{"version":"1.0.0","segments":[{"startTime":1.175,"endTime":4.007,"body":"Today we talk about the significance"},{"startTime":4.151,"endTime":6.275,"body":"of never giving up."},{"startTime":7.295,"endTime":9.855,"body":"I'm Dr. Mark Amols, and"},{"startTime":9.895,"endTime":12.423,"body":"this is Taco about"},{"startTime":12.479,"endTime":13.715,"body":"Fertility Tuesday."},{"startTime":26.325,"endTime":29.157,"body":"Today is a special episode, not just because"},{"startTime":29.181,"endTime":32.037,"body":"it's the first episode of season seven of talking"},{"startTime":32.061,"endTime":34.837,"body":"about Fortilnity Tuesday, but today"},{"startTime":35.021,"endTime":37.941,"body":"is my daughter's birthday, and today"},{"startTime":38.093,"endTime":40.813,"body":"they'18 years old. Like many of"},{"startTime":40.829,"endTime":43.637,"body":"you, I face the fear"},{"startTime":43.781,"endTime":46.549,"body":"of never having children. Yet I stand here"},{"startTime":46.597,"endTime":49.325,"body":"now, 18 years later, filled with"},{"startTime":49.365,"endTime":52.037,"body":"gratitude and joy. So"},{"startTime":52.101,"endTime":55.077,"body":"today, at the start of this new year,"},{"startTime":55.221,"endTime":57.821,"body":"I want to share the significance of never giving"},{"startTime":57.853,"endTime":60.549,"body":"up and how science shows us"},{"startTime":60.637,"endTime":63.385,"body":"the value of perseverance."},{"startTime":63.805,"endTime":66.573,"body":"Throughout your journey, there's always going to be a"},{"startTime":66.589,"endTime":68.865,"body":"point where you're going to be scared,"},{"startTime":69.325,"endTime":72.237,"body":"and there's going to be a point where you feel like"},{"startTime":72.261,"endTime":75.173,"body":"you might want to give up. It may feel like"},{"startTime":75.269,"endTime":78.201,"body":"it's insurmountable, that, there is no chance"},{"startTime":78.375,"endTime":81.357,"body":"of ever having success. And what"},{"startTime":81.373,"endTime":84.373,"body":"we're going to talk about is there is success,"},{"startTime":84.541,"endTime":87.357,"body":"even when it looks dismal. I remember"},{"startTime":87.413,"endTime":89.853,"body":"when I found out I had severe sperm"},{"startTime":89.901,"endTime":92.653,"body":"and we weren't going to be able to get pregnant"},{"startTime":92.701,"endTime":95.685,"body":"naturally. I thought, maybe this means we're not supposed"},{"startTime":95.717,"endTime":98.349,"body":"to have kids. And I remember"},{"startTime":98.389,"endTime":101.333,"body":"thinking, how are we ever going to be"},{"startTime":101.341,"endTime":104.193,"body":"able to afford this? Remember if we couldn't? It"},{"startTime":104.201,"endTime":107.129,"body":"was only because of where I worked and because of a great"},{"startTime":107.209,"endTime":109.549,"body":"program they had the letuce pay it over two years"},{"startTime":110.089,"endTime":113.025,"body":"that we'even able to try. And then,"},{"startTime":113.137,"endTime":115.977,"body":"even then, when we started the process"},{"startTime":116.153,"endTime":118.497,"body":"right from the beginning, things weren't going"},{"startTime":118.553,"endTime":121.385,"body":"great. And when we found there was another problem"},{"startTime":121.577,"endTime":124.549,"body":"and we had to stop, I didn't want to give up."},{"startTime":124.849,"endTime":127.709,"body":"But all of this pressure runs on me"},{"startTime":128.129,"endTime":130.948,"body":"from, this feeling of, is it even going to be working?"},{"startTime":131.128,"endTime":134.116,"body":"We're about ready to go in debt, and I"},{"startTime":134.132,"endTime":136.86,"body":"don't even know if this is going to work. Luckily for"},{"startTime":136.884,"endTime":139.844,"body":"me, I did have some friends in the industry was"},{"startTime":139.876,"endTime":142.828,"body":"able to help me out with some of the medications that we've already spent"},{"startTime":142.868,"endTime":145.652,"body":"thousands on. And we were able to"},{"startTime":145.82,"endTime":148.692,"body":"do it again. Now you know how this story"},{"startTime":148.74,"endTime":151.676,"body":"ends because as I mentioned, my daughter's birthday"},{"startTime":151.732,"endTime":154.404,"body":"today, and they're both 18 years old."