OUR HOSTS: 

Corinne Foxx - @corinnefoxx

Natalie McMillan - @nataliemcm and @shopnataliemcmillan 

What we're drinking: 2021 Colomé Torrontés 

MEET OUR GUEST: 

Dr. Serena Chen - @drserenahchen and @ivf_irms 

Join @ivf_irms every Tuesday at 4:30pm EST for IG Live 

ABOUT OUR GUEST: 

Dr. Serena H. Chen serves as Director of Reproductive Medicine at the Institute for Reproductive Medicine and Science in New Jersey, and at the Cooperman Barnabas Medical Center. She's also an Associate Clinical Professor at Rutgers New Jersey and Rutgers RWJ Medical School. She feels privileged to be trusted with the reproductive health of people in so many different situations, and is dedicated to improving access to reproductive technology by breaking down barriers to care and raising public awareness of technology. 

TOPIC: 

We’re joined by Dr. Chen to get her professional take on when someone should consider egg freezing, what actually goes on during the IVF process, and how reproductive conditions like endometriosis affect fertility. Dr. Chen draws a picture of the typical scenario for people going through fertility treatments and breaks down the key terms associated with reproductive therapies. We also touch on what IVF doctors across the country are concerned about when it comes to the overturning of Roe v. Wade and how women's health care is being compromised with current political agendas. 

In this episode, we discuss:

• How reproductive treatments and societal attitudes towards IVF have changed over the course of Dr. Chen’s career
• Lifestyle choices that you can make years before you're ready to conceive to set yourself up for a healthier family
• What egg freezing is and how the science has advanced in recent years 
• The different ways to form embryos during the IVF process 
• Dr. Chen’s message for anybody who's been actively trying to conceive for a while, and it hasn't happened yet
• What you can expect from Dr. Chen’s weekly Instagram Lives 

END OF THE SHOW: 

Corinne and Natalie introduce Hottie of the Week: Amy Schumer 

WINE RATING:

2021 Colomé Torrontés  = 6.5 / Amy Schumer 

WRAP UP:

To wrap up the episode, Corinne and Natalie play Recent Obsessions. Corinne is loving her new Béis Work Tote and Nat’s on Duolingo TikTok and can’t stop watching. 

We have a newsletter for our Am I community. You can sign up for the newsletter on our website: amidoingthisrightpod.com

You can email us for episode ideas or Random Advice: amidoingthisrightpod@gmail.com

Follow us on Instagram: @amidoingthisrightpod 

Don't forget to rate and review the podcast! It really helps us grow!

[00:00:05] Natalie McMillan: And I'm Natalie McMillan.

[00:00:17] Natalie McMillan: And each week we cover a new topic and we drink a new bottle of wine.

[00:00:42] Natalie McMillan: waiting for the expert. Like, yes,

[00:00:46] Natalie McMillan: Cause we can't talk about, oh, I have no idea what's going on.

We have a lot of questions, too many questions for her, but we found her and I think she's perfect.

[00:01:08] Natalie McMillan: thinking about these things.

I know it's scary, but it's like, And so many listeners have P C O S and like there's so many factors that go into fertility that it's like, yeah, we don't even really know. We really don't. You know, nobody told us these things. Oh, definitely. Hence the entire podcast. Right,

Right. And at the end of the episode, we're gonna be playing.

[00:01:41] Corinne Foxx: But not, but what are we drinking on the bloody? All right. We

[00:01:47] Corinne Foxx: I have a good feeling about this, right? It's a pretty bottle. I don't even see the bottle.

I just, I just got a

[00:02:04] Corinne Foxx: it. I have a, a feeling for it and it's a twist top.

[00:02:12] Corinne Foxx: tops.

Thank you. You guys, I can actually drink the wine. The last few episodes one. I have not actually been able to drink it that much because I was on antibiotics. Yeah. But I'm

[00:02:26] Corinne Foxx: reach. I did, but also. I I, part of it is that I forgot I was on

You're here to tell the tale. Cheers. Cheers,

[00:02:45] Natalie McMillan: tonight. We do have a date night tonight. I'm so excited. You guys,

[00:02:59] Natalie McMillan: If we have, we've never explained it.

We may have mentioned it without explaining it. So

[00:03:09] Natalie McMillan: calendar.

Yeah. We're going to dinner in a movie. Mm-hmm um, but we're going to like a fancy dinner. I

I will say at 5:30 PM. see.

