility specialist. Dr. Barsky talks about some of the testing that can occur when infertility is an issue. She also discusses the treatments available to her patients who want to expand their family. She said this can be a burden on a family financially, emotionally and physically. Crystal and Everett have underlying health issues that caused their infertility. Everett was diagnosed with cystic fibrosis as a child and had a double lung transplant. He knew that having children would be challenging with his condition and the anti- rejection medications. Everett and his wife Crystal went to the Center for Advanced Reproductive Services and had IVF treatments and had their first baby girl and are now pregnant with their second child due in July as a result of IVF treatments! Crystal is a unionized State of Connecticut employee and is not able to utilize CT Paid Leave. However, Everett is planning on taking CT Paid Leave for bonding with his second child. He also used CT Paid Leave when he had serious complications from COVID and was under the care of his doctor. Dr Barsky says that CT Paid Leave is a wonderful program for patients to utilize for the hardships of infertility diagnosis, and infertility and mental health treatments.
Hello, Connecticut and welcome to The Paid Leave Podcast. The title basically says it all. I'm Nancy Barrow and I will be delving into this new state program and how it can help you and your family. This podcast will give you information you should know about Connecticut Paid Leave, and maybe just a little bit more. Connecticut Paid Leave brings peace of mind to your home, family and workplace. Welcome to The Paid Leave podcast. In 2024 Infertility continues to be a really significant global concern 17 and a half percent of the adult population. That's roughly one in six people experience infertility. Male infertility is responsible for about 20 to 30% of infertility cases while 20 to 35% are due to female infertility, and 10 to 20% of the cases no cause is really found. One of the barriers for some people is cost, with single IVF treatments costing up to $20,000. The Center for Advanced Reproductive Services is now one of the largest in Connecticut and one of the most successful family building programs in the country, responsible for the births of over 18,000 babies. That is amazing. The center is an academic affiliate of UConn School of Medicine and just opened their newest location in Middlebury where Dr. Maya Barsky practices, she is the lead physician at the Center for Advanced Reproductive Services, and Assistant Professor in the Department of OBGYN at UConn School of Medicine. She's also an infertility specialist. Welcome to the paid leave podcast. Dr. Barsky.
Doctor Maya Barsky:
Thank you. I'm so happy to be here.
Nancy Barrow:
So happy to have you here. Also joining the podcast is Crystal and Everett. There are a couple in Connecticut who have used IVF to build their family and have their first child and congrats because I believe you're pregnant with your second Crystal. Yes, that is so exciting. So exciting. And Everett has used Connecticut Paid Leave and we'll talk to him about that a little later on. But thank you both for coming on to The Paid Leave Podcast, Crystal and Everett.
Crystal:
Thank you, thanks for having us.
Nancy Barrow:
Dr Barsky what is the definition of infertility? Let's just start at the beginning I guess.
Doctor Maya Barsky:
Yeah so the definition of infertility actually, I'm so glad that you that you asked this question it recently wasn't was updated by ASRM, which is the American Society for Reproductive Medicine. And really, originally, what we say is infertility is when couples are trying to conceive, so having regular unprotected intercourse for 12 months when the female partner is under age 35, or for six months when the female partner is over the age of 35. It also includes anyone that has a medical diagnosis or problems that they've been diagnosed with such as PCOS or endometriosis. So they don't have to be trying for six or 12 months if they have a diagnosis attached to their infertility, but now it further includes anyone that needs to use donor gametes or donor embryos, which means donor egg or donor sperm or donor embryos in order to achieve a successful pregnancy either as an individual or if they have a partner. So they need medical intervention to be able to have a child. And so that really is wonderful because it is including much more inclusive of our LGBTQ plus community.
Nancy Barrow:
How do you guide a couple who comes to you who've tried to conceive naturally, and they're unsuccessful, or they have an underlying health condition?
Doctor Maya Barsky:
So that's a good question. We we start with just a discussion of their medical history and understanding of what their goals are, I think really understanding, you know, what, where do they want to be? And what are they looking for, in terms of their their family building desires and potential, and then we do a full evaluation. And so really understanding what is going on in terms of their reproductive system, from ovaries, fallopian tubes, sperm, and if they have sperm, and understanding if there's any abnormalities that we can identify. So that's how we we start.