},{"startTime":154.596,"endTime":157.564,"body":"Yes, I have twins. I was"},{"startTime":157.596,"endTime":160.42,"body":"fortunate enough to not just be able to get pregnant from"},{"startTime":160.444,"endTime":163.244,"body":"that cycle, but to have twins."},{"startTime":163.436,"endTime":166.181,"body":"But as I, look back now, I really"},{"startTime":166.229,"endTime":168.577,"body":"appreciate the fact that"},{"startTime":169.077,"endTime":171.893,"body":"even through all those hard times, my"},{"startTime":171.925,"endTime":174.657,"body":"wife found the strength to do things again."},{"startTime":174.957,"endTime":177.367,"body":"That, even though we started feeling hopeless,"},{"startTime":177.667,"endTime":180.339,"body":"we never gave up. Now, I'm not going to"},{"startTime":180.363,"endTime":182.967,"body":"pretend that there aren't bad stories out there."},{"startTime":183.327,"endTime":185.647,"body":"Yes, there are people who have"},{"startTime":185.687,"endTime":188.039,"body":"tried and unfortunately have not been"},{"startTime":188.103,"endTime":190.879,"body":"successful. I wish it could be 100% and"},{"startTime":190.943,"endTime":193.783,"body":"everyone could always end with the story I ended"},{"startTime":193.815,"endTime":196.375,"body":"with. Honestly, most of the time,"},{"startTime":196.551,"endTime":199.383,"body":"the reason for people having to stop is more"},{"startTime":199.495,"endTime":202.375,"body":"financial than really is just not being able to keep"},{"startTime":202.431,"endTime":205.383,"body":"going on the journey. It's one of the reasons I"},{"startTime":205.415,"endTime":207.707,"body":"really hope we can have a national"},{"startTime":208.127,"endTime":210.537,"body":"mandate that will give fertility to"},{"startTime":210.577,"endTime":213.281,"body":"everyone and recommend reaching out to your"},{"startTime":213.409,"endTime":216.129,"body":"local politicians to tell them that's what you"},{"startTime":216.153,"endTime":218.857,"body":"want. I can give you countless stories"},{"startTime":219.017,"endTime":221.753,"body":"of where this has come true. If you've listened to my"},{"startTime":221.785,"endTime":224.777,"body":"podcast, you've heard about times when I said, usually"},{"startTime":224.817,"endTime":227.697,"body":"we recommend three IUIs"},{"startTime":227.857,"endTime":230.673,"body":"and then'not successful to move on to"},{"startTime":230.825,"endTime":233.277,"body":"IVF or some other type of testing."},{"startTime":234.017,"endTime":236.937,"body":"And I tell my patients this and I practice this"},{"startTime":236.977,"endTime":239.777,"body":"method, and I remember patients"},{"startTime":239.817,"endTime":242.457,"body":"I've had who have come to me and failed"},{"startTime":242.577,"endTime":245.257,"body":"three IUIs, sometimes even four IUIs, and say,"},{"startTime":245.417,"endTime":248.409,"body":"what do I do? I can't go on ivf. I can't afford it. And"},{"startTime":248.433,"endTime":251.305,"body":"maybe they have insurance for IUIs and they say, can I do another"},{"startTime":251.321,"endTime":253.832,"body":"one? I, tell them, absolutely, there's no reason you"},{"startTime":253.864,"endTime":256.224,"body":"can't. I mean, Statistically speaking,"},{"startTime":256.28,"endTime":258.976,"body":"yes, 90% of the people who get"},{"startTime":259.016,"endTime":261.896,"body":"pregnant are pregnant in those first three. That doesn't mean you can't"},{"startTime":261.936,"endTime":264.934,"body":"try anymore. And lo and behold,"},{"startTime":265.11,"endTime":267.542,"body":"I've had many patients who"},{"startTime":267.574,"endTime":270.478,"body":"decide they want to stick with IUIS for whatever reason that"},{"startTime":270.502,"endTime":273.066,"body":"is religious, financial,"},{"startTime":274.086,"endTime":276.466,"body":"but they eventually get pregnant,"},{"startTime":276.966,"endTime":279.926,"body":"even though statistically it says only 10%"},{"startTime":279.966,"endTime":282.826,"body":"of people are going to get pregnant. In that situation,"},{"startTime":284.206,"endTime":287.182,"body":"perseverance, it paid off because they"},{"startTime":287.214,"endTime":289.886,"body":"kept trying. I have numerous stories."