[00:03:52] Natalie McMillan: I think we have talked on the podcast maybe about how I cannot.

I can't wind down when I go home. Oh, really? yeah, I think so. So if I'm like at a social event and I come home, no matter what time I have to wind down for like three solid hours. And Karen's always been like, what are you talking about? But then you experienced

I know, and I could not wind down. And finally I was like, oh my God, Natalie. I understand what you're talking about. It's torture because I've never had that. But last. I was so tired at that birthday dinner. I was like, I got home and I was like, bam, I know

I went to bed at one.

Yep. And they're coming up. Oh yeah, we do have one.

[00:05:02] Corinne Foxx: be fine. Good. We'll figure it out. Okay. Let's get into this week's episode. Let's do it. And I'm really excited for Dr.

Chen. So

[00:05:13] Corinne Foxx: topic. Yeah, well, I mean, we have to be honest here. Sex ed in the us basically taught us. Absolutely not, not one single thing. Absolutely not one single thing. So in our adult age, I feel like we both still have questions about our reproductive health and beyond that, as we get closer to the age where we might even consider having kids, fertility really becomes top of mind.

And we really don't any don't really know anything about our own fertility. I don't,

[00:05:45] Corinne Foxx: What

[00:05:51] Corinne Foxx: did.

Yes. I thought that was like stuck. I

[00:06:03] Corinne Foxx: more confusing than it

[00:06:09] Corinne Foxx: all right. Well, we have a lot of questions for Dr.

Chen, and I'm sure you guys have a lot

[00:06:17] Corinne Foxx: But let's introduce Dr. Chen before we bring her on.

Wow. I know, I'm sorry. Cooperman, Cooperman, Cooperman, Barnabus, Cooperman. She's also an associate clinical professor at Rutgers New Jersey and Rutgers R WJ medical schools. She feels privileged to be trusted with the reproductive health of people in so many different situations and is dedicated to improving access to reproductive technology by breaking down barriers to care and.

Raising public awareness. We love technology, love technology. You know, we love technology. , she's amazed and grateful every day at the explosion in reproductive science that is happening today, but feels that physicians and scientists must advocate for better support for providers. And patience mm-hmm patient and physician stress and burnout continue to be the biggest barrier between the promise of these new technologies and their actual delivery.

Wow. I know. And, uh, we'll plug her at the end, all of her social things so that you can join her in advocating for better reproductive health for everyone.

[00:07:52] Dr. Serena Chen: Hello, Dr. Chen. Hi Chen. Hi guys. It's so nice to see both of you. I'm really excited to be here. We're

[00:08:00] Corinne Foxx: We are so excited to have you. We were talking before we hopped on with you that there's so much about fertility and like our own female health that we just like don't know, and we're not taught.

And now we're both 28 and we're, you know, thinking about our future and if we wanna have kids, and this is something that's on our minds that we just don't feel well educated in.

And reproductive help is a big one. And the hard part is people don't feel comfortable asking about it. So I'm so glad you guys feel comfortable talking about it. Yeah.

[00:08:44] Natalie McMillan: partially it's for us.

[00:08:59] Dr. Serena Chen: Oh my gosh. It's changed so much. We used to do a lot of testing, but no treatment because we really didn't have a lot of treatment. And now. We don't do that much testing and we, or I guess we do, we, we don't do that much more testing than we used to do. And we have really great treatment that works really, really well.

And actually one of the reasons I got into this field is because when I started IVF was super new and interesting, and there really were not a lot of pregnancies at all, but it just seemed like. You know, crazy science. And I was like, wow, you know, help me get people, get pregnant by growing, making a little embryo on a test tube.

That's incredible. I wanna be part of that. And now today it's so effective and it's so safe and it is more widely accepted, which is really, really wonderful. We still have to work on getting better. Coverage for it. But if somebody has access to IVF and they have infertility, if you can persist with it and not to get discouraged or run out of insurance, then you know, everybody can get a baby.

So we still have some challenges, but the technology itself is amazing. What is

[00:10:20] Dr. Serena Chen: There's a lot of different answers to that question. So, as I said, if you are accepting of the full range of treatments and you have full excess, and you can keep going, ultimately we think it's a hundred percent, but some of those people might need IVF.