Nancy Barrow:
How do you diagnose, because some of the things like endometriosis, you need surgery to even get a diagnosis? Some of them are really hard to diagnose.
Doctor Maya Barsky:
Absolutely! There there are medical aspects of infertility that are challenging to diagnose. And as you say, endometriosis can be very challenging. A lot of women have endometriosis and don't know that they have it. For a lot of physicians don't think about endometriosis as part of the differential what's going on, and they they're not working them up for endometriosis. In fact, 50 about 50% of infertility patients have endometriosis. So anyone coming in with infertility, that should be just on the back of our minds as part of something we should be looking for, especially if they have painful menses. In terms of an infertility diagnosis, as we talked about the definition of infertility is not challenging to make an infertility diagnosis. If a couple has been trying to conceive for what, six months or or, or 12 months they have infertility. It really is not being able to conceive for after trying for a certain amount of time. Some the PCOS is a diagnosis that we can make based on the criteria for PCOS. Fibroids is based on ultrasound findings. So it depends on what we're looking for. But really to say infertility as a diagnosis for an individual or a couple is something that can be made pretty easily. And then you know, treatment can be offered based on the male evaluation mostly consists of a semen analysis. And that really gives us a lot of information about the sperm in terms of volume concentration of sperm, their motility, the way that they look, their morphology, and gives us an idea if there's a male infertility aspect that that really is the extent of the initial evaluation for the males.
Nancy Barrow:
And there's lots of different treatments, what are some of the ones that are very common, or not so common?
Doctor Maya Barsky:
Yeah, so you know, first, we will target if we find something that is contributing to the infertility. So let's say they have a thyroid issue that's causing them to have irregular periods, while we're gonna give them thyroid medication, or some other hormone like prolactin, if that's elevated, would be giving them a medication to suppress that. It so it really is tailored to what the findings are with some of the things that we offer as strictly fertility treatment, and especially for unexplained infertility, which means after this full workup that we do, we find no specific cause as to why the patient or the couple are not being able to conceive together, then we offer medication to help with ovulation. And that's an oral medication, that usually either Clomid or Letrozole, and we can offer IUI intrauterine insemination where we're able to concentrate the most modal sperm and place it into the uterus, which means that the sperm has has less of a distance to travel to the fallopian tube where it's going to meet the egg for fertilization. So that's one, one aspect, the other would be IVF. And IVF really stands for in vitro fertilization, which means that we are fertilizing eggs outside of the body. So the treatment for IVF is trying to stimulate ovaries to mature eggs so we can retrieve them, take them out of the body, and then get sperm again a lot easier. sperm from the males make embryos in the laboratory and then do an embryo transfer. And so you know, for the LGBTQ plus community, sometimes there's different ways that this could be accomplished whether we need donor sperm, sometimes we use shared conception for our sake, same sex female couples, where one of the females has the the egg component of the pregnancy and the other carries the pregnancy. And then we also sometimes need donor egg for a gestational carrier, which is you know, someone that carries the pregnancy and has the uterus or for those females that that don't have a uterus can't use their uterus, or for same sex male couples that don't don't have access to a uterus either.
Nancy Barrow:
Crystal and Everett, let's talk about your journey to grow your own family. Do either of you have any underlying health issues that you knew about that might make pregnancy an issue?
Everett:
I was diagnosed just after birth with a genetic When you want to get pregnant, how did you accomplish that? And disorder called cystic fibrosis. It's extremely common for men with cystic fibrosis to deal with infertility. So I mean, I knew since it was a thing that I was thinking about in terms of family planning that I was probably going to have some sort of involvement with with a center or in this case, the center. who did you go to and how did you get help with that? So first, I talked to my cystic fibrosis doctors. They're sort of my resource for everything. And they directed me to Dr. Hoenig, who is I think at Yale. This was quite a few years ago, this was sort of very early on Crystal and I were fairly recently married and we wanted to, you know, get an idea of what we would be looking at the timeline. So I met with Dr. Hoenig to find out what the process would be like with him. And he said go see Dr. DeLuigi at the center. And so we went and met with her. And then that was kind of a long window. We were we thought we were ready. And then, like many things, the pandemic arrived, and very much delayed everything. Yeah, yeah,
Crystal:
Not only on our end, but the center understandably, had had some services at that time as well. So for us trying to navigate with Everett's health concerns, and then also on the center's end to kind of delayed everything. So we ended up starting the process, it was the middle to late 2020. We did egg retrieval, and then egg embryo transfer in January of 2021. And then our baby girl was born September 2021.