},{"startTime":290.046,"endTime":292.942,"body":"A patient who has gone through IVF and"},{"startTime":292.974,"endTime":295.918,"body":"maybe didn't get a normal embryo, and we keep"},{"startTime":295.982,"endTime":298.786,"body":"trying and trying and eventually"},{"startTime":299.566,"endTime":302.014,"body":"get that normal embryo. Now, it's"},{"startTime":302.07,"endTime":304.606,"body":"obvious if you do more than one IVF"},{"startTime":304.646,"endTime":307.518,"body":"cycle or more than one iui, your chances go"},{"startTime":307.542,"endTime":310.286,"body":"up cumulatively as you keep doing them. Because"},{"startTime":310.326,"endTime":313.158,"body":"obviously, whatever that chance was, you get that chance"},{"startTime":313.222,"endTime":315.506,"body":"again and it has a cumulative effect."},{"startTime":316.466,"endTime":319.298,"body":"But there's more to it than that. We know that"},{"startTime":319.362,"endTime":322.322,"body":"when you do an IVF cycle, as I've mentioned many times"},{"startTime":322.394,"endTime":325.058,"body":"before, IVF is not just a"},{"startTime":325.082,"endTime":328.074,"body":"treatment, it's test. And you get"},{"startTime":328.09,"endTime":330.866,"body":"to learn something about that cycle. And with ivf,"},{"startTime":330.986,"endTime":333.93,"body":"you can change things. And so what we"},{"startTime":333.978,"endTime":336.61,"body":"find is in those cumulative cycles,"},{"startTime":336.778,"endTime":339.722,"body":"people do have success, because now you can"},{"startTime":339.754,"endTime":342.63,"body":"make changes. Now, it's really"},{"startTime":342.678,"endTime":345.31,"body":"important to understand, even if you make zero"},{"startTime":345.358,"endTime":348.334,"body":"changes, which seems crazy, why would you do"},{"startTime":348.35,"endTime":351.266,"body":"the same thing that didn didn't work. But even if you did,"},{"startTime":351.766,"endTime":354.598,"body":"statistically speaking, you have a"},{"startTime":354.622,"endTime":357.606,"body":"higher chance and you will become successful"},{"startTime":357.766,"endTime":360.726,"body":"if you just keep trying. If you're just looking at"},{"startTime":360.766,"endTime":363.646,"body":"regular IVF without even doing any type of genetic"},{"startTime":363.686,"endTime":366.534,"body":"testing. Looking at the Victorian"},{"startTime":366.59,"endTime":369.422,"body":"Assisted Reproductive Treatment Authority, they found"},{"startTime":369.494,"endTime":372.446,"body":"that women after one IVF"},{"startTime":372.486,"endTime":374.822,"body":"cycle their age, 35 had a 48%"},{"startTime":374.894,"endTime":377.146,"body":"chance of having a live birth."},{"startTime":378.166,"endTime":381.146,"body":"After two cycles it was 61%."},{"startTime":381.766,"endTime":384.631,"body":"And after three cycles, was almost 70% chance"},{"startTime":384.671,"endTime":387.319,"body":"of having a live birth. So"},{"startTime":387.375,"endTime":390.271,"body":"just doing the same thing"},{"startTime":390.391,"endTime":392.991,"body":"can increase your chances of having a live"},{"startTime":393.031,"endTime":395.403,"body":"birth. But as I"},{"startTime":395.427,"endTime":398.283,"body":"mentioned, you can actually make adjustments and"},{"startTime":398.307,"endTime":401.275,"body":"those adjustments are what allow you to even"},{"startTime":401.403,"endTime":404.147,"body":"increase the chances, increasing"},{"startTime":404.179,"endTime":406.831,"body":"your overall cumulative pregnancy rate."},{"startTime":407.571,"endTime":410.403,"body":"But what about the situation where"},{"startTime":410.427,"endTime":413.323,"body":"you're talking about you pl embryos? What"},{"startTime":413.347,"endTime":415.791,"body":"if when you go through ivf,"},{"startTime":416.291,"endTime":418.991,"body":"all your embryos come back and app employed?"},{"startTime":419.571,"endTime":421.679,"body":"My first thought as a patient would be"},{"startTime":421.835,"endTime":424.783,"body":"great. None of my eggs are good, they're"},{"startTime":424.847,"endTime":427.663,"body":"all bad. And you can"},{"startTime":427.687,"endTime":430.327,"body":"really feel that way. Imagine if you get seven or eight"},{"startTime":430.359,"endTime":433.231,"body":"eggs and you get from"},{"startTime":433.271,"endTime":436.023,"body":"that four, six embryos and all the embryos"},{"startTime":436.087,"endTime":438.967,"body":"come back genetically abnormal. You"},{"startTime":438.999,"endTime":441.823,"body":"may feel, are there any good ones in there? Well, in the"},{"startTime":441.847,"endTime":444.383,"body":"real world, obviously when you do something exactly the"},{"startTime":444.407,"endTime":447.051,"body":"same, you expect to get the same result."