Some of those people might need donor X. Some people might need donor sperm or a gestational carrier. And that third party reproduction where you're involving another person and making the baby. You know, a lot of people don't feel comfortable with like, some people will be like, you know, I I'm done. I tried really hard with my own eggs and my own sperm, and now I'm gonna adopt, or I'm gonna live a wonderful and rich life with, you know, without children, which, you know, I have all kinds of other things in my life.

So ultimately that's a very personal choice, but on a technical level, theoretically, if you remove all those barriers, we can make a baby for everybody now. The per cycle pregnancy rate is a little bit different because the average number of IVF cycles to a baby in this country is supposedly like two and a half or three.

So. It is a little bit of an inefficient process, which is not surprising because humans make a lot of eggs and sperm and embryos that just are not capable of making a pregnancy. And you know, a lot of pregnancies are not capable of making a healthy baby. So you do a lot of times have to be like, okay, I'm doing IVF.

That didn't work. I'm doing it again. That didn't work. Okay. Let me try it again. And you know, and then I'm successful. So that is a fairly typical scenario for people going through fertility treatment. I hope did that answer your question?

And it speaks

[00:12:32] Dr. Serena Chen: Like

What's your stance on that?

About your health. So why are we waiting for a problem? Why don't we see what is going on? See what our risk factors are and address those ahead of time before we even wanna concede them. That's actually ideal. Like if you look at the old studies on smoking, a lot of people are like, well, if you ask a pregnant woman against quit smoking, the outcomes are not that different.

That's because, you know, we don't see a pregnant poison until she's like 12 weeks pregnant. And then we're like, Hey, why don't you stop drinking whiskey and quit smoking then, you know, it's a little bit late then mm-hmm so you really, you know, at 28 when you're like, oh, I'm still a few years away from having a baby.

Now is the time to be like, well, let me eat more vegetables. Let me get better sleep. Let me exercise a little bit. Let me quit smoking. Now, if I'm smoking, let me. Optimize my health. Now let me see the doctor and see, do I have risk factors? Do I have like ovarian cyst? Do I have a strong family history of premature menopause or endometriosis things that I, that we know in the medical field could impact your ability to conceive?

You know, like do, do I have a family history of. Early cancer. Like, is that something I should I get genetic testing for something like that? Are there genetic diseases in my family? You know? So there's all kinds of things that you can do right now years before you're ready to conceive to set yourself up for a healthier family.

Yeah. Yeah. I didn't

And I am, you know, more aware of my fertility because of that. But even if you don't have endometriosis or you don't have some kind of reproductive Condit, It is good to start thinking about it, you know, as young as, I mean, guys, we're not that young anymore, but you know,

[00:15:15] Natalie McMillan: thing that you just always assume, I guess is like, you think you're pregnant, you take a pregnancy test.

Yeah. Then you go, yeah. You know, and really that is kind of

You look fine. So it's not really part of a system. So that's why, you know, something like your podcast is really important where people learn for themselves. And then. You know, once you're knowledgeable and you know what to look for and know what to do for yourself, you can advocate for yourself because it definitely requires self-advocacy.

[00:16:10] Dr. Serena Chen: for. Yeah. One

And also maybe someone listening, what is egg freezing

And it completely changed the game because we went from a really low pregnancy rate to the same pregnancy rate as. Fresh eggs. It's like, literally, like you're pressing the pause button and then you press plague. It's it's incredible. And so with vitrification and really good pregnancy rates, egg freezing makes sense for more people because to freeze your eggs, you do have to take some medication and for like a week to 10 days, and then you do have to get an egg retrieval.

Usually it's done. Anesthesia. So you go to sleep for like 10 minutes and we put a small needle into the vagina while you're asleep and we pull out the eggs. It takes about 10 minutes. So not a surgery, but it's an ultrasound guided needle procedure. The needle's about the same size as a blood dry needle.

So you have to go through a procedure and a process to freeze your eggs. And so, you know, if it doesn't work so well, why are you putting yourself through that? But now it totally makes sense because that process. So much less risky than having a baby or getting pregnant. And if the success rates are really high and it can really change the gain for your fertility prognosis for a lot of people, it makes a lot of sense.

And people were like, even if it doesn't work so well, even if it works a little bit, your eggs are gonna be crap after this cancer. So all those people should freeze their eggs. So that's been standard of care for a while. We still don't have good access for all the cancer patients in the United States, but theoretically, every young woman with cancer should be told, you know, let's see if we can freeze your eggs.

