Transcription of Fertility, #85
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Dr. Lisa: This is Dr. Lisa Belisle and you’re listening to the Dr. Lisa Radio Hour and Podcast show number 85, Fertility. Airing for the first time on Sunday, April 28th 2013. With the spring, comes the promise of growth and new life. This week on the Dr. Lisa Radio Hour, we discuss what happens when creating new life presents a challenge to couples.
Our guests, Fertility and Adoption Coach Anne Belden and Reproductive Endocrinologist, Dr. Benjamin Lannon, have hopeful perspectives on an emotionally charged topic.
I come from an unusually large family. My parents had 10 children in 16 years including one set of twins. I was the oldest. Raised in a suburban Maine town, mine was not an experience shared by many; that my parents were so obviously fertile causing no end of embarrassment as a youngster.
Another one of my schoolmates would ask, “How many kids do your parents plan on having anyway?” I could not answer that question until after my youngest brother was born on the autumn of my senior year in high school. Ten, that was the final number.
Though I had often suggested that I would never have children myself, having help to raise enough of them already, I became pregnant with my son at the tender age of 21. As a first year medical student, living two states away from my then husband who visited only on weekends as a surprise by this turn of events; surprised and again, slightly embarrassed.
I cannot explain why would I felt extreme over so normally human function. Now, a mother of three and proud big sister and aunt to many, I have greatly benefitted from a fortuitous biology. Others are not so lucky.
As our guest in the Dr. Lisa Radio Hour remind us this week, fertility does not naturally come to all. Fertility and Adoption Counselor Anne Belden and Reproductive Endocrinologist Dr. Benjamon Lannon have worked with countless couple for whom having a baby becomes a challenging ordeal.
They described the shame felt by men and women who cannot accomplish what they are told should occur naturally. Fertility issues for some strange reason remain one of medicine’s dirty little secrets.
I come from an unusually large family. My parents’ fertility status was no secret. The early embarrassment I felt over this on my own discomfort following the surprised pregnancy with my son in no way matches what couples who struggle with fertility must feel.
I have great compassion for those who experience embarrassment over something they cannot control. I hope that fertility, whether abundant, inadvertent or lacking will someday be treated for exactly what it is, a human function about which nobody should feel ashamed.
Whether you are part of a couple challenged by fertility or somebody who knows somebody challenged by fertility, or simply a compassionate human being, we’re very glad that you’ve joined us here on the Dr. Lisa Radio Hour this week and are willing to listen to what Anne Belden and Dr. Benjamin Lannon have to say on this topic.
Last year on the Dr. Lisa Radio Hour and Podcast, we were fortunate to have a group of women come in and talk to us about Hearty Girls, Healthy Women and enjoyed the company of my guest who has returned here again today, Anne Belden.
Today’s conversation is going to be about actually being a hearty girl and a healthy woman but in a very different way. I’m happy to have with me in the studio today, Anne Belden who is a fertility and adoption coach and is also organizing an important event coming up at the end of April. Thanks for joining us today.
Anne: Thank, Lisa. It’s so nice to be here with you.
Dr. Lisa: This is a free fertility seminar. Fertility is something that as you and I were talking, it’s something that a lot of people deal with and yet not a lot of people discuss. The fact that you’re putting the seminar out there and for the first time, it says a lot.
Anne: Right, it does affect a lot of couples. One in eight couples experience infertility which is defined as trying to conceive for a year, deliberately trying to get pregnant without success. One in eight couples is a lot of people.
You’re also right that it’s really not talked about very much. I’d like to say that it’s really one of the last social issues to come out of the closet.
Dr. Lisa: Why do you think that’s true?
Anne: Fertility and infertility tap into such a personal part of ourselves. It says so much about who we are as women in the society, the expectations that our culture puts on us as women. It helps us to think about who we want to become. It taps into our sexuality. Very, very personal issues, our intimate relationship is involved. I just think it carries with it a lot of privacy and sensitivity.
Dr. Lisa: Do you think that women have self-pressure to be all things to all people, go out and work? Also simultaneously get pregnant and be fertile and give birth and parent? Do you think that this contributes to a level of stress that perhaps makes it difficult to get pregnant in the first place?
