It was not such a long time ago when there were only a few voices in the world of infertility that were recognized fertility advocates. My voice was one of them of those lone few.  If the media wanted to know the patient perspective on anything in the world of trying to conceive they were usually sent to me – or a handful of others who were willing to be “out” about infertility.

This was the days before blogs, twitter, and facebook.  Everything has now changed through the world of social media. Now everyone can tell their story – for the same reasons that I told mine. And they don’t even have to give their true identity up if they don’t want to! They can still be heard. Today’s bloggers, tweeters and facebook posters are raising awareness about infertility in a way that we could only have dreamed about ten years ago. And they are doing it for many of the same reasons that I spoke out so many years ago.

I started my role as an advocate because of my need to give myself a voice as a patient and it was that need that helped me become a voice for thousands.  And now – there are hundreds of advocates out there in cyber ether! And we are communicating with each other with lightening speed. It is amazing – and the support, education and advocacy that is going on from lap tops all over the world simply blows my mind. There are so many different voices coming together – working with each other – sharing points of views and opinions in a way that used to be reserved only for occasional meetings of self appointed important “players” in the field of reproductive medicine. Just like the closing of video rental stores around the country – with days of an exclusive club of change makers are over.

You want to know what is going on in the world of reproductive medicine, fertility, infertility and sexuality – jack into the blogs – get yourself a tweeter account – and a facebook profile. That is where the change is happening. And you can start by friending and following me.  This world of social media and on line education, support and advocacy is exploding! Connect with it today – there are lots of seats at the table – and all are welcome!

Posted under Fertility, Fertility Education, Social Media, infertiity

A colleague of mine sent me a link to “Eggsploitation: The Fertility Industry Has a Dirty Little Secret” late last night – her email simply had the link – and word “WOW”.

I sat watching with my mouth looking like a bass fish  – open and gaping – as several young women told their horrifying story of being an egg donor in the United States. They spoke of feeling enticed by the money into donating their eggs – the poor explanations of what they could experience – and the tragedy of the complications that they unexpectedly faced as egg donors. The trailers on the website are riveting – and appalling.

It is certainly not a view – that recipient couples, egg donor coordinators, fertility specialists, and egg donor agencies will likely be comfortable seeing. But does that make it any less valid an exploration?

That is the struggle that those of us who live inside the fertility “industry” really have to grapple with.  So often – when these types of images of the fertility field are presented – we shout “foul play”! We pound our chests – and blog our hearts out about how unfair the media is to our field. You can hear us shout that
the entire story is never told – that the world of infertility is highly sensationalized  and distorted in order to sell magazines – or this evening news story.

Quite frankly – there is a great deal of truth in that opinion and outrage.  Frankly – even in the title of the documentary – calling the experience of egg donors a “dirty little secret’ is beyond over of the top. But the producers of the film  are marketing a documentary! If there is no dirty little secret – why buy a ticket?

And there will be people who will watch the clips – and perhaps even go see the documentary – who will come out drawing an analogy of these young women to aviation safety records – “You know – airplanes land safely every day across the country – thousands of them – and you never hear about that! But if ONE plane goes down – boy does that make the news!”  That’s because there is tragedy when even one airplane goes down – and we need to hear about it.

That is how I feel about “Eggsploitation” even where it fails in it’s own sensationalism. I am still wanting to hear the stories of these young women. It’s that important.  Look -  I didn’t like the trailer featuring the “experts” who said that egg donation is about rich older women taking advantage of younger women with good eggs. That is really horse shit – and shows a complete lack of understanding about the women who need donor egg.  I have never met a woman who needs donor eggs who is anything but grateful to donors. And the majority of the women who need donor egg are not rich.  That characterization was frankly wrong and horrifying – and in my mind brings down the messages that perhaps “Eggsploitation” is trying to get out.

We have to be very, very careful – with the young women who step up to donate their eggs.  We need to be careful about donor compensation being so high that young women feel enticed. We have to do a better job educating donors about the risks of egg donation – no matter how good everyone in the fertility field feels they are already doing it – we will have to do it better. These young women are making what I call “life time decisions” when they decide to donate their eggs. Even when their cycles go perfectly well (and most of them do) – these young women are giving up their genetic material forever – and exposing their bodies to a lot of unknowns in the process at a very young age.  That is simply real.

