Podcast Archives - Anova Fertility

November 11, 2021 Anova Admin 0 Comments

Fertile Thoughts Episode 002: Roberta Scott

Transcript

Dr. Marjorie Dixon:

Welcome to fertile thoughts, a podcast made for TTC warriors. This is our second episode and I have the pleasure to have Roberta Scott join me. So Roberta and I go back. She is a single mother by choice, who has started her support group for thinkers and Tryers, who are on the journey to becoming single moms by choice. She’s joining me today to share her own story, and to provide hope and encouragement, as well as offer support for the often challenging journey to become a Single mother by choice. So welcome, Roberta.

Roberta Scott:

Thank you so much for having me. It’s a pleasure to be here.

Dr. Marjorie Dixon:

Tell us about your story. Yes, well, wow. It was 14 years ago, now that I came to see you. I was 43 years old, I waited a long time to do this. But at 43, I came to see you about having a baby on my own. I had put it off for so long, because I really wanted to meet someone like most women do. Hope I would meet someone hope I would get married or have a partner to have a child with but I got to the age where it was time to either do that, or probably missed the window. So I went to see what 43 and you were very honest with me that my odds were low. But you were willing to take me on and to give it a shot, which I was so grateful for. So I spent a year trying to have a child. I went through six unsuccessful IUI. Then you said, Let’s try IVF. Let’s give it a go. And I was willing to trust you and say let’s do it. Even though I didn’t have the money to do it. I wanted to try everything to have my child. So we did the first IVF it was four eggs on retrieval and transfer day there was only one embryo left, which I heard that news I was very upset. I was very disappointed. And you know, daunted by the fact that I was worried it wouldn’t work and what would I do next, but that one embryo was my now 13 year old son, Jesse. So that first IVF with you with just one embryo worked. And now I have a 13 year old son named Jesse. And it’s just amazing. How fantastic right? the little embryo that could, right? You know, what’s amazing further that you say all of this, and I remembered you, because it is so exceptional, that you came at age 43. Yeah. And you know, think about the program in the province of Ontario, it cuts off on your 43rd birthday. By virtue of the statistically low likelihood of pregnancy per cycle. Yes, no matter what we do. Yeah. And you stuck with it, you came back. And when you came to give it the try. With the one embryo, you were so optimistic and positive, in spite of being I know, you were disappointed, I know, I will validate that it was hard to only have one but recognize that that was actually exceptional, because sometimes patients come at age 43. And we don’t have option by virtue of the extraordinarily low ovarian reserve, right? So it is amazing that you are able to share that story. And it gives perspective to other patients who recognize that you can’t necessarily lose all hope you rely on your fertility specialist and the center’s expertise. But you really do have to have a bit of grit. And that little bit of helpfulness in spite of the odds.

Roberta Scott :

Yes, I agree. And you were so helpful in your attitude, because you were very positive, you’re very realistic, very positive, every month, you kept looking at my chart and saying we’re gonna do this and do this. And when you said to me, let’s do IVF, I just trusted you. And I said, I’m going to go for whatever you recommend, because I want this child and I I’m so I’m so grateful that it worked out.

Dr. Marjorie Dixon:

I’m glad it works out. Right? And, and so you know, you’re right, like every service providers a little bit different. And, you know, at Anova and for me, the whole reason I ended up in the place that I am now I always wanted to be a fertility specialist, but in the place of advocating for others in the place of setting standards through our Fertility Centres. It was really to break down barriers. It was to remove all of the things that could act in a way to prevent any individual who should want to grow their family in any jurisdiction that I was a part of, that I would assist in in trying to break down those barriers. So with that in mind, what were the barriers that you experienced as a single woman What do you think single individuals are facing as they are attempting to move forward in their journeys to grow their family? Unknown Speaker 5:08 Yeah, there is a lot of them, I have to say what I faced. The one thing, the reason that I that I waited so long is because there was that barrier of I didn’t want to do it alone, that was not like, I don’t think it’s many people’s first choice certainly wasn’t mine. So I kept thinking, if I hang on, I will meet someone, I will have a partner, I will know the person. So that was a barrier for me is just pushing my age to the limit, because I’d hope to meet someone. And my age was the, you know, the impetus and me saying I can’t wait any longer. So that’s one barriers kind of trying to vote right now. And you’ve got to, you’ve got to deal with that. And the sooner the better, because I waited quite late. But that’s a barrier is trying to get by that, you know, the image of, you know, having the partner in doing it. There’s the financial barrier, that’s a huge one. And, you know, I didn’t I wasn’t like some women, I didn’t prepare for it, I didn’t save for it, I just, you know, get to the point where I needed to do this because I was 43 years old. And so then there was the financial piece, which was was difficult because it was on my own it was being thrown on myself. So that’s another one that women face, and that I hear a lot that I faced. And the other was just not necessarily having everyone in your life supporting that decision. Now what I did different. I didn’t tell anyone. So I did this totally, just by myself, which Oh, I didn’t tell anyone. And that’s unusual

Dr. Marjorie Dixon:

I realized I hadn’t realized that.

Roberta Scott:

Yeah. I probably didn’t even share that with you guys.

Dr. Marjorie Dixon:

That, but that’s a heavy burden.