},{"startTime":447.231,"endTime":450.059,"body":"But when it comes to the human body, things are"},{"startTime":450.115,"endTime":453.067,"body":"different. Things are happening that we don't even"},{"startTime":453.099,"endTime":455.883,"body":"realize that're happening internally. Even though"},{"startTime":455.947,"endTime":458.431,"body":"externally we are doing things"},{"startTime":458.851,"endTime":461.179,"body":"the same, we can end up having different"},{"startTime":461.235,"endTime":463.827,"body":"outcomes. There was"},{"startTime":463.899,"endTime":466.675,"body":"a article titled the"},{"startTime":466.723,"endTime":469.595,"body":"chances of obtaining a euoid embryo"},{"startTime":469.723,"endTime":471.947,"body":"and subsequent live birth remained"},{"startTime":472.019,"endTime":474.639,"body":"consistent with a national age based"},{"startTime":474.695,"endTime":477.231,"body":"rates after an IVF fertilization"},{"startTime":477.311,"endTime":479.911,"body":"cycle that produced only anibloid"},{"startTime":479.951,"endTime":482.303,"body":"embryos. Essentially the question"},{"startTime":482.367,"endTime":484.967,"body":"was if you had a cycle that"},{"startTime":485.039,"endTime":487.967,"body":"had only unemled embryos, what was the"},{"startTime":487.999,"endTime":490.695,"body":"chances of you then coming away with a"},{"startTime":490.783,"endTime":493.511,"body":"successful cycle when doing it again?"},{"startTime":493.631,"endTime":496.431,"body":"In other words, are all your eggs"},{"startTime":496.471,"endTime":499.399,"body":"bad or does the past not predict"},{"startTime":499.495,"endTime":502.491,"body":"the future? Well, surprisingly,"},{"startTime":502.791,"endTime":505.759,"body":"it was actually quite positive. What"},{"startTime":505.775,"endTime":508.607,"body":"it found is this study found that among patients"},{"startTime":508.639,"endTime":511.551,"body":"who had only anemlid embryos in their first IVF"},{"startTime":511.591,"endTime":514.495,"body":"cycle, 56% obtain"},{"startTime":514.543,"endTime":517.023,"body":"EUOID blastocys in their second"},{"startTime":517.207,"endTime":519.983,"body":"IVF cycle. And"},{"startTime":520.047,"endTime":523.031,"body":"the likelihood was even higher if they were younger."},{"startTime":523.191,"endTime":526.095,"body":"So for example, if you were under"},{"startTime":526.143,"endTime":528.687,"body":"35, even with all"},{"startTime":528.759,"endTime":531.311,"body":"unemloid embryos on the first IVF"},{"startTime":531.351,"endTime":534.091,"body":"cycle, 81%"},{"startTime":534.471,"endTime":537.391,"body":"had euoid embryos on their"},{"startTime":537.431,"endTime":540.087,"body":"second IV cycle. And if you"},{"startTime":540.119,"endTime":543.011,"body":"were women who were over 42,"},{"startTime":544.031,"endTime":546.999,"body":"even up to 25% of them had a"},{"startTime":547.015,"endTime":549.591,"body":"euupoid embryo on their second IVF"},{"startTime":549.631,"endTime":552.287,"body":"cycle, even in the face"},{"startTime":552.399,"endTime":555.263,"body":"of devastation of all the embryos being"},{"startTime":555.287,"endTime":558.091,"body":"abnormal, they never gave up"},{"startTime":558.391,"endTime":561.051,"body":"and they were able to get euoid embryos."