And we all have to cop to the fact – that no matter how careful we are – no matter how much time is spent – and how carefully these young women are consented and educated in the best of circumstances – people make all kinds of informed  decisions – for all kinds of reasons.

And sometimes – things just don’t go as planned.  And all we are left with is regret, pain and anger.

Posted under Egg Donation, Egg Donor Compensation, Fertility, egg donors, eggs, infertiity

Many of you know a lot about me. You know already that I became a patient advocate in the field of infertility because of my own experience with infertility. I have a history of making my life experiences into my life’s work.  And I have noticed when I am quiet enough to have moments of inner reflection – how so much of what I get into forces me to experience the same challenges over and over again. The challenges just occur in a different venue, with different props and costumes.

Giving up control has never been easy for me – and therefore – once again – it is an aspect of my life that I play with a lot .What is it about surrendering that is so hard that sometimes I feel like I need my fingers pried off a project? “Really, Pam, – No REALLY Pam – we have got it!!!”.  Now it really doesn’t matter where that little piece of dialog came from – you get the message. The very idea of giving up control make me feel like the girl in this picture! Very, very anxious! It was as though if I had control over every aspect of my life – I could keep anxiety at bay.  Eventually – I did learn that surrendering to people that I truly trusted – was truly the way to keep anxiety from taking over my life.
Maybe the Universe offered up infertility to me – because I needed to really learn on some base level – that we can only do so much – and then we have to let go.  Infertility is a great one for teaching surrender.  We can show up – read all the books on infertility that are out there – interview and find the best doctors – hang out on message boards and infertility community websites trying to get the facts. We can show up at the doctor’s office with pad and pencil in hand – follow all of the protocol perfectly – and in the end – we are not in control of the outcome.  No matter what we do – there is always the two week wait! We have to give it up – and simply not know and not be in control. God I hated that.

And no matter what I did – the outcome was the outcome.  There is a special lesson in that – don’t you think? It is really about how we learn to cope with the unknown – and those things that we cannot control where we will find sanity.

I have found that the lessons that I learned during my own personal infertility struggle has helped me even so many years later. All of those feeling that I never wanted to feel – come back as I said – just on another stage.

Whether it was moving on from my organization, The American Fertility Association,  to deciding to write my book: SHAMELESS - there was only so much preparation for the experience that was possible. In the end – I had to simply give it up! After all the hard work, set intention, long hours, prayer and burning the mid night oil – I was really not in control of anything.

In medical treatment – it was my doctors and then good fortune who took my best efforts and then told me to trust them – and let them do their part of the heavy lifting! And I did. I let go – and simply had to let them carry my weight.  I had to truly learn trust.  And now so many years later – it is my publisher at Rodale – my editor and my publicity team that are taking all of my best efforts and making the final calls over “my baby”.   They are the ones in charge of editing my work, deciding what stays and what goes – and making such personal decisions about what picture of me is even going to be on the book.  I find my fingers wanting to curl around the manuscript – and my voice wanting to sneak out of my throat as I want to shout “Mine! Mine! Do it MY way!!!” But I learned a lot during those years of trusting my medical team – and I am trying to once again surrender control.  And boy oh boy – it isn’t easy to trust when you feel like your whole world is at stake.

But that is the challenge – and it doesn’t change.  So do your home work. Choose your doctors carefully. Make sure that you are in a place that you on a core level can trust. Once you feel that trust you know that you are home. Then my recommendation? Pry your fingers off o fthe  journey…..I am not saying that you don’t get to show up – and do your best. I am not saying that. But I am saying that once you pick your place – whether it is a fertility doctor – an editor, or a dentist -we all have to get to the place of being able to open our mouths, say “AHHH” and just trust. Without it- we will simply get in the way of our own success. The key is finding where you can truly trust and feel safe.