Roberta Scott:

Yeah. But my decision, the reason to do it was to avoid people may be telling me, you know, maybe you know, this is too late. Or, you know, do you sure you want to do this on your own? Because I just suspected that a lot of people would, if I hadn’t started yet, or if I hadn’t become pregnant yet. I get a lot of opinions about what I should or shouldn’t do. And I just knew that what I was doing was something that I wanted to do and needed to do. So it helped me to just avoid any naysayers, any people that might want it to talk me out of it. Yeah, I like I said, I wouldn’t recommend that for anyone. I think a lot of people in this journey, that support is helpful. But that was what I did. So having the support in your life is a good thing. Don’t have it that can be a barrier. Yeah, and just a general fear of the unknown. I see it now as a fear of the unknown. I just didn’t know, I knew more than anything. I wanted to have a child my whole life, I wanted to be a mother, that was a dream of mine. And I didn’t ever want to give up on that. But it was really daunting to me to do it on my own. Because I just didn’t know how that would go, will I be able to cope as a single mother? Will I have the money to support a child? Will I have, you know, how will my life be? Once I become a single mother? Right? So that was just like a fear I had. And so it was hard to get over that. And I meet a lot of women that feel that way. it’s a real hurdle to jump into the unknown and on the other side, if I do become a mother, how am I gonna be able to cope? can I handle this on my own? So I felt like that.

Dr. Marjorie Dixon:

And then what was it? How did that compare to reality? Actually? So? I know, that’s a big question. But now we’re talking, you know, it’s a reasonable fear. Couples who go into think about it and individuals who are single individuals, feel it to a degree. So, so just out of curiosity, and this is anecdotal, but in your experience, having lived it, how did the fear then compare with the reality of doing it?

Roberta Scott :

That’s the amazing thing about it, as I had so much fear, and so much worry, and so much sort of, Wow, I can’t believe I’m doing this. It was a huge thing for me. And oh, my gosh, was the best thing I ever did. None of the fears that I had came true. Like, none of the things I worried about, were an issue. And I thought to myself, why didn’t I do this earlier? Why didn’t you know? Great it was and none of the worries I had, you know, coping it with it on my own. He’s just a joy. I mean, it’s just a joy to be a mother. And so all the things that I was worried about never came true. Which doesn’t take away from the fear it’s there because I when I talk to women who are who are still thinking about it, those fears are there but I tried to let them know that on the other side for my everyone’s different everyone’s life. So yeah, I mean, this experience is different, right? Doesn’t mean that everyone’s gonna have that but it was just the best thing that ever happened to my life and all the things I was worried about I was fine with and raising a child on my own has been absolute joy.

Dr. Marjorie Dixon:

Fantastic. Yeah. Yeah, you’re very blessed. I mean, and in fairness, not every child is the same, right? And it’s that known. What I hear from my patients who are talking about the potentiality of a journey to become a single parent by choice is one that surround health as a big one, and there are no guarantees in anything that we do, right? And, and so you think, what would you do as a single person? What would you do as a couple? Like, how would you cope either way, right? So those are the kind of bigger, more existential questions that I get that I actually in fairness can answer, because that’s not my genius. My genius is in the medicine and how to handle the situation when patients present. So what do you think? If so, it was a great experience for you? What was the Go ahead?

Roberta Scott:

I was just saying, I went back to work. But I was lucky. Again, not a lot of women can do this, I, I was able to take a year and a half off with my son, which was just a joy. But then I went back to work and I was a full time paramedic, I was working shift work nights, days with a child on my own. Not easy, but I managed all that fine. I managed to do that and take care of him. And I had to have a live in nanny, which is expensive, but I was able to manage that we have a house and so I was able to be a single mom working shift work and make it work. And and I actually wanted to have another one. That’s how much I enjoyed the experience.

Dr. Marjorie Dixon:

Yes, that’s what’s the chronology, right? It catches up eventually. Yes. So if there was one thing, what was the thing that nudged you over the edge to say ok I am going? Like, what was that final moment?

Roberta Scott:

For me my age, my age, I felt in my early 40s, I still had lots of time, I was I was probably not being realistic, but I felt I was still had lots of time. And for some reason, when I turned 43, it was like a light bulb went off. And I said I have no time. And immediately I went to my doctor, I got a referral to a fertility treatment. And all of a sudden, there was something of a light bulb went off. And I realized I have to do this now. And that’s what nudged me. I would recommend: people don’t wait to 43. And I know you know that because you’re the doctor do not wait. That that was what pushed me over the edge is to say, I don’t have any more time here. I need to do this now. And if I want to be a mother, it’s now. Dr. Marjorie Dixon 12:37 Absolutely. And you know what just my public service announcement as a fertility specialist is that I don’t recommend if anyone is contemplating this in their early 30s in their late 20s. It behooves them to find a physician who will do an ovarian reserve assessment or a sperm assessment to see what the condition of the gametes are. And then that individual can kind of make a strategic plan about how they want to do this, you might not want to wait until 43, some people might decide to become a single parent by choice in the first half of their 30s out of a relationship, or in the second half of their 30s. The most important thing is to this to have an ovarian reserve assessment organic assessment of the testicles the sperm sooner rather than later, because then you can make the strategic plan you can say, Okay, well, this is what I look like, I’m single right now, if in two more years, I’m still single, I’m going to jump. So we make plans for our life strategy, when we’re going to buy a house, when we’re going to plan ourselves financially, we have to do a better job of making sure we get patients to contemplate these things sooner rather than later and bringing into your consciousness about about the fact that this is something that people do that stigma that you said you I mean, look, you didn’t tell anybody about it. and, you know, for us, at Anova we do this every day. And so for us, this is just the mainstay, of course you want to have the child, we will help you we’re here for you to help you gain access. But how do we help those individuals who are planning a family on their own to have less stigma, how do we help our community do better? Because it’s not all better. Like we’ve had this typical kind of heterosexism approach to this. We all have our LGBTQ plus community. How do we advocate for our single folks to make sure that they feel seen and heard and included in what it is that we are providing?