},{"startTime":561.351,"endTime":564.151,"body":"I remember this one case, and it was"},{"startTime":564.191,"endTime":566.611,"body":"quite amazing. This patient"},{"startTime":567.071,"endTime":569.471,"body":"went through IVF two"},{"startTime":569.511,"endTime":571.931,"body":"times, and two times"},{"startTime":572.431,"endTime":575.223,"body":"she had un employed embryos. Now that doesn't sound"},{"startTime":575.287,"endTime":577.791,"body":"too impressive. If she only had maybe two embryos each"},{"startTime":577.831,"endTime":580.231,"body":"time, but she was about"},{"startTime":580.311,"endTime":583.131,"body":"38 and she was getting around"},{"startTime":583.251,"endTime":586.035,"body":"eight embryos each time. That's"},{"startTime":586.123,"endTime":588.711,"body":"16 embryos"},{"startTime":589.451,"endTime":592.344,"body":"and still not a normal embryo. And, I do"},{"startTime":592.392,"endTime":595.328,"body":"remember talking to her, telling her, yes, it"},{"startTime":595.344,"endTime":597.856,"body":"is possible someone could have maybe more"},{"startTime":597.928,"endTime":600.768,"body":"abnormal embryos than what would expect"},{"startTime":600.824,"endTime":603.56,"body":"for their age group. But I said, there's"},{"startTime":603.64,"endTime":606.02,"body":"always a normal embryo there eventually."},{"startTime":606.94,"endTime":609.9,"body":"And so they persevered. They did it"},{"startTime":609.94,"endTime":612.716,"body":"again and did get their normal"},{"startTime":612.748,"endTime":614.88,"body":"embryo and did have success."},{"startTime":616.22,"endTime":618.6,"body":"They never gave up."},{"startTime":619.34,"endTime":620.88,"body":"But what about the situation"},{"startTime":621.78,"endTime":623.88,"body":"where you have embryos"},{"startTime":624.66,"endTime":627.476,"body":"and you've done the transfer and it"},{"startTime":627.508,"endTime":630.476,"body":"didn't work? At"},{"startTime":630.508,"endTime":633.0,"body":"what point do you feel like it's never going to work?"},{"startTime":633.59,"endTime":635.99,"body":"Well, there was a study done on that"},{"startTime":636.03,"endTime":639.03,"body":"too. In this study called the rate"},{"startTime":639.07,"endTime":641.59,"body":"of true recurrent implantation failure is"},{"startTime":641.63,"endTime":643.958,"body":"low, results of three"},{"startTime":644.054,"endTime":646.59,"body":"successive frozen EUoID single embryo"},{"startTime":646.63,"endTime":649.09,"body":"transfers. What they found"},{"startTime":649.55,"endTime":652.17,"body":"is that even when there is failure,"},{"startTime":652.67,"endTime":654.93,"body":"things do work over time."},{"startTime":655.75,"endTime":658.438,"body":"Overall, this study concluded that"},{"startTime":658.494,"endTime":661.146,"body":"recurrent implantation failure is rare,"},{"startTime":661.278,"endTime":664.218,"body":"with less than 5% of patients failing to"},{"startTime":664.234,"endTime":666.977,"body":"achieve a, clinical pregnancy after three"},{"startTime":667.073,"endTime":669.709,"body":"successive transfers of euuploid embryos."},{"startTime":670.369,"endTime":673.273,"body":"In this study, the key findings found that after one"},{"startTime":673.321,"endTime":674.617,"body":"transfer there was at least a"},{"startTime":674.673,"endTime":677.601,"body":"69.9% implantation"},{"startTime":677.665,"endTime":679.704,"body":"rate. After 2,"},{"startTime":679.929,"endTime":682.537,"body":"87.9 and by the third one"},{"startTime":682.673,"endTime":684.549,"body":"95.2%"},{"startTime":685.049,"endTime":687.965,"body":"implantation rate. Now if you look at that from"},{"startTime":687.997,"endTime":690.877,"body":"a cumulative live birth rate, after one transfer"},{"startTime":690.933,"endTime":693.797,"body":"it was 64.8%, two transfers,"},{"startTime":693.853,"endTime":696.365,"body":"83.9 and by the third transfer,"},{"startTime":696.437,"endTime":699.381,"body":"92.6%. It's important to understand"},{"startTime":699.445,"endTime":701.797,"body":"again, this is just looking at the cumulative"},{"startTime":701.973,"endTime":704.933,"body":"rates. There are even other"},{"startTime":704.981,"endTime":707.965,"body":"tests you can do to find out there are problems."},{"startTime":708.117,"endTime":710.229,"body":"And so in this situation, this was just doing"},{"startTime":710.309,"endTime":713.053,"body":"transfers. Now this doesn't mean that you should just"},{"startTime":713.101,"endTime":715.997,"body":"keep doing transfers and never look back and see"},{"startTime":716.013,"endTime":718.529,"body":"if there could have been something wrong. Even after"},{"startTime":718.569,"endTime":721.464,"body":"just one fell transfer with, one embryo,"},{"startTime":721.576,"endTime":724.312,"body":"I always look back to see if there's anything"},{"startTime":724.44,"endTime":727.104,"body":"that I noticed that could be changed to"},{"startTime":727.136,"endTime":730.016,"body":"help improve the transfer. But what"},{"startTime":730.032,"endTime":732.958,"body":"this tells us is, is, it just even trying"},{"startTime":733.038,"endTime":736.03,"body":"again, we go from a"},{"startTime":736.134,"endTime":738.878,"body":"64.8% live"},{"startTime":738.918,"endTime":741.486,"body":"birth rate all the way up to almost a"},{"startTime":741.542,"endTime":744.234,"body":"93% Birthra. This"},{"startTime":744.266,"endTime":747.09,"body":"essentially means that no one really is"},{"startTime":747.154,"endTime":750.114,"body":"born without the ability to have implantation."