If we can do it safely. You know, it depends on the circumstances, but a lot of people can do it nowadays because. We know how good egg freezing is. We've been expanding the indications. And personally, I feel like every young woman should have access to egg freezing if they want it. I feel like everybody should understand it, get all the information and be able to say yes or no.

Based upon her own decision making, she should have access. And, but the truth is very few people have access. So a lot of, a lot of newer companies that really work hard to try to recruit, uh, very talented people like Google, apple, Facebook, you know, places like that. And you know, these competitive financial firms where they're competing for talent, a lot of them do provide egg freezing benefits, which.

Awesome. Because a lot of people are shopping their jobs. By, you know, healthcare benefits and reproductive benefits are something that a lot of people are looking for. So the access is getting better, but it it's still not, it's still not perfect. We've been working really hard. Like there's only like nine states now that have egg freezing mandates.

I'm in New Jersey. That's one of them. And we worked really hard to get that mandate. I wanted this mandate to cover everybody, but. That was a little too much for the legislators to swallow. So we got medical egg freezing passed, which covers cancer, transgender youth, people who are going through surgery.

You know, like, let's say you have to get your ovaries taken out or your uterus. That's gonna, even if you don't take out the ovaries, it's gonna impact how your ovaries work. So you definitely should. Have egg freezing before that, but there are other circumstances under which we really feel like, you know, people just delaying childbearing feeling like, well, I'm not gonna be ready to have a baby until I'm older.

I wanna freeze my eggs. Now, endometriosis, I think is a good reason for people to think about freezing their eggs because endometriosis people definitely have a higher risk for infertility. So I feel like 28. You know, if everything looks great, 28 might be a little bit early to freeze your eggs because you might be like, do I really need to do this right now?

But honestly we don't know the answer. If 28 is too early until, you know, we examine you and you look at your numbers. So if you have a history of endometriosis, I would wanna know what are your ovaries look like? What is your egg number, your AMH or anti Mullar hormone. And then I would want you to like, understand the finances, the pros, the cons, the risks, the benefits, and be able to have you say yes, Dr.

Chen, I wanna do this or no, this is not for me.

[00:22:04] Corinne Foxx: Care. Yeah. Just knowing your body, your circumstances, and like what's available to you. Yeah, I think is so empowering. And I have went to a fertility specialist and here in Los Angeles, just to have that conversation of like, where am I at and how much is this gonna cost?

And I do wanna do it. And, and maybe when I do, I'll share it with everyone on the podcast, how it goes. But one thing I, I wanted to talk about because there's egg freezing, then there's also. I V F mm-hmm . And I know that, you know, a lot of, uh, people who have trouble with conception or single parents or people in the LGBTQ IA plus community, this is a really good option for them.

But what's the difference between. egg freezing and IVF, or where does IVF come into the egg freezing process? yes,

So we need a lot of eggs to get a good one. So that's the same in IVF and egg freezing that first part stimulate the ovaries. Can I ask you really quick? What is a follicle? So a follicle is just the little circle that surrounds the egg. You can't see the eggs on the ultrasound, but you can see the little S that's filled with fluid around the egg and as the egg mature.

The follicle grows. So that's one of the measurements. One of the things we can measure on ultrasound to see what your progress is like, how close you are to ovulation, or how are you responding to the myth?

[00:23:46] Dr. Serena Chen: So you're taking these medicines, you're doing ultrasound and blood work.

We're watching the follicles grow. We're watching your estrogen levels rise. That part is all the same in agri, in, in egg, freezing and IVF. And then we give you a trigger shot and you go to sleep for 10 minutes. We pull the eggs out, all of that's the same for egg freezing. So then we freeze the eggs for egg freezing.

And then for IVF, we do. IVF in vitro fertilization, which just means we're fertilizing outside the body. So, you know, it's usually in like a Petri dish and you put the eggs in, you've washed the sperm and gotten the really good sperm. You take the good eggs and then you put them together. There's a couple different ways to put them together.

One is just to drop the eggs into like a bath of sperm. The other way is to do icky, where we actually inject the sperm into the eggs. And there's a lot of different reasons to do one versus the other. But IIE is usually done for if there's a problem with the sperm. It's not as healthy as it should be.

