Episode Transcript
[00:00:00] Speaker A: There's this tension that a lot of ambitious women carry, that drive to succeed professionally, and the quiet, lingering question of when or how to start a family. For women in high demand roles, whether you're a physician, an executive, or building something big, it can feel like there's never a good time to hit pause. Fertility preservation sounds like a smart idea, but when do you make space for that? How do you carve out time for egg freezing or IVF cycles when you're managing patients, leading teams, or handling responsibilities?
Stop when your body needs to rest. And even when you do decide to move forward with treatment, what happens with your career when you're out for retrievals, recovery, or the emotional toll that comes with it? This episode is about the reality behind all of that. Because family planning isn't just about having a baby. It's about making decisions that align with your life, your timing, and your future.
Welcome to the Fertility Cafe, where we explore the beautiful complexity of modern family building.
I'm your host, Ellen, and this is a space for honest conversations about surrogacy, egg donation and the journey to parenthood. With expert insights and real stories, we're here to guide you through the medical, legal and emotional aspects of third party family building.
We believe that love has no limits and neither should parenthood.
Welcome to Fertility Cafe. I'm your host, Eloise Drain. Today we're opening up a conversation that's especially relevant for women in leadership, healthcare and high demand careers. Those who are constantly balancing ambition and personal goals and wondering how family planning fits into the equation. Whether you're just beginning to think about your fertility, considering preservation, or navigating the challenges of IVF or surrogacy, this episode is meant to meet you where you are. I'm so honored to be joined by Dr. Susannah Chatterjee, a dual board certified physician in OB GYN and obesity medicine who's experienced the highs and heartbreaks of infertility herself. She's gone through multiple egg retrievals, turned to donor eggs, and is now preparing to welcome a baby through surrogacy. Her journey is rich with insight and her voice is one we need in this conversation. Susanna, welcome to the show. I'm so glad you're here.
[00:02:28] Speaker B: Thank you so much for having me.
[00:02:30] Speaker A: So your perspective is obviously incredibly unique. You're a dual board certified physician in OBGYN and obesity medicine, but you've also seen or also been on the other side of the exam room. You've gone through multiple egg retrievals, made the decision to use a donor egg. Now doing surrogacy And I know that that's a deeply personal journey and one that so many women in high pressure careers can relate to, but really hear spoken about openly. Can you share a bit about how this journey has unfolded for you?
[00:03:09] Speaker B: I remember being back in OB GYN residency. I was on my REI rotation and I was seeing patients with my attending physician that struggled with infertility. And I was in my late 20s and I had seen women come in to preserve their fertility and do you know, egg retrieval, egg freezing, that kind of thing. So in that moment I made the decision that I was, if I wasn't married, wasn't having children by the age of about 30 or 32, that I would freeze my eggs. And then I was in a long term relationship and I thought we were kind of moving towards marriage and family.
And I was 31 and so I thought, well, there's really no need because you know, we're, we're going in that direction. Um, didn't. That relationship didn't work out. And then I moved from Tennessee and moved. I was already in a position at that point and in practice in ob gyn. I moved to Arkansas and was single. And the last thing I was thinking about was my fertility at the time. And so I went about my life. I ended up meeting my now husband and we kind of just thought, okay, once we get married, we'll, you know, we'll start trying.
And we're. We got married when I was 38 and he was 42 and we didn't really think that there would be. We thought it might take a little bit longer, but we didn't really think that it would be as difficult road as it has ended up being. We actually struggled with both male and female factor infertility. I have endometriosis. I had had an ectopic pregnancy, I have a blocked tube, I have diminished ovarian reserve. And my husband had low sperm count. And so we had to go through treating him, getting his sperm counts up. And once we finally did, then it was focused on me. And so we went to a local fertility clinic. I did try to do an egg retrieval, did a stimulation cycle. There were possibly two follicles or two eggs. And I woke up from anesthesia from the retrieval and I was told that I had prematurely ovulated. So I took my trigger shot and came in exactly 36 hours later. But by the time they got in there and that clinic doesn't as a practice scan, which I guess I think only, I think the statistic is one in a thousand women prematurely ovulate, so they don't routinely scan before retrieval. And so they went in, put me to sleep, and I woke up and there was nothing.
So we decided, let's try again. So we did another cycle, and that cycle ended up being canceled because I wasn't responding. And so what I was told by that office was that my only chance of being able to have a baby was to do donor egg, because I would end up spending hundreds of thousands of dollars, potentially, to only maybe get one or two eggs per cycle. And, you know, there was a question of genetics and that kind of thing. And so it just. It just wasn't going to work out. And if. If they told me if money was no object to go ahead and continue trying to get my own eggs. But if I wanted to have a baby, I needed to do donor egg. So I started looking into donor egg, and I went to several donor banks. And I am of Eastern Indian descent and Eastern Indian women, culturally, I think you and I have talked about this before. Do not. Do not. There's certain cultures that it's just not common practice.