Roberta Scott:

Yeah, I totally agree with you. I think that we have to talk about it more. That’s why I’m so glad that you invited me on to talk about it because I think that the more we talk about this, the more that younger women will start thinking about it sooner. I really recommend that women think about it early and start making a plan. I mean, I did not make a plan, I did not save for it and I wouldn’t recommend that. It’s quite a journey to go through, there’s a lot of things that are going to go on. And the earlier you start thinking about it, the better prepared you are to make that decision if you decide now’s the time. But definitely, I agree with you to go and see for fertility specialists, early, not late.

Dr. Marjorie Dixon:

And you are one of the exceptional great ladies who at age 43 Still had ovarian reserve where IVF was an option, right? You’re fortunate there are a lot of women who come even earlier, in the second half of their 30s were considered advanced maternal age at age 35. So, right? and so and that’s a piece of information that is often missed for women, and then they show up and they’re like, why I’m at the mercy of my biology. And I say time, we haven’t changed the chronology of the ovary. So. So whilst you were fortunate to be able to still have appropriate ovarian functioning, to have a baby at age 43, it’s so critical that share that message that you can plan to be a single parent by choice early, you don’t have to wait as well, right? Like that. It’s really a crossover. Yes. So if you now with your experience and your support groups, and in the time that you’ve spent kind of in this realm of being a single parent by choice, what would you say is the most important or the most helpful? Hint or tip? For someone who’s considering doing this going along this journey? In our trying to conceive community?

Roberta Scott:

Yeah, well, I would say number one, plan ahead, like we just talked about, think about it a lot earlier than I did. I was a thinker. But I didn’t take any steps to look into it until my 40s was. So my first thing would be to just start thinking about it early, don’t wait until it’s too late. And have a plan. I’d also say, you know, to prepare financially for it. And also, I would say, plan for it to be a bit of a journey that it doesn’t, you know, happen quickly, often, as you’re lucky, you know, that it’s a journey that you’re going to be taking for a while you could be taking for a while, right. And there’s lots of ups and downs. But, you know, be prepared to know that it’s may not happen overnight. Again, the other message to start early, right? Because it may take it took me seven tries. Some women it takes a couple of years. So give yourself time.

Dr. Marjorie Dixon:

Absolutely. And, and, you know, patients often talk with me about, you know, they feel the weight of the situation, and they want to be able to see the long haul and see if it ahead and eyes on the prize. And, Dr. Dixon, do you believe this can still happen? And I’m like, Yeah, I, aim to be one and done with an IVF cycle if that’s we get, but it doesn’t always happen that way, particularly if women are over 35, let’s say. And so what would you say? Because it can be an arduous journey? Right? That’s part of the barrier stacks. I think patients are like, I don’t know that I can keep going right? Yeah, what? What was it for you? Because, you know, six IUIs, and then IVF? What gave you hope? And in your journey to keep moving? And not to say like, oh, gosh, like, I don’t think I can handle this anymore. What was that thing that gave you light? To keep moving toward?

Roberta Scott:

Yeah, that’s a good question. And it’s hard. It’s a hard thing to describe. But I would say that when I went in, I had such a desire to be a mom my whole life. And I just felt that it was something that was going to happen. So I believed in you know that it was going to happen. And then I realized that there were certain things I could control and certain things I couldn’t control. So I was getting great treatment by you. And you know, everyone that took care of me there I trusted in you guys that you were going to do everything you could to help me have a child. I always stayed positive. I always believed that it was going to happen. But I also I know this sounds a little bit airy fairy kind of but I really let the universe I sort of said, You know what, if this is meant to be I’m doing everything I can do to make this happen. And the rest I’m going to have to leave to whatever forces are out there. And I’ll go with that. And I’ll just but what I said to myself is I’m going to stick it out as long as I can, which is as long as I need to or as long as I can afford to I mean I was in a position where I just I had to take out loans and things to do it. But I was committed I said, you know, this is my one chance and I’m not going to quit. I’m not going to stop until, I guess until it either happened or, you know, there was something telling me to stop. Luckily, I didn’t have to get to that point. I mean, when I need to get that one embryo put back in, I was alright, my wheels are already turning. Okay, how am I going to get the next? Now isn’t that crazy Dr. Marjorie Dixon 20:25 right now. It’s good to have a plan. I always tell you, well, you’re you might be Plan A but I’m B and C and like a bad call. They don’t go away. Like if you give me an opportunity, we’ll keep moving.

Roberta Scott:

You know, I was very persistent. I really believed in you know, this was what I wanted, and that I wasn’t going to quit. So that was my thought. And I the the lovely nurses, when I went in said, you know, we’re burning, you just need one, you know. And I said, Oh, right. And I love that. I remember that too. Every day, you just need one, just one good egg. And I still call Jesse my one good egg. When I talk to people, I just held out for that that one good egg was still there. And I just tend to get through it, you know. So I was always very optimistic. And I believe that if I wanted it to happen, and I kept going, and I didn’t quit, that it could happen. And I’m just like I said, it’s like a miracle. I’m so grateful that it did work. And, and you guys were so wonderful to get me through it all.

Dr. Marjorie Dixon:

Oh, such a pleasure. You’re a great patient. And you know, honestly, we have passion for what it is that we do, right? Like we really do this. Because we want to be able to create families where otherwise they may never have been right. And for anyone who should so desire and so like I, I hope that our patients get an opportunity to feel surrounded. It’s not just the medicine that we’re providing. But it’s also no matter what happens at the outcome of the journey that patients feel supported and heard and validated. Throughout, regardless of where they come from, to us for our assistance through them.

Roberta Scott:

Yes, that’s so important. That was so important. And you are wonderful. I always remember you as a very positive… and I was following you. And you were like, I’m trusting her and I’m following everything she tells me to do. I’m gonna do. And I and you were always so positive. And you are always optimistic that we’re going to keep doing this until we can, you know, till..