Anne: It’s an interesting question. The whole question as if does stress create fertility problems or do fertility problems create stress? It’s like a chicken and an egg. It’s probably a little bit of both. It’s hard for everyone today in our society to do so many things that we’re wanting to do.
For women in particular, building their families, having careers that are fulfilling and meaningful. Many of us want to do both of those things. Where’s the balance? How do you do that? The question of stress is a really good one though because what happens is the longer women try to conceive and are not able to, it does definitely build stress.
We do know that chronic and ongoing stress can at the same time impact on our state of health over an extended period of time.
Dr. Lisa: Did the stress become an issue in your own journey? I know that you have two children now. They didn’t come easily.
Anne: I can certainly relate to this stress as it relates to fertility. My husband and I spent 10 years trying to build our family. Although that was quite a long time ago, my kids are now 18 and 23. I can completely understand what women are going through because the emotional aspect of infertility are the same as they were 25 years ago.
One of the things that contribute to that is there are so many people who are trying to be helpful by telling you or inviting what to do, how to get pregnant, how to feel better, how to just relax, how to do these things as well as the medical community which are wonderful in trying to direct you down the right path.
It can be really confusing. You can feel like you’re pushed and pulled in so many directions that you lose touch with what is really best for you which might not be best for the next patient or for your friend who’s having trouble conceiving.
That does create some stress. It’s important to be able to begin to untangle that. It’s like those mangles roots that get all gnarled up. What feeling is really coming from what?
Dr. Lisa: One of the things that you do as part of your work with women and families with fertility and adoption issues is that you offer them mind-body methods of dealing with their own stress. I have it in front of me this Breathe pamphlet that you’ve given me. Talk to me about why breathing is so important for your patients or your clients, I should say?
Anne: It’s important because whenever we begin to feel stressed, our bodies have a physiological response no matter what it’s in response to. We start breathing more shallowly. Our heart starts to beat more rapidly. We start to get sweaty. The easiest, most fundamental technique is to try and breathe more diaphragmatically; breathe really deeply.
I talk to my kids about this. I talk with my clients as they’re maybe going into a difficult medical procedure that they’re stressed about. Maybe they’ve just had their embryo transfer for IVF. If they can really begin to just start breathing much more deeply and really thinking about it, mindfully breathing, it can help them to calm down.
There are a lot of other simple things that I have here on this card. Emotional expression which sounds so simple but it’s actually a lot harder to do. That can come in the way of certainly talking with friends in an honest, authentic way. Also writing can really help to move emotions out of us.
Another thing that I talk with people about is what I call, Thought Massaging; just looking at also called Cognitive Restructuring, a more clinical term. Really looking at those negative thought that start to play over and over again in our heads such as, “I’m never going to be a mom. I’m not getting pregnant because I won’t be any good at it.”
Helping them to really get up on a stool and look at those thoughts and begin to take them apart and think about, “Is this really true? How is this helping me? What can I do to intersect those thoughts when I start to realize they’re playing over and over again?
Dr. Lisa: In a newsletter that you sent me recently, talking about the physiologic impact of smiling.
Anne: That was a great study that I put in there. We don’t think about it. The more you smile, people smile back at you. When people are smiling at you, you feel better. If you feel better, it’s going to change the whole way that you move through that day. The more you do those things; it lifts us up in terms of our spirits.
It can really change how we enter into any kind of situation if we do that. Those are the little things that I talk with clients about.
Dr. Lisa: You also offer what you call Back Pocket Comebacks.
Anne: I came up with those because the things that people say to you when you’re trying to get pregnant, not in a way that’s intended to be hurtful or harmful. They do come across like that. One of the things I have on here, one of the most common things that people get are, “Are you ever going to have kids? You’re 30 now. It’s about time you’re getting ready to have children.”
What I’ve got on here is I’ve got two different responses. One I called snarky response, which is a thing that you’re probably not going to say but what you’d really like to say. What I have on here is, “Well, hold on. Let me grab my Ouija board.” Of course, like if we only knew, if we had that Ouija board, that crystal ball wouldn’t that be nice.
The more thoughtful grace just kind of response that is actually helpful to have in your back pocket. It might be something like, “We’d really love to have kids but it’s a lot harder than we expected.”