And so I had a very hard time finding an Indian egg donor. And I finally did. She was actually not from India, but from Bangladesh. So, you know, neighboring country.
And so my thought was, well, close enough, you know, we'll do that. So, so I bought six donor eggs, and we fertilized those with my husband's farm. Only two were mature once we thawed them. So we ended up wasting four of those eggs. So we had two embryos. At that point, we were thinking, okay, do we go ahead and transfer to me? You know, what do we do? And so at that point, I was very closed off to surrogacy because I had already gone into the grieving process of this baby not being biologically mine. And somewhere in my head along the way, I thought, okay, if I at least carry the baby, it'll be more mine.
Which was just the way that I had logically wrapped it up in my head. But then I spoke to another colleague, and he and I were talking, and he said to me, I also have autoimmune illness, so I have multiple sclerosis, and I get chemo infusions twice a year. So in speaking to my neurologist, I would have to stop my chemo infusions to carry. I would not be able to breastfeed for more than three months.
And the rate of relapse of multiple sclerosis is highest after pregnancy. And so there would be a chance that I wouldn't be able to come back to work after carrying a pregnancy if I were to flare and have a relapse when I have been healthy and working, you know, normal hours and. Well, not normal hours, because my hours are not normal, but working, working, you know, 80 plus hours a week and doing fine, and I do very well. So he said to me, what are you losing or what are you risking by carrying this pregnancy versus what you would lose if you used a gestational carrier and a surrogate? And so I kind of thought about it, and then he said, and then let's take, you know, like, let's take risks, but then let's also take money. So, like, what is the cost? Because, of course, the gestational carrier is not something, you know, that is inexpensive.
So what is the cost of my lost wages?
Potentially loss if I had just opened a new private practice in obgyn? Potentially losing my practice and potentially losing my career versus paying for a gestational carrier. And so I kind of had this epiphany moment and it was like, okay, if I'm willing to adopt, because I was at that point and I'm still at that point, I would. I would always be open to adoption. So if I'm willing to adopt a child and know that I would love that child as my own, then what does it matter who carries, you know, my baby? So I was like, okay, you know, this is a donor egg, my husband's sperm. We're going to use the gestational carrier and we're going to have a baby. And that was my ultimate goal. It's always been my ultimate goal. So we ended up transferring to a gestational carrier, and that pregnancy went to about eight and a half weeks, and unfortunately, she miscarried.
So we implanted our second embryo about four months later, and that one didn't take. So then we were back to square one, which was time to buy more donor eggs. And there's not Indian egg donors. And the woman that had donated previously had, I think, seven or eight eggs left, but they had been from a couple years prior. And I already had concern about her egg quality because I bought six and only two were mature.
So I went back to the clinic and I said, okay, I think I'm going to try to maybe look at other races that are similar. And they said, well, that's great, but also your husband's going to have to take medicine again and give us more sperm. And I was like, wait a minute. You know, we. I thought we banked sperm when we first started this. And so from my perspective, this is just me now that we need to worry about or the egg side of things. And they said, oh, no, no, we. We put everything in one vial.
So whenever we thawed that specimen and we fertilized your two donor eggs, the rest of the sperm is. Is wasted.
So they didn't have sperm. So, of course, that was frustrating because as being in this field, I was under the impression that they would aliquot it or separate it into multiple, you know, smaller samples, because, of course, you know, I think he had like 12 or 13 million sperm. And we used two.
You know, the rest of those were where. So at that point and, and we can get into this. But I had a lot of reservations about that office.
And at the time, it was the only office that was available in my state for me to utilize. And with my busy schedule, it was an hour away.
It was like, we're kind of. I don't want to say stuck, but it felt like we had limited options. And so we had moved forward and continued with this clinic, although I had had reservations from the very beginning. And at that point in time, Kindbody had come in to Arkansas in the northwest part of the state. So it's two hours away almost. But I had a residency colleague that I knew that is in the medical advisory for Hindbody. And I had thought, you know, over the years, do I try to reach out to her? Do I, you know, go somewhere else? I know, of course I'm in the field. I know a lot of REI's, you know, what do I do? And so I thought, you know, what. What's a consultation going to hurt? Like, we're going to have to start back over. Let me just do a consultation. And so I met with them in, I guess it was April of last year, so exactly a year ago.
And when I met with the doctor, she looked at my numbers and she said, explain to me why we're not trying to get your eggs. And I was like, well, you know, I. I was told that it wasn't a possibility. And she said, well, we checked your insurance, and your insurance actually will cover up to six lifetime cycles.
So I would try. And so I guess the previous office had not checked that. And so I was unaware. I was like, great. I mean, if it's covered, let's do it. There's no harm in that.
