Everything you need to know if you’re #TTC or supporting the #ttccommunity — and *spoiler alert*, there is good news to be had!

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No matter what you’re going through, we’re here to be another anchor through the storm…

As a specialty, we in the infertility community have weathered so much these past few years. I think about the heroics I’ve seen through hurricanes, snowstorms, and more, where healthcare teams and patients have trudged through feet of snow, waded through rising waters and faced innumerable challenges to get to their egg retrieval or embryo transfer, to check on or relocate precious tanks of eggs and embryos. …


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Don’t do this!

I have felt so invigorated this year by the trend of brave women (and some great #heforshe allies!) fighting stigma around reproductive health. That’s certainly been very needed in the world of infertility and miscarriage, which for too long have been diagnoses generating shame and secrecy. Of the many things I wish my patients could hear in the time they’re struggling before seeking help, one is how real the #ttc struggle is… and how sometimes it feels like your #relationshipgoals are circling the drain.

During those rough times, it may help to know that you are not alone in your struggle! Based on candid disclosures by folks in my professional and personal lives, here are 4 ways #ttc can disrupt your relationship with your partner, and how to deal. …


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A typical polcystic ovary on the right, with a whole bunch of growing follicles! (Follicles are the fluid-filled sacs inside of which eggs develop). (Photo Credit: Bayer Research Magazine)

Gosh, it’s been a minute since I blogged. I’ve been a bit busy collaborating with other folks (talking about egg donation, fertility in your 20s & 30s, and quality of life with PCOS), but TODAY is PCOS Advocacy Day, so I had to come back to my own blog to try put this together to delve into PCOS, or polycystic ovary syndrome. So, without further ado, the “Top Ten Things I Wish Everyone Knew about PCOS”:

  1. The diagnosis: There are multiple different criteria to diagnose PCOS. The most broad is the Rotterdam criteria, in which you have at least 2 out of 3 things (irregular or absent ovulation, symptoms or labwork to show high androgen levels, and polycystic-appearing ovaries). The older NIH criteria requires the first two, and is a stricter phenotype (more the “typical” PCOS patient, and fewer women meet those criteria). Nowadays, we usually use Rotterdam criteria for clinical management because at least some components of the syndrome apply to all women, but it is really helpful to know what criteria were used to give you the diagnosis! …


How to make pregnancies healthier for Black moms even before conception…

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Why we need #BlackMaternalHealthWeek — a great primer at The New York Times

Today marks the close of the first ever Black Maternal Health Week. In recent months, I have been glad to see the increase in stories talking about Black moms — reporting on Serena Williams’ post-partum near-death experience, health disparities in Texas’ high maternal mortality rates, and especially ProPublica’s excellent deep investigation and this New York Times article. All of these resources highlight a shameful truth, which is that African-American moms face greater risk during childbirth than their counterparts of other races and ethnicities — and no, this is not because they are younger (or older), from different socioeconomic or educational backgrounds, with different lifestyle choices, or any other rhetoric that tries to blame women for these outcomes. …


The lowdown on ovarian reserve, and what to do about your ovarian health

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A graphic of the egg (oocyte), inside its follicle, going through the phases of an ovulatory cycle (credit: Repropedia) — because no one needs another “pregnancy bump with a clock” picture…!

This morning I was working with a resident physician, and trying to teach a little bit in between doing egg retrievals. She asked me an important question about IVF success rates that most of my patients wonder about as well, and our conversation just reminded me (yet again!) on how necessary it is for us in healthcare to open up what sometimes feels like a secretive vault of knowledge about reproduction, unlocked only when it’s time to start trying to conceive. …


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As we wrap up #endometriosis awareness month, I hope that many men and women have learned a lot over these past few weeks about this common (1 in 10!), yet poorly understood, condition. The chronic, and sometimes debilitating, pain that is often the hallmark of endometriosis is one of the symptoms for which we certainly need more awareness, but also better treatment options. There are a multitude of pelvic pain specialists that can offer a variety of solutions beyond popping pills. However, as if this weren’t enough, endometriosis can also impact fertility. Many of my patients have learned over the years how to manage their pain, only to belatedly realize the impact the disease has had on their plans to have a family. This shouldn’t happen! We need to get more information out there, to decrease the delay in diagnosis and treatment, and get women the counseling they need. …


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Artwork from SXSW panel “Handmaid’s Tale IRL, What if Roe Were to Go?”

As #SXSW closes, here is — as promised in Part 1! - a more down-to-earth set of fertility-related insights from the conference. Let’s jump right in!

I truly enjoyed a session on “Handmaid’s Tale IRL, What If Roe were to go?”. By now, many of you must have enjoyed at least the recent TV series, if not the original book by Margaret Atwood (which I highly recommend!). I often feel that the social discourse on women’s reproductive health is fragmented — people advocate for choice, specific conditions (hey, #endometriosis awareness month!), access to care, infertility, etc. …


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As a first-timer at SXSW, I had no idea what to expect. I wasn’t primarily attending as a reproductive endocrinologist, but because I never really take that hat off, I dropped in on some great sessions that I couldn’t help but filter through my professional lens. Here are some of the insights I found most thought-provoking:

How much health information do people want? The first session I attended was about empowering people to own their health data. I was thrilled to hear from one of my former #dukemed professors, Robert M Califf, who set the stage for this question:

  • On the one hand, the principle of autonomy suggests giving patients unfettered access to their lab results or even the ability to choose what tests they should have. …

Asking the right questions can make a world of difference in your reproductive health.

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For decades, the general societal advice around reproduction for women in the U.S. has been something like this: Value abstinence throughout your teens and even your early 20s; once you become sexually active, use safe sex practices and contraception; focus on your career and establishing your profession (maybe becoming a #girlboss!); and somewhere along the way, when the right circumstances fall into line, if you feel like it, start a family. …


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Since I chose a career in reproductive medicine, I’ve struggled a bit with how to respond when someone asks “so what do you do?”. I’ve tried a lot of different responses over the years:

Option #1: “I’m a fertility specialist” — That works, but is a little reductive since I (love to) do certain things that aren’t directly about conceiving... and makes me feel like I’m just a part of this burgeoning industry around fertility and women’s health and “femtech”. *Yuck*

Option #2: “I’m in reproductive endocrinology & infertility” — Well that’s the full official name of my specialty. Maybe because most people don’t really know what that first part means (just that we focus on the hormones of reproduction) and partly because it’s hard (even for me) to rattle it off quickly but with clear diction, this response often gets blank stares, to which I have to clarify with option #1. …

About

Rashmi Kudesia, MD MSc

Fertility doc & women’s health crusader. Wife-mother-daughter-sister working on health, happiness and following my passions.

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