People are bombarded all the time with really hurtful things again not intentionally. We lose our focus when we’re in a place of struggle or even emotional pain. We can’t come up with something to say. This is intended to help people come up with that.
Another one, if I could just go through another one that people get all the time is, “Why don’t you just adopt? There are so many kids out there that need good homes.” That initial snarky response, what sometimes you think about saying is, “If there are so many kids out there, why didn’t you just adopt? You could have adopted.”
Of course, the more gracious thing to say might be something like, “You know, we may consider adopting but right now, we’re trying to have a biological child like most people want to have.”
Dr. Lisa: This is something that you have to deal with in your own life. You had questions probably just like this because you ended up having one biological child and one adopted child.
Anne: I did. It took us 10 years to have those kids. Our son was conceived through ART, Artificial Reproductive Technology. That was about a three and a half year process to conceive him. We considered ourselves really lucky. We didn’t have major medical issues. It was mostly unexplained infertility.
Then as soon as he was born about a year afterwards, we started trying pretty much right again to try and conceive. We tried for about five years. First, I had surgeries in there. I had a 12-week miscarriage. I did it all that was available at that time. I did more pergonal cycles than they whatever consider allowing. I think I did around 17.
I did several IVF cycles. That took about 10 years. At the end of that, one of the hardest things is deciding when to stop? How much farther do you go? There’s always that next carrot dangling in front of me, that next medical, new medical drug or procedure.
I finally decided that I didn’t want to do that anymore. We then opened ourselves up to adoption. It was a really, really tough time. One of the things that got me through of course was that my husband and I we’re on the same page about what we wanted.
I’m a real extrovert. I enlisted the support of my friends to help me get through it. I also connected with the Resolve, which is a great national organization that’s been around for about 40 years supporting this issue through advocacy and education. That’s really what this event is tied into is the National Resolve.
Dr. Lisa: The goal of the Dr. Lisa Radio Hour is to help make connections between the health of the individual and the health of the community. The goal of Ted Carter Inspired Landscapes is to deepen our appreciation for the natural world. Here to speak with us today is Ted Carter.
Ted: John O’Donohue is one my favorite theologians, an Irish, mystic poet and author. He has written a book entitled Beauty: The Invisible Embrace. When speaking about a woman, he dedicates this book to, he speaks of this woman’s gentle soul and mystical imagination.
From this I say, this king of seeing, this kind of knowing is the way we connect most intimately with nature. Turning to nature with soft eyes, not hard eyes, we greet her and welcome her into the deepest parts of who we are.
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Dr. Lisa: Why is it that even pregnancy, something that is deeply personal becomes a topic of conversation that everybody feels that they have a part of? Whether it’s pregnancy, whether it’s fertility, why is it that women’s reproductive cycles? Why are they something that we all seem to have a stake in unlike any other topic?
Anne: It’s so fundamental to who we are as women and as human beings. It’s also such a cultural expectation. I’m not sure people even think about it that much in terms of they just have the expectation that it’s part of the life cycle to go on and you move into adulthood. You start to build your family.
It’s a very integral part of how we see ourselves as women is that when we get our periods when we’re teenagers, that is something that everybody starts talking about; it grows from there.
Dr. Lisa: I see that. I still also see that you wouldn’t necessarily openly have a discussion about somebody’s alcoholism per se. You wouldn’t always talk about somebody’s cancer. I don’t know. It’s interesting for me that fertility and infertility and pregnancy and all the things around reproduction just seem like such a public access thing.
Anne: What’s interesting about is that fertility may be and pregnancy; you see book and all this are everywhere. People and public, strangers might touch a pregnant woman’s belly, they don’t even know them. Yet at the same time, what’s interesting is that infertility is not.
You have this huge public access as you said to pregnancy and fertility and child-bearing. Pretty in videos of giving birth online, that kind of stuff. Yet when it comes to infertility, all of a sudden the doors slam shut. There’s a real element of shame around that, not being able to conceive. If it’s such a given, it’s such an expectation, it’s such a part of our womanhood and now we’re not able to meet that expectation and produce that. What does it say about me as a women?
It goes with and part in parcel with people feels that that is in the realm of the public. They don’t think about the fact that someone may not be able to achieve that. They’re just not tuned in to that because it’s such a cultural expectation.