Nancy Barrow:
So did you just have to have one treatment?
Crystal:
Yeah.
Nancy Barrow:
Wow!
Crystal:
So with my all of my background screening that the center performs, doing bloodwork and genetic carrier testing, all of that, it, we didn't really find any issues on my end. So everything went remarkably smoothly. I did one round of IVF had to take a little break afterwards. After the egg retrieval, I took a one month break and then transferred a frozen embryo. And it really did when it really did go so smoothly. I'm we're so fortunate.
Nancy Barrow:
Now tell me a little bit about the IVF process. Is it painful? Is it? Is it a long process? Is there any recovery that you need?
Crystal:
You know, it's funny, in the moment, it feels it's all consuming, you know, it's it's daily bloodwork, it's almost daily ultrasounds, it's, you know, it takes over your whole life. But really is in retrospect, looking back on it, it was, you know, the blink of an eye, and we have our daughter now, and it's so it's so crazy to think of that time in our life. It feels when looking back on it feels difficult, but it also feels like it was so doable, and really went by quickly. Yeah, for us, at least.
Nancy Barrow:
I bet and Everett, for you who, you know, you knew you had cystic fibrosis from a young age, and it might be a problem for you to have children. This must have been like, the most amazing thing to you that science has done such incredible work that you could have, you could start your family.
Everett:
Yeah, yeah, miracles of modern medicine. Really. It's I mean, having our daughter is not that's not the only one I also have had a lung transplant and being born in the 80s with cystic fibrosis, the likelihood that I made it through young you even becoming a toddler was the probability was not great!
Nancy Barrow:
No.
Everett:
Yeah, you know, it's over and over again, medical advances in technology have have enabled all the best things in my life. So yeah, it's been so so fortunate for me and to be to have found someone like Crystal who has been willing to, I mean, really bear the more difficult part of the whole IVF process. I mean, I had one procedure where I went in and they extracted what was needed. And then they just kind of hand it back to you and make it make you take it over to the center yourself, which was sort of a surreal experience! You know, Crystal had to do everything that was difficult about this process. So to find someone like her that I could that I that we you know that I could experience this with us.
Nancy Barrow:
Yeah. And now you're doing it again. It was so easy the first time that you decided
Everett:
It was easy We kept we've got lucky. We had lots, I I didn't have to do anything. That's ridiculously unfaIr! mean, lots, we had a number of very healthy embryos. And so the second time was much easier than the first.
Crystal:
just just the embryo transfer that we had to do, which was
Nancy Barrow:
Right Everett!(laughs)
Everett:
Yeah. But yeah, yeah, it was much easier the embryo transfer and we got incredibly lucky again in that it worked the first time that we tried it.
Nancy Barrow:
Boy, you guys are very lucky. I have a friend who has been they have a child from IVF to and they've been trying and it's just it's really emotionally draining. I think, too. For couples. I think it's really difficult when you know that you can't do this on your own and you need help.
Everett:
Yeah,
Nancy Barrow:
I think emotionally that must be really difficult, you know, and stressful. How did your relationship? I mean, did it make you stronger do you think because I, I think that must be hard on a relationship.
Crystal:
I think it really did bring us together in a way that we hadn't experienced yet. And, and I'm so glad you brought this up because I had never had therapy before, before this whole process started and, and Everett was the one who suggested it and had me consider it. And I'm so thankful that I had started it. I started it about, you know, right, right when we were starting the IVF process, and I feel like it was so valuable. And I would encourage anybody who's struggling with emotional aspects of infertility to definitely reach out to talk to someone because it's been invaluable.
Nancy Barrow:
Do you find that doctor that a lot of your patients, ask you, can you recommend someone, because that is it's so stressful.