Dr. Marjorie Dixon:

it doesn’t make sense, right? Yeah. And you know, like, I think what happens also with more experience, right, this is like 20 years out. Now, you come to recognize that even some of the most dismal appearing circumstances, have a little bit of sound like the crazy doctor, I have a little bit of magic in them. And, and so much as you know, people talk about science and the technology advancing, and our ability to do things with more information that we can do genetic testing, which wasn’t afforded to us before. Now, we can grow embryos for five days out of the body, five, six days to become blastocyst, which before we weren’t they were blastomere stage embryos. Now we can freeze and thaw things, we can use frozen eggs, we have so much that we’ve advanced in over the past few decades in assisted reproductive technologies. But I will maintain that there’s just this little bit of magical data that goes on that we still don’t understand. I mean, like, likely there will be a reasonable explanation to an extent about genetics and genomics that’s coming out. But you know, for our patients out there, but the one that gets people across the finish line is grit, if you were lovely, as a patient, because you were part of your care, you didn’t just relinquish it all to us. But and you were informed about what we were doing. But you also had a degree of an understanding that we were there to provide you with the expertise to guide you in the right direction. And that’s a bit of a trick when you have the, you know, clinical care team working with the patients and wanting to meet people halfway, but also understanding what people need to get to success. So it’s a bit of a balance between the care providers, the clinical care team and the patients. But it’s such a joy, to be able to collaborate with patients and then see what comes out of it. Big people 13 years later, it’s magic. It is magic. You just can’t. It never gets old. You see the cells and then you see people it just doesn’t make sense, but it’s what we do every day.

Roberta Scott:

that’s so nice. Yeah, I remember sitting in the waiting room and looking at all the pictures that are up on the board of all the babies and I remember thinking, I wonder if I’m going to be up there one day, you know, and I just kept the faith I just kept hope and you know, I was able to be a mom and it’s just the best experience in the world.

Dr. Marjorie Dixon:

And then now you’re channeling it into something to help others right, other people along the journey so so that that tell us some about your support group and what it is that you do

Roberta Scott:

Yeah, so I started about four years ago, I saw a need a lot of women talking to me asking me questions wanting to do what I was, had done be a single mom because they weren’t in a partnership. And I realized that there was a need for some support out there. And so I started a support group. And it was a small group that started meeting in my living room about four years ago, of women who were either thinking of which I was a thinker for a long time before I got the nerve up to try it thinking to have it, you know, be a single mom by choice. So I started this group, it’s called journey to become a single mother by choice. And we meet monthly we started off meeting in my living room, small group of women, pre COVID. Yes, exactly. Because this is four years ago. So that was in my living room. Yes. It’s a handful of women who wanted to meet was it was going to be a one time meeting. And I saw so much need for these women to talk to each other. I’ve just sort of become this host for them. And we meet what they now that it’s COVID, we meet online. Basically, we meet to give them some community, some connections, some support, and information sharing, they share a lot of information with each other about what they’ve done and where they’ve gone. And you know, what it’s worth. And so I host it monthly. And I get, you know, we’ve got almost 200 Women now in the group, and we get about

Dr. Marjorie Dixon:

Wow, yeah. Really? Wow, that’s great

Roberta Scott:

It started with, like, 12 women, you know, and it’s like, they told to friends, and they told your friends, you know, they meet people and now we have this large group, and now that we’re online, people even from you don’t even have to be in Canada, come on, which is great. It’s nice, opened up to more people. And wow, you know, it’s really, it’s filling a need for these women who are doing it on their own, they feel so great, being able to talk to other women who are in the same situation going through the journey. And so it’s just a support group for women doing it on their own. And I just started it because I saw the need, and it’s a pleasure to support them and give them an I try and give them hope. You know, I give them hope. And I give them encouragement, and they support each other. It’s a great, it’s a great group. Dr. Marjorie Dixon 27:19 That’s fantastic. I mean, I, when I think back when I first started, like, again, 20 years ago now, which is so weird, but there was this little book that was you know, single women thinking of having a baby was like, this is before the iPhone, it was this little flip pamphlet, and I’m like, I’m gonna support them. I’m gonna advertise there and say that I’m willing to help you because there was stigma back then like, yeah, it was not commonplace at all, in the early 2000s. And though you segue to now, even though it’s more commonplace, there needs to be safe spaces for people to go and discuss and feel kinship with others and and feel the ability to find hope and not like they’re a unicorn in their ownselves as they wished. Right, like, so you’re not alone?

Roberta Scott:

Oh, absolutely. That’s one of the one of the most common comments is when they meet each other. And you see each other now, like I said, on the screen, and they say, Oh, I feel so good to talk to other people, you know, all the thoughts you’re having, I’m having them too. They’re all going through the same thing. And it helps them so much to meet other women and realizing how many women are doing this. And then the amazing thing about my group is that because I’ve been doing it for four years, that original women, a lot of them have babies now, pretty well. Oh, nice. It’s so moms, and then they can give hope to the other women. So I’ve divided into two groups, I have a group for thinkers and Tryers women on the journey. And then I have another group for the women that I say you’ve graduated into the mom group, and then, you know, they continue to need support and the connection and community. So they meet online and share what it’s like to be a single mom with young children. So there’s that support as well along the journey of raising a child by yourself.

Dr. Marjorie Dixon:

Wonderful. Well, thank you for doing what you do, there was clearly a need. And it’s always I think it’s so special. And people come to their own form of advocacy, through having had experience and wanting to be able to extend help to others in a time where maybe they might not have had it right. So thank you for what you do for all of those patients out there. The moms who want to be single parents by choice, and it’s been so fantastic to speak with you and see you again and to think of the little baby that’s now 13 years old or I can’t even believe it time has flown by. So I think that you know we talk about this is called fertile thoughts, right? So this is my moment where I put you on the spot and I ask skill, after all that to give us your fertile Thought for the Day?