Dr. Lisa: I wonder if we will see the same thing happen to infertility that we actually saw happen with pregnancy and birth. It wasn’t that long ago those women were sent in to the twilight sleep and then they magically reappeared with the baby. It wasn’t that long ago those men weren’t really involved. I’m thinking the ‘60s.
Maybe Resolve has been around 40 years. Maybe we are finally heading into a time where this doesn’t have to be quite so shameful or quite so hidden.
Anne: Organizations like Resolve mainly Resolve are really working at that. If you look at just the language around it, infertility versus fertility, people have a hard time talking about that. I do think that people are speaking out a little bit more about their experiences of not being able to get pregnant.
IVF is in the news all the time now. It really hasn’t been all that long that we’ve had IVF. The first IVF baby, Louise Brown was in ’78. Since then, there’ve been over five million babies born through IVF. We see it in the papers. It’s being talked about. It’s becoming much more acceptable.
I think that that will begin to happen. It will begin to move into that more public realm. It’s a much slower grow.
Dr. Lisa: One of the ways that you’re helping this to move into the public realm is to offer a free fertility seminar coming up in honor of National Infertility Awareness Week. I know you have thoughts on the term infertility awareness week. This seminar is coming up on April 30th from 5:30 to 8:00 at the Maine Medical Center.
It’s featuring some pre-high level guests, Dr. Lannon from Boston IVF who is also on the show. Dr. Michael Drouin, Dr. Caroline Hodsdon, who has been a guest of ours before. Dr. Anne Rainville and Dr. Dan Spratt. These are some heavy hitters.
Anne: It’s really fabulous that all of these people are willing and able to come out on this evening to speak on this panel. What people want to see is a range of approaches and a range of practices. It gives people an opportunity to meet these different physicians, get a sense for what they might be like.
It’s a wonderful contribution that they’re making. It’s the first time we’ve ever had an event in honor of what Resolve calls National Infertility Awareness Week. As you pointed out, I’m calling this a free fertility seminar because I think coming at it from a positive approach fertility, it just plain feels better to people than coming in there saying it’s infertility.
Along with those five physicians who are going to be speaking, there are eight alternative practitioners who would then be not speaking on the panel but will be in available to speak with. Some of them will be doing demonstrations, giving little many talks, some meeting with people afterwards.
It’s an opportunity to meet a wide range of practitioners who really focus on and specialize in fertility issues in Portland.
Dr. Lisa: I like the fact that you’re calling a day fertility seminar. I’m sure that you’re going to have a fertile or at least large group. Eventually, hopefully fertile group of people coming to the seminar.
Anne: We hope that they don’t … I planned on the lessons where you want them to come but then I don’t want them to have to come back next year. It’s like the support group that I do. I do a monthly support group through Resolve. I do that. I’m here in Portland. I donate that. We have no around 10 or 12 people who come every month to this, both men and women. It’s held the last Tuesday of each month at Maine Med.
It is my hope that people don’t come back to it because we all want them of course to get pregnant in between meetings.
Dr. Lisa: How can people find out about the fertility seminar that’s coming up on April 30th or about the work that you do as a fertility and adoption coach?
Anne: I have a website which is annebelden.com. I can also be reached on my business number, which is 233-5939. My website is a really good place to get a sense of who I am and how I work. I have this event on there and if there are other events I’m doing. Right now, we’re doing a four-week mind-body program with women who are trying to conceive. I have an office right here in Portland where I work individually. One to one with women or couples who are going through infertility and adoption.
Dr. Lisa: Anne, it’s been a pleasure to have you back in the studio after going from Hearty Girls, Healthy Women to ongoing Hearty Girls, Healthy Women in a different way as you bring fertility to women and families in the Portland and Maine area. I hope that people will take advantage of the seminar.
We’ve been talking to Anne Belden who is a fertility and adoption coach and organizer of the fertility seminar coming up at Maine Medical Center on April 30th. We really appreciate you coming in and talking with us again.
Anne: Thanks so much for having me. I appreciate it.
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Dr. Lisa: Spring is the time of the year when things are growing, plants and flowers and little animals. We’re thinking about fertility and growth. We’re talking today with Dr. Benjamin Lannon. He’s a Reproductive Endocrinologist with the Main Center of Boston IVF. Thanks for coming in and talking to us today.