So we did. We got seven eggs. My first round ended up with two embryos that were at last stage. Unfortunately, both of those tested PGT abnormal. And so we ended up doing five more cycles and got a total of 22 eggs and finally have a euploid embryo. And so we actually have two. We have a Euclid embryo and high mosaic embryo that we've preserved as well, because those are, you know, somewhat abnormal, but there's a potential for those to become in a normal pregnancy. So the plan now is to try a transfer with our euploid embryo to our gestational carrier, who is the same person that we worked with previously next month.
[00:13:46] Speaker A: Oh, my goodness gracious.
[00:13:51] Speaker B: Wow.
[00:13:51] Speaker A: Okay, hold on.
[00:13:53] Speaker B: Yeah.
[00:13:54] Speaker A: You know, and the thing about it, too, is for a lot of women, I think, who can probably relate, especially those in leadership roles or caregiving roles, first, let's just talk about how hard it is to make space for fertility treatment while you're managing a demanding career. Like, you've been through how many IVF journeys and scheduling the logistics of scheduling procedures, recovery from egg retrievals, coordinating with the surrogate, all while still obviously a practicing physician.
[00:14:27] Speaker B: Yes. Yes.
[00:14:28] Speaker A: How did you navigate that? Reality?
[00:14:31] Speaker B: You know, and I tell people this, and it sounds crazy, but I think that has helped me stay sane.
Staying busy has helped me stay sane.
I also, you know, I have so many people tell me, I don't know how you do it. I don't know how you see pregnant patients every day and go through it. And my response to that is, I would say 98% of my patients, I am genuinely excited for them. I'm excited that they're getting to expand their family. I'm excited to be a part of that. I'm happy for them, genuinely. You know, there are patients that, you know, it's where if they're on drugs or what, you know, whatever their situations are, there are some that make it a little bit harder. I mean, I will admit that.
But I think on the day to day, I mean, I'm still doing what I absolutely love, and this is my passion. I can't imagine allowing my own journey to hinder me from being able to do what I've dedicated my life to do. Delivering babies never gets old. I mean, there's just nothing. I still. I still get excited. I. It's still a joyous moment. I mean, it's probably the most real and raw experience that you can have with. With a patient and a couple. And so I love what I do so much that I can't imagine setting it aside to do anything, including focus on, you know, my fertility journey. And I have. I have always found a way to make it work. And I have been fortunate that my Patients are so understanding. I am pretty open about, you know, what's going on. Of course I share on social media, but if patients ask me, I mean, I don't start with that, I don't lead with that. I don't talk about myself. But if patients ask me about it, I'm very open about it. Um, and I tell them, you know, hey, I'm really sorry, you know, I just delivered your baby. I'm. I'm not going to be here tomorrow because I have a procedure for myself or, you know, but I have somebody that's going to take great care of you while I'm gone. And then I just, I have, you know, continued on. It's interesting because my egg retrievals, you know, of course that day I was a little bit groggy, but I came home and I worked on charts and I did, you know, I kind of worked on things and did things. And, um, I will say, my last egg retrieval, I had some complications and I had some bleeding, but I was on call.
And so I didn't really have a choice. Um, I was in a lot of pain. I couldn't move very fast. I remember I had a patient that was in labor, and I told the nurses, you gotta give me a little bit more heads up than usual. Cause I can't run down the hallway. You know, my doctor was like, you cannot run. You cannot, you know, overexert yourself. And I had a patient that came in and was about to have her baby. And, you know, it was like I was torn between, do I run down the hallway and do I, you know, do I not? And, you know, of course, in, in those moments, it's. You put other people before yourself, and it's not always the best decision.
But I've done well and, and I've just made it work. You know, I've had adversity in my health for years now with my multiple sclerosis. And I've not let that stop me. And so this is just kind of a. In addition to it, you know, I make. I make my life fit, you know, or I should say I make these problems fit within my life instead of making these things run my life.
[00:17:46] Speaker A: Was there ever a point where it felt like the system wasn't built for, you know, for driven women from women like you, successful, but also trying to grow their family?
[00:17:57] Speaker B: Oh, absolutely. I mean, and I think it's dependent upon who you're working with.
The previous office that I was with was not understanding at all. They talked down to me. There was no special treatment not that there should be special treatment, but there was no. What I call professional courtesy. You know, these are my colleagues. These are people that I refer patients to literally on a daily basis. And there was no thought about that or concern for that.
You know, it was. If I was on call or if I had something, it was like, this is the time. You gotta make it work.
This is when we can do it. This is what happens. You can't call and talk to us. You have to message the portal.
And I distinctly remember a conversation when I first was about to do stimulation for the first time, and I needed to know what the next. You know, of course, with stimulation, we don't know. You know, you have ultrasounds. It's a guess, you know, but I needed to just have a rough estimate of, like, okay, so if we start medicine this day, what are the potential days that we're going to have retrieval? Because I need to make sure that I have call coverage for those days, and I need to make sure that I don't have surgery scheduled for those days. I can reschedule patients in my office, but I need to kind of have a rough scaffolding of a framework of what the schedule will look like in the next two weeks. And I couldn't get an answer. And so I finally called, and this was through the portal. You know, I would ask the question and I wouldn't get a response back. And so I finally.