Roberta Scott:

Yeah, well, my fertile thought has a lot of hope. And it just says that if you are on your own, and you’ve always dreamed of having a baby, don’t let being single stalk you, you can do it on your own. I did it. And there is support out there for you to help you on your journey. And so I say to women, you can do this.

Dr. Marjorie Dixon:

You can do this. That is great. That’s great. Thank you for that fertile thought. And then I will also share my fertile thought. And it’s by Bear Grylls that says “being brave, isn’t the absence of fear. Being brave is having that fear. But finding a way through it.” I like that, too. Yeah. So Well, thank you so much. Thank you. Thank you. Thank you a million times. Thank you. So good to see you there. Thank you for joining us. And thank you to everyone who is listening. And if you have a story to share with our community, please reach out to us through our social media platforms. We’d love to have you on our next episode. And remember, one positive thought at the beginning of your day can change the entire course of your day. So make sure it’s a fertile one. Till our next episode, stay healthy. And bye for now.

October 15, 2021 Anova Admin 0 Comments

Fertile Thoughts Episode 001: Special Guest Alex Johnson

Transcript

Dr. Dixon: Welcome to fertile thoughts. I am Marjorie Dixon, the Medical Director and CEO of Anova fertility and reproductive health. I’m excited to be here and launch our very first podcast, fertile thoughts, a podcast made for TTC warriors as a new way to bring our community together. We’re here to connect, learn and inspire each other. Let’s get started. My guest today is Alex Johnson. She’s the CEO, a women’s advocate, a policymaker and a lawyer who recently published a book inconceivable about her fertility journey. Alex’s journey to parenthood was not an easy one. On the contrary, it was unexpectedly, a five year long struggle through fertility challenges, medical procedures, uncertainty and loss. She’s joining me today to share her personal story. Alex, welcome. And thank you for coming.

Alex Johnston: Thank you, Marjorie, for having me.

Dr. Dixon: So for people who haven’t read your book, tell us a little bit about your story. And then let’s talk about your book.

Alex Johnston: So my husband and I started trying to have a family when I was 32. My mom had had five kids in seven years, five daughters, and I never anticipated having any issues. 32 felt pretty young to me. I went to see my doctor and my doctor said no reason to believe you’d have any issues, you’re healthy, you’re young, and try for 12 months. And if you know, God forbid anything happens, and you had any difficulty, I’d refer you to someone, but you know, we didn’t feel there would be an issue. We did try for a year and nothing happened. So we were referred to a fertility specialist. And as soon as we got in to see the specialist, which was took a little bit of time, they did a fertility workup. And I was immediately red flagged as someone with significantly reduced ovarian reserve. I was about 34 by then. So we lost about a year and a half of trying. And the doctor said you don’t have any time to lose, you’ve got very little left in your ovaries. And so we moved into pretty aggressive treatments right away, I started IVF. And I did four rounds of IVF, which was what was recommended, and that was not successful. We didn’t know if it was a problem with my eggs or a problem with my body. There was no real indication of what was going on. I just was never able to get pregnant. So we asked my youngest sister Sam, who was doing her PhD at the time in her late 20s. She would consider being an egg donor. And she said yes. So we tried with her. And we were pretty optimistic that with donor eggs, we would be successful, and I still was not able to get pregnant. So we ended up saying it’s, it’s unclear if it’s a body issue or an egg issue. But we’d heard a little bit about surrogacy, which was pretty uncommon at the time, it was sort of 2004, 2005. But we reached out to someone who had been a surrogate to another couple, who someone referred us to. And we ended up working with her and she got pregnant almost immediately using our embryos, my eggs. So we were over the moon and we sort of thought “Why didn’t we think of this sooner?” Because we had been at it for about three years by then trying to build our family and very tragically at full term day passed her due date, she went into labor and my daughter Sam suffocated in labor and delivery was stillborn. So we ended up on a very different journey that was infinitely more complicated than just facing infertility. We grieved the loss of our daughter, Sam profoundly, but we felt very strongly that we wanted to become parents again. And we wanted to have the experience of raising a child, not just having a child and losing a child. So we worked with a number of surrogates. We worked with one of them successfully. And then we found a wonderful surrogate in Ontario and a wonderful surrogate in Green Bay, Wisconsin and we said to both of them that we were planning on doing this with two people simultaneously, would they be okay with that? And they said that we would so we tried with both and both became pregnant. Our Green Bay surrogate at eight weeks call to tell us that she had miscarried and was no longer pregnant and she kept going back to the hospital because she was having all the symptoms of pregnancy and they kept sending her home telling her she had miscarried at five and a half months she called me to say I did not miscarry. They finally did an ultrasound to confirm there is in fact a baby in there. That was our daughter Sadie. So we joke that she disappeared for three and a half months and then reappeared. And then our daughter Georgia, was carried by her wonderful surrogate in Ontario, and she delivered our daughter, Georgia at 29 weeks had its own set of challenges, but we ended up on the other side with two beautiful daughters. So when my daughters were three months and six months I was exhausted and I didn’t know what was going on. I thought I had some medical issue. So I went to see my doctor. And it turned out I was pregnant very unexpectedly, with our son Lucas, and he was born totally normal pregnancy, one and only time I was able to get pregnant and he was born 12 months after his sister Sadie on Christmas Day. So we ended up with three kids in 15 months, which was, again, its own set of experiences and challenges on its own.

Dr. Dixon: I don’t have any words, I can’t imagine how hard that must have been for you. But I so appreciate and thank you for sharing this incredible journey with us.