And I guess – I will be in the black jacket on the cover of my book – I really thought red was best.

Posted under A Purpose Driven Life, Fertility, Fertility Journey, Fertility Message Boards, Fertility Support, Opening to your Life's Purpose, Shameless, infertiity

I am getting ready for photo shoot – don’t be overly impressed.  It’s not for Glamour Magazine or anything. It is for the “Author” picture for the book jacket for my upcoming book – SHAMELESS.

So – I am doing things like getting my nails polished (bright red) and my hair colored (cause I am getting a little gray around the edges!).  And every time I do this kind of “girl stuff” – I always think about to this environmental conference that I attended….

You see – several years ago, I spoke as the representative patient voice at an environmental conference for fertility at San Francisco University. I remember looking out into the audience – a group of doctors, scientists and researchers that studied the environmental effects of the world around us on our health.  I remember being stunned by the grey hair – the lack of nail polish and make up! These folks did not use many of the every day products that most of use without thinking – because they knew the health effects of those products - and they didn’t want them!

Yet very little is still written about the environmental effect of the every day products that we use on our fertility.  Many of us use all kinds of lotions, cremes and expose ourselves to countless concoctions every day which contain an incredible of synthetic chemicals.  We do this often without a thought about how these chemicals could be adversely affecting our overall health and our fertility. The fact is that most of us would be horrified to learn that many of the products that we apply directly to our skin are made from the same harsh chemicals used in industry, and are known hormone disruptor’s for both men and women.

For example, I recently learned that a product called propylene glycol is a solvent used in hair care products, make up and deodorants. It is also the main ingredient in antifreeze and certain types of brake fluid!!  Now, if that does not get your attention – I don’t know what will!

How could this be? Well, in our current state of affairs, only new chemicals by law have to be assessed for their effect on our health, which amounts to no more than 3% of those in everyday use. There are activists here in the United States and around the world that are working to change the laws – but that means going up against industry and lobbyists – so it may take a good long time before all the chemicals in the products that we use on a daily basis will be completed evaluated for use on human bodies!

And the fact is that daily exposures to harmful chemicals add up!  And it is this daily tank up on harmful chemicals that could really be impacting us. Like most things – only doing something  once in a while won’t impact our health. But it is the constant used of these products that come to us in so many different every day forms, that can accumulate in the body and ultimately effect our over all health, including our fertility and the pre conception health of our children.

No one can under estimate the importance of pre conception health.  Whether it is our body weight, our diet, our habits such as smoking and drug use. And for those people who are in the fertility trenches trying to conceive – this constant vigilance can feel so painfully extended. I get that – I really do. But pre conception health is something that you can do something about and it is something that you can be in control of! So use your pre conception time wisely! Consider undertaking a detox program to assist your body in getting  rid of our everyday accumulated toxins. Studies have shown that detoxing can help our bodies regain our natural hormonal balance – and for men who have been adversely effected by industrial toxins and see an improvement in sperm levels.

So, how do you do this? Some of this is common sense. Check out the basic products that you put in your mouth and on your skin on a daily basis. Think about such common items as tooth paste, mouth wash, soap, deodorant, body lotions, make up, nail polish and hair products. Have you ever read the ingredients? Can you understand them?

So I have been reading around – and here are a few of the tidbits that I have found when it comes to the kind of chemicals that are we exposing ourselves to, that can especially effect our fertility and the health of our unborn children.

In 1989 the Australian Occupational Safety and Health Administration analysed nearly 3,000 chemicals used in personal care products. 884 of the ingredients were found to be toxic with 218 of these products found to cause reproductive problems and 314 found to have some effect birth defects in humans!

It is amazing that more information is not out there in Reproductive Endocrinologist’s waiting rooms about this! But who would fund it? Is not a wonder that more people don’t know about this?

Here is a list that I found of the most common offenders – check out the products that you use on a daily basis. If they contain these chemicals – I would ditch them. I did.

Parabens are mostly likely found in body care products. Parabens have been found hanging out in human breast tissue and evidence suggests they can act as oestrogen making them a hormone disrupting chemical in both men and woman. Propyl parabenhas been shown to adversely affect male reproductive functions. At the daily intake level currently acceptable by our govenment it was found to decrease sperm production.