And the lady on the phone, the receptionist said to me, well, Dr. Chatterjee, you know how this works. You have an office. And I was like, absolutely, I know how this works. And I would never allow my receptionist to tell a patient, let alone a fellow physician, that they couldn't talk to at least a nurse to get some answers. And she was like, okay, hold on a second. And so I sat on the phone on hold probably for about 10 minutes, and the IVF nurse came on the phone and she said, you know, I. Well, I think they had told me, you need to write through the portal. And I said, well, you can look in the portal and you can see that I have written this question multiple times. And I'm at a point now where I need to coordinate my schedule and I need somebody to just tell me what's going on. So the IVF nurse gets on the phone and she says to me, well, Dr. Chatterjee, I mean, you know. Cause I just said, you know, I need to know kind of like what this process is going to look like, timeline wise. And she said, well, it takes an egg and a sperm to Create an embryo.
[00:20:32] Speaker A: Oh.
[00:20:33] Speaker B: And I was like. And my husband said to me, how did you not just completely go off on her?
[00:20:40] Speaker A: Because I want to go off now. And it didn't even happen. It just happened a while ago. Like, seriously?
[00:20:46] Speaker B: Yeah. And, you know, it's still. It was like I was so vulnerable because I felt like they literally had my life and my potential future child's life in their hands. I didn't want to make them mad. Yeah. And so I just sat there and took it. And that is not me. That is not me at all.
But I did. It was like, you are so vulnerable.
And even though I'm a strong leader and I can stand up for myself and I can advocate for myself, I couldn't advocate for myself because of the way that I was being treated. And it's. You know, and that was from a nurse, too. That wasn't my provider.
And I don't even know if my provider is aware of those conversations or not.
[00:21:29] Speaker A: And one thing I actually also wanted to just touch on is the added pressure that comes from being a woman in medicine and them obviously knowing your role or in really any leadership role, where the expectation is that you have it all. You always have it all together. You already, you know, these things you should already know. And when it comes to fertility, where, you know, like you said, you're already vulnerable and there can be so much shame and silence, especially around, you know, even when you're doing third party. But just, let's just say ivf. And now you're getting this perspective from. From staff members.
[00:22:08] Speaker B: Yeah.
[00:22:08] Speaker A: And I actually just did a podcast recently about these fertility clinics and these portals and them expect people to get on the portals and leave, you know, their concerns and issues or whatever. And then, you know, just, I'll get back to you. Just put everything in the portal and it's like. But you don't check the portal.
[00:22:29] Speaker B: You don't respond to the portal. You don't look at the portal. It says on there, we will respond to you in three to five business days. And I'm like, this is fertility. Three to five business days could be the whole difference between, you know, medicines that are appropriately so. I mean, there were times where I would page the doctor after hours just so I didn't have to, you know, and I didn't want to abuse it because I understand. I mean, I'm a doctor on call all the time. But I was like, you know what? This is what they're there for. And if I can't get my answer through the Portal, you know, then I'm going to have to call at a reasonable hour and say, you know, and the doctors were. Were very nice. I mean, they never made me feel bad for it. And I would even in the exam room, when I would get there, say, these are the struggles that I'm having with your staff.
And it was kind of like a. Oh, well, okay. Well, you know, just call us on the. You know, call us on the exchange or, you know, do whatever it is, you know, and it was like it kind of just got brushed under the rug, and it was never really handled. And it's like, this is. This is not okay. I mean, we are in the 2020s, and if I want to pick up the phone and call and ask a question, I should be able to do that. And it shouldn't just be. The portal's great, and my current office has a portal, and they're very responsive through that portal. But they've said multiple times, if it's a situation where you would rather talk to somebody or, you know, you're not getting the answer that you need, pick up the phone and call us, as there's still people here that can talk to you.
And so I think, you know, a lot of it, too, is that office was the first office in Arkansas, the first office to do ivf.
The physicians there are brilliant, but they've been doing it for a really long time. And I think that at some point, you lose your passion for what you're doing, and you're just kind of going through the motions. And that was how I felt. And that is not just me. That is every patient that I have sent to that office, every patient that has self referred to that office. I mean, I have not had anybody just say, you know, this is the best experience I could have possibly had. Um, a lot of people have been happy because they ended up with their end goal, which was to have a baby. But sometimes the end doesn't justify the means that you got there.
Um, and it is a vulnerable time. It's. It can be terrifying, it can be expensive. It can be put a lot of strain on your relationship, and to not have the people that are supposedly taking care of you have that compassion for you and that care. You know, it was like I felt like they didn't care whether I was successful or not.
And then I felt more so, like they were more worried about their numbers and their statistics, and I was throwing off their statistics because, you know, REI clinics now, I know, go through. You know, the way that you gauge is by success rates and by live births is how you rate a reproductive endocrinologist.