Alex Johnston: Thank you, Marjorie,

Dr. Dixon: It is such a personal story. And you made such a difference from the policy place, why did you decide to actually let it all out?

Alex Johnston: A. I’ve never felt ashamed about it. Infertility, and the need to get help just seemed like a, you know, not a normal thing. But it seemed like it just was what it was. So it never felt shameful to me of you going through it needed to change. And so you know, you and I know that I advocated as did you as part of the expert panel, I didn’t know that the advocacy would take the form of a book. But as I started three or four years ago, listening to women in their early 30s, talk about their experience, I thought, oh my god, nothing has changed, like this is still pretty similar to what I experienced. And that was a big motivator. And I thought, Okay, this needs to move forward much more aggressively. And I said, I’ve been telling my story matters. The book originally was more policy focused, and it was soundly rejected by all publishers. And they came back and said, no one’s interested in a policy book on infertility. I was interested in policy book and infertility. And my wonderful, wonderful book agent said, we’ve got to embed this in your personal story for it to really resonate with people and through that you can embed learnings in the book, which is ultimately what I did. But this is about advocacy. For me. It’s a purposeful book, and I have written it, but the hope that change is coming. And I want to be part of pushing towards that.

Dr. Dixon: as you said, so aptly that you dealt with these barriers, and it was a scary thought long ago, and you talk to people, it’s exactly the same thing. And, you know, I do a lot of public speaking and you know, we use our social media and talk whenever I get an opportunity to put me in front of people to talk about things since that expert panel on infertility and adoption, and that was all the way back in like 2008. Yeah, yeah, I was pregnant with Gabriel. And he was born, the report came out in 2009, on the 26th of August, and it was, it’s hard to come like he’s 12 years old. And I’m still saying the same things. And patients still are lamenting the two greatest barriers to accessing care in fertility are the emotion of the journey, how difficult it is to navigate. And the second thing is the cost. And, and those are the two things that we have to do better. And so that more people can actually carry it. So it’s one of 6 and it’s not infrequently, supremely prevalent. And, you know, I think that part of what is so interesting in the book was that you were talking about how even your doctor didn’t know about gestational surrogacy and made some kind of outlandish comments about it, you’re like you’re the expert, right? Like why am I actually the expert about this? So. So I think that patients need to know that it’s not illegal in Canada with that the other thing that people keep doing, and that there is always a means of accessing care, even in the higher order assisted reproductive technologies. And now, in this day and age, everybody’s interested we do gestational surrogacy. We’re LGBTQ friendly. But for me, for Anova and for Canada, it was so important to recognize that families are diverse, right? Like there is such a diverse landscape that makes up family in Canada, single people, heterosexual couples to gay men, single dads. And that is something that I think is a tremendous gift in the book as well, because it helps to generalize like this was 2009. This is what I went through. Can we please have some organization to get this to the masses to our patients that need it? In 2021? Already? Yeah.

Alex Johnston: And we have the tools. We haven’t created access. But one of, to me the reframing isn’t so much, you know, women who need fertility help. My book is really directed at women because there is a biological component that’s very real for them at the time that they’re looking at starting their families. But it’s this fundamental desire to become a parent. We want people to become parents. We need people to become parents. Look at that, and we’re putting the value on having a child, that includes everyone. And so whether you’re a man or a woman that desires that need is very profound and people. And so I think the supports really need to focus more on that. I know even though theoretically, anything in the world is possible today is not accessible. So if you don’t have money to access, support for adoption, or support for fertility treatment is very hard, very expensive, very time consuming. And those things have to change. Those barriers are movable. And that’s something that we need to focus on moving.

Dr. Dixon: Yeah, absolutely. Well, we do what we can to Anova that’s it’s part of our mission vision, the whole idea of facilitating the journey for all comers, regardless of who they are, what their socioeconomic status, their sexual orientation, gender identity, whatever, geography HIV status, like we wanted to make access to Fertility Care for all a priority. And, and we’re not perfect at it, but we work at it actively. And I think that reading your story reinforced that while we have come away, we still haven’t arrived. And so what do you see right now as a continued barrier, that we can potentially fit like, I’m thinking about, like, trying to conceive community that are listening. And, you know, what do you think is the mini lift that we can do that can have a big effect? Yes, that’s

Alex Johnston: Yes, that’s a great question. I think there are three big gaps. The first is information. And that’s a pretty simple fix. In my mind, women are not getting information early enough to use it, women are often not getting relevant or accurate information. I understood going into building my family that 35 is the dividing line. And I felt like you’re safe before 35. And things get riskier after 35. And that was really not helpful or accurate in any way, shape, or form. I learned once I was in it, that my fertility, like your average woman had peaked at 28. And by 32, when I started trying 15% of my peer group, we faced infertility, that was big news. And I felt at the time and I feel strongly Now, every woman needs to know that, on average, most women are having babies in their 30s now, and there’s a whole host of information that should go along with that. So they’re well informed. So information is the first gap and making sure that the relationship with a woman’s family doctor is such that the doctor is raising as proactively with women early on. And really making it part of her annual medical checkup is really important, and would be a very significant change that would be beneficial to women. The second big gap is health plans, making sure businesses start to look at this as a significant health issue that it is, for young women and men in their late 20s, early 30s, mid 30s, this is often the thing that is top of mind, it’s the most important thing on their agenda, period, or their health agenda. And making sure that support for family building that fertility treatment and adoption is built into health plans is really important. This is a big issue. And the choice to have a family or not is a really important choice. But that choice being taken away from people is is profound and has very significant impacts on them psychologically, emotionally, financially. And it’s something that businesses can have a huge role in addressing. And the third big gap is government support and funding. To me, this is a very important health issue by the world has changed. Men, women, single people, same sex couples, heterosexual couples want the ability to build a family. And there are tools to do that we have to make those tools accessible to people. And I do feel like family building is too important an issue in people’s lives to simply ignore it or maintain the status quo. And governments have a big role in making options accessible to people broadly, beyond just women like myself, anyone who really wants to start a family. So those would be the big, big gaps.