Phthalates are hormone disruptors and apparently they do not have to be listed on labels. They are most often found in perfumes, musks and fragrances. Phthalates have been shown to have a relationship with low sperm counts and some studies have shown that they can also cause sexual abnormalities and deformities.  According to a survey by the CDC,  women with the highest levels of Phthalates were also women of reproductive age. Phthalates can also be found in hair spray, make up, nail polish, shampoo and soap! In high levels they are linked to reproductive and fertility problems in women.

Triclosan is another endocrine disruptor which can be found in soaps, toothpastes, body washes and those instant antibacterial hand washes. You may be clean…..

Talc is found which is found in baby, face and body powders as well as the dusting on condoms! Which means that it can put directly applied to women’s reproductive organs! Talc is a known carcinogen, and has been link with ovarian cancer when used in the genital area. So why is it still found on condoms?

This is still a partial list.  If you are interested in learning more – please check out Our Stolen Future.

Remember, that environmental toxins such as manicures, hair dye, and what we can find in certain brands of toothpaste – can truly impact our over all health and our reproductive potential. There are replacement products available! We just have to learn how to be educated consumers – we have to get the information so that we can make informed choices. We live in an age where there is natural body care products available almost every where!

Many couples are diagnosed every day with unexplained infertility. Yet we know that stress, diet, lifestyle and environmental toxins can have an effect on fertility. Who knows if changes in these areas in a couple’s life can be the difference between infertility and fertility?

Posted under Fertility, fertility evaluations, infertiity

This is just an observation – but I can’t help but notice in the world of fertility at least -  there is not nearly as much attention paid to Father’s Day as there is to Mother’s Day.  Personally – as a Fertility and Sex Educator – I feel the pressure building around “The Mother’s Day Blog” weeks before the actual day.  What will I say this year? How can I be inspiring and help my community navigate the possible pit falls of family outings and “Mother”s Day Sermons” at their local place of worship. And it is not only me – the entire fertility community rallies with blogs, articles, special support circles.  It is like the coming of Armageddon.

But barely a peep for dear old wanna be Dad. What is that about? I trolled the web and I did find that Fertility Authority has a lovely piece by Ellen Glazer, MSW entitled The Hallmark Holidays.

So what about “Wanna be Dad”?  Is the masculine of our TTC couple just not as impacted by Hallmark as the feminine? Does he not get triggered by all the Sear’s advertisements for a new barbecue or power tools? Is the human male really just more linear and just doesn’t care as much about these things?  Well – that is really quite possible.  But just in case – you might want to check in with your beautiful, loving – and having to give it up in a cup – TTC  Wanna Be Dad.

Father’s Day may not be a walk in the park for him.  So why not take him for a walk  to Sears and buy him that power tool anyway? I think that he has earned it.

PS. If you have written a Father’s Day Blog – or know of one – please post in the comments section. I would love to share it. Or do you have thoughts on this? Come on – type away!

Posted under Father's Day, Fertility, Fertility Authority, Fertility Blogs, Fertility Rites and Symbols, infertiity

Admittedly, this may not seem like a very sexy subject – but if you are a patient seeking treatment for infertility in the United States – or a reporter – or a policy maker – perhaps it is time to do a little primer on what we have in the United States in the way of oversight for reproductive medicine.  You see – there are many folks out there who believe that there have been too many cases of impropriety in the conduct of assisted reproductive technologies (ART) for the field to remain without some form of external oversight.

Did you know that the breast implant industry receives more oversight than reproductive medicine? That is because the breast implant business is overseen by The FDA, not The CDC the way reproductive medicine  is handled. And perhaps that was done intentionally, because the field didn’t want government oversight.  Did you know that with the hundreds of  IVF clinics around the country – that the CDC only has the man power and or budget to make about 15 spot inspections a year? Did you know that there is a little loop hole in the powers of the CDC – and if an IVF Center does not want to let the CDC in to do an inspection – they don’t have to? Shh….don’t’ tell the clinics!