And when you have a big office that has offices all over the country, you know, one or two people is not going to throw off their success rates when you have one singular office.
If I keep going in and doing egg retrievals and we don't get eggs, that's throwing their statistics off. It's making their, that's making them look unsuccessful.
And that's what the, the, the focus seemed to be on. Whereas, you know, when I decided I want to do donor egg, they were much nicer to me. Much nicer. Because again, chances of success have just gone way up and it's, it's easier.
[00:26:09] Speaker A: Obviously, it took a long time for you to become a physician, and I know you were in a relationship, but you had thought that you were going to do the egg freezing. That didn't help. You know, that didn't come to fr.
I mean, there are so many women now that are starting that trajectory now, right? They're, they're starting that of. Well, I'm, I'm a physician and I, I'm in residency or I'm in, you know, what, whatever the case might be, or, you know, I'm an executive. I'm running company with hundreds of employees, and I don't have the time to go through. How many IVF cycles did you have you done?
[00:26:54] Speaker B: So seven total?
Yeah.
Yeah.
[00:26:58] Speaker A: What do you tell somebody? What do you suggest to them
[00:27:04] Speaker B: in
[00:27:05] Speaker A: what they should do and how they should do it? And if you could go back, what you would do differently?
[00:27:12] Speaker B: I would have preserved my eggs. I mean, I preserved my fertility. I would have done what I had thought to do regardless of what my relationship status was. I thought we were moving in that direction, and so it wasn't going to be necessary. But in hindsight, even if he and I had ended up getting married, you know, I don't know, would we have struggled with fertility? But we have not. Probably so.
But at that point in my life, I hadn't been diagnosed with Ms. So I don't know if my, you know, I know I have endometriosis. I know I have that block too, but that doesn't mean that I would have had diminished ovarian reserve at that point time. So I, I don't know, you know, what I could have done was do a cycle or two and potentially gotten several eggs and frozen them. And so I tell patient, I tell patients, you know, if they're, they're kind of in that, on that trajectory of you know, doing a master's or a Ph.D. or a doctorate. I tell them, you know, you get to about 30, you need to start looking at preserving your fertility and don't make the same mistake that I did. And so I see here, I see some physicians on social media that are going through that and documenting their journey. And that makes me very happy because I want, I want that to be the norm. You know, I want, I want that to be what women start to do is no matter where they are, whether they're engaged or they're single or whatever it is, you know, go through one or two cycles when you're a med student or in residency, you know, when you can.
And it's a little bit easier to navigate those things and preserve your eggs, you know, freeze your eggs, and then you've got them there. And then you don't have to worry as much about when and what's going to happen at the point that you become ready. Because I think we know that women are having babies later in life and, you know, as women are more in those leadership roles and in high power leadership roles, we get busy and we, we have to focus on, you know, what you're trying to get through, you know, now. And I really commend women that have babies and med school and residency and in their first years out in practice. I mean, that's, that's a lot to do and it's hard, but if you're choosing one or the other, you know, then you're putting one off and either picking to pursue a family or you're picking to pursue your career.
You know, I think more and more women are trying to do both at the same time. But, but definitely what I would do differently is to go back and redo that and not say, you know, I don't need to worry about that because I'm on this path. You know, we, we weren't married. We were talking about it. We were moving to Arkansas together, but that ended up not panning out.
And I could be sitting here today with preserved eggs that I could, you know, have drawn from.
We got married four years ago. I got married a little bit later. And, you know, I could have, as soon as we got married, if I had a bank of eggs there, we could have fertilized them and had a baby and we wouldn't be four years later now where we are.
[00:30:24] Speaker A: Yeah. Did you do any testing or anything? Like in your 20s? I mean, you had mentioned you had endometriosis and all of that. When did you find out all of
[00:30:35] Speaker B: those details, actually, my fourth year in residency, I got pregnant and it was ectopic pregnancy. And I had gone from like, it was, I was on birth control for my endometriosis to control my symptoms of that was not in a committed. I was in a relationship, but not, you know, married or engaged or anything. And I had switched, I think, from days to nights or nights to days when my schedule had shifted and I had missed like a 24 hour window where I didn't take my birth control pills. So I had a positive pregnancy test. We couldn't see anything on ultrasound, ended up being operated on in the OR that I learned how to operate in and had an ectopic pregnancy.
And so when that doctor did my surgery, she found stage four endo.
So it was all over.
And I, you know, I had that suspicion, of course, because I had horrible heavy periods that were so painful when I was in high school. I would sometimes pass out from how bad the pain was for my periods.