Doctor Maya Barsky:
I wish that was the case. I mean, I would implore that anyone undergoing fertility treatments would seek mental health professionals, because it is stressful, the diagnosis itself is stressful, the treatment is stressful, sometimes negative outcomes happen. And those are stressful. The reality is that a lot of patients don't pursue therapy, while at the same time 40 to 60% have anxiety and depression. So we have we have diagnosis, you know, many patients with a diagnosis of anxiety, depression, on top of the fact that you don't need anxiety and depression, prior to going to infertility to really benefit from a therapist while you go through it. The psychological impact of not being able to conceive is a profound loss for some and could be really a significant life crisis for many. And for some really, there's data to indicate that infertility could be as devastating as a cancer diagnosis. It really is very impactful. And individuals feel isolated and stigmatized and find it difficult to be around children. They feel shame, they feel guilt. There's a lot of cycles to the simplicity of IVF hope, and then loss can happen. And so it really is, I think, essential for providers to talk about it with patients, but also for patients to accept that it's not a failure. If you see a therapist that can only be helpful. Yeah, so Crystal I'm so glad that you mentioned that it is really important.
Nancy Barrow:
Yeah. And just in the realm of Connecticut Paid Leave, we also cover mental health treatment, if you needed to take time away from work, we would give income replacement for that. Let's turn my attention to you. Everett, can you tell me your experience with Connecticut Paid Leave? I mean, I know it was cystic fibrosis related.
Everett:
So in 2022, It was yeah 2022, unfortunately, I was You know the chronic condition of it. I just want you to know exposed and I and I got COVID in about in early July. And I actually I rode it out pretty well, all things considered, I didn't need to be even really hospitalized. But ironically, I was put on a treatment for COVID that interfered with my transplant medication. And the side effects of the interference were actually worse than the problems I had with COVID itself. And one of the things that ended up happening was I had this very strange, massive swelling in my legs. And it was I actually was, it was it became bad enough that I was having trouble walking. And I ended up in the hospital for that. And around that time I was you know, so I had been working from home for a long time and ultimately decided with my employer that the best move would be to try and take some time and and utilize the paid family leave program. And I did it was I sort of expected to kind of walk into a lot of sort of red tape and deal with a lot of incomprehensible forms. And I found it much easier than I expected honestly, it was a pretty straightforward process. And and I overall felt it was it was I guess easier than what you might expect going into this type of program like it's an application for this type of program. It was it was pretty easy. that every year you can take up to those 12 weeks, whether you have to go see your doctor obviously, and you have to travel to see your doctor. I just want you to know that's available to you and that's what we kind of want to spread the news if you do have a chronic condition like CF or MS or any of those things 2022 was very challenging healthwise. OMG Yeah, I did, I did the triple pandemic before it was cool, I had the RSV and everything. So I was very lucky to have the paid family leave. But fortunately, since then, very smooth sailing, I've been very lucky.
Nancy Barrow:
Excellent, excellent.
Everett:
For 23 and thus far for 24. So, fingers crossed.
Nancy Barrow:
Yeah and we do have three types of leave, like
Doctor Maya Barsky:
you can search by state to find support you can take the whole block of 12 weeks or whatever you need. groups in your state. And currently in CT at the Resolve And then we have intermittent if you do need to just go and see a doctor for appointments and also reduced schedule, so if you needed to take like half day, you know, so there's a lot of flexibility. So I just want you to know, have that in your back pocket. Are there support groups for people going through infertility issues, website, there are two one led by a nurse and another by a social worker. There's also hope after loss, we didn't really talk about infertility, and then the fertility aspect of recurrent pregnancy loss is also another major aspect of what we do with reproductive endocrinologist. And so that support group holds groups for women and men who have experienced pregnancy or infant loss. So there are support groups available, I still think infertility is stigmatized, and many patients, find it hard to talk about it, talk about it with others talk about it with friends or family and let alone strangers. I think that that support groups are important to have. But I don't know if the utilization is as high as we want it to be.
Nancy Barrow:
What is the best part of your job, Dr. Barsky?