Or if you are doing you're planning to do genetic testing on your embryo. Doing just one egg into the one sperm into the egg helps keep the genetic testing results more accurate and a little bit more clean. So then once you put the sperm and the egg together, then you wait about 20 hours to see if it fertilizes, not every egg will fertil fertilized, but like, you know, so every step of the way you'll see some drop off.

So. Typical fertilization is around 80% of the mature eggs will fertilize. And then not all the fertilized egg will, will divide and grow and make an embryo. And then not all the nice looking embryos will have normal genetic testing. And not all the genetically normal embryos will actually make a pregnancy and then not every pregnancy will result in a baby.

So there is that natural drop off, and that's not just infertility patients, although they probably have more drop off than fertile patients, but that is just human biology, human reproductive biology.

How long is it between putting the sperm and the egg together and then implanting?

Maybe someday we will. But right now we don't. Uh, so if you're doing genetic testing, then we do have to wait. So it's usually two completely separate menstrual cycle. So a minimum of probably, you know, five weeks between the retrieval and the transfer for that. Now, if you're not doing genetic testing, you can put the embryo in 1, 2, 3, 4, 5 days.

After the egg retrieval, the most common time is to put. The embryo in five days after the egg retrieval. Um, and then, yeah. Wow.

[00:27:17] Dr. Serena Chen: well, because in that type of cycle where you're not doing freezing. The ovary and the uterus are all synced up. So just when you know, and the embryo has to implant around when it's around six or seven days old.

So you, you have to get it into the uterus in order to implant, you have to do that or you have to freeze it. Otherwise it's not gonna survive. Okay.

so

So basically you're putting a lot of embryos in hoping that one of 'em is gonna be normal. So you can put like two, three or four embryos in, but the likelihood is only zero or one of those embryos will be normal. So you're not really increasing. Somebody's multiple pregnancy risk. Having more, you know, I mean, everybody thinks twins are so cute, but it's super high risk for the baby and the yeah.

For the babies and the mom definitely serious complications can potentially happen. So we like to mostly put in just one embryo at a time, every patient is a little bit different, but in general, those are the modern protocols, but we used to put in a bunch, cuz we used to be really bad, bad at IVF and we didn't make very good embryos and we didn't do a lot of genetic testing.

So. And the pregnancy rates were much lower. So that's kind of how. Tried to get just one pregnancy was throwing a whole bunch of embryos in there, but that is a very outdated approach. Okay. Good to know.

Do men have a fertility clock? Because I think it's

So, um, men. Have different types of issues, but there definitely is. We do definitely see reproductive aging in men and, and an impact upon the risks to the children as they get older. So their biological clock doesn't quit quite as early or quite as loudly, so they can reproduce for a lot longer than women, but they, there still is a biological clock.

Having said that for both men and women, you can't stop the biological clock, but definitely optimizing your general health can, you know, can make a difference. And then

[00:30:34] Dr. Serena Chen: That's not a society. Like it's not like a, an American society for reproductive medicine guideline right now.

But it seems to me that a proactive, like guys who are being proactive should freeze their sperm before they turn 40. Uh, because that's when. Kind of see the, the rigs really go up or maybe, you know, maybe even younger sperm freezing is a lot easier and a lot less expensive and a lot more accessible than, so it seems like a very reasonable idea for somebody who really wants to be proactive.

And we are seeing that a lot of people, men and women really are having kids later and later and later. So it seems like a very reasonable thing to do. And of course, guys that have cancer or have to undergo. Significant medical treatment that might affect their fertility. You know, they definitely should treat there.

Wow.

And there's all these like, weird tips on, like, you should lay a certain, put your legs up the wall. Yeah, exactly. Are there any of those tips that are actually true and helpful?

Cause this having a certain position and having sex constantly are both docs of Google myths. And Dr. Google did not go to medical school, you know, so you really only have to like, if the sperm is good and, and you're healthy, then you really only have to have sex a couple times a week to like, make sure that there's always sperm around in the Philippian tubes.

That's how our system is designed. It's designed. So the sperm can hang out and be happy in the fallopian tubes. And. For the egg, the, the egg has very precise timing. Yeah. That is crazy. Yeah. So sperm can live for days and days and days in the fallopian tubes. Whereas the egg really, once it ovulates only has like 24 hours to be fertilized.

So cuz the egg is like the largest cell in the body. It's super complicated because it, it is responsible for providing all the biologic material for three days of the embryo. Life. So it has to do everything. It has to bring all the proteins, the DNA, the RNA, all the mitochondria, and you know, also like maybe a snack and a change of clothing in case you get wet, freezes everything.