My school nurse knew when my cycle, it was like clockwork, and she knew when my cycle was, she'd have the heating pad and two ibuprofen waiting on me, you know, those three days that she knew were gonna be really bad. And I would take my pre period, go down there, you know, sleep it off with a heating pad, and then get up and go back, you know, to school. And so when I got a little bit older, I got on birth control because at the time my, my mother was against me taking anything like that. She felt that it would mean that I would become sexually active if I was taking birth control. And so I waited till I was a freshman in college and went to the student health center and got on birth control. So anyway, I was diagnosed with, you know, I was diagnosed with endometriosis at 18 clinically. But it was proven, you know, when I was in my final year of residency. So I guess I would have been 30 years old. And they did a, they did a laparoscopy and took the ectopic pregnancy out and then saw the endometriosis.
[00:32:34] Speaker A: What are the things you're telling your patients now? So, you know, these young girls, like you said, coming in, having these heavy periods, aren't going to school or similar situation, having to, you know, go into the nurse's office every single month. I think, like, for some people it's just like, whatever, it's just your period. It's like it's no big deal. And, and how many people we have conversations with now that these are issues, these are Significant issues that have consequences down the line that nobody is talking through, no one is talking about. And insurance companies, of course, don't want to pay for anything. They don't want to pay for testing. They don't want to, you know, they don't want to pay for anything. Let's be honest here. And it's like, shouldn't we be taking a better proactive approach in educating people about their reproductive care and health early on when they're teenagers or when they're in their early 20s, instead of waiting until you're 30, when you have now an ectopic pregnancy and now finding out that, yes, you have stage four endometriosis?
[00:33:43] Speaker B: Yeah, absolutely. I mean, I think. I think now things are better in that regard. I think there's more education. I think women are empowered earlier to come in. And, you know, I have patients all the time that come in, which is foreign to me because, of course, they're 18, 19 years old, and they're coming in because they want to check on their fertility and they want to check on what's going on with their periods and they want, you know, and it was like, when I was that age, like, we didn't think about those things. And so I think, you know, as infertility becomes such a bigger conversation and a more common thing, you know, I think back to, you know, when I was a teenager. I mean, you didn't really hear a lot about infertility. It was like the one off, like here and there, not very much. You know, it was 20 years ago. How much infertility did you hear about?
And now you open TikTok or, you know, Instagram, and it's, you know, it's all over.
And. And so people and women are aware of infertility, I think, earlier on, and I think it makes them more curious about their own bodies and their own health. And. And I think the other side to that, separate from infertility, is just health in general. I mean, I think that. I think more and more we get this. Like, I'm going to social media to find out what is wrong with me because obviously this isn't normal. You know, if all of my girlfriends are not in the nurse's office once a month because of their period, or they're not, you know, they're able to wear tampons because their flow isn't so heavy that they've ruined their clothes and their pants. And, you know, why do my friends not have to carry a sweatshirt in case I bleed through my pants and I gotta put Something around my waist, you know, or bring a change of clothes. You know, those were things I had to do. And none of my friends were that way. It was just me. And so, you know, it's, it's one of those things where now I think we talk about it more, which is great, but I think still there are barriers to young girls coming in and talking about those things. Because I think a lot of times it is, it's like, well, I don't have that happen. Or, you know, moms will, you know, they'll ask their mom and it's like, you know, I don't know how many moms come in with their daughters and they go, I don't know what's wrong with her. I don't have these problems. I don't know what to tell her. You know, I'm here to bring her in because I, I don't know, you know, I didn't have problems with my periods or I didn't have problems with these things. I had a period every single month. And, you know, of course we see so much PCOS now and patients come in and they haven't had a period in three or four months. And, you know, mom's looking at me going, I have a period every month. I don't, I don't know what this is. I don't know what to do. So I think we're better than where we were, but there's still a long way to go.
[00:36:27] Speaker A: You mentioned about, obviously, the importance of our health, and I know that is something you also advocate around is bmi, which is the metrics that women, well, so many, many women hear about during, you know, their fertility evaluations and, and it's often delivered in a more clinical way and it's dismissive. And as someone who's both trained in obesity medicine and been through fertility treatment yourself, what would you want women to understand about the role weight can play and how to advocate for themselves and conversations that can be really sensitive?
[00:37:07] Speaker B: Yeah, I think that's hard. And I think, I know a lot of women shy away from even talking to providers because of that very thing. You know, they, they don't want to be weight shamed. I mean, I think we all know if we're overweight, you know, it's, it's not like someone has to tell us that, you know, we know that.
The, the implications of that, I think, are where patients sometimes don't understand.
And so it's hard as a provider, you know, for me, of course, I've struggled with being overweight and obese a lot of my life. And my weight has fluctuated up and down throughout my life. And so I've been on both sides of that. And I've had that first office that I had. I mean, they. They blurted out my weight and my BMI in front of my husband and told me that I didn't meet criteria and that I wasn't going to be able to. And I was, like, right at the borderline. And they told me that I wasn't going to be able to be under their VMI cut off in time for retrieval. So they didn't think it was a good idea for me to go ahead and sign up for that cycle. And I had to lose, like, 10 pounds in about a month. And I was like, I can do it. I know that I can do it. I just need you to tell me what I need to do. And she was like, yeah, that's not going to be possible. You're not going to lose that weight. And. And then that's when she blurted out my weight to my husband and, you know, my bmi. And I was like, I was so embarrassed.