Now how did all of this happen in the first place? In 1992, Congress passed the Fertility Clinic Success Rate and Certificate Act which was authored by Representative Ron Wyden a Democrat from Oregon.  This Act was written with the consultation and endorsement of the medical trade organization for reproductive endocrinologists known as The American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technologies (SART). What the Act requires is for fertility clinics to collect and make public the results of ART treatments. Although national data for all clinics  clinics are compiled and published, including clinic  specific data, this process is voluntary and not enforced, and in the eyes of many patient advocates, reporters and policy makers – not adequate or fully enforceable.  Nor by the way are the “guidelines” for treatment put forth by ASRM or SART – they are also voluntary.

Currently in the United States – due to the Fertility Clinic Success Rate and Certification Act is overseen by The CDC which is a non regulatory body.  Now I wonder about that – why did  “they” choose the CDC and not the FDA?

Consumers use this data to compare clinic A’s success rate to clinic’s B’s success rate – often not understanding that meaningful comparisons between the clinics using this data is not really possible as it has been explained to me by statisticians.  It has something to do with inherent problems of dealing with heterogeneous data , and the large confidence limits around all calculated success rates. I must admit I don’t understand any of it – except to know that using the report in this way – is meaningless -and that is mostly what patients do with this report.

So, here we land with an Act that was designed to inform and protect fertility patients that was given to a non regulatory agency of the Federal Government, The Centers for Disease Control (CDC) which does not have the funding, has a tiny staff, and little power to intervene with IVF centers.

Several people have speculated to me that if the CDC was funded properly that they could do a more complete job of implementing the Wyden Bill.  And perhaps even expand their role in reproductive medicine as they have so successfully done in other arena such as HIV.  Would guidelines created and put out by the CDC be more effective, and carry more weight to fertility doctors than guidelines put out by ASRM?

The CDC has been very successful with their HIV Guidelines. But alas – they are not funded to do this yet. Perhaps we should call our representatives – and start to make a little noise.  If in fact – the CDC is the government agency that is over seeing ART – no matter how tied their hands – perhaps we should be looking at how we as patient advocates should be supporting them so that they have enough budget to see more than 15 clinics a year – and are able to use the powers of their office to put out more educational materials such as guidelines for embryo transfers.

While it is true that there are multiple agencies in the US concerned with what the appropriate behavior is for ART Centers, I wonder what the environment would be like if the Wyden Bill was funded properly and fully implemented.  I wonder if Senator Wyden has even checked in with the CDC or patient organizations to see how his hard won act is doing?  When was the last time he sat down with the CDC I wonder or talked to a patient advocate?

I understand that we live in a time when health care costs are seen as more important than health care outcomes.  And it is unlikely that more oversight will ever get rid of all unethical behavior – just yesterday I was told of a patient who had five embryos transferred into her uterus!

But at the very least we need to understand who is guarding the hen house – and what tools do they have to protect the chickens.  In the field of reproductive medicine – we still are in a land of voluntary oversight and guidelines.  The CDC is under-funded, under staffed – and could be used to do more in regard to putting out education for both patients and providers.

What we need are voices – patient voices – strong patient organizations with leadership that is able to speak out on capitol hill with passion in their hearts -  independently from ASRM and SART – and the fertility industry as a whole.

The issues of our community are not so different from any other enmeshed society.  We are all lying to close together in bed – we need more space between the organizations – more autonomy – and more funding. Until then – patients are stuck using tools that they don’t completely understand – and that in the end don’t truly serve them. And it is only a matter of time until the next horror story hits the news.

Posted under CDC, IVF, The American Society for Reproductive Medicine, infertiity

I have been writing since the recession hit – about the hard economic times that have hit the infertility community and that has only recently begun to lift a bit.

Infertility treatment has historically been a pay as you go, and self funded treatment. Patients who did not have the money on hand to pay for their treatment often used credit to finance their dreams of having a child.  Now, these couples are facing a situation where credit has dried up – jobs have been lost or wages reduced – and for many of them -  they are putting their dreams of a baby on hold. For those patients who are determined to move ahead with their family building plans no matter how difficult it may seem financially for them – this is the time to really look closely at what is available to assist them.