Dr. Ben: Thanks for having me.
Dr. Lisa: Ben, you grew up in New Hampshire. You have a presence here in Maine and you have a presence in Boston. What was it about growing up in New Hampshire that caused you to decide, “You know what, I want to come back here. I want to raise my kids. I like this part of the world.”?
Dr. Ben: My wife and I both grew up near the ocean. It was a really important formative part of our childhoods. I really appreciated just being able to get to the beach easily and the beauty of the coast of New Hampshire and also the coast of Maine and even Massachusetts were really a part of my formative years.
For both of us, it was important to include that in our ongoing lives and also the lives of our children. Being in touch with that aspect of nature is really important for us.
Dr. Lisa: You also received your education largely in New England. You have a very extensive education.
Dr. Ben: I’ve been mostly around New England either in Northern New Hampshire or down in Rhode Island and also in Boston. Haven’t really escaped too far from the New England region which again is part of my identity.
Dr. Lisa: Did you always want to be a doctor?
Dr. Ben: I was in fourth grade and went to career day as a doctor. My father was a doctor. My grandfather was a doctor. Probably that had a major impact. Although my father was very much encouraging me to explore things outside of medicine. Knowing that many children are to follow in the path of their parents without fully thinking of where they want to go.
I went through a long period of time planning to go onto medicine. Then later in college, tried to find other things besides medicine to do but ended up coming back. It’s always been another part of my identity.
Dr. Lisa: What makes it part of your identity? What drew you back?
Dr. Ben: The interaction with using aspects of science and technology but really being able to apply them directly to humans and individuals. I’ve spent some time in the biotech world trying to explore just the pure science of things. Ultimately, it’s the human connection that was important to me and being able to use a wealth of knowledge that physicians acquire but being able to use that in ways that can really help and benefit individual people.
Even I’ve spent some time in the public health world as well and it really didn’t speak to me as much. It’s just that one-on-one interaction with people. That’s what gets me through every day right now.
Dr. Lisa: You do have an extensive education. You have an undergraduate degree from Dartmouth, a medical degree from Brown, master’s in evaluative clinical science again from Dartmouth, did a residency in obstetrics and gynecology at Beth Israel and Harvard and then a fellowship in reproductive endocrinology and infertility at Beth Israel Deaconess.
That’s a lot of investment of time and energy and resources likely to come back around to do something that ends up impacting your life in a big way. Has it been worth it?
Dr. Ben: It’s been worth it so far. I am just coming off of the final phase of my training which has been board certification in reproductive endocrinology. It’s been a time to reflect back at times on exhausting education process. My wife who started in business school when I started in medical school, many of her friends are contemplating down, stepping down in their careers and I feel I just got my first job.
The process along the way is part of a journey. You can’t just wait to get through training to start things. It’s been a really rewarding process so far. I’m looking forward to the next days, which are more of the independent part as supposed to the training.
Most doctors are always in the process of learning or training. It’s what you sign up for when you entered this career.
Dr. Lisa: When you look at your education, you kept narrowing it down and narrowing it down and narrowing it down. Now your focus really is helping bring life into the world. That is absolutely your focus at this point. It’s a challenging focus because people who come to see you are challenged. Talk to me about why you would go into such a field.
Dr. Ben: When I was in medical school and trying to figure out what I wanted to do, I really found myself drawn to this profession. I ultimately went in to my residency anticipating going into further training in infertility medicine.
Again, it’s that nice interplay with there’s a lot of basic science and a very detailed understanding of the molecular aspects of reproduction. The people that are sitting in the room across to me don’t necessarily care about that. They just want to have a baby.
Being able to use the skill and the knowledge that I’ve acquired and really being able to help people. Probably one of the most valuable aspects of their life is really a privilege and it’s rewarding every day whether it works or it not. Helping people get through the process has been the thing that when I look at … with every doctor they have to figure out what’s going to get them up every day. In many profession, that’s true but in particular medicine; what’s the thing that’s going to get you through the whole process?
For me it’s that, the reward of that interaction and the satisfaction when the patients are successful or even if they’re not successful that they come through the process with the feeling of some closure.