And meanwhile, the sperm, the is essentially a DNA missile. Okay. Just like this little clump of DNA attached to a tail with like some mitochondria around the neck to provide some fuel. And you know, this sperm is just like, has to run around and stay active until it finds the egg. And then they all try to race to the egg and the winter only one gets in and the egg shuts down everybody else.

And all the other little sperm are like, didn't make it, they're stuck on the outside. And the sperm that makes it shows up and says, Hey. I brought my DNA. Are you ready to replicate? Right. And, but they don't do the sperm. Doesn't do anything for three days. Okay. That DNA doesn't do anything. It takes three days for the sperm to actually gear up and start making proteins and things like that.

So that, that. The egg has to provide everything in the first three days. So it's really only available for fertilization for 24 hours. The sperms job is to stick around. So sex twice a week means that you always, if you're a normal fertile couple, the sperms around you don't have to have sex all the time.

You don't have to have sex at the time. You're ovulating all this idea of, I need to know exactly when I'm ovulating in order to concede. Is a myth that kind of stresses people out. I think, I don't think it's a good idea.

[00:35:08] Dr. Serena Chen: Yeah. Yeah. So people who have irregular periods, that's what I tell 'em. I'm like have sex twice a week then, you know, there's always a sperm there whenever the, the egg comes out, but it, you know, if you have a regular period, you really should see the gynecologist and get checked out. Cuz there could be some risk factors associated with that.

But, but we don't really want people to stress about when to have sex because we know that if you can not stress and relax, you actually will have sex during your fertile time. If you're healthy, you know, and you're not using contraception. Couples tend to have sex at the right time. Wow. Yeah. You follow your natural

[00:35:46] Natalie McMillan: Yeah. What would you say to somebody who's been actively trying for a while and it hasn't happened yet?

And most of the time there's nothing serious going on. And even if there's something serious going on, usually we can address it and help you get. But you shouldn't let it go on and on and on. Cuz not only are you like not getting help, but you're also really raising your risk for like depression, anxiety, things like that.

Cuz. Incredibly stressful to, you know, be trying to conceive and not to conceive. Yeah. Yeah. I,

Um, and just feeling. Courage, but it's good to know. Like if you're struggling, don't wait too long and see someone like you and there are options. Yeah.

[00:37:14] Natalie McMillan: Speaking of mental health, you know, recently we had Roe V. Wade overturned, which has been ver I think we're all a little hard on all of us.

[00:37:28] Natalie McMillan: So, you know, I think it's quick to just think that it only affects abortion, but. Can you speak on if it has larger implications and then even with IVF, cuz I know there's things being said about IVF being affected by this. What's your take on that? So

A certain type of abortion, uh, termination elective, termination of viable pregnancies or theoretically that's what a lot of the people who are in support of this legislation want to do, and they do that by defining, uh, pregnancies. As a person, like they give a pregnancy, the legal status of a person before they're a person.

And that's general concept is called personhood and personhood bills. If you define, like, let's say an embryo as a person, it could affect what we do in IVF. Cuz we make embryos all the time. And we freeze embryos and we select embryos and we biopsy embryos and we test embryos and we will often discard embryos if they're genetically abnormal, cuz we know they can't make a, a healthy person.

Right. Right. So, and all of those things that we do, depending upon how the bill is written could be considered illegal. And now like in Missouri, for example, Illegal means you're be charged with a felony and thrown in jail. So there's all different kinds of punishments for these illegal actions. So here we are trying to build families, preserve fertility, help people have babies, and yet we could be prosecuted by the law.

That is something that IVF doctors across the country are really, really concerned about. And in every state, the concerns are a little bit different. So we're, we're really, really concerned. And the other issue is that these laws impact not just what they're meant to impact. Elective pregnancy termination of a viable pregnancy, but they also impact just routine medical care for women of reproductive age, who may have all kinds of medical problems because of various things that happen in pregnancy, whether the pregnancy is normal or abnormal and this idea of abortion.

You know, encompasses routine medical procedures of let's say, removing pregnancy tissue from a uterus that's causing somebody to, you know, be at risk for death because it's infected or because it's causing a lot of bleeding or things like that. Those can all, I think, mistakenly fall under the category of abortion because legislators are not doctors and they wrote these laws.