Doctor Maya Barsky:
All of it! That my I personally just love, I fell in love with embryo transfers, that's how I knew that I was going to become a reproductive endocrinologist and fertility specialist. The transfer is just I think Crystal knows that transfer is just incredible you are you get to see on ultrasound, the placement of a catheter with an embryo in it. And then you can see the culture media in place that kind of signifies where the embryo is, at that moment in time, and the amount of hope that everyone in the room feels at that moment or this this little embryo that we hope will turn into a positive pregnancy test and then hope for a live birth from there. It's just beautiful. It's amazing that that, you know patients that have genetic disorders that don't have sperm that don't have eggs that don't have a uterus that just struggle with infertility are able to, you know, potentially have biological children because of fertility treatments that we can offer is just incredible. It's an amazing job. I wouldn't do anything else.
Nancy Barrow:
And Crystal when she talks about that. Were you awake for that whole procedure? So you saw the placement of everything?
Unknown:
Yeah that. So for before you get to that point for the egg retrieval, they put you out for that. Yeah, you're not you know, you don't remember anything. But the embryo transfer, you get to see and they turn the screen towards you to watch the catheter go in. And yeah, it's really magical. It's cool!
Nancy Barrow:
Did you take time off for your first child? Were you able to take any time off?
Everett:
A little? When she was So I do. I'm an accountant. I do. I do taxes. And she was born right in the middle of the second filing season.
Nancy Barrow:
Oh How inconvenient for that baby to
Everett:
that's what I said! You know, it's in like the last be. three weeks of the extension, the end of September, October. But I took a little time after that, like in November and and she's delightful.
Nancy Barrow:
Well, just so you know, you can take bonding leave, which is Connecticut Paid Leave up to 12 weeks. A father can do that. If you want That is the plan that is the plan now coming up Oh, fantastic. I mean, it also helps with postpartum depression. So you know, hopefully you won't have any Crystal but you know, that's one of the benefits of the father being able to take some bonding time with the baby. It really helps the mom. Do you find that Dr Barsky that it helps when
Crystal:
Absolutley. both parents can be at home with the kids its better for everybody?
Doctor Maya Barsky:
Oh, yeah, it is it. It helps in so many aspects. I mean, just the bonding between the mother and the child and the father and the child and and the ability to have you know a time to shower and maybe take care of yourself and perhaps have a meal or whatever it is that that that the mom would would not have the opportunity to do. It's really important for the mental health aspect too. And for the bonding, this is an an incredible opportunity for for parents to be able to take. I think it's wonderful that Connecticut has this offer going through fertility treatments, it takes a toll on patients, it's a lot of times very time consuming. So this, the Connecticut Paid Leave is could be very helpful for patients with an infertility diagnosis. I've seen patients that struggle to understand how they're going to do it. And prior to Connecticut, I was saying, you know, this is this is a priority, we're, we're going to make this happen. But you know, at what cost to their job and to their finances. And so to be able to have a little bit of less stress, based on the fact that they can request paid leave, really can help patients. So I think part of the awareness in Connecticut is to say, hey, let's be aware of the fact that we can apply for this and see if it can help some of the patients going through infertility.
Nancy Barrow:
Crystal and Everett, your story is so amazing. And I'm so pleased you shared it on The Paid Leave Podcast. Continued good health to you, Everett, and again, congratulations.
Crystal:
Thank you so much so much.
Nancy Barrow:
And Dr. Barsky, thank you so much for doing what you do. you look at this couple. I mean, it's just so amazing that this was available to them and they have expanded their family. It's so beautiful.
Doctor Maya Barsky:
It really is incredible. And I don't take it for granted ever. And I'm just thankful for our patients that come to see us and very happy to say congratulations to you both. I think that it's beautiful.
Nancy Barrow:
That must be the best part of your Job.
Doctor Maya Barsky:
The best absolutely!.
Nancy Barrow:
Dr. Maya Barsky, thank you so much for taking time out of your busy day to lend your expertise to The Paid Leave Podcast.
Doctor Maya Barsky:
Thank you.
Nancy Barrow:
Thank you all for joining me. For information about the Center for Reproductive Services where Dr. Barsky works or to schedule an appointment, you can visit UConn fertility.com and the phone number is 844 Hope IVF. The center has six offices throughout the state including the newest one in Middlebury where Dr Barsky is. For more information or to apply for benefits go to CT Paid Leave.org. This has been another edition of The Paid Leave Podcast. Please like and subscribe so you'll be notified about new podcasts that become available. Connecticut Paid Leave is a public act with a personal purpose. I'm Nancy Barrow and thanks for listening!