And I thought those are the moments that should never happen. And those are. Those are the things that, you know, you. You know, I think it's. It is a fine line to explain to patients why, you know, BMI cutoffs are there. And for my purposes, the BMI cutoff was an anesthesia cutoff. And so for my egg retrieval, in order for me to do egg retrieval in their office, I had to be at a certain BMI level. And like I said, I was just right at that borderline. And so it was like, we can't do this because of anesthesia. And they kind of pushed it off on that. You know, I think there's lots of things we know that there's increased risk of miscarriage, there's decreased success rates with obesity or being overweight. You know, there's. Once you get pregnant, if you do get pregnant, there's increased risk of high blood pressure and diabetes and C section rates. I mean, there's all sorts of things that happen that I think we have to educate patients about. But I also think that it needs to be their decision, too. Now, if I understand all of the risks with my current weight, then that's. That's an informed consent, and that's something that, you know, I'm willing to accept the risk of.
I think it's. It's hard sometimes for patients to accept that it's their weight that's the problem, because Instead of providers sitting down and explaining to them what the actual science or the actual medicine is behind it. It's just a, like you said, a dismissive, like, well, you're, you're too big, you're too heavy. We just, we can't do. Your BMI is 42, so you, you don't qualify. Right? And that's it, that's the end of the conversation. And what does that mean? You know, nothing. And so, you know, that's where it's like, okay, so how do we, how do we fix that? What do we do? And that's where my interest in obesity medicine came in. Because it's like, there's gotta be something. And there's gotta be, there has to be something more. Because I knew for me, it's not like I'm sitting and binge eating every night. I mean, I don't have time to do that.
And I noticed like in my family, like the women in my family have always been overweight. I look at some of my patients and some of them are very petite and thin. And then I have patients where grandma, mom, daughter, they're all obese.
There had to be something more than just people are lazy and overweight.
And I think that that's that dismissive idea of like, oh, someone's overweight because they just eat too much, or someone's overweight because they're just too lazy to exercise, or they just don't care about their health.
There's a lot of components there. And I think now with GLP1 medications and all the research that has gone in over the last, you know, five years, we know so much more now about metabolism and hormones and all these things that, you know, I think that instead of the conversation being, you know, I can't help you because your BMI doesn't meet the cutoff. It's how do we get you to a point where you are healthy so that this is more successful?
[00:41:37] Speaker A: How does this journey impact your relationship with people around you, your career, how you approach your day to day work? Now, you know, obviously that's another doctor's office. You're a physician as well and how you move.
[00:41:56] Speaker B: Now, the office that opened in the northwest part of the state originally for about six months, didn't have an embryology lab. And I know you and I had talked about that too. They're an offshoot of the St. Louis office that comes down.
They established their embryology lab, you know, subsequent to that, but in the interim it was, you know, you would have to travel to St. Louis. And so I thought, okay, if I'm going to refer patients out, if I'm going to go out, you know, where are some other options? And so I'm fortunate that there are some great offices in Memphis, which is about three hours away. Tulsa, which is about three hours away, and Shreveport, that's about three hours away. And then you can go north, and there's Springfield, which is three hours away. So all those are three hours away.
But we're kind of uniquely. My town is centered kind of right in the middle of all those. So there's options.
And I kind of would just talk with patients and say, listen, you know, here's the options. And I would still provide the. The other office that I went to as an option, you know, if that's, if that's what you feel. But unfortunately, a lot of the patients that I have, I see have either already had experience with them or they've heard of a friend that's had an experience with them, and they're really just not really that interested. Um, but what I have always said is I will support you in whatever, you know, wherever you decide to go. And, and I understand. I mean, a lot of the reason why I stayed where I stayed was because of convenience. I mean, like, my schedule is so crazy for me to have to travel three hours to go somewhere for one way, right? One way, just for retrieval or for a, you know, a visit. I mean, there's not really anywhere here locally where I can do cycle monitoring, where I can get, you know, you gotta get same day lab and you have to get same day ultrasound. The ultrasound part I can get taken care of, but the same day lab is really difficult. And so, you know, for me to have to travel three hours one way, six hours round trip, I mean, I would have to make a whole, you know, take work, take off work and make an overnight stay of it. And I have friends and colleagues and patients that have done that because that's what they had to do. And it's unfortunate, but fortunately, now, like I said, we do have another option.
And there's still options that are, you know, a little bit further away. It's just. It's hard. It's unique to me and other positions and, and other women that are, you know, don't have a flexible schedule. So I think some people are more. It's a little bit easier because they, you know, they're a little bit lucky or they have a schedule that's a little bit, you know, more.
They can drive it themselves.