Dr. Lisa: Fertility has become a really important field. It’s grown, leaps and bounds. Boston IVF has a lot of different locations including this one in Maine that you work for. Why is that true? Why are we having issues with fertility in our culture today? Conversely, how we’ve been able to come to a place where we can now help this problem more?
Dr. Ben: There’s been not necessarily an explosion but a really constant improvement in the technologies that exist to help couples that are trying to get pregnant. When we look back roughly 35 years ago, the first IVF procedure was performed. The amount of progress that’s occurred in the 35 years since then has been incredible. It’s been made available to a much wider group of people.
Any time you have more technology that’s available to help people, more and more people get access to that treatment. You’ll start to see it become more prevalent in the society.
There are a lot of different things that are occurring in our society that we don’t really know how they’re impacting our fertility. A lot of chemical substances and things called endocrine disruptors that may or may not be having an impact in all of our lives, not just reproduction but lots of studies looking at changes in the time of menarche and the first signs of puberty that girls are having whether they’re changes in semen or sperm parameters that men have over the last 30, 50 years.
It’s unclear exactly what impact those are having and whether we’re experiencing a mild epidemic of infertility. A lot of it has to do with just changes in our society. People are really much more comfortable talking about these things whereas the previous generation are to really suffered in violence around a lot of these issues. That’s one of the biggest factors.
Then also just the changing dynamics socially of when people are having children. As more and more couples and particularly women are making more proactive decisions about reproduction, we see a difference in the time that people are having children compared to one or two generations ago.
There are many more women, about 20% of women are having children after 35 for their first child which one or two generations ago would have been much less common.
Dr. Lisa: What are some of the actual causes of infertility? You’re talking more of global reasons for infertility. What are some of the more common diagnoses that occur?
Dr. Ben: One of the things to appreciate is that infertility really affects couples. It can affect both men and women. It’s not always just even though our specialty comes from women’s health and obstetrics and gynecology, roughly half of the time there is a known factor. It’s either male or female.
There are things that can impact sperm production or the release of sperm that may impact a couple’s fertility. For women, there are a host of problems that can impact ovulations. Either something called Polycystic Ovarian Syndrome where women have an imbalance in the hormonal relationship between their brain and their ovaries and ovulate on less frequent paces or maybe not at all.
As well as other hormone interactions again between the brain and the ovary and those signals that are important in regular ovulation cycles that can reduce the likelihood that women ovulate.
That’s in addition to some of the more structural issues such as having a blockage in the fallopian tubes which is the passage that the egg has to travel as well as the sperm in order to meet each other. Those can be results of either infection or inflammation that’s occurred much before somebody has tried to get pregnant.
One of the differences with fertility or infertility and many other diseases is that it’s mostly asymptomatic. People don’t necessarily know that they have a problem. The definition of infertility itself is really based on the lack of ability to get pregnant over a certain amount of time of trying.
It’s different than having a bladder infection where you feel a symptom and you know that something is different. Therefore you go and have a specific test. Here, it’s really based on what is normal within a population and where you’re deviating.
Dr. Lisa: What are some of the technologies? You’ve talked about IVF, In Vitro Fertilization. What are some of the other things that have recently come about that are helping couples to conceive?
Dr. Ben: The range of treatments can be very simple to being more focused on the timing of intercourse and when couples are trying to get pregnant. Increasing the number of eggs that are produced in a given cycle maybe increase the likelihood of success. As well as a procedure called insemination or intrauterine insemination where sperm is placed rather than in the vagina, directly into the cervix and into the upper part of the reproductive tract.
Those are technologies that have been around for a long time. The more simple end of things, the more advanced aspects involving In Vitro Fertilization as well as something called Intracytoplasmic Sperm Injection or ICSI where a very small amount of sperm can be used to fertilize eggs.
Some of the newer technologies that are emerging are our ability to do genetic testing or chromosomal screening on embryos before they go back into the uterine cavity so that for couples that have either unknown genetic disorder or are trying to screen for chromosomal imbalances such as Down Syndrome.
That testing can be done on an embryo even before it’s implanted in the uterus. That’s made a lot of improvement for couples that are facing some of the not necessarily fertility-related issues but just the genetic complications that come along with reproduction.