Dr. Dixon: Absolutely. I think you just nailed it. And I think that might be one of the most valuable pieces of information that we could build on. I say it all the time. well trained. I am 14 years of postgraduate education. And I didn’t really learn how to talk to people at top class universities in Canada, about conception planning, contraception, contraception, everybody knows five, 6,10 ways or someway to not get pregnant, right? Like, I’m gonna put Fort Knox up there and spermicide there and it’s not getting through. Chastity belt, right? People think oh my god, I’ll slip and fall on sperm and I will get pregnant. That’s the concept that we don’t talk about, okay. It’s not taboo. I’m not saying you have to have a kid but it’s family is your own genetic progeny important to you, if not fine, but you need to understand the limitations of your reproductive lifespan by the age of 30, women have depleted their ovaries of 90% of their eggs, right? The okayness of the 10% that remains is still relatively okay function to 35. But just maybe, maybe probably just if we checked because often we don’t know when it’s not so good. And then after 37 by 40, we’ve depleted our ovaries of 97% of the eggs. 97%. And the 3% that remains is not that good. Right, so and it’s assisted reproductive technologies, it only assists what often has accelerated and it’s diminishing in quality. And so, I would love to talk to university level, like in their 20s I’ve already done like daughter’s 13 I’ve talked to all her friends but you know, when you’re in your 20s, and you’re at university, you got to talk to your parents about maybe freezing some eggs just so you have options it’s an insurance plan, hopefully you never use it, but it’s actually to have that ability now, we need to be better at normalizing it. And then not being I’m not I’m a feminist people, my sons I’m raising they know mom, Yes, Mom, I’m a feminist man, I will be a feminist man, talking about family and, and childbearing and, and planning is not taboo. It gives you options so that you don’t end up at the mercy of your biology in your 30s and 40s.

Alex Johnston: Well, I just spoke to a biology class at Bishop’s University, and I did a book event in the summer and the professor was there. And she said, Would you come speak my classes that of course 60% men, otherwise women, incredibly thoughtful questions, and I said, You’re 21-22, you don’t need to worry about this. But if we start to normalize this, that’s where this conversation starts to change. She’s now going to do a case study. And so she wants to get it into textbooks and and said, it’s not you know, you and me and different people doing one offs are starting to find the platforms where change is broader. And I do think if we can work with family doctors, it’s a huge touch point. I do think if we can start to build this into learnings and textbooks and things like that much, like conception, but at no point is anyone ever saying, if you want to preserve your choice to have a family, and that’s a fundamental choice, we want you to be able to make the things you need to start doing your 20s to protect yourself, and to inform yourself. One of the reasons why I wrote when I was writing this, people said, well, are doctors not having these conversations? I said, Look, I don’t know. I mean, I there’s no research around these kinds of issues. But what I do know is when I look at the public Public Health Agency of Canada, the federal government’s public health information arm on their website, they have that same terrible advice. If you’re under 35, try for 12 months if you’re over 35, try for six months before seeking help. And I kept saying that, but how is our fertility peaking at 28. By 32. When I started 15% of us, we’re going to face infertility, and you’re still routinely telling women don’t worry, try for 12 months, don’t bother getting help. And by 35, many more women than 15% will struggle or not be able to have kids and like it makes no sense. This is widely available information. It’s wrong. It shouldn’t be out there. We need to have better information and we need to the right access points for people to have that information early enough for them to use it.

Dr. Dixon: Absolutely reproductive biology is just don’t just contraception my dad taught reproductive biology at LCC in Montreal and I remember joking with the boys what you know I know first. But it never was anything about conception planning. I remember the library period at ACS in grade 10, where it was the story of Louise Brown’s 10th birthday, and reading about the future of medicine and reproductive medicine. And I was like, oh god, this is so for me. But it was novel. And I should have been like I wasn’t menstruating teen like I should have had some knowledge of I had great biology teachers. We knew about reproductive biology, but we didn’t ever talk about what it might mean to face infertility almost like it wasn’t a thing. And it’s been a thing for a long time. It was actually a woman reproductive biologist that started describing the endometrium and its ability to implant an embryo in 1949. Like, we have known a lot that we don’t apply to public policy to make a change for the people. If we’re thinking about the trying to conceive community, and the struggles that they face in accessing care, the least we can do is just like we’re talking about systemic policy, changing the things that will make a broader difference to how we see the issue will make it not necessarily a non issue, but a lesser issue. It’s nonsense to tell people to try for 12 months and I hear this all the time all the time. People get to me every day and I see patients that I see patients every day when I see patients, I have to say I’m so sorry that this wasn’t told to you sooner. It’s awful as a physician and I don’t know if patients know how terrible an empath physician feels when you’re like I knew, I know all this stuff, it’s in my head, it’s in our training. In fact, the research that we’re doing is looking at how we can identify genetically so we can pinpoint the genes for people early on. So they don’t just end up at the mercy of their biology. But the emotionality let’s talk emotionality, because that’s still a huge thing. So for individuals struggling with fertility, what would be a piece of advice that you would give to like to somehow encourage or you wish you had known because you figured it out? with difficulty, lots of bumps? If you could give a pearl? What would it be?