It’s a great time to pick up a copy of  “Budgeting for Infertility: How to Bring Home a Baby Without Breaking the Bank” by Evelina W. Sterling and Angie Best-Boss.   The description of the book on the Amazon site – provides a great description of the contents of the book -

“Having a baby can be one of the most wonderful times of your life — but if you need help to conceive, it can swiftly become a staggeringly expensive undertaking. With the average cost of infertility treatments ranging from $35,000 to $85,000 in the United States (most of which is not covered by insurance companies), many women and couples find themselves having to make difficult choices about building their families.

Getting a grip on your finances is one of the few things you can do to regain control of this process. Infertility experts Evelina Weidman Sterling and Angie Best-Boss have created the ultimate guide to ensuring the most cost-effective care with the highest chances for success. With anecdotes, interviews, and advice from both doctors and patients, you can easily apply these specific money-saving strategies to your own unique situation. Learn how to:

- Select a fertility clinic with a high rate of success- Convince your insurance company to cover more of the costs

- Track down the most affordable fertility drugs

- Travel abroad for cheaper care or international surrogacy

- Avoid the scams and unnecessary expenses every step of the way

Personal and professional, Budgeting for Infertility is an invaluable resource that shows you how to pay for infertility treatment…and still have money in the bank for diapers and day care.”

Sounds good to me! This is also a great time to take a look at all of the different ways some of the IVF Center’s around the country are working to help patients finance treatment.
East Coast Fertility where I work as the Director of Public Education – has always worked hard to help patients financially. East Coast fertility has been offering free fertility consultations to individuals and couples, and there are many other discounted packages for couples that need IVF.  Consultations with fertility specialists normally range from $250 – $500, depending on the practice.  During the consultation, the physician will spend time reviewing the patient’s medical and reproductive history in depth and discussing her reproductive options.I am feeling really good about ECF’s willingness to step up and help patients during these difficult economic times.

I hope that the chain of giving, and supporting patients through these tough economic times continues our medical community.

Bravo to all that are trying to help.

Posted under Angie Best-Boss, DOH Grants, East Coast Fertility, Fertility, Fertility Consultants, IVF, In Vitro Fertilization, Infertility Funding, Infertility Grants, My Fertility Plan, Recession and Fertility, Recession and Fertility Treatment, infertiity

I have been around National Infertility Awareness Week for a very long time – and frankly I don’t ever remember the community working together quite this like to raise awareness.  Perhaps it is the rise of bloggers, Facebook and twitter that have enabled people to become advocates in their own way and add their voices to the cause.  I am not really sure what it is….but I am loving the feeling of a community that is joining hands.

The folks who Twitter are working to get infertility as a trending topic on Twitter by #infertility repeatedly.  The Facebookers are sharing writings and activities – helping to encourage each other to do more.   So here is a taste from around the web:

At Fertility Ties they are having have daily tips,  and contests with prizes!Their main theme is hearing from their users, experts and Doctors what this week means to them and what would they want to be achieved. They also created an Infertility Awareness ribbon that users can easily put in their blogs, or any social networks.

Posted under East Coast Fertility, Face of Fertility, Fertility, Fertility Authority, Fertility Blogs, Fertility Education, Fertility Support, Fertility Ties, Infertility Funding, RESOLVE, infertiity, inspirational thoughts

Several months ago,  I had a conversation with a reporter from a major media outlet. She wanted to know if David Kreiner, MD ,would go on the record with many of his viewpoints on the treatment of infertility. You see – it can be hard to go on the record when some of your view points may be counter intuitive to the fertility pharmaceutical industry (funding), annoy patient organizations (referrals), and may make life harder for IVF Centers and other reproductive endocrinologists around the country who may be your friends and colleagues. You see, Dr. Kreiner is one of the few reproductive endocrinologists that feels that regulation may not necessary be a bad thing if done right – and is willing to say it – out loud and in writing on his blog thefertilitydoc.com.