Dr. Lisa: We’ll return to our interview in a moment. We in the Dr. Lisa Radio Hour and Podcast hope that our listeners enjoy their own work lives to the same extent we do and fully embrace everyday. As a physician and small business owner, I rely on Marci Booth from Booth, Maine to help me with my own business and to help me live my own life fully. Here are a few thoughts from Marci.
Marci: Have you ever been to the gym and noticed that one person seems to be there all the time. They’re dedicated, sweating, face, feet red, yet their body never seems to change. They never seem to reach that goal and they still have that extra 10 to 20 pounds they just can’t quite shed. Why is it?
Einstein’s ever popular quote, “The definition of insanity is doing the same thing over and over and expecting results rings through,” reigns true. If you always beat yourself up on a treadmill and haven’t loss the weight, maybe you need to switch it up. It’s no different with your life or in your business.
If you are continually frustrated with either one, make some changes happen now. Stop talking about it and just do it. Nothing will change unless you do. I’m Marci Booth. Let’s talk about the changes you need, boothmaine.com.
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Dr. Lisa: Judging by the fact that there are now requirements in some States that insurance companies actually pay for fertility treatments, it seems as though we are finally accepting the fact that this is an important medical diagnosis trying to help people conceive. It’s not an optional thing. It’s not as though some people just because they are fortunate enough to have everything in place.
They have the right to have children. For everybody else, it’s too bad for them. Does that help in some way to move this field along?
Dr. Ben: It has helped. The great underlying question in our society is whether infertility is a medical condition or really a misfortune as you said that we say, “We’re sorry that you can’t get pregnant.” We don’t deem it worthy of other medical conditions that insurance will treat.
It’s very interesting on a State-by-State basis how this is decided. In several States, I won’t say many maybe 10 or 11 States there has some coverage for infertility diagnosis and treatment. While in other States there really isn’t any treatment coverage.
It makes a major difference for many couples because we said, this can be quite an extensive process. When you’re paying for that out of pocket, it comes at a significant expense for the rest of your life. .
Massachusetts has a very comprehensive insurance coverage for infertility whereas Maine is quite limited. In many senses dictate what treatment people do if that all or how far they can get. Price ranges for treatment might range from on a low-end could be in the 500 to a thousand range but it can get upwards of 15 to $20,000 depending on how complicated things get.
For a process that theoretically could be free for most people, it’s a significant amount of money.
Dr. Lisa: Back to the idea of what medicine truly is for, is it for curing an individual’s, cleaning out their arteries so they won’t have another heart attack or is it for looking at things from an eagle eye view? We’re looking at the continuation of a species. If we’re saying that the only people who can reproduce are the people who can do it “naturally”. Then we’re not really looking at the health of the population at large.
Dr. Ben: There are a lot of conditions that are associated with infertility, depression, anxiety as well as other gynecologic or medical conditions that get treated but somehow the infertility diagnosis itself for many people is not considered a medical necessity.
I respect people’s opinion that our society should in some way determine what is considered a medical issue versus not. Anybody who’s struggled with infertility or known somebody who struggled with infertility recognizes that this is the same, meets all the criteria of any disease that we consider in the rest of our population. It’s really unfortunate that many insurance companies or many States don’t require coverage for this.
Dr. Lisa: Ben, you and your wife, Jean have two children, Oliver and Gretchen. How has the work that you’ve done in the field of infertility changed the way that you’ve looked at you own ability to have a family or vice-versa?
Dr. Ben: I have a picture of my family in my office. I put it off to the side. Many times you go to a doctor’s office and there are lots of pictures of their family and their children. I want it to be there for me to know and for my patients to know that I understand what they’re working towards. It’s important not to have it be too much in the face of my patients who are having all these other constant reminders of people’s families.
Anybody who had a family without much difficulty should recognize the challenges that some people have. Anytime that we can successfully form our own families that it’s a blessing for all of us. Many times we take our own families or children for granted sometimes. Many people when they’re talking to somebody who is trying to get pregnant and they say, “I just want to have children.” People will say, “Oh, you can have mine.” They’re driving me crazy.
That speaks to this imbalance of perspective that we all have where it’s a great fortune to be able to have children whether your children were created with minimal amount of complication or significant amount. Everybody has the right to be able to do that if they want.