},{"startTime":750.306,"endTime":753.034,"body":"Now, of course, you can have pathology"},{"startTime":753.106,"endTime":755.602,"body":"that prevents implantation. And it would show up in things"},{"startTime":755.65,"endTime":758.546,"body":"like irregular menses or thin"},{"startTime":758.722,"endTime":761.058,"body":"linings or even very light"},{"startTime":761.138,"endTime":763.73,"body":"periods. But in the normal person"},{"startTime":763.914,"endTime":766.434,"body":"with a normal lining and euoid"},{"startTime":766.466,"endTime":769.146,"body":"embryos, as long as you just try"},{"startTime":769.202,"endTime":771.118,"body":"again, your chances are good."},{"startTime":771.978,"endTime":774.797,"body":"Now, adding adjustment even makes"},{"startTime":774.829,"endTime":777.405,"body":"it better. Again, I have"},{"startTime":777.493,"endTime":779.989,"body":"multiple examples of this. One"},{"startTime":780.005,"endTime":782.973,"body":"of my favorite examples of this is"},{"startTime":782.997,"endTime":785.693,"body":"when we first started. I remember, like"},{"startTime":785.837,"endTime":788.101,"body":"we never had anyone not get"},{"startTime":788.141,"endTime":790.797,"body":"pregnant after putting back two euloid"},{"startTime":790.829,"endTime":793.717,"body":"embryos. It just never happened. At least there was some type of"},{"startTime":793.749,"endTime":796.417,"body":"implantation or something. And this one"},{"startTime":796.449,"endTime":799.021,"body":"time there was no implantation."},{"startTime":799.801,"endTime":802.746,"body":"I remember thinking the patient that, this is crazy what is going on?"},{"startTime":802.786,"endTime":805.738,"body":"And they have a lot of embryos. And"},{"startTime":805.762,"endTime":808.378,"body":"so at this time, the era test came"},{"startTime":808.402,"endTime":811.202,"body":"out and I said, listen, there's this new test."},{"startTime":811.354,"endTime":813.983,"body":"Never had this happen. Let's take a look at it. And lo, and"},{"startTime":813.999,"endTime":815.915,"body":"behold, it was off."},{"startTime":817.175,"endTime":819.983,"body":"And then they went did another transfer with"},{"startTime":820.039,"endTime":822.145,"body":"two youoid embryos."},{"startTime":822.765,"endTime":825.757,"body":"And this time it implanted. But it didn't end"},{"startTime":825.781,"endTime":828.461,"body":"in al live birth. At that"},{"startTime":828.493,"endTime":831.285,"body":"point, even I was confused. I'm thinking, wow, four embryos and"},{"startTime":831.325,"endTime":834.125,"body":"no live birth. And we know by three it should be there."},{"startTime":834.165,"endTime":836.865,"body":"But as I mentioned to them, I said"},{"startTime":837.205,"endTime":840.109,"body":"the first time we did it, it was at the wrong"},{"startTime":840.157,"endTime":843.069,"body":"time. And that may affected whether there"},{"startTime":843.077,"endTime":846.005,"body":"was no implantation. So really it's"},{"startTime":846.045,"endTime":848.581,"body":"only been two when you look atumulative pregnancy"},{"startTime":848.613,"endTime":850.869,"body":"rate. And so when we did another"},{"startTime":850.917,"endTime":853.813,"body":"transfer, this time it worked and they had a"},{"startTime":853.829,"endTime":856.806,"body":"live birth. Now, it doesn't mean it takes three"},{"startTime":856.838,"endTime":859.302,"body":"tries to work. A matter of fact, for most people, they'going to be"},{"startTime":859.326,"endTime":862.01,"body":"pregnant with the very first transfer."