It takes ah…..what is the word? Balls.

I love that about Dr. Kreiner. He is not this big personalty – he is actually a gentle soft spoken guy. He has the training that sets him apart from many of his colleagues, but many would not even know his background because until recently he didn’t talk about it much. He is this incredibly reputable fertility specialist that has quietly been offering for years programs that support patients in making the choice not to have higher order multiple births such as The Single Embryo Transfer Program. A program that encourages patients to only transfer one embryo at a time by not charging them for the freezing, storage and subsequent transfers of their embryos until there is a live birth. And he wants everyone to stop doing intrauterine inseminations (IUI’s) and move on to newer techniques such as Micro IVF that requires less fertility medication and brings down the cost and risk to the patients tremendously. And he is willing to see patients are no cost to them through a free consultation program. Saint Dave? Hardly – but he is willing to put his money and his reputation where his heart and mouth is – and he doesn’t care about being popular among his cronies.

You know – in talking about all of this with this reporter – the issue of conflict of interests in the field of reproductive medicine kept coming up again and again. I guess that the field of reproductive medicine is not the only field in medicine that has to deal with these issues. But sometimes as I look around at our talking heads I wonder if we really see ourselves?

I am lucky – I am finally in the position with this blog (which I own and is controlled by no one but me) to be able to say what I want to say and need to say about the treatment of infertility, the protection of fertility and the intersection of sexuality with complete freedom. No one looks at my writing before I push the publish button (can’t you tell that there is no copy editor?). And I often do not know what I am going to write about until I sit at my computer at 5am with my coffee.

My blog has gained attention because I say what I believe to be so – and I say it the way I always have -with plain language and a frankness that many people find startling (you should meet my mother – you would understand). You might not always agree with me – but I say it. Mostly. And it is that mostly that I am really interested in – in myself and others.

Do I really have the complete freedom that I claim that I have?

There is this internal button inside of all of us that worries about offending and hurting our colleagues. No one wants to make funding sources or referral sources angry right? And there lies the rub. If we don’t bite the hands that feed us – we are as useless as a Jenny Craig frozen dinner at a Chocolate Fair.

But by speaking the truth about what we know is wrong – we risk being left out of the fertility club of associations, organizations and being “unfriended” on Face book! Are we still stuck in high school and worried about being left out of the cliques? If we say what we believe to be so – and do what we know in our hearts is right – will people stop having lunch with us?

I often talk about issues that are important such as the marketing of patient education to infertility patients. It took courage for me to write that – because I didn’t want to upset people. And yet – I only scratched the surface of that issue. But publishing what I put out there made my stomach crawl all day.

What I found interesting – is that my phone burned up all day with people wanting to talk about my patient education blog privately. “Thanks God Pam you are talking about this stuff” and the conversation would go on from there. But these were private conversations. They did not happen in the comments section of the blog or on my very active Face Book or Twitter account. Oh yes – people wanted to talk about all of this – but no one wanted to comment or show support publically. I am not criticizing – and I get it. I am just saying…..

It’s time for all of us to look at the emperors in our kingdom of infertility and be like that kid in the Hans Christian Anderson Tale – “The Emperor’s New Clothes” – where the kid didn’t know that he was suppose to see the clothes and spoke the truth without fear.

It’s time for us to stand up too – and not be frightened of all the various kings in the fertility kingdom. The time has come – and I am so lucky to work with a doctor that  has guts.

Posted under DOH Grants, Dave Kreiner, Dr. Dave Kreiner, East Coast Fertility, Fertility, IUI, IVF, In Vitro Fertilization, Micro-IVF, high order multiple births, infertiity

I love blogs and blogging. Sometime I wonder what I did with my time before I discovered this incredible means of instant communication.  But let’s face it – some people are simply better at blogging than others.  Every once in a while – I enjoy introducing you to some bloggers that you may not have met before – or others that have written specially good blogs that I would hate for you to miss. And you know me – whether it is about infertility, fertility, sex, weight or female self image – I am on it like beans on rice!