Alex Johnston: Ask for the help that you need, you will need support. And so whether that’s at work, and being transparent with the appropriate people, and saying, this is what’s going on, and this is the flexibility or support I’m going to need, these are conversations that are important to have, whether it’s with your partner, your friends, I still think there’s a lot of misinformation when I was going through this, you know, it’s like I was an alien and my friend community, no one was going through this. And so it was really like, well, what did Alex do to end up in a situation where she can’t have children and not mean spirited, but just raising this mental you’re experiencing this, you know, for a little bit, really, really pushed to ask for and get the things that you need, because this is hard. And I always said to our fertility specialists, let me manage the emotional, what I need from you is great medical advice. Treat me like your daughter, do not give me any advice is sort of wishy washy. But the curtains are on fire, the house is close to burning down, let’s put out the fire and get on. Like, let’s save the house. Oh, you your role in my life is pragmatic, best possible medical advice, the emotional piece, I will make sure that I’m taking care of that side of this, but let me do the things that I need to do that are medically necessary. And I will worry about that piece. So I didn’t want my fertility specialist to be my therapist, I wanted the person to really help me build my family and all the other pieces work social, I pushed very hard to get the things that I needed to make it to the other side, which ultimately he did. And I’d say to people, there are a lot of options. Now if you really want to become a parent, there are lots of ways to get there. There are affordability barriers, for sure. But the confidence that there is no one path. At the end of the day, however, I became a parent, I was committed to becoming a parent. And I knew someone was not going to just drop the baby off on my doorstep. But I did he feel like with all the crazy things he experienced, I didn’t feel hopeless, I felt committed to being a parent and I felt like I would. And there are different options to get there. And I would just say to someone, just keep your mind open and explore. Being a parent is the fundamental thing you’re looking for. Because there are different ways of getting at that.

Dr. Dixon: I love that you said that. I think that’s an important message also to get across to people because well trained reproductive endocrinologist fertility specialist gynecologists who specialize in fertility, they are dedicated to getting pregnant and using the tools in their toolkit to get you there. Who cares if it didn’t happen naturally, you’re now in the right place to make it unnatural, but to get you to your goal. And I think that that’s a good message for that because it is disarming. But I also want to encourage women and individuals out there trying to conceive to allow the physician to actively manage them, it’s not a sign of failure, but it’s the only way to get you to the other side. And if your goal is to take home baby, my goal is to get you to take home baby with the least amount of tries and the least amount of time possible. And that’s truly what we’re endeavoring to do for our patients. So I think that’s a great point that you bring forward that you were kind of able to separate maybe to survive the experience. But you’ve got that. Having had my own journey different but you know, transfers and transfers that failed and then going to work and making everybody pregnant. It was weird. It felt like the ultimate irony. But you know getting to the other side was keeping the grip, just grip just keep moving. Keep moving forward 8 failed transfer that totally sucked, torsed ovaries, like admission to hospital emergency surgery. Nothing like yours, but still crazy, intense.

Alex Johnston: Yeah. I say to people when they ask for basis and make sure you’re with a great person to make sure you’re in a really good reputable clinic because that doesn’t mean you’re getting there. But when I started and I walked into the neck and saw this sadness in the waiting room, and you could see if people were struggling with a heart experience, if I’m different, I’m super healthy. I’m super on top of things. I’m only 33 at this point, you know, closing in 34. This is not meant for me like that. I’m sure they’re going to They like it was a mistake, I’m sure they’re gonna give me an injection of a bunch of hormones, they’re gonna kickstart everything and I’m gonna be out here, it’ll be fine. At some point you itself, I’m not special. And I need this trusted, intelligent person who’s responsible now for my family planning, because it’s completely out of my control, to do a great job and to give me on it consistent information that I can use. And that’s what happened. But that shift had to happen. I was not special. My destiny was to be in that clinic for many, many, many years. And to trust that they knew what they were doing. And I could not be like, No, no, no, I can do it my way. We’ll get there. There’s nothing realistic about that. And that trust piece matters.

Dr. Dixon: Yeah, I mean, like I do, like I I think my patients are smart. I talk science to everybody. I share everything that I know, so perfectly, what you said, it’s exactly what you said, you know, there will be failures, and maybe you’ll get pregnant on your first try. I don’t know. But I think that if we think about framing this in a way that makes it manageable, in manageable bites and and keeping goal oriented, we think about having finite disappointments. And Martin Luther King Jr. said it best, we must accept finite disappointment. But we must never lose infinite hope. Right? Like, I think that it’s also what we do in life, when we get over our disappointments and get ourselves back up and keep moving forward, is that we have the hope that we can get across the line. And often the fertility journey for people. Alex you, like the best. I know, I feel like I have more to say and because, look, I still I have visuals of some of the experiences you described. And so I don’t know, either, we’re gonna have to have another one. And do you have any closing thoughts? Your fertile thought for closing?

Alex Johnston: Being hopeful based in reality.

Dr. Dixon: Absolutely. Amen. Thank you so much for taking the time to talk to me and us today. You are tremendous human being and you’re sharing your story, even though it wasn’t policy based as you pragmatically wanted it. So I think that this is going to be an amazing ad for all of the TTC warriors out there that are just trying to get through. So thank you for the generosity of your time, and your willingness to be part of our first podcast.

Alex Johnston: Thank you for your great work, and I hope we get to see each other in person at some point.

Dr Dixon: Yes, you too soon do we can actually hug and touch. Thank you all for listening to our very first episode of fertile thoughts. If you have a story to share with our community, reach out to us through our social media channels. We would love to have you in our next episode. Until then, remember one small positive thought in the morning can change the course of your whole day. So let’s make sure it’s a fertile one. Bye for now.

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Fertile Thoughts Episode 002: Roberta Scott

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Fertile Thoughts Episode 001: Special Guest Alex Johnson

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