Dr. Lisa: The type of work that you do requires not only the high tech and the knowledge and all the education that we spoke of when we first began the interview but also significant sensitivity and compassion and empathy. Do you feel as though medical education today is heading us in the direction of being able to marry those two, the high tech and the high touch?
Dr. Ben: It’s very person-specific. There are always going to be people that are gravitate to the high tech. There are always going to be people that gravitate to the high touch. Some of it you can teach but a lot of it is inherited in the personalities of the people that ultimately decide to go into medicine or any of the really the healthcare professions.
There are many doctors who the last thing they would want to do is deal with my patient population. That’s part of the selection process of all of us when we choose a profession. There are big differences between radiologists and internal medicine doctors and my profession for example.
It’s always important for all of us in whatever we do but particularly in medicine to figure out which things they’re good at and how you can apply those to whatever specialty you end up going into.
Dr. Lisa: Do you think that doctors might not want to deal with your patient population because it does require the high touch and the sensitivity and the compassion and that’s not always easy?
Dr. Ben: It’s a very needy has the connotation but it’s a very demanding population in terms of the amount of time and energy that goes into this process. It’s not, “I’ll see you once for your annual exam and come back in a year,” or ask you for this broken arm or whatever process that you’re dealing with. It evolves over for many of my patients months to years before we achieve the goal. That’s a very unique aspect of this type of medicine that you have to prepare for.
Dr. Lisa: There is also the possibility that the goal that you achieve is finally realizing that you may not be able to carry a biological child and that you may need to explore other options.
Dr. Ben: That’s one of the hardest things that we all face in this profession is helping couples find closure or transition to a different pathway than they had originally intended such as going through adoption or moving on without children or even for many people using donated gametes either sperm or eggs to help them assist in their goal.
That’s again one of the challenges that we all work towards is helping throughout that journey is really helping people get perspective on where they are now and where things are going or maybe going. There are always going to be people that aren’t achieving their exact goal. It doesn’t mean that they aren’t successful.
Dr. Lisa: Ben, you’ll be speaking at the free fertility seminar which is coming up on April 30th from 5:30 to 8:00 at the Maine Medical Center. People can hear more about what you’ve been talking about there at the seminar. Also, people can find out about you through the website for the Maine Center of Boston IVF. Tell us what that website is.
Dr. Ben: You can look us up if you go to Boston IVF or bostonivf.com. That would be the easiest access point. There are a number of fertility groups that are available. We’re certainly one option for many people. Our goal is to make sure that people are aware of this issue and can get access to somebody to provide help. As I said, we’re always happy to tell people or help people make that next step into the process.
Dr. Lisa: We’ve been speaking with Dr. Benjamin Lannon who is a Reproductive Endocrinologist with the Maine Center of Boston IVF. We’re quite privileged to have you in here today. Thank you for the work that you’re doing to bring life into the world.
Dr. Ben: Thanks very much.
Dr. Lisa: You have been listening to the Dr. Lisa Radio Hour and Podcast show number 85, Fertility. Our guests have included Anne Belden and Dr. Benjamin Lannon. For more information on our guests, visit doctorlisa.org. The Dr. Lisa Radio Hour and Podcast is downloadable for free on iTunes. For a preview of each week’s show, sign up for our e-newsletter and like our Dr. Lisa Facebook page. You can also follow me on Twitter and Pinterest, doctorlisa and read my take on health and wellbeing on the Bountiful Blog, bountiful-blog.com.
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We hope that our conversations with Anne Belden and Dr. Benjamin Lannon may add a chance for you to think about life in a slightly different way and perhaps change the way that you approach it. Thank you for allowing me to be a part of your day. May you have a bountiful life.
Speaker 1: The Dr. Lisa Radio Hour and Podcast is made possible with the support of the following generous sponsors: Maine Magazine, Dr. John Herzog of Orthopedics Specialists, Sea Bags, Booth Maine, Apothecary by Design, Mike LePage and Beth Franklin of Re/Max Heritage, Tom Shepard of Shepard Financial and Ted Carter Inspired Landscapes.
The Dr. Lisa Radio Hour and Podcast is recorded at the studios of Maine Magazine at 75 Market Street in Portland, Maine. Our Executive Producers are Kevin Thomas and Dr. Lisa Belisle. Audio Production and original music by John C. McCain.
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