},{"startTime":862.79,"endTime":865.662,"body":"But it's important that they never gave"},{"startTime":865.686,"endTime":868.558,"body":"up. They kept trying, even when"},{"startTime":868.614,"endTime":871.526,"body":"things seemed very dismal. Now, I can"},{"startTime":871.558,"endTime":874.222,"body":"tell you on the"},{"startTime":874.366,"endTime":877.12,"body":"second time when I went through ivf,"},{"startTime":877.82,"endTime":880.82,"body":"it was perseverance. We"},{"startTime":880.86,"endTime":883.549,"body":"kept having, to cancel multiple cycles."},{"startTime":884.489,"endTime":887.481,"body":"We started losing faith, but"},{"startTime":887.625,"endTime":890.417,"body":"we kept going. Now, I had the advantage of being my"},{"startTime":890.433,"endTime":893.409,"body":"own doctor, so the cost was pretty"},{"startTime":893.449,"endTime":895.681,"body":"fair. I didn't charge myself much,"},{"startTime":895.865,"endTime":898.634,"body":"but I remember just thinking,"},{"startTime":898.923,"endTime":901.899,"body":"this is even worth this. And"},{"startTime":902.399,"endTime":905.135,"body":"that resilience is what allow us to"},{"startTime":905.167,"endTime":907.979,"body":"eventually have a second pregnancy."},{"startTime":908.879,"endTime":911.807,"body":"Now, it's easy for me to say that now because"},{"startTime":911.823,"endTime":914.535,"body":"I've had success. But for those of you"},{"startTime":914.607,"endTime":917.539,"body":"who feel like you want to give up,"},{"startTime":917.839,"endTime":920.759,"body":"it's always important to know that that resilience is what"},{"startTime":920.799,"endTime":923.737,"body":"will get you that outcome. And, I'm not saying it has to"},{"startTime":923.753,"endTime":926.689,"body":"be blind resilience. It may have to be"},{"startTime":926.729,"endTime":929.309,"body":"that you have to go, ah, a different route than what you wanted."},{"startTime":929.799,"endTime":932.699,"body":"But what I can tell you is that in general,"},{"startTime":933.599,"endTime":936.399,"body":"if you keep trying, there's a very"},{"startTime":936.439,"endTime":939.303,"body":"good chance you'll have success. Now, for"},{"startTime":939.351,"endTime":941.979,"body":"some of us, that emotional support"},{"startTime":942.479,"endTime":945.431,"body":"might need help. So I would"},{"startTime":945.455,"endTime":948.071,"body":"tell you reach out to the"},{"startTime":948.175,"endTime":950.863,"body":"support networks that are out there, whether it's Facebook"},{"startTime":950.911,"endTime":953.775,"body":"groups, whether it's friends, whether it's meeting up"},{"startTime":953.807,"endTime":956.651,"body":"with people, or even just talking to your clinic and"},{"startTime":956.675,"endTime":959.159,"body":"finding out if there's some support forums."},{"startTime":959.619,"endTime":962.539,"body":"The most important part is not just"},{"startTime":962.659,"endTime":965.403,"body":"not giving up, but not even getting to that"},{"startTime":965.451,"endTime":967.939,"body":"point where the stress has got so"},{"startTime":967.979,"endTime":970.799,"body":"high that you even are considering giving up."},{"startTime":971.139,"endTime":973.715,"body":"Wanting to give up is normal."},{"startTime":973.907,"endTime":976.843,"body":"That's part of being human, especially"},{"startTime":977.011,"endTime":979.443,"body":"when you feel like there's no benefit of moving"},{"startTime":979.491,"endTime":982.375,"body":"forward. And this is where it's so important to"},{"startTime":982.407,"endTime":985.223,"body":"talk to your doctor because what"},{"startTime":985.271,"endTime":987.943,"body":"you see may be dismal"},{"startTime":988.071,"endTime":990.775,"body":"and what they see may be"},{"startTime":990.807,"endTime":993.463,"body":"optimism. This is where second"},{"startTime":993.511,"endTime":996.351,"body":"opinions come in. Sometimes you just"},{"startTime":996.375,"endTime":999.159,"body":"need another set of eyes to give you that"},{"startTime":999.199,"endTime":1002.103,"body":"reassurance to keep moving forward. Or"},{"startTime":1002.151,"endTime":1005.055,"body":"maybe another perspective, like"},{"startTime":1005.087,"endTime":1008.057,"body":"my prior patient. Maybe some new technology has come"},{"startTime":1008.073,"endTime":1011.017,"body":"out. It's always advancing, like where weit e"},{"startTime":1011.033,"endTime":1013.921,"body":"era and so even if you"},{"startTime":1013.945,"endTime":1016.617,"body":"need time off, don't give up."