Without really understanding biology or medical care. And, you know, I heard a story just today about Missouri. Where a lot of doctors at a medical center were told, well, with this new log and the felony and charges and possible jail time, you should make sure that before you take the person to the, or to take care of them, that you see that it's documented that their life is really at risk, which means that we're waiting till they have enough blood loss that they're showing signs that they might.

Be close to death, which is extremely, extremely dangerous and exactly the opposite of what we were told to do when we were train. To take care of patients. You guys are really young. Like if this happened to you, let's say you ha you got a pregnancy and it was stuck in the tube and that's a pregnancy that cannot survive.

It can't be transplanted to the years. It's never gonna make a baby, but it, your tube is very small and delicate. And as the pregnancy expands and grows, it's gonna cause the tube to burst. You're gonna have internal bleeding as a young person, you'll probably have some pain and discomfort, irregular bleeding, you go see the doctor.

You are gonna look fine for a while, even with internal bleeding, because you're young and healthy. What happens in young and healthy people is they compensate for it. They have strong hearts and lungs and good blood and they can look okay for a while and then suddenly, boom. And then they're like, basically, like they could die super quickly.

So the standard of care. Is to address this before you ever get to that point. And just, you know, we, we don't wanna play brinkmanship with some, with a human life, but that is essentially this medical center is worried about their doctors, worried about people going to jail, trying to find a balance. It's not really possible to find a good balance when you have a law that does not take into account human biology or good medical care and is only trying to reach some other.

Agenda some political agenda. So it is really, really concerning. So we, I am not talking about, oh, somebody's gonna give themselves an abortion with a coat hanger. I'm just talking about normal women's healthcare. It is being compromised right now. And, and doctors really need to be able to take care of their patients, keep them healthy, keep them safe.

Being worried about going to jail?

[00:43:34] Dr. Serena Chen: become more limited.

It's happening. Yeah. It's happening already. A lot of doctors are saying, you know, we already have a shortage of obstetricians in this country because it's, it's a really. You know, it's a really demanding field, a very time consuming. There's a lot of doctor burnout because the healthcare system is broken and then we had COVID.

So we really have a big doctor shortage, especially in the middle of the country. And a lot of doctors that are trained as obstetricians can do just GYN. They can just say, you know, the pregnancy part is really too difficult and too complicated and too hard on my life. And now I could be thrown in jail for it.

Let me just do pap smears in my. You know, and just stay away from this whole area. We, we are already seeing access to care issues because of this, even though nobody's actually, maybe nobody's actually gone to jail yet for this. It's

Insane to me, um, or women, or right. And, and we could listen to you all day, but luckily you do, um, Instagram live every Tuesday and what I'm sure you're talking about these kinds of things. What other things are you talking about on the IG live? Yeah. And where can our listeners find you?

So last month, so we were doing a lot of LGBTQ family building. We are gonna be having like a, a Roe V Wade discussion, probably multiple discussions coming up. You know, we try, we, we talk about sperm. We talk about the embryology. We usually have. Some of our patients on to talk about their stories and their experience.

And that's on my practice side, cause we've got like 11 really wonderful doctors and we kind of all rotate every Tuesday, 4:30 PM Eastern standard time. And the hashtag the handle is IVF underscore I R N S. That stands for Institute for reproductive medicine and science. So, um, so we're in New Jersey and New York, but you know, the Instagram lives of course are for everybody.

And we do get people from kind of all over. Um, I do think people enjoy just, you know, being able to hear. Just talk to doctors directly put in their, you know, comments and their questions. So that, and it's fun for us too. Oh man. Awesome.

This is gonna be so helpful for so many people we know so much more. Oh my God. I know. Um, and I. Motivated to, to probably start the egg freezing process. I'm like, OK, you gotta go home home. Yeah. Yeah. But thank you so much for coming

Serena H Chan, cuz we are, you know, I'm gonna be talking a lot about the whole Roe V Wade and women's health issues and, and I'm probably gonna be asking people. For help to speak up about this. So I appreciate your voices so much for bringing those issues up because the more people that hear about this, I think, you know, we can get more people to, to vote and say, you know, no, we don't wanna shut down women's health.

You know, we want. We want women to have a choice and, and, and to be, be able to feel comfortable

[00:47:16] Corinne Foxx: Yeah. So

[00:47:18] Dr. Serena Chen: click. That would be cool. Thank you so much,

[00:47:22] Dr. Serena Chen: rest of your day. You guys too.