So – here are a few my favorites this week.  I just came across “IF Crossroads” frankly because Michelle posted a comment on my blog!  Michelle is in that special place on being pregnant after infertility – at the crossroads between the worlds. I remember that place so deeply – and that place of fitting in – and not fitting in between the fertiles and the infertiles can be amazingly challenging. It is a great blog! I was reading one of her entries  that she wrote about the sex of her child – and what I call “the child imagined” – and I wanted to email her my blog about just that subject!  What I love about the blogosphere – is how we can hold each others hands through it all – and when I went to find her site yesterday to include her in my round up – I got this huge hug from Michelle! Because even though I had never met her – and I didn’t email her the blog on the Child Imagined – she found it and loved it.  And I was able to hold her just where she is right now in her life – and tell her that I do understand, she is not alone – and everything that she is feeling is normal! Isn’t it amazing how we can provide comfort to strangers through the blogosphere? It simply amazes me.  So check out Michelle’s blog – it is great and right now we are having a little mutual admiration party – so forgive us!

And then on Facebook yesterday (If you are not my friend on Facebook or following me on twittering you are missing out on some great stuff!)  – Dr. Edward Ramirez posted in his news stream about a blog that he has been following called “Life and Love in The Petri Dish”.  From the blog description:

“Mo and Will are two 30-something health care professionals traveling the steeper than expected road to parenthood. First came love, then came marriage, then came 6 IVFs and 5 miscarriages. Now into our 3rd year of wedded life, we are cautiously hopeful and steeling ourselves against further disappointment as we continue our efforts to start a family”.

The blog is real and sometimes raw.  I join Dr. Ramirez in recommending that you jack in and spend a little time in the world of Mo and Will.

Both of these blogs written by people in the midst of one stage or another of infertility – reminded me of how important it is that we keep our hearts in a place of loving compassion for each other and ourselves.   A wonderful piece from the blog “Zenhabits” called “A Guide to Cultivating Compassion in Your Life with 7 Practices” – is a great introduction to living a compassionate life.  It truly is a practice.

Feathers are still flying in the fertility community in regard to the concept of “Fertility Raffles”. The latest blog  on the subject “Is It Wrong to Raffle Off a Donor Egg Cycle” belongs to Rachel Gurevich at About.com.

I like Rachel – and I always enjoy her perspective on things. What I like about her blog is that she talking about all of this from the patient perspective – both the egg donor as a patient and the infertile couple as opposed to what is good ROI for the fertility industry.  Isn’t that the perspective that patient advocates are suppose to take?

In the world of doctor bloggers this week -  there were a couple of stand out entries -  of course Dr. David Kreiner (who really is an amazing blogger)  who wrote a piece that I just loved called “Do Financial Discussions  Have a Place in Fertility Consultations With The Doctor?“  If you have not checked out his blog “The Fertility Doc” - you are really missing out. It is not your usual “Doctor Blog”!

And I have really enjoyed getting to know Dr. Edward J. Ramirez, a reproductive endocrinologist in Northern California through the cyber ether. Dr. Ramirez also has an interesting blog that he calls “Women’s Health and Fertility”. Dr. Ramirez works hard out reaching out to the fertility community – whether it is patients,  patient advocates, or his colleagues.  I really respect that.   His blog is more of a question and answer forum – do you have a question for the good doctor? He is likely to make a blog out of it! And if you have a question about your reproductive health care – I bet you might find the answer already written on his blog. Just put it in the search!

The winner of best blog title of the week goes to Andrew Vorzimer, Esq over at his blog “The Spin Doctor”!  Andy takes it with  “Surrogacy and Brothels Make Strange Bedfellows”. Ya think?

Posted under Dave Kreiner, Donor Egg, Dr. Dave Kreiner, Egg Donation, Egg Donor Compensation, Facebook, Female Self Image, Fertility, Fertility Blogs, Fertility Support, IVF, IVF Raffles, IVF and Egg Raffles, In Vitro Fertilization, MD, Pregnancy After Infertility, Women's Health Care, egg donors, infertiity, miscarriage