},{"startTime":1016.793,"endTime":1018.989,"body":"Because there's always something new."},{"startTime":1019.489,"endTime":1022.149,"body":"And with perseverance,"},{"startTime":1023.449,"endTime":1026.137,"body":"science says you have a better chance of coming"},{"startTime":1026.193,"endTime":1028.585,"body":"away successful. What's crazy"},{"startTime":1028.617,"endTime":1031.029,"body":"is now, 18 years later,"},{"startTime":1031.788,"endTime":1034.588,"body":"I fought so hard to have these"},{"startTime":1034.628,"endTime":1037.148,"body":"kids and it's been"},{"startTime":1037.188,"endTime":1039.676,"body":"amazing. These 18 years"},{"startTime":1039.852,"endTime":1042.444,"body":"have enough joy in them, that will last forever."},{"startTime":1043.464,"endTime":1046.0,"body":"Because now I'm saddened by the fact"},{"startTime":1046.072,"endTime":1047.604,"body":"that they're adults"},{"startTime":1048.624,"endTime":1051.136,"body":"and I won't have these"},{"startTime":1051.28,"endTime":1054.136,"body":"kids that I work so hard to have over"},{"startTime":1054.16,"endTime":1057.116,"body":"these years. And just like many of you,"},{"startTime":1057.24,"endTime":1059.865,"body":"you'll think about, did you do it right?"},{"startTime":1060.885,"endTime":1063.741,"body":"Could you have done things better? I think one of the"},{"startTime":1063.773,"endTime":1066.533,"body":"things that comes through our minds as parents"},{"startTime":1066.629,"endTime":1069.053,"body":"of infertility"},{"startTime":1069.109,"endTime":1071.661,"body":"patients is we're probably"},{"startTime":1071.693,"endTime":1074.517,"body":"helicopter parents because we work so hard to have these kids"},{"startTime":1074.581,"endTime":1077.413,"body":"that know they're precious to"},{"startTime":1077.429,"endTime":1080.413,"body":"us. It's God's gift to us. But"},{"startTime":1080.429,"endTime":1083.333,"body":"I can tell you, if you're there, you already know it. But if"},{"startTime":1083.349,"endTime":1086.019,"body":"you're not, it is worth"},{"startTime":1086.187,"endTime":1089.147,"body":"fighting for. And I would be the first to tell"},{"startTime":1089.171,"endTime":1092.171,"body":"you, never give up and do"},{"startTime":1092.203,"endTime":1095.027,"body":"whateverever you have to do to stay in the"},{"startTime":1095.051,"endTime":1097.851,"body":"game emotionally and physically and"},{"startTime":1097.923,"endTime":1100.811,"body":"unfortunately financially. Whether that's getting"},{"startTime":1100.843,"endTime":1103.051,"body":"a job at Starbucks as a"},{"startTime":1103.083,"endTime":1105.371,"body":"barista so you can maybe get their fertility"},{"startTime":1105.403,"endTime":1108.255,"body":"insurance. Just never give up."},{"startTime":1108.795,"endTime":1111.523,"body":"Well, I look forward to go through"},{"startTime":1111.579,"endTime":1114.395,"body":"many more talk about Fertility Tuesdays this year"},{"startTime":1114.435,"endTime":1117.299,"body":"with you and I appreciate"},{"startTime":1117.347,"endTime":1120.323,"body":"everything you guys have done with all the"},{"startTime":1120.499,"endTime":1123.307,"body":"five star reviews and helping make"},{"startTime":1123.331,"endTime":1126.331,"body":"our podcasts quite successful. I don't"},{"startTime":1126.363,"endTime":1129.115,"body":"make any money from this. I purely do it for"},{"startTime":1129.195,"endTime":1132.051,"body":"educational reasons because I know that the"},{"startTime":1132.083,"endTime":1134.371,"body":"information out there isn't always as"},{"startTime":1134.443,"endTime":1137.307,"body":"detailed. And so I want you to be an advocate for"},{"startTime":1137.331,"endTime":1140.175,"body":"yourself and be able to know the information"},{"startTime":1140.675,"endTime":1143.387,"body":"when you're talking to your provider."},{"startTime":1143.571,"endTime":1146.175,"body":"Thank you again for making this podcast"},{"startTime":1146.675,"endTime":1149.235,"body":"successful. I look forward to talking to you"},{"startTime":1149.275,"endTime":1152.076,"body":"again next week on, tboo"},{"startTime":1152.228,"endTime":1153.44,"body":"Fertility Tuesday."},{"startTime":1157.42,"endTime":1158.46,"body":"Happy Birthday."}]}