Thank you so much. Bye. I love her.

[00:47:41] Corinne Foxx: care honestly, with truly, truly the way things

[00:47:49] Corinne Foxx: so knowledgeable and we will link all of her socials in our show notes. If you guys want to connect with her.

Yes, because she's got a lot of great information, especially right now. Everything that's going on. Yep. And we hope you guys learn more about fertility when to see a fertility specialist, how the IVF process works, which I

[00:48:12] Corinne Foxx: And you have a more empowered stance on your reproductive health, because knowledge is power power, but

I feel, yes. I feel empowered. I feel like, you know, I do have type one. That is a condition. Yeah. I probably should have it. Have it

Our what? Tea.

[00:48:51] Corinne Foxx: So she's fresh. Okay. So one, two are hot. Which would you like to intro the hot? Yes, she's a fellow endo warrior with me, but I feel like she's been really transparent about her fertility journey, her endometriosis, her, she had IVF, she had her IVF process, um, how difficult her pregnancy was.

And she's also just an advocate for women's health. Yep. It's. Amy Schumer, Amy Schumer. So one, two Amy. There is a no, I thought this was a hair in my wine, but it's just bubbles. Ah.

[00:49:34] Dr. Serena Chen: it's a hair in

It's fine. Do you, do you see it? No, maybe it's bubbles anyways. Okay. One to Amy Shum. ,

[00:49:48] Corinne Foxx: Oh. And I'm not, you know, it didn't get better. It didn't open

[00:49:54] Corinne Foxx: it kind of got worse as it got as it set. I

It could be,

[00:50:06] Natalie McMillan: it a six and a half. Okay. I'll meet you there. Six and a half, six and a half. Like it's, it's fine. It's fine. It's nice. If somebody gave it to me, you know what also, I think if it

It needs to be chill. It would be, it would be there, but it's good. Okay. Six and a half out of Amy Schumer. For this wine.

All right. This is the part of the episode where we play a little wrap up game. And this week it's recent obsession. Recent what we are recently obsessed with.

So I would like to know

[00:50:59] Natalie McMillan: but Hey, if you wanna sponsor us, let us know. And it's a very

Okay. Wait, I have to show you. You look, first of all, do you see this? Is that a

[00:51:18] Corinne Foxx: No, I don't even, maybe it is. Oh yeah. I just put a bunch of, uh, lip gloss in here. So there's like a little, um, little pouch. It's a removable pouch. Oh, it

[00:51:30] Corinne Foxx: No, it's not, there is a SEP,

[00:51:33] Natalie McMillan: pouch.

Oh, it's a, it's a laptop pouch. No, this is, oh, it's just like a pouch pouch. No, it's just a pouch. You put an iPad in

[00:51:48] Natalie McMillan: also. It's like a very, it's like a two in one purse, cuz that's like a whole other purse.

Yeah.

I like that. When I put it up,

[00:52:21] Corinne Foxx: fall. No. So I feel very professional and very luxurious. Yes. And very efficient. I

would

[00:52:29] Corinne Foxx: three things. I do have to figure out how to put the pouch back in.

Yeah. But this is my recent obsession and we'll link in the show notes. If you guys wanna base back and you wanna feel like a boss, bitch. Yes. I love that, Natalie. What's your recent

[00:52:51] Corinne Foxx: Oh, their Twitter. Account's pretty spicy too.

And like, those are my feeds and that's it. And I don't open it every day, but somebody was like, you have to just like, look up the duo lingo one. So I did. And I'm like, this is so insane. . Like it is beyond, I don't think I've seen their TikTok. I just know from you have

[00:53:28] Natalie McMillan: on, on Twitter.

Oh, oh, well, they're passive aggressive in their comments on TikTok, but their tos are, oh,

[00:53:37] Natalie McMillan: the, like in the costume, the duo. Yeah, the giant, like. Owl and like he's talking, he's like, it's you just have to see it for yourself. Maybe we'll post what on the story we should.

It is the most, what I love about it is this is a corporate company and it is the most inappropriate really. Oh my God. Yes. They're talking about how he has a dumpy. Like

[00:54:06] Natalie McMillan: There's a

[00:54:15] Natalie McMillan: today.

Yes. You've gotta see

Love you guys.