You know, the other Thing too is I have a lot of teachers, and so, you know, they can figure out, you know, okay, you know, summertime is the best time for me. So when I'm off, you know, and they kind of can spend that time focusing on, you know, fertility. And so, you know, we. We figure out what works with our schedule and. And go from there. But it's. It's hard as a physician, I. I have never been one to badmouth other physicians, and I don't like to say, oh, well, I wouldn't go there because, you know, they're not good or whatever it is. But I think I've. I've found, like, I don't want other people to go through that. And what I think of all the time is, as a fellow physician, if I went through what I did and I'm. I mean, I'm tough, I'm strong, they broke me down, I would leave there crying every single time. And that is not me. But I just was broken from. From going there. And I don't wish that on my worst enemy. I don't want to send anybody there, unfortunately.
And so I don't. I really tell patients, if you want to go here, I will send a referral, but my preference is somewhere else from my personal experience, and I kind of leave it at that. And like I said, unfortunately, this isn't news to anybody. You know, it's not like this was a unique situation to me, because I think I take that into account too. You know, I have. I have patients that don't like me, you know, and. And it's. It's okay. And I tell patients all the time, I want you to go where you feel comfortable. Right. And I may not be it. And I want you to go where you feel empowered. I want you to go where you feel cared for, and I want you to go where you feel comfortable. And if my office is not it, then I wholeheartedly support you advocating for yourself and going where you need to. And. And that's kind of the bottom line, even if it's not me. So. So it's. Or even if it is me that they don't want to see anymore. And so, you know, I tell patients, you know, I'm. You're welcome to go there, but just know that you need to advocate for yourself.
[00:46:24] Speaker A: I guess final question is, what advice would you offer one about advocating for yourself? But also as, you know, someone who has kind of put your career first and now dealing with the aftermath of trying to figure all of these things out later on in Life.
What would you tell her?
[00:46:48] Speaker B: You do the best that you can at the time. And so I don't want to say I have regrets. I. If I were to be given the opportunity to do things differently, I might do them differently. But at the same time, my journey has been my journey and I, you know, I have a story and ultimately one day when I hopefully hold my baby, that's going to be the story.
And I made the decisions the best that I could when I made them. And you know, going back, you can play Monday morning quarterback and you can scrutinize yourself, but at the end of the day, I don't know that I would trade anything. You know, I think all of these experiences have shaped me and molded me and created my journey. Dealing with a physician or a physician's office that didn't treat me the way that I wanted to be treated and multiple. I mean, this wasn't the only office. There's been other times.
It's allowed me, I think, to be a better physician. It's allowed me to be more compassionate, it's allowed me to advocate for myself and to try to empower patients to advocate for themselves too. And that's the biggest thing is I think people get intimidated when they're dealing with a provider or they're dealing with somebody and then they're dealing with their health. And I think sometimes they cower, they don't speak up. And I think the biggest thing is, is you have to. This is you and your health and nobody cares about you and your health more than you do. And so you have to advocate for yourself. And it may not be easy, it may be hard, it may be uncomfort, but at the end of the day, it's you. And you have to care about yourself enough to be uncomfortable sometimes and, and go after it. And so if you're not getting what you need, you need to find it. And it may take some time like it did for me. I mean, I was like, I had to, I had to go through the motions and I had to have multiple people say, hey, why, why are you doing this? Why are you not. You know, But I had to, I had to figure it out on my own. I had to move when I felt like it was right and it did and it worked out. Now, of course, do I wish I had switched offices years prior? Absolutely. But again, I like to not live with regret, I think. And you know, it's. I coulda, shoulda, woulda all day long, but at the end of the day, it's made me who I am today and hopefully will make the child that I have in the future.
[00:49:08] Speaker A: Yes, absolutely. So before we wrap up, where can listeners. Listeners learn more about where you work and connect and resources specifically, you know, and resources specifically for anybody going through fertility or even considering wanting to get more information about your weight loss program.
[00:49:31] Speaker B: Yeah, so I am healthy OBGYN on social media for Instagram TikTok and have website. My office website is river valley obgyn.com I'm located in Russellville, Arkansas. And so I'm happy to have anybody reach out to me personally or to my office and we can get, you know, if. If your people aren't in the state that I'm in, I'm happy to. I mean, there's so many resources so people that I know, so many different websites and support systems and pages that I even follow that I would be more than happy to refer people to. So, you know, I'd be happy to have people reach out directly to me.
[00:50:13] Speaker A: All right, well, thank you, Suzanne. I really appreciate you coming on.
[00:50:17] Speaker B: Yeah, thank you so much for having me.
[00:50:19] Speaker A: Don't forget to subscribe to the podcast, check out the full video on YouTube and follow us at fertilitycafe on social media. And remember, love has no limits. Neither should parenthood. Thank you for joining us at the Fertility Cafe. If you found value in today's episode, please subscribe, leave a review and share with someone who might benefit from this information.
You can find, show notes and resources from this episode in the description or visit the fertilitycafe.com for more information.
