The Paid Leave Podcast

A Couple Opens Up About Infertility, Their IVF Journey, and the Joys of Parenthood.

• The Connecticut Paid Leave Authority • Season 3 • Episode 18

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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.

To get in touch with one of the six locations at the Center for Advanced Reproductive Services visit:  UConn Fertility | Center for Advanced Reproductive Services in Connecticut
Or you can reach them at: 844-467-3483

For information about CT Paid Leave or to apply for benefits please go to: CT Paid Leave




 

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Nancy Barrow:

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!

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 had their first child. And congrats, because I believe you're pregnant with your second Crystal?

Crystal Generic:

Yes, in July.

Nancy Barrow:

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 Generic:

Thank you for having us.

Nancy Barrow:

Dr Barsky what is the definition of infertility? Let's just start at the beginning, I guess.

Maya Barsky:

Yeah, so the definition of infertility, actually, I'm so glad that you, that you asked this question. It recently was 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. 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. So that's, 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, utopian tubes, sperm, and if they have sperm, and understanding if there is any abnormalities that we can identify. So that's how we we start. 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, 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 don't know that they have it, or a lot of physicians don't think about endometriosis as part of the differential of what's going on. And they they're not working them up for endometriosis. In fact, you know 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, it's not challenging to make an infertility diagnosis if a couple has been trying to conceive for what six months 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 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 that. 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. But 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.

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 going to give them thyroid medication or some other horlact, and if that's elevated, would be giving them a medication to suppress that. So it really is tailored to what the findings are, but some of the things that we offer is strictly a 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. That's an oral medication I 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 a 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 do shared conception for our 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 or a gestational carrier, which is, you know, someone that carries the pregnancy and has the uterus. For 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 Generic:

I was diagnosed just after birth with a genetic 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, in this case, the center.So yes.

Nancy Barrow:

When you wanted to get pregnant, how did you accomplish that, and who did you go to, and how did you get help with that?

Everett Generic:

So first I talked to my cystic fibrosis doctors. They're sort of my resource for everything, and they directed me to Dr Honig, 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 Honig to find out what the process would be like with him. And he said, go see Dr Julie at the center. And so we went and met with her. And then there 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 Generic:

Not only on our end, but the center understandably had cut back 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, it 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 Generic:

Yeah, so with my all of my background screening that the Center performed, doing blood work 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 Generic:

You know, it's funny in the moment, it feels it's all consuming, you know, it's, it's daily blood work, 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 Generic:

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, even becoming a toddler, was the probability was not great, no. So, 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 fortunate for me and to be to have found someone like Crystal who's 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, yeah,

Nancy Barrow:

And now you're doing it again.It was so easy the first time that you decided

Everett Generic:

Easy, we kept we got so lucky. We had lots, I mean, lots. We had a number of very healthy embryos. And so the second time was much easier than than the first.

Crystal Generic:

It was just, just the embryo transfer that we had to do, which was, I didn't have to do anything

Everett Generic:

Ridiculously unfair, right? Everett, yeah, 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:

Well, you guys are very lucky. I have a friend who's been, they have a child from IVF too, 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. Yeah, 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 Generic:

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 am 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 the 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.

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, so we have, we have died. You know, many patients with a diagnosis of anxiety and 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 cyclicity 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, it can only be helpful. So crystal, I'm so glad that you mentioned that it's 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 Generic:

so in 2022, So in 2022 Yeah, 22 unfortunately, I was exposed and I and I got COVID in about in early July,and I actually, I wrote 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 wasI 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, 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 this, an application for this type of program. It was, it was pretty

Nancy Barrow:

You know, the chronic condition of it. I just want you to know 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.

Everett Generic:

2022 was very challenging, yeah. Health wise, I did, I did the triple demic. Before it was cool. I had the RSV, I had everything. So I was very lucky to have the paid family leave. But fortunately, since then, very smooth sailing. Very excellent, excellent for 23 and thus far for 24 so fingers crossed.

Nancy Barrow:

Yeah. And we do have three types of leave, like you can take the whole block of 12 weeks, or whatever you need. And then we have intermittent if you do need to just go and see a doctor for appointments, and also reduce 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?

Maya Barsky:

There are definitely support groups available. Resolve is a wonderful society and has a great website, which you can search by state to find support groups in your state, and currently in CT at the resolve 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 as reproductive endocrinologists, 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?

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, the 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 being placed 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 for 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?

Crystal Generic:

Yeah, the so for, before you get to that point for the egg retrieval, they put you out for that, yeah, you don't remember anything but the embryo transfer, you get to see they turn the screen towards you to watch the catheter go in. And, yeah, it's really magical. It was cool.

Nancy Barrow:

Did you take time off for your first child? Were you able to take any time off?

Everett Generic:

A little 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 of.

Nancy Barrow:

How inconvenient for that baby to be born then!

Everett Generic:

You know, it's in, like, the last 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 to

Everett Generic:

That is the plan that is the plan now.

Nancy Barrow:

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.

Crystal Generic:

Absolutely!

Nancy Barrow:

Do you find that Dr Barsky that when both parents can be at home with the kids, it's it's better for everybody?

Maya Barsky:

Oh yeah it is, It helps in so many aspects. I mean, just the bonding between the mother and the child and the father and the child, and then 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 incredible opportunity for for parents to 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 Generic:

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 that this was available to them, and they have expanded their family. It's so beautiful.

Maya Barsky:

It really is incredible. I don't take it for granted ever, and I'm just thankful for the 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.

Maya Barsky:

The best absoutely!

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.

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 ctpaidleave.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.

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